Nitric Oxide redistribution by a phospholipid nanoparticle colloid to treat septic shock.

PROJECT SUMMARY Septic shock continues to be a leading cause of morbidity and mortality worldwide. The increasing bacterial antibiotic resistance is forcing the search for new methods to improve prognosis. Traditional resuscitation therapy is not designed to address the physiological mechanisms of septic shock that contribute to hypotension and organ failure. The inflammatory response is a limiting factor even with interventions such as renal replacement therapy and extracorporeal membrane oxygenation. Vivacelle Bio has patented VBI-1, a novel anti-inflammatory suspension of phospholipid nanoparticles designed to modulate the bioavailability of nitric oxide (NO) responsible for excessive vasodilatation, hypotension, or dangerous reperfusion injury that leads to organ failure in septic shock. Preliminary data support the ability of VBI-1 to carry life-sustaining amounts of oxygen and to absorb reversibly and quickly NO. Because of this reversibility, VBI-1 represents a novel approach to the modulation of NO that reduces its bioavailability without stopping its production or its autocrine or paracrine effects. Through its NO uptake and release, VBI-1 acts as a high-capacity NO modulator. At the same time, VBI-1 can carry oxygen and enable oxygen transport during resuscitation therapy. VBI-1 also inhibits the inflammatory response, reducing ischemia-reperfusion injury and organ dysfunction. Also, the small nanoparticle size and high emulsifier content of VBI-1 guarantee longer stability and higher efficacy in raising blood pressure when compared to currently used resuscitation fluids. Finally, VBI-1 is based on non-allergic soybean-oil micelles and liposomes comprised of phospholipid bilayers which make the new formulation highly biocompatible. VBI-1 formulation has been successfully proven to treat hemorrhagic shock with up to 55% replacement of blood volume without evidence of fat emboli, toxicity, or lung injury. In this SBIR grant, Vivacelle Bio will validate VBI-1 as a superior product for intravascular volume replacement compared to current resuscitation fluids, such as albumin or saline, in treating septic shock. To establish the feasibility of this approach, we propose the following two specific aims: 1) demonstrate the efficacy of VBI-1 when used in vivo on a Cecal Ligation Puncture (CLP) rat model of severe septic shock and 2) validate in vivo the NO modulatory effect by measuring NO biomarkers in the same CLP rat model. This work will be preparatory for further studies in Phase II, aimed at optimizing the formulation of VBI-1 and obtaining an FDA licensure for its use as a fluid for reducing the intensity of the inflammatory process in the intravascular space.PROJECT NARRATIVE Given the high mortality of septic shock and the worsening of bacterial antibiotic resistance, there is an urgent need for new antibiotic-independent methods to treat septic shock. Vivacelle Bio is developing a phospholipid nanoparticle colloid to treat refractory septic shock by effectively raising blood pressure, modulating nitric oxide (NO), and protecting against reperfusion injury. The proposed project will establish the feasibility of this novel product in a preclinical animal model for sepsis by demonstrating its efficacy and validating its NO modulatory effect, to drive future clinical validation.