Safety and immunogenicity of SCB-2019, an adjuvanted, recombinant SARS-CoV-2 trimeric S-protein subunit COVID-19 vaccine in healthy 12-17 year-old adolescents.

We previously demonstrated the efficacy of the COVID-19 vaccine candidate, SCB-2019, in adults in the SPECTRA phase 2/3 efficacy study. We extended the study to include 1278 healthy 12-17-year-old adolescents in Belgium, Colombia, and the Philippines who received either two doses of SCB-2019 or placebo 21 days apart, to assess immunogenicity as neutralizing antibodies against prototype SARS-CoV-2 and variants of concern, and safety and reactogenicity as solicited and unsolicited adverse events with a comparator group of young adults (18-25 years). In participants with no evidence of prior SARS-CoV-2 infection SCB-2019 immunogenicity in adolescents was non-inferior to that in young adults; respective geometric mean neutralizing titers (GMT) against prototype SARS-CoV-2 14 days after the second vaccination were 271 IU/mL (95% CI: 211-348) and 144 IU/mL (116-178). Most adolescents (1077, 84.3%) had serologic evidence of prior SAR-CoV-2 exposure at baseline; in these seropositive adolescents neutralizing GMTs increased from 173 IU/mL (135-122) to 982 IU/mL (881-1094) after the second dose. Neutralizing titers against Delta and Omicron BA SARS-CoV-2 variants were also increased, most notably in those with prior exposure. SCB-2019 vaccine was well tolerated with generally mild or moderate, transient solicited and unsolicited adverse events that were comparable in adolescent vaccine and placebo groups except for injection site pain - reported after 20% of SCB-2019 and 7.3% of placebo injections. SCB-2019 vaccine was highly immunogenic against SARS-CoV-2 prototype and variants in adolescents, especially in those with evidence of prior exposure, with comparable immunogenicity to young adults. Clinical trial registration: EudraCT 2020-004272-17; ClinicalTrials.gov NCT04672395.

Propensity for Clinically Meaningful Improvement and Surgical Failure After Anterior Cruciate Ligament Repair.

Background: Primary repair of the anterior cruciate ligament (ACL) confers an alternative to ACL reconstruction in appropriately selected patients. Purpose: To prospectively assess survivorship and to define the clinically meaningful outcomes after ACL repair. Study Design: Case series; Level of evidence, 4. Methods: Included were consecutive patients with Sherman grade 1-2 tears who underwent primary ACL repair with or without suture augmentation between 2017 and 2019. Patient-reported outcomes (Lysholm, Tegner, International Knee Documentation Committee, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee injury and Osteoarthritis Outcome Score [KOOS] subscales) were collected preoperatively and at 6 months, 1 year, and 2 years postoperatively. The minimal clinically important difference (MCID) was calculated using a distribution-based method, whereas the Patient Acceptable Symptom State (PASS) and substantial clinical benefit (SCB) were calculated using an anchor-based method. Plain radiographs and magnetic resonance imaging (MRI) were obtained at 6 months, 1 year, and 2 years postoperatively. Results: A total of 120 patients were included. The overall failure rate was 11.3% at 2 years postoperatively. Changes in outcome scores required to achieve the MCID ranged between 5.1 and 14.3 at 6 months, 4.6 and 8.4 at 1 year, and 4.7 and 11.9 at 2 years postoperatively. Thresholds for PASS achievement ranged between 62.5 and 89 at 6 months, 75 and 89 at 1 year, and 78.6 and 93.2 at 2 years postoperatively. Threshold scores (absolute/change based) for achieving the SCB ranged between 82.8 and 96.4/17.7 and 40.1 at 6 months, between 94.7 and 100/23 and 45 at 1 year, and between 95.3 and 100/29.4 and 45 at 2 years. More patients achieved the MCID and PASS at 1 year compared with 6 months and 2 years. For SCB, this trend was also observed for non-KOOS outcomes, while for KOOS subdomains, more patients achieved the SCB at 2 years. High-intensity signal of the ACL repair (odds ratio [OR], 31.7 [95% CI, 1.5-73.4]; P = .030) and bone contusions on MRI (OR, 4.2 [95% CI, 1.7-25.2]; P = .041) at 1 year postoperatively were independently associated with increased risk of ACL repair failure. Conclusion: The rate of clinically meaningful outcome improvement was high early after ACL repair, with the greatest proportion of patients achieving the MCID, PASS, and SCB at 1 year postoperatively. Bone contusions involving the posterolateral tibia and lateral femoral condyle as well as high repair signal intensity at 1 year postoperatively were independent predictors of failure at 2 years postoperatively.

Multiple resistance to primary pests of grain sorghum hybrids: Spodoptera frugiperda (Lepidoptera: Noctuidae), Diatraea saccharalis (Lepidoptera: Crambidae), and Diceraeus melacanthus (Hemiptera: Pentatomidae)

ABSTRACT Plant resistance is an important tactic within the precepts of Integrated Pest Management, and the existence of grain sorghum hybrids with multiple insect resistance could benefit crop management and sustainability. This study evaluated the susceptibility of 30 grain-sorghum hybrids to three major pests, namely, fall armyworm (FAW) Spodoptera frugiperda, sugarcane borer (SCB) Diatraea saccharalis, and green-belly stink bug (GBS) Diceraeus melacanthus. The hybrids were cultivated and experiments with each insect species were conducted separately in a greenhouse. For FAW, visual injury assessments were performed on plants 7 and 14 days after infestation (DAI). For SCB, insect presence and injury were assessed 40 DAI. For GBS, the plants were evaluated using a damage rating scale 12, 19, and 26 DAI. Cluster analysis allowed separating the grain sorghum hybrids into groups regarding the levels of resistance to each pest. Hybrid BRS373 stood out as moderately resistant to FAW; AG1090, 80G20, BRAVO, BRS373, AG1615, and IG220 were the most promising for SCB; and for GBS, hybrids 50A40, A9735R, JADE, ENFORCER, BUSTER, 50A10, and IG244 were the most nominated. This information will significantly aid sorghum breeding programs focused on developing commercial hybrids that comprise both insect-resistance and high-yield characteristics. However, further research should evaluate potential chemical and morphological plant traits underlying the lower levels of susceptibility to FAW, SCB, and GBS found in the selected sorghum hybrids.

MON 95379 Bt maize as a new tool to manage sugarcane borer (Diatraea saccharalis) in South America.

BACKGROUND: The sugarcane borer (SCB), Diatraea saccharalis (Lepidoptera: Crambidae), is a key pest of maize in Argentina, and genetically modified maize, producing Bacillus thuringiensis (Bt) proteins, has revolutionized the management of this insect in South America. However, field-evolved resistance to some Bt technologies has been observed in SCB in Argentina. Here we assessed a new Bt technology, MON 95379, in the laboratory, greenhouse and field for efficacy against SCB. RESULTS: In a laboratory leaf disc bioassay, both MON 95379 (producing Cry1B.868 and Cry1Da_7) and Cry1B.868_single maize (producing only Cry1B.868) resulted in 100% mortality of SCB. The level of Cry1B.868 in the Cry1B.868_single maize is comparable to that in MON 95379 maize. However, the Cry1Da_7 protein does not have high efficacy against SCB, as evidenced by < 20% mortality on Cry1Da_7_single leaf tissue. Total (100%) mortality of SCB in a Cry1B.868_single tissue dilution bioassay indicated that Cry1B.868_single maize meets the criteria to be classified as a high dose. Similar median lethal concentration (LC50 ) values were observed for MON 89034-R and susceptible SCB strains exposed to Cry1B.868 protein. MON 95379 also controlled SCB strains resistant to MON 89034 (Cry1A.105/Cry2Ab2) and Cry1Ab. Under field conditions in Brazil and Argentina, MON 95379 maize plants were consistently protected from SCB damage. CONCLUSION: MON 95379 maize will bring value to maize growers in South America by effectively managing SCB even in locations where resistance to other Bt-containing maize technologies has been reported. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Molecular Characterization of Xyloglucanase cel74a from Trichoderma reesei.

BACKGROUND: The filamentous fungus Trichoderma reesei is used on an industrial scale to produce enzymes of biotechnological interest. This fungus has a complex cellulolytic system involved in the degradation of lignocellulosic biomass. However, several aspects related to the regulation of the expression of holocellulolytic genes and the production of cellulases by this fungus are still understood. METHODS: Here, we constructed a null mutant strain for the xyloglucanase cel74a gene and performed the characterization of the Δcel74a strain to evaluate the genetic regulation of the holocellulases during sugarcane bagasse (SCB) cultivation. RESULTS: Our results demonstrate that the deletion of xyloglucanase cel74a may impact the regulation of holocellulase expression during SCB cultivation. The expression of cellulases cel7a, cel7b, and cel6a was reduced in Δcel74a strain, while the hemicellulases xyn1 and xyn2 were increased in the presence of SCB. The cel74a mutation also affected the xyloglucan hydrolysis patterns. In addition, CEL74A activity was modulated in the presence of calcium, suggesting that this ion may be required for efficient degradation of xyloglucan. CONCLUSIONS: CEL74A affects the regulation of holocellulolytic genes and the efficient degradation of SCB in T. reesei. This data makes a significant contribution to our understanding of the carbon utilization of fungal strains as a whole.

Puesta a punto de la técnica de Ussing Chamber para estudios de permeabilidad intestinal en tejido de cerdo / Optimization of the Ussing Chamber Technique for studies of intestinal permeability in pig tissue

El Sistema de Clasificación Biofarmacéutica es un marco científico para clasificar ingredientes farmacéuticos activos en base a su solubilidad acuosa y su permeabilidad intestinal, que cuando se combina con la disolución del producto toma en cuenta los tres factores principales que gobiernan la velocidad y el alcance de la absorción de un fármaco a partir de formas posológicas orales sólidas de liberación inmediata. Cuando los fármacos cumplen con determinados criterios biofarmacéuticos este sistema permite reemplazar los estudios in vivo de biodisponibilidad / bioequivalencia por estudios in vitro. La permeabilidad intestinal de los IFAs puede ser estudiada por diferentes métodos, uno de ellos es la técnica de Ussing Chamber que utiliza una porción de tejido intestinal. La ventaja de esta técnica es que permite conservar las capacidades funcionales de los tejidos. En la puesta a punto de esta nueva técnica se obtuvieron datos concordantes con bibliografía. Se evaluó la permeabilidad de ibuprofeno, metoprolol y atenolol (drogas de alta y baja permeabilidad) utilizando Ussing Chamber con intestino delgado de cerdo. Contar con esta técnica en el Departamento de Farmacología representa un valioso complemento a las metodologías ya utilizadas: estudios in vitro (células Caco-2 y MDCK) e in situ (perfusión intestinal en rata).

The Biopharmaceutical Classification System is a scientific framework for classifying Active Pharmaceutical Ingredients based on their aqueous solubility and their intestinal permeability which, when combined with the dissolution of the product takes into account the three main factors that govern the absorption speed and extent of a drug from immediate-release solid oral dosage form. When drugs meet certain biopharmaceutical criteria, this system allows in vivo bioavailability / bioequivalence studies to be replaced by in vitro studies. The intestinal permeability of APIs can be studied by different methods, one of them is the Ussing Chamber technique that uses a portion of intestinal tissue. The advantage of this technique is that it allows to conserve the functional capacities of tissues. In the development of this new technique, concordant data with bibliography was obtained. The permeability of ibuprofen, metoprolol and atenolol (high and low permeability drugs) was evaluated utilizing the Ussing Chamber Technique with pig small intestine. To have this technique in the Department of Pharmacology represents a valuable complement to the methodologies already used; both in vitro (Caco-2 and MDCK cells) and in situ (intestinal perfusion in rat) studies.

Avaliação dos mecanismos envolvidos na permeabilidade de fármacos antirretrovirais por meio dos modelos ex vivo ( células de Franz ) e in vitro ( PAMPA ) / Evaluation of mechanisms involved in the permeability of antiretroviral drugs through ex vivo ( Franz cells ) and in vitro ( PAMPA ) models

Para fármacos administrados por via oral, o controle da extensão e da velocidade de absorção depende basicamente de duas importantes etapas: solubilidade do fármaco nos líquidos fisiológicos e sua permeabilidade através das membranas biológicas. Assim, o Sistema de Classificação Biofarmacêutica (SCB) foi proposto como uma ferramenta para o desenvolvimento de novos fármacos, de novas formulações e para auxiliar nos processos de bioisenção. No entanto, outro fator relacionado à biodisponibilidade e que deve ser considerado nos estudos biofarmacêuticos é o metabolismo. Desta forma, o Sistema de Classificação Biofarmacêutica de Distribuição de Fármacos (SCBDF) foi proposto com a finalidade de classificar os fármacos de acordo com suas características de solubilidade e de metabolismo de modo que seja possível avaliar e predizer o comportamento do fármaco in vivo. O metabolismo tem sido amplamente investigado, sobretudo as enzimas do citocromo P450, as quais estão presentes também nos enterócitos. Além disso, o SCBDF oferece um suporte quanto à avaliação dos mecanismos de permeabilidade envolvidos nos processos de absorção, interações fármaco-fármaco e interações fármaco-alimento. Assim, o presente trabalho teve como objetivo elucidar os mecanismos envolvidos na permeabilidade de fármacos antirretrovirais por meio dos modelos ex vivo (câmaras de difusão vertical tipo Franz) e in vitro (PAMPA, MDCK-MDR1 e microssomas) considerando os aspectos relacionados ao metabolismo intestinal e ao efluxo destes fármacos. Dada a importância da utilização de fármacos antirretrovirais na terapia medicamentosa contra a Síndrome da Imunodeficiência Adquirida (SIDA) e que estes medicamentos são normalmente administrados cronicamente, a compreensão dos mecanismos envolvidos na permeabilidade é de suma importância, uma vez que estes não estão totalmente esclarecidos e poucas informações são encontradas na literatura. Além disso, a biodisponibilidade de fármacos como estavudina, lamivudina e zidovudina indica variação na permeabilidade, necessitando de uma investigação científica mais aprofundada dos processos absortivos. Assim, segmentos de jejuno provenientes de ratos machos Wistar foram utilizados para a avaliação da permeabilidade intestinal dos referidos antirretrovirais considerando a avaliação de efluxo pela glicoproteína-P e o metabolismo intestinal pela CYP3A. De maneira complementar, estudos in vitro com o emprego de membranas artificiais paralelas (PAMPA) e culturas celulares de MDCK-MDR1 foram realizados com a finalidade de auxiliar na elucidação dos mecanismos de permeabilidade dos fármacos antirretrovirais. Além disso, a avaliação do metabolismo dos referidos fármacos foi realizada com o emprego de microssomas a fim de verificar se tais substâncias são substratos de enzimas da família CYP3A e, assim, verificar o impacto do metabolismo intestinal na absorção. Os resultados de permeabilidade obtidos em PAMPA foram: 0,74±0,11 x 10-6 cm/s para a estavudina, 0,25±0,12 x 10-6 cm/s para a lamivudina e 1,14±0,25 x 10-6 cm/s para a zidovudina. Já no modelo ex vivo com o emprego de câmaras de difusão vertical tipo Franz, os resultados foram: 1,56±0,32 x 10-5 cm/s para a estavudina, 1,26±0,27 x 10-5 cm/s para a lamivudina e 2,54±0,49 x 10-5 cm/s para a zidovudina. Portanto, com base nos resultados obtidos a partir dos dois métodos empregados, sugere-se que 30 outro mecanismo de transporte que não envolva a permeabilidade por difusão transcelular passiva possa estar relacionado à permeabilidade dos fármacos antirretrovirais. Com relação aos estudos de efluxo, os resultados obtidos a partir dos experimentos realizados em câmaras de difusão vertical tipo Franz demonstraram o aumento significativo da permeabilidade dos três antirretrovirais quando o inibidor de P-gp foi empregado, sendo: de 15,6 x 10-6 para 42,5 x 10-6 cm/s para a estavudina, de 12,6 x 10-6 para 37,5 x 10-6 cm/s para a lamivudina e de 25,4 x 10-6 para 56,6 x 10-6 cm/s para a zidovudina. Em culturas celulares MDCK-MDR1, os resultados de permeabilidade foram utilizados para a obtenção das razões entre as direções B→A e A→B. Os valores de Papp na condição inibida para os fármacos estudados apresentaram razão menor do que 1. Já a razão B→A/A→B para cada fármaco nos ensaios sem inibidor apresentou-se igual ou maior que 2, evidenciando a interação fármaco-transportador. Com base nisso, o modelo ex vivo com o emprego de segmentos intestinais em câmaras de difusão vertical tipo Franz apresentou-se adequado na avaliação do mecanismo de efluxo dos fármacos antirretrovirais, o que foi confirmado com os estudos realizados em MDCK-MDR1. Assim, os fármacos antirretrovirais estudados apresentaram interação significativa com a P-gp. Em relação aos estudos de metabolismo realizados em câmaras de difusão vertical tipo Franz, os resultados demonstraram grande variação na permeabilidade dos três antirretrovirais quando o inibidor de CYP3A foi empregado, sendo: de 15,6 x 10-6 para 23,5 x 10-6 cm/s para a estavudina, de 12,6 x 10-6 para 27,3 x 10-6 cm/s para a lamivudina e de 25,4 x 10-6 para 40,5 x 10-6 cm/s para a zidovudina. Já no modelo que emprega microssomas, os resultados de metabolização na ausência e na presença de inibidor de CYP3A foram: de 16,56% para 19,79% para a estavudina, de 14,56% para 15,55% para a lamivudina e de 17,85% para 16,48% para a zidovudina. Com base nisso, sugerese o emprego de microssomas para a determinação de metabolismo, uma vez que o método ex vivo empregado demonstrou grande variação entre os valores obtidos. Desta forma, observou-se que, para cada fármaco, não houve influência significativa no metabolismo pré-sistêmico relacionado às enzimas do complexo CYP3A, o que indica que a absorção oral das referidas substâncias não é limitada por tais enzimas. Portanto, a utilização dos diferentes métodos empregados no desenvolvimento do presente trabalho permitiu compreender os mecanismos envolvidos no transporte dos fármacos antirretrovirais, o que se torna de grande relevância nas etapas de desenvolvimento farmacêutico de novas moléculas e na compreensão de eventos clínicos ainda não esclarecidos atualmente

For orally administered drugs, control of the extent and rate of absorption depends on two important steps: solubility of the drug in physiological liquids and their permeability across biological membranes. Thus, the Biopharmaceutics Classification System (BCS) has been proposed as a tool for the development of new drugs, new formulations and aid in the biowaiver processes. However, another factor related to bioavailability that should be considered in biopharmaceutic studies is the metabolism. Thus, the Biopharmaceutics Drug Disposition Classification System (BDDCS) has been proposed for drug classification according to their solubility and metabolism characteristics, so it is possible to evaluate and predict the in vivo behavior of a compound. Metabolism has been extensively investigated, especially cytochrome P450 enzymes, which are also expressed in enterocytes. Besides, BDDCS provides support in evaluating the permeability mechanisms involved in the absorption processes, drug-drug interactions and drug-food interactions. Thus, the present study aimed to evaluate the mechanisms of permeability of antiretroviral drugs through the ex vivo (Franz cells) and in vitro (PAMPA, MDCK-MDR1 and microsomes) models considering aspects related to the intestinal metabolism and efflux of these drugs. Given the importance of the use of antiretroviral drugs in drug therapy against Acquired Immune Deficiency Syndrome (AIDS) and that these drugs are usually administered in a long-term way, understanding the mechanisms involved in the permeability is of a great importance, since they are not totally elucidated and no information is found in the literature. In addition, drugs as stavudine, lamivudine and zidovudine indicate variation in the permeability, which require further scientific investigation of absorptive processes. Thus, jejunum segments from rats were used to evaluate the intestinal permeability of these antiretroviral drugs, considering the evaluation of efflux by P-glycoprotein and intestinal metabolism by CYP3A. In a complementary manner, in vitro studies using parallel artificial membranes (PAMPA) and cell cultures MDCK-MDR1 were performed to aid in the elucidation of the permeability mechanisms of antiretroviral drugs. Also, the evaluation of the metabolism was carried out using microsomes to verify if such substances are substrates of CYP3A, and verify the impact of the intestinal metabolism in the absorption. The permeability results obtained in PAMPA were: 0.74±0.11x10-6 cm/s for stavudine, 0.25±0.12x10-6 cm/s for lamivudine and 1.14±0.25x10-6 cm/s for zidovudine. In ex vivo method using the intestinal segments in Franz cells, the results were: 1.56±0.32x10-5 cm/s for stavudine, 1.26±0.27x10-5 cm/s for lamivudine and 2.54±0.49x10-5 cm/s for zidovudine. Thus, based on the results obtained from these two methods, it is suggested that the antiretroviral drugs present other transport mechanism that is different from transcellular passive diffusion. For efflux studies, results obtained from experiments performed in Franz cells shown the increase of the permeability of the three antiretroviral drugs when the P-gp inhibitor was used: from 15.6x10-6 to 42,5x10-6 cm/s for stavudine, from 12.6x10-6 cm/s to 37.5x10-6 cm/s for lamivudine, and 25.4x10-6 to 56.6x10-6 cm/s for zidovudine. In MDCK-MDR1, the permeability results were used for obtaining ratio values between the directions B→A and A→B. The Papp values obtained with 33 inhibitor shown a ratio less than 1. For ratio B→A/A→B for each drug in experiments without inhibitor, the values obtained was equal or greater than 2, which shows the interaction between drug and transporter. Based on that, the ex vivo model using intestinal segments in Franz cells seems to be adequate for evaluation of efflux mechanism of antiretroviral drugs, which was confirmed by MDCK-MDR1 studies. Thus, the antiretroviral drugs presented interaction with P-gp. For metabolism studies in intestinal segments in Franz cells, a wide range of standard deviation was observed for the three antiretroviral drugs when the CYP3A inhibitor was used: from 15.6x10-6 cm/s to 23.5x10-6 cm/s for stavudine, from 12.6x10-6 cm/s to 27.3x10-6 cm/s for lamivudine, and from 25.4x10-6 cm/s to 40.5x10-6 cm/s for zidovudine. In experiments in microsomes, the results of metabolization in the absence and presence of CYP3A inhibitor were: from 16.56 to 19.79% for stavudine, from 14.56 to 15.55% for lamivudine and from 17.85 to 16.48% for zidovudine. Based on that, it is suggested the use of microsomes for metabolism evaluation, since the ex vivo method presented high variability between the results obtained. For each drug, no significative influence in pre-systemic metabolism related to CYP3A enzymes was observed, which indicates that the oral absorption of the drugs is not limited by these enzymes. The use of different methods in this work allowed to understand the mechanisms involved in the transport of antiretroviral drugs, which is of a great relevance in drug development and in the understanding of clinical events currently not clarified

Avaliação dos mecanismos envolvidos na permeabilidade de fármacos antirretrovirais por meio dos modelos ex vivo (células de Franz) e in vitro (PAMPA) / Evaluation of mechanisms involved in the permeability of antiretroviral drugs through ex vivo (Franz cells) and in vitro (PAMPA) models

Para fármacos administrados por via oral, o controle da extensão e da velocidade de absorção depende basicamente de duas importantes etapas: solubilidade do fármaco nos líquidos fisiológicos e sua permeabilidade através das membranas biológicas. Assim, o Sistema de Classificação Biofarmacêutica (SCB) foi proposto como uma ferramenta para o desenvolvimento de novos fármacos, de novas formulações e para auxiliar nos processos de bioisenção. No entanto, outro fator relacionado à biodisponibilidade e que deve ser considerado nos estudos biofarmacêuticos é o metabolismo. Desta forma, o Sistema de Classificação Biofarmacêutica de Distribuição de Fármacos (SCBDF) foi proposto com a finalidade de classificar os fármacos de acordo com suas características de solubilidade e de metabolismo de modo que seja possível avaliar e predizer o comportamento do fármaco in vivo. O metabolismo tem sido amplamente investigado, sobretudo as enzimas do citocromo P450, as quais estão presentes também nos enterócitos. Além disso, o SCBDF oferece um suporte quanto à avaliação dos mecanismos de permeabilidade envolvidos nos processos de absorção, interações fármaco-fármaco e interações fármaco-alimento. Assim, o presente trabalho teve como objetivo elucidar os mecanismos envolvidos na permeabilidade de fármacos antirretrovirais por meio dos modelos ex vivo (câmaras de difusão vertical tipo Franz) e in vitro (PAMPA, MDCK-MDR1 e microssomas) considerando os aspectos relacionados ao metabolismo intestinal e ao efluxo destes fármacos. Dada a importância da utilização de fármacos antirretrovirais na terapia medicamentosa contra a Síndrome da Imunodeficiência Adquirida (SIDA) e que estes medicamentos são normalmente administrados cronicamente, a compreensão dos mecanismos envolvidos na permeabilidade é de suma importância, uma vez que estes não estão totalmente esclarecidos e poucas informações são encontradas na literatura. Além disso, a biodisponibilidade de fármacos como estavudina, lamivudina e zidovudina indica variação na permeabilidade, necessitando de uma investigação científica mais aprofundada dos processos absortivos. Assim, segmentos de jejuno provenientes de ratos machos Wistar foram utilizados para a avaliação da permeabilidade intestinal dos referidos antirretrovirais considerando a avaliação de efluxo pela glicoproteína-P e o metabolismo intestinal pela CYP3A. De maneira complementar, estudos in vitro com o emprego de membranas artificiais paralelas (PAMPA) e culturas celulares de MDCK-MDR1 foram realizados com a finalidade de auxiliar na elucidação dos mecanismos de permeabilidade dos fármacos antirretrovirais. Além disso, a avaliação do metabolismo dos referidos fármacos foi realizada com o emprego de microssomas a fim de verificar se tais substâncias são substratos de enzimas da família CYP3A e, assim, verificar o impacto do metabolismo intestinal na absorção. Os resultados de permeabilidade obtidos em PAMPA foram: 0,74±0,11 x 10-6 cm/s para a estavudina, 0,25±0,12 x 10-6 cm/s para a lamivudina e 1,14±0,25 x 10-6 cm/s para a zidovudina. Já no modelo ex vivo com o emprego de câmaras de difusão vertical tipo Franz, os resultados foram: 1,56±0,32 x 10-5 cm/s para a estavudina, 1,26±0,27 x 10-5 cm/s para a lamivudina e 2,54±0,49 x 10-5 cm/s para a zidovudina. Portanto, com base nos resultados obtidos a partir dos dois métodos empregados, sugere-se que 30 outro mecanismo de transporte que não envolva a permeabilidade por difusão transcelular passiva possa estar relacionado à permeabilidade dos fármacos antirretrovirais. Com relação aos estudos de efluxo, os resultados obtidos a partir dos experimentos realizados em câmaras de difusão vertical tipo Franz demonstraram o aumento significativo da permeabilidade dos três antirretrovirais quando o inibidor de P-gp foi empregado, sendo: de 15,6 x 10-6 para 42,5 x 10-6 cm/s para a estavudina, de 12,6 x 10-6 para 37,5 x 10-6 cm/s para a lamivudina e de 25,4 x 10-6 para 56,6 x 10-6 cm/s para a zidovudina. Em culturas celulares MDCK-MDR1, os resultados de permeabilidade foram utilizados para a obtenção das razões entre as direções B→A e A→B. Os valores de Papp na condição inibida para os fármacos estudados apresentaram razão menor do que 1. Já a razão B→A/A→B para cada fármaco nos ensaios sem inibidor apresentou-se igual ou maior que 2, evidenciando a interação fármaco-transportador. Com base nisso, o modelo ex vivo com o emprego de segmentos intestinais em câmaras de difusão vertical tipo Franz apresentou-se adequado na avaliação do mecanismo de efluxo dos fármacos antirretrovirais, o que foi confirmado com os estudos realizados em MDCK-MDR1. Assim, os fármacos antirretrovirais estudados apresentaram interação significativa com a P-gp. Em relação aos estudos de metabolismo realizados em câmaras de difusão vertical tipo Franz, os resultados demonstraram grande variação na permeabilidade dos três antirretrovirais quando o inibidor de CYP3A foi empregado, sendo: de 15,6 x 10-6 para 23,5 x 10-6 cm/s para a estavudina, de 12,6 x 10-6 para 27,3 x 10-6 cm/s para a lamivudina e de 25,4 x 10-6 para 40,5 x 10-6 cm/s para a zidovudina. Já no modelo que emprega microssomas, os resultados de metabolização na ausência e na presença de inibidor de CYP3A foram: de 16,56% para 19,79% para a estavudina, de 14,56% para 15,55% para a lamivudina e de 17,85% para 16,48% para a zidovudina. Com base nisso, sugerese o emprego de microssomas para a determinação de metabolismo, uma vez que o método ex vivo empregado demonstrou grande variação entre os valores obtidos. Desta forma, observou-se que, para cada fármaco, não houve influência significativa no metabolismo pré-sistêmico relacionado às enzimas do complexo CYP3A, o que indica que a absorção oral das referidas substâncias não é limitada por tais enzimas. Portanto, a utilização dos diferentes métodos empregados no desenvolvimento do presente trabalho permitiu compreender os mecanismos envolvidos no transporte dos fármacos antirretrovirais, o que se torna de grande relevância nas etapas de desenvolvimento farmacêutico de novas moléculas e na compreensão de eventos clínicos ainda não esclarecidos atualmente

For orally administered drugs, control of the extent and rate of absorption depends on two important steps: solubility of the drug in physiological liquids and their permeability across biological membranes. Thus, the Biopharmaceutics Classification System (BCS) has been proposed as a tool for the development of new drugs, new formulations and aid in the biowaiver processes. However, another factor related to bioavailability that should be considered in biopharmaceutic studies is the metabolism. Thus, the Biopharmaceutics Drug Disposition Classification System (BDDCS) has been proposed for drug classification according to their solubility and metabolism characteristics, so it is possible to evaluate and predict the in vivo behavior of a compound. Metabolism has been extensively investigated, especially cytochrome P450 enzymes, which are also expressed in enterocytes. Besides, BDDCS provides support in evaluating the permeability mechanisms involved in the absorption processes, drug-drug interactions and drug-food interactions. Thus, the present study aimed to evaluate the mechanisms of permeability of antiretroviral drugs through the ex vivo (Franz cells) and in vitro (PAMPA, MDCK-MDR1 and microsomes) models considering aspects related to the intestinal metabolism and efflux of these drugs. Given the importance of the use of antiretroviral drugs in drug therapy against Acquired Immune Deficiency Syndrome (AIDS) and that these drugs are usually administered in a long-term way, understanding the mechanisms involved in the permeability is of a great importance, since they are not totally elucidated and no information is found in the literature. In addition, drugs as stavudine, lamivudine and zidovudine indicate variation in the permeability, which require further scientific investigation of absorptive processes. Thus, jejunum segments from rats were used to evaluate the intestinal permeability of these antiretroviral drugs, considering the evaluation of efflux by P-glycoprotein and intestinal metabolism by CYP3A. In a complementary manner, in vitro studies using parallel artificial membranes (PAMPA) and cell cultures MDCK-MDR1 were performed to aid in the elucidation of the permeability mechanisms of antiretroviral drugs. Also, the evaluation of the metabolism was carried out using microsomes to verify if such substances are substrates of CYP3A, and verify the impact of the intestinal metabolism in the absorption. The permeability results obtained in PAMPA were: 0.74±0.11x10-6 cm/s for stavudine, 0.25±0.12x10-6 cm/s for lamivudine and 1.14±0.25x10-6 cm/s for zidovudine. In ex vivo method using the intestinal segments in Franz cells, the results were: 1.56±0.32x10-5 cm/s for stavudine, 1.26±0.27x10-5 cm/s for lamivudine and 2.54±0.49x10-5 cm/s for zidovudine. Thus, based on the results obtained from these two methods, it is suggested that the antiretroviral drugs present other transport mechanism that is different from transcellular passive diffusion. For efflux studies, results obtained from experiments performed in Franz cells shown the increase of the permeability of the three antiretroviral drugs when the P-gp inhibitor was used: from 15.6x10-6 to 42,5x10-6 cm/s for stavudine, from 12.6x10-6 cm/s to 37.5x10-6 cm/s for lamivudine, and 25.4x10-6 to 56.6x10-6 cm/s for zidovudine. In MDCK-MDR1, the permeability results were used for obtaining ratio values between the directions B→A and A→B. The Papp values obtained with 33 inhibitor shown a ratio less than 1. For ratio B→A/A→B for each drug in experiments without inhibitor, the values obtained was equal or greater than 2, which shows the interaction between drug and transporter. Based on that, the ex vivo model using intestinal segments in Franz cells seems to be adequate for evaluation of efflux mechanism of antiretroviral drugs, which was confirmed by MDCK-MDR1 studies. Thus, the antiretroviral drugs presented interaction with P-gp. For metabolism studies in intestinal segments in Franz cells, a wide range of standard deviation was observed for the three antiretroviral drugs when the CYP3A inhibitor was used: from 15.6x10-6 cm/s to 23.5x10-6 cm/s for stavudine, from 12.6x10-6 cm/s to 27.3x10-6 cm/s for lamivudine, and from 25.4x10-6 cm/s to 40.5x10-6 cm/s for zidovudine. In experiments in microsomes, the results of metabolization in the absence and presence of CYP3A inhibitor were: from 16.56 to 19.79% for stavudine, from 14.56 to 15.55% for lamivudine and from 17.85 to 16.48% for zidovudine. Based on that, it is suggested the use of microsomes for metabolism evaluation, since the ex vivo method presented high variability between the results obtained. For each drug, no significative influence in pre-systemic metabolism related to CYP3A enzymes was observed, which indicates that the oral absorption of the drugs is not limited by these enzymes. The use of different methods in this work allowed to understand the mechanisms involved in the transport of antiretroviral drugs, which is of a great relevance in drug development and in the understanding of clinical events currently not clarified