Alzheimer’s
disease (AD) is a progressive neurodegenerative
disorder associated with memory and cognitive impairment. Donepezil
is an acetylcholinesterase inhibitor used for the symptomatic treatment
of AD. However, high dose of donepezil is prescribed to achieve effective
concentration in the brain, which leads to significant side effects,
gastrointestinal alterations, and hepatotoxicity. In the present study,
ApoE3 conjugated polymeric nanoparticles derived from diblock copolymer
methoxy poly(ethylene glycol)–polycaprolactone (mPEG–PCL)
have been used to boost the delivery of donepezil to the brain. mPEG–PCL
is an amphiphilic diblock polymer with a tendency to avoid nanoparticle
uptake by phagocytic cells in the liver and can significantly reduce
the gastric mucosal irritations. Moreover, ApoE3-based nanocarriers
showed a promising ability to enhance brain uptake, binding to amyloid
beta with high affinity and accelerating its clearance. Donepezil-loaded
polymeric nanoparticles were performed by using a nanoprecipitation
method and further surface modified with polysorbate 80 and ApoE3
to increase the brain bioavailability and reduce the dose. Optimization
of various process parameters were performed using quality by design
approach. ApoE3 polymeric nanoparticles were found to be stable in
simulated gastric fluids and exhibited a sustained drug release pattern.
Cellular uptake studies confirmed better neuronal uptake of the developed
formulation, which is further corroborated with pharmacokinetic and
biodistribution studies. Orally administered ApoE3 polymeric nanoparticles
resulted in significantly higher brain donepezil levels after 24 h
(84.97 ± 11.54 ng/mg tissue) as compared to the pure drug (not
detected), suggesting a significant role of surface coating. Together,
these findings are promising and offer preclinical evidence for better
brain availability of donepezil by oral administration.
Epilepsy is a neurological disorder affecting around 1%–2% of population worldwide and its treatment includes use of antiepileptic drugs to control seizures. Failure to respond to antiepileptic drug therapy is a major clinical problem and over expression of ATP-binding cassette transporters is considered one of the major reasons for pharmacoresistance. In this review, we have summarized the regulation of ABC transporters in response to oxidative stress due to disease and antiepileptic drugs. Further, ketogenic diet and antioxidants were examined for their role in pharmacoresistance. The understanding of signalling pathways and mechanism involved may help in identifying potential therapeutic targets and improving drug response.
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