Tuberculosis is the leading cause of death from a single infectious agent, ranking
above the human immunodeficiency virus (HIV). Effective treatment using antibiotics is
achievable, but poor patient compliance constitutes a major challenge impeding
successful pharmacotherapeutic outcomes. This is often due to the prolonged treatment
periods required and contributes significantly to the rising incidence of drug
resistance, which is a major cause of tuberculosis mortality. Thus, innovative
interventions capable of encouraging compliance and decreasing lengthy and frequent
dosing are needed. Previously, aqueous tin protoporphyrin IX (SnPPIX), a heme
oxygenase-1 inhibitor, administered as multiple daily intraperitoneal (IP) injections,
showed considerable antitubercular efficacy and treatment shortening capabilities as a
host-directed therapy in infected mice. Since daily IP injection is a clinically
impractical administration approach, this proof-of-concept study aims to develop a
novel, sustained action injectable formulation of SnPPIX for safe intramuscular (IM)
administration. Herein, a SnPPIX-loaded poloxamer-poly(acrylic acid)-based
thermoresponsive injectable formulation (SnPPIX-TIF) is designed for effective IM
delivery. Results show SnPPIX-TIF is microparticulate, syringeable, injectable, and
exhibits complete
in vitro
/
in vivo
gelation.
Administered once weekly, SnPPIX-TIF significantly prolonged absorption and
antimicrobial efficacy in infected mice. In addition, SnPPIX-TIF is well-tolerated
in vivo
; results from treated animals show no significant
histopathologic alterations and were indistinguishable from the untreated control group,
thus supporting its biocompatibility and preclinical safety. Overall, the IM delivery of
the thermoresponsive injectable formulation safely sustains antitubercular effect in an
infected murine model and decreases the number of injections required, signifying a
potentially practical approach for future clinical translation.