Polymers for the sustained release of proteins and other macromolecules

Angiogenic factors and their assay: activity of formyl methionyl leucyl phenylalanine, adenosine diphosphate, heparin, copper, and bovine endothelium stimulating factor

A number of chemically unrelated substances have been compared for their neovasculogenic activity by two different in vivo tests, and for their ability to induce cultured endothelial cell migration and proliferation. Formyl methionyl leucyl phenylalanine, copper ions, heparin, adenosine diphosphate, and low-molecular-weight bovine endothelium stimulating factor were all neovasculogenic by the corneal pocket assay. By the chorioallantoic membrane assay, copper ions and formyl methionyl leucyl phenylalanine were not detectably neovasculogenic. By the same assay it has been possible to demonstrate angiogenic activity in bovine endothelium stimulating factor that is distinguishable from copper ions. This bovine factor, in contrast to the other agents, induced marked endothelial cell migration and also proliferation and may belong to a special class of agents which represents direct acting angiogenic activity.

Tumour angiogenesis

A variety of different factors has been implicated in inducing angiogenesis. Their identity and precise mechanisms of action remain elusive. The present treatise summarises the state of our knowledge not only in relation to tumour-induced capillary growth but also for non-neoplastic situations and mechanisms.

A micro sustained release system for epidermal growth factor

A technique for ensuring the controlled release of microgram and smaller amounts of biologically active epidermal growth factor (EGF) from polymeric delivery systems is described. We show that albumin in milligram quantities can facilitate the sustained release of picogram amounts of EGF for at least 3 wk. The EGF-containing polymer matrix can be placed directly into cell culture and will increase the proliferation rate of serum-starved cells. The method reported here should be suited particularly to the delivery of biologically active growth factors that are obtainable in only microgram or smaller amounts.

In vivo and in vitro release of macromolecules from polymeric drug delivery systems

In vivo release rates of a macromolecule from an ethylene-vinyl acetate copolymer have been shown to be indistinguishable from those of identical implants tested in vitro. The studies were conducted for approximately 2 months, and two different techniques were used to assess release rates. One of these techniques, using [3H]inulin as a marker, may be particularly useful in future studies assessing in vivo release rates from drug delivery systems. The appearance of [3H]inulin in the urine of rats bearing implants allowed continuous monitoring of release. A histological evaluation of tissue sections surrounding polymer implanted for 7 months showed no inflammatory cell reaction.

Oxygen tension regulates the expression of angiogenesis factor by macrophages

When cultured in a hypoxic environment similar to that found in the center of a wound, macrophages secreted active angiogenesis factor into the medium. Under conditions similar to those of well-oxygenated tissue, macrophages did not secrete active angiogenesis factor. Macrophages that secreted the factor at hypoxic conditions stopped secreting it when returned to room air. Thus the control of angiogenesis in wound healing may be the result of macrophages responding to tissue oxygen tension without the necessity of interacting with other cell types or biochemical signals.

Shark cartilage contains inhibitors of tumor angiogenesis

Shark cartilage contains a substance that strongly inhibits the growth of new blood vessels toward solid tumors, thereby restricting tumor growth. The abundance of this factor in shark cartilage, in contrast to cartilage from mammalian sources, may make sharks an ideal source of the inhibitor and may help to explain the rarity of neoplasms in these animals.

Angiogenesis inhibition and tumor regression caused by heparin or a heparin fragment in the presence of cortisone

Heparin or a heparin fragment administered with cortisone inhibited angiogenesis, caused regression of large tumor masses, and prevented metastases. Oral administration of heparin resulted in the release of non-anticoagulant heparin fragments in the serum which, in the presence of cortisone, had similar anti-angiogenic and antitumor effects. Of all the heparin fragments tested, the most potent inhibition of angiogenesis in the presence of cortisone was provided by a hexasaccharide with a molecular weight of about 1600.

Angiogenic and growth factors in human amnio-chorion and placenta

Human amnio-chorionic membranes and placenta maintained in culture release factors with angiogenic and mitogenic capacities at concentrations corresponding to nanogram amounts of protein. Angiogenic activity of amnio-chorion and placenta-conditioned media was assessed by their ability to stimulate neovascularisation in the dorsal subcutaneous fascia in the rat and the chorio-allantoic membrane in the chick embryo. Mitogenic characteristics were assessed by their ability to initiate DNA synthesis in cells at resting state, unstimulated peripheral blood lymphocytes and serum-deprived 3T3 fibroblasts. These growth promoting factors can be isolated from amnio-chorion and placenta-conditioned media mostly as factor-protein complexes of high molecular weight (higher than 100000 daltons) by gel filtration, and dissociated by magnesium chloride in components of low molecular weight including molecules readily diffusable through dialysis membranes of 2000 molecular weight cutoff. Presence of angiogenic and mitogenic factors in amnio-chorion suggests they might play a role in wound healing when amniotic membranes are used as biological dressings, besides the role they may play, in conjunction with placental factors, in embryonic and foetal development.

Hyaluronate in vasculogenesis

Limb buds of chicken embryos contain within the peripheral mesoderm an avascular zone that is rich in hyaluronic acid. Epithelial tissues that synthesize large amounts of hyaluronic acid relative to other glycosaminoglycans caused avascularity when implanted into normally vascular wing mesoderm. Epithelia that synthesize little hyaluronic acid did not cause avascularity. Elvax implants containing hyaluronic acid caused the formation of avascular zones, whereas similar implants containing other glycosaminoglycans did not give rise to avascular zones. Hyaluronic acid may thus play a role in determining the location of blood vessels in the embryo.

Angiogenesis inhibitors and their delivery systems

The extensive vascularity of solid tumors has been recognized for over 100 yr (1). However, only in the past 15 yr has the importance of this phenomenon been appreciated and only in the past 6 yr has the possibility of chemical interference been apparent. In this article, we review the emerging field of tumor vascularization inhibitors.

In vivo release of testosterone from vinyl polymer composites prepared by radiation-induced polymerization

Polymer-testosterone composites with long periods of controlled slow release were made by radiation-induced polymerization in a supercooled state at low temperature using glass-forming monomers. The in vitro release of testosterone from various vinyl polymer composites was found to follow a matrix-controlled process (Q-t1/2). The rate of drug delivery was accelerated with increasing water content of polymers. In experiments in vivo, the composites were implanted subcutaneously in the back of castrated rats during the 30 day test period. The in vivo release rate of testosterone was a little smaller than in vitro. This difference between two releases also increased with the increase of hydrophilicity of polymer. The physiological response in rats was investigated by measuring the weight of ventral prostate and serum testosterone concentration with testosterone-containing composites. The weight of ventral prostate increased linearly with increasing rate of drug release and the serum testosterone concentration could be correlated with the release and with the weight increase of ventral prostate. It was found from microscopic observation that the used polymer carriers had relatively good biocompatibility to cause little foreign body reaction.

Isolation of a nonmitogenic angiogenesis factor from wound fluid

Angiogenesis, or new capillary growth, is essential to normal growth and wound healing. It is also active in several pathologic states, including the growth of malignant tumors. An extracellular, nonneoplastic angiogenesis factor has been isolated from cell-free rabbit wound fluid by pore-limit dialysis and chromatography on a size-exclusion HPLC column. The isolated angiogenesis factor was purified 9,600-fold with a yield of 81% and has a molecular weight between 2,000 and 14,000. Wound fluid angiogenesis factor was completely separated from the mitogenic activity of wound fluid; it did not increase the number of capillary endothelial cells in vitro or stimulate [3H]thymidine uptake by these cells. The isolated angiogenesis factor stimulated endothelial cell migration in vitro, and less than 200 ng of the factor stimulated angiogenesis in vivo in the corneal implant assay.

Angiogenesis: initiation and control

From in vivo experiments using new methods such as the rabbit cornea, it is now becoming clear that the growth of a capillary involves an ordered sequence of events that includes lysis of the basement membrane of a parent venule, directional migration of capillary endothelial cells toward the angiogenic stimulus, lumen formation, development of branches, and anastomosis of the tip of one tube with another to form a loop. It is also clear that diffusible angiogenic stimuli can be released not only from most solid tumors, but also from at least three non-neoplastic cells. These include activated macrophages, sensitized lymphocytes, and adipocytes. Other normal tissues can also stimulate angiogenesis, but the type of cell giving rise to the angiogenic stimulus is unknown, and the period of angiogenic stimulation is brief. With the recent ability to clone capillary endothelial cells and to carry them in long-term culture, it has been possible to further delineate the mechanism of capillary growth. In vitro studies have shown that the mast cell seems to behave as a helper cell for capillary endothelial cells, in some way speeding up their rate of directional migration. At this writing, heparin appears to be the principal mast cell factor responsible for this effect on capillary endothelial cells. One theoretical possibility is that mast cells may prepare the matrix, perhaps by slow release of heparin, so that capillary sprouts can more easily move through it toward their angiogenic target. While the study of angiogenesis as a phenomenon is still in an early phase, it has become possible, by using a combination of in vitro and in vivo techniques, to more thoroughly understand the initiation and control of capillary growth.

Development and evaluation of an inhibitor-releasing matrix for intrauterine devices

Antifibrinolytic agents when released into the uterine cavity decrease menorrhagia associated with IUD use. Our objective was to develop a matrix that could be incorporated onto an IUD and release anti-fibrinolytic agents. The copolymer ethylene-vinyl acetate (EVA) was selected for detailed study because it has the advantage over other materials in that it can release large molecular weight substances for more than 100 days, and allows incorporation of large amounts of anti-fibrinolytic agents with different molecular weights. Two compounds, tranexamic acid (AMCA, MW=157) and Trasylol (Kunitz pancreatic trypsin inhibitor, (MW=6,500) were incorporated into the EVA matrix and their release rates measured. In vitro studies with AMCA showed that after the initial burst, a constant high release rate was obtained over a prolonged period of time. The in utero release rate of AMCA from the EVA matrix in rabbits was similar to that obtained in vitro. By contrast, the release rate of Trasylol decreased to low levels during incubation in vitro. The release rate of Trasylol in utero however, appeared to be higher than that in vitro.

Magnetic modulation of release of macromolecules from polymers

Sustained-release systems were made by incorporating bovine serum albumin and magnetic steel beads in an ethylene-vinyl acetate copolymer matrix. When exposed to aqueous medium, the polymer matrix released the albumin slowly and continuously. Application of an oscillating magnetic field increased the release rate by as much as 100%. Intervals of 6-hr periods of magnetic exposure and nonexposure were alternated over a 5-day period, resulting in corresponding increases and decreases in release and establishing a pattern of modulated sustained release.

Biocompatibility of polymeric delivery systems for macromolecules

We previously reported the use of polymeric delivery systems capable of sustained release of substances with molecular weights up to 2 X 10(6). The current study examined the tissue compatibilities of these slow-release agents and of other polymeric materials. To observe in vivo host responses to specific implants, tests were conducted in the rabbit cornea. The cornea as an implant site has several advantages compared to other organs including its clarity, avascularity, sensitivity, and convenient access to view. Corneas were examined using stereomicroscopy and histology. Two polymers suitable for sustained macromolecular release, poly(hydroxyethyl methacrylate), and alcohol-washed ethylene-vinyl acetate copolymer, were noninflammatory. Other polymers considered for sustained macromolecular release, such as polyacrylamide and poly(vinyl pyrrolidone), produced significant inflammation.

Inhibition of tumor growth, vascularization, and collagenolysis in the rabbit cornea by medroxyprogesterone

Medroxyprogesterone, dexamethasone, or cortisone, locally applied in sustained release polymer to rabbit V2 carcinoma implanted in the rabbit cornea, blocked neovascularization and three-dimensional growth of the tumor. These hormones similarly prevented the vascular proliferative response to implants in the rabbit cornea of mouse B-16 melanoma and also the response to implants of polymer containing tumor extract with angiogenesis activity. The inhibitory responses were accompanied by considerable reduction in collagenolytic activity released into culture medium by explants of the two tumors and of the corneal region containing angiogenic hepatoma extract. Morphologic studies revealed extensive three-dimensional disruption of the compact laminated collagenous structure of the cornea by untreated V2 carcinoma. In the presence of hormone the tumor grew slowly as a noninvasive two-dimensional plaque limited to the narrow region of the insertion pocket in the cornea, with no obvious disturbance of structure elsewhere. Cortisone was much les effective than medroxyprogesterone or dexamethasone. Testosterone and estradiol had no effect on the three measured properties. The data suggest that local hormonal interference with neovascularization, collagenase production, and tumor growth can prevent neoplastic invasion and destruction of a dense collagenous connective tissue.

Rubeosis iridis in "pseudogliomas"

A total of 85 eyes (75 patients) with pseudogliomas (i.e., certain conditions which simulate retinoblastoma, were examined histopathologically to determine the incidence of rubeosis iridis. Neovascularization of the anterior surface of the iris was found in 70 eyes (82%). The principal associated changes in these eyes were moderate to severe inflammation of the uveal tract and retinal detachment. These findings are interpreted as indicating that inflammation, retinal detachment, and/or ischemia are effective stimulants in producing iris neovascularization, and rubeosis is not a significant factor in differentiating eyes with retinoblastoma from those eyes with pseudogliomas.

Control of tumor growth in animals by infusion of an angiogenesis inhibitor

Angiogenesis and tumor growth were inhibited in two different animal models by regional infusion of a partially purified cartilage extract. In rabbits bearing corneal implants of V2 carcinoma and receiving the inhibitor, vascular growth rates were < 3% of those in control animals receiving either Ringer's solution or bovine trypsin inhibitor (Trasylol). Subconjunctival B16 melanoma implants in mice receiving the inhibitor weight < 2.5% of implants in mice receiving Ringer's solution, Trasylol, or albumin. Histologic study of major organs and standard blood tests revealed no toxic effects in any of the animals. The inhibitor did not retard the growth of either tumor cell type in tissue culture at concentrations as high as 1 mg/ml. These results suggest that the cartilage factor does not interfere with the growth of the tumor cell population directly but that it prevents tumor growth by inhibiting angiogenesis.

Polymers for sustained macromolecule release: procedures to fabricate reproducible delivery systems and control release kinetics

Matrixes composed of ethylene-vinyl acetate copolymer are useful vehicles for the sustained release of macromolecules such as proteins. A new procedure for fabricating these polymeric delivery systems involved mixing the dry, powdered macromolecule with a polymer solution and casting the mixture at -80 degrees. The resulting matrix was dried in two 48-hr stages, first at -20 degress and then at 20 degrees. These polymer systems had uniform drug distribution, and their release kinetics were reproducible. Fabrication parameters such as drug particle size, drug loading, and matrix coating all significantly affected release kinetics.

The demonstration of angiogenic activity from ocular tissues. Preliminary report

Human, bovine, and rabbit retinal extracts are shown to be capable of stimulating (1) proliferation and thymidine uptake of bovine vascular endothelial cells in cultures and (2) neovascularization of the chick chorioallantoic membrane (CAM). Extracts of skeletal muscle, heart, and liver lack similar stimulatory activity. Vitreous aspirates from patients with proliferative diabetic retinopathy, in a preliminary study, were able to stimulate vascular endothelial cell thymidine uptake. Most vitreous samples from patients without intraocular neovascularization lacked similar stimulatory activity. Indirect evidence suggests the liberation of an angiogenic factor from the retina in several ocular disorders. The data contained in this report represent the first direct evidence of angiogenic activity from mammalian retina.

Demonstration of vasoproliferative activity from mammalian retina

Vasoproliferative activity has been demonstrated in extracts of retinas from human, bovine, and feline sources. These retinal extracts are capable of stimulating (a) proliferation and thymidine uptake of bovine vascular endothelial cells in culture and (b) neovascularization on the chick chorioallantoic membrane. Extracts of skeletal muscle, cardiac muscle, and liver lack similar stimulatory activity. The activity is nondialyzable, stable at 56 degrees C, and inactivated at 100 degrees C. Retinal extracts stimulate the proliferation of corneal fibroblasts but have no effect on the proliferation of vascular smooth muscle cells. Indirect evidence suggests the liberation of a vasoproliferative factor from retina in several ocular disorders. The data in this report represent the first direct demonstration of vasoproliferative activity from mammalian retina.

Neovasculogenesis. Triggering factors and possible mechanisms

The possible regulating mechanism(s) of neovascularization are discussed. Experimental data supporting the view that ocular neovascularization might be triggered by a fundamental metabolic mechanism are presented. Based on his own data and scattered evidence from the literature, the author suggests a model for a possible regulating mechanism of the neovascular process in which the prostaglandins fulfill the role of neovascular mediating substances. Preliminary results demonstrating that indomethacin limits the extent of the neovascular process support this concept and may have a therapeutic implication. Further studies are in progress in order to better understand the pivotal role fulfilled by the prostaglandins in neovasculogenesis.

Importance of a collagen substratum for stimulation of capillary endothelial cell proliferation by tumour angiogenesis factor

Tumour extracts were obtained from rat Walker 256 carcinoma and examined for the presence of tumour angiogenesis factor (TAF) in vivo before being used in tissue culture experiments. Capillary endothelial cells derived from cow brain white matter were used to study the effects of TAF-containing tumour extracts on cell proliferation in vitro. The cells were grown on two types of substrata: (1) plastic tissue culture dishes and (2) hydrated gels made of rat tail tendon type I collagen. Human platelets or platelet-released factors were introduced into the system because of the many inter-relationships known to exist between platelets, collagen and endothelial cells. If trypsin was used during the preparation of TAT, the resulting batches stimulated endothelial cell proliferation only when the cells were growing on a collagen substratum and either platelets or platelet-released factors were present in the growth medium. If incubation with trypsin was omitted from the TAF extraction procedure, the resulting batches stimulated cell growth both on plastic and on collagen. A synergistic interaction also occurred between these TAF-containing tumour extracts and platelet-released factors. This effect was always more marked when the cells were growing on collagen than when on plastic. These data suggest that the nature of the substratum affects the response of the endothelial cells to TAF and to platelet-released factors.

A single-step immunization by sustained antigen release

An inert polymer pellet less than 1 mm in diameter, implanted subcutaneously in mice, releases free antigen continuously and enhances antibody formation for over 6 months. The immune response stimulated by sustained antigen delivery is comparable to the secondary response induced by the same total dose of antigen emulsified in complete Freund's adjuvant. The sustained release polymer implants, using antigens over a wide molecular weight range, proved effective in eliciting prolonged antibody formation. The antigens tested included bovine serum albumin, gamma-globulin, and ribonuclease. Superior biocompatibility and release characteristics make the ethylene-vinyl acetate copolymer a promising method for the single-step induction of immunity.

Poly-HEMA sponge: a biocompatible calcification implant

Poly-hydroxyethyl methacrylate (Poly-HEMA) was investigated for biocompatibility and calcification potential. S.C. and I.M. implants and transplants to subperiosteal sites were examined. The material was judged to be tolerated by the host tissue since no inflammatory or degenerative changes were observed. This study established that calcification does occur. This calcification does not simulate bone formation; osteoblasts were not observed. The x-ray diffraction pattern resembles that of calcium hydroxyapatite.

A new approach to the problem of retinal neovascularization

Tumor cells introduced into the rabbit vitreous produced a form of retinal neovascularization, but only when the tumor cells were in direct contact with the vascularized retina. This contrasted with the production of neovascularization at a distance of several millimeters in other angiogenesis models. An extract of adult rabbit vitreous was found to inhibit the growth of limbal neovascularization induced by tumors implanted in the rabbit corneal stroma. The experimental model of retrolental fibroplasia provides a bioassay to investigate further the apparent inhibitory substances in the vitreous.

Controlled drug release from polymers

Unlike conventional routes of drug administration, controlled-release systems that use implanted, inserted, or surface-applied noninflammatory polymeric vehicles can deliver a steady quantity of drug to a target area over long periods of time. This is now true for drugs of both high and low molecular weight. Some of the devices are described, and existing as well as potential clinical applications are discussed.

Inhibition of neovascularization by an extract derived from vitreous

An extract of the vitreous body, inhibited the growth of new blood vessels induced by tumors in the rabbit cornea. This extract was delivered by an inert, continuously releasing polymer. The average vessel growth rate in the region surrounding the polymer was 32% less in corneas containing the inhibitory substance than in control corneas.