Central Composite Design for Formulation and Optimization of Solid Lipid Nanoparticles to Enhance Oral Bioavailability of Acyclovir.

Treatment of herpes simplex infection requires high and frequent doses of oral acyclovir to attain its maximum therapeutic effect. The current therapeutic regimen of acyclovir is known to cause unwarranted dose-related adverse effects, including acute kidney injury. For this reason, a suitable delivery system for acyclovir was developed to improve the pharmacokinetic limitations and ultimately administer the drug at a lower dose and/or less frequently. In this study, solid lipid nanoparticles were designed to improve the oral bioavailability of acyclovir. The central composite design was applied to investigate the influence of the materials on the physicochemical properties of the solid lipid nanoparticles, and the optimized formulation was further characterized. Solid lipid nanoparticles formulated from Compritol 888 ATO resulted in a particle size of 108.67 ± 1.03 nm with an entrapment efficiency of 91.05 ± 0.75%. The analyses showed that the optimum combination of surfactant and solid lipid produced solid lipid nanoparticles of good quality with controlled release property and was stable at refrigerated and room temperature for at least 3 months. A five-fold increase in oral bioavailability of acyclovir-loaded solid lipid nanoparticles was observed in rats compared to commercial acyclovir suspension. This study has presented promising results that solid lipid nanoparticles could potentially be used as an oral drug delivery vehicle for acyclovir due to their excellent properties.

The Standardized Extract of Centella asiatica and Its Fractions Exert Antioxidative and Anti-Neuroinflammatory Effects on Microglial Cells and Regulate the Nrf2/HO-1 Signaling Pathway.

Background: Neuroinflammation and oxidative stress can aggravate the progression of Alzheimer's disease (AD). Centella asiatica has been traditionally consumed for memory and cognition. The triterpenes (asiaticoside, madecassoside, asiatic acid, madecassic acid) have been standardized in the ethanolic extract of Centella asiatica (SECA). The bioactivity of the triterpenes in different solvent polarities of SECA is still unknown. Objective: In this study, the antioxidative and anti-neuroinflammatory effects of SECA and its fractions were explored on lipopolysaccharides (LPS)-induced microglial cells. Methods: HPLC measured the four triterpenes in SECA and its fractions. SECA and its fractions were tested for cytotoxicity on microglial cells using MTT assay. NO, pro-inflammatory cytokines (TNF-α, IL-6, IL-1ß), ROS, and MDA (lipid peroxidation) produced by LPS-induced microglial cells were measured by colorimetric assays and ELISA. Nrf2 and HO-1 protein expressions were measured using western blotting. Results: The SECA and its fractions were non-toxic to BV2 microglial cells at tested concentrations. The levels of NO, TNF-α, IL-6, ROS, and lipid peroxidation in LPS-induced BV2 microglial cells were significantly reduced (p < 0.001) by SECA and its fractions. SECA and some of its fractions can activate the Nrf2/HO-1 signaling pathway by significantly enhancing (p < 0.05) the Nrf2 and HO-1 protein expressions. Conclusions: This study suggests that the inhibitory activity of SECA and its fractions on pro-inflammatory and oxidative stress events may be the result of the activation of antioxidant defense systems. The potential of SECA and its fractions in reducing neuroinflammation and oxidative stress can be further studied as a potential therapeutic strategy for AD.

Exploring Critical Components of Physician-Patient Communication: A Qualitative Study of Lay and Professional Perspectives.

(1) Background: The ability to communicate with patients and their relatives is a crucial skill for a physician. Unfortunately, many physicians and medical students are not well-equipped in this area. Therefore, this study aims to better understand the views on critical components of physician-patient communication to improve their skills. (2) Methods: This qualitative study utilized focus group discussions (FGDs) and in-depth interviews (IDIs). Through a purposive sampling technique, 32 medical students and physicians from the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (FMHS UPM) and Universiti Putra Malaysia Teaching Hospital (HPUPM), as well as patients and relatives from government and private hospitals or clinics were recruited. All sessions were audio-recorded, transcribed, and analyzed thematically. (3) Results: Seven themes were identified: professionalism, content of communication, verbal, non-verbal and paraverbal communication skills, environment, and visual communication. Good eye contact, providing treatment plans, and ensuring patient privacy and confidentiality were emphasized by physicians and medical students. In comparison, patients and relatives focused on the prognosis of disease, physician's empathy and advice, and physician's skills in building rapport with their patients and relatives. (4) Conclusion: The critical components that were highlighted by both professionals and laymen in the study should be practiced to ensure effective communication between physician and patient. There were different expectations in terms of the content of information between both groups. Patients and relatives were more interested in the physician's advice regarding their diet, care plans, physical activities, and daily routine. They were also focused on the prognosis of the disease, which indicates how quickly they would get better. Meanwhile, physicians and medical students were concentrating on management and treatment strategies, such as what additional procedures should be considered and what medications might work best for their patients. We also found that the patients and relatives had a lack of awareness on confidentiality issues. These findings provide an insight on the improvement of medical training and patient education to improve patient care. Patients have a right to privacy protection, and physicians should be well trained to carry out all procedures and treatment plans to ensure patients are treated with respect.

Acyclovir-Loaded Solid Lipid Nanoparticles: Optimization, Characterization and Evaluation of Its Pharmacokinetic Profile.

Acyclovir is an antiviral drug used for the treatment of herpes simplex virus infection. Its oral bioavailability is low; therefore, frequent and high doses are prescribed for optimum therapeutic efficacy. Moreover, the current therapeutic regimen of acyclovir is associated with unwarranted adverse effects, hence prompting the need for a suitable drug carrier to overcome these limitations. This study aimed to develop solid lipid nanoparticles (SLNs) as acyclovir carriers and evaluate their in vivo pharmacokinetic parameters to prove the study hypothesis. During the SLN development process, response surface methodology was exploited to optimize the composition of solid lipid and surfactant. Optimum combination of Biogapress Vegetal 297 ATO and Tween 80 was found essential to produce SLNs of 134 nm. The oral bioavailability study showed that acyclovir-loaded SLNs possessed superior oral bioavailability when compared with the commercial acyclovir suspension. The plasma concentration of acyclovir-loaded SLNs was four-fold higher than the commercial suspension. Thus, this investigation presented promising results that the method developed for encapsulation of acyclovir offers potential as an alternative pathway to enhance the drug's bioavailability. In conclusion, this study exhibited the feasibility of SLNs as an oral delivery vehicle for acyclovir and therefore represents a new promising therapeutic concept of acyclovir treatment via a nanoparticulate drug delivery system.

GC-MS Evaluation, Antioxidant Content, and Cytotoxic Activity of Propolis Extract from Peninsular Malaysian Stingless Bees, Tetrigona Apicalis.

INTRODUCTION: Propolis has been used traditionally in several countries for treating various diseases as it possessed healing properties including antioxidant and anticancer qualities. In Peninsular Malaysia, Tetrigona apicalis is one of the species of stingless bees mainly found in virgin jungle reserves which largely contribute to propolis production. Therefore, this study is designed to evaluate the phytochemical contents, antioxidant properties, and the cytotoxic effect of ethanolic crude of propolis extract against MCF7 and MCF 10A cell lines. METHOD: The ethanolic extract of propolis (EEP) was extracted using 80% ethanol. Identification of phytochemical contents and antioxidant properties of EEP was analysed by gas chromatography-mass spectrometry (GC-MS) and using 2, 2'-azinobis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) method, respectively. The EEP cytotoxic activity was evaluated on MCF7 and MCF 10A using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. RESULTS: Phytochemical contents of EEP demonstrated 28 compounds in which caryophyllene (99%), ß-amyrin (96%), α-amyrin (93%), and caryophyllene oxide (93%) were the main compounds. The percentage of ABTS+ scavenging activity of EEP showed an inhibition of 9.5% with half-inhibitory concentration (IC50) value of 1.68 mg/mL. The EEP reduced MCF7 cells viability at IC50 value of 62.24 µg/mL, 44.15 µg/mL, and 32.70 µg/mL at 24, 48, and 72 hours, respectively. The IC50 value of MCF 10A was 49.55 µg/mL, 56.05 µg/mL, and 72.10 µg/mL at 24, 48, and 72 hours, respectively. The EEP cytotoxic effect of T. apicalis was more selective towards MCF7 at 72-hour incubation with a selectivity index (SI) of 2.20. CONCLUSION: The EEP has been shown to have antioxidants and potential bioactive compounds and inhibited proliferation of the MCF7 cells. Further studies on the EEP role in the apoptosis pathway and its screening towards other cell lines will be evaluated.

Antioxidant and anti-inflammatory properties of Erythroxylum cuneatum alkaloid leaf extract.

Erythroxylum cuneatum (E. cuneatum) which belongs to Erythroxylaceae family is a tropical flowering plant from the genus of Erythroxylum. It is used in Malaysia and Thailand's traditional medicines, yet there is limited scientific reports on its medicinal value. This study aimed at exploring the antioxidative and anti-inflammatory properties of E. cuneatum alkaloid leaf extract. The alkaloid extract was obtained through Soxhlet heat extraction method, while the antioxidantive properties were assessed via 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging, ferric reducing antioxidant power (FRAP) and xanthine oxidase inhibition (XOI) assays. Further, anti-inflammatory property of the extract was evaluated on rat's model of carrageenan induced paw model of edema via physical measurements and histology. The extract exhibited antioxidant activity with an EC50 value of 1482 µg/ml in the DPPH radical scavenging assay, an EC1 value of 2191 µg/ml in the FRAP assay and 10.15 ± 6.20% in the XOI assay. Rats pretreated with the extract have shown dose dependent decrease in paw edema when compared to non-treated group of rats. The highest dose (50 mg/kg) of extract exhibited similar effects to aspirin in terms of reducing paw thickness, leucocytes infiltration and disruption of collagen. In conclusion, the E. cuneatum alkaloid leaf extract possesses both antioxidative and anti-inflammatory properties suggesting its potentials for future development of antioxidant and anti-inflammatory drugs.

A detailed microscopic study of the changes in the aorta of experimental model of postmenopausal rats fed with repeatedly heated palm oil.

Hypercholesterolaemia, increase in lipid peroxidation and hyperhomocysteinaemia may contribute to the pathogenesis of atherosclerosis. This study was performed to examine the effects of repeatedly heated palm oil mixed with 2% cholesterol diet on atherosclerosis in oestrogen-deficient postmenopausal rats. Ovariectomy causes disruption of tunica intima layer of the rat aorta simulating a postmenopausal condition in females. Twenty-four ovariectomized female Sprague-Dawley rats were divided into four groups. The control group received 2% cholesterol diet without palm oil. A diet with 2% cholesterol content fortified with fresh, once-heated and five-times-heated palm oil was given to the other treatment groups. The rats were sacrificed at the end of 4 months of study and the aortic arch tissue was processed for histomorphometry and electron microscopy. On observation, there was disruption of the intimal layer of the ovariectomized rat aorta. There was no obvious ultrastructural change in the aorta of the rats fed with fresh palm oil. The ultrastructural changes were minimal with once-heated palm oil, in which there was a focal disruption of the endothelial layer. The focal disruption was more pronounced with five-times-heated palm oil. The results of this study show that the ingestion of fresh palm oil may have a protective effect on the aorta but such a protective action may be lost when the palm oil is repeatedly heated. The study may be clinically important for all postmenopausal women who are susceptible to atherosclerosis.

Consumption of repeatedly heated soy oil increases the serum parameters related to atherosclerosis in ovariectomized rats.

Repeated heating of soy oil may promote lipid peroxidation. Oxidized unsaturated fatty acids may contribute to the pathogenesis of atherosclerosis, especially in estrogen-deficient states. This study was performed to explore the deleterious effects of repeatedly heated soy oil on the development of atherosclerosis using ovariectomized rats, which represent an estrogen-deficient state. Twenty-four female Sprague-Dawley rats were ovariectomized and were divided equally into four groups. The control group was fed with 2% cholesterol diet without any oil. The three treatment groups each received 2% cholesterol diet fortified with fresh, once-heated or five-times-heated (repeatedly heated) soy oil, respectively. Serum thiobarbituric acid reactive substances (TBARS), lipid profile and homocysteine levels were measured prior to ovariectomy and at the end of four months. Ovariectomized rats treated with repeatedly heated soy oil showed significant increases in lipid peroxidation and low-density lipoprotein (LDL) levels. Treatment with once-heated or repeatedly heated soy oil caused a significant increase in total cholesterol, while fresh soy oil caused significant reduction in homocysteine level as compared to other groups. Repeatedly heated soy oil caused significant increases in TBARS and LDL as compared to fresh oil. The higher level of homocysteine in the ovariectomized rats fed with repeatedly heated oil, as compared to those fed with fresh oil, also suggests the repeatedly heated oil contributes to the development of atherosclerosis. Importantly, the protective effect of the soy oil may be lost once it was being repeatedly heated. In conclusion, the consumption of repeatedly heated oil may predispose to atherosclerosis in estrogen-deficient states.

Effects of repeatedly heated palm oil on serum lipid profile, lipid peroxidation and homocysteine levels in a post-menopausal rat model.

Oxidized unsaturated fatty acids may contribute to the pathogenesis of atherosclerosis. In the present study, we examined the effects of heated palm oil mixed with 2% cholesterol diet on serum lipid profile, homocysteine and thiobarbituric acid reactive substances (TBARS) levels in estrogen-deficient rats. Twenty-four female Sprague Dawley rats were ovariectomized and then were divided equally into four groups. The control group was given 2% cholesterol diet only throughout the study period. The three treatment groups received 2% cholesterol diet fortified with fresh, once-heated or five-times-heated palm oil, respectively. Serum TBARS, lipid profile and homocysteine levels were measured prior to ovariectomy and at the end of four months of the study. Five-times-heated palm oil caused a significant increase in TBARS and total cholesterol (TC) compared to control (F=22.529, p<0.05). There was a significant increase in serum homocysteine in the control as well as five-times heated palm oil group compared to fresh and once-heated palm oil groups (F=4.432, p<0.05). The findings suggest that repeatedly heated palm oil increase lipid peroxidation and TC. Ovariectomy increases the development of atherosclerosis as seen in this study. Feeding with fresh and once-heated palm oil does not cause any deleterious effect but repeatedly heated oil may be harmful because it causes oxidative damage thereby predisposing to atherosclerosis.

Bioactive Extract from Moringa oleifera Inhibits the Pro-inflammatory Mediators in Lipopolysaccharide Stimulated Macrophages.

INTRODUCTION: Inflammation is a well-known physiological response to protect the body against infection and restore tissue injury. Nevertheless, the chronic inflammation can trigger various inflammatory associated diseases/disorder. Moringa oleifera is a widely grown plant in most tropical countries and it has been recognized traditionally for several medicinal benefits. OBJECTIVES: The objective of this study was to investigate the anti-inflammatory properties of M. oleifera extract on lipopolysaccharide (LPS) - stimulated macrophages. MATERIALS AND METHODS: The anti-inflammatory effect of M. oleifera hydroethanolic bioactive leaves extracts was evaluated by assessing the inhibition of nitric oxide (NO) production during Griess reaction and the expression of pro-inflammatory mediators in macrophages. RESULTS: Interestingly, we found that M. oleifera hydroethanolic bioactive leaves extract significantly inhibited the secretion of NO production and other inflammatory markers such as prostaglandin E2, tumor necrosis factor alpha, interleukin (IL)-6, and IL-1ß. Meanwhile, the bioactive extract has induced the production of IL-10 in a dose-dependent manner. In addition, M. oleifera hydroethanolic bioactive leaves extract effectively suppressed the protein expression of inflammatory markers inducible NO synthase, cyclooxygenase-2, and nuclear factor kappa-light-chain-enhancer of activated B-cells p65 in LPS-induced RAW264.7 macrophages in a dose-dependent manner. CONCLUSION: These findings support the traditional use of M. oleifera plant as an effective treatment for inflammation associated diseases/disorders. SUMMARY: Hydroethanolic extracts of Moringa oleifera effectively inhibit the NO production in LPS induced inflammatory model.M. oleifera crude extracts successfully modulate the production of pro-inflammatory mediators in LPS stimulated macrophages.M. oleifera extracts suppressed the expression of inflammatory mediators in LPS stimulated macrophages.

Interleukin-18 Antagonism Improved Histopathological Conditions of Malaria Infection in Mice.

BACKGROUND: Interleukin 18 (IL-18) exerts pleiotropic roles in many inflammatory-related diseases including parasitic infection. Previous studies have demonstrated the promising therapeutic potential of modulating IL-18 bioactivity in various pathological conditions. However, its involvement during malaria infection has yet to be established. In this study, we demonstrated the effect of modulating IL-18 on the histopathological conditions of malaria infected mice. METHODS: Plasmodium berghei ANKA infection in male ICR mice was used as a model for malaria infection. Modulation of IL-18 release was carried out by treatment of malarial mice with recombinant mouse IL-18 (rmIL-18) and recombinant mouse IL-18 Fc chimera (rmIL-18Fc) intravenously. Histopathological study and analysis were performed on major organs including brain, liver, spleen, lungs and kidney. RESULTS: Treatment with rmIL-18Fc resulted in significant improvements on the histopathological conditions of the organs in malaria-infected mice. CONCLUSION: IL-18 is an important mediator of malaria pathogenesis and targeting IL-18 could prove beneficial in malaria-infected host.

Heated vegetable oils and cardiovascular disease risk factors.

Cardiovascular disease (CVD) is one of the leading major causes of morbidity and mortality worldwide. It may result from the interactions between multiple genetic and environmental factors including sedentary lifestyle and dietary habits. The quality of dietary oils and fats has been widely recognised to be inextricably linked to the pathogenesis of CVD. Vegetable oil is one of the essential dietary components in daily food consumption. However, the benefits of vegetable oil can be deteriorated by repeated heating that leads to lipid oxidation. The practice of using repeatedly heated cooking oil is not uncommon as it will reduce the cost of food preparation. Thermal oxidation yields new functional groups which may be potentially hazardous to cardiovascular health. Prolonged consumption of the repeatedly heated oil has been shown to increase blood pressure and total cholesterol, cause vascular inflammation as well as vascular changes which predispose to atherosclerosis. The harmful effect of heated oils is attributed to products generated from lipid oxidation during heating process. In view of the potential hazard of oxidation products, therefore this review article will provide an insight and awareness to the general public on the consumption of repeatedly heated oils which is detrimental to health.

Reprint of "heated vegetable oils and cardiovascular disease risk factors".

Cardiovascular disease (CVD) is one of the leading major causes of morbidity and mortality worldwide. It may result from the interactions between multiple genetic and environmental factors including sedentary lifestyle and dietary habits. The quality of dietary oils and fats has been widely recognised to be inextricably linked to the pathogenesis of CVD. Vegetable oil is one of the essential dietary components in daily food consumption. However, the benefits of vegetable oil can be deteriorated by repeated heating that leads to lipid oxidation. The practice of using repeatedly heated cooking oil is not uncommon as it will reduce the cost of food preparation. Thermal oxidation yields new functional groups which may be potentially hazardous to cardiovascular health. Prolonged consumption of the repeatedly heated oil has been shown to increase blood pressure and total cholesterol, cause vascular inflammation as well as vascular changes which predispose to atherosclerosis. The harmful effect of heated oils is attributed to products generated from lipid oxidation during heating process. In view of the potential hazard of oxidation products, therefore this review article will provide an insight and awareness to the general public on the consumption of repeatedly heated oils which is detrimental to health.

Fresh soy oil protects against vascular changes in an estrogen-deficient rat model: an electron microscopy study.

OBJECTIVE: To observe the effects of consuming repeatedly heated soy oil on the aortic tissues of estrogen-deficient rats. METHODS: Thirty female Sprague Dawley rats (200-250 g) were divided equally into five groups. One group served as the normal control (NC) group. The four treated groups were ovariectomized and were fed as follows: 2% cholesterol diet (OVXC); 2% cholesterol diet + fresh soy oil (FSO); 2% cholesterol diet + once-heated soy oil (1HSO); and 2% cholesterol diet + five-times-heated soy oil (5HSO). After four months, the rats were sacrificed, and the aortic tissues were obtained for histological studies. RESULTS: After four months of feeding, the NC, FSO and 1HSO groups had a lower body weight gain compared to the OVXC and 5HSO groups. The tunica intima/media ratio in the 5HSO group was significantly thicker (p < 0.05) compared to the NC, OVXC and FSO groups. Electron microscopy showed that endothelial cells were normally shaped in the FSO and NC groups but irregular in the 1HSO and 5HSO groups. A greater number of collagen fibers and vacuoles were observed in the 5HSO group compared to the other treatment groups. CONCLUSIONS: Fresh soy oil offered protection in the estrogen-deficient state, as these rats had similar features to those of the NC group. The damage to the tunica intima and the increase in the ratio of tunica intima/media thickness showed the deleterious effect of consuming repeatedly heated soy oil in castrated female rats.

Fresh soy oil protects against vascular changes in an estrogen-deficient rat model: an electron microscopy study

OBJECTIVE: To observe the effects of consuming repeatedly heated soy oil on the aortic tissues of estrogen-deficient rats. METHODS: Thirty female Sprague Dawley rats (200- 250 g) were divided equally into five groups. One group served as the normal control (NC) group. The four treated groups were ovariectomized and were fed as follows: 2 percent cholesterol diet (OVXC); 2 percent cholesterol diet + fresh soy oil (FSO); 2 percent cholesterol diet + once-heated soy oil (1HSO); and 2 percent cholesterol diet + five-times-heated soy oil (5HSO). After four months, the rats were sacrificed, and the aortic tissues were obtained for histological studies. RESULTS: After four months of feeding, the NC, FSO and 1HSO groups had a lower body weight gain compared to the OVXC and 5HSO groups. The tunica intima/media ratio in the 5HSO group was significantly thicker (p < 0.05) compared to the NC, OVXC and FSO groups. Electron microscopy showed that endothelial cells were normally shaped in the FSO and NC groups but irregular in the 1HSO and 5HSO groups. A greater number of collagen fibers and vacuoles were observed in the 5HSO group compared to the other treatment groups. CONCLUSIONS: Fresh soy oil offered protection in the estrogen-deficient state, as these rats had similar features to those of the NC group. The damage to the tunica intima and the increase in the ratio of tunica intima/media thickness showed the deleterious effect of consuming repeatedly heated soy oil in castrated female rats.