Abstract

Human serum albumin (HSA) has been widely used as a pharmaceutical excipient in Botulinum toxin serotype A (BoNT/A) products that are indicated for use in therapeutics and cosmetics. However, HSA as a human-derived material has some concerns, such as the potential risk of transmission of infectious agents, an insufficient supply, and difficulty in maintaining a certain quality. For those reasons, newly developed BoNT/A products (CORETOX®, Medytox, Inc., Republic of Korea) contained polysorbate 20, a non-human-derived excipient, to replace the HSA. However, most safety studies of polysorbate 20 have been conducted with non-invasive routes of administration, and thus there are a few studies on the safety of polysorbate 20 when administered intramuscularly. To secure the in vivo safety profile of polysorbate 20, a four-week repeated intramuscular dose toxicity study (0.02, 0.1, and 0.4 mg/kg, one injection every two weeks for a total of three injections) was conducted in 66 Sprague-Dawley (SD) rats. An intradermal irritation study was further conducted with 18 New Zealand White (NZW) rabbits. The toxicological evaluation of HSA (0.06 and 0.12 mg/kg) was also carried out as a comparative substance. Systemic and local toxicities were not observed in any of the SD rats or NZW rabbits based on clinical signs, body weight, hematology, clinical biochemistry, macroscopic findings on necropsy, histopathology of the injection site, and allergic reactions. The current study suggested that intramuscular administration of polysorbate 20 was considered to be safe at a level similar to that of HSA, which has an in vivo safety profile accumulated over the years. This provided the basis for the in vivo safety profile of polysorbate 20 administered intramuscularly and the scientific reliability of the use of polysorbate 20 as an alternative to HSA, which is used as an excipient for various pharmaceuticals in terms of its safety.

Highlights

  • Human serum albumin (HSA), the most abundant protein in human plasma, has the functions of regulating the colloid osmotic pressure, binding to and transporting various molecules, antioxidant action, anticoagulant action, regulating membrane permeability, and a direct neuroprotective action [1, 2]

  • Most botulinum toxin serotype A (BoNT/A) products that are indicated for use in therapeutics and cosmetics use HSA as an excipient [4, 5]

  • There was no significant change in the level of serum IgE and histamine in New Zealand White (NZW) rabbits administered polysorbate 20 and HSA compared to the control group

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Summary

Introduction

Human serum albumin (HSA), the most abundant protein in human plasma, has the functions of regulating the colloid osmotic pressure, binding to and transporting various molecules, antioxidant action, anticoagulant action, regulating membrane permeability, and a direct neuroprotective action [1, 2]. Most botulinum toxin serotype A (BoNT/A) products that are indicated for use in therapeutics and cosmetics use HSA as an excipient [4, 5]. The market demand for HSA has dramatically increased (over 500 tons), and it is one of the most widely used biopharmaceutical solutions today [7, 8]. This could lead to a worldwide shortage of HSA in the market [2]. The transmission of viral diseases, such as hepatitis B virus, human immunodeficiency virus, and West Nile virus are well controlled through strict management of HSA, but there are still concerns about the transmission of prion-derived variant Creutzfeldt-Jakob disease [10, 11]

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