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Chen Y, Xu J, Li P, Shi L, Zhang S, Guo Q, Yang Y. Advances in the use of local anesthetic extended-release systems in pain management. Drug Deliv 2024; 31:2296349. [PMID: 38130151 PMCID: PMC10763865 DOI: 10.1080/10717544.2023.2296349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Pain management remains among the most common and largely unmet clinical problems today. Local anesthetics play an indispensable role in pain management. The main limitation of traditional local anesthetics is the limited duration of a single injection. To address this problem, catheters are often placed or combined with other drugs in clinical practice to increase the time that local anesthetics act. However, this method does not meet the needs of clinical analgesics. Therefore, many researchers have worked to develop local anesthetic extended-release types that can be administered in a single dose. In recent years, drug extended-release systems have emerged dramatically due to their long duration and efficacy, providing more possibilities for the application of local anesthetics. This paper summarizes the types of local anesthetic drug delivery systems and their clinical applications, discusses them in the context of relevant studies on local anesthetics, and provides a summary and outlook on the development of local anesthetic extended-release agents.
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Affiliation(s)
- Yulu Chen
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Jingmei Xu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Ping Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, China
| | - Liyang Shi
- College of Biology, Hunan University, Changsha, China
| | - Sha Zhang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Qulian Guo
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Yang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Le Franc A, Da Silva A, Lepetre-Mouelhi S. Nanomedicine and voltage-gated sodium channel blockers in pain management: a game changer or a lost cause? Drug Deliv Transl Res 2024; 14:2112-2145. [PMID: 38861139 DOI: 10.1007/s13346-024-01615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 06/12/2024]
Abstract
Pain, a complex and debilitating condition affecting millions globally, is a significant concern, especially in the context of post-operative recovery. This comprehensive review explores the complexity of pain and its global impact, emphasizing the modulation of voltage-gated sodium channels (VGSC or NaV channels) as a promising avenue for pain management with the aim of reducing reliance on opioids. The article delves into the role of specific NaV isoforms, particularly NaV 1.7, NaV 1.8, and NaV 1.9, in pain process and discusses the development of sodium channel blockers to target these isoforms precisely. Traditional local anesthetics and selective NaV isoform inhibitors, despite showing varying efficacy in pain management, face challenges in systemic distribution and potential side effects. The review highlights the potential of nanomedicine in improving the delivery of local anesthetics, toxins and selective NaV isoform inhibitors for a targeted and sustained release at the site of pain. This innovative strategy seeks to improve drug bioavailability, minimize systemic exposure, and optimize therapeutic outcomes, holding significant promise for secure pain management and enhancing the quality of life for individuals recovering from surgical procedures or suffering from chronic pain.
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Affiliation(s)
- Adélaïde Le Franc
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400, Orsay, France
| | - Alexandre Da Silva
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400, Orsay, France
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da Silva CB, dos Santos CP, Serpe L, Sanchez JB, Ferreira LEN, de Melo NFS, Groppo FC, Fraceto LF, Volpato MC, Franz-Montan M. Polymeric Nanocapsules Loaded with Lidocaine: A Promising Formulation for Topical Dental Anesthesia. Pharmaceuticals (Basel) 2024; 17:485. [PMID: 38675445 PMCID: PMC11054800 DOI: 10.3390/ph17040485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Lidocaine is the most commonly used local anesthetic worldwide, known for its rapid onset and moderate duration of anesthesia. However, it is short-lived and does not effectively promote effective topical anesthesia in the oral cavity when used alone. Our aim was to investigate whether an approximate 50% encapsulation of lidocaine in poly(ε-caprolactone) nanocapsules (LDC-Nano) would be able to increase its permeation and analgesic efficacy and reduce cytotoxicity. In this study, we characterized LDC-Nano and conducted MTT tests with HaCaT cells to assess their in vitro cytotoxicity. Additionally, in vitro permeation assays across the pig esophageal epithelium and the anesthetic efficacy of the hind paw incision model in rats were performed. Plain lidocaine (LDC) was compared with LDC-Nano and lidocaine hydrochloride plus epinephrine (LDC-Epi). The physicochemical characteristics of LDC-Nano were satisfactory (pH: 8.1 ± 0.21; polydispersity index: 0.08 ± 0.01; mean diameter (nm): 557.8 ± 22.7; and encapsulation efficiency (%): 51.8 ± 1.87) and remained stable for up to 4 months. LDC-Nano presented similar in vitro cytotoxicity to LDC but was higher than LDC-Epi (LD50: LDC = 0.48%; LDC-Nano = 0.47%; and LDC-Epi = 0.58%; p < 0.0001). Encapsulation increased the permeability coefficient about 6.6 times and about 7.5 the steady-state flux of lidocaine across the mucosal epithelium. Both encapsulation and epinephrine improved anesthesia duration, with epinephrine demonstrating superior efficacy (100% of animals were anesthetized up to 100, 30, and 20 min when LDC-Epi, LDC-nano, and LDC were used, respectively). Although LDC-Epi demonstrated superior in vivo anesthetic efficacy, the in vitro permeation and cytotoxicity of LDC-Nano indicate promising avenues for future research, particularly in exploring its potential application as a topical anesthetic in the oral cavity.
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Affiliation(s)
- Camila Batista da Silva
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Cleiton Pita dos Santos
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Luciano Serpe
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Jonny Burga Sanchez
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Luiz Eduardo Nunes Ferreira
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
- Laboratory of Inflammation and Immunology, Guarulhos University, Guarulhos, SP 07023-070, Brazil
| | | | - Francisco Carlos Groppo
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Leonardo Fernandes Fraceto
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP 18087-180, Brazil; (N.F.S.d.M.); (L.F.F.)
| | - Maria Cristina Volpato
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
| | - Michelle Franz-Montan
- Department of Biosciences, Piracicaba Dental School, Universidade Estadual de Campinas, Av. Limeira, 901, Piracicaba, SP 13414-903, Brazil; (C.B.d.S.); (C.P.d.S.); (L.S.); (J.B.S.); (L.E.N.F.); (F.C.G.); (M.C.V.)
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Zhang Y, Shi K, Yang X, Chen W, Wang T, Kang Y, Gong D, Qian Z, Zhang W. Sustained release of levobupivacaine from temperature-sensitive injectable hydrogel for long-term local anesthesia in postoperative pain management. Biomaterials 2023; 299:122129. [PMID: 37167892 DOI: 10.1016/j.biomaterials.2023.122129] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
Postoperative pain is a major concern for most of the surgical patients, and an inadequate postoperative pain control may cause a series of complications. With an effective pain control and lesser side effects, local anesthetics are preferred for use in postoperative pain management. However, the action duration of current local anesthetics is too short to meet the requirements of postoperative analgesia. In this study, an injectable levobupivacaine (LB)-loaded thermo-sensitive hydrogel system based on biodegradable poly(D,L-lactide)-poly(ethylene glycol)-poly(D,L-lactide) (PLEL) was developed for long-acting local anesthetic, in which the soluble charged cation form of LB (LB HCl) was partly alkalified to the poorly soluble base form (LB base). This hybrid LB loaded PLEL system (hLB/PLEL) is a free flowable liquid at room temperature and changes into a semi-solid hydrogel once injection in response to the physiological temperature. Then, the dissolved LB HCl could release firstly from the hydrogel contributing to a quick work, and the insoluble LB base dissolved and released gradually as the decrease of the pH during the biodegradation of PLEL hydrogel, resulting in a long-term LB release in local. The drug release behavior, pharmacokinetic, and biocompatibility of the thermo-sensitive hLB/PLEL were studied in vitro and in vivo. The anesthetic effects of hLB/PLEL system were evaluated in the rat models of sciatic nerve block, subcutaneous infiltration anesthesia and postoperative pain as well. This hLB/PLEL system generated a significantly prolonged analgesic effect in rat models, which produced approximately 7 times longer duration than 0.75% LB HCl and effectively relieved the spontaneous pain for 3 days. In general, the presented hLB/PLEL system can not only achieve a fast-acting but also sustainably release LB to block the nerve and significantly extend the effect of local analgesia, which means a promising candidate for long-acting postoperative pain management.
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Affiliation(s)
- YuJun Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, 610041, China
| | - Kun Shi
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xi Yang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wen Chen
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - TianHong Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, 610041, China
| | - Yi Kang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, 610041, China
| | - DeYing Gong
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, 610041, China
| | - ZhiYong Qian
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - WenSheng Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, 610041, China.
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Vasconcelos MO, Silva LAD, Sousa-Junior AA, dos Santos TRM, da Silva CA, Valadares MC, Lima EM. Lidocaine- and chloramphenicol-loaded nanoparticles embedded in a chitosan/hyaluronic acid/glycerol matrix: Drug-eluting biomembranes with potential for guided tissue regeneration. FRONTIERS IN NANOTECHNOLOGY 2022. [DOI: 10.3389/fnano.2022.1049599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Guided tissue regeneration (GTR) is a dentistry technique based on the use of polymeric biomembranes as physical barriers for selective cell exclusion, directing the growth of gingival tissue, bone tissue, and periodontal ligaments in a region previously affected by periodontitis. Postoperative pain and microbial infection constitute, however, two major challenges to be tackled right after implantation. To address these challenges, we prepared and characterized eight chitosan/hyaluronic acid/glycerol (CS/HA/GL) bioresorbable membranes embedded with lidocaine- and chloramphenicol-loaded polycaprolactone nanoparticles (LDNP and CHNP, respectively), combining the local anesthetic effects of lidocaine with the antibacterial effects of chloramphenicol. The formulations were prepared with varying amounts of CS, HA, GL, LDNP, and CHNP. As a plasticizing agent, GL could modulate the samples mechanical properties such as thickness, morphology, tensile strength, elongation at break, as well as swelling and degradation in simulated saliva. Two samples exhibited greater resistance to biodegradation and were selected for further studies. Their drug release profiles indicated that LDNP and CHNP first detach from the membrane matrix, and a zeroth order drug release kinetics from the detached NPs dominates the overall process thereafter, with lidocaine being released 3 times faster than chloramphenicol, in a controlled and sustained rate over time. Drug encapsulation efficiency was such that optimal samples exhibited bactericidal activity (inhibition halos) against gram-positive S. aureus and gram-negative A. actinomycetemcomitans strains similar to that observed for free chloramphenicol. Finally, one of these samples showed no intrinsic toxicity against healthy mammalian model cells (99% viability for the unloaded membrane; 80% viability for the fully LDNP- and CHNP-loaded membrane), and may now be further optimized as a drug-eluting biomembrane with potential for GTR.
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Future Treatment of Neuropathic Pain in Spinal Cord Injury: The Challenges of Nanomedicine, Supplements or Opportunities? Biomedicines 2022; 10:biomedicines10061373. [PMID: 35740395 PMCID: PMC9219608 DOI: 10.3390/biomedicines10061373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/28/2022] [Accepted: 06/08/2022] [Indexed: 12/12/2022] Open
Abstract
Neuropathic pain (NP) is a common chronic condition that severely affects patients with spinal cord injuries (SCI). It impairs the overall quality of life and is considered difficult to treat. Currently, clinical management of NP is often limited to drug therapy, primarily with opioid analgesics that have limited therapeutic efficacy. The persistence and intractability of NP following SCI and the potential health risks associated with opioids necessitate improved treatment approaches. Nanomedicine has gained increasing attention in recent years for its potential to improve therapeutic efficacy while minimizing toxicity by providing sensitive and targeted treatments that overcome the limitations of conventional pain medications. The current perspective begins with a brief discussion of the pathophysiological mechanisms underlying NP and the current pain treatment for SCI. We discuss the most frequently used nanomaterials in pain diagnosis and treatment as well as recent and ongoing efforts to effectively treat pain by proactively mediating pain signals following SCI. Although nanomedicine is a rapidly growing field, its application to NP in SCI is still limited. Therefore, additional work is required to improve the current treatment of NP following SCI.
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Li MN, Wan B, Yang S, Tang Y, Zhang H, Zhang SQ, Liu HY, Ye Y. Aerobic Baeyer−Villiger oxidation catalyzed by metal corroles. European J Org Chem 2022. [DOI: 10.1002/ejoc.202200462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Meng-Ni Li
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Bei Wan
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Shuang Yang
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Yan Tang
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Hao Zhang
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Si-Quan Zhang
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
| | - Hai-Yang Liu
- South China University of Technology Department of Chemistry 381# Wushan Road 510641 Guangzhou CHINA
| | - Yong Ye
- South China University of Technology School of Chemistry and Chemical Engineering CHINA
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Using Chitosan-Coated Polymeric Nanoparticles-Thermosensitive Hydrogels in association with Limonene as Skin Drug Delivery Strategy. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9165443. [PMID: 35434138 PMCID: PMC9010220 DOI: 10.1155/2022/9165443] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/16/2022] [Indexed: 12/16/2022]
Abstract
Topical delivery of local anesthetics (LAs) is commonly used to decrease painful sensations, block pain throughout procedures, and alleviate pain after surgery. Dermal and/or transdermal delivery of LAs has other advantages, such as sustained drug delivery and decreased systemic adverse effects. This study reports the development of poly(D,L-lactide-co-glycolide) (PLGA) nanoparticles coated with chitosan for the sustained release and topicality of benzocaine (BZC) and topical delivery. BZC PLGA nanoparticles or nonencapsulated drugs were further incorporated into Poloxamer hydrogels (Pluronic™ F-127). The nanoparticles showed a mean diameter of 380 ± 4 nm, positive zeta potential after coating with chitosan (23.3 ± 1.7 mV), and high encapsulation efficiency (96.7 ± 0.02%). Cellular viability greater than 70% for both fibroblasts and keratinocytes was observed after treatment with nanoparticles, which is in accordance with the preconized guidelines for biomedical devices and delivery systems. Both the nanoparticles and hydrogels were able to modulate BZC delivery and increase drug permeation when compared to the nonencapsulated drug. Furthermore, the incorporation of limonene into hydrogels containing BZC-loaded nanoparticles increased the BZC permeation rates. Non-Newtonian and pseudoplastic behaviors were observed for all hydrogel nanoformulations with or without nanoparticles. These results demonstrate that the hydrogel-nanoparticle hybrids could be a promising delivery system for prolonged local anesthetic therapy.
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Zhao W, Du Y, Ashfaq S, Ali S, Alanazi AM, Santi M. Evaluation of the Efficacy, Biocompatibility, and Permeation of Bupivacaine-Loaded Poly(epsilon-caprolactone) Nano-Capsules as an Anesthetic. J Biomed Nanotechnol 2022; 18:268-276. [PMID: 35180921 DOI: 10.1166/jbn.2022.3223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In this study bupivacaine (BVC) was encapsulated in Nano-capsules of poly-ε-caprolactone (PCL) and its cytotoxicity in HaCaT (MTT) cells, its permeability in the oesophageal epithelium of pigs, as well as its anesthetic effect in the incision model of rat's hind paw (electronic von Frey anesthesiometer) were evaluated. BVC and epinephrine-associated bupivacaine (BVC-Epi) have been compared to BVC-Nano and it was demonstrated that BVC-Nano had high physicochemical properties and remained stable for 120 days; also, encapsulation of bupivacaine did not affect its toxicity to HaCaT cells, but epinephrine reduced its toxicity. Although both methods of combination with epinephrine and encapsulation in nanocapsules resulted in an extended time of anesthesia, the efficacy of epinephrine was more favorable. The permeation evaluation indicated that encapsulation increased both the permeability coefficient and the steady-state flux of bupivacaine across the esophageal epithelium. BVC permeation was enhanced by encapsulation into Nano-capsules, as a new novel therapeutic strategy, facilitating future research as a topical anesthetic.
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Affiliation(s)
- Wangcheng Zhao
- Department of Anesthesiology, 3201 Hospital, Hanzhong, 723000, China
| | - Yan Du
- Department of Anesthesiology, Binzhou Traditional Chinese Medicine Hospital, Binzhou, 256600, China
| | - Shameen Ashfaq
- Women Medical Officer Punjab Health Department, Faisalabad, 38000, Pakistan
| | - Shafaqat Ali
- Department of Environmental Sciences and Engineering, Government College University, Allama Iqbal Road, 38000, Faisalabad, Pakistan
| | - Amer M Alanazi
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Moreno Santi
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
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Wang H, Zhang Y, Xu X, Wang A. An injectable mesoporous silica-based analgesic delivery system prolongs the duration of sciatic nerve block in mice with minimal toxicity. Acta Biomater 2021; 135:638-649. [PMID: 34520884 DOI: 10.1016/j.actbio.2021.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/16/2022]
Abstract
The major limitation of traditional local anesthetics is the finite duration of a single injection. The present study developed two kinds of novel injectable anesthetic nanocomposites based on mesoporous silica, and evaluated their long-lasting analgesic effect and biosafety. The nanoparticulate carriers, mesoporous silica nanoparticles (MSNs) and mesoporous silica-coated gold nanorods (GNR@MSN), were firstly constructed using the oil-water biphase reaction approach and then ropivacaine (RPC), a local anesthetic, was loaded into the mesoporous carriers by vacuum suction. Transmission electron microscopic images showed the well-ordered mesoporous structure for drug loading. RPC-loaded MSNs and RPC-loaded GNR@MSN exhibited a sustained-release pattern in vitro, and the latter also showed a controlled-release manner triggered by near-infrared (NIR) irradiation. RPC-loaded MSNs and RPC-loaded GNR@MSN caused an initial sensory blockade in mice that lasted for 6 h, almost 2.5 folds of that from free RPC solution. Furthermore, upon NIR irradiation, the latter induced three additional periods of the blockade. Neither of them showed motor nerve block, which may be due to the sustained release manner. The low myotoxicity and low neurotoxicity of the two nanocomposites were presented both in vitro and in vivo. These results demonstrate the potential of the mesoporous silica-based analgesic nanocomposites in effectively controlling postoperative pain, maybe RPC-loaded MSNs for moderate pain and RPC-loaded GNR@MSN for severe pain. STATEMENT OF SIGNIFICANCE: Adequate postoperative analgesia helps early functional exercise after surgery and accelerates rapid recovery, while uncontrolled postoperative pain probably develops chronic post-surgical pain that impacts the life quality of patients for a long time. However, postoperative pain management is still a challenge. The current treatment drugs are always accompanied by some side effects due to their systemic effect. Opioids have risks of addiction and respiratory depression, and nonsteroidal anti-inflammatory drugs can lead to gastrointestinal reaction. Therefore, the long-lasting local anesthetic formulation with good biocompatibility is the most promising solution to manage post-surgical pain. The present study developed novel injectable anesthetic nanocomposites based on mesoporous silica, providing long-lasting pain relief in mice with minimal toxicity.
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Affiliation(s)
- Haiyan Wang
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Road, Shanghai 200233, China
| | - Yu Zhang
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Road, Shanghai 200233, China
| | - Xiaotao Xu
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Road, Shanghai 200233, China
| | - Aizhong Wang
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yi Shan Road, Shanghai 200233, China.
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Bhansali D, Teng SL, Lee CS, Schmidt BL, Bunnett NW, Leong KW. Nanotechnology for Pain Management: Current and Future Therapeutic Interventions. NANO TODAY 2021; 39:101223. [PMID: 34899962 PMCID: PMC8654201 DOI: 10.1016/j.nantod.2021.101223] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pain is one of the most common medical conditions and affects more Americans than diabetes, heart disease, and cancer combined. Current pain treatments mainly rely on opioid analgesics and remain unsatisfactory. The life-threatening side effects and addictive properties of opioids demand new therapeutic approaches. Nanomedicine may be able to address these challenges as it allows for sensitive and targeted treatments without some of the burdens associated with current clinical pain therapies. This review discusses the physiology of pain, the current landscape of pain treatment, novel targets for pain treatment, and recent and ongoing efforts to effectively treat pain using nanotechnology-based approaches. We highl ight advances in nanoparticle-based drug delivery to reduce side effects, gene therapy to tackle the source of pain, and nanomaterials-based scavenging to proactively mediate pain signaling.
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Affiliation(s)
- Divya Bhansali
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Shavonne L. Teng
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY 10010
- Department of Neuroscience and Physiology, Neuroscience Institute, New York University Langone School of Medicine, New York, NY 10010
| | - Caleb S. Lee
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Brian L. Schmidt
- Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY 10010
| | - Nigel W. Bunnett
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY 10010
- Department of Neuroscience and Physiology, Neuroscience Institute, New York University Langone School of Medicine, New York, NY 10010
| | - Kam W. Leong
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
- Department of Systems Biology, Columbia University, New York, NY 10027
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Batista da Silva C, Volpato MC, Muniz BV, dos Santos CP, Serpe L, Ferreira LEN, de Melo NFS, Fraceto LF, Groppo FC, Franz-Montan M. Promising potential of articaine-loaded poly(epsilon-caprolactone) nanocapules for intraoral topical anesthesia. PLoS One 2021; 16:e0246760. [PMID: 33571275 PMCID: PMC7877576 DOI: 10.1371/journal.pone.0246760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/25/2021] [Indexed: 01/12/2023] Open
Abstract
To determine whether the permeation capacity and analgesic efficacy of articaine (ATC) could be increased and cytotoxicity decreased by encapsulation in poly(ɛ-caprolactone) nanocapsules (ATCnano), aiming at local or topical anesthesia in dentistry. Cellular viability was evaluated (using the MTT test and fluorescence microscopy) after 1 h and 24 h exposure of HaCaT cells to ATC, ATCnano, ATC with epinephrine (ATCepi), and ATC in nanocapsules with epinephrine (ATCnanoepi). The profiles of permeation of 2% ATC and 2% ATCnano across swine esophageal epithelium were determined using Franz-type vertical diffusion cells. Analgesic efficacy was evaluated with a von Frey anesthesiometer in a postoperative pain model in rats, comparing the 2% ATC, 2% ATCnano, 2% ATCepi, and 2% ATCnanoepi formulations to 4% ATCepi (a commercially available formulation). We show that use of the nanocapsules decreased the toxicity of articaine (P<0.0001) and increased its flux (P = 0.0007). The 2% ATCepi and 4% ATCepi formulations provided higher analgesia success and duration (P<0.05), compared to 2% ATC, 2% ATCnano, and 2% ATCnanoepi. Articaine-loaded poly(ɛ-caprolactone) nanocapsules constitute a promising formulation for intraoral topical anesthesia (prior to local anesthetic injection), although it is not effective when injected in inflamed tissues for pain control, such as irreversible pulpitis.
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Affiliation(s)
- Camila Batista da Silva
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
- Health Sciences, University of Mogi das Cruzes–UMC, Mogi das Cruzes, São Paulo, Brazil
| | - Maria Cristina Volpato
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
| | - Bruno Vilela Muniz
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
- Itapeva Faculty of Social and Agrarian Sciences—FAIT, Itapeva, São Paulo, Brazil
| | - Cleiton Pita dos Santos
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
| | - Luciano Serpe
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Luiz Eduardo Nunes Ferreira
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
- Laboratory of Inflammation and Immunology, Guarulhos University–UNG, Guarulhos, São Paulo, Brazil
| | - Nathalie Ferreira Silva de Melo
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP, Brazil
- Department of Immunology and Molecular Biology, São Leopoldo Mandic Research Institute, Campinas, SP, Brazil
| | | | - Francisco Carlos Groppo
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
| | - Michelle Franz-Montan
- Department of Biosciences, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba, São Paulo, Brazil
- * E-mail:
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John GSM, Vuttaradhi VK, Takeuchi S, Pitani RS, Venkatraman G, Rayala SK. Facile synthesis and nanoscale features of a nanostructured nordihydroguaiaretic acid analog for therapeutic applications. J Nanobiotechnology 2020; 18:74. [PMID: 32410712 PMCID: PMC7227240 DOI: 10.1186/s12951-020-00628-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/07/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Nordihydroguaiaretic acid (NDGA) is a plant lignan obtained from creosote bush, known to possess anti-oxidant, anti-cancer and anti-viral activities and is being used in traditional medicine. However, toxicity studies indicated liver and kidney damage despite its immense medicinal properties. There has been a recent increase of curiosity in the chemical synthesis of NDGA derivatives for therapeutic applications. NDGA derivatives have been developed as better alternatives to NDGA and for targeted delivery to the site of tissue by chemical derivatives. In this regard, an analog of NDGA, Acetyl NDGA (Ac-NDGA), has been synthesized based on a previous procedure and formulated as a nanostructured complex with Polycaprolactone/Polyethylene glycol polymer matrices, by o/w solvent evaporation method. RESULTS The drug-incorporated polymeric nanospheres exhibited a drug load of 10.0 ± 0.5 µg drug per mg of nanospheres in acetonitrile solvent with 49.95 ± 10% encapsulation efficiency and 33-41% drug loading capacity with different batches of nanospheres preparation. The in vitro drug release characteristics indicated 82 ± 0.25% drug release at 6 h in methanol. Further, the nanospheres have been characterized extensively to evaluate their suitability for therapeutic delivery. CONCLUSIONS The present studies indicate a new and efficient formulation of the nanostructured AcNDGA with good therapeutic potential.
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Affiliation(s)
| | - Veena Kumari Vuttaradhi
- Department of Biotechnology, Indian Institute of Technology, Madras, Chennai, Tamilanadu, 600036, India
| | - Satoru Takeuchi
- Factory of Takeuchi Nenshi, TAKENEN, 85NE Takamatsu, Kahoku, Ishikawa, 929-1215, Japan
| | - Ravi Shankar Pitani
- Department of Community Medicine, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, Tamilnadu, 600116, India
| | - Ganesh Venkatraman
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education & Research, & Sri Ramachandra Center for Biomedical Nanotechnology, Porur, Chennai, Tamilnadu, 600116, India.
| | - Suresh Kumar Rayala
- Department of Biotechnology, Indian Institute of Technology, Madras, Chennai, Tamilanadu, 600036, India.
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Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials. J Craniomaxillofac Surg 2020; 48:293-307. [DOI: 10.1016/j.jcms.2020.01.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/23/2019] [Accepted: 01/25/2020] [Indexed: 02/06/2023] Open
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He Y, Qin L, Huang Y, Ma C. Advances of Nano-Structured Extended-Release Local Anesthetics. NANOSCALE RESEARCH LETTERS 2020; 15:13. [PMID: 31950284 PMCID: PMC6965527 DOI: 10.1186/s11671-019-3241-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/26/2019] [Indexed: 05/08/2023]
Abstract
Extended-release local anesthetics (LAs) have drawn increasing attention with their promising role in improving analgesia and reducing adverse events of LAs. Nano-structured carriers such as liposomes and polymersomes optimally meet the demands of/for extended-release, and have been utilized in drug delivery over decades and showed satisfactory results with extended-release. Based on mature technology of liposomes, EXPAREL, the first approved liposomal LA loaded with bupivacaine, has seen its success in an extended-release form. At the same time, polymersomes has advances over liposomes with complementary profiles, which inspires the emergence of hybrid carriers. This article summarized the recent research successes on nano-structured extended-release LAs, of which liposomal and polymeric are mainstream systems. Furthermore, with continual optimization, drug delivery systems carry properties beyond simple transportation, such as specificity and responsiveness. In the near future, we may achieve targeted delivery and controlled-release properties to satisfy various analgesic requirements.
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Affiliation(s)
- Yumiao He
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, 100730, China
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Linan Qin
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, 100730, China
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Yuguang Huang
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, 100730, China.
| | - Chao Ma
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, 100730, China.
- Department of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
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16
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Sato Y, Ikoma T, Wakita R, Fukayama H. Interfacial interaction of anesthetic lidocaine and mesoporous silica nanoparticles in aqueous solutions and its release properties. J Mater Chem B 2019; 7:7026-7032. [PMID: 31638628 DOI: 10.1039/c9tb01999e] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Lidocaine has been used as a local anesthetic by injection. The controlled release of lidocaine loaded into nanospheres is necessary to reduce the onset time of the anesthetic effect or increase the anesthetic analgesia duration. In this study, mesoporous silica nanoparticles (MSNs) with a large specific surface area were prepared by a sol-gel method, and the interfacial interaction between MSNs and lidocaine positively charged in aqueous solutions at different concentrations was investigated by adsorption tests, Fourier-transformed infrared spectroscopy, thermogravimetry-differential thermal analysis, and Brunauer-Emmett-Teller (BET) measurements. The electrostatic interaction between Si-OH on MSNs and lidocaine-NH+ was of importance for the adsorption phenomenon in aqueous solutions, indicating the monolayer adsorption of lidocaine. BET measurements also supported the decrease of pore volumes, and the hysteresis loop of the isotherm curve was not closed since the condensation of lidocaine in the mesopores formed micropores of less than 1.5 nm in size. The release profiles in phosphate buffered saline containing calcium and magnesium ions showed a rapid and higher release of lidocaine compared with that in phosphate buffered saline without divalent cations. The released lidocaine concentrations were sufficient for the expression of the anesthetic effect in dental anesthesia.
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Affiliation(s)
- Yu Sato
- Tokyo Medical and Dental University, School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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17
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Long-term anesthetic analgesic effects: Comparison of tetracaine loaded polymeric nanoparticles, solid lipid nanoparticles, and nanostructured lipid carriers in vitro and in vivo. Biomed Pharmacother 2019; 117:109057. [DOI: 10.1016/j.biopha.2019.109057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/20/2019] [Accepted: 05/31/2019] [Indexed: 12/28/2022] Open
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Zhang Y, Yin Q, Gong D, Kang Y, Yang J, Liu J, Zhang W. The Preclinical Pharmacological Study of a Novel Long-Acting Local Anesthetic, a Fixed-Dose Combination of QX-OH/Levobupivacaine, in Rats. Front Pharmacol 2019; 10:895. [PMID: 31474859 PMCID: PMC6704344 DOI: 10.3389/fphar.2019.00895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/16/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction: Previous studies demonstrated that 35 mM QX-OH/10 mM Levobupivacaine (LL-1), a fixed-dose combination, produced a long-acting effect in rat local anesthesia models. All preclinical pharmacodynamic results indicated that LL-1 had potential for postsurgical pain treatment. The objective of this study was to investigate the pharmacokinetics of LL-1. Then, the possible mechanism of the extended duration by the combination was examined. Methods and Results: All experiments were examined and approved by the Committee of Animal Care of the West China Hospital Sichuan University (Ethical approval number, 2015014A). The compound action potentials were recorded to verify the pharmacodynamic result in ex vivo. In frog sciatic nerve, LL-1 produced an effective inhibition with rapid onset time. The concentration-time profiles of LL-1 were determined in plasma and local tissues after sciatic nerve block. The maximum concentration of QX-OH and levobupivacaine were 727.22 ± 43.38 µg/g and 256.02 ± 28.52 µg/g in muscle, 634.26 ± 36.04 µg/g and 429.63 ± 48.64 µg/g in sciatic nerve, and 711.71 ± 25.14 ng/ml and 114.40 ± 10.19 ng/ml in plasma, respectively. The absorption of QX-OH into circulation was very rapid at 0.71 ± 0.06 h, which was faster than that of levobupivacaine (4.11 ± 0.39 h, p = 0.003). The half-time of QX-OH in plasma and local tissues had no significant difference (p = 0.329), with the values of 2.64 h, 3.20 h, and 3.79 h in plasma, muscle, and sciatic nerve, respectively. The elimination profile of levobupivacaine differed from that of QX-OH, which was slower eliminated from plasma (4.89 ± 1.77 h, p = 0.036) than from muscle (1.38 ± 0.60 h) or sciatic nerve (1.28 ± 0.74 h). When levobupivacaine was used alone, the Tmax in plasma was 1.07 ± 0.16 h. Interestingly, the Tmax of levobupivacaine in the plasma was increased by four times in combination with QX-OH (4.11 ± 0.39 h). Levobupivacaine promotes cellular QX-OH uptake. Conclusion: The preclinical pharmacokinetic study of LL-1 in the rat plasma, muscle, and sciatic nerve was accomplished. Then, the possible mechanism of the prolonged duration was that QX-OH delayed the absorption of levobupivacaine from the injection site into circulation, and levobupivacaine accelerated QX-OH to accumulate into cells.
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Affiliation(s)
- YuJun Zhang
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - QinQin Yin
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - DeYing Gong
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Kang
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Yang
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - WenSheng Zhang
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Engineering Laboratory of Transformation Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
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Martín Giménez VM, Díaz-Rodríguez P, Sanz RL, Vivero-Lopez M, Concheiro A, Diez E, Prado N, Enrique Kassuha D, Alvarez-Lorenzo C, Manucha W. Anandamide-nanoformulation obtained by electrospraying for cardiovascular therapy. Int J Pharm 2019; 566:1-10. [DOI: 10.1016/j.ijpharm.2019.05.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 01/20/2023]
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20
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Chakravarthy KV, Boehm FJ, Christo PJ. Nanotechnology: A Promising New Paradigm for the Control of Pain. PAIN MEDICINE 2019; 19:232-243. [PMID: 29036629 DOI: 10.1093/pm/pnx131] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective The objective of this article is to critically review both preclinical and clinical studies that focus on the use of nanotechnology for both acute and chronic pain management, surveying both diagnostic and therapeutic applications. The article also provides information on nanotechnology for pain practitioners, so that they may better understand how this technology works and how it may be applied to their day-to-day clinical practice. Study Design Narrative review. Methods The Pubmed NCBI and EMBASE databases were utilized to review published reports of in vivo and clinical studies that focus on using nanotechnology for pain management applications in both the acute and chronic pain settings. Results Articles were screened by title, abstract, and full article review. They were then analyzed by specific clinical indications, and appropriate data were presented based on a critical analysis of those articles. Conclusions As the development of nanomedical applications in acute and chronic pain management continues, medical practitioners should consider their growing potential to enhance the care of patients who are consistently living with pain. Current barriers to implementation include manufacturing scale-up for commercial viability, long-term nanoparticle toxicity considerations, and high cost for successful passage through clinical trials. These challenges will need to be overcome with ongoing translational research efforts in collaboration with industry and government bodies such as the Food and Drug Administration (FDA).
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Affiliation(s)
- Krishnan V Chakravarthy
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Johns Hopkins Institute for NanoBioTechnology (INBT), Baltimore, Maryland
| | | | - Paul J Christo
- Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
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Comparison of antinociceptive effects of plain lidocaine versus lidocaine complexed with hydroxypropyl-β-cyclodextrin in animal models of acute and persistent orofacial pain. Naunyn Schmiedebergs Arch Pharmacol 2019; 392:573-583. [PMID: 30613838 DOI: 10.1007/s00210-018-01609-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
Herein, it was investigated whether a complex of lidocaine with 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) would present a better antinociceptive profile in vivo when compared with plain lidocaine in models of orofacial pain. Plain lidocaine (LDC) and complexed lidocaine (LDC:HP-β-CD) were initially evaluated in vitro to determine the release rate of the two formulations. Subsequently, the effect of both formulations was evaluated in independent groups of rats submitted to the orofacial formalin test, induction of facial heat hyperalgesia by capsaicin and carrageenan, and induction of facial heat and mechanical hyperalgesia by constriction of the infraorbital nerve. LDC:HP-β-CD led to a reduction in the lidocaine release assessed in the in vitro release assay compared to plain LDC. Both formulations presented an antinociceptive effect in all models, but LDC:HP-β-CD showed a better effect in the second phase of the formalin response, in carrageenan-induced heat hyperalgesia, and in the heat hyperalgesia associated to infraorbital nerve constriction. Our results show that complexation improved in vivo antinociceptive effects of LDC, but further studies are necessary to elucidate what properties contribute to the better effect of the complexed formulation on this models and/or what characteristics of the pain model facilitate the action of the complexed formulation.
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Hybrid Hydrogel Composed of Polymeric Nanocapsules Co-Loading Lidocaine and Prilocaine for Topical Intraoral Anesthesia. Sci Rep 2018; 8:17972. [PMID: 30568251 PMCID: PMC6299281 DOI: 10.1038/s41598-018-36382-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 11/15/2018] [Indexed: 12/20/2022] Open
Abstract
This study reports the development of nanostructured hydrogels for the sustained release of the eutectic mixture of lidocaine and prilocaine (both at 2.5%) for intraoral topical use. The local anesthetics, free or encapsulated in poly(ε-caprolactone) nanocapsules, were incorporated into CARBOPOL hydrogel. The nanoparticle suspensions were characterized in vitro in terms of particle size, polydispersity, and surface charge, using dynamic light scattering measurements. The nanoparticle concentrations were determined by nanoparticle tracking analysis. Evaluation was made of physicochemical stability, structural features, encapsulation efficiency, and in vitro release kinetics. The CARBOPOL hydrogels were submitted to rheological, accelerated stability, and in vitro release tests, as well as determination of mechanical and mucoadhesive properties, in vitro cytotoxicity towards FGH and HaCaT cells, and in vitro permeation across buccal and palatal mucosa. Anesthetic efficacy was evaluated using Wistar rats. Nanocapsules were successfully developed that presented desirable physicochemical properties and a sustained release profile. The hydrogel formulations were stable for up to 6 months under critical conditions and exhibited non-Newtonian pseudoplastic flows, satisfactory mucoadhesive strength, non-cytotoxicity, and slow permeation across oral mucosa. In vivo assays revealed higher anesthetic efficacy in tail-flick tests, compared to a commercially available product. In conclusion, the proposed hydrogel has potential for provision of effective and longer-lasting superficial anesthesia at oral mucosa during medical and dental procedures. These results open perspectives for future clinical trials.
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Zhu J, Liu J, Shen G, Zhong T, Yu X. Comparison of Efficacy Outcomes of Lidocaine Spray, Topical Lidocaine Injection, and Lidocaine General Anesthesia in Nasal Bone Fractures Surgeries: A Randomized, Controlled Trial. Med Sci Monit 2018; 24:4386-4394. [PMID: 29941861 PMCID: PMC6050998 DOI: 10.12659/msm.908468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Lidocaine is widely used as a general and local anesthetic in minor or major surgeries. The objective of the study was to compare postoperative pain relief and adverse events using different forms of lidocaine administration in patients following closed nasal bone reduction surgery. Material/Methods A total of 381 patients with a solitary nasal fracture that could be managed with closed reduction were included in this study and divided into 3 groups of 127 patients in each group. Patients had received 1% lidocaine HCl with epinephrine (LL group), inserted a mesh impregnated with lidocaine spray (TL group), or 1 mg/kg/h lidocaine infusion (GL group) before surgeries. Patients also received morphine when the pain was not controlled. The postoperative pain was assessed at 6 hours and 48 hours after surgery. Postoperative vomiting and nausea were evaluated. Repeated ANOVA/Tukey-Kramer multiple comparisons test was performed at 95% confidence level. Results At 6 hours after surgery, patients in the general lidocaine (GL) group reported decreased postoperative pain compared with those in the topical lidocaine (TL) group (P<0.001, q=6.633) and LL group (P<0.001, q=8.056). The morphine consumption within 48 hours was least in GL group than TL group (P<0.001, q=172.9) and LL group (P<0.001, q=226.42). Lidocaine infusion caused nausea (P<0.001, q=6.742) and vomiting (P<0.001, q=4.306). Conclusions Topical lidocaine anesthesia had the same postoperative pain relief and the least adverse events as local and general lidocaine anesthesia.
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Affiliation(s)
- Jihong Zhu
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang, China (mainland)
| | - Jian Liu
- Department of General Surgery, Wuyi Traditional Chinese Medical Hospital, Jinhua, Zhejiang, China (mainland)
| | - Guoying Shen
- Our-Patient Department, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang, China (mainland)
| | - Taidi Zhong
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang, China (mainland)
| | - Xin Yu
- Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang, China (mainland)
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Zhang W, Ning C, Xu W, Hu H, Li M, Zhao G, Ding J, Chen X. Precision-guided long-acting analgesia by Gel-immobilized bupivacaine-loaded microsphere. Theranostics 2018; 8:3331-3347. [PMID: 29930733 PMCID: PMC6010997 DOI: 10.7150/thno.25276] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/08/2018] [Indexed: 12/17/2022] Open
Abstract
Peripheral nerve blockade (PNB) is a conventional strategy for the management of acute postoperative pain. However, the short duration of the associated analgesia and the potential systemic toxicity due to the low molecular weights of local anesthetics limit their application. Methods: An in situ forming injectable Gel-microsphere (Gel-MS) system consisting of PLGA-PEG-PLGA Gel (Gel) and Gel-immobilized bupivacaine-loaded microsphere (MS/BUP) was prepared for precision-guided long-acting analgesia. A series of in vitro characterizations, such as scanning electron microscopy, rheology analysis, confocal laser scanning microscopy, drug release, and erosion and degradation, were carried out. After that, the in vivo analgesia effect of the Gel-MS system, the immobilization effect of Gel on the MS, and biocompatibility of the system were evaluated using a sciatic nerve block model. Results: The BUP release from the Gel-MS system was regulated by both the inner MS and the outer Gel matrix, demonstrating sustained BUP release in vitro for several days without an initial burst release. More importantly, incorporation of the Gel immobilized the MS and hindered the diffusion of MS from the injection site because of its in situ property, which contributed to a high local drug concentration and prevented systemic side effects. In vivo, a single injection of Gel-MS/BUP allowed rats to maintain sensory and motor blockade significantly longer than treatment with MS/BUP (P < 0.01) or BUP-loaded Gel (Gel-BUP, P < 0.01). Histopathological results demonstrated the excellent biodegradability and biocompatibility of the Gel-MS system without neurotoxicity. Conclusion: This precision-guided long-acting analgesia, which provides an in situ and sustained release of BUP, is a promising strategy for long-acting analgesia, and could represent a potential alternative for clinical pain management.
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Affiliation(s)
- Wenjing Zhang
- Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun 130033, P. R. China
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China
| | - Cong Ning
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun 130021, P. R. China
| | - Weiguo Xu
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China
| | - Hanze Hu
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States
| | - Mingqiang Li
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States
- Guangdong Provincial Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, P. R. China
| | - Guoqing Zhao
- Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun 130033, P. R. China
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China
| | - Xuesi Chen
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, P. R. China
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Andreu V, Arruebo M. Current progress and challenges of nanoparticle-based therapeutics in pain management. J Control Release 2017; 269:189-213. [PMID: 29146243 DOI: 10.1016/j.jconrel.2017.11.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 02/07/2023]
Abstract
Pain is a widespread and growing health problem worldwide that exerts a considerable social and economic impact on both patients and healthcare systems and, therefore, on society in general. Although current treatment modalities include a wide variety of pharmacological and non-pharmacological approaches, due to the complexity of pain and individual differences in clinical response these options are not always effective in mitigating and relieving pain. In addition, some pain drugs such as non-steroidal anti-inflammatory drugs (NSAIDs), local anesthetics and opioids show several unfavorable side effects. Therefore, current research advances in this medical field are based on the development of potential treatments to address many of the unmet needs and to overcome the existing limitations in pain management. Nanoparticle drug delivery systems present an exciting opportunity as alternative platforms to improve efficacy and safety of medications currently in use. Herein, we review a broad range of nanoparticle formulations (organic nanostructures and inorganic nanoparticles), which have been developed to encapsulate an array of painkillers, paying special attention to the key advantages that these systems offer, (compared to the use of the free drug), as well as to the more relevant results of preclinical studies in animal models. Additionally, we will briefly discuss the impact of some of these nanoformulations in clinical trials.
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Affiliation(s)
- Vanesa Andreu
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Aragon Health Research Institute (IIS), Aragón, 50009 Zaragoza, Spain.
| | - Manuel Arruebo
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Aragon Health Research Institute (IIS), Aragón, 50009 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
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26
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Natural lipids-based NLC containing lidocaine: from pre-formulation to in vivo studies. Eur J Pharm Sci 2017; 106:102-112. [DOI: 10.1016/j.ejps.2017.05.060] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 11/22/2022]
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Nanocapsules Containing Neem (Azadirachta Indica) Oil: Development, Characterization, And Toxicity Evaluation. Sci Rep 2017; 7:5929. [PMID: 28724950 PMCID: PMC5517525 DOI: 10.1038/s41598-017-06092-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 06/07/2017] [Indexed: 02/02/2023] Open
Abstract
In this study, we prepared, characterized, and performed toxicity analyses of poly(ε-caprolactone) nanocapsules loaded with neem oil. Three formulations were prepared by the emulsion/solvent evaporation method. The nanocapsules showed a mean size distribution around 400 nm, with polydispersity below 0.2 and were stable for 120 days. Cytotoxicity and genotoxicity results showed an increase in toxicity of the oleic acid + neem formulations according to the amount of oleic acid used. The minimum inhibitory concentrations demonstrated that all the formulations containing neem oil were active. The nanocapsules containing neem oil did not affect the soil microbiota during 300 days of exposure compared to the control. Phytotoxicity studies indicated that NC_20 (200 mg of neem oil) did not affect the net photosynthesis and stomatal conductance of maize plants, whereas use of NC_10 (100:100 of neem:oleic acid) and NC_15 (150:50 of neem:oleic acid) led to negative effects on these physiological parameters. Hence, the use of oleic acid as a complement in the nanocapsules was not a good strategy, since the nanocapsules that only contained neem oil showed lower toxicity. These results demonstrate that evaluation of the toxicity of nanopesticides is essential for the development of environmentally friendly formulations intended for applications in agriculture.
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Moradkhani MR, Karimi A, Negahdari B. Nanotechnology application to local anaesthesia (LA). ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2017; 46:355-360. [PMID: 28395522 DOI: 10.1080/21691401.2017.1313263] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Several advancements have been made on the exact release of local anaesthetics formulation and its efficiency at inducing motor and sensory block for an extended time has been harnessed in clinical practice. The use of sustained release formulations delivers analgesia for a lengthier period of time with one administration, thereby reducing complications that usually arise with administration of conventional analgesia. In addition, controlled release of an anaesthetic drug is said to prevent overdosing, reduced side effects, especially cardiotoxicity, neurotoxicity and tissue lesions. The use of nanotechnology knowledge via liposomal formulation has recorded high successful results in pain control and quick patient recovery.
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Affiliation(s)
- Mahmoud Reza Moradkhani
- a Department of Anesthesiology , Lorestan University of Medical Sciences , Khorramabad , Iran
| | - Arash Karimi
- a Department of Anesthesiology , Lorestan University of Medical Sciences , Khorramabad , Iran
| | - Babak Negahdari
- b Department of Medical Biotechnology , School of Advanced Technologies in Medicine, Tehran University of Medical Sciences , Tehran , Iran
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Santamaria CM, Woodruff A, Yang R, Kohane DS. Drug delivery systems for prolonged duration local anesthesia. MATERIALS TODAY (KIDLINGTON, ENGLAND) 2017; 20:22-31. [PMID: 28970739 PMCID: PMC5621744 DOI: 10.1016/j.mattod.2016.11.019] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Numerous drug delivery systems have been applied to the problem of providing prolonged duration local anesthesia (PDLA). Here we review the rationale for PDLA, the desirable features for and important attributes of such systems, and specific examples that have been developed.
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Affiliation(s)
- Claudia M Santamaria
- Laboratory for Biomaterials and Drug Delivery, Division of Critical Care Medicine, Department of Anesthesiology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Alan Woodruff
- Laboratory for Biomaterials and Drug Delivery, Division of Critical Care Medicine, Department of Anesthesiology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Rong Yang
- Laboratory for Biomaterials and Drug Delivery, Division of Critical Care Medicine, Department of Anesthesiology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Daniel S Kohane
- Laboratory for Biomaterials and Drug Delivery, Division of Critical Care Medicine, Department of Anesthesiology, Boston Children's Hospital, Boston, Massachusetts, United States
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Franz-Montan M, Ribeiro LNDM, Volpato MC, Cereda CMS, Groppo FC, Tofoli GR, de Araújo DR, Santi P, Padula C, de Paula E. Recent advances and perspectives in topical oral anesthesia. Expert Opin Drug Deliv 2016; 14:673-684. [DOI: 10.1080/17425247.2016.1227784] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zorzetto L, Brambilla P, Marcello E, Bloise N, De Gregori M, Cobianchi L, Peloso A, Allegri M, Visai L, Petrini P. From micro- to nanostructured implantable device for local anesthetic delivery. Int J Nanomedicine 2016; 11:2695-709. [PMID: 27354799 PMCID: PMC4907738 DOI: 10.2147/ijn.s99028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Local anesthetics block the transmission of painful stimuli to the brain by acting on ion channels of nociceptor fibers, and find application in the management of acute and chronic pain. Despite the key role they play in modern medicine, their cardio and neurotoxicity (together with their short half-life) stress the need for developing implantable devices for tailored local drug release, with the aim of counterbalancing their side effects and prolonging their pharmacological activity. This review discusses the evolution of the physical forms of local anesthetic delivery systems during the past decades. Depending on the use of different biocompatible materials (degradable polyesters, thermosensitive hydrogels, and liposomes and hydrogels from natural polymers) and manufacturing processes, these systems can be classified as films or micro- or nanostructured devices. We analyze and summarize the production techniques according to this classification, focusing on their relative advantages and disadvantages. The most relevant trend reported in this work highlights the effort of moving from microstructured to nanostructured systems, with the aim of reaching a scale comparable to the biological environment. Improved intracellular penetration compared to microstructured systems, indeed, provides specific drug absorption into the targeted tissue and can lead to an enhancement of its bioavailability and retention time. Nanostructured systems are realized by the modification of existing manufacturing processes (interfacial deposition and nanoprecipitation for degradable polyester particles and high- or low-temperature homogenization for liposomes) or development of novel strategies (electrospun matrices and nanogels). The high surface-to-volume ratio that characterizes nanostructured devices often leads to a burst drug release. This drawback needs to be addressed to fully exploit the advantage of the interaction between the target tissues and the drug: possible strategies could involve specific binding between the drug and the material chosen for the device, and a multiscale approach to reach a tailored, prolonged drug release.
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Affiliation(s)
- Laura Zorzetto
- Department of Chemistry, Materials and Chemical Engineering 'G. Natta', Politecnico di Milano, Milan, Italy
| | - Paola Brambilla
- Department of Chemistry, Materials and Chemical Engineering 'G. Natta', Politecnico di Milano, Milan, Italy
| | - Elena Marcello
- Department of Chemistry, Materials and Chemical Engineering 'G. Natta', Politecnico di Milano, Milan, Italy
| | - Nora Bloise
- Department of Molecular Medicine, Centre for Health Technologies (CHT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy
| | - Manuela De Gregori
- Pain Therapy Service, IRCCS Foundation Policlinico San Matteo Pavia, Pavia, Italy
| | - Lorenzo Cobianchi
- General Surgery Department, IRCCS Foundation Policlinico San Matteo, Pavia, Italy; Departments of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Peloso
- General Surgery Department, IRCCS Foundation Policlinico San Matteo, Pavia, Italy; Departments of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Massimo Allegri
- Department of Surgical Sciences, University of Parma, Parma, Italy
| | - Livia Visai
- Department of Molecular Medicine, Centre for Health Technologies (CHT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy; Department of Occupational Medicine, Toxicology and Environmental Risks, S. Maugeri Foundation, IRCCS, Lab of Nanotechnology, Pavia, Italy
| | - Paola Petrini
- Department of Chemistry, Materials and Chemical Engineering 'G. Natta', Politecnico di Milano, Milan, Italy
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Sharma D, Sharma RK, Sharma N, Gabrani R, Sharma SK, Ali J, Dang S. Nose-To-Brain Delivery of PLGA-Diazepam Nanoparticles. AAPS PharmSciTech 2015; 16:1108-21. [PMID: 25698083 DOI: 10.1208/s12249-015-0294-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/12/2015] [Indexed: 12/19/2022] Open
Abstract
The objective of the present investigation was to optimize diazepam (Dzp)-loaded poly(lactic-co-glycolic acid) nanoparticles (NP) to achieve delivery in the brain through intranasal administration. Dzp nanoparticles (DNP) were formulated by nanoprecipitation and optimized using Box-Behnken design. The influence of various independent process variables (polymer, surfactant, aqueous to organic (w/o) phase ratio, and drug) on resulting properties of DNP (z-average and drug entrapment) was investigated. Developed DNP showed z-average 148-337 d.nm, polydispersity index 0.04-0.45, drug entrapment 69-92%, and zeta potential in the range of -15 to -29.24 mV. Optimized DNP were further analyzed by differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), ex-vivo drug release, and in-vitro cytotoxicity. Ex-vivo drug release study via sheep nasal mucosa from DNP showed a controlled release of 64.4% for 24 h. 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay performed on Vero cell line showed less toxicity for DNP as compared to Dzp suspension (DS). Gamma scintigraphy and biodistribution study of DNP and DS was performed on Sprague-Dawley rats using technetium-99m-labeled ((99m)Tc) Dzp formulations to investigate the nose-to-brain drug delivery pathway. Brain/blood uptake ratios, drug targeting efficiency, and direct nose-to-brain transport were found to be 1.23-1.45, 258, and 61% for (99m)Tc-DNP (i.n) compared to (99m)Tc-DS (i.n) (0.38-1.06, 125, and 1%). Scintigraphy images showed uptake of Dzp from nose-to-brain, and this observation was in agreement with the biodistribution results. These results suggest that the developed poly(D,L-lactide-co-glycolide) (PLGA) NP could serve as a potential carrier of Dzp for nose-to-brain delivery in outpatient management of status epilepticus.
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Stowers MDJ, Lemanu DP, Coleman B, Hill AG, Munro JT. Review article: Perioperative care in enhanced recovery for total hip and knee arthroplasty. J Orthop Surg (Hong Kong) 2014; 22:383-92. [PMID: 25550024 DOI: 10.1177/230949901402200324] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Enhanced recovery pathways for total hip and knee arthroplasty can reduce length of hospital stay and perioperative morbidity. 22 studies were reviewed for identification of perioperative care interventions, including preoperative (n=4), intra-operative (n=8), and postoperative (n=4) care interventions. Factors that improve outcomes included use of pre-emptive and multimodal analgesia regimens to reduce opioid consumption, identification of patients with poor nutritional status and provision of supplements preoperatively to improve wound healing and reduce length of hospital stay, use of warming systems and tranexamic acid, avoidance of drains to reduce operative blood loss and subsequent transfusion, and early ambulation with pharmacological and mechanical prophylaxis to reduce venous thromboembolism and to speed recovery.
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Affiliation(s)
- Marinus D J Stowers
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand
| | - Daniel P Lemanu
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand
| | - Brendan Coleman
- Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand
| | - Andrew G Hill
- Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, Auckland, New Zealand
| | - Jacob T Munro
- Department of Orthopaedic Surgery, Auckland City Hospital, University of Auckland, Auckland, New Zealand
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34
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Silva de Melo NF, Campos EVR, Gonçalves CM, de Paula E, Pasquoto T, de Lima R, Rosa AH, Fraceto LF. Development of hydrophilic nanocarriers for the charged form of the local anesthetic articaine. Colloids Surf B Biointerfaces 2014; 121:66-73. [PMID: 24934456 DOI: 10.1016/j.colsurfb.2014.05.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/18/2014] [Accepted: 05/23/2014] [Indexed: 10/25/2022]
Abstract
One of the current challenges in drug encapsulation concerns the development of carrier systems for hydrophilic compounds. Potential carriers include nanocapsules prepared with amphiphilic polymers, which consist of a polymeric coating surrounding an aqueous nucleus, or dense matrices such as nanospheres of alginate/chitosan, where the drug may be dispersed in the matrix or adsorbed on the surface. The development of new formulations of nanocarriers, for example the poly(ethylene glycol)-poly(ɛ-caprolactone) (PEG-PCL) nanocapsules and alginate/chitosan (AG/CS) nanospheres described in this work, is needed in the case of ionized drugs such as articaine. This amino amide local anesthetic is the drug of choice in dentistry for regional anesthesia as well as the relief of acute and chronic pain. Here, the physico-chemical properties of suspensions of the nanoparticles (considering diameter, polydispersion, and zeta potential) were determined as a function of time, in order to establish the stability of the systems. The formulations did not show any substantial changes in these parameters, and were stable for up to 120 days of storage at ambient temperature. Satisfactory encapsulation efficiencies were obtained for the PEG-PCL nanocapsules (60%) and the AG/CS nanospheres (45%). Cytotoxicity assays confirmed that the encapsulation of articaine reduced its toxicity, relative to the free drug. The most promising results were obtained using the vesicular system (PEG-PCL nanocapsules), which not only altered the release profile of the drug, but also resulted in the lowest toxicity. This carrier system therefore holds promise for use in future practical applications.
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Affiliation(s)
- Nathalie Ferreira Silva de Melo
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP, Brazil; Department of Biochemistry, State University of Campinas, Campinas, SP, Brazil
| | - Estefânia Vangelie Ramos Campos
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP, Brazil; Department of Biochemistry, State University of Campinas, Campinas, SP, Brazil
| | | | - Eneida de Paula
- Department of Biochemistry, State University of Campinas, Campinas, SP, Brazil
| | - Tatiane Pasquoto
- Department of Biotechnology, University of Sorocaba, Sorocaba, SP, Brazil
| | - Renata de Lima
- Department of Biotechnology, University of Sorocaba, Sorocaba, SP, Brazil; São Carlos Federal University, Sorocaba, SP, Brazil
| | - André Henrique Rosa
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP, Brazil
| | - Leonardo Fernandes Fraceto
- Department of Environmental Engineering, São Paulo State University, Sorocaba, SP, Brazil; Department of Biochemistry, State University of Campinas, Campinas, SP, Brazil.
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Arantes LM, Varejão EVV, Pelizzaro-Rocha KJ, Cereda CMS, de Paula E, Lourenço MP, Duarte HA, Fernandes SA. Benzocaine complexation with p-sulfonic acid calix[n]arene: experimental ((1) H-NMR) and theoretical approaches. Chem Biol Drug Des 2014; 83:550-9. [PMID: 24289315 DOI: 10.1111/cbdd.12267] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 11/04/2013] [Indexed: 12/20/2022]
Abstract
The aim of this work was to study the interaction between the local anesthetic benzocaine and p-sulfonic acid calix[n]arenes using NMR and theoretical calculations and to assess the effects of complexation on cytotoxicity of benzocaine. The architectures of the complexes were proposed according to (1) H NMR data (Job plot, binding constants, and ROESY) indicating details on the insertion of benzocaine in the cavity of the calix[n]arenes. The proposed inclusion compounds were optimized using the PM3 semiempirical method, and the electronic plus nuclear repulsion energy contributions were performed at the DFT level using the PBE exchange/correlation functional and the 6-311G(d) basis set. The remarkable agreement between experimental and theoretical approaches adds support to their use in the structural characterization of the inclusion complexes. In vitro cytotoxic tests showed that complexation intensifies the intrinsic toxicity of benzocaine, possibly by increasing the water solubility of the anesthetic and favoring its partitioning inside of biomembranes.
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Affiliation(s)
- Lucas M Arantes
- Grupo de Química Supramolecular e Biomimética (GQSB), Departamento de Química, Universidade Federal de Viçosa (UFV), Viçosa, Brazil, 36570-000
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Filipović N, Stevanović M, Nunić J, Cundrič S, Filipič M, Uskoković D. Synthesis of poly(ɛ-caprolactone) nanospheres in the presence of the protective agent poly(glutamic acid) and their cytotoxicity, genotoxicity and ability to induce oxidative stress in HepG2 cells. Colloids Surf B Biointerfaces 2014; 117:414-24. [PMID: 24681414 DOI: 10.1016/j.colsurfb.2014.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 01/23/2014] [Accepted: 03/05/2014] [Indexed: 11/18/2022]
Abstract
Nanospheres of poly(ɛ-caprolactone) (PCL) with sizes smaller than 200 nm were produced by combining the freeze drying method and the physicochemical solvent/non-solvent approach. The influence of various types of cryoprotectants (poly(glutamic acid) (PGA) or sacharose) and their concentrations on the outcome of freeze-dried poly(ɛ-caprolactone) particles was evaluated. The physiochemical properties, structural and morphological characteristics of thereby obtained PCL particles were determined by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The cytotoxicity of the samples was examined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay (MTT assay). The formation of intracellular reactive oxygen species was measured spectrophotometrically using a fluorescent probe (DCFH-DA assay). In addition, the genotoxic response of PCL particles obtained using PGA as a cryoprotectant was investigated by the Comet assay. This paper focuses on the role of PGA in the synthesis of PCL particles and demonstrates that PGA plays a dual role in the synthesis, i.e. it acts as a stabilizer but also as a cryoprotective agent. The sufficient and optimal concentration of PGA for producing uniform, spherical but also biocompatible PCL nanoparticles is established to be 0.05%.
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Affiliation(s)
- Nenad Filipović
- Institute of Technical Sciences of the Serbian Academy of Sciences and Arts, Knez Mihailova 35/IV, Belgrade 11000, Serbia
| | - Magdalena Stevanović
- Institute of Technical Sciences of the Serbian Academy of Sciences and Arts, Knez Mihailova 35/IV, Belgrade 11000, Serbia.
| | - Jana Nunić
- Department of Genetic Toxicology and Cancer Biology, National Institute of Biology, Ljubljana, Slovenia
| | - Sandra Cundrič
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Metka Filipič
- Department of Genetic Toxicology and Cancer Biology, National Institute of Biology, Ljubljana, Slovenia
| | - Dragan Uskoković
- Institute of Technical Sciences of the Serbian Academy of Sciences and Arts, Knez Mihailova 35/IV, Belgrade 11000, Serbia
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Silva RF, Araújo DR, Silva ER, Ando RA, Alves WA. L-diphenylalanine microtubes as a potential drug-delivery system: characterization, release kinetics, and cytotoxicity. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2013; 29:10205-12. [PMID: 23879638 DOI: 10.1021/la4019162] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Microtubes obtained from the self-assembly of L-diphenylalanine (FF-MTs) were evaluated as potential vehicles for drug delivery. The biological marker Rhodamine B (RhB) was chosen as a model drug and conjugated to the peptide arrays during self-organization in the liquid phase. Microscopy and X-ray studies were performed to provide morphological and structural information. The data revealed that the cargo was distributed either in small aggregates at the hydrophobic surface of the FF-MTs or homogeneously embedded in the structure, presumably anchored at polar sites in the matrix. Raman spectroscopy revealed notable shifts of the characteristic RhB resonance peaks, demonstrating the successful conjugation of the fluorophore and peptide assemblies. In vitro assays were conducted in erythrocytes and fibroblast cells. Interestingly, FF-MTs were found to modulate the release of the load. The release of RhB from the FF-MTs followed first-order kinetics with a steady-state profile, demonstrating the potential of these carriers to deliver drugs at constant rates in the body. Cytotoxicity investigations revealed high cell viability up to concentrations of 5 mg mL(-1), demonstrating the low toxicity of the FF-MTs.
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Affiliation(s)
- Rondes F Silva
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, 09210-170 Santo André, SP, Brazil
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