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Review
. 2019 Aug;16(8):869-882.
doi: 10.1080/17425247.2019.1646725. Epub 2019 Jul 24.

Nanotechnology approaches for delivery of cytochrome P450 substrates in HIV treatment

Yuqing Gong  1 , Pallabita Chowdhury  1 , Prashanth K B Nagesh  1 , Theodore J Cory  2 , Chelsea Dezfuli  2 , Sunitha Kodidela  1 , Ajay Singh  1 , Murali M Yallapu  1 , Santosh Kumar  1
Affiliations
Review

Nanotechnology approaches for delivery of cytochrome P450 substrates in HIV treatment

Yuqing Gong et al. Expert Opin Drug Deliv. 2019 Aug.

Abstract

Introduction: Antiretroviral therapy (ART) has led to a significant reduction in HIV-1 morbidity and mortality. Many antiretroviral drugs (ARVs) are metabolized by cytochrome P450 (CYP) pathway, and the majority of these drugs are also either CYP inhibitors or inducers and few possess both activities. These CYP substrates, when used for HIV treatment in the conventional dosage form, have limitations such as low systemic bioavailability, potential drug-drug interactions, and short half-lives. Thus, an alternative mode of delivery is needed in contrast to conventional ARVs. Areas covered: In this review, we summarized the limitations of conventional ARVs in HIV treatment, especially for ARVs which are CYP substrates. We also discussed the preclinical and clinical studies using the nanotechnology strategy to overcome the limitations of these CYP substrates. The preclinical studies and clinical studies published from 2000 to February 2019 were discussed. Expert opinion: Since preclinical and clinical studies for prevention and treatment of HIV using nanotechnology approaches have shown considerable promise in recent years, nanotechnology could become an alternative strategy for daily oral therapy as a future treatment.

Keywords: Antiretroviral drugs; CYP substrates; HIV; nanotechnology.

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Conflict of interest statement

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.
(a) Peer-reviewed articles studying native CYP substrates/nanoformulation of CYP substrates used in HIV treatment published in PubMed until February 15, 2019. *indicates the percentage (%) of nanoformulation studies of total studies. (b) Structure of the commonly used nanoformulation of CYP substrates in HIV treatment.
Figure 2.
Figure 2.
A comparison of CYP substrates used in HIV treatment between conventional drug delivery and nano-based drug delivery. The comparisons of first pass metabolism, drug-drug interactions, the use of pharmacoenhancers and long-acting profile are included.
See this image and copyright information in PMC

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