Design, synthesis, and biological evaluation of furosemide analogs as therapeutics for the proteopathy and immunopathy of Alzheimer's disease.

ß-Amyloid (Aß) triggered proteopathic and immunopathic processes are a postulated cause of Alzheimer's disease (AD). Monomeric Aß is derived from amyloid precursor protein, whereupon it aggregates into various assemblies, including oligomers and fibrils, which disrupt neuronal membrane integrity and induce cellular damage. Aß is directly neurotoxic/synaptotoxic, but may also induce neuroinflammation through the concomitant activation of microglia. Previously, we have shown that furosemide is a known anthranilate-based drug with the capacity to downregulate the proinflammatory microglial M1 phenotype and upregulate the anti-inflammatory M2 phenotype. To further explore the pharmacologic effects of furosemide, this study reports a series of furosemide analogs that target both Aß aggregation and neuroinflammation, thereby addressing the combined proteopathic-immunopathic pathogenesis of AD. Forty compounds were synthesized and evaluated. Compounds 3c, 3g, and 20 inhibited Aß oligomerization; 33 and 34 inhibited Aß fibrillization. 3g and 34 inhibited the production of TNF-α, IL-6, and nitric oxide, downregulated the expression of COX-2 and iNOS, and promoted microglial phagocytotic activity, suggesting dual activity against Aß aggregation and neuroinflammation. Our data demonstrate the potential therapeutic utility of the furosemide-like anthranilate platform in the development of drug-like molecules targeting both the proteopathy and immunopathy of AD.

Safe, swallowable and palatable paediatric mini-tablet formulations for a WHO model list of essential medicines for children compound - A promising starting point for future PUMA applications.

More than 10 years after the Paediatric Regulation came into place there is still a strong need for paediatric medicines for off-patent drug substances. Numerous compounds for which a paediatric formulation does not exist can be found on the WHO Model List of Essential Medicines for Children and in the EMA Inventory of the Needs for Paediatric Medicines. Many of these compounds are off patent, which offers the opportunity for obtaining marketing authorisations for paediatric use. The present study focused on the development of paediatric immediate-release mini-tablet formulations for furosemide. Essential formulation criteria included the use of excipients that are regarded as safe for children, the ease of manufacturing, a high dose flexibility, fast disintegration, a robust drug release and a good acceptability. Only excipients regarded as safe for use in children were used in formulation screening. Compressibility, tablet hardness, disintegration and palatability were the main screening parameters. Formulations with a hardness of  > 20 N, a disintegration time < 3 min (fast disintegration) and a good palatability were selected for mini-tablet production. Based on this pre-assessment two mini-tablet formulations with a furosemide drug load of 2.5 mg were developed. Both were easy to manufacture, had an appropriate hardness, a short disintegration time and met pharmacopoeial requirements with regard to content uniformity and physical testing. Biorelevant in vitro dissolution experiments mimicking different modes (with water or dosing vehicles) of administering age-appropriate furosemide doses to children of different age groups indicated a fast and robust drug release. Overall, the novel mini-tablet formulations present with an increased dose flexibility, excipient safety, swallowability and palatability and are thus a promising starting point for the development of solid oral dosage forms for drugs with paediatric therapeutic needs.

Utilization of a Single Experimental Design for the Optimization of Furosemide Modified-Release Tablet Formulations.

BACKGROUND: The loop diuretic drug furosemide is widely used for the treatment of edema in various conditions, such as pulmonary, cardiac and hepatic edema, as well as cardiac infarction. Furosemide, due to its poor water solubility and low bioavailability after oral administration of conventional dosage form, is categorized as class IV in the biopharmaceutical classification system. OBJECTIVE: In the case of furosemide, this release profile is responsible for various physiological problems, acute diuresis being the most serious. This adverse effect can be circumvented by the modified release of furosemide from tablet formulations compared to those forms designed for immediate release. METHODS: In this report, a D-optimal combined experimental design was applied for the development of furosemide containing bilayer and compression coated tablets, aiming at lowering the drug's burst release in the acidic environment of the stomach. A D-optimal combined design was selected in order to include all requirements in one design with many levels for the factors examined. The following responses were selected as the ones reflecting better criteria for the desired drug release: dissolution at 120 min (30-40%), 300 min (60-70%) and 480 min >95%. The new formulations, suggested by the Doptimal combined design, incorporated different grades of Eudragit ® polymers (Eudragit® E100 and Eudragit® L100-55), lactose monohydrate and HPMC K15M. The dissolution profile of furosemide from these systems was probed via in vitro dissolution experiments in buffer solutions simulating the pH of the gastrointestinal tract. RESULTS: The results indicate that the use of Eudragit® E100 in conjunction with lactose monohydrate led to 21.32-40.85 % drug release, in the gastric medium, in both compression-coated and bilayer tablets. This is lower than the release of the mainstream drug Lasix® (t=120 min, 44.5% drug release), implying longer gastric retention and drug waste minimization. CONCLUSION: Furosemide's release in the intestinal environment, from compression coated tablets incorporating Eudragit® L100-55 and HPMC K15M in the inner core or one of the two layers of the bilayer tablets, was delayed, compared to Lasix®.

FSE-Ag complex NS: preparation and evaluation of antibacterial activity.

Silver (Ag) complexes of drugs and their nanosystems have great potential as antibacterials. Recently, an Ag complex of furosemide (Ag-FSE) has shown to be a promising antimicrobial. However, poor solubility of Ag-FSE could hamper its introduction into clinics. Therefore, the authors developed a nanosuspension of Ag-FSE (Ag-FSE_NS) for its solubility and antibacterial activity enhancement. The aim of this study was to introduce a novel nanoantibiotic with enhanced antibacterial efficacy. Ag-FSE_NS was prepared by precipitation-ultrasonication technique. Size, polydispersity index (PI) and zeta potential (ZP) of prepared Ag-FSE_NS were measured by dynamic light scattering, whereas surface morphology was determined using scanning electron microscopy (SEM). In vitro antibacterial activity was evaluated against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa using broth microdilution method. Size, PI and ZP of optimised Ag-FSE_NS1 were 191.2 ± 19.34 nm, 0.465 ± 0.059 and -55.7 ± 8.18 mV, respectively. SEM revealed that Ag-FSE_NS1 particles were rod or needle-like with smooth surfaces. Saturation solubility of Ag-FSE in NS increased eight-fold than pure Ag-FSE. Ag-FSE_NS1 exhibited two-fold and eight-fold enhancements in activity against E. coli and S. aureus, respectively. The results obtained showed that developed Ag-FSE_NS1 holds a promise as a topical antibacterial.

Nanocristais de furosemida: preparação, caracterização físico-química e avaliação in silico de absorção oral e pulmonar / Furosemide nanocrystals: preparation, physical-chemical characterization and in silico evaluation of oral and lung absorption

Segundo a Organização Mundial de Saúde, a hipertensão arterial é responsável por uma crise global de saúde pública, sendo as doenças cardiovasculares implicadas em aproximadamente 17 milhões de mortes/ano, das quais, 9,4 milhões ocasionadas por complicações provocadas pela hipertensão, como edema pulmonar. Quanto ao arsenal terapêutico disponível, a furosemida, potente diurético de alça, é amplamente utilizada em situações de controle e emergência relacionadas à hipertensão e ao edema pulmonar cardiogênico. Apesar do elevado índice de sua prescrição, esse fármaco pertence à classe IV do Sistema de Classificação Biofarmacêutica (SCB), apresentando absorções intestinais erráticas e variáveis. Tais características representam desafio para o desenvolvimento de formas farmacêuticas orais. Assim, adoção de tecnologias inovadoras associadas à via de administração pulmonar pode permitir abordagem terapêutica alternativa, com elevado potencial de aplicação. Entre as tecnologias inovadoras, a obtenção de nanocristais de fármacos classes II e IV tem sido promissora. Nanocristais podem exibir desempenho in vivo superior quando comparados aos seus homólogos, na forma micronizada. Portanto, estratégias que permitam o desenvolvimento de medicamentos contendo furosemida, com maior eficácia e segurança, são de fundamental importância. Nesse sentido, a aplicação de tecnologia in silico, com propriedade preditiva, contribui para a racionalização de ensaios na pesquisa e no desenvolvimento de novas formas farmacêuticas. Objetivou-se, desse modo, a preparação e a caracterização físico-química de nanocristais de furosemida e sua avaliação in silico na absorção oral e pulmonar empregando ferramenta computacional. Os nanocristais foram obtidos por moagem à alta energia, utilizando movimentos simultâneos de revolução/rotação. A determinação da distribuição do tamanho e a morfologia foram realizadas por difração de raios laser e microscopia eletrônica de varredura, respectivamente. As possíveis interações e/ou alterações do estado cristalino do fármaco foram investigadas por calorimetria exploratória diferencial, termogravimetria diferencial, difração de raio X e espectroscopia Raman de baixo deslocamento. Quanto à solubilidade do nanocristal, foram realizados ensaios para a determinação do aumento na solubilidade de equilíbrio e da velocidade dissolução, utilizando os métodos shake flask e velocidade de dissolução intrínseca (VDI), respectivamente. A moagem à alta energia permitiu a obtenção de nanocristais com tamanho médio trinta vezes menor (231nm) do que o tamanho inicial, na escala micrométrica (7,1 µm). Os nanocristais apresentaram estabilidade térmica. Não foram observadas interações entre os excipientes e os nanocristais, que, entretanto, exibiram estrutura cristalina menos definida, o que indica parcial amorfização do nanocristal. A solubilidade de saturação dos nanocristais aumentou aproximadamente três vezes; como consequência, houve aumento na VDI em 2,2 vezes, 1,8 vezes e 3,8 vezes, quando comparado à VDI da furosemida micronizada em meio SGF, tampão 4,5 e SIF, respectivamente. Quanto às avaliações in silico dos nanocristais, sua absorção oral revelou moderada alteração no perfil farmacocinético. Quando foi utilizada a via de administração pulmonar, os nanocristais apresentaram maior desempenho quando comparada a via de administração oral; destacando-se o aumento na Fa% e na Cmáx e a acentuada diminuição no Tmáx. Em conclusão, a plataforma tecnológica obtida tem potencial aplicação no desenvolvimento de formas farmacêuticas inovadoras para administração pulmonar de furosemida

According to the World Health Organization, hypertension is responsible for global public health crisis, being the cardiovascular diseases involved in approximately 17 million deaths a year, of these, 9.4 million occasioned by hypertension complications such as pulmonary edema. Regarding therapeutic arsenal available, Furosemide is a potent loop diuretic widely used in control and emergency situations related to hypertension and cardiogenic pulmonary edema. Despite the high level of prescribing, this drug belongs a class IV drug, according to Biopharmaceutics Classification System (BCS), exposing erratic and variable intestinal absorption. These characteristics represent a challenge for the development of oral dosage forms. Thus, adoption of innovative technologies associated with pulmonary route of administration may allow an alternative therapeutic approach, with high potential for application. Among the new technologies, those for obtaining nanocrystals of classes II and IV drugs have been a promising approach. Nanocrystals can exhibit in vivo higher performance when compared to their counterparts in micronized form. Therefore, strategies to develop medicines containing Furosemide, with greater efficacy and safety, are of critical importance. In this sense, the application of technology in silico, with predictive property, contributes to the rationalization of testing in research and development of new dosage forms. The objectives, as a result, were the preparation and the physicochemical characterization of Furosemide nanocrystals, and it's in silico evaluation on oral and pulmonary absorption using a computational tool. The nanocrystals were obtained using a high-energy milling technology under simultaneous revolution/rotation motion. The determination of the size distribution and morphology was performed using laser diffraction and scanning electron microscopy, respectively. Furthermore, differential scanning calorimetry, differential thermogravimetry, X-ray diffraction and Low Shift Raman spectroscopy were performed to investigate possible interactions and changes in the crystalline state of the nanocrystals. To measure the increase in the equilibrium solubility and dissolution rate, the shake flask and intrinsic dissolution rate (IDR) methods were used respectively. The nanocrystals size appeared thirty times lower (231 nm) compared to the initial size (7,1 µm). The nanocrystals were stable with concern to its thermal characteristic not showing interactions between the excipients and the nanocrystals; however, they exhibited less defined crystal structure, indicating partial amorphization. The nanocrystals saturation solubility increased approximately three times. Consequently, 2.2, 1.8 and 3.8 folds increase were observed in IDR when compared to the Furosemide raw material in SGF, buffer 4.5 and SIF, respectively. The in silico nanocrystal studies revealed moderate changes in its oral absorption and pharmacokinetic profile. When the pulmonary route of administration was used, the nanocrystals showed higher performance compared to oral route administration; highlighting the increase in Fa % and Cmax and a significant decrease in Tmax. In conclusion, the technology platform obtained has potential application in the development of innovative dosage forms for Furosemide pulmonary delivery

Nano-encapsulation of furosemide microcrystals for controlled drug release.

Furosemide microcrystals were encapsulated with polyions and gelatin to control the release of the drug in aqueous solutions. Charged linear polyions and gelatin were alternatively deposited on 5-microm drug microcrystals through layer-by-layer (LbL) assembly. Sequential layers of poly(dimethyldiallyl ammonium chloride) (PDDA) and poly(styrenesulfonate) (PSS) were followed by adsorption of two to six gelatin/PSS bilayers with corresponding capsule wall thicknesses ranging from 45 to 115 nm. The release of furosemide from the coated microparticles was measured in aqueous solutions of pH 1.4 and 7.4. At both pH values, the release rate of furosemide from the encapsulated particles was reduced by 50-300 times (for capsules coated with two to six bilayers) compared to uncoated furosemide. The results provide a method of achieving prolonged drug release through self-assembly of polymeric shells on drug microcrystals.

5-sulfamoylorthanilic acids, a sulfonamide series with salidiuretic activity.

A series of 4,N-disubstituted 5-sulfamoylorthanilic acids was synthesized by nucleophilic substitution reactions starting either from 2,4-dihalogeno-5-sulfamoylbenzenesulfonic acids or, in most cases, from phenyl 2,4-dihalogeno-5-sulfamoylbenzenesulfonates. The latter method is based on the relative stability of the phenoxysulfonyl group to nucleophiles, e.g., amines, phenols, and thiols, and the possibility of smooth hydrolytic or hydrogenolytic cleavage as a final step, with formation of the SO3H group. On evaluation of these compounds for salidiuretic activity in rats orally (po), and in dogs orally and intravenously (iv), a number of highly active substances was found; the best had a threshold dose of 0.02 mg/kg po in dogs. The results are given in tables, and the structure-activity relationships within the series are discussed. Besides the known effect of the phenoxy radical, an outstanding activating effect was shown by the butylsulfonyl and cycloalkylsulfonyl radicals and by the N-methylanilino radical in particular when they were located in the 4-position of the orthanilic acid molecule. The sulfanilic acid isomers corresponding to three of the most active compounds were synthesized and proved to be completely inactive in rats.

Bumetanide--the way to its chemical structure.

The steps in the evolution of sulfamoyl diuretics in current clinical use are outlined. The development was initiated by the chance observation of a clinical side effect of sulfanilamide, which became the first sulfamoyl group (-SO2NH2)-bearing compound used for diuretic treatment of patients. Ensuing chemical synthesis over the past three decades led to the development of three types of sulfamoyl diuretics:carbonic anhydrase inhibitors, thiazides, and the loop or high-ceiling saluretic agents represented by furosemide and bumetanide. The structural relationship of furosemide to sulfanilamide and the thiazide-type diuretics and, for bumetanide, the more specific structure for loop diuretic activity are discussed.