The Effect of Polyethylene Oxide on the Aggregation State and Toxicity of Amphotericin B

폴리에틸렌 옥사이드가 암포테리신-B의 응집 특성 및 독성에 미치는 영향

Amphotericin B (AmB) is a drug of choice for the treatment of systemic fungal diseases, but its use is considerably limited due to a high incidence of toxicity, particularly nephrotoxicity. It has been demonstrated that the toxicity of AmB is caused by self-aggregated species of the drug and that unaggregated (monomeric) drug is nontoxic but still expresses antifungal activity. Poly (ethylene oxide) (PEO) is a water-soluble polymer, which may impact the aggregation state of AmB. We have studied the aggregation state of AmB as a function of PEO molecular weight and concentration. At 3,000 and 8,000 g/mole, there was minimal or no change of critical aggregation concentration (CAC) of AmB regardless of the concentration of polymer. By contrast at 20,000 g/mole, the CAC of AmB strikingly increased to 24.3 and $37.5\;{\mu}M$ at 5.0% and 10 % w/v of polymer, respectively. The critical overlap concentration (COC) of PEO 20,000 g/mole was 5.5%. It appears that an interaction between monomeric AmB and polymer coil increases above the COC, competing with self-aggregation of the drug. Accordingly, the degree of aggregation of AmB stayed low and the toxicity became less. There was no such effect at 3,000 and 8,000 g/mole of PEO, owing perhaps to small dimensions in comparison to AmB. Based upon these findings, less toxic AmB formulation may be developed by a pharmaceutical technique such as solid dispersion system containing both AmB and PEO 20,000 g/mole.