L'objectif principal de ce travail est d'évaluer si l'amendement calco-magnésien de deux bassins versants acidifiés du massif vosgien (un sur grès et un sur granite) engendre des changements de la morphologie des humus, de l'abondance et de la diversité de la mésofaune, de la biomasse fongique, du stockage de carbone dans les horizons organiques 5 et 7 ans après l'amendement. Par ailleurs, nous avons effectué une étude dans des conditions contrôlées de laboratoire en utilisant des microcosmes contenant les horizons organiques du sol provenant de bassins versants acidifiés sur grès et sur granite afin d'évaluer les effets à court terme de l'amendement. Les résultats indiquent que les effets de l'amendement sont beaucoup plus marqués sur le substrat le plus acide. À court terme, sur substrat gréseux, nous observons une diminution de l'abondance de la mésofaune puis une augmentation de celle-ci 5 ans après l'amendement avant de ne montrer plus aucun effet 7 ans après l'épandage. L'effet inverse ou aucun effet n'est par contre observé sur substrat granitique. Le contenu en Ca et Mg de l'horizon OL a augmenté avec l'amendement, mais cet effet n'est également significatif que sur grès. La biomasse fongique du sol n'a pas été affectée par le chaulage, mais est significativement plus élevée sur granite que sur grès. Le chaulage a augmenté l'épaisseur de l'horizon OH sur grès alors qu'il a diminué l'épaisseur de l'horizon OL sur granite, probablement en relation avec les modifications de l'activité biologique (mésofaune ou microorganismes). Enfin, sur substrat gréseux, le stock de carbone de l'humus a augmenté du fait d'un épaississement notable de l'horizon OH avec le chaulage. / The main objective of this work is to assess the consequences of calco-magnesium liming on two acidified forested catchments in Vosges Mountain (sandstone and granite) on humus morphology, abundance and diversity of mesofauna, fungal biomass and carbon storage in organic horizons 5 and 7 years after liming. Moreover, we performed a study to verify under laboratories conditions by using microcosms filled with soil from acidified catchments lying on sandstone and granite in order to study the short-term effect of calco-magnesium liming. During the two field campaigns, we determined calcium and magnesium contents of OL horizon, pH, humus morphology, mesofauna abundance and diversity, fungal biomass, soil carbon storage of organic layers OL, OF and OH.Results indicated that calco-magnesium liming affects studied parameters in different ways according to elapsed time after liming and the geological substrate (sandstone and granite), the more acidic catchment (sandstone) showing the most remarkable reaction. Results of immediate effects of liming showed a decrease of mesofauna abundance and then gradually increasing tendencies in field campaigns after 5 years while no effect after 7 years after liming. The opposite or no effects were observed on granite substrate. Ca and Mg contents in OL horizon increased by liming but this effect were only significant on sandstone substrate. Soil fungal biomass was not affected by liming but was significantly higher on granite substrate than sandstone. Liming increased the OH horizon thickness on sandstone while decreased the OL horizon on granite, under the influence of biological activity (mesofauna vs microorganisms).

Les pompes d'efflux sont des complexes macromoléculaires qui permettent l'efflux des antibiotiques à travers les deux membranes (interne et externe). Ces pompes, spécifiques des bactéries Gram négatif, constituent l'un des acteurs majeurs du phénomène de résistance aux antibiotiques, en contribuant ainsi à la résistance intrinsèque et acquise de ces bactéries à de nombreuses molécules utilisées en antibiothérapie. Chez P. aeruginosa, ces pompes appartiennent pour la plupart à la famille des transporteurs RND. Ce sont des complexes tripartites constitués d'un transporteur de la membrane interne (RND), d'un adaptateur périplasmique (MFP) et d'un canal de la membrane externe (OMF). Ces composants ont été caractérisés individuellement chez de nombreuses bactéries. Cependant, les mécanismes qui régissent l'assemblage et la dissociation de la pompe, essentiels pour son fonctionnement, demeurent mal compris. Nous nous sommes donc intéressés au cours de ce travail aux pompes à efflux de Pseudomonas aeruginosa. Nous avons notamment procédé à la caractérisation structurale du canal OprN de la pompe MexEF-OprN impliquée dans la résistance aux fluoroquinolones et à la caractérisation biophysique du transporteur RND MexY de la pompe MexXY-OprM, spécifique des aminoglycosides. Nous avons étudié en parallèle le mécanisme d'ouverture du canal OprM seul in vitro (aspects structuraux) et in vivo (aspects fonctionnels) au sein de la pompe assemblée. Nos résultats montrent que les OMFs de P. aeruginosa présentent des similitudes avec les OMFs d'autres bactéries Gram négatif, mais également des différences, notamment pour OprN et OprM au niveau de l'interaction avec leurs partenaires ou encore pour OprM concernant l'ouverture du canal. Nous avons par ailleurs participé à l'étude in vitro de l'assemblage et du transport à travers la pompe MexAB-OprM, reconstituée au sein de protéoliposomes, confirmant l'importance de l'acylation de la MFP dans la formation du complexe et montrant l'importance de la force proto-motrice dans l'assemblage de la pompe mais pas dans sa dissociation. En parallèle de l'étude des pompes à efflux, nous nous sommes intéressés à un autre système de résistance, impliqué dans la dégradation des antibiotiques. Nous avons donc réalisé, en collaboration avec le Pr Patrick Plésiat (laboratoire de Bactériologie de Besançon), la modélisation de mutants de la beta-lactamase AmpC de P. aeruginosa, permettant de lier les effets fonctionnels observés à des hypothèses de modifications conformationnelles. / Multidrug efflux systems are membrane transport proteins that are used to translocate a wide variety of drugs across the inner and the outer membranes of Gram-negative bacteria, leading to natural and acquired antimicrobial resistances.Most of the multidrug transporters of P. aeruginosa belong to the resistance-nodulation-cell division (RND) superfamily.They function as three-component assemblies made of an inner membrane transporter (RND), a periplasmic membrane fusion protein (MFP) and an outer membrane factor channel (OMF). Along with functional studies, many crystal structures of the individual components of the pump have been solved but the interactions underlying the complex assembly and the opening mechanism of the outer channel remain unclear. In this study, we investigated structural and functional insights of P. aeruginosa efflux pumps. We solved the crystal structure of the MexEF-OprN efflux pump outer membrane channel OprN mainly involved in fluoroquinolones resistance. Our new structure highlights the differences between P. aeruginosa and other Gram-negative bacteria OMFs that could explain their specific interaction with the cognate MFP partners. We also purified and characterized the inner membrane transporter MexY from the MexXY-OprM efflux pump, which is the major determinant of aminoglycosides resistance in P. aeruginosa. Besides, we solved the crystal structure of a mutatedform of the outer membrane channel OprM in order to understand its opening mechanism. We also investigated in vivo effect of the OprM mutants in antibiotics resistance by MIC measurements and tried to correlate with the observed structural modifications leading to the open state. Moreover, we set up a new in vitro test allowing the investigation of the assembly of the MexAB-OprM efflux pump. Our results showed the importance of MexA and its lipid anchor in promoting and stabilizing the complex assembly. In addition, as a side project with the group of Pr Plésiat (laboratoire de Bactériologie de Besançon), we built different structural models of AmpC mutants from overproducing clinical isolates,showing the possible conformational changes that lead to the resistance increase.

O HDL-c é um fator de risco cardiovascular negativo e sua concentração plasmática apresenta relação inversa com a incidência de eventos cardiovasculares. Entretanto, as evidências relativas ao grupo de indivíduos com níveis de HDL-c acima do percentil 95 da população geral ainda são escassas e o impacto da hiperalfalipoproteinemia (HALP) sobre o risco cardiovascular continua representando motivo de controvérsia na literatura médica. Alguns estudos em populações específicas associam a HALP a aumento do risco cardiovascular. Ao mesmo tempo, outros estudos identificaram populações de indivíduos hipoalfalipoproteinêmicos com marcada longevidade. Assim, demonstrou-se aparente dissociação entre níveis de HDL-c e risco cardiovascular em determinadas populações, reconduzível a aspectos disfuncionais da HDL. O objetivo do presente estudo foi verificar o papel da HALP na determinação do risco cardiovascular; comparar a prevalência de doença cardiovascular subclínica, avaliada por meio da quantificação ultrassonográfica da Espessura Íntimo-Medial Carotídea (EIMC), entre portadores de HDL-c >= 90mg/dL (grupo HALP) e portadores de concentrações de HDL-c atualmente consideradas normais (entre 40 e 50mg/dL para os homens e entre 50 e 60mg/dL para as mulheres); e avaliar características e função da HDL em portadores de HALP por meio do estudo de sua composição, de sua capacidade de efluxo de colesterol, e de sua atividade anti-inflamatória e antioxidante, correlacionando estas características com a presença de doença cardiovascular subclínica avaliada por meio da determinação da EIMC, da Velocidade de Onda de Pulso (VOP) e da presença de Calcificação Arterial Coronariana (CAC) avaliada pela TCMD. Para responder estas perguntas, o presente estudo foi articulado em dois braços: Braço 1: Análise da coorte do estudo ELSA com o objetivo de determinar a prevalência de HALP em uma população geral; definir o perfil demográfico, antropométrico e metabólico dos portadores de HALP; e comparar a prevalência de doença vascular subclínica deste grupo com controles da mesma coorte com níveis normais de HDL-colesterol. Braço 2: Recrutamento de 80 voluntários hígidos e portadores de HALP para avaliação da correlação entre presença de doença vascular subclínica, e aspectos estruturais e funcionais da HDL. Em seus dois braços, o estudo levou a quatro conclusões principais: 1) Níveis marcadamente elevados de HDL-c estão associados a menor espessura íntimo-medial carotídea quando comparados a níveis de HDL-c considerados normais pelas diretrizes vigentes. Embora portadores do fenótipo HALP apresentem, como grupo, um perfil metabólico mais favorável que o encontrado em indivíduos com HDL-c normal, a associação entre EIMC e HALP foi independente dos fatores de risco tradicionais, indicando que a menor prevalência destes últimos em portadores de HDL-c marcadamente elevado justifica apenas parcialmente a menor prevalência de doença vascular subclínica neste grupo; 2) Embora a HALP se apresente como um fenótipo ateroprotetor, há indivíduos com níveis marcadamente elevados de HDL-c que evoluem com doença cardiovascular, clínica ou subclínica. Neste contexto, nossos resultados indicam correlação entre os três métodos avaliados para estudar doença vascular subclínica em portadores de HALP: EIMC, VOP e CAC; 3) Os fatores de risco tradicionais continuam exercendo seu peso na determinação do risco cardiovascular em portadores de HALP. Idade, tabagismo, hipertensão arterial, hipertrigliceridemia e altos níveis de LDL-c apresentaram associação estatisticamente significativa com a presença de doença vascular subclínica no grupo estudado; 4) A avaliação da composição e da função da HDL em portadores de HALP pode permitir identificar indivíduos especificamente mais suscetíveis à aterosclerose. Nossos resultados indicam que, em particular, a atividade anti-inflamatória da HDL, avaliada pela capacidade de inibição da produção de IL-6; o efluxo de colesterol e a capacidade de transferência de triglicérides apresentaram associação independente com menor espessura íntimo-medial carotídea em portadores de HALP, enquanto níveis mais altos de Apo A-IV se associaram a maior grau de doença cardiovascular subclínica / HDL-c is a negative cardiovascular risk factor and its plasma concentration is inversely related to the incidence of cardiovascular events. However, evidence of benefit among subjects with HDL-c levels above the 95th percentile of the general population is still scarce and the impact of hyperalphalipoproteinemia (HALP) on cardiovascular risk continues to represent matter of debate in the medical literature. Some studies with specific populations indicated an increased cardiovascular risk associated with HALP. In addition, other reports identified groups of patients with marked hypoalphalipoproteinemia and longevity. Hence, there could be a dissociation between HDL-c levels and cardiovascular risk in certain populations, possibly due to dysfunctional HDL particles. The aim of this study was to investigate the role of HALP phenotype in determining cardiovascular risk; to compare the prevalence of subclinical cardiovascular disease, assessed by ultrasound measurement of Carotid Intima-Media Thickness (CIMT) among patients with HDL-c >= 90mg/dL (HALP group) and patients with HDL-c currently considered normal (40-50mg/dL for men and 50-60mg/dL for women); and to evaluate HDL functionality in patients with HALP through the study of its composition, its cholesterol efflux capacity, and its anti-inflammatory and antioxidant activity; correlating those characteristics with the presence of subclinical cardiovascular disease assessed by CIMT, Pulse Wave Velocity (PWV) and Coronary Artery Calcification (CAC). To answer these questions, the present study was articulated into two arms: Arm 1: ELSA-Brasil study cohort analysis in order to assess HALP prevalence in a general population, defining demographic, anthropometric and metabolic profile of HALP individuals; and comparing the prevalence of subclinical vascular disease among HALP subjects with controls with normal HDL-c. Arm 2: Recruitment of 80 healthy volunteers with HALP to study the correlation between subclinical vascular disease and HDL functionality in this group. Our study led to four main conclusions: 1) markedly elevated HDL-c is associated with lower CIMT compared to the control group with normal HDL-c levels. Although individuals with HALP display a more favorable metabolic profile than subjects with normal HDL-c, the association between CIMT and HALP was independent of traditional risk factors, indicating that the lower prevalence of subclinical vascular disease in this group is only partially justified by the lower prevalence of cardiovascular risk factors; 2) Although HALP can be regarded as an atheroprotective phenotype, there are individuals with markedly elevated levels of HDL-c who develop cardiovascular disease. Our results indicate good correlation of the three methods here adopted to study subclinical vascular disease among HALP patients: CIMT, VOP and CAC; 3) Traditional risk factors continue to exert their weight in determining cardiovascular risk in patients with HALP. Age, smoking, hypertension, hypertriglyceridemia and high levels of LDL-c were significantly associated with the presence of subclinical vascular disease among HALP individuals; 4) the assessment of the HDL composition and functionality in patients with HALP may allow to identify individuals specifically more susceptible to atherosclerosis. Our results indicate that, in particular, cholesterol efflux capacity, the anti-inflammatory activity of HDL, and triglyceride transfer capacity were independently associated with lower CIMT in HALP individuals, while higher levels of Apo A-IV were associated with a greater burden of subclinical cardiovascular disease

<p>Although, pulmonary drug delivery is a well established means for targeting of drugs to the lungs for the treatment of respiratory diseases as well as for the systemic delivery of volatile anesthetic agents, drug absorption kinetics in the lung have not been subjected to extensive research. The main objective of this thesis was to investigate drug absorption characteristics of the lung barrier, using the isolated and perfused rat lung model and in vivo pharmacokinetic studies in rats. Physicochemically diverse drugs (i.e. atenolol, budesonide, cromolyn, cyanocobalamin, enalapril, enalaprilate, formoterol, imipramine, losartan, metoprolol, propranolol, talinolol, terbutaline, and the tetrapeptide TArPP) were used as model compounds. In connection to these investigations, a nebulization catheter device was successfully adapted and evaluated as a new technique for delivery of defined aerosol doses to the rat lung. In addition, a physicochemical profile of the inhaled drugs on the market worldwide during 2001 was made.</p><p>The pulmonary first-order absorption rate constant and bioavailability were found to correlate to the drug lipophilicity, the molecular polar surface area, and the apparent permeability of Caco-2 cell monolayers. In contrast to the intestinal mucosa and the blood-brain barrier, the pulmonary epithelium was highly permeable to drugs with a high molecular polar surface area. Accordingly, a small hydrophilic tetrapeptide (oral bioavailability ~0.5%) showed a complete bioavailability after pulmonary delivery to rats in vivo. Regional differences in bioavailability, absorption rate, and first-pass metabolism of the peptide was demonstrated after targeted delivery to different regions of the respiratory tract in rats in vivo. The high pulmonary bioavailability of the efflux transporter substrates losartan and talinolol provides functional evidence for an insignificant role of efflux transporters such as P-glycoprotein in limiting the absorption of these drugs from the rat lung. </p><p>The results of this thesis demonstrate that the lung efficiently absorbs drugs with a wide range of lipophilicity. The pulmonary route should thus be regarded as a potential alternative for administration of drugs with low oral bioavailability. In addition, drug inhalation present an opportunity to attain a more rapid onset of drug action than can be attained by the oral route.</p>

<p>The general aim of the present project was to increase the understanding of the in vivo dissolution of poorly soluble drugs and thereby improve possibility to predict in vivo solubility from substance properties. Increased understanding of the in vivo limitations of drug solubility could potentially also generate ideas for improved formulation principles for poorly soluble compounds and more relevant in vitro dissolution test methods used in formulation development.</p><p>The dynamic gastrointestinal secretory and enzymatic responses to a liquid meal were studied in human intestinal fluid (HIF) by in vivo perfusion of a nutritional drink. The main diversity found compared to simulated intestinal fluids was the presence of dietary lipids in fed human intestinal fluid. This difference was showed to be of importance in the solubility of low soluble drugs, since this parameter was underestimated in the simulated fluid. Thus suggesting that simulated intestinal fluids should be prepared with the addition of dietary lipids for better in vitro in vivo predictions. </p><p>Solubility and dissolution determinations in fasted and fed HIF showed that the solubility was higher in fed state fluid, probably owing to the higher concentration of lipids in this media. The higher solubility was correlated to both the lipophilicity and aqueous solubility of the drug. The dissolution rate also increased, but not to the same extent as the solubility. These findings need to be considered in the design of in vitro models and in the prediction of food effects on oral bioavailability of poorly soluble drugs.</p><p>In addition, an in vivo porcine perfusion study was performed to investigate importance of different mechanisms in food-drug interactions. The results showed that solubilisation might be a more important factor than P-gp inhibition for food-related effects on the intestinal absorption kinetics of Class II drugs. </p>

Although, pulmonary drug delivery is a well established means for targeting of drugs to the lungs for the treatment of respiratory diseases as well as for the systemic delivery of volatile anesthetic agents, drug absorption kinetics in the lung have not been subjected to extensive research. The main objective of this thesis was to investigate drug absorption characteristics of the lung barrier, using the isolated and perfused rat lung model and in vivo pharmacokinetic studies in rats. Physicochemically diverse drugs (i.e. atenolol, budesonide, cromolyn, cyanocobalamin, enalapril, enalaprilate, formoterol, imipramine, losartan, metoprolol, propranolol, talinolol, terbutaline, and the tetrapeptide TArPP) were used as model compounds. In connection to these investigations, a nebulization catheter device was successfully adapted and evaluated as a new technique for delivery of defined aerosol doses to the rat lung. In addition, a physicochemical profile of the inhaled drugs on the market worldwide during 2001 was made. The pulmonary first-order absorption rate constant and bioavailability were found to correlate to the drug lipophilicity, the molecular polar surface area, and the apparent permeability of Caco-2 cell monolayers. In contrast to the intestinal mucosa and the blood-brain barrier, the pulmonary epithelium was highly permeable to drugs with a high molecular polar surface area. Accordingly, a small hydrophilic tetrapeptide (oral bioavailability ~0.5%) showed a complete bioavailability after pulmonary delivery to rats in vivo. Regional differences in bioavailability, absorption rate, and first-pass metabolism of the peptide was demonstrated after targeted delivery to different regions of the respiratory tract in rats in vivo. The high pulmonary bioavailability of the efflux transporter substrates losartan and talinolol provides functional evidence for an insignificant role of efflux transporters such as P-glycoprotein in limiting the absorption of these drugs from the rat lung. The results of this thesis demonstrate that the lung efficiently absorbs drugs with a wide range of lipophilicity. The pulmonary route should thus be regarded as a potential alternative for administration of drugs with low oral bioavailability. In addition, drug inhalation present an opportunity to attain a more rapid onset of drug action than can be attained by the oral route.

The general aim of the present project was to increase the understanding of the in vivo dissolution of poorly soluble drugs and thereby improve possibility to predict in vivo solubility from substance properties. Increased understanding of the in vivo limitations of drug solubility could potentially also generate ideas for improved formulation principles for poorly soluble compounds and more relevant in vitro dissolution test methods used in formulation development. The dynamic gastrointestinal secretory and enzymatic responses to a liquid meal were studied in human intestinal fluid (HIF) by in vivo perfusion of a nutritional drink. The main diversity found compared to simulated intestinal fluids was the presence of dietary lipids in fed human intestinal fluid. This difference was showed to be of importance in the solubility of low soluble drugs, since this parameter was underestimated in the simulated fluid. Thus suggesting that simulated intestinal fluids should be prepared with the addition of dietary lipids for better in vitro in vivo predictions. Solubility and dissolution determinations in fasted and fed HIF showed that the solubility was higher in fed state fluid, probably owing to the higher concentration of lipids in this media. The higher solubility was correlated to both the lipophilicity and aqueous solubility of the drug. The dissolution rate also increased, but not to the same extent as the solubility. These findings need to be considered in the design of in vitro models and in the prediction of food effects on oral bioavailability of poorly soluble drugs. In addition, an in vivo porcine perfusion study was performed to investigate importance of different mechanisms in food-drug interactions. The results showed that solubilisation might be a more important factor than P-gp inhibition for food-related effects on the intestinal absorption kinetics of Class II drugs.

There is a global rise in the use of herbal products in combination with allopathic medicines, while most patients do not inform their health care providers of the use of these natural products. Both pharmacodynamic and pharmacokinetic interactions between herbal products and conventional drugs must be avoided for the wellbeing of the patient. Increasing evidence from in vitro and in vivo studies indicate that changed drug pharmacokinetics by co-administered herbs may be attributed to modulation of efflux drug transporters such as P-glycoprotein (P-gp). Garlic (Allium sativum), lemon (Citrus limonum) and beetroot (Beta vulgaris) are widely used by human immunodeficiency virus (HIV) patients, especially following the pronouncement by a former President of South Africa and the Ministers of Health at that time who promoted the use of these botanicals in HIV patients. The aim of this study was to measure the bi-directional in vitro transport of indinavir, a protease inhibitor, in the presence of crude extracts and pure phytoconstituents of A. sativum (L-alliin and diallyl disulphide), C. limonum (hesperidin and eriocitrin) and B. vulgaris (betaine monohydrate and ß-carotene) across excised porcine intestinal tissue in Sweetana-Grass diffusion chambers. In the negative control group, the transport of indinavir alone (200 M) was determined with no modulator added. In the positive control group, the transport of indinavir was determined in the presence of verapamil (100 M), a known P-gp related efflux inhibitor. The control experiments were used to indicate that the effects of the test compounds were caused by their action and not by chance interferences or external factors. Samples collected at pre-determined time intervals were analysed by means of a validated high performance liquid chromatography (HPLC) method and the transport was expressed as the apparent permeability coefficient (Papp) and the transepithelial flux (J) from which the efflux ratio (ER) and the net flux (Jnet) values were calculated. Statistical analysis was used to compare the results of the test compounds with the control groups in order to indicate significant differences. The mean ER value for indinavir in the negative control group was 1.41 ± 0.170 and in the positive control group it was 0.56 ± 0.0426. Statistically significant (p < 0.05) inhibition of indinavir efflux as indicated by reduced ER values was obtained for L-alliin (ER = 0.280 ± 0.030), diallyl disulphide (ER = 0.505 ± 0.034) and ß-carotene (ER = 0.664 ± 0.075). Inhibition of indinavir efflux will lead to increased transport and therefore a potentially higher bioavailability. Statistically significant (p < 0.05) promotion of indinavir efflux as indicated by increased ER values was obtained for C. limonum crude extract (ER = 5.551 ± 0.575) and hesperidin (ER = 3.385 ± 0.477), which potentially may lead to lower bioavalability. B. vulgaris crude extract (p = 0.8452), betaine monohydrate (p = 0.9982), A. sativum crude extract (p = 0.7161) and eriocitrin (p = 0.4431) displayed no statistically significant effect compared to the negative control group on indinavir transport across excised porcine intestinal tissue. The results from this study demonstrate that L-alliin, diallyl disulphide and ß-carotene have an inhibitory effect on indinavir efflux, which may significantly increase indinavir plasma levels after oral administration. C. limonum crude extract and hesperidin promote indinavir efflux, which may significantly reduce indinavir plasma levels. These pharmacokinetic interactions between certain drugs and plant extracts may negatively affect the anti-retroviral treatment of HIV patients, but deliberate and controlled inclusion of L-alliin, diallyl disulphide and ß-carotene in dosage forms may possibly cause more effective delivery of protease inhibitors after oral administration resulting in less frequent dosing intervals. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

There is a global rise in the use of herbal products in combination with allopathic medicines, while most patients do not inform their health care providers of the use of these natural products. Both pharmacodynamic and pharmacokinetic interactions between herbal products and conventional drugs must be avoided for the wellbeing of the patient. Increasing evidence from in vitro and in vivo studies indicate that changed drug pharmacokinetics by co-administered herbs may be attributed to modulation of efflux drug transporters such as P-glycoprotein (P-gp). Garlic (Allium sativum), lemon (Citrus limonum) and beetroot (Beta vulgaris) are widely used by human immunodeficiency virus (HIV) patients, especially following the pronouncement by a former President of South Africa and the Ministers of Health at that time who promoted the use of these botanicals in HIV patients. The aim of this study was to measure the bi-directional in vitro transport of indinavir, a protease inhibitor, in the presence of crude extracts and pure phytoconstituents of A. sativum (L-alliin and diallyl disulphide), C. limonum (hesperidin and eriocitrin) and B. vulgaris (betaine monohydrate and ß-carotene) across excised porcine intestinal tissue in Sweetana-Grass diffusion chambers. In the negative control group, the transport of indinavir alone (200 M) was determined with no modulator added. In the positive control group, the transport of indinavir was determined in the presence of verapamil (100 M), a known P-gp related efflux inhibitor. The control experiments were used to indicate that the effects of the test compounds were caused by their action and not by chance interferences or external factors. Samples collected at pre-determined time intervals were analysed by means of a validated high performance liquid chromatography (HPLC) method and the transport was expressed as the apparent permeability coefficient (Papp) and the transepithelial flux (J) from which the efflux ratio (ER) and the net flux (Jnet) values were calculated. Statistical analysis was used to compare the results of the test compounds with the control groups in order to indicate significant differences. The mean ER value for indinavir in the negative control group was 1.41 ± 0.170 and in the positive control group it was 0.56 ± 0.0426. Statistically significant (p < 0.05) inhibition of indinavir efflux as indicated by reduced ER values was obtained for L-alliin (ER = 0.280 ± 0.030), diallyl disulphide (ER = 0.505 ± 0.034) and ß-carotene (ER = 0.664 ± 0.075). Inhibition of indinavir efflux will lead to increased transport and therefore a potentially higher bioavailability. Statistically significant (p < 0.05) promotion of indinavir efflux as indicated by increased ER values was obtained for C. limonum crude extract (ER = 5.551 ± 0.575) and hesperidin (ER = 3.385 ± 0.477), which potentially may lead to lower bioavalability. B. vulgaris crude extract (p = 0.8452), betaine monohydrate (p = 0.9982), A. sativum crude extract (p = 0.7161) and eriocitrin (p = 0.4431) displayed no statistically significant effect compared to the negative control group on indinavir transport across excised porcine intestinal tissue. The results from this study demonstrate that L-alliin, diallyl disulphide and ß-carotene have an inhibitory effect on indinavir efflux, which may significantly increase indinavir plasma levels after oral administration. C. limonum crude extract and hesperidin promote indinavir efflux, which may significantly reduce indinavir plasma levels. These pharmacokinetic interactions between certain drugs and plant extracts may negatively affect the anti-retroviral treatment of HIV patients, but deliberate and controlled inclusion of L-alliin, diallyl disulphide and ß-carotene in dosage forms may possibly cause more effective delivery of protease inhibitors after oral administration resulting in less frequent dosing intervals. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

Achromobacter xylosoxidans est un bacille à Gram négatif non fermentaire pathogène opportuniste. Il est de plus en plus fréquemment isolé chez les patients atteints de mucoviscidose, colonisant leur arbre bronchique et pouvant être responsable d'une dégradation de la fonction respiratoire. Il s'agit d'une espèce bactérienne naturellement résistante à de nombreux antibiotiques : aux céphalosporines (hors ceftazidime), à l'aztréonam et aux aminosides. Les résistances acquises sont fréquentes, en particulier dans les souches isolées d'expectorations de patients atteints de mucoviscidose. Ces résistances acquises concernent des molécules antibiotiques très utilisées pour le traitement des exacerbations respiratoires de la maladie, ce qui conduit parfois à de véritables impasses thérapeutiques. Au début de notre travail, seuls quelques mécanismes de résistance acquise aux β-lactamines avaient été décrits, mais aucun mécanisme impliqué dans la multi-résistance naturelle d'A. xylosoxidans.La résistance aux antibiotiques par efflux actif de type Resistance-Nodulation-cell Division (RND) est très répandue chez les bacilles à Gram négatif non fermentaires. Nous avons identifié dans le génome d'A. xylosoxidans trois opérons pouvant coder pour des systèmes d'efflux RND. Par une technique d'inactivation génique nous avons montré que les trois systèmes d'efflux (AxyABM, AxyXY-OprZ et AxyCDJ) pouvaient exporter des antibiotiques. Deux d'entre eux participent à l'antibio-résistance naturelle d'A. xylosoxidans : AxyABM (résistance à l'aztréonam et à plusieurs céphalosporines) et AxyXY-OprZ (résistance aux aminosides)