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Biomedical subjects

G K Khuller

Publications and source records attributed to G K Khuller.

At least 19 recordsLinked to original sources

Tuberculosis subunit vaccine design: the conflict of antigenicity and immunogenicity.

The attempts to find an effective antituberculous subunit vaccine are based on the assumption that it must drive a Th1 response. In the absence of effective correlates of protection, a vast array of mycobacterial components are being evaluated worldwide either on the basis of their ability to be recognized by T lymphocytes in in vitro assays during early stage of animal or human infection (antigenicity) or their capacity to induce T cell response following immunization in animal models (immunogenicity). The putative vaccine candidates selected using either of these strategies are then subjected to challenge studies in different animal models to evaluate the protective efficacy. Here we review the outcome of this current scheme of selection of vaccine candidates using an 'antigenicity' or 'immunogenicity' criterion on the actual protective efficacy observed in experimental animal models. The possible implications for the success of some of the leading vaccine candidates in clinical trials will also be discussed.

Animals↗

Antimycobacterial activity of econazole against multidrug-resistant strains of Mycobacterium tuberculosis.

This study evaluated the antimycobacterial activity of econazole against multidrug-resistant (MDR) strains of Mycobacterium tuberculosis. The minimum inhibitory concentration (MIC(90)) and minimum bactericidal concentration (MBC(>99.99)) against MDR strains were found to be 0.120-0.125 microg/mL and 0.125-0.150 microg/mL, respectively, demonstrating the antimycobacterial potential of econazole.

Antitubercular Agents↗

Lung and blood mononuclear cell responses of tuberculosis patients to mycobacterial proteins.

The differences in specificity of human lung and peripheral lymphocytes for mycobacterial antigens (Ag) need to be evaluated in order to identify vaccine candidates against pulmonary tuberculosis (TB). Therefore, the present study examined the response to low molecular weight secretory proteins of Mycobacterium tuberculosis in bronchoalveolar lavage (BAL) and peripheral blood mononuclear cells (PBMCs) from minimal pulmonary TB and non-TB patients. Ag85A, Ag85B, culture filtrate protein (CFP)-31, CFP-22.5, CFP-21, M. tuberculosis protein-64 and an as yet uncharacterised 19 kDa protein were found to be predominantly recognised by BAL cells of TB patients on the basis of lymphocyte proliferation and significant interferon-gamma release. However, recognition of CFP-8, 6-kDa early secreted antigenic target, CFP-10, CFP-14.5, M. tuberculosis secretory protein-17 and five other as yet uncharacterised low molecular weight polypeptides was found to be high on the basis of lymphocyte proliferation at the level of PBMCs. Furthermore, BAL macrophages, and not blood monocytes, were found to produce nitric oxide (NO) in response to mycobacterial Ags. Among polypeptides predominantly recognised by BAL lymphocytes, only Ag85A and Ag85B were found to induce both NO and interleukin-12 (p40) by alveolar macrophages. In conclusion, the present results indicate heterogeneity in antigen recognition by bronchoalveolar lavage cells and peripheral mononuclear blood cells of minimal tuberculosis patients, and also suggest the utility of antigen 85 complex polypeptides for the development of a future mucosal antituberculous vaccine.

Antigens, Bacterial↗

A multivalent combination of experimental antituberculosis DNA vaccines based on Ag85B and regions of difference antigens.

Two candidate DNA vaccines based on the proteins CFP10 and CFP21 encoded by regions of difference (RDs) of Mycobacterium tuberculosis were evaluated individually and in multivalent combination with the immunodominant protein Ag85B for induction of protective immune responses against experimental tuberculosis. Experimental DNA vaccines induced substantial levels of cell-mediated immune responses as indicated by marked lymphocyte proliferation, significant release of the Th1 cytokines IFN-gamma and IL-12 (p40), and predominant cytotoxic T cell activity. High levels of antigen-specific IgG1 and IgG2a antibodies observed in the sera of immunized mice depicted strong humoral responses generated by DNA vaccine constructs. The multivalent combination of three DNA vaccine constructs induced maximal T cell and humoral immune responses. All the experimental vaccines imparted significant protection against challenge with M. tuberculosis H(37)Rv (in terms of colony-forming unit reduction in lungs and spleen) as compared to vector controls. The level of protection exhibited by multivalent DNA vaccine formulation was found to be equivalent to that of Mycobacterium bovis BCG observed both at 4 and 8 weeks post-challenge. These results show the protective potential of the multivalent DNA vaccine formulation used in this study.

Animals↗

Oral nanoparticle-based antituberculosis drug delivery to the brain in an experimental model.

OBJECTIVES: To evaluate the potential of orally administered poly-lactide-co-glycolide (PLG, a synthetic polymer) nanoparticle encapsulated antituberculosis drugs (ATDs) (rifampicin + isoniazid + pyrazinamide + ethambutol) for cerebral drug delivery in a murine model. METHODS: The formulation was prepared using the multiple emulsion technique and administered orally to mice for biodistribution, pharmacokinetic and chemotherapeutic studies. RESULTS: A single oral dose of the formulation to mice could maintain sustained drug levels for 5-8 days in the plasma and for 9 days in the brain. There was a significant improvement in the pharmacokinetic parameters such as mean residence time and relative bioavailability as compared with free drugs. The pharmacodynamic parameters such as the ratio of area under the curve to minimum inhibitory concentration (AUC/MIC) and the time up to which MIC levels were maintained in plasma (T(MIC)) were also improved. In Mycobacterium tuberculosis H(37)Rv infected mice, five oral doses of the nanoparticle formulation administered every 10th day resulted in undetectable bacilli in the meninges, as assessed on the basis of cfu and histopathology. CONCLUSIONS: Polymeric nanoparticles bear significant potential for ATD delivery to the brain.

Administration, Oral↗

Expression and purification of the Mycobacterium tuberculosis complex-restricted antigen CFP21 to study its immunoprophylactic potential in mouse model.

Secreted proteins encoded by different regions of difference (RDs) from the genome of Mycobacterium tuberculosis have been considered as attractive candidates for vaccination against tuberculosis owing to their absence in most BCG strains. In this study, the structural gene for the RD2 locus encoding protein CFP21 was PCR amplified and expressed as a fusion protein with hexahistidine residues in Escherichia coli. Expression of CFP21 in E. coli under transcriptional regulation of the T7 promoter yielded a protein located within inclusion bodies. The inclusion bodies were solubilized in the presence of 8M urea and the protein was purified to homogeneity under denaturing conditions at low pH using nitrilotriacetic acid (Ni-NTA) affinity chromatography. The denatured protein was renatured by gradient dialysis against a decreasing concentration of urea. The purified protein was shown to have esterase activity. CFP21 protein was evaluated for immunogenicity in C57BL/6J mice. We observed an elevated T cell proliferative response and production of IFN-gamma and IL-12 (p40). CFP21 also induced an optimum level of cytotoxic T cell activity and induced a strong humoral response as indicated by higher levels of specific IgG1 and IgG2a antibody isotypes. In addition, a moderate level of protection was observed against experimental tuberculosis. This is the first report describing esterase activity of the M. tuberculosis complex-restricted protein CFP21 and its protective potential against experimental tuberculosis.

Animals↗

Protective efficacy of intranasal vaccination with Mycobacterium bovis BCG against airway Mycobacterium tuberculosis challenge in mice.

The effect of route of immunization on the protective efficacy of BCG against tuberculosis has been investigated. Immunoprotection was monitored by evaluating the bacterial burden in the lungs and spleen of mice challenged with Mycobacterium tuberculosis H(37)Rv after BCG immunization by intranasal (i.n.) and subcutaneous (s.c.) routes. Our results showed that as compared to s.c. BCG immunization, intranasal BCG vaccination induces significantly higher immune responses at local level (mediastinal lymph nodes, cervical lymph nodes and lung). Further, i.n. BCG vaccination induced significantly higher reduction in bacterial load in the lungs over s.c. BCG vaccination, whereas, the bacilli load in the spleen was comparable in both the groups. Hence, intranasal vaccination with BCG holds promise for pulmonary tuberculosis.

Administration, Intranasal↗

Azole antifungals as novel chemotherapeutic agents against murine tuberculosis.

The present study was designed to evaluate the in vivo antimycobacterial potential of econazole alone and in combination with antitubercular drugs against tuberculosis in mice. Econazole was found to reduce bacterial burden by 90% in the lungs and spleen of mice infected with 1 x 10(7) cells of Mycobacterium tuberculosis and was found to be equipotent to rifampicin. Further, our results indicate that econazole can replace rifampicin/isoniazid as well as both rifampicin and isoniazid in chemotherapy of murine tuberculosis. Econazole alone or in combination with antitubercular drugs did not produce any hepatotoxicity in normal or M. tuberculosis-infected mice.

Animals↗

Nanotechnology based drug delivery system(s) for the management of tuberculosis.

The era of nanotechnology has allowed new research strategies to flourish in the field of drug delivery. Nanoparticle-based drug delivery systems are suitable for targeting chronic intracellular infections such as tuberculosis. Polymeric nanoparticles employing poly lactide-co-glycolide have shown promise as far as intermittent chemotherapy in experimental tuberculosis is concerned. It has distinct advantages over the more traditional drug carriers, i.e. liposomes and microparticles. Although the experience with natural carriers, e.g. solid lipid nanoparticles and alginate nanoparticles is in its infancy, future research may rely heavily on these carrier systems. Given the options for oral as well as parenteral therapy, the very nature of the disease and its complex treatment urges one to emphasize on the oral route for controlled drug delivery. Pending the discovery of more potent antitubercular drugs, nanotechnology-based intermittent chemotherapy provides a novel and sound platform for an onslaught against tuberculosis.

Animals↗

Oral poly(lactide-co-glycolide) nanoparticle based antituberculosis drug delivery: toxicological and chemotherapeutic implications.

The present study reports on the detailed toxicological and chemotherapeutic evaluation of antituberculosis drug loaded nanoparticles in mice. A single oral dose administration of poly(lactide-co-glycolide) (PLG, a synthetic polymer) nanoparticles containing rifampicin+isoniazid+pyrazinamide+ethambutol could maintain drug levels in various tissues for 9-10 days and did not elicit any adverse response even when administered at several fold higher than the recommended therapeutic dose. However, dosing with conventional free drugs at the equivalent higher doses was lethal. Despite multiple oral dosing with the formulation at every 10th day, no toxicity was observed on the completion of subacute (28 days) or chronic (90 days) toxicity studies based on survival, gross pathology, histopathology, blood biochemistry and hematology. In mice harboring a high mycobacterial load (mimicking human tuberculosis), two independent chemotherapeutic regimens, i.e. 5 doses of PLG nanoparticles encapsulating (rifampicin+isoniazid+pyrazinamide+ethambutol) administered 10 days apart, or 2 doses of the 4-drug formulation followed by 3 doses of 2-drug formulation (rifampicin+isoniazid) resulted in undetectable bacilli. Further, the efficacy was comparable to 46 daily doses of oral free drugs. Therefore, the experimental evidence suggests that PLG nanoparticle-based antituberculosis drug delivery system is safe and well suited for prolonged and intermittent oral chemotherapy.

Administration, Oral↗

Oral solid lipid nanoparticle-based antitubercular chemotherapy.

The present study was planned to evaluate the chemotherapeutic potential of oral solid lipid nanoparticles (SLNs) incorporating rifampicin, isoniazid and pyrazinamide against experimental tuberculosis. The SLNs were prepared by the "emulsion solvent diffusion" technique with an encapsulation efficiency of 51+/-5% for rifampicin, 45+/-4% for isoniazid and 41+/-4% for pyrazinamide. Following a single oral administration to mice, therapeutic drug concentrations were maintained in the plasma for 8 days and in the organs (lungs, liver and spleen) for 10 days whereas free drugs were cleared by 1-2 days. In M. tuberculosis H37Rv infected mice, no tubercle bacilli could be detected in the lungs/spleen after 5 oral doses of drug loaded SLNs administered at every 10th day whereas 46 daily doses of oral free drugs were required to obtain an equivalent therapeutic benefit. Thus, SLN based antitubercular drug therapy forms a sound basis for reducing dosing frequency and improving patient compliance for better management of tuberculosis.

Administration, Oral↗

In vitro and ex vivo antimycobacterial potential of azole drugs against Mycobacterium tuberculosis H37Rv.

The antimycobacterial activity of two clinically approved antifungal azole drugs, clotrimazole and econazole, was evaluated against Mycobacterium tuberculosis H37Rv under in vitro and ex vivo conditions. The minimum inhibitory concentration (MIC90) was 0.120 microg ml(-1), whereas the minimum bactericidal concentration and effective concentration was 0.125 microg m l(-1) for both the drugs demonstrating their potent antimycobacterial activity. Further, the azole drugs exhibited a synergistic activity with either rifampicin or isoniazid as evaluated on the basis of reduction of colony forming units. The results suggest that azole compounds bear the potential to enhance the efficacy of currently prescribed antitubercular drugs.

Anti-Bacterial Agents↗

Immunodominance of low molecular weight secretory polypeptides of Mycobacterium tuberculosis to induce cytotoxic T-lymphocyte response.

The cytotoxic T-lymphocyte (CTL) responses to culture filtrate antigens of Mycobacterium tuberculosis H(37)Rv (RvCFP) and purified protein derivative (PPD) were investigated in active pulmonary tuberculosis patients, healthy tuberculosis contacts and non-contacts. Healthy tuberculin skin test (Mantoux) positive tuberculosis contacts demonstrated strong CTL response against RvCFP and Mantoux reactivity was found to correlate with CTL response. The specificity of CTL response in healthy Mantoux positive contacts was further assessed using different molecular weight fractions of RvCFP. Peripheral blood mononuclear cells (PBMCs) derived CTLs recognized multiple antigenic targets and demonstrated predominant cytotoxicity against low molecular weight (below 15 kDa) protein fractions as well as those migrated in the region of 30 kDa. Subsequently, evaluation of CTL responses against selected purified prominent T-cell antigens indicated maximum CTL response directed against Ag 85 complex proteins; most notably Ag 85 A. From this study, it is suggested that identification of more mycobacterial antigens activating various CTL subsets could be an important step for the rational designing of future antituberculous vaccine.

Acyltransferases↗

Nano-encapsulation of azole antifungals: potential applications to improve oral drug delivery.

The present study was designed to improve the oral bioavailability of two clinically important antifungal drugs-clotrimazole and econazole. Each drug was encapsulated in nanoparticles of a synthetic polymer (polylactide-co-glycolide, PLG) or a natural polymer (alginate stabilized with chitosan). The nanoparticles were prepared by the emulsion-solvent-evaporation technique in case of PLG and by the cation-induced controlled gelification in case of alginate. Drug encapsulation efficiency was better (>90%) for the alginate formulation compared with the PLG formulation (nearly 50%). The formulations were orally administered to mice and the drugs were analyzed in plasma by a validated HPLC technique. The biodistribution/pharmacokinetic data suggested that there was a controlled drug release for 5-6 days with each of the formulations, compared with unencapsulated drugs, which were cleared within 3-4 h of oral/intravenous administration. There was a striking improvement in the relative and absolute bioavailability of each drug. Further, the drugs were detected in the tissues (lungs, liver and spleen) till 6-8 days in case of nanoparticles whereas free drugs were cleared by 12 h. Overall, the alginate formulation appeared to be better than the PLG formulation. The results emphasize the power of nanotechnology to make the concept of enhancement in oral bioavailability of azole antifungal drugs come to reality.

Administration, Oral↗

Multicomponent antituberculous subunit vaccine based on immunodominant antigens of Mycobacterium tuberculosis.

The low molecular mass polypeptides of secretory proteome of Mycobacterium tuberculosis are dominant targets for recognition by lymphocytes of human models of immunity to tuberculosis. In the present study, we evaluated the inherent immunogenicity of 102 individual polypeptides purified from low molecular mass region below 40kDa in mouse model of immunization. The aim of this study was to identify molecules relevant for development of subunit vaccine against tuberculosis based on high degree of immunogenecity. Here, we demonstrate that experimental multicomponent subunit vaccine (MSV) consisting of five immunodominant polypeptides with high immunogenicity (CFP-25, CFP-20.5, Ag85B, Ag85A and CPF-32) induced both cellular and humoral immune responses characterized by Th1 and Th2 cytokine induction and imparted significant protection when administered with DDA-MPL adjuvants in C57BL/6J mice. The degree of protection imparted by experimental MSV on the basis of decrease in CFU's from target organs (lungs and spleen) was comparable to BCG and total mycobacterial culture filtrate proteins (CFPs) based vaccines. These results, therefore, suggest the potential of multicomponent subunit vaccination against tuberculosis based on strongly immunogenic proteins of M. tuberculosis.

Animals↗

Antitubercular inhaled therapy: opportunities, progress and challenges.

Pulmonary tuberculosis remains the commonest form of this disease and the development of methods for delivering antitubercular drugs directly to the lungs via the respiratory route is a rational therapeutic goal. The obvious advantages of inhaled therapy include direct drug delivery to the diseased organ, targeting to alveolar macrophages harbouring the mycobacteria, reduced risk of systemic toxicity and improved patient compliance. Research efforts have demonstrated the feasibility of various drug delivery systems employing liposomes, polymeric microparticles and nanoparticles to serve as inhalable antitubercular drug carriers. In particular, nanoparticles have emerged as a remarkably useful tool for this purpose. While some researchers have preferred dry powder inhalers, others have emphasized nebulization. Beginning with the respiratory delivery of a single antitubercular drug, it is now possible to deliver multiple drugs simultaneously with a greater therapeutic efficacy. More experience and expertise have been observed with synthetic polymers, nevertheless, the possibility of using natural polymers for inhaled therapy has yet to be explored. Several key issues such as patient education, cost of treatment, stability and large scale production of drug formulations, etc. need to be addressed before antitubercular inhaled therapy finds its way from theory to clinical reality.

Administration, Inhalation↗

Inhalable alginate nanoparticles as antitubercular drug carriers against experimental tuberculosis.

Pharmacokinetic and chemotherapeutic studies have been carried out with aerosolised alginate nanoparticles encapsulating isoniazid (INH), rifampicin (RIF) and pyrazinamide (PZA). The nanoparticles were prepared by cation-induced gelification of alginate and were 235.5 +/- 0 nm in size, with drug encapsulation efficiencies of 70-90% for INH and PZA and 80-90% for RIF. The majority of particles (80.5%) were in the respirable range, with mass median aerodynamic diameter of 1.1 +/- 0.4 microm and geometric standard deviation of 1.71 +/- 0.1 microm. The relative bioavailabilities of all drugs encapsulated in alginate nanoparticles were significantly higher compared with oral free drugs. All drugs were detected in organs (lungs, liver and spleen) above the minimum inhibitory concentration until 15 days post nebulisation, whilst free drugs stayed up to day 1. The chemotherapeutic efficacy of three doses of drug-loaded alginate nanoparticles nebulised 15 days apart was comparable with 45 daily doses of oral free drugs. Thus, inhalable alginate nanoparticles can serve as an ideal carrier for the controlled release of antitubercular drugs.

Aerosols↗

Solid lipid particle-based inhalable sustained drug delivery system against experimental tuberculosis.

The present study was planned to evaluate the chemotherapeutic potential of nebulized solid lipid particles (SLPs) incorporating rifampicin, isoniazid and pyrazinamide against experimental tuberculosis. The SLPs prepared by the "emulsion solvent diffusion" technique possessed a favourable mass median aerodynamic diameter suitable for bronchoalveolar drug delivery. Following a single nebulization to guinea pigs, therapeutic drug concentrations were maintained in the plasma for 5 days and in the organs (lungs, liver and spleen) for 7 days whereas free drugs were cleared by 1-2 days. The mean residence time and drug bioavailability were improved several-fold in the case of drug-loaded SLPs. A similar pharmacokinetic profile was observed in Mycobacterium tuberculosis-infected guinea pigs. On nebulization of drug-loaded SLPs to infected guinea pigs at every 7th day, no tubercle bacilli could be detected in the lungs/spleen after 7 doses of treatment whereas 46 daily doses of orally administered drugs were required to obtain an equivalent therapeutic benefit. Further, there was no evidence of any biochemical hepatotoxicity. Thus, nebulization of SLP-based antitubercular drugs forms a sound basis for improving drug bioavailability and reducing the dosing frequency for better management of pulmonary tuberculosis.

Administration, Inhalation↗