Short-term and Long-lasting Effects of Hypo-Cariogenic Dietary Advice and Oral Care on Oral Flora: a Randomised Clinical Trial.

PURPOSE: To investigate the short- and long-term effects of different combinations of dietary instructions on cariogenic food intake and salivary cariogenic bacteria (Streptococcus mutans [SM] and Lactobacillus [LB]). MATERIALS AND METHODS: In this randomised 2-arm parallel study, 75 6-year-old subjects were assigned to repeated (group A; 19M/19F) or isolated (group B; 17M/20F) verbal and/or written dietary advice (VWDA), with foods classified by cariogenic potential. Both groups underwent a baseline salivary test for SM/LB, kept a monthly food diary, and attended 4 weekly visits (T1-T4). At T1-T2; group A only received VDA. At T3, both groups received VWDA. At T4, participants handed in their food diaries and underwent another salivary test. After 1 year (T5), subjects were recalled for weekly food diary monitoring and salivary testing. Relative risk (RR) of high-to-low SM/LB density was calculated at T4 and T5. RESULTS: Comparing groups A and B, VDA determined an increase in the intake of weakly cariogenic food (p < 0.05) and a decrease in that of intermediately cariogenic food (p < 0.05). After VWDA, a statistically significant increase in intake of weakly cariogenic food and a statistically significant decrease in the RR of high-density SM/LB colonies occurred in both groups. At T5, group A showed less intake of highly cariogenic food than did group B (p = 0.05) and persistent, although non-significant, reduction in the RR of high-density SM/LB colonies. CONCLUSIONS: Reinforcement measures on behavioural changes towards a noncariogenic diet not only help maintain long-lasting, healthier eating habits, but also decrease the cariogenic bacterial load in the short term, which tends to persist over time.

OX26-cojugated gangliosilated liposomes to improve the post-ischemic therapeutic effect of CDP-choline.

Cerebrovascular impairment represents one of the main causes of death worldwide with a mortality rate of 5.5 million per year. The disability of 50% of surviving patients has high social impacts and costs in long period treatment for national healthcare systems. For these reasons, the efficacious clinical treatment of patients, with brain ischemic stroke, remains a medical need. To this aim, a liposome nanomedicine, with monosialic ganglioside type 1 (GM1), OX26 (an anti-transferrin receptor antibody), and CDP-choline (a neurotrophic drug) (CDP-choline/OX26Lip) was prepared. CDP-choline/OX26Lip were prepared by a freeze and thaw method and then extruded through polycarbonate filters, to have narrow size distributed liposomes of ~80 nm. CDP-choline/OX26Lip were stable in human serum, they had suitable pharmacokinetic properties, and 30.0 ± 4.2% of the injected drug was still present in the blood stream 12 h after its systemic injection. The post-ischemic therapeutic effect of CDP-choline/OX26Lip is higher than CDP-choline/Lip, thus showing a significantly high survival rate of the re-perfused post-ischemic rats, i.e. 96% and 78% after 8 days. The treatment with CDP-choline/OX26Lip significantly decreased the peroxidation rate of ~5-times compared to CDP-choline/Lip; and the resulting conjugated dienes, that was 13.9 ± 1.1 mmol/mg proteins for CDP-choline/Lip and 3.1 ± 0.8 for CDP-choline/OX26Lip. OX26 increased the accumulation of GM1-liposomes in the brain tissues and thus the efficacious of CDP-choline. Therefore, this nanomedicine may represent a strategy for the reassessment of CDP-choline to treat post-ischemic events caused by brain stroke, and respond to a significant clinical need.

Thermoresponsive M1 macrophage-derived hybrid nanovesicles for improved in vivo tumor targeting.

Despite the efforts and advances done in the last few decades, cancer still remains one of the main leading causes of death worldwide. Nanomedicine and in particular extracellular vesicles are one of the most potent tools to improve the effectiveness of anticancer therapies. In these attempts, the aim of this work is to realize a hybrid nanosystem through the fusion between the M1 macrophages-derived extracellular vesicles (EVs-M1) and thermoresponsive liposomes, in order to obtain a drug delivery system able to exploit the intrinsic tumor targeting capability of immune cells reflected on EVs and thermoresponsiveness of synthetic nanovesicles. The obtained nanocarrier has been physicochemically characterized, and the hybridization process has been validated by cytofluorimetric analysis, while the thermoresponsiveness was in vitro confirmed through the use of a fluorescent probe. Tumor targeting features of hybrid nanovesicles were in vivo investigated on melanoma-induced mice model monitoring the accumulation in tumor site through live imaging and confirmed by cytofluorimetric analysis, showing higher targeting properties of hybrid nanosystem compared to both liposomes and native EVs. These promising results confirmed the ability of this nanosystem to combine the advantages of both nanotechnologies, also highlighting their potential use as effective and safe personalized anticancer nanomedicine.

Ammonium glycyrrhizate skin delivery from ultradeformable liposomes: A novel use as an anti-inflammatory agent in topical drug delivery.

Glycyrrhiza glabra L. is a native plant of Central and South-Western Asia that is also diffused in the Mediterranean area and contains several bioactive compounds such as: flavonoids, sterols, triterpene and saponins. Glycyrrhizin, containing glycyrrhizic and glycyrrhizinic acids has anti-inflammatory and antiallergic effects that are similar to corticosteroids. Ammonium glycyrrhizinate is a derivative salt of glycyrrhizic acid with similar anti-inflammatory activity that cannot pass through the skin due to its physicochemical properties and molecular weight. Although several nanoformulations, such as ethosomes, are designed to provide a systemic effect through a topical application, there are different limitations to the distribution inside the blood stream. For this reason, ultradeformable liposomes, or transfersomes, are selected to improve the topical delivery of drugs and allow the distribution of payloads in the blood stream because they pass intact through the stratum corneum epidermis barrier, due to the presence of sodium cholate, aqueous cutaneous gradient, and the rapid penetration of transfersomes by cutaneous tight junctions, thus allowing the systemic delivery of different therapeutic cargo in non-occlusive conditions. The aim of this work was the synthesis and physicochemical characterization of the ammonium glycyrrhizinate-loaded ultradeformable liposomes, the evaluation of drug release and permeation through stratum corneum and epidermis barrier. The in vivo anti-inflammatory effect of ammonium glycyrrhizinate-loaded ultradeformable liposomes was tested on human healthy volunteers. The results demonstrated that the ammonium glycyrrhizinate-loaded ultradeformable liposomes decreased the skin inflammation on the human volunteers and the resulting nanoformulations can be used as a potential topical drug delivery system for anti-inflammatory therapy. ☆Parts of these results were presented as a poster communication at the Recent Developments in Pharmaceutical Analysis 2019 (RDPA 2019), Chieti, Italy.