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Published in Valerio Voliani, Nanomaterials and Neoplasms, 2021
Joseph M. Caster, Artish N. Patel, Tian Zhang, Andrew Wang
Aronex pharmaceuticals is developing a liposomal formulation of nystatin called Nyotran. Nystatin is a potent antifugal drug and has shown additive toxicity with other antifungal agents including amphotericin B, itraconazole, and flucytosine with various fungal cultures. Unfortunately, nystatin is of limited value as a systemic therapy because of significant toxicities including nephrotoxicity, cardiopulmonary instability, and extreme cutaneous reactions including Stevens-Johnsons syndrome [64]. The liposomal formulation Nyotran has been well tolerated in early phase clinical trials and has completed a phase III trial which randomized neutropenic patients with presumed fungal infections to amphotericin B or Nyotran. The authors presented the results of a modified intention to treat analysis of 131 patients (out of a total 538) demonstrating similar efficacy with less renal toxicity than amphotericin B. Additional studies are ongoing and Aronex plans to file a new drug application (NDA) in the near future.
Design and in vitro antifungal activity of Nystatin loaded chitosan-coated magnetite nanoparticles for targeted therapy
Published in Inorganic and Nano-Metal Chemistry, 2021
Kamiar Zomorodian, Hamed Veisi, Somayeh Yazdanpanah, Sajad Najafi, Aida Iraji, Saba Hemmati, Bikash Karmakar, Hojat Veisi
Nystatin, the first antifungal agent belonging to the polyene polyhydroxy group, exhibits good activity against Candida species. While concerned about the mode of action, it is proposed that Nystatin acts as an ionophore, binds with the ergosterol, a major component of the fungal cell membrane, and subsequently forms pores on the membrane to leak out K+ ions, which ultimately results in the death of the affected cell. Since Nystatin is a highly non-polar compound and insoluble in water, it is not absorbed by the gastrointestinal tract during oral administration.[18] Despite the high toxicity of Nystatin, it is still prescribed for the treatment of oropharyngeal candidiasis and cutaneous aspergillosis in high-risk populations.[19] Despite its outstanding antifungal and fungicidal properties, Nystatin has no systemic administration and is solely used to treat mucocutaneous fungal infections.[20] Furthermore, mucosal circulation affects its efficacy, resulting in fast drug exertion from body surfaces. To overcome this issue, loading Nystatin onto biocompatible iron nanoparticles might result in improvement of its effectiveness through target therapy with magnetic fields.