Clofazimine, a drug previously used to treat leprosy, has recently been identified as a potential new drug for the treatment for cryptosporidiosis: a diarrheal disease that contributes to 500 000 infant deaths a year in developing countries. Rapid dissolution and local availability of the drug in the small intestine is considered key to the treatment of the infection. However, the commercially available clofazimine formulation (Lamprene) is not well-suited to pediatric use, and therefore reformulation of clofazimine is desirable. Development of clofazimine nanoparticles through the process of flash nanoprecipitation (FNP) has been previously shown to provide fast and improved drug dissolution rates compared to clofazimine crystals and Lamprene. In this study, we investigate the effects of milk-based formulations (as possible pediatric-friendly vehicles) on the in vitro solubilization of clofazimine formulated as either lecithin- or zein/casein-stabilized nanoparticles. Milk and infant formula were used as the lipid vehicles, and time-resolved synchrotron X-ray scattering was used to monitor the presence of crystalline clofazimine in suspension during in vitro lipolysis under intestinal conditions. The study confirmed faster dissolution of clofazimine from all the FNP formulations after the digestion of infant formula was initiated, and a reduced quantity of fat was required to achieve similar levels of drug solubilization compared to the reference drug material and the commercial formulation. These attributes highlight not only the potential benefits of the FNP approach to prepare drug particles but also the fact that enhanced dissolution rates can be complemented by considering the amount of co-administered fat in lipid-based formulations to drive the solubilization of poorly soluble drugs.
Clofazimine, a drug previously used to treat leprosy, has recently been identified as a potential new drug for the treatment for cryptosporidiosis: a diarrheal disease that contributes to 500 000 infantdeaths a year in developing countries. Rapid dissolution and local availability of the drug in the small intestine is considered key to the treatment of the infection. However, the commercially available clofazimine formulation (Lamprene) is not well-suited to pediatric use, and therefore reformulation of clofazimine is desirable. Development of clofazimine nanoparticles through the process of flash nanoprecipitation (FNP) has been previously shown to provide fast and improved drug dissolution rates compared to clofazimine crystals and Lamprene. In this study, we investigate the effects of milk-based formulations (as possible pediatric-friendly vehicles) on the in vitro solubilization of clofazimine formulated as either lecithin- or zein/casein-stabilized nanoparticles. Milk and infant formula were used as the lipid vehicles, and time-resolved synchrotron X-ray scattering was used to monitor the presence of crystalline clofazimine in suspension during in vitro lipolysis under intestinal conditions. The study confirmed faster dissolution of clofazimine from all the FNP formulations after the digestion of infant formula was initiated, and a reduced quantity of fat was required to achieve similar levels of drug solubilization compared to the reference drug material and the commercial formulation. These attributes highlight not only the potential benefits of the FNP approach to prepare drug particles but also the fact that enhanced dissolution rates can be complemented by considering the amount of co-administered fat in lipid-based formulations to drive the solubilization of poorly soluble drugs.
Entities:
Keywords:
X-ray scattering; clofazimine; drug solubilization; in vitro digestion; infant formula; milk; nanoparticles
Clofazimine is a riminophenazine antibiotic
that has been used
for the treatment of multibacillary leprosy in a multidrug therapy
recommended by the World Health Organization (WHO).[1] Its efficacy against Mycobacterium tuberculosis has also been evaluated because of the emergence of multidrug-resistant
strains.[2] More recently, clofazimine was
identified as a potential new drug for the treatment of cryptosporidiosis.[3] Cryptosporidiosis is an infection of the epithelial
cells in the gastrointestinal and respiratory tracts by Cryptosporidium parasites[4] and is one of the leading causes of diarrhea in children in developing
countries.[5] Children under the age of five,
particularly those who are immunocompromised, are susceptible to Cryptosporidium infections where the diarrhea can
cause severe dehydration and malnutrition that can lead to diarrheadeaths: more than 500 000 children die each year from diarrheal
diseases,[6] and only one drug (nitazoxanide)
has currently been approved as an oral suspension for systematic treatment
of cryptosporidiosis.[7] An oral suspension
is not favored for use in challenging climate conditions from a stability
standpoint, and consequently there is therefore an urgent need to
develop new solid-state drug formulations to achieve local and fast
onset treatment with high efficacy for pediatric populations.Clofazimine is a lipophilic compound (log P =
7.51; chemical structure in Figure ) that is categorized as either a class II
or class IV drug in the biopharmaceutics classification system.[8] Hence, the dissolution rate of clofazimine in
the gastrointestinal tract can become the rate-limiting step in oral
absorption.[9] In the treatment of gut-resident
cryptosporidiosis, rapid and complete dissolution of the drug is required
for optimal treatment. A range of formulation approaches has been
made to enhance the solubility and dissolution rate of clofazimine,
including complexation,[10] formation of
clofazimine salts,[11,12] encapsulation of clofazimine
in polymeric or silica nanoparticles (NPs)[13,14] and liposomes,[15] incorporation of clofazimine
in self-microemulsifying drug delivery systems,[16] and size reduction via high-pressure homogenization and
milling.[17] More recently, the formation
of clofazimine NPs using flash nanoprecipitation (FNP) followed by
spray-drying to produce fine powders that can be readily reconstituted
in aqueous solution for pediatric use has been reported.[18,19] FNP is a process of nanoprecipitation where the rapid, controlled
mixing between an aqueous phase and an organic phase containing a
drug and an amphiphilic stabilizer induces high supersaturation conditions
that lead to precipitation and encapsulation of hydrophobic drugs.[20,21] The dissolution rates of clofazimine NPs in suspensions have been
shown to be superior compared to Lamprene, the current commercial
formulation based on micronized drug in an oil–wax matrix within
50 or 100 mg capsules.[18]
Figure 1
Schematic representation
of the concept of this study on investigating
the solubilization of clofazimine (in the form of NPs produced by
the FNP process, clofazimine API crystals, and clofazimine in commercially
available capsules) in milk or IF during in vitro digestion.
Schematic representation
of the concept of this study on investigating
the solubilization of clofazimine (in the form of NPs produced by
the FNP process, clofazimineAPI crystals, and clofazimine in commercially
available capsules) in milk or IF during in vitro digestion.We have previously gained a new
understanding of milk as a pediatric
drug delivery system for poorly water-soluble drugs by considering
the impact of digestion on the lipid species produced and their subsequent
interaction with drugs during the digestion process.[22−25] Full cream milk typically contains 3.5–4.0% w/v fat, of which
about 98% are triglycerides and could potentially serve as a lipid-based
formulation for the delivery of poorly water-soluble drugs for pediatric
acceptability.[25−27] Previous reports have shown that administration of
clofazimine with fat-containing food can improve the oral bioavailability,
although the results are highly variable.[28,29] Administration of clofazimine with a high-fat meal, for example,
has been shown to improve the bioavailability of clofazimine compared
to fasting.[29] Clofazimine should therefore
be taken with food or milk, as recommended by WHO,[30] although the effects of milk on the solubilization of clofazimine
are unclear and no bioavailability studies have been conducted.Considering the poor aqueous solubility of clofazimine and its
proposed use in pediatric treatment, the behavior of clofazimine formulations
in the presence of digesting milk was studied. To further understand
the behavior of clofazimine NPs in the gastrointestinal tract after
oral administration with milk-based systems, in this work, the solubilization
behavior of the different clofazimine formulations (NPs, reference
drug, and the commercial formulation) during in vitro intestinal digestion
was investigated using synchrotron small-angle X-ray scattering (SAXS).
This approach enables the kinetics and the extent of drug solubilization
to be determined and also enables potential identification of any
intermediate solid-state forms of the drug which may form during digestion
as clofazimine is known to exhibit polymorphism and solvatomorphism.[11,31] As differences in the molecular packing can give rise to different
physical properties including melting point, dissolution, and solubility,
these different crystalline forms can potentially affect the stability
and oral bioavailability of clofazimine, and the characterization
of the polymorphs and their transformations is of great importance.
The influence of the types of lipids on the solubilization of clofazimine
was probed using milk and a low-lactoseinfant formula (IF). The use
of IF is particularly advantageous as it allows a wide range of fat
contents to be explored by the use of varying amounts of IF powder
dispersed in the system. High-performance liquid chromatography (HPLC)
was used to quantify the phase distributions of clofazimine in milk
and IF during and after digestion.
Experimental Methods
Materials
Clofazimine active pharmaceutical ingredient
(API) (≥98% purity), Trizma maleate reagent grade, sodium azide
(≥99%, Fluka), and 4- bromophenylboronic acid (4-BPBA, >95%
purity) were purchased from Sigma-Aldrich (St. Louis, Missouri). Lamprene
capsules were sourced from Novartis Pharmaceuticals Corp., East Hanover,
NJ. Calcium chloride dihydrate (>99% purity), sodium hydroxide
pellets
(minimum 97% purity), and salicylic acid were purchased from Ajax
Finechem (New South Wales, Australia). Hydrochloric acid (36%) was
purchased from LabServ (Ireland). Sodium chloride (>99% purity)
was
purchased from Chem Supply (South Australia, Australia). Lipase (USP-grade
pancreatin extract) was purchased from Southern Biologicals (Victoria,
Australia). Bovine milk (Pauls brand, 3.8% and 4.7 wt % fat) was purchased
from local supermarkets (Victoria, Australia). IF powder (brand not
disclosed as it is commercial-in-confidence) was generously provided
by Medicines for Malaria Venture (Geneva, Switzerland). Nutritional
information for the milk and the IF used in this study is summarized
in Table S1 in the Supporting Information. Medium-chaintriglycerides (MCTs, triglycerides of caprylic/capric
acid, Labrafac WL 1349) were a generous gift from Gattefossé
(Saint-Priest, France). Long-chain triglycerides (LCTs) containing
high amounts of sn-2 palmitate (Infat CC) were a
gift from Enzymotec Ltd. (Midgal HaEmek, Israel). Milk fat globular
membrane (MFGM-enriched whey protein concentrate) was a generous gift
from Arla Food Ingredients (Viby J, Denmark). Water was sourced from
Milli-Q Millipore purification systems (Merck Millipore, Australia).
Unless otherwise stated, all chemicals were used without further purification.
Preparation of Clofazimine Nanoparticles Using Flash Nanoprecipitation
The clofazimine NPs were prepared using zein (a hydrophobic protein)[32] and lecithin (mixtures of phospholipids) as
the stabilizers, as they are generally recognized as safe ingredients.
NPs were formed via FNP using a multi-inlet vortex mixer (MIVM) as
previously described.[18,19,33] In brief, for the lecithin-stabilized formulation, clofazimine was
dissolved at 50 mg/mL along with lecithin at 25 mg/mL in tetrahydrofuran
and fed into an MIVM at 16 mL/min using a Harvard syringe pump apparatus.
Three water streams, each at 36 mL/min, were also fed to the mixer.
The resulting NPs were subsequently mixed with concentrated mannitol
solution with an NP/mannitol weight ratio of 1:3 before drying using
a B-290 mini spray-dryer (Büchi Corp., New Castle, DE) under
conditions reported previously.[19] For the
zein/casein formulation, four different streams were fed to the MIVM:
(1) clofazimine at 6 mg/mL in acetone, (2) zein in 60%/40% ethanol/water
v/v at 6 mg/mL, (3) citrate buffer at pH 7.4, and (4) sodium caseinate
at 1 mg/mL in citrate buffer at pH 7.4.[18] These particles were also spray-dried. The NP powder samples were
stored in a freezer at −20 °C after preparation. The schematic
diagram and the mechanistic description for the formation of NPs are
outlined in the Supporting Information,
Figure S1. The size distributions of lecithin and zein/casein-stabilized
NPs in water are shown in Figure S2 in the Supporting Information.
Preparation of Lipid Formulations and In
Vitro Lipolysis Experiments
Dispersions of clofazimineAPI,
Lamprene, and the zein/casein-
and lecithin-stabilized clofazimine NPs were prepared by the addition
of 50 mg clofazimine (and in the case of Lamprene and the NPs, the
appropriate mass of formulation to match this mass of drug) to 2.5
mL of water and 0.25 mL of 1 M HCl. The amount of drug present in
the digesting formulation was selected from preclinical results that
validated the local concentration when completely dissolved. The drug
solution was mixed with 17.5 mL of the medium for testing. The different
media were digestion buffer alone (no fat), milk, IF of specific fat
content (Table ),
dispersions of MCTs, LCTs, or 0.5 wt % methyl cellulose (MC)/0.5 wt
% Tween 80 (T80) prepared in digestion buffer. The digestion buffer
was 50 mM tris maleate containing 5 mM CaCl2·2H2O, 6 mM NaN3 and 150 mM NaCl, adjusted to pH 6.5
(see Table ). The
dispersions of MCTs and LCTs were prepared by mixing the triglycerides
(0.76 g) with MFGM (0.11 g) as an emulsifier in 10 mL of digestion
buffer prior to ultrasonication at 2 s on/off cycles and 25% amplitude
with 3 and 4 min processing times (Misonix S-4000 ultrasonic liquid
processor, NY, USA) for the MCTs and LCTs, respectively. The volume
of the samples was subsequently adjusted to 20 mL with the digestion
buffer.
Table 1
Summary of the Fat Content Used in
the Formulations
formulation
fat content (w/v, %)
amount
of
fat in the formulation (g)
ratio of
CFZ API equivalent to fat (mg/g)
tris buffer
0.0
0.00
N/A
milk
4.7
0.82
60.8
3.8
0.67
74.6
IF
7.8
1.37
36.5
3.8
0.67
74.6
2.0
0.35
142.9
1.0
0.18
277.8
0.25
0.04
1250
For subsequent lipolysis experiments, the drug mixtures
were added
to a thermostatted glass vessel at 37 °C under constant magnetic
stirring, and the pH of the samples was adjusted to 6.500 ± 0.005
prior to the injection of pancreatin solution (2.25 mL, with approximately
700 tributyrin unit/mL of digest) to initiate lipolysis. The pancreatin
lipase solution was prepared from the pancreatin extract using the
methods previously described.[34] The pH
of the samples was maintained at 6.5 during digestion by the automatic
dosing unit of the pH-stat apparatus (902 STAT titration system, Metrohm
AG, Herisau, Switzerland) using 2 M NaOH. All of the lipolysis experiments
reported herein were performed in the absence of bile salts (that
could serve to accelerate lipid digestion and drug solubilization)
with high enzymatic activity; it is important to recognize that the
conditions in the small intestine of malnourished children with chronic
diarrheal disease differ from that of healthy patients and that such
conditions are not well characterized; so, they are used here as nominal
reference points.[35]
Synchrotron SAXS Measurements
Flow-through
Measurements
The pH-stat digestion apparatus
was interfaced to the SAXS and wide-angle X-ray scattering (WAXS)
beamline at the Australian Synchrotron (ANSTO, Clayton, Victoria),
as has been described previously.[27] The
samples from the digestion vessel (after pH adjustment to 6.5) were
aspirated through a fixed quartz capillary (Charles Supper Co., Natick,
MA, USA) mounted in the X-ray beam (wavelength = 0.954 Å, photon
energy = 13 keV) using a peristaltic pump operating at approximately
10 mL/min. Two-dimensional SAXS images were acquired using a Pilatus
1 M detector with a 5 s acquisition time and a 15 s delay with a sample-to-detector
distance of 562 mm (covering a q range of 0.04 < q < 1.82 Å–1), where q = (4π/λ)sin θ, with λ being the photon wavelength
and 2θ the scattering angle. The raw data were reduced to scattering
functions I(q) versus q using the in-house developed software package Scatterbrain version
2.71.
Static Capillary Measurements
Diffraction patterns
of the clofazimineAPI powder and the spray-dried clofazimine NPs
(zein/casein- and lecithin-stabilized) were acquired using the SAXS/WAXS
beamlines at the Australian Synchrotron (ANSTO, Clayton, Victoria).
The powder samples were loaded into special glass microcapillaries
of 1.5 mm outer diameter (Charles Supper Co., Natick, MA, USA) and
placed in the X-ray beam (wavelength = 0.954 Å, photon energy
= 13 keV). Acquisition times of 1 s were used, and the sample-to-detector
distance was 560 mm to give a q range of 0.04 < q < 1.95 Å–1.
Hot-Stage
Measurements
X-ray diffraction measurements
of clofazimine across a range of temperatures were performed to confirm
the identities of the drug polymorphs by correlation with the known
temperature-dependent solid-state transformations.[31] ClofazimineAPI and the NP powder samples were placed on
glass cover slips and covered with Kapton tape. The samples were secured
in a Mettler Toledo FP82HT hot stage, with the sample window placed
in
the X-ray beam (wavelength = 0.954 Å, photon energy = 13 keV),
and the temperature of the hot stage was increased at 10 °C/min
until no diffracted X-rays from crystallites were detected. Acquisition
times of 1 s were used with a 11 s delay between acquisitions while
heating (corresponding to steps of 2 °C, one measurement every
12 s), and the sample-to-detector distance was 572 mm to give a q range of 0.04 < q < 1.93 Å–1.
Quantification and Distribution of Clofazimine
in the Digested
Formulations
Digested samples containing clofazimine in lipid-free
(buffer only) and lipid-based formulations were collected before (0
min) and during digestion at predetermined time points (2, 5, 30,
and 60 min). The enzymatic activity of the lipase was inhibited using
0.5 M 4-BPBA prepared in methanol, where 2 μL was added to 200
μL samples prior to ultracentrifugation at 434 900g for 1 h. The resultant lipid phase (lower density than
the supernatant), aqueous supernatant phase, and the pellet phase
(higher density than the supernatant) were collected separately, and
the drug in each layer was extracted using methanol (500 μL
of methanol for the pellet and lipid layers, and 400 μL in 100
μL of the aqueous supernatant layer). The methanol used for
extraction contained salicylic acid as an internal standard for HPLC.[36] The samples were then vortexed and ultrasonicated
in a water bath sonicator for approximately 40 min prior to centrifugation
at 16 160g for 7 min. The supernatants were
collected and diluted with the mobile phase for the HPLC measurements
(26:74 v/v 0.25 M sodium acetate trihydrate, pH 3.3/methanol). The
separation of clofazimine was performed using a 150 mm long reversed-phase
C8 column (Phenomenex Luna, 5 μm particle size, 100 Å pore
size, and 4.6 mm inner diameter) at 35 °C on a Shimadzu Nexera
system based on isocratic elution with UV detection at 286 nm. The
injection volume of the samples was 10 μL and the flow rate
was 1 mL/min. The concentrations of clofazimine were determined based
on the standard curves prepared from 0.01 to 40.0 μg/mL in the
relevant digested media (buffer, IF, or milk).
Results and Discussion
Solid-State
Forms of Clofazimine and the Effects of Heating
Previous
studies have shown that polymorphs of clofazimine can
be identified as form (F) I, II, III, and IV, with the thermodynamic
stability of the solids predicted to be in the order of F III >
F
II > F I at room and physiological temperatures,[31] whereas clofazimine F IV was only seen at high temperatures
of approximately 91 °C.[31] The X-ray
diffraction pattern of commercially available clofazimine sourced
from Sigma-Aldrich (marked API in Figure a) is the F I polymorph, which is known to
be arranged in a triclinic lattice with two molecules per unit cell.[37] The evaluation of the solid forms of clofazimine
after the FNP process revealed the presence of different polymorphs
with varying degrees of crystallinity observed depending on the types
of stabilizers used (upper two profiles in Figure a). The X-ray diffraction pattern for lecithin-stabilized
clofazimine NPs contained high-intensity well-defined Bragg peaks,
including signals from both clofazimine and the mannitol excipient
crystals (indicated by “+” in Figure a, with Figure S3 in the Supporting Information showing the X-ray diffractogram of
mannitol[38]), whereas the zein/casein-stabilized
NPs possessed less-intense diffraction peaks that were indicative
of lower crystallinity. The lack of crystallinity of clofazimine in
the zein/casein NPs was also reflected by the previously reported
broadening of the melting temperature range and lower onset of melting
temperature in the zein/casein-stabilized NPs when compared to clofazimineAPI.[18]
Figure 2
(a) X-ray scattering patterns for clofazimine
API, lecithin-, and
zein/casein-stabilized NPs, and (b) close-up view of the zein/casein
NP powder pattern after background subtraction from an empty capillary.
Positions of the mannitol peaks are indicated by “+”
in panel (a), and the asterisk symbol “*” in panel (b)
illustrates the F I peak of interest.
(a) X-ray scattering patterns for clofazimineAPI, lecithin-, and
zein/casein-stabilized NPs, and (b) close-up view of the zein/casein
NP powder pattern after background subtraction from an empty capillary.
Positions of the mannitol peaks are indicated by “+”
in panel (a), and the asterisk symbol “*” in panel (b)
illustrates the F I peak of interest.The analysis of the peak positions for lecithin- and zein/casein-stabilized
NPs indicated that both the samples contained clofazimine in the F
I polymorph. The scattering peak at q = 0.66 Å–1, which was only present for the F I polymorph,[31] was clearly seen for lecithin NPs in Figure a and is clearer
for zein/casein NPs in the expanded view in Figure b, labeled by an asterisk. However, peaks
belonging to the F II polymorph were also observed in the zein/casein
NP powder, with the characteristic peaks observed at q = 0.55 and 0.95 Å–1. The diffraction peaks
of the F II polymorph had higher intensities than the diffraction
peaks of the F I polymorph, indicating that F II was the dominant
polymorph for the zein/casein NPs. In the lecithin NP powder, peaks
that did not belong to the F I polymorph also appeared but were not
attributable to the other clofazimine polymorphs and could arise from
the mannitol crystals in the excipients.[18,19] The positions of the peaks in the NP samples and the four polymorphs
of clofazimine (data from the literature) are summarized in Table
S2 in the Supporting Information, and the
identifier codes for the Cambridge Structural Database were DAKXUI01
(F I), DAKXUI (F II), DAKXUI03 (F III), and DAKXUI02 (F IV).Previous reports have suggested that the transformations of clofazimine
from one polymorphic form to another could also occur with changes
in temperature, depending on the initial polymorphs present.[31] The clofazimine F IV polymorph was only seen
after heating of the F II polymorph to ∼91 °C, whereas
no changes in crystal structure occurred during the heating of the
F I and F III polymorphs.[31] Therefore,
no structural changes were anticipated during the heating of clofazimineAPI and the lecithin NP samples, but the polymorphic transformation
from the F II to the F IV polymorph could take place in the zein/casein
NP powders.To test this hypothesis, clofazimineAPI and the
NP samples were
heated until no observable diffraction peaks were present, and the
X-ray scattering profiles obtained during the heating cycle are shown
in Figure . The diffraction
peaks from the F I polymorph in clofazimineAPI disappeared after
heating to approximately 228 °C, and no observable new peaks
were observed during heating, indicating an absence of polymorphic
transitions. In contrast, the diffraction peaks of the lecithin NPs
disappeared when the sample was heated to between 164 and 172 °C
because of the melting of the mannitol crystals,[19,38] with a weak residual peak observed at q = 0.66
Å–1, characteristic of trace amounts of the
F I polymorph. The results obtained were consistent with the melting
endotherm from the differential scanning calorimetry (DSC) thermogram[19] and from the optical polarizing microscope images
(Figure S4 in the Supporting Information) acquired during heating of the lecithin NP samples where two melting
events (birefringent–isotropic transitions) were observed.
In the case of zein/casein NPs, where a polymorphic transformation
was expected upon heating, splitting of the peak at q = 0.55 Å–1 into two separate peaks at 0.54
and 0.56 Å–1 was observed as the temperature
was increased to ∼89 °C, indicative of polymorphic transformations
from the F II to the F IV polymorph. The diffraction peaks of the
F IV polymorph subsequently disappeared completely at about 214 °C.
This correlated well with the DSC profiles reported in the previous
studies, which indicated the complete melting of clofazimine zein/casein
NP samples at this temperature.[19]
Figure 3
X-ray scattering
patterns of (a) clofazimine API (b) lecithin NPs,
and (c) zein/casein NPs as a function of increasing temperature. (d)
Close-up view of zein/casein NPs at 40 °C (F II polymorph) and
180 °C (F IV polymorph) with reference to the clofazimine API
powder X-ray diffractogram.[31]
X-ray scattering
patterns of (a) clofazimineAPI (b) lecithin NPs,
and (c) zein/casein NPs as a function of increasing temperature. (d)
Close-up view of zein/casein NPs at 40 °C (F II polymorph) and
180 °C (F IV polymorph) with reference to the clofazimineAPI
powder X-ray diffractogram.[31]
Solid-State Forms of Clofazimine in Buffer,
Infant Formula,
and Milk during Dispersion
The propensity of one polymorphic
form of a drug to transform into another as a solution-mediated transformation
in the absence of digestion is of interest for pharmaceutical applications.
This is because the physical properties of polymorphs are often significantly
different, and this can impact their solubility and dissolution behavior
in the gastrointestinal tract. Therefore, we investigated the polymorphic
forms of clofazimine following dispersion of the different formulations
in aqueous media with and without lipids present (milk/IF or tris
buffer, respectively) prior to lipid digestion. The X-ray scattering
patterns are summarized in Figure and the polymorphic forms of clofazimine in the different
formulations are annotated on the profiles.
Figure 4
X-ray scattering patterns
of (a) clofazimine API, lecithin FNP
NPs, and Lamprene, as well as (b) zein/casein NPs after dispersion
in tris and various media (milk and IF) after background subtraction
of the tris buffer.
X-ray scattering patterns
of (a) clofazimineAPI, lecithin FNP
NPs, and Lamprene, as well as (b) zein/casein NPs after dispersion
in tris and various media (milk and IF) after background subtraction
of the tris buffer.The positions of the
diffraction peaks for clofazimine on dispersion
of Lamprene and lecithin NPs were comparable to those for clofazimineAPI, suggesting that the F I polymorph was present. However, additional
peaks at q = 1.34 and 1.37 Å–1 (peaks with asterisks in Figure a) that were exclusive to the F III polymorph were
observed when clofazimineAPI was dispersed in a solution containing
MC/T80, a standard formulation used in pharmacokinetic studies in
animal models. The results therefore suggest that these surfactants
could potentially cause polymorphic changes of clofazimine, although
these transformations were
not seen when clofazimine was dispersed in milk and IF. Interestingly,
comparisons between the diffraction peak positions for the lecithinFNP samples before (sample in the powder form, Figure ) and after dispersion (Figure a) in buffer, IF, and milk
showed the disappearance of several peaks, notably at q = 1.22, 1.32, 1.44, and 1.49 Å–1, which was
attributed to the solubilization of the mannitol excipient.The scattering profiles for the zein/casein clofazimine NPs on
dispersion in various media are shown separately in Figure b for clarity. No changes in
the scattering of the F I or F II polymorphs were apparent before
and after dispersion of the zein/casein clofazimine NPs, although
an additional peak at q = 1.22 Å–1 appeared when the zein/casein NPs were dispersed in milk and IF.
The origin of this peak was unknown as it did not belong to the F
I, F II, or F III polymorphs. The positions of the diffraction peaks
for all systems are tabulated in Table S3 in the Supporting Information.
Solubilization of Clofazimine
in Infant Formulas during Dispersion
and Digestion
To understand the effects of fat content and
the types of lipids on the solubilization of clofazimine in the API
and the NPs as well as commercial Lamprene capsules, synchrotron X-ray
scattering was used to monitor the changes in the intensity of the
drug diffraction peaks over the course of dispersion and digestion.
This technique has been shown previously to enable parallel determination
of drug polymorphic transformations (digestion- and/or dispersion-induced)
and drug solubilization.[25,39] Integration of the
peaks at q = 0.96 Å–1 for
the clofazimine F I polymorph and 0.95 Å–1 for
the F II polymorph was performed to determine the peak areas, with
a decrease in area representing drug solubilization and/or loss of
crystallinity, whereas an increase in area represents drug precipitation
in the crystalline state.[40]Figure shows the effect of varying
fat content using increasing amounts of IF powder on the solubilization
of clofazimine during dispersion (negative time points) and digestion
(positive time points), with the initiation of digestion by injection
of lipase occurring at time = 0 min. The next two paragraphs discuss
the dispersion and digestion behaviors separately for clarity.
Figure 5
Area under
the diffraction peaks for clofazimine in (a) clofazimine
API, (b) lecithin NPs, (c) zein/casein NPs, and (d) Lamprene during
dispersion (negative time scale) and digestion (positive time scale)
in tris and IF from 0 to 3.8% fat. Peaks at q = 0.96
Å–1 and q = 0.95 Å–1 were representative of the F I and F II clofazimine
polymorphs, respectively. Lipase was injected at time = 0 min.
Area under
the diffraction peaks for clofazimine in (a) clofazimineAPI, (b) lecithin NPs, (c) zein/casein NPs, and (d) Lamprene during
dispersion (negative time scale) and digestion (positive time scale)
in tris and IF from 0 to 3.8% fat. Peaks at q = 0.96
Å–1 and q = 0.95 Å–1 were representative of the F I and F II clofazimine
polymorphs, respectively. Lipase was injected at time = 0 min.Very little or no drug solubilization
was evident during the dispersion
phase for API or lecithin NP formulations (Figure a,b), although for lecithin, greater initial
drug solubilization was evident when the starting fat content was
higher (indicated by the lower initial peak area) because of drug
dissolution into the native lipids in the media. This was not evident
for the API, possibly because of the very poor solubility and compromised
dissolution of the crystalline API compared to the rapidly dissolving
NPs. The zein/casein particles provided comparably low initial diffraction
peak areas, indicating significantly less crystalline drug being present
at the start of the dispersion process, consistent with the reduced
crystallinity seen in Figure . Interestingly, the peak areas for clofazimine with the zein/casein
NPs steadily increased during dispersion, indicating drug crystallization
or precipitation from the NPs which were mainly amorphous prior to
dispersion but apparently crystallized upon contact with the dispersion
media. However, the amount of crystallized clofazimine in zein/casein
NPs was still relatively low compared to that of lecithin NPs. The
increase in the amount of crystalline drug in suspension upon dispersion
of the zein/casein clofazimine NPs was more pronounced in the IF samples
compared to the lipid-free buffer, presumably because of the lipid
particles and other IF components providing an increased capacity
to dissolve the free drug. This can lead to supersaturation of the
drug in solution, which provides a pathway for recrystallization to
occur.Digestion of the formulations generally resulted in decreases
in
diffraction peak areas because of solubilization, and it was generally
observed that increasing the amount of fat present resulted in greater
solubilization of clofazimine, although the extent of drug solubilization
varied depending on the formulation. Complete disappearance of the
clofazimine peak was observed at ≥2% and ≥1% fat for
the formulated lecithin (Figure b) and zein/casein NPs (Figure c), respectively, after 20 min of digestion.
In contrast, for the crystalline API (Figure a), the diffraction peak of clofazimine was
still present after digestion at 3.8% fat despite having a similar
initial degree of crystallinity to the lecithin NPs. The faster drug
dissolution (into the digested lipid products) of the lecithin NPs
could result from the particle size reduction through the FNP process
and a synergistic solubilizing interaction of the digestion products
with the additional lecithin stabilizer.[18]In contrast to all of the other formulations, the commercially
available Lamprene formulation displayed no significant solubilization
of clofazimine attributable to the presence of added lipids during
30 min of in vitro digestion. A slow and progressive decrease in the
clofazimine peak areas was seen in both the tris buffer and the IF
media (Figure d) even
prior to lipase injection, which could be caused by the slow dissolution
of the micronized drug into the lipid excipients including beeswax
and plant oils from the Lamprene formulation.[41]In contrast to the lecithin NP system, where only the F I
clofazimine
polymorph was observed throughout the dispersion and digestion, clofazimine
in the zein/casein NPs was predominantly the F II polymorph (indicated
by the peak at q = 0.95 Å–1) during the initial stages of dispersion, with the F I polymorph
(indicated by the peak at q = 0.96 Å–1) also appearing over time. Figure a shows the evolution of these diffraction peaks in
0.25% fat IF during dispersion and digestion. The results indicate
that despite the growth in the diffraction peak area associated with
both the F II and F I polymorphs (slightly faster for the least stable
F I polymorph, which is in accordance with the Ostwald rule of stages),[42] the diffraction peak observed for the F I polymorph
nearly disappears after 30 min of digestion, but the diffraction peak
of the F II polymorph is still very evident after 40 min of digestion.
This could suggest different solubilization behaviors of the different
clofazimine polymorphs and that faster solubilization was observed
for the less stable form. In addition, the growth of the F I polymorph
at q = 0.96 Å–1 was also dependent
on the fat content of the IF (Figure b). The larger peak area seen in IF with 0.25% fat
compared to ≥1% fat was expected because of greater drug solubilization
at higher fat contents.
Figure 6
(a) Area under the diffraction peaks for clofazimine
at q = 0.95 Å–1 (F II polymorph)
and
0.96 Å–1 (F I polymorph) during dispersion
(negative time scale) and digestion (positive time scale) of zein/casein-stabilized
clofazimine FNP NPs in 0.25% fat IF. (b) Effects of fat content in
IF on the formation of the F I polymorph (diffraction peak at 0.96
Å–1) during dispersion and digestion.
(a) Area under the diffraction peaks for clofazimine
at q = 0.95 Å–1 (F II polymorph)
and
0.96 Å–1 (F I polymorph) during dispersion
(negative time scale) and digestion (positive time scale) of zein/casein-stabilized
clofazimineFNP NPs in 0.25% fat IF. (b) Effects of fat content in
IF on the formation of the F I polymorph (diffraction peak at 0.96
Å–1) during dispersion and digestion.
Solubilization of Clofazimine
in Milk and Medium- and Long-Chain
Triglycerides during Dispersion and Digestion
In contrast
to the observations with clofazimine in IF, with milk there was only
a slight drop in the peak area on digestion after lipase injection,
and this is possibly a dilution effect from adding the lipase solution,
with no apparent decrease in diffraction peak area observed throughout
the 35 min digestion period (Figure a). Similar profiles were obtained when the fat content
of milk was increased from 3.8 to 4.7% although the overall peak areas
in the high fat milk were lower presumably because of an initially
greater solubility in undigested milk (see Figure S5 in the Supporting Information).
Figure 7
(a) Area under the diffraction
peak for clofazimine at q = 0.96 Å–1 from clofazimine API
during dispersion and digestion in milk, IF, LCTs, and MCTs containing
3.8% fat. (b) Corresponding clofazimine peak areas divided by the
amount of titrated fatty acids (normalized peak area) during digestion
in milk, IF, and LCTs, and MCTs.
(a) Area under the diffraction
peak for clofazimine at q = 0.96 Å–1 from clofazimineAPI
during dispersion and digestion in milk, IF, LCTs, and MCTs containing
3.8% fat. (b) Corresponding clofazimine peak areas divided by the
amount of titrated fatty acids (normalized peak area) during digestion
in milk, IF, and LCTs, and MCTs.The reasons for the differences in the solubilization behavior
of clofazimine in milk and the IF were unclear, although it was likely
that differences in the types of lipids and other solubilizing excipients
within the two systems may play an important role.[43,44] The notion that the solubilization of clofazimine may be affected
by the types of lipids was also supported by studies performed by
O’Reilly et al. where the authors observed fatty acid-dependent
solubility of clofazimine in mixed micelles.[45] Consequently, the solubilization behavior of clofazimineAPI during
digestion in MCT and LCT emulsified with MFGM isolate at the same
drug-to-fat weight ratio (74.6 mg clofazimineAPI to 1 g of fat) was
investigated. Figure a shows that clofazimine was solubilized to a greater extent in MCT
and LCT emulsions compared to milk and IF. The amount of fatty acids
released at certain time points and the extents of digestion varied
between the different lipid emulsions even at the same fat content;
therefore, comparisons were also made in Figure b based on the normalized peak area, that
is, the peak area of clofazimine divided by the titrated fatty acids.
The results show that the drop in normalized peak areas with digestion
was consistent with the time-dependent data in panel (a), but clearer
differentiation between the systems was apparent. Comparing the solubilization
of clofazimineAPI by the lipids used to solubilize them gave an order
of effectiveness of MCT > LCT > IF > milk during 30–35
min
of digestion. Hence, our studies confirmed that the solubilization
of clofazimine could be affected by not only the amount of fat present
but also the lipid composition, with MCTs providing the most effective
solubilization. The exact lipid composition of the IF has not been
disclosed, but IFs are well-known to have lipid compositions different
from bovine milk, and the results suggest that it is likely that the
IF has more medium-chainlipids present than long-chain lipids when
compared with bovine milk. To further elucidate the impact of fatty
acid chain lengths on drug solubility, separate sets of experiments
were performed to determine the solubility of clofazimine in MCT,
LCT, and their corresponding fatty acids using caprylic acid and oleic
acid as the representative lipids (see Supporting Information for the experimental methods). Despite unsuccessful
attempts to determine the solubility of clofazimine in fatty acids
because of the high viscosity of the samples, higher drug loadings
in MCT were obtained compared with LCT (12.1 ± 0.5 and 6.8 ±
0.5 mg drug/g lipid, respectively).Finally, although the diffraction
studies enable understanding
of the solid-state form of the drug and peak areas to estimate the
proportions of the crystalline drug present, it is neither accepted
as an analytical technique, nor can it provide clarity on the phase
distribution of the noncrystallized drug. Therefore, to support the
results from SAXS and to specifically elaborate on the apparent poor
solubilization of clofazimine in milk when compared with IF during
digestion, HPLC was used to quantify the amount of drug present in
the lipid phase, the supernatant, and any precipitated pellets after
ultracentrifugation. This method is typically used to determine the
amount of excess nonsolubilized drugs or precipitated drugs not in
a solubilized state.[46] The digests were
collected at predetermined time points during the digestion of milk
and IF containing clofazimineAPI, and the lipolytic enzymes were
inhibited prior to phase separation. The amount of clofazimine remaining
in the pellet phase was higher for milk compared to IF at 30 min (and
under prolonged digestion to 60 min), which supported the observations
from SAXS that more crystalline drug was present after the digestion
of milk than of IF (Figure a). The results also confirmed that clofazimine was increasingly
partitioned into the upper lipid layer as digestion progressed because
of the formation of digestion products, which self-assemble into liquid
crystalline phases and reside at the upper layer after centrifugation[24] (Figure b). Furthermore, no drug solubilization was apparent when
digestion was performed in the absence of lipids (Figure S6 in the Supporting Information), which is also in agreement
with the SAXS results.
Figure 8
(a) Comparison between the amount of undissolved clofazimine
recovered
from the pellet phase in 3.8% IF and milk after 30 and 60 min in vitro
digestion and (b) distributions of clofazimine with digestion time
for 3.8% IF showing an increasing amount of drug partitioned into
the upper lipid layer as digestion progressed.
(a) Comparison between the amount of undissolved clofazimine
recovered
from the pellet phase in 3.8% IF and milk after 30 and 60 min in vitro
digestion and (b) distributions of clofazimine with digestion time
for 3.8% IF showing an increasing amount of drug partitioned into
the upper lipid layer as digestion progressed.
Conclusions
Clofazimine NPs prepared using the FNP
process produced different
solid-state forms of the API depending on the types of surface stabilizers
used. Clofazimine in the lecithin NPs was comprised of the F I polymorph,
whereas for the zein/casein NPs, the F II polymorph was the dominant
form. The NPs exhibited lipid-dependent solubilization that required
lipolysis of the coformulated fat. The amount of lipid required to
solubilize the drug was lower for the zein/casein NPs than for the
lecithin NPs, with clofazimineAPI requiring the most added fat to
solubilize it. Rapid drug solubilization of the NP samples was observed
during digestion, whereas solubilization of clofazimine from the commercially
available Lamprene formulation was slower. The studies demonstrated
that IF could be used as a lipid-based formulation to improve the
solubilization of clofazimine in the small intestine as a reduced
amount of residual undissolved drug crystals was apparent when compared
with milk, based on the in vitro lipolysis experiments performed herein.
The lipid composition in such systems appears to be important with
MCT solubilizing clofazimine more efficiently than LCT or the other
vehicles tested. The studies not only strongly support the suitability
of clofazimine NPs for the treatment of cryptosporidiosis where fast
onset of action by dissolution in the intestines is required, but
also reinforce the potential benefits of coformulation with fat-containing
excipients such as IF containing medium-chainfatty acids or simple
triglyceride emulsions.
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