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    Jessica Scott

    May 17, 1999

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    What is a liposome?

    Spherical vesicles with a phospholipid bilayer

    Hydrophilic

    Hydrophobic

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    Cell Membrane

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    Uses of Liposomes

    Chelation therapy for treatment of heavy metal

    poisoning

    Enzyme replacementDiagnostic imaging of tumors

    Study of membranes

    Cosmetics

    Drug Delivery

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    Why Use Liposomes in Drug

    Delivery?

    Inactive: Unmodified liposomes gather in specific tissue

    reticuloendothelial systemActive: alter liposome surface with ligand (antibodies,enzymes, protein A, sugars)

    Directly to sitePhysical:temperature or pH sensitive liposomes

    Drug Targeting

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    Protection

    Decrease harmful side effects

    Pharmokinetics - efficacy and toxicityChanges the absorbance and biodistribution

    Change where drug accumulates in the body

    Protects drug

    Deliver drug in desired formMultidrug resistance

    Why Use Liposomes in

    Drug Delivery?

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    ReleaseAffect the time in which the drug is released

    Prolong time -increase duration of action and

    decrease administration

    Dependent on drug and liposome propertiesLiposome composition, pH and osmotic gradient, and

    environment

    Why Use Liposomes in

    Drug Delivery?

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    Modes of Liposome/Cell

    Interaction

    Adsorption Endocytosis

    Fusion Lipid transfer

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    Classes of Liposomes

    Conventional Long circulating

    Immuno

    Cationic

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    Liposomes Help Improve

    Therapeutic indexRapid metabolismUnfavorable pharmokineticsLow solubilityLack of stabilityIrritation

    Custom designLipid contentSizeSurface charge

    Method of preparation

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    Current liposomal drug

    preparationsType of Agents ExamplesAnticancer Drugs

    Anti bacterial

    Antiviral

    DNA material

    Enzymes

    Radionuclide

    Fungicides

    Vaccines

    *Currently in Clinical Trials or Approved for Clinical Use

    Malaria merozoite, Malaria sporozoite

    Hepatitis B antigen, Rabies virus glycoprotein

    Amphotericin B*

    In-111*, Tc-99m

    Hexosaminidase A

    Glucocerebrosidase, Peroxidase

    Duanorubicin, Doxorubicin*, Epirubicin

    Methotrexate, Cisplatin*, Cytarabin

    Triclosan, Clindamycin hydrochloride,

    Ampicillin, peperacillin, rifamicinAZTcDNA - CFTR*

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    CFTRGene Therapy

    Deliver cDNA of Cystic Fibrosis Transmembrane Conductance

    Regulator (CFTR) to epithelial tissue of respiratory system

    Fuse to cell membrane and

    incorporate cDNA into cell

    Clinical trials - no significant

    change in symptoms

    Now trying adeno associated

    virus

    Cationic liposome

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    DoxilChemotherapy drug doxorubin

    Anemia, damage to veins and tissue at injection, decrease

    platelet and WBC count, toxic to

    Treats Kaposis sarcoma lesions or cancer tumorsModifications of liposome stealth

    keeps doxorubin in blood for 50 hours instead of20 minutes

    concentrates at KS lesions and tumors

    *Just approved by FDA*

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    Amphotericin B

    Side effects: nephrotoxicity, chills, and fevers

    Systemic fungalinfections in immune compromised patients

    Fungizone - AmB with deoxycholate

    AmB - kills ergosterol-containing fungal cells, also

    kills cholesterol-containing human cells

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    Liposomal Formulation of AmB

    Decrease in toxicity

    Exact Mechanism of liposomes not understood

    Cholesterol - only few %moles

    Phospholipid:AmB ratio

    Diffusion

    Lipid transfer

    AmB

    Lipid

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    Problems with Liposomal

    Preparations of Drugs

    $$$$Fungizone $40.58 Amphotec $2334

    Doxil $1200 per treatment, twice the cost of normal protocolof chemotherapy and drugs

    Lack long term stability (short shelf life)

    Freeze dry and pH adjustment

    Low Pay Load - poor encapsulation

    Physical and chemical instability

    Polar drugs and drugs without opposite charge

    Modifications

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    Possibility of new side effectsDoxil hand and foot syndrome

    Problems continued

    EfficacyCFTR

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    Studies with insulin show that liposomes may

    be an effective way to package proteins

    and peptides for useClinical Trials for several liposomal formulations

    More studies on the manipulation of liposomes

    Future

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    JournalsAllen, Theresa M. "Liposomal Drug Formulations: Rationale for Development and What We Can

    Expect for the Future." Drugs 56: 747-756, 1998.

    Allen, Theresa M. "Long-circulating (sterically stabilized) liposomes for targeted drug delivery."

    TiPs 15: 214-219, 1994.

    Allen, Theresa M. "Opportunities in Drug Delivery." Drugs 54 Suppl. 4: 8-14, 1997Janknegt, Robert. "Liposomal and Lipid Formulations of Amphotericin B." Clinical Pharmacokinetics.

    23(4): 279-291, 1992.

    Kim, Anna et al. "Pharmacodynamics of insulin in polyethylene glycol-coated liposomes."

    International Journal of Pharmaceutics. 180: 75-81, 1999.

    Quilitz, Rod. "Oncology Pharmacotherapy: The Use of Lipid Formulations of Amphotericin B in Cancer

    Patients." Cancer Control.5:439-449, 1998.

    Ranade, Vasant V. "Drug Delivery Systems: Site-Specific Drug Delivery Using Liposomes as Carriers."

    Pharmacology. 29: 685-694, 1989.

    Storm, Gert and Daan J.A. Crommelin. "Liposomes:quo vadi?" PSTT1: 19-31, 1998.

    Taylor, KMG and JM Newton. "Liposomes as a vecicle for drug delivery." British Journal of Hospital

    Medicine. 51: 55-59, 1994

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    WebsitesJames, John S. "Doxil Approved for KS." www.immunet. org.imminet/atn.nsf/page/a-235-03.

    Wasan, Ellen. "Targeted Gene Transfer." Member.tripod.com/~rrishna/lipos1.html

    "Introduction to Controlled Drug Delivery Systems." www5.bae.ncsu.edu/bae/reearch/blak

    k/otherprojects/drugDeliver_97/

    http://www. Mssm.edu/medicine/thrombosis/phosphol.html"Doxorubicin." http://tirgan.com/adria.htm

    "Clinical Pharmacology Online." http://www.cponline.gsm.com/scripts/fullmono/showmono.

    "Drugstore.com" http://www.drugstore.com/pharmacy/prices/Amphotec.

    "Sequus' Doxil Becomes First Liposome Product Approved In U.S." www.slip.net/~mcdavis/

    database/doxor_1

    "Liposomes." www.collabo.com/liposom0.htm

    Paustin, Timothy. Cellular Membranes.www.bact.wisc.edu/microtextbook/bacterialstructure/Membranegen.htmlwww.cbc.umn.edu/~mwd/cell_www/chapter2/membrane.html#PHOSPHOLIPIDS

    BooksJones, Macolm N. and Chapman, David. Micelles, Monolayers and Biomembranes. Wiley-Liss.

    New York (1995).

    Garrett, R. and Grisham C. Biochemistry, 2nd

    ed. Saunders Colleges Publishing. New York (1999). 264.