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    Development of effective AmB/AmB-?CD complex double loaded liposomes using a factorial design for systemic fungal infection treatment
    (Taylor & Francis Ltd, 2021) Mutlu-Agardan, N. Basaran; Yilmaz, Sukran; Kaynak Onurdag, Fatma; Celebi, Nevin
    Amphotericin B (AmB) is a very potent antibiotic which still remains as the gold standard for the treatment of systemic fungal infections. AmB is a member of Biopharmaceutical Classification System Class IV, mainly characterized by its poor solubility and low permeability. In this study, AmB/AmB-alpha cyclodextrin complex double loaded liposomes (DLLs) were developed using the design of experiments (DoE (R)) approach to optimize/determine the effects of lipid composition and other parameters on final product properties such as encapsulation efficacy, particle size, polydispersity index, and zeta potential. Experimental design 2(4) was used for optimization of these properties in which four factors were studied in two levels. DLLs showed much higher physical stability than liposomes loaded only with free AmB by the means of particle size, zeta potential and encapsulation efficiency, in addition exhibited sustained release of AmB over 72 h (26.7%) with faster onset time. On the other hand, fourfold improved antimicrobial efficiency, minimum inhibitory concentration (0.125 mu g/ml), and minimum fungicidal concentration (0.5 mu g/ml) was determined by DLLs against C. albicans compared to Ambisome. Dose dependent effects of the DLLs were investigated by cytotoxicity studies on Vero and L-929 cells. No significant cytotoxicity observed for AmB/AmB-alpha CD complex DLLs and Ambisome at tested concentrations while free AmB caused severe cytotoxicity. Lastly the developed DLLs did not cause an increase in NGAL (an early biomarker for acute kidney toxicity) levels for both Vero and HK-2 cell lines compared to free AmB.