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Jeitler R, Glader C, König G, Kaplan J, Tetyczka C, Remmelgas J, Mußbacher M, Fröhlich E, Roblegg E. On the Structure, Stability, and Cell Uptake of Nanostructured Lipid Carriers for Drug Delivery. Mol Pharm 2024; 21:3674-3683. [PMID: 38838194 PMCID: PMC11220792 DOI: 10.1021/acs.molpharmaceut.4c00392] [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: 04/11/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
The efficacy of nanostructured lipid carriers (NLC) for drug delivery strongly depends on their stability and cell uptake. Both properties are governed by their compositions and internal structure. To test the effect of the lipid composition of NLC on cell uptake and stability, three kinds of liquid lipids with different degrees of unsaturation are employed. After ensuring homogeneous size distributions, the thermodynamic characteristics, stability, and mixing properties of NLC are characterized. Then the rates and predominant pathways of cell uptake are determined. Although the same surfactant is used in all cases, different uptake rates are observed. This finding contradicts the view that the surface properties of NLC are dominated by the surfactant. Instead, the uptake rates are explained by the structure of the nanocarrier. Depending on the mixing properties, some liquid lipids remain inside the nanocarrier, while other liquid lipids are present on the surface. Nanocarriers with liquid lipids on the surface are taken up more readily by the cells. This shows that the engineering of efficient lipid nanocarriers requires a delicate balance of interactions between all components of the nanocarrier on the molecular level.
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Affiliation(s)
- Ramona Jeitler
- Institute
of Pharmaceutical Sciences, Pharmaceutical Technology and Biopharmacy, University of Graz, 8010 Graz, Austria
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
| | - Christina Glader
- Institute
of Pharmaceutical Sciences, Pharmaceutical Technology and Biopharmacy, University of Graz, 8010 Graz, Austria
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
| | - Gerhard König
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
- Centre
for Enzyme Innovation, School of Biological Sciences, University of Portsmouth, Portsmouth PO1 2DY, United
Kingdom
| | - Jay Kaplan
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
| | - Carolin Tetyczka
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
| | - Johan Remmelgas
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
| | - Marion Mußbacher
- Institute
of Pharmaceutical Sciences, Pharmacology and Toxicology, University of Graz, 8010 Graz, Austria
| | - Eleonore Fröhlich
- Center
for
Medical Research, Medical University of Graz, 8010 Graz, Austria
| | - Eva Roblegg
- Institute
of Pharmaceutical Sciences, Pharmaceutical Technology and Biopharmacy, University of Graz, 8010 Graz, Austria
- Research
Center Pharmaceutical Engineering GmbH, 8010 Graz, Austria
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2
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Attar ES, Jayakumar S, Devarajan PV. Oral In-Situ Nanoplatform with Balanced Hydrophobic-Hydrophilic Property for Transport Across Gastrointestinal Mucosa. AAPS PharmSciTech 2024; 25:113. [PMID: 38750336 DOI: 10.1208/s12249-024-02824-8] [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: 02/22/2024] [Accepted: 04/29/2024] [Indexed: 09/05/2024] Open
Abstract
Transport of oral nanocarriers across the GI epithelium necessitates transport across hydrophilic mucus layer and the hydrophobic epithelium. Based on hydrophobic-hydrophilic balance, Curcumin-Lipomer (lipid-polymer hybrid nanoparticles) comprising hydrophobic stearic acid and hydrophilic Gantrez™ AN 119 (Gantrez) were developed, by a radical in-situ approach, to successfully traverse both barriers. A monophasic preconcentrate (Cur-Pre) comprising Cur (Curcumin), stearic acid, Gantrez and stabilizers, prepared by simple solution, was added to an aqueous phase to instantaneously generate Curcumin-Lipomer (Cur-Lipo) of nanosize and high entrapment efficiency (EE). Cur-Lipo size and EE was optimized by Box-Behnken Design. Cur-Lipomers of varying hydrophobic-hydrophilic property obtained by varying the stearic acid: Gantrez ratio exhibited size in the range 200-400 nm, EE > 95% and spherical morphology as seen in the TEM. A decrease in contact angle and in mucus interaction, evident with increase in Gantrez concentration, indicated an inverse corelation with hydrophilicity, while a linear corelation was observed for mucopenetration and hydrophilicity. Cur-SLN (solid lipid nanoparticles) which served as the hydrophobic reference revealed contact angle > 90°, maximum interaction with mucus and minimal mucopenetration. The ex-vivo permeation study through chicken ileum, revealed maximum permeation with Cur-Lipo1 and comparable and significantly lower permeation of Cur-Lipo1-D and Cur-SLN proposing the importance of balancing the hydrophobic-hydrophilic property of the nanoparticles. A 1.78-fold enhancement in flux of hydrophobic Cur-SLN, with no significant change in permeation of the hydrophilic Cur-Lipomers (p > 0.05) following stripping off the mucosal layer was observed. This reiterated the significance of hydrophobic-hydrophilic balance as a promising strategy to design nanoformulations with superior permeation across the GI barrier.
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Affiliation(s)
- Esha S Attar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology Matunga (E), Mumbai, 400019, India
| | - S Jayakumar
- Radiation Biology and Health Sciences Division, Modular Laboratories, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
| | - Padma V Devarajan
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology Matunga (E), Mumbai, 400019, India.
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3
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Stoilov B, Truong VK, Gronthos S, Vasilev K. Noninvasive and Microinvasive Nanoscale Drug Delivery Platforms for Hard Tissue Engineering. ACS APPLIED BIO MATERIALS 2023; 6:2925-2943. [PMID: 37565698 DOI: 10.1021/acsabm.3c00095] [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] [Indexed: 08/12/2023]
Abstract
Bone tissue plays a crucial role in protecting internal organs and providing structural support and locomotion of the body. Treatment of hard tissue defects and medical conditions due to physical injuries, genetic disorders, aging, metabolic syndromes, and infections is more often a complex and drawn out process. Presently, dealing with hard-tissue-based clinical problems is still mostly conducted via surgical interventions. However, advances in nanotechnology over the last decades have led to shifting trends in clinical practice toward noninvasive and microinvasive methods. In this review article, recent advances in the development of nanoscale platforms for bone tissue engineering have been reviewed and critically discussed to provide a comprehensive understanding of the advantages and disadvantages of noninvasive and microinvasive methods for treating medical conditions related to hard tissue regeneration and repair.
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Affiliation(s)
- Borislav Stoilov
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
| | - Vi Khanh Truong
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
| | - Stan Gronthos
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide/SAHMRI, North Terrace, Adelaide, South Australia 5001, Australia
| | - Krasimir Vasilev
- Biomedical Nanoengineering Laboratory, College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia
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4
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Ma Y, Yu N, Lu H, Shi J, Zhang Y, Chen Z, Jia G. Titanium dioxide nanoparticles: revealing the mechanisms underlying hepatotoxicity and effects in the gut microbiota. Arch Toxicol 2023; 97:2051-2067. [PMID: 37344693 DOI: 10.1007/s00204-023-03536-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
Numerous studies in recent years have questioned the safety of oral exposure to titanium dioxide nanoparticles (TiO2 NPs). TiO2 NPs are not only likely to accumulate in the gastrointestinal tract, but they are also found to penetrate the body circulation and reach distant organs. The liver, which is considered to be a target organ for nanoparticles, is of particular concern. TiO2 NPs accumulate in the liver and cause oxidative stress and inflammatory reactions, resulting in pathological damage. The impact of TiO2 NPs on liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was studied using a meta-analysis. According to the findings, TiO2 NPs exposure can cause an elevation in AST and ALT levels in the blood. Furthermore, TiO2 NPs are eliminated mostly through feces, and their lengthy residence in the gut exposes them to microbiota. The gut microbiota is also dysbiotic due to titanium dioxide's antibacterial capabilities. This further leads to changes in the amount of microbiota metabolites, which can reach the liver with blood circulation and trigger hepatotoxicity through the gut-liver axis. This review examines the gut-liver axis to assess the effects of gut microbiota dysbiosis on the liver to provide suggestions for assessing the gut-hepatotoxicity of TiO2 NPs.
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Affiliation(s)
- Ying Ma
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Nairui Yu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Huaye Lu
- Jiangsu Prov Ctr Dis Control and Prevent, 172 Jiangsu Rd, Nanjing, 210009, People's Republic of China
| | - Jiaqi Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Yi Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Zhangjian Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China.
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China.
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
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Nair VV, Cabrera P, Ramírez-Lecaros C, Jara MO, Brayden DJ, Morales JO. Buccal delivery of small molecules and biologics: Of mucoadhesive polymers, films, and nanoparticles - An update. Int J Pharm 2023; 636:122789. [PMID: 36868332 DOI: 10.1016/j.ijpharm.2023.122789] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/08/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023]
Abstract
Buccal delivery of small and large molecules is an attractive route of administration that has been studied extensively over the past few decades. This route bypasses first-pass metabolism and can be used to deliver therapeutics directly to systemic circulation. Moreover, buccal films are efficient dosage forms for drug delivery due to their simplicity, portability, and patient comfort. Films have traditionally been formulated using conventional techniques, including hot-melt extrusion and solvent casting. However, newer methods are now being exploited to improve the delivery of small molecules and biologics. This review discusses recent advances in buccal film manufacturing, using the latest technologies, such as 2D and 3D printing, electrospraying, and electrospinning. This review also focuses on the excipients used in the preparation of these films, with emphasis on mucoadhesive polymers and plasticizers. Along with advances in manufacturing technology, newer analytical tools have also been used for the assessment of permeation of the active agents across the buccal mucosa, the most critical biological barrier and limiting factor of this route. Additionally, preclinical and clinical trial challenges are discussed, and some small molecule products already on the market are explored.
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Affiliation(s)
- Varsha V Nair
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA
| | - Pablo Cabrera
- Advanced Center for Chronic Diseases (ACCDiS), Sergio Livingstone 1007, Independencia, Santiago 8380494, Chile; Departamento de Química Farmacológica y Toxicológica, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380494, Chile
| | | | - Miguel O Jara
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA
| | - David J Brayden
- UCD School of Veterinary Medicine and UCD Conway Institute, Belfield, Dublin D04 V1W8, Ireland
| | - Javier O Morales
- Advanced Center for Chronic Diseases (ACCDiS), Sergio Livingstone 1007, Independencia, Santiago 8380494, Chile; Center of New Drugs for Hypertension (CENDHY), Santiago 8380492, Chile; Drug Delivery Laboratory, Departamento de Ciencias y Tecnología Farmacéuticas, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380492, Chile.
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6
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Bashir S, Fitaihi R, Abdelhakim HE. Advances in formulation and manufacturing strategies for the delivery of therapeutic proteins and peptides in orally disintegrating dosage forms. Eur J Pharm Sci 2023; 182:106374. [PMID: 36623699 DOI: 10.1016/j.ejps.2023.106374] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/08/2023]
Abstract
Therapeutic proteins and peptides (TPPs) are increasingly favoured above small drug molecules due to their high specificity to the site of action and reduced adverse effects resulting in increased use of these agents for medical treatments and therapies. Consequently, there is a need to formulate TPPs in dosage forms that are accessible and suitable for a wide range of patient groups as the use of TPPs becomes increasingly prevalent in healthcare settings worldwide. Orally disintegrating dosage forms (ODDF) are formulations that can ensure easy-to-administer medication to a wider patient population including paediatrics, geriatrics and people in low-resource countries. There are many challenges involved in developing suitable pharmaceutical strategies to protect TPPs during formulation and manufacturing, as well as storage, and maintenance of a cold-chain during transportation. This review will discuss advances being made in the research and development of pharmaceutical and manufacturing strategies used to incorporate various TPPs into ODDF systems.
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Affiliation(s)
- Shazia Bashir
- School of Cancer and Pharmaceutical Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Rawan Fitaihi
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK; Department of Pharmaceutics, College of pharmacy, King Saud University, Riyadh, KSA
| | - Hend E Abdelhakim
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK.
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7
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Guedes MDV, Marques MS, Berlitz SJ, Facure MHM, Correa DS, Steffens C, Contri RV, Külkamp-Guerreiro IC. Lamivudine and Zidovudine-Loaded Nanostructures: Green Chemistry Preparation for Pediatric Oral Administration. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:770. [PMID: 36839138 PMCID: PMC9965208 DOI: 10.3390/nano13040770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Here, we report on the development of lipid-based nanostructures containing zidovudine (1 mg/mL) and lamivudine (0.5 mg/mL) for oral administration in the pediatric population, eliminating the use of organic solvents, which is in accordance with green chemistry principles. The formulations were obtained by ultrasonication using monoolein (MN) or phytantriol (PN), which presented narrow size distributions with similar mean particle sizes (~150 nm) determined by laser diffraction. The zeta potential and the pH values of the formulations were around -4.0 mV and 6.0, respectively. MN presented a slightly higher incorporation rate compared to PN. Nanoemulsions were obtained when using monoolein, while cubosomes were obtained when using phytantriol, as confirmed by Small-Angle X-ray Scattering. The formulations enabled drug release control and protection against acid degradation. The drug incorporation was effective and the analyses using an electronic tongue indicated a difference in palatability between the nanotechnological samples in comparison with the drug solutions. In conclusion, PN was considered to have the strongest potential as a novel oral formulation for pediatric HIV treatment.
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Affiliation(s)
- Marina D. V. Guedes
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil
| | - Morgana S. Marques
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil
| | - Simone J. Berlitz
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre 35400-000, RS, Brazil
| | - Murilo H. M. Facure
- Laboratório Nacional de Nanotecnologia para o Agronegócio (LNNA), Embrapa Instrumentação, São Carlos 70770-901, SP, Brazil
- Programa de Pós-Graduação em Química (PPGQ), Universidade Federal de São Carlos, São Carlos 66075-110, SP, Brazil
| | - Daniel S. Correa
- Laboratório Nacional de Nanotecnologia para o Agronegócio (LNNA), Embrapa Instrumentação, São Carlos 70770-901, SP, Brazil
- Programa de Pós-Graduação em Química (PPGQ), Universidade Federal de São Carlos, São Carlos 66075-110, SP, Brazil
| | - Clarice Steffens
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e Missões, Erechim 99709-910, RS, Brazil
| | - Renata V. Contri
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil
| | - Irene C. Külkamp-Guerreiro
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre 35400-000, RS, Brazil
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre 90050-170, RS, Brazil
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8
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Saadati F, da Silva Brito WA, Emmert S, Bekeschus S. Optimized High-Content Imaging Screening Quantifying Micronuclei Formation in Polymer-Treated HaCaT Keratinocytes. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4463. [PMID: 36558315 PMCID: PMC9788386 DOI: 10.3390/nano12244463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Research on nano- and micro-plastic particles (NMPPs) suggests their potential threat to human health. Some studies have even suggested genotoxic effects of NMPP exposure, such as micronuclei (MN) formation, while others found the opposite. To clarify the ability of NMPP to induce MN formation, we used non-malignant HaCaT keratinocytes and exposed these to a variety of polystyrene (PS) and poly methyl methacrylate (PMMA) particle types at different concentrations and three different sizes. Investigations were performed following acute (one day) and chronic exposure (five weeks) against cytotoxic (amino-modified NMPPs) and genotoxic (methyl methanesulfonate, MMS) positive controls. An optimized high-content imaging workflow was established strictly according to OECD guidelines for analysis. Algorithm-based object segmentation and MN identification led to computer-driven, unsupervised quantitative image analysis results on MN frequencies among the different conditions and thousands of cells per condition. This could only be realized using accutase, allowing for partial cell detachment for optimal identification of bi-nucleated cells. Cytotoxic amino-modified particles were not genotoxic; MMS was both. During acute and long-term studies, PS and PMMA particles were neither toxic nor increased MN formation, except for 1000 nm PS particles at the highest concentration of unphysiological 100 µg/mL. Interestingly, ROS formation was significantly decreased in this condition. Hence, most non-charged polymer particles were neither toxic nor genotoxic, while aminated particles were toxic but not genotoxic. Altogether, we present an optimized quantitative imaging workflow applied to a timely research question in environmental toxicity.
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Affiliation(s)
- Fariba Saadati
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Clinic and Policlinic for Dermatology and Venereology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
| | - Walison Augusto da Silva Brito
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Department of General Pathology, State University of Londrina, Rodovia Celso Garcia Cid, Londrina 86057970, Brazil
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
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9
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Jeitler R, Glader C, Tetyczka C, Zeiringer S, Absenger-Novak M, Selmani A, Fröhlich E, Roblegg E. Investigation of Cellular Interactions of Lipid-Structured Nanoparticles With Oral Mucosal Epithelial Cells. Front Mol Biosci 2022; 9:917921. [PMID: 35677878 PMCID: PMC9170126 DOI: 10.3389/fmolb.2022.917921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Lipid-based nanosystems enable intracellular delivery of drugs in the oral cavity for the treatment of local diseases. To rationally design such systems, suitable matrix compositions and particle properties need to be identified, and manufacturing technologies that allow reproducible production have to be applied. This is a prerequisite for the reliable and predictable performance of in-vitro biological studies. Here, we showed that solid lipid nanoparticles (SLN, palmitic acid) and nanostructured lipid carriers (NLC, palmitic acid and oleic acid in different ratios) with a size of 250 nm, a negative zeta potential, and a polydispersity index (PdI) of less than 0.3 can be reproducibly prepared by high-pressure homogenization using quality by design and a predictive model. SLN and NLC were colloidally stable after contact with physiological fluid and did not form agglomerates. The in-vitro studies clearly showed that besides particle size, surface charge and hydrophobicity, matrix composition had a significant effect. More specifically, the addition of the liquid lipid oleic acid increased the cellular uptake capacity without changing the underlying uptake mechanism. Regardless of the matrix composition, caveolin-mediated endocytosis was the major route of uptake, which was confirmed by particle localization in the endoplasmic reticulum. Thus, this work provides useful insights into the optimal composition of lipid carrier systems to enhance the intracellular uptake capacity of drugs into the oral mucosa.
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Affiliation(s)
- R. Jeitler
- Pharmaceutical Technology and Biopharmacy, Institute of Pharmaceutical Sciences, University of Graz, Universitätsplatz 1, Graz, Austria
| | - C. Glader
- Pharmaceutical Technology and Biopharmacy, Institute of Pharmaceutical Sciences, University of Graz, Universitätsplatz 1, Graz, Austria
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - C. Tetyczka
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - S. Zeiringer
- Pharmaceutical Technology and Biopharmacy, Institute of Pharmaceutical Sciences, University of Graz, Universitätsplatz 1, Graz, Austria
| | - M. Absenger-Novak
- Center for Medical Research, Medical University of Graz, Graz, Austria
| | - A. Selmani
- Pharmaceutical Technology and Biopharmacy, Institute of Pharmaceutical Sciences, University of Graz, Universitätsplatz 1, Graz, Austria
| | - E. Fröhlich
- Center for Medical Research, Medical University of Graz, Graz, Austria
| | - E. Roblegg
- Pharmaceutical Technology and Biopharmacy, Institute of Pharmaceutical Sciences, University of Graz, Universitätsplatz 1, Graz, Austria
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
- *Correspondence: E. Roblegg,
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10
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Srivastava N, Aslam S. Recent Advancements and Patents on Buccal Drug Delivery Systems: A Comprehensive Review. RECENT PATENTS ON NANOTECHNOLOGY 2022; 16:308-325. [PMID: 34126916 DOI: 10.2174/1872210515666210609145144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
The major requirement for a dosage form to be successful is its ability to penetrate the site of application and the bioavailability of the drug released from the dosage form. The buccal drug delivery is an influential route to deliver the drug into the body. Here, in this context, various novel approaches that include lipoidal carriers like ethosomes, transferosomes, niosomes etc. and electrospun nanofibers are discussed, with respect to buccal drug delivery. These carriers can be easily incorporated into buccal dosage forms like patches and gels that are responsible for increased permeation across the buccal epithelium. The in vivo methods of evaluation on animal models are conscribed here. The novel biocarriers of lipoidal and non-lipoidal nature can be utilized by loading the drug into them, which are helpful in preventing drug degradation and other drawbacks as compared to conventional formulations. The globally patented buccal formulations give us a wide context in literature about the patents filed and granted in the recent years. When it comes to patient compliance, age is an issue, which is also solved by the buccal route. The pediatric buccal formulations are researched for the customization to be delivered to children. Diseases like mouth ulcers, oral cancer, Parkinson's disease, aphthous stomatitis etc. have been successfully treated through the buccal route, which infers that the buccal drug delivery system is an effective and emerging area for formulation and development in the field of pharmaceutics.
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Affiliation(s)
- Nimisha Srivastava
- Department of Pharmaceutics, Faculty of Pharmacy, Amity University Uttar Pradesh, Lucknow, India
| | - Sahifa Aslam
- Department of Pharmaceutics, Faculty of Pharmacy, Amity University Uttar Pradesh, Lucknow, India
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11
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Cytokine-Mediated Inflammation in the Oral Cavity and Its Effect on Lipid Nanocarriers. NANOMATERIALS 2021; 11:nano11051330. [PMID: 34070004 PMCID: PMC8157841 DOI: 10.3390/nano11051330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 01/17/2023]
Abstract
Topical drug administration to the oral mucosa proves to be a promising treatment alternative for inflammatory diseases. However, disease-related changes in the cell barrier must be considered when developing such delivery systems. This study aimed at investigating the changes in the lining mucosa caused by inflammation and evaluating the consequences on drug delivery systems such as nanostructured lipid carriers (NLC). For this, TR146 cells were treated with inflammatory cytokines and bacterial components. Cell viability and integrity, reactive oxygen species (ROS), and interleukin (IL)-8 release were used as endpoints to assess inflammation. Translocation of phosphatidylserine, cytoskeletal arrangement, opening of desmosomes, and cell proliferation were examined. Transport studies with NLC were performed considering active and passive pathways. The results showed that IL-1ß and tumor necrosis factor α induced inflammation by increasing IL-8 and ROS production (22-fold and 2-fold). Morphologically, loss of cell–cell connections and formation of stress fibers and hyperplasia were observed. The charge of the cell membrane shifted from neutral to negative, which increased the absorption of NLC due to the repulsive interactions between the hydrophobic negative particles and the cell membrane on the one hand, and interactions with lipophilic membrane proteins such as caveolin on the other.
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12
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Gomez-Casado C, Sanchez-Solares J, Izquierdo E, Díaz-Perales A, Barber D, Escribese MM. Oral Mucosa as a Potential Site for Diagnosis and Treatment of Allergic and Autoimmune Diseases. Foods 2021; 10:970. [PMID: 33925074 PMCID: PMC8146604 DOI: 10.3390/foods10050970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022] Open
Abstract
Most prevalent food allergies during early childhood are caused by foods with a high allergenic protein content, such as milk, egg, nuts, or fish. In older subjects, some respiratory allergies progressively lead to food-induced allergic reactions, which can be severe, such as urticaria or asthma. Oral mucosa remodeling has been recently proven to be a feature of severe allergic phenotypes and autoimmune diseases. This remodeling process includes epithelial barrier disruption and the release of inflammatory signals. Although little is known about the immune processes taking place in the oral mucosa, there are a few reports describing the oral mucosa-associated immune system. In this review, we will provide an overview of the recent knowledge about the role of the oral mucosa in food-induced allergic reactions, as well as in severe respiratory allergies or food-induced autoimmune diseases, such as celiac disease.
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Affiliation(s)
- Cristina Gomez-Casado
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Javier Sanchez-Solares
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Elena Izquierdo
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Araceli Díaz-Perales
- Center of Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain;
| | - Domingo Barber
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - María M. Escribese
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
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Barbosa de Souza A, Vinícius Chaud M, Francine Alves T, Ferreira de Souza J, Andrade Santana MH. Hyaluronic Acid in the Intestinal Tract: Influence of Structure, Rheology, and Mucoadhesion on the Intestinal Uptake in Rats. Biomolecules 2020; 10:E1422. [PMID: 33050089 PMCID: PMC7601924 DOI: 10.3390/biom10101422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 01/14/2023] Open
Abstract
Oral hyaluronic acid (HA) is a ubiquitous biopolymer that has gained attention as a treatment for local or systemic diseases. Here, we prepared and characterized structures of free HA (f-HA) with a high (>105 Da), intermediate (≤105 Da), and low (≤104 Da) average molar mass (MM); nanoparticles crosslinked with adipic dihydrazide (n-HA); and mixed formulations (mixed-HA) containing f-HA and n-HA. MM distribution determined the structure, hydrodynamic diameter, and zeta potential of the f-HAs. Crosslinking changed the physicochemical properties in n-HA. In vitro tack adhesion assays, using mucin tablets or a viable rat intestinal mucosa, showed better mucoadhesion with f-HA (intermediate MM) and mixed-HA (25% n-HA), especially in the jejunum segment. High MM f-HA presented negligible mucoadhesion. n-HA showed the deepest diffusion into the porous of the membranes. In vivo results showed that, except for high MM f-HA, there is an inverse relationship between rheological changes in the intestinal membrane macerates resulting from mucoadhesion and the effective intestinal permeability that led to blood clearance of the structures. We conclude that the n-HA formulations are promising for targeting other tissues, while formulations of f-HA (intermediate MM) and mixed-HA are better for treating dysbiosis.
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Affiliation(s)
- Alexandro Barbosa de Souza
- Department of Materials and Bioprocesses Engineering, School of Chemical Engineering, University of Campinas, P.O. Box 6066, Campinas 13083 852, SP, Brazil;
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba, Sorocaba 18300 000, SP, Brazil; (M.V.C.); (T.F.A.); (J.F.d.S.)
| | - Marco Vinícius Chaud
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba, Sorocaba 18300 000, SP, Brazil; (M.V.C.); (T.F.A.); (J.F.d.S.)
| | - Thais Francine Alves
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba, Sorocaba 18300 000, SP, Brazil; (M.V.C.); (T.F.A.); (J.F.d.S.)
| | - Juliana Ferreira de Souza
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba, Sorocaba 18300 000, SP, Brazil; (M.V.C.); (T.F.A.); (J.F.d.S.)
| | - Maria Helena Andrade Santana
- Department of Materials and Bioprocesses Engineering, School of Chemical Engineering, University of Campinas, P.O. Box 6066, Campinas 13083 852, SP, Brazil;
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Galić E, Ilić K, Hartl S, Tetyczka C, Kasemets K, Kurvet I, Milić M, Barbir R, Pem B, Erceg I, Dutour Sikirić M, Pavičić I, Roblegg E, Kahru A, Vinković Vrček I. Impact of surface functionalization on the toxicity and antimicrobial effects of selenium nanoparticles considering different routes of entry. Food Chem Toxicol 2020; 144:111621. [PMID: 32738372 DOI: 10.1016/j.fct.2020.111621] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022]
Abstract
Selenium nanoparticles (SeNPs) were first designed as nutritional supplements, but they are attractive also for use in diagnostic and therapeutic systems owing to their biocompatibility and protective effects. This study aimed to examine if different SeNPs stabilization strategies affect their (i) antimicrobial activity against bacteria Escherichia coli and Staphylococcus aureus and yeast Saccharomyces cerevisiae and (ii) toxicity to human cells of different biological barriers i.e., skin, oral and intestinal mucosa. For surface stabilization, polyvinylpyrrolidone (PVP), poly-L-lysine (PLL) and polyacrylic acid (PAA) were used rendering neutral, positively and negatively charged SeNPs, respectively. The SeNPs (primary size ~80 nm) showed toxic effects in human cells in vitro and in bacteria S. aureus, but not in E. coli and yeast S. cerevisiae. Toxicity of SeNPs (24 h IC50) ranged from 1.4 to >100 mg Se/L, depending on surface functionalization (PLL > PAA > PVP) and was not caused by ionic Se. At subtoxic concentrations, all SeNPs were taken up by all human cell types, induced oxidative stress response and demonstrated genotoxicity. As the safety profile of SeNPs was dependent not only on target cells (mammalian cells, bacteria, yeast), but also on surface functionalization, these aspects should be considered during development of novel SeNPs-based biomedical products.
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Affiliation(s)
- Emerik Galić
- University J.J. Strossmayer in Osijek, Faculty of Agrobiotechnical Sciences Osijek, Croatia
| | - Krunoslav Ilić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Sonja Hartl
- University of Graz, Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, Graz, Austria
| | - Carolin Tetyczka
- University of Graz, Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, Graz, Austria
| | - Kaja Kasemets
- Laboratory of Environmental Toxicology, National Institute of Chemical Physics and Biophysics, Tallinn, Estonia
| | - Imbi Kurvet
- Laboratory of Environmental Toxicology, National Institute of Chemical Physics and Biophysics, Tallinn, Estonia
| | - Mirta Milić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Rinea Barbir
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Barbara Pem
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Ina Erceg
- Laboratory for Biocolloids and Surface Chemistry, Division of Physical Chemistry, Ruđer Bošković Institute, Zagreb, Croatia
| | - Maja Dutour Sikirić
- Laboratory for Biocolloids and Surface Chemistry, Division of Physical Chemistry, Ruđer Bošković Institute, Zagreb, Croatia
| | - Ivan Pavičić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Eva Roblegg
- University of Graz, Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, Graz, Austria
| | - Anne Kahru
- Laboratory of Environmental Toxicology, National Institute of Chemical Physics and Biophysics, Tallinn, Estonia; Estonian Academy of Sciences, Kohtu 6, Tallinn, Estonia.
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15
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Kotak DJ, Devarajan PV. Bone targeted delivery of salmon calcitonin hydroxyapatite nanoparticles for sublingual osteoporosis therapy (SLOT). NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2020; 24:102153. [DOI: 10.1016/j.nano.2020.102153] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/11/2019] [Accepted: 01/17/2020] [Indexed: 11/30/2022]
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16
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Hesler M, Aengenheister L, Ellinger B, Drexel R, Straskraba S, Jost C, Wagner S, Meier F, von Briesen H, Büchel C, Wick P, Buerki-Thurnherr T, Kohl Y. Multi-endpoint toxicological assessment of polystyrene nano- and microparticles in different biological models in vitro. Toxicol In Vitro 2019; 61:104610. [DOI: 10.1016/j.tiv.2019.104610] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/16/2019] [Accepted: 07/24/2019] [Indexed: 12/29/2022]
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17
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Pokrowiecki R, Wojnarowicz J, Zareba T, Koltsov I, Lojkowski W, Tyski S, Mielczarek A, Zawadzki P. Nanoparticles And Human Saliva: A Step Towards Drug Delivery Systems For Dental And Craniofacial Biomaterials. Int J Nanomedicine 2019; 14:9235-9257. [PMID: 31819427 PMCID: PMC6886554 DOI: 10.2147/ijn.s221608] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/27/2019] [Indexed: 12/02/2022] Open
Abstract
Aim The aims of this study were to investigate new nano-formulations based on ZnO and Ag nanoparticle (NP) compounds when used against clinical strains of oral gram-positive and gram-negative bacteria, and to examine the stability and behaviour of nano-formulation mixtures in saliva based on different compositions of Ag NPs, ZnO NPs and ZnO+x·Ag NPs. Methods: ZnO NPs with and without nanosilver were obtained by microwave solvothermal synthesis. Then, antibacterial activity was evaluated against bacteria isolated from human saliva. Behavior and nanoparticle solutions were evaluated in human saliva and control (artificial saliva and deionized water). Results were statistically compared. Results The NP mixtures had an average size of 30±3 nm, while the commercial Ag NPs had an average size of 55±5 nm. The suspensions displayed differing antibacterial activities and kinetics of destabilisation processes, depending on NPs composition and fluid types. Conclusion The present study showed that all NPs suspensions displayed significant destabilisation and high destabilisation over the 24 h of the analyses. The agglomeration processes of NPs in human saliva can be reversible.
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Affiliation(s)
- Rafal Pokrowiecki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Medical University of Warsaw, Warsaw, Poland.,Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland.,Private Practice, Warsaw, Poland
| | - Jacek Wojnarowicz
- Institute of High Pressure Physics, Polish Academy of Sciences, Warsaw, Poland
| | - Tomasz Zareba
- Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland
| | - Iwona Koltsov
- Institute of High Pressure Physics, Polish Academy of Sciences, Warsaw, Poland
| | - Witold Lojkowski
- Institute of High Pressure Physics, Polish Academy of Sciences, Warsaw, Poland
| | - Stefan Tyski
- Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland.,Department of Pharmaceutical Microbiology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Mielczarek
- Department of Conservative Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Pawel Zawadzki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Medical University of Warsaw, Warsaw, Poland
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Madani F, Hsein H, Busignies V, Tchoreloff P. An overview on dosage forms and formulation strategies for vaccines and antibodies oral delivery. Pharm Dev Technol 2019; 25:133-148. [DOI: 10.1080/10837450.2019.1689402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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19
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Hua S. Advances in Nanoparticulate Drug Delivery Approaches for Sublingual and Buccal Administration. Front Pharmacol 2019; 10:1328. [PMID: 31827435 PMCID: PMC6848967 DOI: 10.3389/fphar.2019.01328] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/15/2019] [Indexed: 01/16/2023] Open
Abstract
The sublingual and buccal routes of administration have significant advantages for both local and systemic drug delivery. They have shown to be an effective alternative to the traditional oral route, especially when fast onset of action is required. Drugs can be rapidly and directly absorbed into the systemic circulation via venous drainage to the superior vena cava. Therefore, they are useful for drugs that undergo high hepatic clearance or degradation in the gastrointestinal tract, and for patients that have swallowing difficulties. Drugs administered via the sublingual and buccal routes are traditionally formulated as solid dosage forms (e.g., tablets, wafers, films, and patches), liquid dosage forms (e.g., sprays and drops), and semi-solid dosage forms (e.g., gels). Conventional dosage forms are commonly affected by physiological factors, which can reduce the contact of the formulation with the mucosa and lead to unpredictable drug absorption. There have been a number of advances in formulation development to improve the retention and absorption of drugs in the buccal and sublingual regions. This review will focus on the physiological aspects that influence buccal and sublingual drug delivery and the advances in nanoparticulate drug delivery approaches for sublingual and buccal administration. The clinical development pipeline with formulations approved and in clinical trials will also be addressed.
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Affiliation(s)
- Susan Hua
- Therapeutic Targeting Research Group, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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20
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Tran PH, Duan W, Tran TT. Recent developments of nanoparticle-delivered dosage forms for buccal delivery. Int J Pharm 2019; 571:118697. [DOI: 10.1016/j.ijpharm.2019.118697] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 12/23/2022]
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21
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dos Santos Chaves P, Frank LA, Torge A, Schneider M, Pohlmann AR, Guterres SS, Beck RCR. Spray-dried carvedilol-loaded nanocapsules for sublingual administration: Mucoadhesive properties and drug permeability. POWDER TECHNOL 2019. [DOI: 10.1016/j.powtec.2019.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Drumond N, Stegemann S. An evaluation of the gliding performance of solid oral dosage form film coatings using an artificial mucous layer. Colloids Surf B Biointerfaces 2019; 177:235-241. [PMID: 30763788 DOI: 10.1016/j.colsurfb.2019.02.012] [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: 09/29/2018] [Revised: 01/24/2019] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Abstract
Oral drug delivery technology is mainly provided in the form of solid oral dosage forms (SODF) that have to be swallowed intact and move throughout the oro-esophageal system to release the drug content in the stomach or intestine. As there is growing evidence for an increasing prevalence of impaired swallowing functions in certain diseases, multimorbidity and advanced age, predictive in vitro methods for the oro-esophageal gliding behavior of SODF would be very useful. The gliding performance of different SODF polymer films was investigated across an artificial mucous layer using a versatile in vitro gliding system. In a first phase, the system measures the force required to move the polymer surface when placed in contact with the mucin layer and, in a second phase, the resistance behavior over a defined length. The obtained results showed that comprehensive gliding profiles could be obtained depending on the polymer film tested. The carnauba wax and PEG coatings required lower gliding peak forces and showed poor gliding resistance, which is indicative of free gliding capacity. In contrast, HPMC, PVP and gelatin coatings required higher gliding forces and exhibited greater resistance due to an adhesive interaction with the artificial mucous layer. The obtained profiles correlate with prior in vitro data during polymer gliding evaluations on mucosal membranes.
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Affiliation(s)
- Nélio Drumond
- Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria.
| | - Sven Stegemann
- Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria; Lonza, Rijksweg 11, 2880 Bornem, Belgium.
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Can nano-hydroxyapatite permeate the oral mucosa? A histological study using three-dimensional tissue models. PLoS One 2019; 14:e0215681. [PMID: 31013294 PMCID: PMC6478310 DOI: 10.1371/journal.pone.0215681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/06/2019] [Indexed: 12/11/2022] Open
Abstract
Nano-hydroxyapatite is used in oral care products worldwide. But there is little evidence yet whether nano-hydroxyapatite can enter systemic tissues via the oral epithelium. We investigated histologically the ability of two types of nano-hydroxyapatite, SKM-1 and Mi-HAP, to permeate oral epithelium both with and without a stratum corneum, using two types of three-dimensional reconstituted human oral epithelium, SkinEthic HGE and SkinEthic HOE respectively with and without a stratum corneum. Both types of nano-hydroxyapatite formed aggregates in solution, but both aggregates and primary particles were much larger for SKM-1 than for Mi-HAP. Samples of each tissue model were exposed to SKM-1 and Mi-HAP for 24 h at concentrations ranging from 1,000 to 50,000 ppm. After treatment, paraffin sections from the samples were stained with Dahl or Von Kossa stains. We also used OsteoSense 680EX, a fluorescent imaging agent, to test for the presence of HAP in paraffin tissue sections for the first time. Our results for both types of nano-hydroxyapatite showed that the nanoparticles did not penetrate the stratum corneum in SkinEthic HGE samples and penetrated only the outermost layer of cells in SkinEthic HOE samples without stratum corneum, and no permeation into the deeper layers of the epithelium in either tissue model was observed. In the non-cornified model, OsteoSense 680EX staining confirmed the presence of nano-hydroxyapatite particles in both the cytoplasm and extracellular matrix of outermost cells, but not in the deeper layers. Our results suggest that the stratum corneum may act as a barrier to penetration of nano-hydroxyapatite into the oral epithelium. Moreover, since oral epithelial cell turnover is around 5–7 days, superficial cells of the non-keratinized mucosa in which nanoparticles are taken up are likely to be deciduated within that time frame. Our findings suggest that nano-hydroxyapatite is unlikely to enter systemic tissues via intact oral epithelium.
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Dos Santos Chaves P, Visioli F, Buffon A, Raffin Pohlmann A, Stanisçuaski Guterres S, Beck RCR. SCC4 cell monolayers as an alternative sublingual barrier model: influence of nanoencapsulation on carvedilol transport. Drug Dev Ind Pharm 2018; 45:63-66. [PMID: 30230390 DOI: 10.1080/03639045.2018.1517775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate, for the first time, the use of SCC4 cell monolayers as an alternative sublingual barrier model and study the influence of nanoencapsulation on carvedilol transport across SCC4 cell monolayers. SIGNIFICANCE The sublingual cavity is an interesting route for administration of drugs with limited oral bioavailability due to hepatic first pass metabolism. By this route, the drug is directly absorbed into blood circulation. In this sense, mucoadhesive carvedilol-loaded nanocapsules (CAR-NC) were previously proposed for the administration of this drug by sublingual route. Carvedilol is used for cardiovascular diseases and suffers metabolism in liver when orally administrated. Nanoencapsulation of carvedilol controlled its permeation across porcine sublingual mucosa. METHODS Carvedilol-loaded cationic nanocapsules were prepared by interfacial deposition of a preformed polymer. Drug permeation studies were carried out in Transwell® inserts. The integrity of cell monolayers after the drug transport was assessed by transepithelial electric resistance. Compatibility of the CAR-NC with the SCC4 cells was evaluated by the Sulforhodamine B assay. RESULTS The drug permeated the cell monolayer by a controlled way when nanoencapsulated and this profile had a linear relation with those observed in porcine sublingual mucosa. The integrity of the cell monolayer was maintained after drug permeation and CAR-NC was no cytotoxic to SCC4 cells. CONCLUSION Nanoencapsulated carvedilol permeated by a controlled and safe way by SCC4 cell monolayer. SCC4 cells monolayers may be used as in vitro model for sublingual drug transport studies in the development of novel formulations.
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Affiliation(s)
- Paula Dos Santos Chaves
- a Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
| | - Fernanda Visioli
- b Programa de Pós-Graduação em Odontologia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
| | - Andréia Buffon
- a Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
| | - Adriana Raffin Pohlmann
- a Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil.,c Departamento de Química Orgânica, Instituto de Química , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Sílvia Stanisçuaski Guterres
- a Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
| | - Ruy Carlos Ruver Beck
- a Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
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25
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Yang D, Liu D, Qin M, Chen B, Song S, Dai W, Zhang H, Wang X, Wang Y, He B, Tang X, Zhang Q. Intestinal Mucin Induces More Endocytosis but Less Transcytosis of Nanoparticles across Enterocytes by Triggering Nanoclustering and Strengthening the Retrograde Pathway. ACS APPLIED MATERIALS & INTERFACES 2018; 10:11443-11456. [PMID: 29485849 DOI: 10.1021/acsami.7b19153] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Mucus, which is secreted by the goblet cells of enterocytes, constitutes the first obstacle encountered for the intestinal absorption of nanomedicines. For decades, mucus has simply been regarded as a physical barrier that hinders the permeation and absorption of drugs, because of its high viscosity and reticular structure, whereas the interaction of mucus ingredients with nanomedicines is usually neglected. It is unclear whether glycoproteins, as the main components of mucus, interact with nanomedicines. We also do not know how the potential interaction affects the subsequent transportation of nanomedicines through the intestinal epithelium. In this study, mucin as the key element of mucus was investigated to characterize the interaction of nanomedicines with mucus. PEG-modified gold nanoparticles (PGNPs) were fabricated as model nanoparticles. Mucin was found to adhere to the nanoparticle surface to form a corona structure and induce the clustering of PGNPs by joining particles together, demonstrating the interaction between mucin and PGNPs. In addition, two intestinal epithelia, Caco-2 (non- mucus secretion) and HT-29 (high mucus secretion), were compared to evaluate the influence of mucin on the cellular interaction of PGNPs. Amazingly, mucin altered the trafficking characteristic of PGNPs in intestinal epithelium. Both in vitro and in vivo investigations demonstrated more nanoparticles being internalized by cells due to the mucin coverage. However, mucin induced a significant reduction in the transcytosis of PGNPs across epithelial monolayers. The mechanism exploration further revealed that the "more endocytosis but less transcytosis (MELT)" effect was mainly attributed to the strengthened retrograde pathway in which more PGNPs were transported to Golgi apparatus and exocytosed back to the apical but not the basolateral side of the epithelial monolayers. The "MELT" effect endowed mucin with duality in the nanoparticle transportation. Therefore, the rational regulation based on the "MELT" effect will provide new insight into overcoming the mucus obstacle as a barrier and enhancing the oral absorption rate of nanomedicines.
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Affiliation(s)
- Dan Yang
- School of Pharmacy , Shenyang Pharmaceutical University , Shenyang 110016 , China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Dechun Liu
- School of Pharmacy , Shenyang Pharmaceutical University , Shenyang 110016 , China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Mengmeng Qin
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Binlong Chen
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Siyang Song
- School of Pharmacy , Shenyang Pharmaceutical University , Shenyang 110016 , China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Wenbing Dai
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Hua Zhang
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Xueqing Wang
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Yiguang Wang
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Bing He
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
| | - Xing Tang
- School of Pharmacy , Shenyang Pharmaceutical University , Shenyang 110016 , China
| | - Qiang Zhang
- School of Pharmacy , Shenyang Pharmaceutical University , Shenyang 110016 , China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences , Peking University , Beijing 100191 , China
- State Key Laboratory of Natural and Biomimetic Drugs , Peking University , Beijing 100191 , China
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Teubl BJ, Stojkovic B, Docter D, Pritz E, Leitinger G, Poberaj I, Prassl R, Stauber RH, Fröhlich E, Khinast JG, Roblegg E. The effect of saliva on the fate of nanoparticles. Clin Oral Investig 2018; 22:929-940. [PMID: 28691145 PMCID: PMC5820401 DOI: 10.1007/s00784-017-2172-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/26/2017] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The design of nanocarriers for local drug administration to the lining mucosa requires a sound knowledge of how nanoparticles (NPs) interact with saliva. This contact determines whether NPs agglomerate and become immobile due to size- and interaction-filtering effects or adsorb on the cell surface and are internalized by epithelial cells. The aim of this study was to examine the behavior of NPs in saliva considering physicochemical NP properties. MATERIALS AND METHODS The salivary pore-size distribution was determined, and the viscosity of the fluid inside of the pores was studied with optical tweezers. Distinct functionalized NPs (20 and 200 nm) were dispersed in saliva and salivary buffers and characterized, and surface-bound MUC5B and MUC7 were analyzed by 1D electrophoresis and immunoblotting. NP mobility was recorded, and cellular uptake studies were performed with TR146 cells. RESULTS The mode diameter of the salivary mesh pores is 0.7 μm with a peak width of 1.9 μm, and pores are filled with a low-viscosity fluid. The physicochemical properties of the NPs affected the colloidal stability and mobility: compared with non-functionalized particles, which did not agglomerate and showed a cellular uptake rate of 2.8%, functionalized particles were immobilized, which was correlated with agglomeration and increased binding to mucins. CONCLUSION The present study showed that the salivary microstructure facilitates NP adsorption. However, NP size and surface functionalization determine the colloidal stability and cellular interactions. CLINICAL RELEVANCE The sound knowledge of NP interactions with saliva enables the improvement of current treatment strategies for inflammatory oral diseases.
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Affiliation(s)
- Birgit J Teubl
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, University of Graz, Universitätsplatz 1, 8010, Graz, Austria
- BioTechMed, 8010, Graz, Austria
| | - Biljana Stojkovic
- Faculty of Mathematics and Physics, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Dominic Docter
- Department of Nanobiomedicine, Mainz University Medical Center, 55131, Mainz, Germany
| | - Elisabeth Pritz
- Institute of Cell Biology, Histology and Embryology, Research Unit Electron Microscopic Techniques, Medical University of Graz, 8010, Graz, Austria
| | - Gerd Leitinger
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, University of Graz, Universitätsplatz 1, 8010, Graz, Austria
- Institute of Cell Biology, Histology and Embryology, Research Unit Electron Microscopic Techniques, Medical University of Graz, 8010, Graz, Austria
| | - Igor Poberaj
- Faculty of Mathematics and Physics, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Ruth Prassl
- BioTechMed, 8010, Graz, Austria
- Institute of Biophysics, Medical University of Graz, 8010, Graz, Austria
| | - Roland H Stauber
- Department of Nanobiomedicine, Mainz University Medical Center, 55131, Mainz, Germany
| | - Eleonore Fröhlich
- BioTechMed, 8010, Graz, Austria
- Center for Medical Research, Medical University of Graz, 8010, Graz, Austria
| | - Johannes G Khinast
- BioTechMed, 8010, Graz, Austria
- Institute for Process and Particle Engineering, Graz University of Technology, 8010, Graz, Austria
- Research Center Pharmaceutical Engineering, 8010, Graz, Austria
| | - Eva Roblegg
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, University of Graz, Universitätsplatz 1, 8010, Graz, Austria.
- BioTechMed, 8010, Graz, Austria.
- Research Center Pharmaceutical Engineering, 8010, Graz, Austria.
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A slippery slope: On the origin, role and physiology of mucus. Adv Drug Deliv Rev 2018; 124:16-33. [PMID: 29108861 DOI: 10.1016/j.addr.2017.10.014] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/17/2017] [Accepted: 10/29/2017] [Indexed: 02/07/2023]
Abstract
The mucosa of the gastrointestinal tract, eyes, nose, lungs, cervix and vagina is lined by epithelium interspersed with mucus-secreting goblet cells, all of which contribute to their unique functions. This mucus provides an integral defence to the epithelium against noxious agents and pathogens. However, it can equally act as a barrier to drugs and delivery systems targeting epithelial passive and active transport mechanisms. This review highlights the various mucins expressed at different mucosal surfaces on the human body, and their role in creating a mucoid architecture to protect epithelia with specialized functions. Various factors compromising the barrier properties of mucus have been discussed, with an emphasis on how disease states and microbiota can alter the physical properties of mucus. For instance, Akkermansia muciniphila, a bacterium found in higher levels in the gut of lean individuals induces the production of a thickened gut mucus layer. The aims of this article are to elucidate the different physiological, biochemical and physical properties of bodily mucus, a keen appreciation of which will help circumvent the slippery slope of challenges faced in achieving effective mucosal drug and gene delivery.
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Morales JO, Brayden DJ. Buccal delivery of small molecules and biologics: of mucoadhesive polymers, films, and nanoparticles. Curr Opin Pharmacol 2017; 36:22-28. [PMID: 28800417 DOI: 10.1016/j.coph.2017.07.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 01/28/2023]
Abstract
Buccal delivery of macromolecules (biologics) sets a great challenge for researchers. Although several niche small molecule products have been approved as simple sprays, tablets and oral films, it is not simply a case of adapting existing technologies to biologics. Buccal delivery of insulin has reached clinical trials with two approaches: oromucosal sprays of the peptide with permeation enhancers, and embedded gold nanoparticles in a dissolvable film. However, neither of these approaches have led to FDA approvals likely due to poor efficacy, submaximal peptide loading in the dosage form, and to wide intra-subject variability in pharmacokinetics and pharmacodynamics. It is likely however that printed film designs with lower molecular weight stable biotech payloads including lipophilic glucagon-like 1 (GLP-1) agonists and macrocycles with long half-lives will generate greater efficacy than was achieved to date for insulin.
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Affiliation(s)
- Javier O Morales
- Department of Pharmaceutical Science and Technology, School of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 8380494, Chile; Advanced Center for Chronic Diseases (ACCDiS), Santiago 8380494, Chile; Pharmaceutical Biomaterial Research Group, Department of Health Sciences, Luleå University of Technology, Luleå 97187, Sweden.
| | - David J Brayden
- UCD School of Veterinary Medicine and UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
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Mercier-Bonin M, Despax B, Raynaud P, Houdeau E, Thomas M. Mucus and microbiota as emerging players in gut nanotoxicology: The example of dietary silver and titanium dioxide nanoparticles. Crit Rev Food Sci Nutr 2017; 58:1023-1032. [PMID: 27740849 DOI: 10.1080/10408398.2016.1243088] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Given the growing use of nanotechnology in many common consumer products, including foods, evaluation of the consequences of chronic exposure to nanoparticles in humans has become a major public health issue. The oral route of exposure has been poorly explored, despite the presence of a fraction of nanosized particles in certain food additives/supplements and the incorporation of such particles into packaging in contact with foods. After their ingestion, these nanoparticles pass through the digestive tract, where they may undergo physicochemical transformations, with consequences for the luminal environment, before crossing the epithelial barrier to reach the systemic compartment. In this review, we consider two examples, nanosilver and nanotitanium dioxide. Despite the specific features of these particles and the differences between them, both display a close relationship between physicochemical reactivity and bioavailability/biopersistence in the gastrointestinal tract. Few studies have focused on the interactions of nanoparticles of silver or titanium dioxide with the microbiota and mucus. However, the microbiota and mucus play key roles in intestinal homeostasis and host health and are undoubtedly involved in controlling the distribution of nanoparticles in the systemic compartment.
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Affiliation(s)
- Muriel Mercier-Bonin
- a Toxalim (Research Centre in Food Toxicology) , Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse , France , France
| | - Bernard Despax
- b LAPLACE, Université de Toulouse, CNRS, INPT, UPS , Toulouse cedex 9 , France
| | - Patrice Raynaud
- b LAPLACE, Université de Toulouse, CNRS, INPT, UPS , Toulouse cedex 9 , France
| | - Eric Houdeau
- a Toxalim (Research Centre in Food Toxicology) , Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse , France , France
| | - Muriel Thomas
- c Micalis Institute, INRA, AgroParisTech , Université Paris-Saclay , France
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Tetyczka C, Griesbacher M, Absenger-Novak M, Fröhlich E, Roblegg E. Development of nanostructured lipid carriers for intraoral delivery of Domperidone. Int J Pharm 2017; 526:188-198. [DOI: 10.1016/j.ijpharm.2017.04.076] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/25/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
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Konstantinova V, Ibrahim M, Lie SA, Birkeland ES, Neppelberg E, Marthinussen MC, Costea DE, Cimpan MR. Nano-TiO 2 penetration of oral mucosa: in vitro analysis using 3D organotypic human buccal mucosa models. J Oral Pathol Med 2017; 46:214-222. [PMID: 27387227 PMCID: PMC5347879 DOI: 10.1111/jop.12469] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral cavity is a doorway for a variety of products containing titanium dioxide (TiO2 ) nanoparticles (NPs) (nano-TiO2 ) such as food additives, oral healthcare products and dental materials. Their potential to penetrate and affect normal human oral mucosa is not yet determined. OBJECTIVES To evaluate the ability of nano-TiO2 to penetrate the in vitro reconstructed normal human buccal mucosa (RNHBM). METHODS RNHBM was generated from primary normal human oral keratinocytes and fibroblasts isolated from buccal oral mucosa of healthy patients (n = 6). The reconstructed tissues were exposed after 10 days to clinically relevant concentrations of spherical or spindle rutile nano-TiO2 in suspension for short (20 min) and longer time (24 h). Ultrahigh-resolution imaging (URI) microscopy (CytoViva™ , Auburn, AL, USA) was used to assess the depth of penetration into reconstructed tissues. RESULTS Ultrahigh-resolution imaging microscopy demonstrated the presence of nano-TiO2 mostly in the epithelium of RNHBM at both 20 min and 24-h exposure, and this was shape and doze dependent at 24 h of exposure. The depth of penetration diminished in time at higher concentrations. The exposed epithelium showed increased desquamation but preserved thickness. CONCLUSION Nano-TiO2 is able to penetrate RNHBM and to activate its barrier function in a doze- and time-dependent manner.
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Affiliation(s)
- Victoria Konstantinova
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Gade Laboratory for PathologyDepartment of Clinical MedicineFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Department of Global Public Health and Primary CareCentre for International HealthFaculty of Medicine and DentistryUniversity of BergenBergenNorway
| | - Mohamed Ibrahim
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Department of Global Public Health and Primary CareCentre for International HealthFaculty of Medicine and DentistryUniversity of BergenBergenNorway
| | - Stein A. Lie
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
| | - Eivind Salmorin Birkeland
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Gade Laboratory for PathologyDepartment of Clinical MedicineFaculty of Medicine and DentistryUniversity of BergenBergenNorway
| | - Evelyn Neppelberg
- Department of Oral SurgeryInstitute of Clinical DentistryUniversity of BergenBergenNorway
- Department of Ear‐Nose‐and‐Throat SurgeryHaukeland University HospitalBergenNorway
| | - Mihaela Cuida Marthinussen
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Oral Health Centre of Expertise in Western NorwayHordalandNorway
| | - Daniela Elena Costea
- Gade Laboratory for PathologyDepartment of Clinical MedicineFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Department of Global Public Health and Primary CareCentre for International HealthFaculty of Medicine and DentistryUniversity of BergenBergenNorway
- Department of PathologyHaukeland University HospitalBergenNorway
| | - Mihaela R. Cimpan
- Department of Clinical DentistryFaculty of Medicine and DentistryUniversity of BergenBergenNorway
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Micro- and nano-carrier systems: The non-invasive and painless local administration strategies for disease therapy in mucosal tissues. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 13:153-171. [DOI: 10.1016/j.nano.2016.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/05/2016] [Accepted: 08/17/2016] [Indexed: 12/12/2022]
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Fröhlich E, Roblegg E. Oral uptake of nanoparticles: human relevance and the role of in vitro systems. Arch Toxicol 2016; 90:2297-314. [PMID: 27342244 DOI: 10.1007/s00204-016-1765-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 06/14/2016] [Indexed: 01/03/2023]
Abstract
Nanoparticles (NPs) present in environment, consumer and health products, food and medical applications lead to a high degree of human exposure and concerns about potential adverse effects on human health. For the general population, the exposure through contact with the skin, inhalation and oral uptake are most relevant. Since in vivo testing is only partly able to study the effects of human oral exposure, physiologically relevant in vitro systems are being developed. This review compared the three routes taking into account the estimated concentration, size of the exposed area, morphology of the involved barrier and translocation rate. The high amounts of NPs in food, the large absorption area and the relatively high translocation rate identified oral uptake as most important portal of entry for NPs into the body. Changes of NP properties in the physiological fluids, mechanisms to cross mucus and epithelial barrier, and important issues in the use of laboratory animals for oral exposure are mentioned. The ability of in vitro models to address the varying conditions along the oro-gastrointestinal tract is discussed, and requirements for physiologically relevant in vitro testing of orally ingested NPs are listed.
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Affiliation(s)
- Eleonore Fröhlich
- Center for Medical Research, Medical University of Graz, Stiftingtalstr. 24, 8010, Graz, Austria.
| | - Eva Roblegg
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, Karl-Franzens-University of Graz, Graz, Austria
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34
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Fage SW, Muris J, Jakobsen SS, Thyssen JP. Titanium: a review on exposure, release, penetration, allergy, epidemiology, and clinical reactivity. Contact Dermatitis 2016; 74:323-45. [PMID: 27027398 DOI: 10.1111/cod.12565] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 11/29/2022]
Abstract
Exposure to titanium (Ti) from implants and from personal care products as nanoparticles (NPs) is common. This article reviews exposure sources, ion release, skin penetration, allergenic effects, and diagnostic possibilities. We conclude that human exposure to Ti mainly derives from dental and medical implants, personal care products, and foods. Despite being considered to be highly biocompatible relative to other metals, Ti is released in the presence of biological fluids and tissue, especially under certain circumstances, which seem to be more likely with regard to dental implants. Although most of the studies reviewed have important limitations, Ti seems not to penetrate a competent skin barrier, either as pure Ti, alloy, or as Ti oxide NPs. However, there are some indications of Ti penetration through the oral mucosa. We conclude that patch testing with the available Ti preparations for detection of type IV hypersensitivity is currently inadequate for Ti. Although several other methods for contact allergy detection have been suggested, including lymphocyte stimulation tests, none has yet been generally accepted, and the diagnosis of Ti allergy is therefore still based primarily on clinical evaluation. Reports on clinical allergy and adverse events have rarely been published. Whether this is because of unawareness of possible adverse reactions to this specific metal, difficulties in detection methods, or the metal actually being relatively safe to use, is still unresolved.
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Affiliation(s)
- Simon W Fage
- Department of Dermato-Venereology, Aarhus University Hospital, 8000 Aarhus, Denmark
| | - Joris Muris
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Stig S Jakobsen
- Department of Orthopaedic Surgery, Aarhus University Hospital, 8000 Aarhus, Denmark
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Herlev-Gentofte, 2900 Hellerup, Denmark
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35
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Baumgartner R, Teubl BJ, Tetyczka C, Roblegg E. Rational Design and Characterization of a Nanosuspension for Intraoral Administration Considering Physiological Conditions. J Pharm Sci 2016; 105:257-67. [DOI: 10.1016/j.xphs.2015.10.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/14/2015] [Accepted: 10/23/2015] [Indexed: 12/29/2022]
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Asikainen P, Sirviö E, Mikkonen JJW, Singh SP, Schulten EAJM, ten Bruggenkate CM, Koistinen AP, Kullaa AM. Microplicae – Specialized Surface Structure of Epithelial Cells of Wet-Surfaced Oral Mucosa. Ultrastruct Pathol 2015. [DOI: 10.3109/01913123.2015.1054015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Mauro M, Crosera M, Bianco C, Bellomo F, Bovenzi M, Adami G, Filon FL. In vitro permeability of silver nanoparticles through porcine oromucosal membrane. Colloids Surf B Biointerfaces 2015; 132:10-6. [PMID: 26001797 DOI: 10.1016/j.colsurfb.2015.04.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/26/2015] [Accepted: 04/27/2015] [Indexed: 01/06/2023]
Abstract
Silver nanoparticles (AgNPs) can come in contact with human oral mucosa due to their wide use in food industry and hygiene devices. We evaluate transmucosal absorption of 19 nm AgNPs using excised porcine buccal mucosa applied on Franz diffusion cells. Two donor solutions were used: one containing AgNPs (0.5 g/L) and one derived from the ultrafiltration of the former and containing only Ag in its soluble form. Experiments were carried out separately for 4 h. Silver flux permeation was demonstrated through oral mucosa, showing similar values for AgNPs (6.8±4.5 ng cm(-2) h(-1)) and Ag ions (5.2±4.3 ng cm(-2) h(-1)). Our study demonstrates that silver can permeate the oromucosal barrier and that absorption is substantially due to Ag ions, since no permeation difference was found using the two solutions. Mucosal absorption has to be considered in further risk assessment studies.
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Affiliation(s)
- Marcella Mauro
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Via della Pietà 19, 1-34100 Trieste, Italy
| | - Matteo Crosera
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, via Giorgieri, 1-34127 Trieste, Italy
| | - Carlotta Bianco
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, via Giorgieri, 1-34127 Trieste, Italy
| | - Francesca Bellomo
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Via della Pietà 19, 1-34100 Trieste, Italy
| | - Massimo Bovenzi
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Via della Pietà 19, 1-34100 Trieste, Italy
| | - Gianpiero Adami
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, via Giorgieri, 1-34127 Trieste, Italy
| | - Francesca Larese Filon
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Via della Pietà 19, 1-34100 Trieste, Italy.
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Teubl BJ, Schimpel C, Leitinger G, Bauer B, Fröhlich E, Zimmer A, Roblegg E. Interactions between nano-TiO2 and the oral cavity: impact of nanomaterial surface hydrophilicity/hydrophobicity. JOURNAL OF HAZARDOUS MATERIALS 2015; 286:298-305. [PMID: 25590824 DOI: 10.1016/j.jhazmat.2014.12.064] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/16/2014] [Accepted: 12/30/2014] [Indexed: 05/28/2023]
Abstract
Titanium dioxide (TiO2) nanoparticles are available in a variety of oral applications, such as food additives and cosmetic products. Thus, questions about their potential impact on the oro-gastrointestinal route rise. The oral cavity represents the first portal of entry and is known to rapidly interact with nanoparticles. Surface charge and size contribute actively to the particle-cell interactions, but the influence of surface hydrophilicity/hydrophobicity has never been shown before. This study addresses the biological impact of hydrophilic (NM 103, rutile, 20 nm) and hydrophobic (NM 104, rutile, 20 nm) TiO2 particles within the buccal mucosa. Particle characterization was addressed with dynamic light scattering and laser diffraction. Despite a high agglomeration tendency, 10% of the particles/agglomerates were present in the nanosized range and penetrated into the mucosa, independent of the surface properties. However, significant differences were observed in intracellular particle localization. NM 104 particles were found freely distributed in the cytoplasm, whereas their hydrophobic counterparts were engulfed in vesicular structures. Although cell viability/membrane integrity was not affected negatively, screening assays demonstrated that NM 104 particles showed a higher potential to decrease the physiological mitochondrial membrane potential than NM 103, resulting in a pronounced generation of reactive oxygen species.
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Affiliation(s)
- Birgit J Teubl
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, 8010, Austria
| | - Christa Schimpel
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, 8010, Austria
| | - Gerd Leitinger
- Institute of Cell Biology, Histology and Embryology, Research Unit Electron Microscopic Techniques, Medical University of Graz, 8010, Austria; Center for Medical Research, Medical University of Graz, 8010, Austria; BioTechMed, Graz 8010, Austria
| | - Bettina Bauer
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, 8010, Austria
| | - Eleonore Fröhlich
- Center for Medical Research, Medical University of Graz, 8010, Austria; BioTechMed, Graz 8010, Austria
| | - Andreas Zimmer
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, 8010, Austria; BioTechMed, Graz 8010, Austria
| | - Eva Roblegg
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology, University of Graz, 8010, Austria; BioTechMed, Graz 8010, Austria.
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Mucoadhesive polymers in the design of nano-drug delivery systems for administration by non-parenteral routes: A review. Prog Polym Sci 2014. [DOI: 10.1016/j.progpolymsci.2014.07.010] [Citation(s) in RCA: 333] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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40
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Khan SA, Schneider M. Stabilization of Gelatin Nanoparticles Without Crosslinking. Macromol Biosci 2014; 14:1627-38. [DOI: 10.1002/mabi.201400214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/29/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Saeed Ahmad Khan
- Department of Pharmaceutics and Biopharmacy; Philipps University Marburg; Ketzerbach 63 D-35037 Marburg Germany
- Department of Pharmacy; Kohat University of Science and Technology; Pakistan
| | - Marc Schneider
- Department of Pharmaceutics and Biopharmacy; Philipps University Marburg; Ketzerbach 63 D-35037 Marburg Germany
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41
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Teubl BJ, Leitinger G, Schneider M, Lehr CM, Fröhlich E, Zimmer A, Roblegg E. The buccal mucosa as a route for TiO2 nanoparticle uptake. Nanotoxicology 2014; 9:253-61. [PMID: 24873758 DOI: 10.3109/17435390.2014.921343] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The oral cavity, although part of the aero-digestive tract, is still neglected in terms of risk assessment with respect to nanoparticle uptake. If nanoparticles enter the oral cavity, either via oral products or inhaled materials, it is not clear whether they rapidly interact with the mucosae or are swallowed. In this study, interactions of three distinct titanium dioxide (TiO2) particles (i.e. NM 100, NM 101 and NM 105) with oral tissues are presented. Physicochemical properties were addressed in relevant media, and particle penetration was investigated with an ex vivo model using porcine mucosa. To avoid modification of the particle surfaces via labeling, multiphoton microscopy was introduced as an accurate method to detect TiO2 particles within the tissue. The spatiotemporal aspects of nanoparticle uptake, as well as the intracellular localization in human epithelial cells, were studied and potential toxic effects were evaluated. Although TiO2 particles formed large aggregates once dispersed in media, 10-50% remained in the nanoscale range, rapidly interacting with the mucus layer and infecting the epithelium. However, differences in the penetration depth were observed depending on the particle characteristics. NM 100 and NM 105 were found in both the upper part and the lower part of the buccal mucosa, while NM 101 (smallest particle sizes) only penetrated the upper parts. Transport studies revealed that TiO2 nanoparticles were found in vesicles, as well as freely distributed in the cytoplasm. Cell viability/integrity was not affected negatively; however, NM 105 triggered the production of reactive oxygen species. These data clearly suggest that the oral cavity should be considered in further risk assessment studies.
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Affiliation(s)
- Birgit Johanna Teubl
- Department of Pharmaceutical Technology, Institute of Pharmaceutical Sciences, Karl-Franzens University , Graz , Austria
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42
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Barua S, Mitragotri S. Challenges associated with Penetration of Nanoparticles across Cell and Tissue Barriers: A Review of Current Status and Future Prospects. NANO TODAY 2014; 9:223-243. [PMID: 25132862 PMCID: PMC4129396 DOI: 10.1016/j.nantod.2014.04.008] [Citation(s) in RCA: 691] [Impact Index Per Article: 69.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Nanoparticles (NPs) have emerged as an effective modality for the treatment of various diseases including cancer, cardiovascular and inflammatory diseases. Various forms of NPs including liposomes, polymer particles, micelles, dendrimers, quantum dots, gold NPs and carbon nanotubes have been synthesized and tested for therapeutic applications. One of the greatest challenges that limit the success of NPs is their ability to reach the therapeutic site at necessary doses while minimizing accumulation at undesired sites. The biodistribution of NPs is determined by body's biological barriers that manifest in several distinct ways. For intravascular delivery of NPs, the barrier manifests in the form of: (i) immune clearance in the liver and spleen, (ii) permeation across the endothelium into target tissues, (iii) penetration through the tissue interstitium, (iv) endocytosis in target cells, (v) diffusion through cytoplasm and (vi) eventually entry into the nucleus, if required. Certain applications of NPs also rely on delivery through alternate routes including skin and mucosal membranes of the nose, lungs, intestine and vagina. In these cases, the diffusive resistance of these tissues poses a significant barrier to delivery. This review focuses on the current understanding of penetration of NPs through biological barriers. Emphasis is placed on transport barriers and not immunological barriers. The review also discusses design strategies for overcoming the barrier properties.
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Affiliation(s)
- Sutapa Barua
- Center for Bioengineering, Department of Chemical Engineering University of California, Santa Barbara, CA 93106
| | - Samir Mitragotri
- Center for Bioengineering, Department of Chemical Engineering University of California, Santa Barbara, CA 93106
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43
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Morales JO, McConville JT. Novel strategies for the buccal delivery of macromolecules. Drug Dev Ind Pharm 2014; 40:579-90. [DOI: 10.3109/03639045.2014.892960] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Schimpel C, Teubl B, Absenger M, Meindl C, Fröhlich E, Leitinger G, Zimmer A, Roblegg E. Development of an advanced intestinal in vitro triple culture permeability model to study transport of nanoparticles. Mol Pharm 2014; 11:808-18. [PMID: 24502507 DOI: 10.1021/mp400507g] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Intestinal epithelial cell culture models, such as Caco-2 cells, are commonly used to assess absorption of drug molecules and transcytosis of nanoparticles across the intestinal mucosa. However, it is known that mucus strongly impacts nanoparticle mobility and that specialized M cells are involved in particulate uptake. Thus, to get a clear understanding of how nanoparticles interact with the intestinal mucosa, in vitro models are necessary that integrate the main cell types. This work aimed at developing an alternative in vitro permeability model based on a triple culture: Caco-2 cells, mucus-secreting goblet cells and M cells. Therefore, Caco-2 cells and mucus-secreting goblet cells were cocultured on Transwells and Raji B cells were added to stimulate differentiation of M cells. The in vitro triple culture model was characterized regarding confluence, integrity, differentiation/expression of M cells and cell surface architecture. Permeability of model drugs and of 50 and 200 nm polystyrene nanoparticles was studied. Data from the in vitro model were compared with ex vivo permeability results (Ussing chambers and porcine intestine) and correlated well. Nanoparticle uptake was size-dependent and strongly impacted by the mucus layer. Moreover, nanoparticle permeability studies clearly demonstrated that particles were capable of penetrating the intestinal barrier mainly via specialized M cells. It can be concluded that goblet cells and M cells strongly impact nanoparticle uptake in the intestine and should thus be integrated in an in vitro permeability model. The presented model will be an efficient tool to study intestinal transcellular uptake of particulate systems.
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Affiliation(s)
- Christa Schimpel
- Institute of Pharmaceutical Sciences, University of Graz , Graz, Austria
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45
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Fröhlich E, Roblegg E. Mucus as Physiological Barrier to Intracellular Delivery. INTRACELLULAR DELIVERY II 2014. [DOI: 10.1007/978-94-017-8896-0_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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46
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Asikainen P, Mikkonen JJ, Ruotsalainen TJ, Koistinen AP, Kullaa AM. Microstructure of the Superficial Epithelial Cells of the Human Oral Mucosa. Ultrastruct Pathol 2013; 38:6-12. [DOI: 10.3109/01913123.2013.816401] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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