Prof. Lewis’ group used the multicomponent complex formation of CDs with hydroxy acids to improve the pharmacokinetic of voriconazole.
Fungal keratitis is one of the leading causes of ophthalmic mycosis affecting the vision due to corneal scarring. Voriconazole (VRC) is the most preferred azole antifungal agent for treating ocular mycotic infections. Ocular drug delivery is challenging due to the shorter corneal residence time of the formulation requiring frequent administration, leading to poor patient compliance. The present study aimed at improving the solubility, transcorneal permeation, and efficacy of voriconazole via the formation of cyclodextrin-based ternary complexes with SBEBCD and succinic acid and incorporation of the complex into mucoadhesive films (Soluplus). A phase solubility study suggested a ∼14-fold improvement in VRC solubility, whereas physicochemical characterization confirmed the inclusion of VRC in the cyclodextrin inner cavity. In silico docking studies were performed to predict the docking conformation and stability of the inclusion complex. Complex-loaded films showed sustained release of voriconazole from the films and improved transcorneal permeation by ∼4-fold with an improved flux of 8.36 μg/(cm2 h) for ternary complex-loaded films compared to 1.86 μg/(cm2 h) for the pure VRC film. The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) and hen’s egg-chorioallantoic membrane test (HET-CAM) assays confirmed that the complexes and ocular films were nonirritant and safe for ocular administration. The antifungal study performed using Aspergillus fumigatus and Fusarium oxysporum suggested improved antifungal activity compared to the pure drug film. In conclusion, the supramolecular cyclodextrin ternary complex proved to be a promising strategy for enhancing the solubility and permeability and augmenting the antifungal activity of voriconazole in the management of fungal keratitis.
Pooja Suvarna, Pinal Chaudhari, Sumit Birangal, Lakshmi Sruthi Mallela, Sanhita Roy, Ananthamurthy Koteshwara, Jesil Mathew Aranjani, and Shaila Angela Lewis (2022) Voriconazole–Cyclodextrin Supramolecular Ternary Complex-Loaded Ocular Films for Management of Fungal Keratitis. Mol. Pharmaceutics 19, 1, 258–273. https://doi.org/10.1021/acs.molpharmaceut.1c00746