4.2. PK Modeling and Analysis
From the data generated for the NCA in Table 6, the AUC, AUMC, MRT, Cl and Vss are all above the 125% range for bioequivalence. Bioequivalence of a given product is conferred if the mean bioavailability of the product under consideration is within 80-125% of the reference formulation. From the perspective of pharmacokinetic modeling, the FDA 2003 guidance indicated that other parameters such as AUC (0-∞), AUC(0-tlast) and C
max also be considered [
41]. The values of AUC, AUMC and MRT were all significantly higher for the niosomal formulation than for the unentrapped drug (Table 6 and Table 7). The decreased volume of distribution, decreased clearance, and enhanced MRT and AUC are positive outcomes of niosomal encapsulation, which is indicative of the potential of niosomes to increase the drug’s therapeutic efficacy whilst concurrently minimizing its adverse effects. While the one-compartment behavior of levofloxacin niosomes and the corresponding increase of MRT and reduced CL and Vss cannot be easily explained, it appears that the niosomal formulation prevented rapid drug release and released it in a sustained manner. Therefore, the relative bioavailability and the MRT of the niosomes-encapsulated drug were increased above those of unencapsulated drug molecules.
Fluoroquinolones generally have superior ability to penetrate tissues [
42] than other antibiotics and can penetrate organelles like macrophages and neutrophils to accentuate bactericidal activity [
1,
2,
3] . Analysis of the data generated for one compartment model of levofloxacin shows several parameters’ differences between the niosome encapsulated formulations and the conventional pure drug. All parameters tested were out of the bioequivalence range indicating significant differences in their pharmacokinetic parameters. Differences in all parameters tested were significant at 95% confidence interval except for MRT, Vd and t
1/2. Even though the MRT, Vd and t
1/2 showed no significant difference, the MRT for the niosome formulation (40.62h) was 1.64 times higher than that of the unentrapped conventional formulation (24.66h). The same was observed for the t
1/2 of the niosome entrapped drug (28.66h) which shows a half-life of 1.64 X that of the unentrapped drug (17.09h). Thus, niosome entrapped drug showed higher effect on all other parameters than the unentrapped drug. The only possible reason for this difference was the drug delivery system employed. Encapsulation in niosomes seems to restrict drug distribution, enhance plasma levels and allow for sustained release of drug molecules from the construct. In the two-compartment model (Table 8), only the values of Vc and C
max were bioequivalent, with all other parameters falling outside of the stipulated 80-125% range. The data, however, were not significantly different as can be seen from the “t” values as well as the p values generated for this data (Table 8). Progression to the Three Compartmental analysis (Table 9) resulted in PK parameters losing reliability as the coefficient of variation increased dramatically.
The Hooke and Jeeves pattern search [
34] also showed a difference in the release and pharmacokinetic characteristics of the two formulations. The patterns shown in Figures 5A & B indicate that niosome formulation shows a linear pattern of drug release. The initial post-absorption rate of drug release from the niosomal formulation was much slower and sustained than those from the conventional free drug
Figure 6A & B. The logarithmic display for niosome (
Figure 5B) and conventional drug (
Figure 6B) show a clear difference in release pattern as the niosomes profile is linear compared to the nonlinear profile of the conventional drug. The plot of residuals for the niosomes-treated animals (
Figure 5C) showed an even distribution around the horizontal axis that supports a linear profile of drug release. This even distribution was not seen in the plot for the conventional formulation (
Figure 6C). The average Cp Vs time profiles for rats administered levofloxacin niosomes and those with pure levofloxacin are shown in
Figure 7. Similar findings have been reported by other studies in literature. Ruckmani et al (2010) [
43] and Ammar et al (2017)[
44] showed that niosomes entrapment of the drugs enhanced the AUC, MRT and t
1/2. Feitosa et al (2022) [
45] developed a niosomal formulation of doxycycline using Span 60/Tween 60 and cholesterol via modified thin hydration method. The average size of the final formulation was 281.9 nm and encapsulation efficiency (EE) was 72.1%. A significantly lower minimum inhibitory concentration (MIC) against different Gram-positive and Gram-negative bacteria were reported, indicating higher antibacterial activity of doxycycline niosomes than that of the free drug [
10,
45] (Akbarzadeh et al., 2020; Feitosa et al, 2022).
Figure 7(A).
Cp vs t for levofloxacin niosomes.
Figure 7(A).
Cp vs t for levofloxacin niosomes.
Figure 7(B).
log Cp vs t for levofloxacin niosomes.
Figure 7(B).
log Cp vs t for levofloxacin niosomes.
Figure 7(C).
Plot of residuals for levofloxacin niosomes.
Figure 7(C).
Plot of residuals for levofloxacin niosomes.
PK parameters from data analysis in GastroPlus
TM are reported with values for both SIC and AIC as model suitability indices (Table 10). To determine the model that best fit the drug exposure in the rats, model search was extended from non-compartmental (purely mechanistic) to physiologic models depicting the body compartments into 1, 2 or 3, depending on rate of perfusion and rapidity of equilibration between plasma (central compartment) and various organs (rapidly equilibrating organs and tissues) (Nestorov et al, 1998; Jeong et al, 2022) [
46,
47]. While noting that PK models cannot indicate the absolute physiologic or anatomic location of drug molecules as they traverse the body of an animal (Burnham et al, 2002) [
48], a close approximation of one model relative to another may provide the most accurate representation of drug exposure systemically. Since presently, many drugs needed to be administered at sufficient doses to obtain require dose at the desire site of action, which, often times, may be outside of the plasma compartment, PK parameters selected based on the most predictive model could be advantageous in the choice of delivery design that would provide the most efficient drug dosing. For instance, as was previously reported [
31] (Jankie, et al, 2012), a 50 % reduction in MIC/MBC of some fluoroquinolones niosomes (including levofloxacin, gatifloxacin and ciprofloxacin) on P. aeruginosa, E. coli and S. aureus could enable dose reduction if the PK parameters indicate that drug perfusion is concurrently enhanced by niosomes encapsulation of the drug molecules. Therefore, the slower rate of distribution of niosomes-encapsulated levofloxacin from plasma to the extravascular compartment (niosomes kz = 0.025; pure drug kz = 0.041) and the significantly higher mean residence time (MRT,
Figure 8) suggest a high potential for the translation of the observed reduction in MIC/MBC in vitro to in vivo microenvironment.
Figure 8(A).
Cp vs t for pure unenca sulated levofloxacin.
Figure 8(A).
Cp vs t for pure unenca sulated levofloxacin.
Figure 8(B).
log Cp vs t for pure unencapsulated levofloxacin.
Figure 8(B).
log Cp vs t for pure unencapsulated levofloxacin.
Figure 8(C).
Plot of residuals for pure, unencapsulated levofloxacin.
Figure 8(C).
Plot of residuals for pure, unencapsulated levofloxacin.
Encapsulation in sub-microscopic particles generally has been associated with improved bioavailability. Until recently, liposomes have been used extensively to improve the pharmacokinetic profile of drugs for administration via different routes (Xie et al, 2016; Bayindir et al, 2015) [
49,
50]. The results of those studies indicate the ability of the drug carrier to preserve the drug
en route distribution channels to thhe plasma, protect it from the external environment and preferentially deliver it to the site where its action is needed. These outcomes have inspired the FDA approval of some liposomal formulations for clinical use. However, the short
in vivo fate of liposomes is a limiting factor and studies have focused on improving its circulation time [
49]. Unlike liposomes, niosomes are cheaper to produce and do not require special storage and handling conditions. Hence, recent attention has been focused on niosomal drug delivery as in this study. Taken together with our previous report [
31], this PK model analysis indicates that niosomes encapsulation of levofloxacin, by concentrating the drug in the intravascular compartment, preventing its binding to plasma protein, and preventing bacteria sensing of drug molecules that are enveloped in lipid vesicles (niosomes), has the potential to obviate the resistance development, which is currently limiting the efficacy of the drug.