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WO2024098127A1 - Nanostructured lipid system containing besifloxacin, pharmaceutical composition and uses - Google Patents

Nanostructured lipid system containing besifloxacin, pharmaceutical composition and uses Download PDF

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Publication number
WO2024098127A1
WO2024098127A1 PCT/BR2023/050377 BR2023050377W WO2024098127A1 WO 2024098127 A1 WO2024098127 A1 WO 2024098127A1 BR 2023050377 W BR2023050377 W BR 2023050377W WO 2024098127 A1 WO2024098127 A1 WO 2024098127A1
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WIPO (PCT)
Prior art keywords
besifloxacin
lipid
system containing
nanostructured lipid
nanostructured
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PCT/BR2023/050377
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French (fr)
Portuguese (pt)
Inventor
Nádia Araci BOU CHACRA
Mirla Anali BAZÁN HENOSTROZA
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Pearson Saude Animal SA
Universidade de Sao Paulo USP
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Pearson Saude Animal SA
Universidade de Sao Paulo USP
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Priority claimed from BR102022022706-3A external-priority patent/BR102022022706A2/en
Application filed by Pearson Saude Animal SA, Universidade de Sao Paulo USP filed Critical Pearson Saude Animal SA
Publication of WO2024098127A1 publication Critical patent/WO2024098127A1/en
Priority to CONC2025/0005890A priority Critical patent/CO2025005890A2/en
Priority to MX2025005335A priority patent/MX2025005335A/en
Anticipated expiration legal-status Critical
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/4709Non-condensed quinolines and containing further heterocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/10Dispersions; Emulsions
    • A61K9/107Emulsions ; Emulsion preconcentrates; Micelles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/51Nanocapsules; Nanoparticles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00Drugs for disorders of the senses
    • A61P27/02Ophthalmic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/02Local antiseptics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04Antibacterial agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/04Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/12Cyclic peptides, e.g. bacitracins; Polymyxins; Gramicidins S, C; Tyrocidins A, B or C

Definitions

  • NANOSTRUCTURED LIPID SYSTEM CONTAINING BESIFLOXACIN, PHARMACEUTICAL COMPOSITION AND USES FIELD OF THE INVENTION [1] The present invention belongs to the field of pharmaceutical sciences and nanotechnology, as it deals with the preparation of nanostructured lipid systems containing antibiotics for the treatment of ophthalmic infections.
  • a nanostructured lipid system containing besifloxacin and, optionally, polymyxin B sulfate, and its application in the therapy and/or prevention of ocular bacterial infections are described.
  • BACKGROUND OF THE INVENTION Bacteria are the main cause of ophthalmic infections globally. These infections can damage superficial and deep structures of the human or animal eye, promoting possible blindness and visual impairment.
  • the antibiotic besifloxacin a fluoroquinolone of fourth generation for exclusive topical ophthalmic use, it has been shown to be effective against susceptible and resistant bacterial strains of both Gram-positive and Gram-negative types.
  • Besifloxacin was synthesized by the Japanese company SSP Co. Ltd and approved for commercialization in 2009 by the Food and Drug Administration (FDA) under the name BesivanceTM (6 mg/mL) by the pharmaceutical company Bausch & Lomb Inc. In 2010, the National Health Surveillance Agency (ANVISA) approved the new antibiotic for use in Brazil. This drug has been indicated for conjunctivitis, having demonstrated effectiveness in different clinical trials (COMSTOCK et al., 2014; MAH; SANFILIPPO, 2016).
  • Besifloxacin has the chemical formula C19H21ClFN3O3, molar mass equal to 430.40 g/mol, has low solubility in water (0.143 mg/mL) and pKas of 5.64 (medium acid, hydroxyl group) and 9.67 ( medium basic, primary amine group).
  • besifloxacin has an important 1-n cyclopropyl group, responsible for the broad spectrum of activity against aerobic bacteria. This substituent also appears in other fluoroquinolones such as ciprofloxacin, second generation, gatifloxacin and gemifloxacin, third generation, and fourth generation moxifloxacin (LAL et al., 2014) ( Figure 1).
  • besifloxacin has a fluorine atom in position 6 of the molecule, an important pharmacophore; chlorine atom, in position 8, responsible for increasing the potency of the antimicrobial against the bacterial enzymes DNA gyrase (topoisomerase II) and topoisomerase IV, which are essential in the processes of bacterial transcription and replication (CAMBAU et al., 2009).
  • This double connection to specific domains and conformations underlies the bactericidal activity of fluoroquinolones (HOOPER; JACOBY, 2016; MAH; SANFILIPPO, 2016).
  • DNA gyrase is the primary target in most Gram-negative bacteria and topoisomerase IV is the primary target in Gram-positive bacteria (MITSCHER et al., 2008; PETRI, 2006).
  • MITSCHER et al., 2008; PETRI, 2006 A study carried out by Haas and colleagues (2010) showed that besifloxacin had a lower minimum inhibitory concentration when compared to moxifloxacin, gatifloxacin, ciprofloxacin, azithromycin and tobramycin for S. aureus, S. epidermidis and S. pneumoniae. Thus, this antibiotic revealed potent antimicrobial action against these bacteria.
  • besifloxacin showed greater efficiency against Gram-positive and Gram-negative bacteria resistant to other fluoroquinolones.
  • Haas and collaborators (2010) subsequently, evaluated the bactericidal activity of besifloxacin and other antimicrobial agents (oxacillin, tobramycin, azithromycin, ciprofloxacin, moxifloxacin and gatifloxacin) against microorganisms that frequently cause bacterial conjunctivitis: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Haemophilus influenzae.
  • Besifloxacin unlike the other fluoroquinolones tested, showed high potency and bactericidal activity. This activity was even demonstrated against strains that presented multiple mutations in the genes responsible for encoding DNA gyrase and topoisomerase IV (HAAS et al., 2011). Additionally, a study carried out by Zhang and Ward (2008) showed that besifloxacin also acts as an anti-inflammatory agent in monocytes in vitro. Such activity may improve its effectiveness in treating ocular infections concomitant with inflammation. [16] Despite the therapeutic advantages presented, besifloxacin may have limited therapeutic efficacy due to its low solubility in water. This chemical property represents the main challenge in the development of preparations containing besifloxacin.
  • SSN nanostructured lipid systems
  • CLN nanostructured lipid carrier
  • the transport of antibiotics in nanostructured lipid systems has been explored as one of the most promising strategies for obtaining products with greater efficacy and safety. These systems have brought significant progress in the development of new pharmaceutical products due to their intrinsic properties, such as size in the nanometer range, surface charge, improved permeability and high surface area/volume ratio. These properties allow maximizing the interaction of the antibiotic with bacteria, inhibiting biofilm formation, improving penetration through biofilms and being more effective against intracellular infections.
  • SSN The nanostructured lipid system (SLN) enables the transport of hydrophobic drugs such as besifloxacin. Additionally, it allows the improvement of its pharmacokinetics and pharmacodynamics through different routes of administration, such as the topical ocular route.
  • the transcorneal flux of SLN-ciprofloxacin in an ex vivo assay revealed a 4-fold increase compared to the ciprofloxacin solution, and the transcorneal permeability of SLN-ciprofloxacin was 3.5 times greater compared to the free drug.
  • the pores present in the cornea facilitate the intracellular transport of SLN particles with a size in the range of 200-300 nm.
  • the lipid phase can interact with the lipid segment of the tear film, increasing retention time.
  • Nanostructured lipid system containing dexamethasone (SLN-dexamethasone) was developed for the treatment of dry eye.
  • the final formulation included cholesterol, LabrafacTM lipophile WL1349 and polysorbate 80 in its composition.
  • the particle size was 19.51 ⁇ 0.5 nm; polydispersity index (PI), equal to 0.08; and encapsulation efficiency equal to 99.6 ⁇ 0.5%.
  • SLN labeled with a fluorescent substance demonstrated increased internalization of nanoparticles in primary human corneal epithelial cells in in vitro assays.
  • This SLN showed adequate distribution of nanoparticles on the surface of the cornea after 4 h at 37 °C, showing a possible increase in the bioavailability of the drug and increased residence time on the ocular surface.
  • SLN-dexamethasone was more effective in reducing inflammatory cytokines compared to free dexamethasone.
  • the developed nanoparticle was considered a potentially commercial candidate for inflammatory ocular diseases such as dry eye syndrome (KUMARI et al., 2021).
  • Kassaee and Mahboobian's carrier presents a simple lipid matrix composed of only one liquid lipid (glycerol triester) that differs from that used in this invention (caprylic capric acid triglycerides). In addition to comprising components different from those used in the present invention, they were obtained through low-energy emulsification, while a high-energy process is applied to the solution. technique now described.
  • the work of Baig et al (2020) describes the development of a cationic nanostructured lipid carrier containing besifloxacin.
  • a solid lipid (Compritol®888 ATO) and liquid lipid (Labrafac® PG) were combined, combined with just one surfactant (Gelucire®50/13) and a cationic agent (cetyltrimethylammonium bromide).
  • the carriers which contain components different from those used here, in quality and quantity, were prepared using the ultrasonication method, which is also different from that used in the invention described here (high pressure homogenization).
  • the study by Bhattacharjee et al (2020) describes a liposome gel containing besifloxacin. Such liposomes were prepared by the thin film hydration method. The authors selected soy lecithin and cholesterol as components of the lipid matrix.
  • Document BR1020180762494 describes the preparation of a nanoemulsion containing rifampicin for the treatment of ophthalmic infection caused by Mycobaterium tuberculosis using the high pressure homogenization method.
  • the nanoemulsion was prepared using a liquid lipid (oleic acid) and a surfactant (polysorbate 80) in very specific concentrations 1.0 m/m and 0.9 m/m, respectively.
  • the rifampicin nanoemulsion can be coated with polymyxin B sulfate.
  • the BR1020180762494 nanoemulsion differs from the SLN of the present invention in terms of the type of formulation, the quality and quantity of the components and the method of obtaining, in addition to the antibiotic carried. be distinct.
  • Document BR1020140230505 describes a cationic nanostructured lipid carrier containing dexamethasone acetate and polymyxin B sulfate for ophthalmic use.
  • the nanoparticles comprise: an unsaturated fatty acid, a saturated fatty acid, lecithin, a nonionic surfactant, dexamethasone acetate, a thickening agent, a cationic surfactant, and polymyxin B sulfate.
  • composition and the concentration of components used in the preparation of lipid nanoparticles described in BR1020140230505 are particularly applicable to the encapsulation of dexamethasone acetate. Therefore, it would not be possible to extrapolate the BR1020140230505 solution to prepare a SLN containing the antibiotic besifloxacin, as described below.
  • Document US20160128944A1 discloses a nanoparticle comprising a core comprising one or more active agents, including besifloxacin, a surfactant and one or more coating layers comprising one or more lipids.
  • lipid compositions of besifloxacin containing the drug, a surfactant and a lipid none of them comprise a liquid lipid, a solid lipid, a surfactant and a cosurfactant, formulated in a SLN by high pressure homogenization.
  • the SLN of the present invention specific for encapsulating besifloxacin, remains stable for 90 days after its preparation, significantly above those similar ones already described. Such an unexpected effect has the potential to allow the delivery of besifloxacin in a more effective and safe product for the prevention and treatment of ocular bacterial infections and with long shelf stability.
  • the SLN containing besifloxacin described here in an unprecedented way was designed using well-established methods in the pharmaceutical industry and components approved by regulatory bodies, favoring ready adoption on an industrial scale.
  • BRIEF DESCRIPTION OF THE INVENTION [39]
  • the present invention provides nanostructured lipid systems (SLN) containing besifloxacin encapsulated in a complex lipid matrix composed of a solid lipid, a liquid lipid, a surfactant and a cosurfactant.
  • the solid lipid is hydrogenated palm oil
  • the liquid lipid is triglyceride of caprylic capric acid (TACC)
  • the surfactant is phosphatidylcholine
  • the cosurfactant is polyoxyethylene sorbitan monooleate.
  • the SLN contains 25 mg of besifloxacin and comprises from 3.0 to 7.0% (m/m) hydrogenated palm oil, from 1.0 to 2.0% (m/m) m) caprylic capric acid triglycerides (TACC), 1.0 to 2.0% (m/m) of phosphatidylcholine and 2.0 to 4.0% (m/m) of polyoxyethylene sorbitan monooleate.
  • TACC caprylic capric acid triglycerides
  • the SLN containing besifloxacin is additionally coated with a cationic antibacterial agent.
  • the cationic agent is polymyxin B sulfate, which can be applied to coat the SLN at a concentration between 1000 and 5000 IU/mL.
  • Another aspect of the invention provides for a pharmaceutical composition comprising the SLN containing besifloxacin, one or more pharmaceutically acceptable excipients and/or one or more additional active pharmaceutical ingredients.
  • uses of SLN containing besifloxacin or the composition pharmaceutical company comprising it to prepare a medicament for treating ophthalmic bacterial infections.
  • such an ophthalmic bacterial infection affects a farm animal, a pet and/or a human patient, causing, for example, conjunctivitis, keratitis, blepharitis or endophthalmitis.
  • Bacterial infection is caused by Gram-positive and Gram-negative bacteria.
  • main microorganisms that affect the eye are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa.
  • a method of treating a mammal comprising administering to the mammal in need of treatment a therapeutically effective amount of the SLN containing besifloxacin or the pharmaceutical composition comprising it.
  • the mammal requires treatment for, for example, conjunctivitis, keratitis, blepharitis, or endophthalmitis caused by a bacterial infection.
  • the mammal is a farm animal, a pet, or a human patient in need of treatment for an ophthalmic bacterial infection caused by Gram-positive or Gram-negative bacteria.
  • Figure 1 illustrates the two-dimensional formula of besifloxacin, taken from the ChemSpider.com website.
  • Figure 2 represents optical microscopy, in which A: Besifloxacin in aqueous medium.
  • B Softisan®154.
  • FIG. 1 C: mixture of Softisan®154 (1.0 g) and besifloxacin (5.0 mg).
  • D mixture of Softisan®154 (1.0 g) with excess besifloxacin (6.0 mg).
  • Figure 3 refers to the molecular structure of the main components of Softisan®154: stearic acid and palmitic acid/triglycerides (Source: European Chemical Agency).
  • Figure 4 illustrates the quadratic and linear effects on the mean hydrodynamic diameter (DHM).
  • Figure 5 presents contour plots of the CLN-BF mathematical model for DHM, containing the following variables: Softisan®154, TACC, Lipoid® S100 and Tween 80.
  • nanostructured lipid systems comprising besifloxacin encapsulated by a lipid layer composed of hydrogenated palm oil (Softisan 154), caprylic capric acid triglycerides (TACC), polyoxyethylene sorbitan monooleate (polysorbate 80 or tween 80), phosphatidylcholine (Lipoid S100).
  • SLN can also be coated with a cationic antibacterial agent, for example, polymyxin B.
  • the terms “nanostructured lipid system” or “nanostructured lipid carrier” denote lipid particles with a structure formed by one or more lipids. pharmaceutically acceptable, in the presence of one or more pharmaceutically acceptable surfactants, the average particular diameter of which is less than 1000 nanometers (nm), as measured by conventional particle size measurement techniques well known to those skilled in the art, such as, for example, diffraction laser or dynamic light scattering.
  • the SLN has an average particle size, denoted by the average hydrodynamic diameter (DMH), measured by dynamic light scattering, equal to or less than about 200 nm.
  • the DHM is from about 50 to about 200 nm, from about 50 to about 190 nm, or from about 70 at about 180 nm. In a preferred form of the invention, the DHM of the SLN is about 80 nm to about 100 nm.
  • pharmaceutically acceptable lipid encompasses a broad spectrum of oils and fats such as, for example, medium or long chain fatty acids, mono-, di- or triglycerides, or mixtures thereof.
  • the pharmaceutically acceptable lipids of the invention can be in a solid or liquid state at room temperature.
  • solid lipids applicable in the present context may be selected from saturated fatty acid triglycerides (Witepsol® E85), hydrogenated palm oil (Softisan® 154), triestearin (Dynasan® 118), Glyceryl Monostearate and Acid stearic.
  • Relevant liquid lipids may be type I glycerol monocaprylate (Imwitor® 988), isopropyl myristate and capric and caprylic acid triglycerides (Miglyol® 812).
  • the SLN is composed of a solid pharmaceutically acceptable lipid, which is hydrogenated palm oil, and a liquid pharmaceutically acceptable lipid, which is capric and caprylic acid triglycerides.
  • pharmaceutically acceptable surfactant denotes a pharmaceutically acceptable substance, or a combination thereof, that reduces the surface tension of a liquid and decreases the interfacial tension between two liquids.
  • surfactants are generally organic compounds that are amphipathic, meaning they contain hydrophobic groups (their "tails”) and hydrophilic groups (their "heads”). Therefore, they are typically sparingly soluble in organic solvents and water.
  • a surfactant can be classified by the presence or absence of formally charged groups in its head.
  • a nonionic surfactant does not have charge groups in its head.
  • the head of an ionic surfactant carries a net charge; if the charge is negative, the surfactant is anionic; if the charge is positive, it is cationic, if it contains a head with two groups of opposite charges, it is zwitterionic.
  • surfactants and stabilizers are synonyms used interchangeably throughout the description.
  • Surfactants applicable in the context of the invention include polyoxyethylene sorbitan monooleate (polysorbate 80 or Tween 80), poloxamer 407 (Kolliphor® P 407), poloxamer 188 (Kolliphor® P 188), sorbitan monooleate (Span 80) and soy phosphatidylcholine (Lipoid ®S 100).
  • Surfactants particularly relevant to the invention are soy phosphatidylcholine (Lipoid®S 100) and polyoxyethylene sorbitan monooleate (Tween 80).
  • cationic antibacterial agent represents a group of compounds with a net positive charge that bind to the cell wall of negatively charged bacteria and destabilize the structural integrity of the wall and reduce bacterial viability. Coating the SLN containing besifloxacin with a cationic antibacterial agent increases the residence time of the product on the ocular surface, increases the bioavailability of the drug and favors the antibiotic effect promoted by besifloxacin.
  • Cationic antibacterial agents applicable to present invention may be selected, for example, from low molecular weight compounds, synthetic polymers or polypeptides.
  • the besifloxacin-containing SLN is further coated with a corona formed by a cationic antibacterial agent, which is, particularly, polymyxin B.
  • a cationic antibacterial agent which is, particularly, polymyxin B.
  • the besifloxacin-containing SLN of the present invention can be prepared, for example, by of a high pressure homogenization method. In this protocol, the oil and aqueous phases are heated under stirring separately, until the besifloxacin is completely solubilized and the surfactants are dispersed. In general, solubilization is followed by dispersion of the water phase into the oil phase and subsequent exposure to high shear. The protocol is completed by transferring the mixture to the high pressure homogenizer.
  • nanostructured lipid systems present stability with a homogeneous appearance, particle size and polydispersity index depending on the following factors: physical-chemical properties of the components; concentration of excipients and drug; preparation method and equipment performance; order of addition of phases; temperature; speed; emulsification and homogenization time; and storage conditions (DEKIC; PRIMORAC, 2017).
  • concentration of excipients and drug concentration of excipients and drug
  • preparation method and equipment performance order of addition of phases
  • temperature temperature
  • speed emulsification and homogenization time
  • storage conditions DEKIC; PRIMORAC, 2017.
  • the main instability phenomena refer to coalescence, flocculation, Oswald Ripening, creamation and sedimentation (ALI et al., 2017).
  • the term “stability”, as used throughout the text, refers to the maintenance of physical characteristics of the SLN, such as, for example, size, morphology and uniformity of the size distribution of the SLN particles. Ways to evaluate each of these parameters are widely known to those skilled in the art and are particularly summarized in the work of Phan and Haes (2019).
  • An efficient way to test and determine the appropriate proportions of solid lipid, liquid lipid, surfactant and cosurfactant is through statistical experiment optimization tools, such as, for example, central compound design, among others.
  • the SLN containing besifloxacin includes Softisan®154 as a solid lipid, TACC as a liquid lipid, Lipoid®S100 (palm oil hydrogenated) as surfactant and Tween 80 (polyoxyethylene sorbitan monooleate) as cosurfactant.
  • DHM represents the average hydrodynamic diameter of SLN particles, measured by dynamic light scattering
  • Sof represents the percentage mass of hydrogenated palm oil (Softisan® 154) in relation to the mass of the composition
  • TACC represents the percentage mass of capric and caprylic acid triglycerides (Miglyol® 812) in relation to the mass of the composition
  • Lip represents the percentage mass of soy phosphatidylcholine (Lipoid®S 100) in relation to the mass of the composition
  • Tw represents the percentage mass of polyoxy
  • the SLN has the following constitution: - Hydrogenated palm oil in a concentration of 3.0 to 7.0% m/m; - Caprylic capric acid triglycerides in a concentration of 1.0 to 2.0% m/m; - Phosphatidylcholine in a concentration of 1.0 to 2.0% m/m; - Polyoxyethylene sorbitan monooleate in a concentration of 2.0 to 4.0% m/m.
  • the SLN is additionally coated with Polymyxin B. In this embodiment, the coating is carried out with 1000 to 5000 IU/mL of polymyxin B sulfate.
  • compositions pharmaceuticals comprising the SLNs described herein and one or more pharmaceutically acceptable excipients.
  • Such compositions can be prepared and formulated employing conventional methods and excipients, such as disclosed, for example, in the British, European and United States Pharmacopoeia, Remington's Pharmaceutical Sciences (REMINGTON; GENNARO, 1990), Martindale: The Extra Pharmacopoeia (MARTINDALE; RAYNOLDS , 1996) and in Prista's Pharmaceutical technology (PRISTA et al., 1996).
  • Preferred pharmaceutical compositions can be formulated for topical administration, particularly for ophthalmic application.
  • Topical ophthalmic forms are sterile and may be liquid, semisolid or solid preparations, which may additionally contain one or more active pharmaceutical ingredients intended for application to the conjunctiva, conjunctival sac or eyelids.
  • the invention provides for the use of SLN containing besifloxacin to prepare medicament for treating bacterial infectious diseases that affect the eyes, therefore ophthalmic or ocular.
  • the infections treatable with a medicine containing the SLN of the present invention are those caused by Gram-positive or Gram-negative bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa.
  • Gram-positive or Gram-negative bacteria such as Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa.
  • Such bacterial infections cause, for example, conjunctivitis, keratitis, blepharitis and endophthalmitis.
  • the term "treat” includes extinguishing, substantially inhibiting, delaying or reversing the progression of a disease or disorder, substantially improving the clinical symptoms of a disease or disorder, or substantially preventing the onset of clinical symptoms of a disease or disorder.
  • a method of treating a mammal comprising administering to the mammal in need of treatment a therapeutically effective amount of the SLN containing besifloxacin or the pharmaceutical composition comprising it, as described above.
  • the mammal is a farm animal, a pet, or a human patient in need of treatment for an ophthalmic bacterial infection caused by Gram-positive or Gram-negative bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae. , Haemophilus influenzae and Pseudomonas aeruginosa.
  • the disease caused by the bacterial infection and treated by the method provided herein is, for example, conjunctivitis, keratitis, blepharitis or endophthalmitis.
  • the term "therapeutically effective” denotes an effective amount of an active ingredient (eg besifloxacin) to achieve a desired clinical effect. A therapeutically effective amount varies with the nature of the condition being treated, the period of The length of time the activity is desired and the age and condition of the subject is ultimately determined by the healthcare professional.
  • the following examples are intended to be purely exemplary of the invention. They are presented in order to provide the person skilled in the art with a complete description of how the SLN of this invention are prepared, evaluated and employed.
  • Liquid lipids ⁇ Glycerol dibehenate (Compritol ® 888), Stearoyl polyoxyl-32 glycerides (Gelucire® 50/13), Glycerol distearate (Precirol ® ATO 5), Lauryl polyoxyl-32 glycerides (Gelucire ® 44/14), Polyglyceryl 3 dioleate (Plurol ® Oleique CC 497), Propylene glycol Dicaprylate/Dicaprate (Labrafac TM PG), Glyceryl monolinoleate (Maisine ® CC), Capric/caprylic acid triglycerides (LabrafacTM lipophile WL 1349) were kindly donated by Gatefossé (France) .
  • ⁇ Diacetylated monoglycerides (Dynacet ® 285), glycerol monocaprylate type I (IMWITOR ® 988), glycerol monocaprylate/caprate type I (IMWITOR ® 742), propylene glycol diester (Mygliol ® 840), capric and caprylic acid triglycerides (Miglyol® 812) were kindly donated by IOI Oleo Chemical (Germany).
  • Solid lipids ⁇ Saturated fatty acid triglycerides (Witepsol® E85), hydrogenated palm oil (Softisan ® 154) and triestearin (Dynasan® 118) were kindly donated by IOI Oleo Chemical (Germany). ⁇ Stearic acid and glyceryl monostearate were purchased from Synth (Brazil).
  • Surfactants ⁇ Soy phosphatidylcholine (Lipoid ® S100) was purchased from Lipoid GMBH.
  • ⁇ Polyoxyethylene sorbitan monooleate (Polysorbate 80) was purchased from Sigma-Aldrich.
  • the mixture was placed in a heating bath at 75 ⁇ 5°C and stirring at 200 rpm for 60 min.
  • visual inspection and inspection were carried out using optical microscopy (Motic SMZ/165 Series, Motic®, China) in order to detect the presence or absence of particles in the lipid.
  • the solubility of the drug in the lipid was determined by its highest concentration at which no suspended particles were observed. Determination of solubility of besifloxacin in solid lipids [83] The solubility of besifloxacin in solid lipids was assessed according to Kasongo et al (2011).
  • the particle mean hydrodynamic diameter (Z- ave) and polydispersity index (IP) were determined by the dynamic light scattering (DLS) method on the equipment Nano ZS90 (Malvern Instruments, Malvern, United Kingdom). This method determines the DHM as a function of fluctuations in the intensity of scattered laser light when incident on the emulsified system. Readings were taken in triplicate after diluting the sample, at a ratio of 1:100, in Milli-Q water. A 90° angle and a polystyrene cuvette with 1 cm optical pitch were used.
  • zeta potential PZ
  • the zeta potential was determined using Zetasizer Nano ZS90 equipment (Malvern Instruments, Malvern, United Kingdom). In this equipment, electrophoretic mobility is converted into zeta potential using the Henry equation (equation 1) 2 ⁇ where ⁇ the dielectric constant and ⁇ the viscosity of the solvent at a temperature of 25 °C, UE the electrophoretic mobility, zo zeta potential, and f( ⁇ a) the Henry function.
  • the applied field strength was 20 V/cm.
  • the conductivity of Milli-Q water was adjusted to 50 ⁇ S/cm using 0.9% (m/v) NaCl solution.
  • Imwitor ® 988 is a mixture composed of 45-75% monoglycerides, 20-50% medium chain diglycerides (C8 and C11) and 10% mainly made up of triglycerides (IOI OLEOCHEMICAL, 2021) ( Figure 3) .
  • Imwitor ® 988 has an amphiphilic character with a single hydrocarbon chain and a hydrophilic main group. Thus, Imwitor ® 988 can act as a drug solubilizer.
  • This lipid is often used in self-emulsifying systems for oral administration, acting as a secondary lipid or cosurfactant (DEVRAJ et al., 2013; KAZI et al., 2020; ABDALLAH et al., 2020).
  • Imwitor ® 988 is not approved, to date, for ophthalmic use.
  • Assessment of the solubility of besifloxacin in solid lipids [91] Optical microscopy is the most frequently used method to select solid lipids (MONTEIRO et al., 2017; PATIL-GADHE; POKHARKAR 2016; KASONGO et al., 2011).
  • Table 2 presents the results of the solubility of besifloxacin in different solid lipids using optical microscopy (Motic SMZ/165 Series, Motic, China). Lipids were classified by the presence of besifloxacin particles. Softisan®154 was selected because it does not present particles as shown in Figure 2.
  • Figures 2A, 2B, 2C and 2D show images of optical microscopy slides of besifloxacin particles dispersed in water and Softisan ® 154, in different proportions.
  • Figure 2A shows besifloxacin particles agglomerated and not solubilized in the aqueous medium.
  • Figure 2B shows the arrangement of besifloxacin-free Softisan ® 154.
  • Figure 2C it is not possible to observe any particle of besifloxacin in Softisan ® 154. This result surprisingly confirmed the solubility of besifloxacin in this lipid, in an approximate amount of 5.0 mg/g.
  • Figure 2D the presence of besifloxacin particles is observed, showing that amounts greater than 5.0 mg/g of besifloxacin will not be solubilized by Softisan ® 154.
  • Softisan®154 is the hydrogenated palm oil compound mainly by long-chain glycerides, stearic acid (C18) and palmitic acid (C16) ( Figure 3). It is an excipient used as an oil phase in modified release formulations (Uronnachi et al., 2020; Monteiro et al., 2017; Shazly et al., 2017, Stelzner et al., 2018).
  • polysorbate 80, poloxamer 407, poloxamer 188, Span 80 and Lipoid ® S 100 were tested as they had lower toxicity, lower hemolytic incidence and less irritation to ocular tissues.
  • Table 3 presents the nanostructured lipid systems developed using Softisan®154 as the only component of the oily phase at concentrations of 3.0 and 5.0% (m/m) and hydrophilic surfactants independently at a concentration of 1. 0% (m/m).
  • Preparations containing tween 80 and poloxamer 407 showed phase separation after 24 hours of preparation.
  • the liquid lipids preferably used in ophthalmic preparations are vegetable oils and short and medium chain triglycerides due to their good tolerability by ocular tissues.
  • Imwitor 988 is a possible alternative for use due to the solubilization capacity of besifloxacin as previously shown, toxicity studies against ocular tissues have not been reported. [99] Therefore, in the present invention, it was decided to use caprylic capric acid triglycerides (TACC) as a liquid lipid.
  • TACC has been shown to be non-irritating or to have a low potential for irritation after prolonged exposure to the eye in in vivo tests.
  • preparations containing tween 80, span 80 and Lipoid ® S100 (F7B, F7, F8B and F8) showed phase separation immediately after preparation. Therefore, polxamer 407 and span 80 were disregarded for the next steps.
  • the DHM values of the preparations obtained using tween 80 and Lipoid ® S100 (F1B, F1, F5B and F5) varied between 85.4 ⁇ 0.7 and 223.1 ⁇ 5.1 nm with monomodal distribution .
  • the polydispersity indices varied between 0.15 ⁇ 0.04 and 0.34 ⁇ 0.01. Phase separation was observed over a period of 7, 21 and 90 days for preparations F1B and F1, F5B and F5, F2B and F2, respectively.
  • the F2B preparation showed DHM values between 180.1 ⁇ 1.2 and 185.6 ⁇ 2.6 nm; and IP between 0.18 ⁇ 0.01 and 0.19 ⁇ 0.01.
  • Formulation F2 presented DHM values between 178.6 ⁇ 1.1 and 185.7 ⁇ 2.4 nm; and IP between 0.19 ⁇ 0.01 and 0.23 ⁇ 0.02.
  • Table 8 Average hydrodynamic diameter (DHM) and polydispersity index (IP) of nanostructured systems containing besifloxacin.
  • Table 9 Variables and level of experiment in the development of the nanostructured lipid system containing besifloxacin.
  • TACC caprylic capric acid triglycerides
  • Table 10 Test matrix of the central composite design and DHM and IP values of the nanostructured lipid system containing besifloxacin F20 5.0 1.5 1.5 3.0 25 84.41 0.16 F21 5.0 1.5 1.5 3.0 25 93.28 0.16
  • Table 11 Analysis of variance to test the significance of the regression for the data obtained in the test to evaluate the DHM.
  • N1 N2 (% m/m) (% m/m) Softisan ® 154 3.00 5.00 TACC 1.00 1.67 Lipoid ® S100 1.00 1.67 Tween 80 2.11 3.50 Water 92, 89 88.16 Observed DHM (nm) ⁇ SD 85.1 ⁇ 2.2 93.6 ⁇ 1.7 Predicted DHM (nm) 90 136 IP ⁇ SD 0.18 ⁇ 0.01 0.15 ⁇ 0.01 PZ (mV) ⁇ SD - 16.7 ⁇ 0.3 -15.9 ⁇ 0.3 pH 7.00 7.00 SD: standard deviation; N1: 15.0 mg of BSF; N2: 25.0 mg of BSF; ATCC: capric caprylic acid triglycerides [113] In order to verify the mathematical model obtained in the statistical analysis, formulations N1 and N2 were prepared.
  • TACC being selected as a liquid lipid, which comprises the family of medium-chain triglycerides
  • vegetable lipids can present similar characteristics in the stability of the formulation. This fact may be based on the disorganization of the lipid matrix favored by the mixture of solid and liquid lipids. The greater this disorganization, the greater the effectiveness of drug encapsulation in this matrix. Considering this phenomenon, all vegetable oils have the potential to compose the lipid matrix and stabilize the preparation (system nanostructured lipid containing besifloxacin).
  • HAAS, W. et al. Bactericidal activity of besifloxacin against staphylococci, Streptococcus pneumoniae and Haemophilus influenza. Journal of Antimicrobial Chemotherapy, v.65, n.7, p.1441-1447, 2010.
  • HAAS, W. et al. Monitoring antibiotic resistance in ocular microorganisms: results from the Antibiotic Resistance Monitoring in Ocular micRorganisms (ARMOR) 2009 surveillance study.
  • Nanotechnology Drug Delivery Market (By Technology - Nanocrystals, Nanoparticles, Liposomes, Micelles, Nanotubes, and Others; By Application - Neurology, Oncology, Cardiovascular/Physiology, Anti-inflammatory/Immunology, Anti-infective, and Others) - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2015 – 2023. Available at: ⁇ https://www.transparencymarketresearch.com/nanotechnology- drug-delivery.html > Accessed on: August 7th. 2021. [141] YUKUYAMA, MN et al. Challenges and Future Prospects of Nanoemulsion as a Drug Delivery System. Current Pharmaceutical Design, vol. 23, no. 3, p. 495–508, 2017.

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Abstract

The present invention describes nanostructured lipid systems containing the antibiotic besifloxacin and the application thereof in the treatment and prevention of bacterial eye infections. Besifloxacin, an antibiotic with low aqueous solubility, is encapsulated in a nanostructured lipid system comprising a solid lipid, a liquid lipid, a surfactant and a co-surfactant. Optionally, the system of the invention can be additionally coated with an antibacterial cationic agent. The nanostructured lipid system according to the invention allows the topical administration of besifloxacin in the eyes and gives the drug a longer retention time on the surface of the eye. Furthermore, the system described herein is designed using industrially applicable methods and remains stable under storage conditions for at least 90 days, so it can be readily reproduced on an industrial scale.

Description

SISTEMA LIPÍDICO NANOESTRUTURADO CONTENDO BESIFLOXACINO, COMPOSIÇÃO FARMACÊUTICA E USOS CAMPO DA INVENÇÃO [1] A presente invenção pertence ao campo das ciências farmacêuticas e da nanotecnologia, posto que trata da preparação de sistemas lipídicos nanoestruturados contendo antibiótico para o tratamento de infecções oftálmicas. São descritos um sistema lipídico nanoestruturado contendo besifloxacino e, opcionalmente, sulfato de polimixina B, e sua aplicação na terapia e/ou prevenção de infecções bacterianas oculares. FUNDAMENTOS DA INVENÇÃO [2] As bactérias são a principal causa de infecções oftálmicas em âmbito global. Essas infecções podem danificar estruturas superficiais e profundas do olho humano ou animal promovendo possível cegueira e deficiência visual. Assim, é necessário diagnóstico e tratamento imediato. [3] Nos cuidados primários, em humanos, a conjuntivite, a ceratite e a blefarite estão entre as principais causas de consulta médica (BERTINO, 2009, TEWELDEMEDHIN, 2017). Essa doença afeta muitas pessoas e impõe ônus econômico e social. Estima-se que a conjuntivite aguda afeta 6 milhões de pessoas anualmente nos Estados Unidos (UDEH; SHNEIDER; OHSFELDT, 2008). No Brasil, existem poucos dados epidemiológicos dessa doença. O número de casos de conjuntivite cresceu substancialmente no início de 2018 em pelo menos quatro Estados do país: Mato Grosso, Goiás, Minas Gerais e Pernambuco. Além disso, Salvador, Fortaleza e Petrópolis registraram números de casos muito acima do normal no mês de janeiro desse ano (BBC BRASIL, 2018). [4] Schneider e colaboradores (2014) reportaram que o custo total da conjuntivite atingiu quase 800 milhões de dólares nos Estados Unidos, considerando custos sociais que incluem os custos indiretos associados aos dias de perda de trabalho, dias de perda escolar, custos de disseminação da doença associada a diagnósticos imprecisos e os custos da resistência aos antibióticos. Também, a publicação de Smith e Waycaster (2009) revelou que os custos diretos ou indiretos no diagnóstico e tratamento da conjuntivite bacteriana foram estimados em $589 milhões, nos Estados Unidos. [5] No caso de infecções oftálmicas em animais, a Organização Mundial da Saúde revelou que as doenças infecciosas serão o segundo maior desafio que o setor de saúde animal enfrentará nos próximos cinco anos devido ao aumento da resistência a antibióticos. Assim, as doenças infecciosas representarão a maior preocupação em saúde animal, em âmbito global, especialmente, nos mercados emergentes como o Brasil. [6] A seleção do fármaco para o tratamento das principais doenças infecciosas oculares bacterianas para o segmento anterior do olho é limitada à aplicação tópica de antibióticos, tanto para humanos quanto para animais. Bremond-Gignac et al (2011) indicaram os fármacos disponíveis para o tratamento: fluorquinolonas, aminoglicosídeos, penicilinas, cloranfenicol, tetraciclinas e eritromicina/azitromicina. [7] As fluorquinolonas são os antibióticos mais comuns utilizados por via tópica na terapia farmacológica da conjuntivite bacteriana devido a seu amplo espectro de ação (CHEN et al., 2018). No caso da ceratite considerada não grave, essa requer monoterapia com antibiótico fluoroquinolona de quarta geração como moxilfoxacino ou gatifloxacino. Entretanto, a ceratite bacteriana grave necessita de terapia intensiva empregando fluoroquinolona ou aminoglicosídeo e cefalosporina (McDONALD et al., 2014; SCHECHTER, PAREKH, TRATTLER, 2015). [8] Com referência ao tratamento da blefarite, não há diretrizes estabelecidas a respeito dos regimes terapêuticos, mas ensaios clínicos recentes mostraram que os antibióticos (tópicos ou sistêmicos) e corticosteroides tópicos podem produzir melhora significativa nos sinais e sintomas da blefarite (PFLUGFELDER, KARPECKI, PEREZ, et al., 2014). [9] Porém, o aumento nos índices de infecções com bactérias resistentes aos antibióticos, como o Staphylococcus aureus resistente à meticilina (MRSA), é preocupante. O Centro de Prevenção para Controle e Prevenção de Doenças dos Estados Unidos estima que 2 milhões de pessoas estejam infectadas com esses patógenos resistentes (EUROSURVEILLANCE TEAM, 2013). [10] Aproximadamente 80% dos isolados oculares de Staphylococcus aureus resistentes à meticilina nos Estados Unidos têm sido relatados como resistentes frente às fluoroquinolonas de segunda geração, o ciprofloxacino e ofloxacino (ASBELL et al., 2008; HAAS et al., 2011, COMSTOCK et al., 2014). Com referência às infecções oftálmicas resistentes em animais, não há dados na literatura. Afortunadamente, o antibiótico besifloxacino tem se mostrado eficaz contra as cepas resistentes. [11] O antibiótico besifloxacino, fluoroquinolona de quarta geração de uso exclusivo por via tópica oftálmica, tem se mostrado eficaz frente a cepas bacterianas susceptíveis e resistentes tanto de Gram-positivas quanto Gram-negativas. O besifloxacino foi sintetizado pela companhia japonesa SSP Co. Ltd e aprovado para comercialização, em 2009, pela Food and Drug Administration (FDA) sob o nome Besivance™ (6 mg/mL) pela empresa farmacêutica Bausch & Lomb Inc. Em 2010, a Agência Nacional de Vigilância Sanitária (ANVISA) aprovou o novo antibiótico para uso no Brasil. Esse fármaco tem sido indicado para conjuntivite, tendo demonstrado eficácia em diferentes ensaios clínicos (COMSTOCK et al., 2014; MAH; SANFILIPPO, 2016). [12] O besifloxacino apresenta fórmula química C19H21ClFN3O3, massa molar igual a 430,40 g/mol, apresenta baixa solubilidade em água (0,143 mg/mL) e pKas de 5,64 (médio ácido, grupo hidroxila) e 9,67 (médio básico, grupo amina primária). Com relação à sua estrutura química, o besifloxacino possui importante grupo 1-n ciclopropil, responsável pelo amplo espectro de atividade contra bactérias aeróbicas. Esse substituinte também aparece em outras fluoroquinolonas como ciprofloxacino, segunda geração, gatifloxacino e gemifloxacino, terceira geração, e moxifloxacino de quarta geração (LAL et al., 2014) (Figura 1). [13] Adicionalmente, o besifloxacino apresenta átomo de flúor na posição 6 da molécula, importante farmacóforo; átomo de cloro, na posição 8, responsável por aumentar a potência do antimicrobiano contra as enzimas bacterianas DNA girase (topoisomerase II) e topoisomerase IV, as quais são essenciais nos processos de transcrição e replicação bacteriana (CAMBAU et al., 2009). Essa dupla ligação aos domínios específicos e conformações fundamentam a atividade bactericida das fluorquinolonas (HOOPER; JACOBY, 2016; MAH; SANFILIPPO, 2016). Assim, a DNA girase é o alvo primário na maioria das bactérias Gram-negativas e a topoisomerase IV é o alvo primário das bactérias Gram-positivas (MITSCHER et al., 2008; PETRI, 2006). [14] Estudo realizado por Haas e colaboradores (2010) mostrou que o besifloxacino apresentou menor concentração mínima inibitória quando comparado ao moxifloxacino, gatifloxacino, ciprofloxacino, azitromicina e tobramicina para S. aureus, S. epidermidis e S. pneumoniae. Assim, esse antibiótico revelou potente ação antimicrobiana contra essas bactérias. Ademais, Comsctock e colaboradores (2014), no estudo clínico, revelaram que o besifloxacino teve atividade antimicrobiana frente a S. aureus e S. epidermidis resistentes a meticilina com índices significativos para erradicação dos micro-organismos. Além disso, o besifloxacino mostrou maior eficiência contra bactérias Gram-positivas e Gram-negativas resistentes a outras fluoroquinolonas. [15] Haas e colaboradores (2010), posteriormente, avaliaram a atividade bactericida do besifloxacino e outros agentes antimicrobianos (oxacilina, tobramicina, azitromicina, ciprofloxacina, moxifloxacina e gatifloxacina) frente a micro-organismos frequentemente causadores de conjuntivite bacteriana: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae e Haemophilus influenzae. Os resultados revelaram que o besifloxacino, de maneira contrária às demais fluoroquinolonas testadas, mostrou elevada potência e atividade bactericida. Essa atividade foi demonstrada inclusive contra cepas que apresentaram múltiplas mutações nos genes responsáveis pela codificação do DNA girase e topoisomerase IV (HAAS et al., 2011). Adicionalmente, estudo realizado por Zhang e Ward (2008) mostrou que o besifloxacino também atua como agente anti-inflamatório em monócitos in vitro. Tal atividade pode melhorar a sua eficácia no tratamento de infecções oculares concomitantes à inflamação. [16] Apesar das vantagens terapêuticas apresentadas, o besifloxacino pode ter sua eficácia terapêutica limitada em função de sua baixa solubilidade em água. Essa propriedade química representa o principal desafio no desenvolvimento de preparações contendo besifloxacino. Adicionalmente, as preparações convencionais como soluções, suspensões ou pomadas oftálmicas apresentam limitada biodisponibilidade dos fármacos em função dos mecanismos de proteção do olho, das suas barreiras biológicas, metabólicas e fisiológicas (DUBALD et al., 2018; BARANOWSKI, 2014). Para superar esses desafios, os sistemas lipídicos nanoestruturados (SLN) como o carreador lipídico nanoestruturado (CLN) tem-se apresentado como estratégia promissora para o desenvolvimento de produtos oftálmicos que ofereçam maior eficácia e segurança ao paciente. [17] Tendo em vista a necessidade de adequada terapia das infecções bacterianas oftálmicas, o desenvolvimento de sistema lipídico nanoestruturado (SLN) contendo besifloxacino representa estratégia promissora em função do aumento da solubilidade do fármaco e o aumento da sua eficácia e segurança. Adicionalmente, tem potencial para prevenir o surgimento de cepas bacterianas resistentes. [18] Até o momento, um SLN contendo besifloxacino não está disponível no mercado nem descrito em publicações acadêmicas ou patentárias e é, portanto, o objeto da presente invenção. ESTADO DA TÉCNICA [19] A aplicação da nanotecnologia no desenvolvimento de formas farmacêuticas tem alcançado importante crescimento. Foram aprovados pela FDA (Food and Drug Administration) aproximadamente 50 produtos com base nanotecnológica desde 1995, e cerca de 70 estão em fase de estudo clínico. Há previsão que o mercado nanotecnológico de produtos farmacêuticos se expandirá com taxa de crescimento anual composta de 12,5% entre 2015 e 2023. Se a previsão se confirmar, o mercado subirá de uma avaliação de US$ 4,1 bilhões em 2014 para US$ 11,9 bilhões em 2023 (Transparency Market Research, 2016). [20] O transporte de antibióticos em sistemas lipídicos nanoestruturados tem sido explorado como uma das estratégias mais promissoras para a obtenção de produtos com maior eficácia e segurança. Esses sistemas trouxeram progressos expressivos no desenvolvimento de novos produtos farmacêuticos devido às suas propriedades intrínsecas, como tamanho na faixa nanométrica, carga superficial, permeabilidade aprimorada e alta relação área superficial/volume. Essas propriedades permitem maximizar a interação do antibiótico com as bactérias, inibir a formação de biofilme, melhorar a penetração através de biofilmes e possuem maior eficácia frente a infecções intracelulares. [21] O sistema lipídico nanoestruturado (SLN) possibilita o transporte de fármaco hidrofóbicos como o besifloxacino. Adicionalmente, possibilita a melhoria da sua farmacocinética e farmacodinâmica por diversas vias de administração como a via tópica ocular. Tais melhorias referem-se às vantagens tais como liberação modificada do fármaco, maior eficácia, efeitos adversos reduzidos, e a melhor proteção do fármaco contra processos enzimáticos ou oxidativos (YUKUYAMA et al., 2017). Além disso, as preparações otimizadas em escala laboratorial e as tecnologias atuais para produção em escala piloto viabilizam a transposição para a produção industrial sem modificar as propriedades dos sistemas lipídicos nanoestruturados. [22] A seguir são revisados os antecedentes da presente invenção. Cabe ressaltar que a simples mistura de quaisquer componentes não constitui uma fórmula farmacêutica. Uma formulação farmacêutica de sucesso é constituída da mistura de componentes únicos com interações particulares. [23] Youssef e colaboradores (2020) desenvolveram sistema lipídico nanoestruturado contendo ciprofloxacino (SLN-ciprofloxacino) para o tratamento da endoftalmite bacteriana. Esse carreador foi preparado empregando Precirol® ATO 5 e ácido oleico como lipídio sólido e líquido, respectivamente. O polissorbato 80 e poloxamer 188 foram utilizados como tensoativos. A preparação otimizada apresentou tamanho de partícula igual a 193,1 ± 5,1 nm e IP, 0,43 ± 0,01. O fluxo transcorneal do SLN-ciprofloxacino em ensaio ex vivo revelou aumento de 4 vezes comparado a solução de ciprofloxacino, e a permeabilidade transcorneal de SLN- ciprofloxacino foi 3,5 vezes maior comparado ao fármaco livre. [24] Os poros presentes na córnea facilitam o transporte intracelular de partículas do SLN com tamanho na faixa de 200-300 nm. Além disso, a fase lipídica pode interagir com o segmento lipídico do filme lacrimal aumentando o tempo de retenção. Consequentemente, quantidade maior de nanopartículas pode ser internalizada por endocitose, o que poderia reduzir potencialmente os danos ao tecido ocular pela infecção e pelo tratamento antibiótico (DE OLIVEIRA et al., 2020, GARRIGUE et al., 2017). [25] Sistema lipídico nanoestruturado contendo dexametasona (SLN-dexametasona) foi desenvolvido para o tratamento de olho seco. A formulação final apresentou colesterol, Labrafac™ lipophile WL1349 e polissorbato 80 em sua composição. O tamanho de partícula foi igual a 19,51 ± 0,5 nm; índice de polidispersão (IP), igual a 0,08; e eficiência de encapsulação igual a 99,6 ± 0,5%. O SLN marcado com substância fluorescente demostrou aumento da internalização das nanopartículas nas células epiteliais primárias da córnea humana em ensaios in vitro. Esse SLN mostrou adequada distribuição das nanopartículas na superfície da córnea após 4 h a 37 °C mostrando possível aumento da biodisponibilidade do fármaco e aumento do tempo de residência na superfície ocular. Além disso, SLN- dexametasona foi mais eficaz na redução de citocinas inflamatórias comparada à dexametasona livre. A nanopartícula desenvolvida foi considerada candidata potencialmente comercializável para doenças inflamatórias oculares como a síndrome do olho seco (KUMARI et al., 2021). [26] Visando evitar complicações como a opacificação capsular após cirurgia de catarata, Yan e colaboradores (2021) desenvolveram transportador em gel sensível à temperatura contendo sistema lipídico nanoestruturado contendo genisteína, dexametasona e moxifloxacino. SLN- genisteína apresentou tamanho de partícula, índice de polidispersão, potencial zeta e eficiência de encapsulação igual a 39,47 ± 0,69 nm, 0,213 ± 0,016, −4,32 ± 0,84 mV e 92,75 ± 2,72%, respectivamente. Os estudos de liberação in vitro revelaram liberação completa do moxifloxacino ao final de 10 dias. [27] No trabalho de Yan e colaboradores (2021), a dexametasona apresentou liberação modificada a taxa constante até o trigésimo dia e a genisteína mostrou liberação cumulativa de 63% por quarenta dias. Adicionalmente, hidrogel termorresponsivo contendo sistema lipídico nanoestruturado inibiu a proliferação, migração e transição epitelial-mesenquimal de células epiteliais do cristalino do olho em ensaios in vitro. Desse modo, a preparação mostrou-se promissora na redução da opacificação capsular após cirurgia de catarata. [28] O trabalho de Kassaee e Mahboobian (2022) descreve uma nanoemulsão contendo besifloxacino para administração ocular. [29] Como uma nanoemulsão, o carreador de Kassaee e Mahboobian apresenta uma matriz lipídica simples composta por apenas um lipídio líquido (triester de glicerol) que difere daquele empregado nesta invenção (triglicérideos do ácido cáprico caprílico). Além de compreender componentes distintos daqueles utilizados na presente invenção, foram obtidas através de emulsificação de baixa energia, ao passo que um processo de alta energia é o aplicado à solução técnica ora descrita. [30] O trabalho de Baig et al (2020) descreve o desenvolvimento de carreador lipídico nanoestruturado catiônico contendo besifloxacino. Foram combinados um lipídio sólido (Compritol®888 ATO) e lipídio líquido (Labrafac® PG), combinados a apenas um tensoativo (Gelucire®50/13) e um agente catiônico (brometo de cetiltrimetilamónio). Os carreadores, que contêm componentes distintos daqueles aqui empregados, em qualidade e quantidade, foram preparados pelo método de ultrassonicação, que também é distinto daquele empregado na invenção aqui descrita (homogeneização à alta pressão). [31] O estudo de Bhattacharjee et al (2020) descreve um lipossoma em gel contendo besifloxacino. Tais lipossomas foram preparados pelo método de hidratação de filme fino. Os autores selecionaram lecitina de soja e colesterol como componentes da matriz lipídica. Essa preparação foi incorporada em gel de Carbopol 940 (1% m/v) para obtenção de gel lipossomal contendo besifloxacino. A nanopartícula resultante difere daquela que é objeto da presente invenção quanto ao tipo, à composição e ao método de obtenção. [32] O trabalho de Dos Santos et al (2020) ensina o desenvolvimento de lipossomas catiônicos contendo besifloxacino. Os lipossomas foram preparados pelo método de hidratação do filme lipídico. Os pesquisadores utilizaram fosfatidilcolina, colesterol, esterilamina e espermina. De modo semelhante ao documento anterior, a nanopartícula de Dos Santos et al difere daquela que é objeto da presente invenção quanto ao tipo, à composição e ao método de obtenção. [33] O documento BR1020180762494 descreve a preparação de nanoemulsão contendo rifampicina para tratamento de infeção oftálmica causada pelo Mycobaterium tuberculosis pelo método de homogeneização à alta pressão. A nanoemulsão foi preparada empregando um lipídio líquido (ácido oleico) e um tensoativo (polissorbato 80) em concentrações bastantes particulares 1,0 m/m e 0,9 m/m, respectivamente. Ainda, a nanoemulsão de rifampicina pode ser revestida com sulfato de polimixina B. Novamente, a nanoemulsão de BR1020180762494 difere do SLN da presente invenção quanto ao tipo de formulação, à qualidade e quantidade dos componentes e ao método de obtenção, além do antibiótico carreado também ser distinto. [34] O documento BR1020140230505 descreve um carreador lipídico nanoestruturado catiônico contendo acetato de dexametasona e sulfato de polimixina B para uso oftálmico. As nanopartículas compreendem: um ácido graxo insaturado, um ácido graxo saturado, lecitina, um tensoativo não iônico, acetato de dexametasona, um agente de espessamento, um tensoativo catiônico e sulfato de polimixina B. [35] Apesar dos ensinamentos abrangentes, a composição e a concentração dos componentes empregados no preparo de nanopartículas lipídicas descritas em BR1020140230505 são particularmente aplicáveis à encapsulação de acetato de dexametasona. Assim, não seria possível extrapolar a solução de BR1020140230505 para elaborar um SLN contendo o antibiótico besifloxacino, conforme descrito adiante. [36] O documento US20160128944A1 revela uma nanopartícula compreendendo um núcleo que compreende um ou mais agentes ativos, dentre os quais está o besifloxacino, um tensoativo e uma ou mais camadas de revestimento compreendendo um ou mais lipídios. Apesar da menção a diversas composições lipídicas de besifloxacino contendo o fármaco, um tensoativo e um lipídio, nenhuma delas compreende um lipídeo líquido, um lipídeo sólido, um tensoativo e um cotensoativo, formulados em uma SLN por homogeneização à alta pressão. [37] Em comparação aos carreadores lipídicos nanoestruturados dos documentos precedentes, o SLN da presente invenção, específico para encapsular o besifloxacino, permanece estável por 90 dias após seu preparo, significativamente acima daqueles semelhantes já descritos. Tal efeito inesperado tem o potencial de permitir a veiculação de besifloxacino em um produto mais eficaz e seguro na prevenção e tratamento de infecções bacterianas oculares e com longa estabilidade de prateleira. [38] O SLN contendo besifloxacino aqui descrito de maneira inédita foi concebido através da utilização de métodos bem estabelecidos na indústria farmacêutica e componentes aprovados pelos órgãos regulatórios, favorecendo a pronta adoção em escala industrial. BREVE DESCRIÇÃO DA INVENÇÃO [39] A presente invenção fornece sistemas lipídicos nanoestruturados (SLN) contendo besifloxacino encapsulado em uma matriz lipídica complexa composta de um lipídeo sólido, um lipídeo líquido, um tensoativo e um cotensoativo. [40] Em certas modalidades do sistema lipídico nanoestruturado contendo besifloxacino, o lipídeo sólido é óleo de palma hidrogenado, o lipídeo líquido é triglicerídeo do ácido cáprico caprílico (TACC), o tensoativo é fosfatidilcolina e o cotensoativo é Monooleato de polioxietileno sorbitano. [41] Em um outro aspecto da invenção, as proporções de óleo de palma hidrogenado, triglicerídeos do ácido cáprico caprílico (TACC), fosfatidilcolina e Monooleato de polioxietileno sorbitano no SLN contendo besifloxacino estão de acordo com a equação geral: ^^^ = 130 + 74,1 ^^^ + 152 ^^^^ + 187,7^^^ − 314,4 ^^ + 153 ^^^^ ∗ ^^^^ + 69,1^^ ∗ ^^ − 42,63^^^ ∗ ^^^^ − 18,82^^^ ∗ ^^^ − 64,0 ^^^^ ∗ ^^ − 37,4^^ ∗ ^^. [42] Em modalidades preferenciais da invenção, o SLN contém 25 mg de besifloxacino e compreende de 3,0 a 7,0% (m/m) de óleo de palma hidrogenado, de 1,0 a 2,0% (m/m) de triglicerídeos do ácido cáprico caprílico (TACC), de 1,0 a 2,0% (m/m) de fosfatidilcolina e de 2,0 a 4,0% (m/m) de Monooleato de polioxietileno sorbitano. [43] Em uma outra modalidade da invenção, o SLN contendo besifloxacino é adicionalmente revestido com um agente catiônico antibacteriano. Em um aspecto preferencial, o agente catiônico é sulfato de polimixina B, que pode ser aplicado para revestimento do SLN em uma concentração entre 1000 e 5000 UI/mL. [44] Um outro aspecto da invenção prevê uma composição farmacêutica compreendendo o SLN contendo besifloxacino, um ou mais excipientes farmaceuticamente aceitáveis e/ou um ou mais ingredientes farmacêuticos ativos adicionais. [45] Em uma outra modalidade da invenção, estão previstos usos do SLN contendo besifloxacino ou da composição farmacêutica que o compreende para preparar um medicamento para tratar infecções bacterianas oftálmicas. Em modalidades preferenciais, tal infecção bacteriana oftálmica afeta um animal de produção, um animal de estimação e/ou um paciente humano, causando, por exemplo, uma conjuntivite, ceratite, blefarite ou endoftalmite. A infecção bacteriana é causada por bactérias Gram-positivas e Gram-negativas. Entre os principais micro-organismos que acometem o olho encontram- se Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae e Pseudomonas aeruginosa. [46] Em outra modalidade da invenção, é fornecido um método de tratamento de um mamífero compreendendo a administração ao mamífero com necessidade de tratamento de uma quantidade terapeuticamente eficaz do SLN contendo besifloxacino ou da composição farmacêutica que o compreende. Em certas modalidades, o mamífero necessita de de tratamento para, por exemplo, conjuntivite, ceratite, blefarite ou endoftalmite causadas por uma infecção bacteriana. [47] Em modalidades preferenciais, o mamífero é um animal de produção, um animal de estimação ou um paciente humano que necessita de tratamento para uma infecção bacteriana oftálmica causada por bactérias Gram-positivas ou Gram-negativas. Entre os principais micro-organismos que acometem o olho encontram-se Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae e Pseudomonas aeruginosa. BREVE DESCRIÇÃO DAS FIGURAS [48] Para auxiliar na identificação das principais características da presente invenção, são apresentadas as seguintes figuras: a Figura 1 ilustra a fórmula bidimensional do besifloxacino, extraída do sítio da internet ChemSpider.com. [49] A Figura 2 representa a Microscopia óptica, na qual A: Besifloxacino em meio aquoso. B: Softisan®154. C: mistura de Softisan®154 (1,0 g) e besifloxacino (5,0 mg). D: mistura de Softisan®154 (1,0 g) com excesso de besifloxacino (6,0 mg). [50] A Figura 3 se refere à estrutura molecular dos principais componentes do Softisan®154: ácido esteárico e ácido palmítico/triglicerídeos (Fonte: European Chemical Agency). [51] A Figura 4 ilustra os efeitos quadrático e linear sobre o diâmetro hidrodinâmico médio (DHM). [52] A Figura 5 apresenta gráficos de contorno do modelo matemático CLN-BF para o DHM, contendo as seguintes variáveis: Softisan®154, TACC, Lipoid® S100 e Tween 80. DESCRIÇÃO DETALHADA DA INVENÇÃO [53] A menos que especificado de maneira distinta, os termos usados ao longo deste relatório descritivo têm seus significados comuns na técnica, dentro do contexto da divulgação e no contexto específico em que cada termo é usado. Certos termos que são usados para descrever a divulgação são discutidos abaixo, ou em outro lugar na especificação, para fornecer orientação adicional ao profissional em relação à descrição da divulgação. As publicações aqui citadas e o material para o qual são citados são especificamente incorporados por referência em sua totalidade. [54] Será apreciado que a mesma coisa pode ser dita de maneiras distintas. Consequentemente, linguagem alternativa e sinônimos podem ser usados para qualquer um ou mais dos termos aqui discutidos. Nenhum significado especial deve ser colocado sobre se um termo é elaborado ou discutido aqui. Sinônimos para certos termos são fornecidos, mas a exemplificação de alguns sinônimos não exclui o potencial uso de outros porventura não listados aqui. [55] Nesta invenção, são fornecidos sistemas lipídicos nanoestruturados (SLN) compreendendo besifloxacino encapsulado por uma camada lipídica composta de óleo de palma hidrogenado (Softisan 154), triglicerídeos do ácido cáprico caprílico (TACC), Monooleato de polioxietileno sorbitano (polisorbato 80 ou tween 80), fosfatidilcolina (Lipoid S100). Tal SLN pode ainda ser revestido por um agente catiônico antibacteriano, por exemplo, polimixina B. [56] Conforme empregado nesta invenção, as expressões “sistema lipídico nanoestruturado” ou “carreador lipídico nanoestruturado” denotam partículas lipídicas de estrutura formada por um ou mais lipídeos farmaceuticamente aceitáveis, na presença de um ou mais tensoativos farmaceuticamente aceitáveis, cujo diâmetro particular médio é inferior a 1000 nanômetros (nm), conforme medido por técnicas convencionais de medição de tamanho de partícula bem conhecidas daqueles versados na técnica, como, por exemplo, difração a laser ou espalhamento de luz dinâmica. [57] Em algumas modalidades da invenção, o SLN tem tamanho de partícula médio, denotado pelo diâmetro hidrodinâmico médio (DMH), medido por espalhamento dinâmico de luz, igual ou inferior a cerca de 200 nm. Em formas de realização da invenção, o DHM é de cerca de 50 a cerca de 200 nm, de cerca de 50 a cerca de 190 nm ou de cerca de 70 a cerca de 180 nm. Em uma forma preferencial da invenção, o DHM do SLN é de cerca de 80 nm a cerca de 100 nm. [58] Conforme aqui utilizado, o termo “lipídeo farmaceuticamente aceitável” engloba um amplo espectro de óleos e gorduras tais como, por exemplo, ácidos graxos, mono-, di- ou triglicerídeos de cadeia média ou longa, ou misturas destes. Os lipídeos farmaceuticamente aceitáveis da invenção podem se encontrar em estado sólido ou líquido à temperatura ambiente. [59] Por exemplo, os lipídeos sólidos aplicáveis no presente contexto podem ser selecionados de triglicérides de ácidos graxos saturados (Witepsol® E85), óleo de palma hidrogenado (Softisan® 154), triestearina (Dynasan® 118), Monoestearato de glicerila e Ácido esteárico. Os lipídeos líquidos pertinentes podem ser monocaprilato de glicerol tipo I (Imwitor® 988), miristato de isopropila e triglicérides de ácido cáprico e caprílico (Miglyol® 812). [60] Em uma modalidade preferencial, o SLN é composto por um lipídeo farmaceuticamente aceitável sólido, que é óleo de palma hidrogenado, e um lipídeo farmaceuticamente aceitável líquido, que é triglicérides de ácido cáprico e caprílico. [61] Conforme aqui utilizado, o termo “tensoativo farmaceuticamente aceitável” denota uma substância farmaceuticamente aceitável, ou uma combinação das mesmas, que reduz a tensão superficial de um líquido e diminui a tensão interfacial entre dois líquidos. Tensoativos são geralmente compostos orgânicos que são anfipáticos, o que significa que eles contêm grupos hidrofóbicos (suas "caudas") e grupos hidrofílicos (suas "cabeças"). Portanto, eles são tipicamente moderadamente solúveis em solventes orgânicos e água. [62] Um tensoativo pode ser classificado pela presença ou ausência de grupos formalmente carregados em sua cabeça. Um tensoativo não iônico não possui grupos de carga em sua cabeça. A cabeça de um tensoativo iônico carrega uma carga líquida, se a carga for negativa, o tensoativo é aniônico; se a carga for positiva, é catiônica, se contiver uma cabeça com dois grupos de cargas opostas, é zwitteriônica. [63] No contexto desta invenção, tensoativos e estabilizantes são sinônimos utilizados de maneira intercambiável ao longo da descrição. Tensoativos aplicáveis no contexto da invenção incluem monooleato de polioxietileno sorbitano (polissorbato 80 ou Tween 80), poloxamer 407 (Kolliphor® P 407), poloxamer 188 (Kolliphor® P 188), monooleato de sorbitano (Span 80) e fosfatidilcolina de soja (Lipoid®S 100). Tensoativos particularmente relevantes à invenção são fosfatidilcolina de soja (Lipoid®S 100) e monooleato de polioxietileno sorbitano (Tween 80). [64] No contexto da invenção, a expressão “agente catiônico antibacteriano” representa um grupo de compostos com carga líquida positiva que se ligam à parede celular de bactérias, de carga negativa, e desestabilizam a integridade estrutural da parede e reduzem a viabilidade bacteriana. O revestimento do SLN contendo besifloxacino com um agente catiônico antibacteriano aumenta o tempo de residência do produto na superfície ocular, incrementa a biodisponibilidade do fármaco e favorece o efeito antibiótico promovido pelo besifloxacino. [65] Agentes catiônicos antibacterianos aplicáveis à presente invenção podem ser selecionados, por exemplo, de compostos de baixo peso molecular, polímeros sintéticos ou polipeptídeos. Em certas modalidades da invenção, o SLN contendo besifloxacino é adicionalmente revestido por uma coroa formada por um agente catiônico antibacteriano, que é, particularmente, a polimixina B. [66] O SLN contendo besifloxacino da presente invenção pode ser preparado, por exemplo, através de um método de homogeneização à alta pressão. Neste protocolo, as fases oleosa e aquosa são aquecidas sob agitação separadamente, até a completa solubilização do besifloxacino e dispersão dos tensoativos. Em geral, a solubilização é seguida de dispersão da fase aquosa na fase oleosa e subsequente exposição a elevado cisalhamento. O protocolo é concluído com a transferência da mistura para o homogeneizador à alta pressão. [67] Considerando suas características, os sistemas lipídicos nanoestruturados apresentam estabilidade com aspecto homogêneo, tamanho de partícula e índice de polidispersão dependente dos seguintes fatores: propriedades físico-químicas dos componentes; concentração dos excipientes e do fármaco; método de preparo e desempenho do equipamento; ordem de adição das fases; temperatura; velocidade; tempo de emulsificação e de homogeneização; e as condições de armazenamento (DEKIC; PRIMORAC, 2017). [68] Para se alcançar a estabilidade do SLN, deve-se combinar componentes específicos em concentração adequada e processá-los de maneira particular. Assim, cada fórmula é única e, portanto, só pode ser alcançada por meio de ensaios empíricos e exaustivos. [69] Dentre esses fatores, a adequada proporção de lipídio(s) e tensoativo(s) é de fundamental importância para a estabilidade dos SLN. Os principais fenômenos de instabilidade, decorrentes de combinações de excipientes de fármaco inapropriadas, referem-se à coalescência, floculação, Oswald Ripening, cremeação e sedimentação (ALI et al., 2017). [70] O termo “estabilidade”, conforme utilizado ao longo do texto, diz respeito à manutenção de características físicas do SLN, como, por exemplo, tamanho, morfologia e uniformidade da distribuição de tamanho das partículas do SLN. Formas de avaliar cada um desses parâmetros são amplamente conhecidas do técnico no assunto e se encontram particularmente sintetizadas no trabalho de Phan e Haes (2019). [71] Uma maneira eficiente de testar e determinar as proporções adequadas de lipídeo sólido, lipídeo líquido, tensoativo e cotensoativo é através de ferramentas estatísticas de otimização de experimentos, como, por exemplo, delineamento composto central, entre outras. Lançando mão de ferramentas desse tipo, é possível estabelecer a influência de um ou mais componentes do SLN (i.e. variáveis independentes) sobre um parâmetro representativo da qualidade do SLN como, por exemplo, o diâmetro hidrodinâmico médio (DHM), e fornecer uma equação geral capaz de predizer todas as configurações das variáveis independentes que resultarão em valores desejados para a variável dependente. [72] Em uma modalidade preferencial, o SLN contendo besifloxacino inclui Softisan®154 como lipídeo sólido, TACC como lipídeo líquido, Lipoid®S100 (óleo de palma hidrogenado) como tensoativo e Tween 80 (monooleato de polioxietileno sorbitano) como cotensoativo. Na modalidade preferencial, as proporções dos componentes que resultarão em SLN estáveis e dentro da faixa de DHM desejável é dada pela fórmula geral: ^^^ = 130 + 74,1 ^^^ + 152 ^^^^ + 187,7^^^ − 314,4 ^^ + 153 ^^^^ ∗ ^^^^ + 69,1^^ ∗ ^^ − 42,63^^^ ∗ ^^^^ − 18,82^^^ ∗ ^^^ − 64,0 ^^^^ ∗ ^^ − 37,4^^ ∗ ^^ onde: DHM representa o diâmetro hidrodinâmico médio das partículas de SLN, medido por espalhamento de luz dinâmica; Sof representa a massa percentual de óleo de palma hidrogenado (Softisan® 154) em relação à massa da composição; TACC representa a massa percentual de triglicérides de ácido cáprico e caprílico (Miglyol® 812) em relação à massa da composição; Lip representa a massa percentual de fosfatidilcolina de soja (Lipoid®S 100) em relação à massa da composição; e Tw representa a massa percentual de monooleato de polioxietileno sorbitano (Tween 80) em relação à massa da composição. [73] Em uma modalidade preferencial, o SLN apresenta a seguinte constituição: - Óleo de palma hidrogenado em uma concentração de 3,0 a 7,0% m/m; - Triglicerídeos do ácido cáprico caprílico em uma concentração de 1,0 a 2,0% m/m; - Fosfatidilcolina em uma concentração de 1,0 a 2,0% m/m; - Monooleato de polioxietileno sorbitano em uma concentração de 2,0 a 4,0% m/m. [74] Em um outro aspecto da invenção, o SLN é adicionalmente revestido por Polimixina B. Nesta modalidade, o revestimento é realizado com 1000 a 5000 UI/mL de sulfato de polimixina B. [75] Em uma modalidade, a invenção prevê composições farmacêuticas compreendendo os SLN ora descritos e um ou mais excipientes farmaceuticamente aceitáveis. Tais composições podem ser preparadas e formuladas empregando métodos e excipientes convencionais, tais como divulgados, por exemplo, nas Farmacopeias Britânica, Europeia e dos Estados Unidos, Remington's Pharmaceutical Sciences (REMINGTON; GENNARO, 1990), Martindale: The Extra Pharmacopoeia (MARTINDALE; RAYNOLDS, 1996) e em Prista's Pharmaceutical technology (PRISTA et al., 1996). [76] As composições farmacêuticas preferenciais podem ser formuladas para administração por via tópica, particularmente, para aplicação oftálmica. As formas oftálmicas tópicas (como colírios) são estéreis e podem ser preparações líquidas, semissólidas ou sólidas, que podem conter adicionalmente um ou mais ingredientes farmacêuticos ativos destinados à aplicação na conjuntiva, no saco conjuntival ou nas pálpebras. [77] Em uma modalidade adicional, a invenção fornece o uso do SLN contendo besifloxacino para preparar medicamento para tratar doenças infecciosas bacterianas que afetam os olhos, portanto oftálmicas ou oculares. Entre as infecções tratáveis com um medicamento contendo o SLN da presente invenção estão aquelas ocasionadas por bactérias Gram- positivas ou Gram-negativas, tais como Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae e Pseudomonas aeruginosa. Tais infecções bacterianas ocasionam, por exemplo, conjuntivite, ceratite, blefarite e endoftalmite. [78] Conforme aqui empregado, o termo "tratar" inclui extinguir, inibir substancialmente, retardar ou reverter a progressão de uma doença ou distúrbio, melhorar substancialmente os sintomas clínicos de uma doença ou distúrbio ou prevenir substancialmente o aparecimento de sintomas clínicos de uma doença ou distúrbio. [79] Em outra modalidade da invenção, é fornecido um método de tratamento de um mamífero compreendendo a administração ao mamífero com necessidade de tratamento de uma quantidade terapeuticamente eficaz do SLN contendo besifloxacino ou da composição farmacêutica que o compreende, conforme descritos acima. Em modalidades preferenciais, o mamífero é um animal de produção, um animal de estimação ou um paciente humano que necessita de tratamento para uma infecção bacteriana oftálmica ocasionada por bactérias Gram- positivas ou Gram-negativas, tais como Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae e Pseudomonas aeruginosa. Em certas modalidades, a doença causada pela infecção bacteriana e tratada pelo método aqui previsto é, por exemplo, conjuntivite, ceratite, blefarite ou endoftalmite. [80] Conforme empregado aqui, O termo "terapeuticamente eficaz" denota uma quantidade eficaz de um princípio ativo (e.g. besifloxacino) para alcançar um efeito clínico desejado. Uma quantidade terapeuticamente eficaz varia com a natureza da condição a ser tratada, o período de tempo em que a atividade é desejada e a idade e a condição do sujeito, em última análise, é determinada pelo profissional de saúde. [81] Os exemplos a seguir pretendem ser puramente exemplificativos da invenção. São apresentados de modo a fornecer ao técnico no assunto descrição completa de como são preparados, avaliados e empregados o SLN desta invenção. Um técnico no assunto, à luz da presente divulgação, reconhecerá que muitas alterações podem ser feitas nas modalidades específicas que são divulgadas e ainda assim obter um resultado semelhante ou equivalente sem se afastar do espírito e do escopo da invenção. EXEMPLOS DE CONCRETIZAÇÃO Exemplo 1: Preparo do sistema lípidico nanoestruturado contendo besifloxacino - Desenvolvimento e otimização MATERIAL −Besifloxacino, Jinan Shengqi Pharmaceutical Co., Ltd., China com teor especificado de 99,93%. Lipídios líquidos: −Dibehenato de glicerol (Compritol® 888), Glicérides de Estearoil polioxil-32 (Gelucire® 50/13), Diestearato de glicerol (Precirol® ATO 5), Lauril polioxil-32 glicérides (Gelucire® 44/14), Poligliceril 3 dioleate (Plurol® Oleique CC 497), propilenoglicol Dicaprilato/Dicaprato (LabrafacTM PG), Monolinoleato de glicerila (Maisine® CC), Triglicerídes ácidos cáprico / caprílico (Labrafac™ lipophile WL 1349) foram gentilmente doados pela Gatefossé (França). −Monoglicerídeos diacetilados (Dynacet® 285), monocaprilato de glicerol tipo I (IMWITOR®988), monocaprilo/caprato de glicerol tipo I (IMWITOR® 742), diéster de propilenoglicol (Mygliol® 840), triglicérides de ácido cáprico e caprílico (Miglyol® 812) foram gentilmente doados pela IOI Oleo Chemical (Alemanha). −Óleo de algodão (Super Refined Cottonseed NF-LQ-MH), Óleo de castor (Super Refined Sessame NF-LQ-MH), Óleo de girassol (Super Refined sunflower USP-LQ-MH), Óleo de milho (Super Refined Corn NF-LQ®), Óleo de oliva (Super Refined Olive-LQ-MH), Óleo de sésamo (Super Refined Sesame NF-LQ- MH), Óleo de soja (Super Refined Soybean USP NP-LQ), Palmitato de isopropila (Cromadol IPP), Miristato de isopropila (Cromadol IPM) foram gentilmente doados pela Croda (Brasil). −Óleo de amêndoas (Almond oil N.F), Welch, Holme & Clark −Caprilato / caprato de glicerila (Capmul® MCM EP), Gliceril tricaprilato e tricaprato (Captex 300 EP/NF®) e triglicérides de ácido oleico (Captex® GTO) foram gentilmente doados pela Abitec (EUA). −Ácido oleico e óleo mineral foram adquiridos da Sigma- Aldrich (Brasil). Lipídios sólidos: −Triglicerídes de ácidos graxos saturados (Witepsol® E85), óleo de palma hidrogenado (Softisan® 154) e triestearina (Dynasan® 118) foram gentilmente doados pela IOI Oleo Chemical (Alemanha). −Ácido esteárico e gliceril monoestearato foram adquiridos da Synth (Brasil). Tensoativos: −Fosfatidilcolina de soja (Lipoid® S100) foi adquirido de Lipoid GMBH. −Monooleato de polioxietileno sorbitano (Polissorbato 80) foi adquirido Sigma-Aldrich. −Poloxamer 407 (Kolliphor® P 407), e poloxamer 188 (Kolliphor® P 188), surfactantes não iônicos, foram gentilmente doados pela BASF (Brasil). −Span 80 (monooleato de sorbitano)foi doado pela CRODA (Brasil). MÉTODOS Determinação da solubilidade de besifloxacino em lipídios líquidos [82] A solubilidade do besifloxacino nos lipídios líquidos foi determinada pelo método de saturação adaptado de Kasongo e colaboradores (2011). Quantidade igual a 1,0 mg de besifloxacino foi transferida para béquer de 20,0 mL contendo 1,0 g de lipídio líquido. A mistura foi colocada em banho de aquecimento a 75 ± 5°C e 200 rpm de agitação durante 60 min. Finalizado o tempo, foi efetuada inspeção visual e inspeção por meio de microscopia óptica (Motic SMZ/165 Series, Motic®, China) tendo em vista detectar a presença ou não de partículas no lipídio. A solubilidade do fármaco no lipídio foi determinada pela sua maior concentração em que não foi observada partículas em suspensão. Determinação da solubilidade de besifloxacino em lipídios sólidos [83] A solubilidade do besifloxacino em lipídios sólidos foi avaliada de acordo com Kasongo et al (2011). Adicionou-se 1,0 mg besifloxacino a 1,0g de lipídio sólido; a mistura foi aquecida até 10 °C acima do ponto de fusão de cada lipídio, sob agitação constante. Alíquotas foram tomadas e observadas por microscópio óptico; a concentração de besifloxacino foi ajustada até a observação de partículas do antibiótico. Desenvolvimento e otimização de sistema lipídico nanoestruturado contendo besifloxacino [84] Quantidade igual a 100,0 g da formulação foi preparada conforme apresentada na Tabela 4. A fase oleosa e fase aquosa foram aquecidas separadamente em banho 70,0±5,0 °C, sob agitação empregando agitador RTC basic (IKA®, Ika Works, Inc. Alemanha) a 200 rpm, até completa solubilização do besifloxacino e dispersão dos tensoativos. A fase aquosa foi dispersa na fase oleosa sob agitação magnética a 400 rpm por 1 min. A mistura foi submetida a elevado cisalhamento empregando equipamento T25 Ultra- Turrax® (IKA®, Ika Works, Inc. Alemanha) a 4.000 rpm, por 5 min; após essa etapa, a mistura formada foi transferida para o homogeneizador à alta pressão do tipo pistão-orifício (Nano DeBEE, BEE International, Inc. Estados Unidos) utilizando pressão de 10.000 Psi e 5 ciclos sucessivos. Determinação do diâmetro hidrodinâmico médio (DHM) e índice de polidispersão (IP) [85] O diâmetro hidrodinâmico médio da partícula (Z- ave) e índice de polidispersão (IP) foram determinados pelo método de espalhamento de luz dinâmica (DLS) no equipamento Nano ZS90 (Malvern Instruments, Malvern, Reino Unido). Esse método determina o DHM em função das flutuações da intensidade de luz laser espalhada quando incidida no sistema emulsionado. As leituras foram realizadas em triplicata após diluição da amostra, na razão de 1:100, em água Milli-Q. Empregou-se ângulo de 90° e cubeta de poliestireno de 1 cm de passo ótico. Determinação do potencial zeta (PZ) [86] O potencial zeta foi determinado empregando-se equipamento Zetasizer Nano ZS90 (Malvern Instruments, Malvern, Reino Unido). Nesse equipamento, a mobilidade eletroforética é convertida em potencial zeta empregando a equação de Henry (equação 1) 2 ^

Figure imgf000031_0001
onde ε a constante dielétrica e η a viscosidade do solvente na temperatura de 25 °C, UE a mobilidade eletroforética, z o potencial zeta, e f(κa) a função de Henry. A força do campo aplicado foi de 20 V/cm. A condutividade da água Milli-Q foi ajustada a 50 µS/cm empregando solução de NaCl 0,9% (m/v). Determinação do pH [87] A determinação do valor de pH das formulações foi feita em pHmetro (SevenExcellenceTM, Mettler Toledo® Inc. Estados Unidos) previamente calibrado com padrão ácido (pH: 4,00) e básico (pH: 7,00), utilizando eletrodo de imersão direta a 20,0 ± 5,0° C. RESULTADOS Avaliação da solubilidade de besifloxacino em lipídios líquidos [88] A Tabela 1 apresenta a solubilidade do besifloxacino em diferentes lipídios líquidos. Os lipídios que solubilizaram maior quantidade do fármaco foram: Imwitor®988 (1 mg/g) e miristato de isopropila (<1 mg/g), de maneira surpreendente. Os demais lipídios indicados na Tabela 1, não solubilizaram o besifloxacino. Tabela 1 - Perfil de solubilidade de besifloxacino em lipídios líquidos. Lipídios líquidos Solubilidade Quantidade (mg/g) Monocaprilato de glicerol tipo I + =1 (Imwitor®988) Miristato de isopropila + ≤1 Capmul MCM EP - 0 Captex 300 EP/NF - 0 Captex GTO - 0 Cetiol OE - 0 Monoglicerídeos diacetilados - 0 Óleo de milho - 0 Óleo de algodão - 0 Óleo de semente de uva - 0 Óleo de avelã 0 Óleo mineral - 0 Óleo de oliva - 0 Óleo de girassol - 0 Óleo de rícino - 0 Óleo de sésamo - 0 Óleo de soja - 0 Óleo de gérmen de trigo - 0 Palmitato de isopropila - 0 Poligliceril 3-dioleato - 0 Propilenoglicol - 0 dicaprilato/dicaprato Triglicerídes ácidos cáprico / - 0 caprílico +: ausência de partículas [89] Os lipídios normalmente empregados em preparações oftálmicas são os óleos vegetais e ostriglicérides de cadeia curta e média em função de sua reduzida toxicidade (LALLEMAND et al., 2012). A capacidade de solubilização dos lipídios é dependente do comprimento da cadeia, polaridade e flexibilidade da cadeia acila, saturação e insaturação da cadeia, temperatura de fusão e estrutura do fármaco (SINAROV et al., 2020; KATEV et al., 2021). [90] Imwitor®988 é uma mistura composta por 45-75% de monoglicerídeos, 20-50% de diglicerídeos de cadeia média (C8 e C11) e 10% é constituído principalmente por triglicerídeos (IOI OLEOCHEMICAL, 2021) (Figura 3). Imwitor®988 possui caráter anfifílico com cadeia única de hidrocarbonetos e um grupo principal hidrofílico. Assim, o Imwitor®988 pode agir como solubilizante de fármacos. Esse lipídio é frequentemente empregado em sistemas auto-emulsionantes para administração por via oral agindo como lipídio secundário ou cotensoativo (DEVRAJ et al., 2013; KAZI et al., 2020; ABDALLAH et al., 2020). Apesar de apresentar mínima solubilidade (1 mg de besifloxacino/g de imwitor®988), o Imwitor®988 não é aprovado, até o presente momento, para uso oftálmico. Avaliação da solubilidade de besifloxacino em lipídios sólidos [91] A microscopia óptica é o método empregado com maior frequência para selecionar os lipídios sólidos (MONTEIRO et al., 2017; PATIL-GADHE; POKHARKAR 2016; KASONGO et al., 2011). A Tabela 2 apresenta os resultados da solubilidade do besifloxacino em diferentes lipídios sólidos empregando microscopia óptica (Motic SMZ/165 Series, Motic, China). Os lipídios foram classificados pela presença de partículas de besifloxacino. O Softisan®154 foi selecionado por não apresentar partículas como mostra a Figura 2. Tabela 2 - Perfil de solubilidade de besifloxacino em l
Figure imgf000033_0001
Gelucire® 50/13 1 44-50 Precirol® ATO 5 1 56-66
Figure imgf000034_0001
[92] As Figuras 2A, 2B, 2C e 2D apresentam as imagens das lâminas de microscopia óptica das partículas de besifloxacino dispersas em água e Softisan®154, em diferentes proporções. A Figura 2A mostra partículas de besifloxacino aglomeradas e não solubilizadas no meio aquoso. A Figura 2B apresenta o arranjo do Softisan®154 livre de besifloxacino. Na Figura 2C não é possível observar qualquer partícula de besifloxacino no Softisan®154. Esse resultado confirmou, de forma surpreendente, a solubilidade de besifloxacino nesse lipídio, em quantidade aproximada de 5,0 mg/g. No entanto, na Figura 2D observa-se a presença de partículas de besifloxacino mostrando que quantidade maior que 5,0 mg/g de besifloxacino não será solubilizada pelo Softisan®154. [93] O Softisan®154 é o óleo de palma hidrogenado composto principalmente por glicerídeos de cadeia longa, o ácido esteárico (C18) e o ácido palmítico (C16) (Figura 3). É um excipiente empregado como fase oleosa em formulações de liberação modificada (Uronnachi et al., 2020; Monteiro et al., 2017; Shazly et al., 2017, Stelzner et al., 2018). Também pode ser usado como auxiliar de revestimento em formulações de liberação modificada; como modificador de viscosidade de formulações líquidas e semissólidas à base de óleo; na preparação de supositórios, para reduzir a sedimentação dos componentes em suspensão e melhorar o processo de solidificação; e na formulação de preenchimentos líquidos e semissólidos para cápsulas de gelatina dura (Handbook of Green Chemicals, 2004). Desenvolvimento e otimização do sistema lipídico nanoestruturado contendo besifloxacino: preparações preliminares [94] Os sistemas lipídicos nanoestruturados preliminares apresentaram fase oleosa constituída de Softisan®154 por solubilizar maior quantidade de besifloxacino entre os lipídios avaliados, conforme mencionado nos itens anteriores. Com referência aos tensoativos, foram testados polissorbato 80, poloxamer 407, poloxamer 188, Span 80 e Lipoid®S 100 por apresentarem menor toxicidade, menor incidência hemolítica e menor irritação para os tecidos oculares. Além da aplicação e da aceitação desses pelas agências regulatórias no desenvolvimento de preparações oftálmicas e em colírios comercializados. [95] A Tabela 3 apresenta os sistemas lipídicos nanoestruturados desenvolvidos empregando o Softisan®154 como único componente da fase oleosa nas concentrações de 3,0 e 5,0% (m/m) e tensoativos hidrofílicos de forma independente na concentração de 1,0% (m/m). As preparações contendo tween 80 e poloxamer 407 apresentaram separação de fase após 24 horas de preparo. Observou-se incompatibilidade do poloxamer 188 com os demais componentes da formulação. Assim, o poloxamer 188, tensoativo promissor, foi desconsiderado para as etapas subsequentes. Tabela 3 - Sistema lipídico nanoestruturado contendo besifloxacino com tensoativos independentes. Composição % (m/m) Estabilidade S S S S S
Figure imgf000036_0001
[96] Com intuito de se alcançar a estabilidade dos sistemas lipídicos nanoestruturados contendo besifloxacino, foi introduzido na formulação tensoativo de natureza lipofílica o Lipoid® S100 a concentração de 1,0% (m/m) mantendo os tensoativos hidrofílicos na concentração de 1,0% e 3,0% (m/m) para poloxamer 407 e tween 80, respectivamente (Tabela 4). Tabela 4 - Sistemas lipídicos nanoestrurados (SLN) c S S
Figure imgf000036_0002
Água purificada 93,0 [97] A utilização do Lipoid®S100 não permitiu alcançar a estabilidade do sistema lipídico nanoestruturado contendo besifloxacino contendo apenas o Softisan 154 como fase lipídica. A instabilidade foi observada mesmo utilizando concentração elevada do tensoativo (concentração do tensoativo maior que a fase oleosa). Esse resultado inesperado revelou que as preparações constituídas por uma matriz lipídica formada somente com lipídio sólido (Softisan®154) tem sua estabilidade comprometida e, surpreendentemente, não permitiu o desenvolvimento do sistema lipídico nanoestruturado. [98] Portanto, a modificação da matriz lipídica foi efetuada por meio da introdução de lipídio líquido. Esse permite a redução do ponto de fusão do lipídio sólido, porém mantendo a matriz lipídica na forma sólida à temperatura ambiente e corporal. Os lipídios líquidos empregados preferencialmente nas preparações oftálmicas são os óleos vegetais e os triglicérides de cadeia curta e média em virtude de sua boa tolerabilidade pelos tecidos oculares. Embora, o Imwitor 988 seja uma possível alternativa para uso devido à capacidade de solubilização do besifloxacino conforme mostrado anteriormente, estudos de toxicidade frente aos tecidos oculares não foram reportados. [99] Por conseguinte, na presente invenção, optou-se pelo emprego dos triglicerídeos do ácido cáprico caprílico (TACC) como lipídio líquido. O TACC mostrou ser não irritante ou com baixo potencial de irritação após exposições prolongadas no olho em ensaios in vivo. Adicionalmente, não apresentaram capacidade de indução de hipersensibilidade após o tratamento. [100] A adição de TACC na preparação, de maneira inesperada, permitiu alcançar a estabilidade do sistema. Com referência aos tensoativos, além do Lipoid®S100, tween 80 e poloxamer 407, foi introduzido adicionalmente o span 80. [101] A Tabela 5 apresenta a composição das preparações com a introdução de lipídio líquido (triglicerídeos do ácido cáprico caprílico), assim como, a adição de tensoativo lipofílico o span 80. Tabela 5 - Composição dos sistemas lipídicos nanoestruturados contendo besifloxacino. F
Figure imgf000038_0001
, , , , , , 6 F1B, F2B, F3B, F4B, F5B, F6B, F7B e F8B: Preparações sem besifloxacino; F1, F2, F3, F4, F5, F6, F7 e F8: Preparações contendo besifloxacino. BSF: Besifloxacino. TACC: Triglicerídeos do ácido cáprico caprílico [102] A Tabela 6 apresenta os valores de diâmetro hidrodinâmico médio (DHM) e índice de polidispersão (IP) no intervalo de tempo de 3 meses das preparações preliminares contendo besifloxacino preparados conforme Tabela 5. Tabela 6 – Diâmetro hidrodinâmico médio (DHM) e índice de polidispersão (IP) das preparações contendo besifloxacino após 24 horas de preparo. Estabilidad Fórmulas DHM (nm) IP PZ (mV) e máxima (dias)** F1B 222,0 ± 7,5 0,34 ± 0,01 -5.9 ± 0.5 <7 F1 223,1 ± 5,1 0,22 ± 0,01 -4.4 ± 0,8 <7 F2B 180,6 ± 1,2 0,18 ± 0,01 -6.0 ± 0.5 =90 F2 180,9 ± 1,9 0,19 ± 0,01 -5,6 ± 1,1 =90 F3B 211,4 ± 9,1 0,19 ± 0,01 -1,5 ± 0.1 <7 F3 210,2 ± 0,4 0,23 ± 0,01 -1,7 ± 0.5 <7 F4B 105,5 ± 4,6 0,27 ± 0,05 + 0,8 ± 0.1 <7 F4 102,9 ± 3,4 0,21 ± 0,03 + 0,6 ± 0.1 <7 F5B 87,6 ± 0.8 0,15 ± 0,04 - 6,0 ± 0.1 <21 F5 85,4 ± 0,7 0,21 ± 0,01 +3,2 ± 0,1 <21 F6B 55,5 ± 2,2 0,13 ± 0,01 -1,86 ± 0,1 <7 F6 52,4 ± 2,7 0,03 ± 0,01 +5,8 ± 0,1 <7 F7B Separação de fase após o preparo <1 F7 Separação de fase após o preparo <1 F8B Separação de fase após o preparo <1 F8 Separação de fase após o preparo <1 F1B, F2B, F3B, F4B, F5B, F6B, F7B e F8B: Preparações sem besifloxacino; F1, F2, F3, F4, F5, F6, F7 e F8: Preparações contendo besifloxacino; *pH das preparações: 5,5 a 5,8. ** Ausência de separação de fase; condições do teste: 20±5°C; medições, acondicionamento em frascos e vidro de borosilicato. [103] Surpreendentemente, apenas a formulação F2B e F2 apresentaram estabilidade por 90 dias. As preparações contendo poloxamer 407 e Lipoid®S100 (F3B, F3, F4B, F4, F6B e F6), mostraram valores para o DHM entre 52,4 ± 2,7 e 211,4 ± 9,1 nm e índice de polidispersão entre 0,03 ± 0,01 e 0,19 ± 0,01 (Tabela 6). Essas preparações apresentaram separação de fase em intervalo de tempo igual a 7 dias. Adicionalmente, as preparações contendo tween 80, span 80 e Lipoid®S100 (F7B, F7, F8B e F8) apresentaram separação de fase imediatamente após o preparo. Assim o polxamer 407 e o span 80 foram desconsiderados para as próximas etapas. [104] Os valores de DHM das preparações obtidas empregando-se o tween 80 e Lipoid®S100 (F1B, F1, F5B e F5) variaram entre 85,4 ± 0,7 e 223,1± 5,1 nm com distribuição monomodal. Os índices de polidispersão variaram entre 0,15 ± 0,04 e 0,34 ± 0,01. Observou-se separação de fase no período de 7, 21 e 90 dias para as preparações F1B e F1, F5B e F5, F2B e F2, respectivamente. [105] Conforme mencionado anteriormente, excepcionalmente, apenas as preparações F2B (branca sem o fármaco) e F2 (preparação com o fármaco) (Tabela 7) apresentaram aspecto homogêneo, DHM (nm) e IP inalterados, no período de 90 dias acondicionadas em frasco de boro silicato a temperatura de 20 ± 5°C (Tabela 8). [106] A adição de triglicerídeos do ácido cáprico caprílico em concentração de 1,0 % (m/m) na preparação, mantendo a concentração de 1,0% (m/m) e 3,0% (m/m) de Lipoid®S100 e tween 80, respectivamente, permitiu alcançar estabilidade por 3 meses. Essa condição única foi alcançada apenas com a presença desses três componentes e nas concentrações específicas, na formulação. As demais formulações que não apresentaram esses três componentes nas concentrações descritas não permaneceram estáveis. A estabilidade física das preparações é característica indispensável para que um produto farmacêutico seja comercializado. Tabela 7 - Composição do sistema lipídico nanoestrurado F2B (sem besifloxacino) e F2 (com besifloxacino) F2B (% m/m) F2 (% m/m) Besifloxacino - 0,015 Softisan®154 3,00 3,00 TACC 1,00 1,00 Lipoid®S100 1,00 1,00 Tween 80 3,00 3,00 Água purificada 92,00 88,16 [107] Os resultados mostraram estabilidade dessas preparações pelo seu aspecto homogêneo, DHM e IP sem alteração de seu aspecto visual evidente e observou-se distribuição monomodal das partículas. A preparação F2B mostrou valores DHM entre 180,1 ± 1,2 e 185,6 ± 2,6 nm; e IP entre 0,18 ± 0,01 e 0,19 ± 0,01. A formulação F2 apresentou valores de DHM entre 178,6 ± 1,1 e 185,7 ± 2,4 nm; e IP entre 0,19 ± 0,01 e 0,23 ± 0,02. Tabela 8 – Diâmetro hidrodinâmico médio (DHM) e índice de polidispersão (IP) dos sistemas nanoestruturados contendo besifloxacino.
Figure imgf000041_0001
DHM (nm) 180,6 ± 1,2 180,9 ± 1,9 IP 018 001 019 001
Figure imgf000042_0001
Distribuição Monomodal Monomodal [108] Considerando os resultados surpreendentes obtidos na primeira etapa do desenvolvimento que revelou composição única e específica do sistema lipídico nanoestruturado estável (F2B e F2), foi realizada a otimização desse sistema contendo besifloxacino empregando ferramenta estatística, o delineamento composto central. As variáveis independentes foram a concentração de Softisan®154, TACC, Lipoid®S100 e Tween 80 (Tabela 9). [109] A variável dependente (resposta) foi o tamanho de partícula (DHM). Total de 31 experimentos foram projetados empregando Minitab 18 (Tabela 10). Tabela 9 - Variáveis e nível do experimento no desenvolvimento do sistema lipídico nanoestruturado contendo besifloxacino.
Figure imgf000043_0001
TACC: triglicerídeos do ácido cáprico caprílico Tabela 10 - Matriz de ensaios do delineamento composto central e valores de DHM e IP do sistema lipídico nanoestruturado contendo besifloxacino
Figure imgf000043_0002
F20 5,0 1,5 1,5 3,0 25 84,41 0,16 F21 5,0 1,5 1,5 3,0 25 93,28 0,16
Figure imgf000044_0002
Tabela 11 - Análise de variância para testar a significância da regressão para os dados obtidos no ensaio para avaliação do DHM. M L S T L T Q T T I F S S S T L E F E
Figure imgf000044_0001
Total 27 163395 Equação 2
Figure imgf000045_0001
Soft: Softisan®154; TACC: triglicerídeos do ácido cáprico caprílico; Lip: Lipoid®S100; Tw: Tween 80 [110] O R2, R2 ajustado (R2-adj) e o R2 de predição (R2- pred) foram, respectivamente, 94,62%, 91,46% e 80,89%. O gráfico de probabilidade normal dos resíduos foi linear, revelando comportamento normalmente distribuído. O modelo linear, o modelo quadrático e a interação dos fatores foram significativos (p <0,05; α = 0,05). Foram reveladas, de maneira inesperada, interações entre os componentes da fórmula: interação do Softisan®154*TACC; Softisan®154*Lipoid®S100; TACC*Tween 80; Lipoid®S100 *Tween 80. Essas interações permitem a redução do tamanho da partícula, sendo a interação com maior influência nesse sentido, a interação entre o TACC e o tween 80 (coeficiente igual a - 64,0). Adicionalmente, foram revelados efeitos quadráticos do TACC (+153) e do tween 80 (+69,1) (Equação 2). Esses efeitos indicam que a faixa de concentração desses componentes na fórmula deve ser selecionada de maneira que o tamanho da partícula permaneça com valores < 200 nm. Os efeitos quadráticos observados do TACC e tween 80 no DHM foram surpreendentes (Figura 4). [111] Exemplificando a condição única da presente inovação, preparações contendo 2,0% de TACC e 2% de Tween 80 apresentaram fenômeno de gelificação devido aos polimorfos formados durante o processo de esfriamento. Assim, evidencia-se a excepcionalidade da formulação estável. [112] A Tabela 12 apresenta as formulações otimizadas com DHM menor que 200 nm utilizada para a verificação da validade do modelo matemático. Os gráficos de contorno (Figura 5) mostram a relação entre a concentração dos componentes da formulação e o DHM. A regiões com os menores valores de DHM são aquelas com coloração verde clara. Tabela 12 - Formulações otimizadas: diâmetro hidrodinâmico médio (DHM) predito e observado, índice de polidispersão (IP) e potencial zeta (PZ). N1 N2 (% m/m) (% m/m) Softisan®154 3,00 5,00 TACC 1,00 1,67 Lipoid®S100 1,00 1,67 Tween 80 2,11 3,50 Água 92,89 88,16 DHM observado (nm) ± DP 85,1 ± 2,2 93,6 ± 1,7 DHM predito (nm) 90 136 IP ± DP 0,18 ± 0,01 0,15 ± 0,01 PZ (mV) ± DP - 16,7 ± 0,3 -15,9 ± 0,3 pH 7,00 7,00 DP: desvio padrão; N1: 15,0 mg de BSF; N2: 25,0 mg de BSF; ATCC: triglicerídeos do ácido cáprico caprílico [113] Tendo em vista a verificação do modelo matemático obtido na análise estatística, foram preparadas as formulações N1 e N2. Essas apresentaram valor de DHM observado próximo do valor teórico. Assim, pode se concluir que o modelo matemático permitiu prever os valores de DHM. Portanto, os valores práticos estão próximos dos valores previstos demostrando a validade do modelo matemático. [114] A abordagem racional permitiu desenvolver com sucesso o primeiro sistema lipídico nanoestruturado contendo besifloxacino com DHM inferior a 200 nm. O delineamento composto central foi efetivamente usado para otimizar a formulação. Esse delineamento revelou concentrações específicas de três componentes (ATCC, Lipoid®S100 e tween 80), na formulação. O Softisan®154, lipídio sólido e quarto componente, não alterou a estabilidade da formulação. A estabilidade física das preparações é característica indispensável para que um produto farmacêutico com base nanotecnológica seja comercializado. [115] Nesse sentido, supreendentemente, o emprego de 0,025% m/m de besifloxacino, 5% m/m de Softisan®154, 1,67% m/m de Triglicerídeos do ácido cáprico caprílico, 3,5% m/m de Tween 80 e 1,67% m/m de Lipoid® S100 permitiu a obtenção do carreador lipídico nanoestruturado encapsulando o besifloxacino. Assim, a invenção revelou que a presença do lipídio líquido na matriz lipídica foi essencial para obtenção da preparação. [116] Cabe destacar que, apesar de ser selecionado o TACC como lipídio líquido, que compreende a família dos triglicerídeos de cadeia média, os lipídios vegetais (óleo de soja, óleo de amêndoas, óleo de girassol) e monoglicerideos (Imwitor 988) podem apresentar características semelhantes na estabilidade da formulação. Tal fato pode ser fundamentado na desorganização da matriz lipídica favorecida pela mistura dos lipídios sólido e líquido. Quanto maior essa desorganização, maior a eficácia de encapsulação do fármaco nessa matriz. Considerando esse fenômeno, todos os óleos vegetais apresentam potencial para compor a matriz lipídica e estabilizar a preparação (sistema lipídico nanoestruturado contendo besifloxacino). Referências Bibliográficas [117] BERTINO, J.S.; ZHANG, J.Z. 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R. Remington's Pharmaceutical Sciences. Mack Publishing Co., 18th ed. 1990. [160] MARTINDALE, W. AND REYNOLDS, J. E. F. Martindale: The Extra Pharmacopoeia. London, The Pharmaceutical Press 31st ed, 1996) [161] PRISTA, L. V. N., ALVES, A. C., MORGADO, R. M. R. Técnica Farmacêutica e Farmácia Galênica. 4ª edição. Fundação Calouste Gulbenkian. Serviço de Educação e Bolsas, 1996. [162] KASONGO, W.A. Selection and Characterization of Suitable Lipid Excipients for use in the Manufacture of Didanosine-Loaded Solid Lipid Nanoparticles and Nanostructured Lipid Carriers. Journal of Pharmaceutical Sciences, v.100, n.12, dez. 2011. [163] LALLEMAND, F. et al. Successfully improving ocular drug delivery using cationic nanoemulsion, Novasorb. Journal of Drug Delivery, v. 2012, n. 1, p. 1-16, 2012. [164] Katev,V.; Vinarov,Z.; Tcholakova, S. Mechanisms of drug solubilization by polar lipids in biorelevant media. European Journal of Pharmaceutical Sciences, v.159, p.105- 733, 2021. [165] DEVRAJ, R. et al. In vitro assessment of drug-free and fenofibrate-containing lipid formulations using dispersion and digestion testing gives detailed insights into the likely fate of formulations in the intestine. European Journal of Pharmaceutical Sciences, v. 49, n. 4, p. 748–760, 2013. [166] KAZI, M. et al. Pharmaceutics Development, Characterization Optimization, and Assessment of Curcumin- Loaded Bioactive Self-Nanoemulsifying Formulations and Their Inhibitory Effects on Human Breast Cancer MCF-7 Cells. BioMed Research International, v. 2017, 2017. [167] ABDALLAH, Q. M. et al. Utilization of novel self- nanoemulsifying formulations (SNEFs) loaded paclitaxel for the treatment prosperity of bladder cancer. Journal of Drug Delivery Science and Technology, v. 56, p. 101514, 2020. [168] URONNACHI, E. et al. Solidified Reverse Micellar Solution-Based Lipid Microparticles of Miconazole Nitrate: Formulation Design, Biopharmaceutical Characterization, and Dissolution Studies. Journal of Pharmaceutical Innovation, 2020. [169] SHAZLY, G. A. Characterization, In Vitro Release, and Antibacterial Activity Assessment. 2017. [170] STELZNER, J. J. et al. Squalene containing solid lipid nanoparticles, a promising adjuvant system for yeast vaccines. Vaccine, v. 36, n. 17, abr. 2018. NANOSTRUCTURED LIPID SYSTEM CONTAINING BESIFLOXACIN, PHARMACEUTICAL COMPOSITION AND USES FIELD OF THE INVENTION [1] The present invention belongs to the field of pharmaceutical sciences and nanotechnology, as it deals with the preparation of nanostructured lipid systems containing antibiotics for the treatment of ophthalmic infections. A nanostructured lipid system containing besifloxacin and, optionally, polymyxin B sulfate, and its application in the therapy and/or prevention of ocular bacterial infections are described. BACKGROUND OF THE INVENTION [2] Bacteria are the main cause of ophthalmic infections globally. These infections can damage superficial and deep structures of the human or animal eye, promoting possible blindness and visual impairment. Therefore, immediate diagnosis and treatment are necessary. [3] In primary care, in humans, conjunctivitis, keratitis and blepharitis are among the main causes of medical consultation (BERTINO, 2009, TEWELDEMEDHIN, 2017). This disease affects many people and imposes economic and social burdens. It is estimated that acute conjunctivitis affects 6 million people annually in the United States (UDEH; SHNEIDER; OHSFELDT, 2008). In Brazil, there are few epidemiological data on this disease. The number of conjunctivitis cases grew substantially at the beginning of 2018 in at least four states in the country: Mato Grosso, Goiás, Minas Gerais and Pernambuco. Furthermore, Salvador, Fortaleza and Petrópolis recorded numbers of cases well above normal in January of this year (BBC BRASIL, 2018). [4] Schneider and colleagues (2014) reported that the total cost of conjunctivitis reached almost 800 million dollars in the United States, considering social costs that include indirect costs associated with days missed from work, days missed from school, dissemination costs of disease associated with inaccurate diagnoses and the costs of antibiotic resistance. Also, the publication by Smith and Waycaster (2009) revealed that the direct or indirect costs of diagnosing and treating bacterial conjunctivitis were estimated at $589 million in the United States. [5] In the case of ophthalmic infections in animals, the World Health Organization revealed that infectious diseases will be the second biggest challenge the animal health sector will face in the next five years due to the rise in antibiotic resistance. Thus, infectious diseases will represent the biggest concern in animal health, globally, especially in emerging markets such as Brazil. [6] Drug selection for the treatment of major bacterial ocular infectious diseases for the anterior segment of the eye is limited to topical application of antibiotics for both humans and animals. Bremond-Gignac et al (2011) indicated the drugs available for treatment: fluoroquinolones, aminoglycosides, penicillins, chloramphenicol, tetracyclines and erythromycin/azithromycin. [7] Fluoroquinolones are the most common antibiotics used topically in the pharmacological therapy of bacterial conjunctivitis due to their broad spectrum of action (CHEN et al., 2018). In the case of keratitis considered not severe, this requires monotherapy with fourth-generation fluoroquinolone antibiotics such as moxilfoxacin or gatifloxacin. However, severe bacterial keratitis requires intensive therapy using a fluoroquinolone or aminoglycoside and cephalosporin (McDONALD et al., 2014; SCHECHTER, PAREKH, TRATTLER, 2015). [8] With regard to the treatment of blepharitis, there are no established guidelines regarding therapeutic regimens, but recent clinical trials have shown that antibiotics (topical or systemic) and topical corticosteroids can produce significant improvement in the signs and symptoms of blepharitis (PFLUGFELDER, KARPECKI , PEREZ, et al., 2014). [9] However, the increase in rates of infections with antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), is worrying. The United States Centers for Disease Control and Prevention estimates that 2 million people are infected with these resistant pathogens (EUROSURVEILLANCE TEAM, 2013). [10] Approximately 80% of ocular isolates of methicillin-resistant Staphylococcus aureus in the United States have been reported to be resistant to the second-generation fluoroquinolones ciprofloxacin and ofloxacin (ASBELL et al., 2008; HAAS et al., 2011, COMSTOCK et al., 2014). Regarding resistant ophthalmic infections in animals, there are no data in the literature. Fortunately, the antibiotic besifloxacin has proven effective against resistant strains. [11] The antibiotic besifloxacin, a fluoroquinolone of fourth generation for exclusive topical ophthalmic use, it has been shown to be effective against susceptible and resistant bacterial strains of both Gram-positive and Gram-negative types. Besifloxacin was synthesized by the Japanese company SSP Co. Ltd and approved for commercialization in 2009 by the Food and Drug Administration (FDA) under the name Besivance™ (6 mg/mL) by the pharmaceutical company Bausch & Lomb Inc. In 2010, the National Health Surveillance Agency (ANVISA) approved the new antibiotic for use in Brazil. This drug has been indicated for conjunctivitis, having demonstrated effectiveness in different clinical trials (COMSTOCK et al., 2014; MAH; SANFILIPPO, 2016). [12] Besifloxacin has the chemical formula C19H21ClFN3O3, molar mass equal to 430.40 g/mol, has low solubility in water (0.143 mg/mL) and pKas of 5.64 (medium acid, hydroxyl group) and 9.67 ( medium basic, primary amine group). Regarding its chemical structure, besifloxacin has an important 1-n cyclopropyl group, responsible for the broad spectrum of activity against aerobic bacteria. This substituent also appears in other fluoroquinolones such as ciprofloxacin, second generation, gatifloxacin and gemifloxacin, third generation, and fourth generation moxifloxacin (LAL et al., 2014) (Figure 1). [13] Additionally, besifloxacin has a fluorine atom in position 6 of the molecule, an important pharmacophore; chlorine atom, in position 8, responsible for increasing the potency of the antimicrobial against the bacterial enzymes DNA gyrase (topoisomerase II) and topoisomerase IV, which are essential in the processes of bacterial transcription and replication (CAMBAU et al., 2009). This double connection to specific domains and conformations underlies the bactericidal activity of fluoroquinolones (HOOPER; JACOBY, 2016; MAH; SANFILIPPO, 2016). Thus, DNA gyrase is the primary target in most Gram-negative bacteria and topoisomerase IV is the primary target in Gram-positive bacteria (MITSCHER et al., 2008; PETRI, 2006). [14] A study carried out by Haas and colleagues (2010) showed that besifloxacin had a lower minimum inhibitory concentration when compared to moxifloxacin, gatifloxacin, ciprofloxacin, azithromycin and tobramycin for S. aureus, S. epidermidis and S. pneumoniae. Thus, this antibiotic revealed potent antimicrobial action against these bacteria. Furthermore, Comsctock and collaborators (2014), in the clinical study, revealed that besifloxacin had antimicrobial activity against methicillin-resistant S. aureus and S. epidermidis with significant rates for the eradication of microorganisms. Furthermore, besifloxacin showed greater efficiency against Gram-positive and Gram-negative bacteria resistant to other fluoroquinolones. [15] Haas and collaborators (2010), subsequently, evaluated the bactericidal activity of besifloxacin and other antimicrobial agents (oxacillin, tobramycin, azithromycin, ciprofloxacin, moxifloxacin and gatifloxacin) against microorganisms that frequently cause bacterial conjunctivitis: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Haemophilus influenzae. The results revealed that the Besifloxacin, unlike the other fluoroquinolones tested, showed high potency and bactericidal activity. This activity was even demonstrated against strains that presented multiple mutations in the genes responsible for encoding DNA gyrase and topoisomerase IV (HAAS et al., 2011). Additionally, a study carried out by Zhang and Ward (2008) showed that besifloxacin also acts as an anti-inflammatory agent in monocytes in vitro. Such activity may improve its effectiveness in treating ocular infections concomitant with inflammation. [16] Despite the therapeutic advantages presented, besifloxacin may have limited therapeutic efficacy due to its low solubility in water. This chemical property represents the main challenge in the development of preparations containing besifloxacin. Additionally, conventional preparations such as ophthalmic solutions, suspensions or ointments have limited drug bioavailability due to the eye's protection mechanisms, biological, metabolic and physiological barriers (DUBALD et al., 2018; BARANOWSKI, 2014). To overcome these challenges, nanostructured lipid systems (SLN) such as the nanostructured lipid carrier (CLN) have been presented as a promising strategy for the development of ophthalmic products that offer greater efficacy and safety to the patient. [17] In view of the need for adequate therapy for ophthalmic bacterial infections, the development of a nanostructured lipid system (SLN) containing besifloxacin represents a promising strategy due to the increase in the solubility of the drug and the increase in its efficacy and safety. Additionally, it has the potential to prevent the emergence of resistant bacterial strains. [18] To date, an SLN containing besifloxacin is neither available on the market nor described in academic or patent publications and is, therefore, the object of the present invention. STATE OF THE TECHNIQUE [19] The application of nanotechnology in the development of pharmaceutical forms has achieved important growth. Approximately 50 nanotechnology-based products have been approved by the FDA (Food and Drug Administration) since 1995, and around 70 are in the clinical study phase. It is predicted that the nanotechnology market for pharmaceutical products will expand with a compound annual growth rate of 12.5% between 2015 and 2023. If the prediction is confirmed, the market will rise from a valuation of US$ 4.1 billion in 2014 to US $11.9 billion by 2023 (Transparency Market Research, 2016). [20] The transport of antibiotics in nanostructured lipid systems has been explored as one of the most promising strategies for obtaining products with greater efficacy and safety. These systems have brought significant progress in the development of new pharmaceutical products due to their intrinsic properties, such as size in the nanometer range, surface charge, improved permeability and high surface area/volume ratio. These properties allow maximizing the interaction of the antibiotic with bacteria, inhibiting biofilm formation, improving penetration through biofilms and being more effective against intracellular infections. [21] The nanostructured lipid system (SLN) enables the transport of hydrophobic drugs such as besifloxacin. Additionally, it allows the improvement of its pharmacokinetics and pharmacodynamics through different routes of administration, such as the topical ocular route. Such improvements refer to advantages such as modified release of the drug, greater efficacy, reduced adverse effects, and better protection of the drug against enzymatic or oxidative processes (YUKUYAMA et al., 2017). Furthermore, preparations optimized on a laboratory scale and current technologies for pilot-scale production enable transposition to industrial production without modifying the properties of nanostructured lipid systems. [22] The background to the present invention is reviewed below. It should be noted that the simple mixture of any components does not constitute a pharmaceutical formula. A successful pharmaceutical formulation is made up of a mixture of unique components with particular interactions. [23] Youssef and colleagues (2020) developed a nanostructured lipid system containing ciprofloxacin (SLN-ciprofloxacin) for the treatment of bacterial endophthalmitis. This carrier was prepared using Precirol® ATO 5 and oleic acid as solid and liquid lipid, respectively. Polysorbate 80 and poloxamer 188 were used as surfactants. The optimized preparation had a particle size of 193.1 ± 5.1 nm and an IP of 0.43 ± 0.01. The transcorneal flux of SLN-ciprofloxacin in an ex vivo assay revealed a 4-fold increase compared to the ciprofloxacin solution, and the transcorneal permeability of SLN-ciprofloxacin was 3.5 times greater compared to the free drug. [24] The pores present in the cornea facilitate the intracellular transport of SLN particles with a size in the range of 200-300 nm. Furthermore, the lipid phase can interact with the lipid segment of the tear film, increasing retention time. Consequently, a greater quantity of nanoparticles can be internalized by endocytosis, which could potentially reduce damage to ocular tissue due to infection and antibiotic treatment (DE OLIVEIRA et al., 2020, GARRIGUE et al., 2017). [25] Nanostructured lipid system containing dexamethasone (SLN-dexamethasone) was developed for the treatment of dry eye. The final formulation included cholesterol, Labrafac™ lipophile WL1349 and polysorbate 80 in its composition. The particle size was 19.51 ± 0.5 nm; polydispersity index (PI), equal to 0.08; and encapsulation efficiency equal to 99.6 ± 0.5%. SLN labeled with a fluorescent substance demonstrated increased internalization of nanoparticles in primary human corneal epithelial cells in in vitro assays. This SLN showed adequate distribution of nanoparticles on the surface of the cornea after 4 h at 37 °C, showing a possible increase in the bioavailability of the drug and increased residence time on the ocular surface. Furthermore, SLN-dexamethasone was more effective in reducing inflammatory cytokines compared to free dexamethasone. The developed nanoparticle was considered a potentially commercial candidate for inflammatory ocular diseases such as dry eye syndrome (KUMARI et al., 2021). [26] Aiming to avoid complications such as capsular opacification after cataract surgery, Yan and colleagues (2021) developed a temperature-sensitive gel carrier containing a nanostructured lipid system containing genistein, dexamethasone and moxifloxacin. SLN- genistein presented particle size, polydispersity index, zeta potential and encapsulation efficiency equal to 39.47 ± 0.69 nm, 0.213 ± 0.016, −4.32 ± 0.84 mV and 92.75 ± 2.72 %, respectively. In vitro release studies revealed complete release of moxifloxacin after 10 days. [27] In the work of Yan and collaborators (2021), dexamethasone showed modified release at a constant rate until the thirtieth day and genistein showed a cumulative release of 63% for forty days. Additionally, a thermoresponsive hydrogel containing a nanostructured lipid system inhibited the proliferation, migration and epithelial-mesenchymal transition of eye lens epithelial cells in in vitro assays. Therefore, the preparation showed promise in reducing capsular opacification after cataract surgery. [28] The work of Kassaee and Mahboobian (2022) describes a nanoemulsion containing besifloxacin for ocular administration. [29] As a nanoemulsion, Kassaee and Mahboobian's carrier presents a simple lipid matrix composed of only one liquid lipid (glycerol triester) that differs from that used in this invention (caprylic capric acid triglycerides). In addition to comprising components different from those used in the present invention, they were obtained through low-energy emulsification, while a high-energy process is applied to the solution. technique now described. [30] The work of Baig et al (2020) describes the development of a cationic nanostructured lipid carrier containing besifloxacin. A solid lipid (Compritol®888 ATO) and liquid lipid (Labrafac® PG) were combined, combined with just one surfactant (Gelucire®50/13) and a cationic agent (cetyltrimethylammonium bromide). The carriers, which contain components different from those used here, in quality and quantity, were prepared using the ultrasonication method, which is also different from that used in the invention described here (high pressure homogenization). [31] The study by Bhattacharjee et al (2020) describes a liposome gel containing besifloxacin. Such liposomes were prepared by the thin film hydration method. The authors selected soy lecithin and cholesterol as components of the lipid matrix. This preparation was incorporated into Carbopol 940 gel (1% w/v) to obtain a liposomal gel containing besifloxacin. The resulting nanoparticle differs from that which is the object of the present invention in terms of type, composition and method of obtaining. [32] The work of Dos Santos et al (2020) teaches the development of cationic liposomes containing besifloxacin. Liposomes were prepared by the lipid film hydration method. The researchers used phosphatidylcholine, cholesterol, sterylamine and spermine. Similar to the previous document, the nanoparticle of Dos Santos et al differs from that which is the object of the present invention in terms of type, composition and method of obtaining. [33] Document BR1020180762494 describes the preparation of a nanoemulsion containing rifampicin for the treatment of ophthalmic infection caused by Mycobaterium tuberculosis using the high pressure homogenization method. The nanoemulsion was prepared using a liquid lipid (oleic acid) and a surfactant (polysorbate 80) in very specific concentrations 1.0 m/m and 0.9 m/m, respectively. Furthermore, the rifampicin nanoemulsion can be coated with polymyxin B sulfate. Again, the BR1020180762494 nanoemulsion differs from the SLN of the present invention in terms of the type of formulation, the quality and quantity of the components and the method of obtaining, in addition to the antibiotic carried. be distinct. [34] Document BR1020140230505 describes a cationic nanostructured lipid carrier containing dexamethasone acetate and polymyxin B sulfate for ophthalmic use. The nanoparticles comprise: an unsaturated fatty acid, a saturated fatty acid, lecithin, a nonionic surfactant, dexamethasone acetate, a thickening agent, a cationic surfactant, and polymyxin B sulfate. [35] Despite the comprehensive teachings, the composition and the concentration of components used in the preparation of lipid nanoparticles described in BR1020140230505 are particularly applicable to the encapsulation of dexamethasone acetate. Therefore, it would not be possible to extrapolate the BR1020140230505 solution to prepare a SLN containing the antibiotic besifloxacin, as described below. [36] Document US20160128944A1 discloses a nanoparticle comprising a core comprising one or more active agents, including besifloxacin, a surfactant and one or more coating layers comprising one or more lipids. Despite the mention of several lipid compositions of besifloxacin containing the drug, a surfactant and a lipid, none of them comprise a liquid lipid, a solid lipid, a surfactant and a cosurfactant, formulated in a SLN by high pressure homogenization. [37] In comparison to the nanostructured lipid carriers of previous documents, the SLN of the present invention, specific for encapsulating besifloxacin, remains stable for 90 days after its preparation, significantly above those similar ones already described. Such an unexpected effect has the potential to allow the delivery of besifloxacin in a more effective and safe product for the prevention and treatment of ocular bacterial infections and with long shelf stability. [38] The SLN containing besifloxacin described here in an unprecedented way was designed using well-established methods in the pharmaceutical industry and components approved by regulatory bodies, favoring ready adoption on an industrial scale. BRIEF DESCRIPTION OF THE INVENTION [39] The present invention provides nanostructured lipid systems (SLN) containing besifloxacin encapsulated in a complex lipid matrix composed of a solid lipid, a liquid lipid, a surfactant and a cosurfactant. [40] In certain embodiments of the nanostructured lipid system containing besifloxacin, the solid lipid is hydrogenated palm oil, the liquid lipid is triglyceride of caprylic capric acid (TACC), the surfactant is phosphatidylcholine and the cosurfactant is polyoxyethylene sorbitan monooleate. [41] In another aspect of the invention, the proportions of hydrogenated palm oil, caprylic capric acid triglycerides (TACC), phosphatidylcholine and polyoxyethylene sorbitan monooleate in the SLN containing besifloxacin are in accordance with the general equation: ^^^ = 130 + 74.1 ^^^ + 152 ^^^^ + 187.7^^^ − 314.4 ^^ + 153 ^^^^ ∗ ^^^^ + 69.1^^ ∗ ^^ − 42.63 ^^^ ∗ ^^^^ − 18.82^^^ ∗ ^^^ − 64.0 ^^^^ ∗ ^^ − 37.4^^ ∗ ^^. [42] In preferred embodiments of the invention, the SLN contains 25 mg of besifloxacin and comprises from 3.0 to 7.0% (m/m) hydrogenated palm oil, from 1.0 to 2.0% (m/m) m) caprylic capric acid triglycerides (TACC), 1.0 to 2.0% (m/m) of phosphatidylcholine and 2.0 to 4.0% (m/m) of polyoxyethylene sorbitan monooleate. [43] In another embodiment of the invention, the SLN containing besifloxacin is additionally coated with a cationic antibacterial agent. In a preferred aspect, the cationic agent is polymyxin B sulfate, which can be applied to coat the SLN at a concentration between 1000 and 5000 IU/mL. [44] Another aspect of the invention provides for a pharmaceutical composition comprising the SLN containing besifloxacin, one or more pharmaceutically acceptable excipients and/or one or more additional active pharmaceutical ingredients. [45] In another embodiment of the invention, uses of SLN containing besifloxacin or the composition pharmaceutical company comprising it to prepare a medicament for treating ophthalmic bacterial infections. In preferred embodiments, such an ophthalmic bacterial infection affects a farm animal, a pet and/or a human patient, causing, for example, conjunctivitis, keratitis, blepharitis or endophthalmitis. Bacterial infection is caused by Gram-positive and Gram-negative bacteria. Among the main microorganisms that affect the eye are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa. [46] In another embodiment of the invention, there is provided a method of treating a mammal comprising administering to the mammal in need of treatment a therapeutically effective amount of the SLN containing besifloxacin or the pharmaceutical composition comprising it. In certain embodiments, the mammal requires treatment for, for example, conjunctivitis, keratitis, blepharitis, or endophthalmitis caused by a bacterial infection. [47] In preferred embodiments, the mammal is a farm animal, a pet, or a human patient in need of treatment for an ophthalmic bacterial infection caused by Gram-positive or Gram-negative bacteria. Among the main microorganisms that affect the eye are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa. BRIEF DESCRIPTION OF THE FIGURES [48] To assist in identifying the main characteristics of the present invention, the following are presented: following figures: Figure 1 illustrates the two-dimensional formula of besifloxacin, taken from the ChemSpider.com website. [49] Figure 2 represents optical microscopy, in which A: Besifloxacin in aqueous medium. B: Softisan®154. C: mixture of Softisan®154 (1.0 g) and besifloxacin (5.0 mg). D: mixture of Softisan®154 (1.0 g) with excess besifloxacin (6.0 mg). [50] Figure 3 refers to the molecular structure of the main components of Softisan®154: stearic acid and palmitic acid/triglycerides (Source: European Chemical Agency). [51] Figure 4 illustrates the quadratic and linear effects on the mean hydrodynamic diameter (DHM). [52] Figure 5 presents contour plots of the CLN-BF mathematical model for DHM, containing the following variables: Softisan®154, TACC, Lipoid® S100 and Tween 80. DETAILED DESCRIPTION OF THE INVENTION [53] Unless otherwise specified In a different way, the terms used throughout this specification have their common meanings in the art, within the context of the disclosure and in the specific context in which each term is used. Certain terms that are used to describe the disclosure are discussed below, or elsewhere in the specification, to provide additional guidance to the practitioner regarding the description of the disclosure. The publications cited herein and the material to which they are cited are specifically incorporated by reference in their entirety. [54] It will be appreciated that the same thing can be said in different ways. Consequently, language Alternative and synonyms may be used for any one or more of the terms discussed here. No special meaning should be placed on whether a term is elaborated or discussed here. Synonyms for certain terms are provided, but the exemplification of some synonyms does not exclude the potential use of others perhaps not listed here. [55] In this invention, nanostructured lipid systems (SLN) are provided comprising besifloxacin encapsulated by a lipid layer composed of hydrogenated palm oil (Softisan 154), caprylic capric acid triglycerides (TACC), polyoxyethylene sorbitan monooleate (polysorbate 80 or tween 80), phosphatidylcholine (Lipoid S100). Such SLN can also be coated with a cationic antibacterial agent, for example, polymyxin B. [56] As used in this invention, the terms “nanostructured lipid system” or “nanostructured lipid carrier” denote lipid particles with a structure formed by one or more lipids. pharmaceutically acceptable, in the presence of one or more pharmaceutically acceptable surfactants, the average particular diameter of which is less than 1000 nanometers (nm), as measured by conventional particle size measurement techniques well known to those skilled in the art, such as, for example, diffraction laser or dynamic light scattering. [57] In some embodiments of the invention, the SLN has an average particle size, denoted by the average hydrodynamic diameter (DMH), measured by dynamic light scattering, equal to or less than about 200 nm. In embodiments of the invention, the DHM is from about 50 to about 200 nm, from about 50 to about 190 nm, or from about 70 at about 180 nm. In a preferred form of the invention, the DHM of the SLN is about 80 nm to about 100 nm. [58] As used herein, the term “pharmaceutically acceptable lipid” encompasses a broad spectrum of oils and fats such as, for example, medium or long chain fatty acids, mono-, di- or triglycerides, or mixtures thereof. The pharmaceutically acceptable lipids of the invention can be in a solid or liquid state at room temperature. [59] For example, solid lipids applicable in the present context may be selected from saturated fatty acid triglycerides (Witepsol® E85), hydrogenated palm oil (Softisan® 154), triestearin (Dynasan® 118), Glyceryl Monostearate and Acid stearic. Relevant liquid lipids may be type I glycerol monocaprylate (Imwitor® 988), isopropyl myristate and capric and caprylic acid triglycerides (Miglyol® 812). [60] In a preferred embodiment, the SLN is composed of a solid pharmaceutically acceptable lipid, which is hydrogenated palm oil, and a liquid pharmaceutically acceptable lipid, which is capric and caprylic acid triglycerides. [61] As used herein, the term “pharmaceutically acceptable surfactant” denotes a pharmaceutically acceptable substance, or a combination thereof, that reduces the surface tension of a liquid and decreases the interfacial tension between two liquids. Surfactants are generally organic compounds that are amphipathic, meaning they contain hydrophobic groups (their "tails") and hydrophilic groups (their "heads"). Therefore, they are typically sparingly soluble in organic solvents and water. [62] A surfactant can be classified by the presence or absence of formally charged groups in its head. A nonionic surfactant does not have charge groups in its head. The head of an ionic surfactant carries a net charge; if the charge is negative, the surfactant is anionic; if the charge is positive, it is cationic, if it contains a head with two groups of opposite charges, it is zwitterionic. [63] In the context of this invention, surfactants and stabilizers are synonyms used interchangeably throughout the description. Surfactants applicable in the context of the invention include polyoxyethylene sorbitan monooleate (polysorbate 80 or Tween 80), poloxamer 407 (Kolliphor® P 407), poloxamer 188 (Kolliphor® P 188), sorbitan monooleate (Span 80) and soy phosphatidylcholine (Lipoid ®S 100). Surfactants particularly relevant to the invention are soy phosphatidylcholine (Lipoid®S 100) and polyoxyethylene sorbitan monooleate (Tween 80). [64] In the context of the invention, the expression “cationic antibacterial agent” represents a group of compounds with a net positive charge that bind to the cell wall of negatively charged bacteria and destabilize the structural integrity of the wall and reduce bacterial viability. Coating the SLN containing besifloxacin with a cationic antibacterial agent increases the residence time of the product on the ocular surface, increases the bioavailability of the drug and favors the antibiotic effect promoted by besifloxacin. [65] Cationic antibacterial agents applicable to present invention may be selected, for example, from low molecular weight compounds, synthetic polymers or polypeptides. In certain embodiments of the invention, the besifloxacin-containing SLN is further coated with a corona formed by a cationic antibacterial agent, which is, particularly, polymyxin B. [66] The besifloxacin-containing SLN of the present invention can be prepared, for example, by of a high pressure homogenization method. In this protocol, the oil and aqueous phases are heated under stirring separately, until the besifloxacin is completely solubilized and the surfactants are dispersed. In general, solubilization is followed by dispersion of the water phase into the oil phase and subsequent exposure to high shear. The protocol is completed by transferring the mixture to the high pressure homogenizer. [67] Considering their characteristics, nanostructured lipid systems present stability with a homogeneous appearance, particle size and polydispersity index depending on the following factors: physical-chemical properties of the components; concentration of excipients and drug; preparation method and equipment performance; order of addition of phases; temperature; speed; emulsification and homogenization time; and storage conditions (DEKIC; PRIMORAC, 2017). [68] To achieve SLN stability, specific components must be combined in appropriate concentrations and processed in a particular way. Thus, each formula is unique and can therefore only be achieved through empirical and exhaustive testing. [69] Among these factors, the appropriate proportion of lipid(s) and surfactant(s) is of fundamental importance for the stability of SLN. The main instability phenomena, resulting from inappropriate drug excipient combinations, refer to coalescence, flocculation, Oswald Ripening, creamation and sedimentation (ALI et al., 2017). [70] The term “stability”, as used throughout the text, refers to the maintenance of physical characteristics of the SLN, such as, for example, size, morphology and uniformity of the size distribution of the SLN particles. Ways to evaluate each of these parameters are widely known to those skilled in the art and are particularly summarized in the work of Phan and Haes (2019). [71] An efficient way to test and determine the appropriate proportions of solid lipid, liquid lipid, surfactant and cosurfactant is through statistical experiment optimization tools, such as, for example, central compound design, among others. Using tools of this type, it is possible to establish the influence of one or more components of the SLN (ie independent variables) on a parameter representative of the quality of the SLN, such as, for example, the mean hydrodynamic diameter (DHM), and provide a general equation capable of predicting all configurations of the independent variables that will result in desired values for the dependent variable. [72] In a preferred embodiment, the SLN containing besifloxacin includes Softisan®154 as a solid lipid, TACC as a liquid lipid, Lipoid®S100 (palm oil hydrogenated) as surfactant and Tween 80 (polyoxyethylene sorbitan monooleate) as cosurfactant. In the preferred embodiment, the proportions of the components that will result in stable SLN and within the desirable DHM range are given by the general formula: ^^^ = 130 + 74.1 ^^^ + 152 ^^^^ + 187.7^^ ^ − 314.4 ^^ + 153 ^^^^ ∗ ^^^^ + 69.1^^ ∗ ^^ − 42.63^^^ ∗ ^^^^ − 18.82^^^ ∗ ^^^ − 64.0 ^^^^ ∗ ^^ − 37.4^^ ∗ ^^ where: DHM represents the average hydrodynamic diameter of SLN particles, measured by dynamic light scattering; Sof represents the percentage mass of hydrogenated palm oil (Softisan® 154) in relation to the mass of the composition; TACC represents the percentage mass of capric and caprylic acid triglycerides (Miglyol® 812) in relation to the mass of the composition; Lip represents the percentage mass of soy phosphatidylcholine (Lipoid®S 100) in relation to the mass of the composition; and Tw represents the percentage mass of polyoxyethylene sorbitan monooleate (Tween 80) in relation to the mass of the composition. [73] In a preferred embodiment, the SLN has the following constitution: - Hydrogenated palm oil in a concentration of 3.0 to 7.0% m/m; - Caprylic capric acid triglycerides in a concentration of 1.0 to 2.0% m/m; - Phosphatidylcholine in a concentration of 1.0 to 2.0% m/m; - Polyoxyethylene sorbitan monooleate in a concentration of 2.0 to 4.0% m/m. [74] In another aspect of the invention, the SLN is additionally coated with Polymyxin B. In this embodiment, the coating is carried out with 1000 to 5000 IU/mL of polymyxin B sulfate. [75] In one embodiment, the invention provides for compositions pharmaceuticals comprising the SLNs described herein and one or more pharmaceutically acceptable excipients. Such compositions can be prepared and formulated employing conventional methods and excipients, such as disclosed, for example, in the British, European and United States Pharmacopoeia, Remington's Pharmaceutical Sciences (REMINGTON; GENNARO, 1990), Martindale: The Extra Pharmacopoeia (MARTINDALE; RAYNOLDS , 1996) and in Prista's Pharmaceutical technology (PRISTA et al., 1996). [76] Preferred pharmaceutical compositions can be formulated for topical administration, particularly for ophthalmic application. Topical ophthalmic forms (such as eye drops) are sterile and may be liquid, semisolid or solid preparations, which may additionally contain one or more active pharmaceutical ingredients intended for application to the conjunctiva, conjunctival sac or eyelids. [77] In an additional embodiment, the invention provides for the use of SLN containing besifloxacin to prepare medicament for treating bacterial infectious diseases that affect the eyes, therefore ophthalmic or ocular. Among the infections treatable with a medicine containing the SLN of the present invention are those caused by Gram-positive or Gram-negative bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa. Such bacterial infections cause, for example, conjunctivitis, keratitis, blepharitis and endophthalmitis. [78] As used herein, the term "treat" includes extinguishing, substantially inhibiting, delaying or reversing the progression of a disease or disorder, substantially improving the clinical symptoms of a disease or disorder, or substantially preventing the onset of clinical symptoms of a disease or disorder. [79] In another embodiment of the invention, there is provided a method of treating a mammal comprising administering to the mammal in need of treatment a therapeutically effective amount of the SLN containing besifloxacin or the pharmaceutical composition comprising it, as described above. In preferred embodiments, the mammal is a farm animal, a pet, or a human patient in need of treatment for an ophthalmic bacterial infection caused by Gram-positive or Gram-negative bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae. , Haemophilus influenzae and Pseudomonas aeruginosa. In certain embodiments, the disease caused by the bacterial infection and treated by the method provided herein is, for example, conjunctivitis, keratitis, blepharitis or endophthalmitis. [80] As used herein, the term "therapeutically effective" denotes an effective amount of an active ingredient (eg besifloxacin) to achieve a desired clinical effect. A therapeutically effective amount varies with the nature of the condition being treated, the period of The length of time the activity is desired and the age and condition of the subject is ultimately determined by the healthcare professional. [81] The following examples are intended to be purely exemplary of the invention. They are presented in order to provide the person skilled in the art with a complete description of how the SLN of this invention are prepared, evaluated and employed. One skilled in the art, in light of the present disclosure, will recognize that many changes can be made to the specific embodiments that are disclosed and still obtain a similar or equivalent result without departing from the spirit and scope of the invention. EXAMPLES OF EMBODIMENT Example 1: Preparation of nanostructured lipid system containing besifloxacin - Development and optimization MATERIAL −Besifloxacin, Jinan Shengqi Pharmaceutical Co., Ltd., China with specified content of 99.93%. Liquid lipids: −Glycerol dibehenate (Compritol ® 888), Stearoyl polyoxyl-32 glycerides (Gelucire® 50/13), Glycerol distearate (Precirol ® ATO 5), Lauryl polyoxyl-32 glycerides (Gelucire ® 44/14), Polyglyceryl 3 dioleate (Plurol ® Oleique CC 497), Propylene glycol Dicaprylate/Dicaprate (Labrafac TM PG), Glyceryl monolinoleate (Maisine ® CC), Capric/caprylic acid triglycerides (Labrafac™ lipophile WL 1349) were kindly donated by Gatefossé (France) . −Diacetylated monoglycerides (Dynacet ® 285), glycerol monocaprylate type I (IMWITOR ® 988), glycerol monocaprylate/caprate type I (IMWITOR ® 742), propylene glycol diester (Mygliol ® 840), capric and caprylic acid triglycerides (Miglyol® 812) were kindly donated by IOI Oleo Chemical (Germany). −Cotton oil (Super Refined Cottonseed NF-LQ-MH), Castor oil (Super Refined Sessame NF-LQ-MH), Sunflower oil (Super Refined sunflower USP-LQ-MH), Corn oil (Super Refined Corn NF-LQ ® ), Olive Oil (Super Refined Olive-LQ-MH), Sesame Oil (Super Refined Sesame NF-LQ- MH), Soybean Oil (Super Refined Soybean USP NP-LQ), Isopropyl Palmitate ( Cromadol IPP), Isopropyl Myristate (Cromadol IPM) were kindly donated by Croda (Brazil). −Almond oil (Almond oil NF), Welch, Holme & Clark −Glyceryl caprylate / caprate (Capmul ® MCM EP), Glyceryl tricaprylate and tricaprate (Captex 300 EP/NF ® ) and oleic acid triglycerides (Captex® GTO) were kindly donated by Abitec (USA). −Oleic acid and mineral oil were purchased from Sigma-Aldrich (Brazil). Solid lipids: −Saturated fatty acid triglycerides (Witepsol® E85), hydrogenated palm oil (Softisan ® 154) and triestearin (Dynasan® 118) were kindly donated by IOI Oleo Chemical (Germany). −Stearic acid and glyceryl monostearate were purchased from Synth (Brazil). Surfactants: −Soy phosphatidylcholine (Lipoid ® S100) was purchased from Lipoid GMBH. −Polyoxyethylene sorbitan monooleate (Polysorbate 80) was purchased from Sigma-Aldrich. −Poloxamer 407 (Kolliphor® P 407), and poloxamer 188 (Kolliphor® P 188), non-ionic surfactants, were kindly donated by BASF (Brazil). −Span 80 (sorbitan monooleate) was donated by CRODA (Brazil). METHODS Determination of the solubility of besifloxacin in liquid lipids [82] The solubility of besifloxacin in liquid lipids was determined by the saturation method adapted from Kasongo and colleagues (2011). An amount equal to 1.0 mg of besifloxacin was transferred to a 20.0 mL beaker containing 1.0 g of liquid lipid. The mixture was placed in a heating bath at 75 ± 5°C and stirring at 200 rpm for 60 min. At the end of the time, visual inspection and inspection were carried out using optical microscopy (Motic SMZ/165 Series, Motic®, China) in order to detect the presence or absence of particles in the lipid. The solubility of the drug in the lipid was determined by its highest concentration at which no suspended particles were observed. Determination of solubility of besifloxacin in solid lipids [83] The solubility of besifloxacin in solid lipids was assessed according to Kasongo et al (2011). 1.0 mg besifloxacin was added to 1.0 g of solid lipid; the mixture was heated to 10 °C above the melting point of each lipid, under constant stirring. Aliquots were taken and observed under an optical microscope; the concentration of besifloxacin was adjusted until particles were observed of the antibiotic. Development and optimization of a nanostructured lipid system containing besifloxacin [84] A quantity equal to 100.0 g of the formulation was prepared as shown in Table 4. The oil phase and aqueous phase were heated separately in a bath at 70.0±5.0 °C, under agitation using an RTC basic shaker (IKA®, Ika Works, Inc. Germany) at 200 rpm, until complete solubilization of the besifloxacin and dispersion of the surfactants. The aqueous phase was dispersed in the oil phase under magnetic stirring at 400 rpm for 1 min. The mixture was subjected to high shear using T25 Ultra-Turrax® equipment (IKA®, Ika Works, Inc. Germany) at 4,000 rpm for 5 min; After this step, the mixture formed was transferred to the high-pressure piston-orifice homogenizer (Nano DeBEE, BEE International, Inc. United States) using a pressure of 10,000 Psi and 5 successive cycles. Determination of the mean hydrodynamic diameter (DHM) and polydispersity index (IP) [85] The particle mean hydrodynamic diameter (Z- ave) and polydispersity index (IP) were determined by the dynamic light scattering (DLS) method on the equipment Nano ZS90 (Malvern Instruments, Malvern, United Kingdom). This method determines the DHM as a function of fluctuations in the intensity of scattered laser light when incident on the emulsified system. Readings were taken in triplicate after diluting the sample, at a ratio of 1:100, in Milli-Q water. A 90° angle and a polystyrene cuvette with 1 cm optical pitch were used. Determination of zeta potential (PZ) [86] The zeta potential was determined using Zetasizer Nano ZS90 equipment (Malvern Instruments, Malvern, United Kingdom). In this equipment, electrophoretic mobility is converted into zeta potential using the Henry equation (equation 1) 2 ^
Figure imgf000031_0001
where ε the dielectric constant and η the viscosity of the solvent at a temperature of 25 °C, UE the electrophoretic mobility, zo zeta potential, and f(κa) the Henry function. The applied field strength was 20 V/cm. The conductivity of Milli-Q water was adjusted to 50 µS/cm using 0.9% (m/v) NaCl solution. Determination of pH [87] The determination of the pH value of the formulations was carried out using a pH meter (SevenExcellence TM , Mettler Toledo ® Inc. United States) previously calibrated with an acidic (pH: 4.00) and basic (pH: 7.00) standard ), using a direct immersion electrode at 20.0 ± 5.0° C. RESULTS Assessment of the solubility of besifloxacin in liquid lipids [88] Table 1 shows the solubility of besifloxacin in different liquid lipids. The lipids that solubilized the greatest amount of the drug were: Imwitor®988 (1 mg/g) and isopropyl myristate (<1 mg/g), surprisingly. The other lipids indicated in Table 1 did not solubilize besifloxacin. Table 1 - Solubility profile of besifloxacin in liquid lipids. Liquid lipids Solubility Quantity ( mg/g) Glycerol monocaprylate type I + =1 (Imwitor ® 988) Isopropyl myristate + ≤1 Capmul MCM EP - 0 Captex 300 EP/NF - 0 Captex GTO - 0 Cetiol OE - 0 Diacetylated monoglycerides - 0 Corn oil - 0 Cottonseed oil - 0 Grapeseed oil - 0 Hazelnut oil 0 Mineral oil - 0 Olive oil - 0 Sunflower oil - 0 Castor oil - 0 Sesame oil - 0 Soybean oil - 0 Wheat germ oil - 0 Isopropyl palmitate - 0 Polyglyceryl 3-dioleate - 0 Propylene glycol - 0 dicaprylate/dicaprate Triglycerides capric acids / - 0 caprylic +: absence of particles [89] The lipids normally used in ophthalmic preparations are the vegetable oils and short and medium chain ostriglycerides due to their reduced toxicity (LALLEMAND et al., 2012). The solubilization capacity of lipids is dependent on the chain length, polarity and flexibility of the acyl chain, chain saturation and unsaturation, melting temperature and drug structure (SINAROV et al., 2020; KATEV et al., 2021). [90] Imwitor ® 988 is a mixture composed of 45-75% monoglycerides, 20-50% medium chain diglycerides (C8 and C11) and 10% mainly made up of triglycerides (IOI OLEOCHEMICAL, 2021) (Figure 3) . Imwitor ® 988 has an amphiphilic character with a single hydrocarbon chain and a hydrophilic main group. Thus, Imwitor ® 988 can act as a drug solubilizer. This lipid is often used in self-emulsifying systems for oral administration, acting as a secondary lipid or cosurfactant (DEVRAJ et al., 2013; KAZI et al., 2020; ABDALLAH et al., 2020). Despite having minimal solubility (1 mg of besifloxacin/g of imwitor ® 988), Imwitor ® 988 is not approved, to date, for ophthalmic use. Assessment of the solubility of besifloxacin in solid lipids [91] Optical microscopy is the most frequently used method to select solid lipids (MONTEIRO et al., 2017; PATIL-GADHE; POKHARKAR 2016; KASONGO et al., 2011). Table 2 presents the results of the solubility of besifloxacin in different solid lipids using optical microscopy (Motic SMZ/165 Series, Motic, China). Lipids were classified by the presence of besifloxacin particles. Softisan®154 was selected because it does not present particles as shown in Figure 2. Table 2 - Solubility profile of besifloxacin in l
Figure imgf000033_0001
Gelucire® 50/13 1 44-50 Precirol® ATO 5 1 56-66
Figure imgf000034_0001
[92] Figures 2A, 2B, 2C and 2D show images of optical microscopy slides of besifloxacin particles dispersed in water and Softisan ® 154, in different proportions. Figure 2A shows besifloxacin particles agglomerated and not solubilized in the aqueous medium. Figure 2B shows the arrangement of besifloxacin-free Softisan ® 154. In Figure 2C it is not possible to observe any particle of besifloxacin in Softisan ® 154. This result surprisingly confirmed the solubility of besifloxacin in this lipid, in an approximate amount of 5.0 mg/g. However, in Figure 2D the presence of besifloxacin particles is observed, showing that amounts greater than 5.0 mg/g of besifloxacin will not be solubilized by Softisan ® 154. [93] Softisan®154 is the hydrogenated palm oil compound mainly by long-chain glycerides, stearic acid (C18) and palmitic acid (C16) (Figure 3). It is an excipient used as an oil phase in modified release formulations (Uronnachi et al., 2020; Monteiro et al., 2017; Shazly et al., 2017, Stelzner et al., 2018). It can also be used as a coating aid in modified release formulations; as a viscosity modifier of liquid and semi-solid oil-based formulations; in the preparation of suppositories, to reduce sedimentation of suspended components and improving the solidification process; and in the formulation of liquid and semisolid fillers for hard gelatin capsules (Handbook of Green Chemicals, 2004). Development and optimization of the nanostructured lipid system containing besifloxacin: preliminary preparations [94] The preliminary nanostructured lipid systems presented an oily phase consisting of Softisan®154 for solubilizing the greatest amount of besifloxacin among the lipids evaluated, as mentioned in the previous items. With reference to surfactants, polysorbate 80, poloxamer 407, poloxamer 188, Span 80 and Lipoid ® S 100 were tested as they had lower toxicity, lower hemolytic incidence and less irritation to ocular tissues. In addition to their application and acceptance by regulatory agencies in the development of ophthalmic preparations and commercialized eye drops. [95] Table 3 presents the nanostructured lipid systems developed using Softisan®154 as the only component of the oily phase at concentrations of 3.0 and 5.0% (m/m) and hydrophilic surfactants independently at a concentration of 1. 0% (m/m). Preparations containing tween 80 and poloxamer 407 showed phase separation after 24 hours of preparation. Incompatibility of poloxamer 188 with the other components of the formulation was observed. Therefore, poloxamer 188, a promising surfactant, was disregarded for subsequent steps. Table 3 - Nanostructured lipid system containing besifloxacin with independent surfactants. Composition % (m/m) Stability SSSSS
Figure imgf000036_0001
[96] In order to achieve the stability of nanostructured lipid systems containing besifloxacin, Lipoid ® S100 was introduced into the lipophilic surfactant formulation at a concentration of 1.0% (m/m) while maintaining the hydrophilic surfactants at a concentration of 1. 0% and 3.0% (w/w) for poloxamer 407 and tween 80, respectively (Table 4). Table 4 - Nanostructured lipid systems (SLN) and SS
Figure imgf000036_0002
Purified water 93.0 [97] The use of Lipoid®S100 did not allow achieving the stability of the nanostructured lipid system containing besifloxacin containing only Softisan 154 as the lipid phase. Instability was observed even when using high surfactant concentration (surfactant concentration greater than the oil phase). This unexpected result revealed that preparations consisting of a lipid matrix formed only with solid lipid (Softisan ® 154) have their stability compromised and, surprisingly, did not allow the development of the nanostructured lipid system. [98] Therefore, the modification of the lipid matrix was carried out through the introduction of liquid lipid. This allows the reduction of the melting point of the solid lipid, while maintaining the lipid matrix in solid form at room and body temperature. The liquid lipids preferably used in ophthalmic preparations are vegetable oils and short and medium chain triglycerides due to their good tolerability by ocular tissues. Although Imwitor 988 is a possible alternative for use due to the solubilization capacity of besifloxacin as previously shown, toxicity studies against ocular tissues have not been reported. [99] Therefore, in the present invention, it was decided to use caprylic capric acid triglycerides (TACC) as a liquid lipid. TACC has been shown to be non-irritating or to have a low potential for irritation after prolonged exposure to the eye in in vivo tests. Additionally, they did not show the capacity to induce hypersensitivity after treatment. [100] The addition of TACC in the preparation, unexpectedly, allowed the system to be stable. With reference to surfactants, in addition to Lipoid ® S100, tween 80 and poloxamer 407, span 80 was additionally introduced. [101] Table 5 presents the composition of the preparations with the introduction of liquid lipid (caprylic capric acid triglycerides), as well such as, the addition of lipophilic surfactant span 80. Table 5 - Composition of nanostructured lipid systems containing besifloxacin. F
Figure imgf000038_0001
, , , , , 6 F1B, F2B, F3B, F4B, F5B, F6B, F7B and F8B: Preparations without besifloxacin; F1, F2, F3, F4, F5, F6, F7 and F8: Preparations containing besifloxacin. BSF: Besifloxacin. TACC: Caprylic capric acid triglycerides [102] Table 6 presents the values of mean hydrodynamic diameter (DHM) and polydispersity index (PI) in the time interval of 3 months for preliminary preparations containing besifloxacin prepared according to Table 5. Table 6 – Average hydrodynamic diameter (DHM) and polydispersity index (PI) of preparations containing besifloxacin after 24 hours of preparation. Stability Formulas DHM (nm) IP PZ (mV) and maximum (days)** F1B 222.0 ± 7.5 0.34 ± 0.01 -5.9 ± 0.5 <7 F1 223.1 ± 5.1 0.22 ± 0.01 -4.4 ± 0.8 <7 F2B 180.6 ± 1.2 0.18 ± 0.01 -6.0 ± 0.5 =90 F2 180.9 ± 1.9 0.19 ± 0.01 -5 .6 ± 1.1 =90 F3B 211.4 ± 9.1 0.19 ± 0.01 -1.5 ± 0.1 <7 F3 210.2 ± 0.4 0.23 ± 0.01 -1.7 ± 0.5 <7 F 4B 105.5 ± 4.6 0.27 ± 0.05 + 0.8 ± 0.1 <7 F 4 102.9 ± 3.4 0.21 ± 0.03 + 0.6 ± 0.1 <7 F 5B 87.6 ± 0.8 0.15 ± 0.04 - 6.0 ± 0.1 <21 F 5 85.4 ± 0.7 0.21 ± 0.01 +3.2 ± 0.1 <21 F 6B 55.5 ± 2.2 0.13 ± 0.01 -1.86 ± 0.1 <7 F 6 52.4 ± 2.7 0.03 ± 0.01 +5.8 ± 0.1 <7 F7B Phase separation after preparation <1 F7 Phase separation after preparation <1 F8B Phase separation after preparation <1 F8 Phase separation after preparation <1 F1B, F2B, F3B, F4B, F5B, F6B, F7B and F8B: Preparations without besifloxacin; F1, F2, F3, F4, F5, F6, F7 and F8: Preparations containing besifloxacin; *pH of preparations: 5.5 to 5.8. ** Absence of phase separation; test conditions: 20±5°C; measurements, packaging in bottles and borosilicate glass. [103] Surprisingly, only the F2B and F2 formulation were stable for 90 days. The preparations containing poloxamer 407 and Lipoid ® S100 (F3B, F3, F4B, F4, F6B and F6) showed DHM values between 52.4 ± 2.7 and 211.4 ± 9.1 nm and a polydispersity index between 0.03 ± 0.01 and 0.19 ± 0.01 (Table 6). These preparations showed phase separation within a time interval of 7 days. Additionally, preparations containing tween 80, span 80 and Lipoid ® S100 (F7B, F7, F8B and F8) showed phase separation immediately after preparation. Therefore, polxamer 407 and span 80 were disregarded for the next steps. [104] The DHM values of the preparations obtained using tween 80 and Lipoid ® S100 (F1B, F1, F5B and F5) varied between 85.4 ± 0.7 and 223.1 ± 5.1 nm with monomodal distribution . The polydispersity indices varied between 0.15 ± 0.04 and 0.34 ± 0.01. Phase separation was observed over a period of 7, 21 and 90 days for preparations F1B and F1, F5B and F5, F2B and F2, respectively. [105] As mentioned previously, exceptionally, only preparations F2B (white without the drug) and F2 (preparation with the drug) (Table 7) presented a homogeneous appearance, DHM (nm) and IP unchanged, within a period of 90 days stored in boron silicate flask at a temperature of 20 ± 5°C (Table 8). [106] The addition of caprylic capric acid triglycerides at a concentration of 1.0% (m/m) in the preparation, maintaining a concentration of 1.0% (m/m) and 3.0% (m/m) of Lipoid ® S100 and tween 80, respectively, allowed stability to be achieved for 3 months. This unique condition was achieved only with the presence of these three components and in specific concentrations in the formulation. The rest Formulations that did not present these three components in the concentrations described did not remain stable. The physical stability of preparations is an essential characteristic for a pharmaceutical product to be commercialized. Table 7 - Composition of the nanostructured lipid system F2B (without besifloxacin) and F2 (with besifloxacin) F2B (% m/m) F2 (% m/m) Besifloxacin - 0.015 Softisan ® 154 3.00 3.00 TACC 1.00 1 .00 Lipoid ® S100 1.00 1.00 Tween 80 3.00 3.00 Purified water 92.00 88.16 [107] The results showed stability of these preparations due to their homogeneous appearance, DHM and IP without changing their visual appearance evident and a monomodal distribution of the particles was observed. The F2B preparation showed DHM values between 180.1 ± 1.2 and 185.6 ± 2.6 nm; and IP between 0.18 ± 0.01 and 0.19 ± 0.01. Formulation F2 presented DHM values between 178.6 ± 1.1 and 185.7 ± 2.4 nm; and IP between 0.19 ± 0.01 and 0.23 ± 0.02. Table 8 – Average hydrodynamic diameter (DHM) and polydispersity index (IP) of nanostructured systems containing besifloxacin.
Figure imgf000041_0001
DHM (nm) 180.6 ± 1.2 180.9 ± 1.9 IP 018 001 019 001
Figure imgf000042_0001
Monomodal Monomodal Distribution [108] Considering the surprising results obtained in the first stage of development that revealed the unique and specific composition of the stable nanostructured lipid system (F2B and F2), the optimization of this system containing besifloxacin was carried out using a statistical tool, the central compound design. The independent variables were the concentration of Softisan ® 154, TACC, Lipoid ® S100 and Tween 80 (Table 9). [109] The dependent (response) variable was particle size (DHM). Total 31 experiments were designed employing Minitab 18 (Table 10). Table 9 - Variables and level of experiment in the development of the nanostructured lipid system containing besifloxacin.
Figure imgf000043_0001
TACC: caprylic capric acid triglycerides Table 10 - Test matrix of the central composite design and DHM and IP values of the nanostructured lipid system containing besifloxacin
Figure imgf000043_0002
F20 5.0 1.5 1.5 3.0 25 84.41 0.16 F21 5.0 1.5 1.5 3.0 25 93.28 0.16
Figure imgf000044_0002
Table 11 - Analysis of variance to test the significance of the regression for the data obtained in the test to evaluate the DHM. MLSTLTQTTIFSSSTLEFE
Figure imgf000044_0001
Total 27 163395 Equation 2
Figure imgf000045_0001
Soft: Softisan ® 154; TACC: caprylic capric acid triglycerides; Lip: Lipoid ® S100; Tw: Tween 80 [110] OR 2 , adjusted R 2 (R 2 -adj) and the prediction R 2 (R 2 - pred) were, respectively, 94.62%, 91.46% and 80.89%. The normal probability plot of the residuals was linear, revealing normally distributed behavior. The linear model, the quadratic model and the interaction of factors were significant (p <0.05; α = 0.05). Interactions between the components of the formula were unexpectedly revealed: interaction of Softisan ® 154*TACC; Softisan ® 154*Lipoid ® S100; TACC*Tween 80; Lipoid ® S100 *Tween 80. These interactions allow the reduction of particle size, with the interaction with the greatest influence in this regard being the interaction between TACC and tween 80 (coefficient equal to - 64.0). Additionally, quadratic effects of TACC (+153) and tween 80 (+69.1) were revealed (Equation 2). These effects indicate that the concentration range of these components in the formula must be selected so that the particle size remains at values < 200 nm. The observed quadratic effects of TACC and tween 80 on DHM were surprising (Figure 4). [111] Exemplifying the unique condition of the present innovation, preparations containing 2.0% TACC and 2% Tween 80 showed gelling phenomenon due to polymorphs formed during the cooling process. Thus, the exceptionality of the stable formulation is evident. [112] Table 12 presents the optimized formulations with DHM less than 200 nm used to verify the validity of the mathematical model. The contour plots (Figure 5) show the relationship between the concentration of the formulation components and the DHM. The regions with the lowest DHM values are those with a light green color. Table 12 - Optimized formulations: predicted and observed mean hydrodynamic diameter (DHM), polydispersity index (IP) and zeta potential (PZ). N1 N2 (% m/m) (% m/m) Softisan ® 154 3.00 5.00 TACC 1.00 1.67 Lipoid ® S100 1.00 1.67 Tween 80 2.11 3.50 Water 92, 89 88.16 Observed DHM (nm) ± SD 85.1 ± 2.2 93.6 ± 1.7 Predicted DHM (nm) 90 136 IP ± SD 0.18 ± 0.01 0.15 ± 0.01 PZ (mV) ± SD - 16.7 ± 0.3 -15.9 ± 0.3 pH 7.00 7.00 SD: standard deviation; N1: 15.0 mg of BSF; N2: 25.0 mg of BSF; ATCC: capric caprylic acid triglycerides [113] In order to verify the mathematical model obtained in the statistical analysis, formulations N1 and N2 were prepared. These presented an observed DHM value close to the theoretical value. Thus, it can be concluded that the mathematical model made it possible to predict the DHM values. Therefore, the practical values are close to the predicted values, demonstrating the validity of the mathematical model. [114] The rational approach allowed us to develop The first nanostructured lipid system containing besifloxacin with DHM less than 200 nm was successful. The central composite design was effectively used to optimize the formulation. This design revealed specific concentrations of three components (ATCC, Lipoid®S100 and tween 80) in the formulation. Softisan®154, solid lipid and fourth component, did not change the stability of the formulation. The physical stability of preparations is an essential characteristic for a nanotechnology-based pharmaceutical product to be commercialized. [115] In this sense, surprisingly, the use of 0.025% m/m of besifloxacin, 5% m/m of Softisan®154, 1.67% m/m of caprylic capric acid triglycerides, 3.5% m/m of Tween 80 and 1.67% m/m of Lipoid® S100 allowed obtaining the nanostructured lipid carrier encapsulating besifloxacin. Thus, the invention revealed that the presence of liquid lipid in the lipid matrix was essential to obtain the preparation. 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Claims

REIVINDICAÇÕES 1. Sistema lipídico nanoestruturado contendo besifloxacino caracterizado pelo fato de que compreende: a) um lipídeo sólido; b) um lipídeo líquido; c) um tensoativo; e d) um cotensoativo. 2. Sistema lipídico nanoestruturado contendo besifloxacino, de acordo com a reivindicação 1 ou 2, caracterizado pelo fato de que o lipídeo sólido é óleo de palma hidrogenado, o lipídeo líquido é triglicerídeos do ácido cáprico caprílico (TACC), o tensoativo é fosfatidilcolina e o cotensoativo é Monooleato de polioxietileno sorbitano. 3. Sistema lipídico nanoestruturado contendo besifloxacino, de acordo com a reivindicação 2, caracterizado pelo fato de que as proporções de óleo de palma hidrogenado, triglicerídeos do ácido cáprico caprílico (TACC), fosfatidilcolina e Monooleato de polioxietileno sorbitano estão de acordo com a equação geral: ^^^ = 130 + 74,1 ^^^ + 152 ^^^^ + 187,7^^^ − 314,4 ^^ + 153 ^^^^ ∗ ^^^^ + 69,1^^ ∗ ^^ − 42,63^^^ ∗ ^^^^ − 18,82^^^ ∗ ^^^ − 64,0 ^^^^ ∗ ^^ − 37,4^^ ∗ ^^. 4. Sistema lipídico nanoestruturado contendo besifloxacino, de acordo com a reivindicação 2 ou 3, caracterizado pelo fato de que contém 0,025% m/m de besifloxacino e compreende de 3,0 a 7,0% (m/m) de óleo de palma hidrogenado, de 1,0 a 2,0% (m/m) de triglicerídeos do ácido cáprico caprílico (TACC), de 1,0 a 2,0% (m/m) de fosfatidilcolina e de 2,0 a 4,0% (m/m) de monooleato de polioxietileno sorbitano. 5. Sistema lipídico nanoestruturado contendo besifloxacino, de acordo com qualquer uma das reivindicações 1 a 4, caracterizado pelo fato de que é adicionalmente revestido com um agente catiônico antibacteriano, em que o agente catiônico é polimixina B. 6. Sistema lipídico nanoestruturado contendo besifloxacino, de acordo com a reivindicação 5, caracterizado pelo fato de que o SLN é revestido com 1000 e 5000 UI/mL de sulfato de polimixina B. 7. Composição farmacêutica, caracterizada pelo fato de que compreende o sistema lipídico nanoestruturado contendo besifloxacino, conforme definido em qualquer uma das reivindicações 1 a 6, um ou mais excipientes farmaceuticamente aceitáveis e/ou um ou mais ingredientes farmacêuticos ativos adicionais. 8. Uso do sistema lipídico nanoestruturado contendo besifloxacino, conforme definido em qualquer uma das reivindicações 1 a 6, ou da composição, como definida na reivindicação 7, caracterizado pelo fato de ser para o preparo de um medicamento para tratar infecções bacterianas oftálmicas. 9. Uso, de acordo com a reivindicação 8, caracterizado pelo fato de que a infecção bacteriana oftálmica afeta um animal de produção, um animal de estimação e/ou um paciente humano. 10. Uso, de acordo com a reivindicação 8 ou 9, caracterizado pelo fato de que a infecção bacteriana oftálmica causa uma doença selecionada do grupo que consiste em conjuntivite, ceratite, blefarite e endoftalmite. 11. Uso, de acordo com qualquer uma das reivindicações 8 a 10, caracterizado pelo fato de que a infecção bacteriana oftálmica é causada por uma bactéria selecionada do grupo consistindo em Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae e Haemophilus influenzae. CLAIMS 1. Nanostructured lipid system containing besifloxacin characterized by the fact that it comprises: a) a solid lipid; b) a liquid lipid; c) a surfactant; and d) a cosurfactant. 2. Nanostructured lipid system containing besifloxacin, according to claim 1 or 2, characterized by the fact that the solid lipid is hydrogenated palm oil, the liquid lipid is caprylic capric acid triglycerides (TACC), the surfactant is phosphatidylcholine and the Cosurfactant is Polyoxyethylene Sorbitan Monooleate. 3. Nanostructured lipid system containing besifloxacin, according to claim 2, characterized by the fact that the proportions of hydrogenated palm oil, caprylic capric acid triglycerides (TACC), phosphatidylcholine and polyoxyethylene sorbitan monooleate are in accordance with the general equation : ^^^ = 130 + 74.1 ^^^ + 152 ^^^^ + 187.7^^^ − 314.4 ^^ + 153 ^^^^ ∗ ^^^^ + 69.1^^ ∗ ^^ − 42.63^^^ ∗ ^^^^ − 18.82^^^ ∗ ^^^ − 64.0 ^^^^ ∗ ^^ − 37.4^^ ∗ ^^. 4. Nanostructured lipid system containing besifloxacin, according to claim 2 or 3, characterized by the fact that it contains 0.025% m/m of besifloxacin and comprises from 3.0 to 7.0% (m/m) of palm oil hydrogenated, from 1.0 to 2.0% (m/m) of caprylic capric acid triglycerides (TACC), from 1.0 to 2.0% (m/m) of phosphatidylcholine and from 2.0 to 4, 0% (m/m) monooleate polyoxyethylene sorbitan. 5. Nanostructured lipid system containing besifloxacin, according to any one of claims 1 to 4, characterized by the fact that it is additionally coated with an antibacterial cationic agent, wherein the cationic agent is polymyxin B. 6. Nanostructured lipid system containing besifloxacin, according to claim 5, characterized by the fact that the SLN is coated with 1000 and 5000 IU/mL of polymyxin B sulfate. 7. Pharmaceutical composition, characterized by the fact that it comprises the nanostructured lipid system containing besifloxacin, as defined in any one of claims 1 to 6, one or more pharmaceutically acceptable excipients and/or one or more additional active pharmaceutical ingredients. 8. Use of the nanostructured lipid system containing besifloxacin, as defined in any one of claims 1 to 6, or the composition, as defined in claim 7, characterized by the fact that it is for the preparation of a medicine to treat ophthalmic bacterial infections. 9. Use according to claim 8, characterized in that the ophthalmic bacterial infection affects a production animal, a pet and/or a human patient. 10. Use according to claim 8 or 9, characterized in that the ophthalmic bacterial infection causes a disease selected from the group consisting of conjunctivitis, keratitis, blepharitis and endophthalmitis. 11. Use according to any one of claims 8 to 10, characterized in that the ophthalmic bacterial infection is caused by a bacteria selected from the group consisting of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Haemophilus influenzae.
PCT/BR2023/050377 2022-11-08 2023-11-08 Nanostructured lipid system containing besifloxacin, pharmaceutical composition and uses Ceased WO2024098127A1 (en)

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