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Prihatiningsih MC, Pratama C, Kundari NA, Megasari K, Ariyanti D, Saputra A, Kusuma HD, Astuti P. Rifampicin adsorption and release study using Santa Barbara amorphous-16 modified Al (SBA-16-Al) for a drug delivery system. RSC Adv 2024; 14:7371-7382. [PMID: 38433940 PMCID: PMC10906368 DOI: 10.1039/d3ra08360h] [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: 12/07/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
In this study, the surface modification of Santa Barbara Amorphous-16 (SBA-16) with aluminum (SBA-16-Al) was carried out as a rifampicin matrix for the treatment of tuberculosis. Surface modification of SBA-16 was achieved using the direct-synthesis grafting method. Then, the adsorption and release properties of rifampicin from the SBA-16-Al matrix have been studied in batches. In addition, the SBA-16-Al has been characterized using Fourier-Transform Infrared Spectroscopy (FTIR), X-ray diffraction analysis (XRD), transmission electron microscopy (TEM), and Surface Area Analysis (SAA) Brunaur, Emmett and Teller (SAA-BET). The results show that the mesoporous material, the SBA-16-Al has a specific surface area of 843.5 m2 g-1 and 624.3 m2 g-1 for SBA-16, nanometer-sized pore diameters, and an amorphous crystal lattice. The FTIR spectra showed the Al-O bond at 802 cm-1 which indicates the Al group has been successfully added into SBA-16. The adsorption isotherm of rifampicin in SBA-16-Al follows the Freundlich model which illustrates the adsorption is heterogeneous and forms a multilayer. The adsorption of rifampicin is chemisorption which occurs non-spontaneously and is quite stable. The release kinetics of rifampicin in the drug delivery system followed the Higuchi model with k1 0.5472 mg 0.5/hour pH 1.5 and k2 mg 0.5/hour pH 6.5.
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Affiliation(s)
| | - Chaidir Pratama
- Research Center for Radioisotope, Radiopharmaceutical, and Biodosimetry Technology, Research Organization of Nuclear Energy, National Research and Innovation Agency (BRIN) Indonesia
| | - Noor Anis Kundari
- Polytechnic Institute of Nuclear Technology, National Research and Innovation Agency (BRIN) Yogyakarta Indonesia
| | - Kartini Megasari
- Polytechnic Institute of Nuclear Technology, National Research and Innovation Agency (BRIN) Yogyakarta Indonesia
| | - Dhita Ariyanti
- Polytechnic Institute of Nuclear Technology, National Research and Innovation Agency (BRIN) Yogyakarta Indonesia
| | - Andri Saputra
- Department of Rubber and Plastic Processing Technology, Politeknik ATK Yogyakarta Indonesia
| | - Hersandy Dayu Kusuma
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran Jl. Raya Bandung - Sumedang KM. 21 Jatinangor Sumedang 45363 Indonesia
| | - Puji Astuti
- Polytechnic Institute of Nuclear Technology, National Research and Innovation Agency (BRIN) Yogyakarta Indonesia
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2
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Okeyo PO, Rajendran ST, Zór K, Boisen A. Sensing technologies and experimental platforms for the characterization of advanced oral drug delivery systems. Adv Drug Deliv Rev 2021; 176:113850. [PMID: 34182015 DOI: 10.1016/j.addr.2021.113850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022]
Abstract
Complex and miniaturized oral drug delivery systems are being developed rapidly for targeted, controlled drug release and improved bioavailability. Standard analytical techniques are widely used to characterize i) drug carrier and active pharmaceutical ingredients before loading into a delivery device (to ensure the solid form), and ii) the entire drug delivery system during the development process. However, in light of the complexity and the size of some of these systems, standard techniques as well as novel sensing technologies and experimental platforms need to be used in tandem. These technologies and platforms are discussed in this review, with a special focus on passive delivery systems in size range from a few 100 µm to a few mm. Challenges associated with characterizing these systems and evaluating their effect on oral drug delivery in the preclinical phase are also discussed.
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3
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Kjeldsen RB, Kristensen MN, Gundlach C, Thamdrup LHE, Müllertz A, Rades T, Nielsen LH, Zór K, Boisen A. X-ray Imaging for Gastrointestinal Tracking of Microscale Oral Drug Delivery Devices. ACS Biomater Sci Eng 2021; 7:2538-2547. [PMID: 33856194 DOI: 10.1021/acsbiomaterials.1c00225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Microscale devices are promising tools to overcome specific challenges within oral drug delivery. Despite the availability of advanced high-quality imaging techniques, visualization and tracking of microscale devices in the gastrointestinal (GI) tract is still a challenge. This work explores the possibilities of applying planar X-ray imaging and computed tomography (CT) scanning for visualization and tracking of microscale devices in the GI tract of rats. Microcontainers (MCs) are an example of microscale devices that have shown great potential as an oral drug delivery system. Barium sulfate (BaSO4) loaded into the cavity of the MCs increases their overall X-ray contrast, which allows them to be easily tracked. The BaSO4-loaded MCs are quantitatively tracked throughout the entire GI tract of rats by planar X-ray imaging and visualized in 3D by CT scanning. The majority of the BaSO4-loaded MCs are observed to retain in the stomach for 0.5-2 h, enter the cecum after 3-4 h, and leave the cecum and colon 8-10 h post-administration. The imaging approaches can be adopted and used with other types of microscale devices when investigating GI behavior in, for example, preclinical trials and potential clinical studies.
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Affiliation(s)
- Rolf Bech Kjeldsen
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Maja Nørgaard Kristensen
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark.,Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Carsten Gundlach
- Department of Physics, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Lasse Højlund Eklund Thamdrup
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Anette Müllertz
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark.,Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Thomas Rades
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark.,Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Line Hagner Nielsen
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Kinga Zór
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
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4
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In vitro and in vivo comparison of microcontainers and microspheres for oral drug delivery. Int J Pharm 2021; 600:120516. [PMID: 33775722 DOI: 10.1016/j.ijpharm.2021.120516] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 11/22/2022]
Abstract
Microcontainers, which are microfabricated cylindrical devices with a reservoir function, have shown promise as an oral drug delivery system for small molecular drug compounds. However, they have never been evaluated against a relevant control formulation. In the current study, we prepared microcrystalline cellulose (MCC) microspheres as a control for in vitro and in vivo testing of SU-8 microcontainers as an oral drug delivery system. Both dosage forms were loaded with paracetamol and coated with chitosan or polyethylene glycol (PEG) (12 kDa). These coatings were followed by an additional enteric coating of Eudragit® S100. In addition, a control dosage form was coated with Eudragit® alone. The dosage forms were evaluated in vitro, in a physiologically relevant two-step model simulating rat gastrointestinal fluids, and in vivo by oral administration to rats. In vitro, the microcontainers coated with PEG/Eudragit® resulted in a prolonged release of paracetamol compared to the respective microspheres, which was consistent with in vivo observations of a later time (Tmax) for maximum plasma concentration (Cmax) for the microcontainers. For microspheres and microcontainers coated with chitosan/Eudragit®, the time for complete in vitro release of paracetamol was very similar, due to an earlier release from the microcontainers. This trend was supported by very similar Tmax values in vivo. The in vitro in vivo relation was confirmed by a linear regression with R2 = 0.9, when Tmax for each dosage form was plotted as a function of time for 90% paracetamol release in vitro. From the in vivo study, the average plasma concentration of paracetamol 120 min after dosing was significantly higher for microcontainers than for microspheres (0.3 ± 0.1 µg/mL and 0.1 ± <0.1 µg/mL, respectively) - regardless of the coating applied.
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Measurement of the Intestinal pH in Mice under Various Conditions Reveals Alkalization Induced by Antibiotics. Antibiotics (Basel) 2021; 10:antibiotics10020180. [PMID: 33670214 PMCID: PMC7916911 DOI: 10.3390/antibiotics10020180] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022] Open
Abstract
The intestinal pH can greatly influence the stability and absorption of oral drugs. Therefore, knowledge of intestinal pH is necessary to understand the conditions for drug delivery. This has previously been measured in humans and rats. However, information on intestinal pH in mice is insufficient despite these animals being used often in preclinical testing. In this study, 72 female ICR mice housed in SPF (specific pathogen-free) conditions were separated into nine groups to determine the intestinal pH under conditions that might cause pH fluctuations, including high-protein diet, ageing, proton pump inhibitor (PPI) treatment, several antibiotic treatment regimens and germ-free mice. pH was measured in samples collected from the ileum, cecum and colon, and compared to control animals. An electrode, 3 mm in diameter, enabled accurate pH measurements with a small amount of gastrointestinal content. Consequently, the pH values in the cecum and colon were increased by high-protein diet, and the pH in the ileum was decreased by PPI. Drastic alkalization was induced by antibiotics, especially in the cecum and colon. The alkalized pH values in germ-free mice suggested that the reduction in the intestinal bacteria caused by antibiotics led to alkalization. Alkalization of the intestinal pH caused by antibiotic treatment was verified in mice. We need further investigations in clinical settings to check whether the same phenomena occur in patients.
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Kamguyan K, Torp AM, Christfort JF, Guerra PR, Licht TR, Hagner Nielsen L, Zor K, Boisen A. Colon-Specific Delivery of Bioactive Agents Using Genipin-Cross-Linked Chitosan Coated Microcontainers. ACS APPLIED BIO MATERIALS 2020. [DOI: 10.1021/acsabm.0c01333] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Khorshid Kamguyan
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Anders Meyer Torp
- The National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Juliane Fjelrad Christfort
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Priscila R. Guerra
- The National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Tine Rask Licht
- The National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Line Hagner Nielsen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Kinga Zor
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Department of Health Technology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
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7
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Development and characterization of a PDMS-based masking method for microfabricated Oral drug delivery devices. Biomed Microdevices 2020; 22:35. [DOI: 10.1007/s10544-020-00490-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Beardslee LA, Banis GE, Chu S, Liu S, Chapin AA, Stine JM, Pasricha PJ, Ghodssi R. Ingestible Sensors and Sensing Systems for Minimally Invasive Diagnosis and Monitoring: The Next Frontier in Minimally Invasive Screening. ACS Sens 2020; 5:891-910. [PMID: 32157868 DOI: 10.1021/acssensors.9b02263] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ingestible electronic systems that are capable of embedded sensing, particularly within the gastrointestinal (GI) tract and its accessory organs, have the potential to screen for diseases that are difficult if not impossible to detect at an early stage using other means. Furthermore, these devices have the potential to (1) reduce labor and facility costs for a variety of procedures, (2) promote research for discovering new biomarker targets for associated pathologies, (3) promote the development of autonomous or semiautonomous diagnostic aids for consumers, and (4) provide a foundation for epithelially targeted therapeutic interventions. These technological advances have the potential to make disease surveillance and treatment far more effective for a variety of conditions, allowing patients to lead longer and more productive lives. This review will examine the conventional techniques, as well as ingestible sensors and sensing systems that are currently under development for use in disease screening and diagnosis for GI disorders. Design considerations, fabrication, and applications will be discussed.
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Affiliation(s)
- Luke A. Beardslee
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - George E. Banis
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Sangwook Chu
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - Sanwei Liu
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - Ashley A. Chapin
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Justin M. Stine
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland 20742, United States
| | - Pankaj Jay Pasricha
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Reza Ghodssi
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland 20742, United States
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9
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Christfort JF, Guillot AJ, Melero A, Thamdrup LHE, Garrigues TM, Boisen A, Zór K, Nielsen LH. Cubic Microcontainers Improve In Situ Colonic Mucoadhesion and Absorption of Amoxicillin in Rats. Pharmaceutics 2020; 12:E355. [PMID: 32295139 PMCID: PMC7238233 DOI: 10.3390/pharmaceutics12040355] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 02/02/2023] Open
Abstract
An increased interest in colonic drug delivery has led to a higher focus on the design of delivery devices targeting this part of the gastrointestinal tract. Microcontainers have previously facilitated an increase in oral bioavailability of drugs. The surface texture and shape of microcontainers have proven to influence the mucoadhesion ex vivo. In the present work, these findings were further investigated using an in situ closed-loop perfusion technique in the rat colon, which allowed for simultaneous evaluation of mucoadhesion of the microcontainers as well as drug absorption. Cylindrical, triangular and cubic microcontainers, with the same exterior surface area, were evaluated based on in vitro release, in situ mucoadhesion and in situ absorption of amoxicillin. Additionally, the mucoadhesion of empty cylindrical microcontainers with and without pillars on the top surface was investigated. From the microscopy analysis of the colon sections after the in situ study, it was evident that a significantly higher percentage of cubic microcontainers than cylindrical microcontainers adhered to the intestinal mucus. Furthermore, the absorption rate constants and blood samples indicated that amoxicillin in cubic microcontainers was absorbed more readily than when cylindrical or triangular microcontainers were dosed. This could be due to a higher degree of mucoadhesion for these particular microcontainers.
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Affiliation(s)
- Juliane Fjelrad Christfort
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads, 2800 Kgs. Lyngby, Denmark; (L.H.E.T.); (A.B.); (K.Z.); (L.H.N.)
| | - Antonio José Guillot
- Department de Farmàcia I Tecnología Farmacèutica, Avda. Vincent Andrés Estellés s/n, 46100 Burjassot (Valencia), Spain; (A.J.G.); (T.M.G.)
| | - Ana Melero
- Department de Farmàcia I Tecnología Farmacèutica, Avda. Vincent Andrés Estellés s/n, 46100 Burjassot (Valencia), Spain; (A.J.G.); (T.M.G.)
| | - Lasse Højlund Eklund Thamdrup
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads, 2800 Kgs. Lyngby, Denmark; (L.H.E.T.); (A.B.); (K.Z.); (L.H.N.)
| | - Teresa M. Garrigues
- Department de Farmàcia I Tecnología Farmacèutica, Avda. Vincent Andrés Estellés s/n, 46100 Burjassot (Valencia), Spain; (A.J.G.); (T.M.G.)
| | - Anja Boisen
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads, 2800 Kgs. Lyngby, Denmark; (L.H.E.T.); (A.B.); (K.Z.); (L.H.N.)
| | - Kinga Zór
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads, 2800 Kgs. Lyngby, Denmark; (L.H.E.T.); (A.B.); (K.Z.); (L.H.N.)
| | - Line Hagner Nielsen
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads, 2800 Kgs. Lyngby, Denmark; (L.H.E.T.); (A.B.); (K.Z.); (L.H.N.)
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Ward A, Walton K, Stoycheva S, Wallis M, Adebisi A, Nep E, Ngwuluka NC, Shaboun S, Smith AM, Conway BR, Asare-Addo K. The use of visible and UV dissolution imaging for the assessment of propranolol hydrochloride in liquisolid compacts of Sesamum radiatum gum. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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11
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Vaut L, Juszczyk JJ, Kamguyan K, Jensen KE, Tosello G, Boisen A. 3D Printing of Reservoir Devices for Oral Drug Delivery: From Concept to Functionality through Design Improvement for Enhanced Mucoadhesion. ACS Biomater Sci Eng 2020; 6:2478-2486. [DOI: 10.1021/acsbiomaterials.9b01760] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Lukas Vaut
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Julia J. Juszczyk
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Khorshid Kamguyan
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Kristian E. Jensen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Guido Tosello
- Department of Mechanical Engineering, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Kongens Lyngby 2800, Denmark
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12
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Micro and nanoscale technologies in oral drug delivery. Adv Drug Deliv Rev 2020; 157:37-62. [PMID: 32707147 PMCID: PMC7374157 DOI: 10.1016/j.addr.2020.07.012] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022]
Abstract
Oral administration is a pillar of the pharmaceutical industry and yet it remains challenging to administer hydrophilic therapeutics by the oral route. Smart and controlled oral drug delivery could bypass the physiological barriers that limit the oral delivery of these therapeutics. Micro- and nanoscale technologies, with an unprecedented ability to create, control, and measure micro- or nanoenvironments, have found tremendous applications in biology and medicine. In particular, significant advances have been made in using these technologies for oral drug delivery. In this review, we briefly describe biological barriers to oral drug delivery and micro and nanoscale fabrication technologies. Micro and nanoscale drug carriers fabricated using these technologies, including bioadhesives, microparticles, micropatches, and nanoparticles, are described. Other applications of micro and nanoscale technologies are discussed, including fabrication of devices and tissue engineering models to precisely control or assess oral drug delivery in vivo and in vitro, respectively. Strategies to advance translation of micro and nanotechnologies into clinical trials for oral drug delivery are mentioned. Finally, challenges and future prospects on further integration of micro and nanoscale technologies with oral drug delivery systems are highlighted.
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13
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Abid Z, Strindberg S, Javed MM, Mazzoni C, Vaut L, Nielsen LH, Gundlach C, Petersen RS, Müllertz A, Boisen A, Keller SS. Biodegradable microcontainers - towards real life applications of microfabricated systems for oral drug delivery. LAB ON A CHIP 2019; 19:2905-2914. [PMID: 31367713 DOI: 10.1039/c9lc00527g] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Microfabrication techniques have been applied to develop micron-scale devices for oral drug delivery with a high degree of control over size, shape and material composition. Recently, microcontainers have been introduced as a novel approach to obtain unidirectional release to avoid luminal drug loss, enhance drug permeation, protect drug payload from the harsh environment of the stomach, and explore the ability for targeted drug delivery. However, in order to eventually pave the way for real life applications of these microfabricated drug delivery systems, it is necessary to fabricate them in biodegradable materials approved for similar applications and with strategies that potentially allow for large scale production. In this study, we for the first time evaluate biodegradable microcontainers for oral drug delivery. Asymmetric poly-ε-caprolactone (PCL) microcontainers with a diameter of 300 μm and a volume of 2.7 nL are fabricated with a novel single-step fabrication process. The microcontainers are loaded with the model drug paracetamol and coated with an enteric pH-sensitive Eudragit® S100 coating to protect the drug until it reaches the desired location in the small intestine. In vitro dissolution studies are performed to assess the drug load and release profile of the PCL microcontainers. Finally, in vivo studies in rats showed a higher bioavailability compared to conventional dosage forms and confirm the potential of biodegradable microcontainers for oral drug delivery.
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Affiliation(s)
- Zarmeena Abid
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and National Centre for Nano Fabrication and Characterization, DTU Nanolab, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
| | - Sophie Strindberg
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Madeeha M Javed
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and National Centre for Nano Fabrication and Characterization, DTU Nanolab, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
| | - Chiara Mazzoni
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Health Technology, DTU Health Tech, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Lukas Vaut
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Health Technology, DTU Health Tech, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Line Hagner Nielsen
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Health Technology, DTU Health Tech, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Carsten Gundlach
- Department of Physics, DTU Physics, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Ritika Singh Petersen
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and National Centre for Nano Fabrication and Characterization, DTU Nanolab, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
| | - Anette Müllertz
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Physics, DTU Physics, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and Department of Health Technology, DTU Health Tech, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Stephan S Keller
- The Danish National Research Foundation and, Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Denmark and National Centre for Nano Fabrication and Characterization, DTU Nanolab, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
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14
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Kaur G, Arora M, Ravi Kumar MNV. Oral Drug Delivery Technologies-A Decade of Developments. J Pharmacol Exp Ther 2019; 370:529-543. [PMID: 31010845 PMCID: PMC6806634 DOI: 10.1124/jpet.118.255828] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/17/2019] [Indexed: 12/17/2022] Open
Abstract
Advanced drug delivery technologies, in general, enable drug reformulation and administration routes, together contributing to life-cycle management and allowing the innovator to maintain the product monopoly. Over the years, there has been a steady shift from mere life-cycle management to drug repurposing-applying delivery technologies to tackle solubility and permeability issues in early stages or safety and efficacy issues in the late stages of drug discovery processes. While the drug and the disease in question primarily drive the choice of route of administration, the oral route, for its compliance and safety attributes, is the most preferred route, particularly when it comes to chronic conditions, including pain, which is not considered a disease but a symptom of a primary cause. Therefore, the attempt of this review is to take a stock of the advances in oral delivery technologies that are applicable for injectable to oral transformation, improve risk-benefit profiles of existing orals, and apply them in the early discovery program to minimize the drug attrition rates.
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Affiliation(s)
- G Kaur
- Department of Pharmaceutical Sciences, College of Pharmacy, Texas A&M University, College Station, Texas
| | - M Arora
- Department of Pharmaceutical Sciences, College of Pharmacy, Texas A&M University, College Station, Texas
| | - M N V Ravi Kumar
- Department of Pharmaceutical Sciences, College of Pharmacy, Texas A&M University, College Station, Texas
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15
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Mazzoni C, Tentor F, Antalaki A, Jacobsen RD, Mortensen J, Slipets R, Ilchenko O, Keller SS, Nielsen LH, Boisen A. Where Is the Drug? Quantitative 3D Distribution Analyses of Confined Drug-Loaded Polymer Matrices. ACS Biomater Sci Eng 2019; 5:2935-2941. [DOI: 10.1021/acsbiomaterials.9b00495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chiara Mazzoni
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Fabio Tentor
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Anastasia Antalaki
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Rasmus D. Jacobsen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Jacob Mortensen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Roman Slipets
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Oleksii Ilchenko
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Stephan S. Keller
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), National Centre for Nano Fabrication and Characterization, Technical University of Denmark, Ørsteds Plads Building 345B, Kgs. Lyngby 2800, Denmark
| | - L. Hagner Nielsen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
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16
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Biorelevant intrinsic dissolution profiling in early drug development: Fundamental, methodological, and industrial aspects. Eur J Pharm Biopharm 2019; 139:101-114. [PMID: 30862481 DOI: 10.1016/j.ejpb.2019.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/07/2019] [Accepted: 03/08/2019] [Indexed: 01/24/2023]
Abstract
Intrinsic dissolution rate (IDR) is the surface specific dissolution rate of a drug. In early drug development, this property (among other parameters) is measured in order to compare different polymorphs and salt forms, guide formulation decisions, and to provide a quality marker of the active pharmaceutical ingredient (API) during production. In this review, an update on different methods and small-scale techniques that have recently evolved for determination of IDR is provided. The importance of biorelevant media and the hydrodynamic conditions of dissolution are also discussed. Different preparation techniques for samples are presented with a focus on disc, particle- and crystal-based methods. A number of small-scale techniques are then described in detail, and their applicability domains are identified. Finally, an updated industrial perspective is provided about IDR's place in the early drug development process.
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17
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Nielsen LH, Keller SS, Boisen A. Microfabricated devices for oral drug delivery. LAB ON A CHIP 2018; 18:2348-2358. [PMID: 29975383 DOI: 10.1039/c8lc00408k] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Oral administration of drugs is most convenient for patients and therefore the ultimate goal when developing new medication. The physical barriers in the body, low pH of the stomach and degradation by enzymes in the gastrointestinal tract are a few of the obstacles to succeeding with oral drug delivery. Microfabricated devices show promise to overcome some of these hindrances and thereby improve the bioavailability of drugs after oral administration. There is an increasing focus on microfabricated oral drug delivery systems, and so far there have been three main groups of designs: patch-like structures, microcontainers and microwells. Here, we review the newest development in top-down microfabricated devices for oral drug delivery with coverage of the aspects of design, choice of material and fabrication techniques. Furthermore, the drug loading techniques and methods for testing are discussed. In addition, we discuss the future perspectives for microfabricated devices.
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Affiliation(s)
- Line Hagner Nielsen
- Department of Micro- and Nanotechnology, Technical University of Denmark, Ørsteds Plads 345C, 2800 Kgs. Lyngby, Denmark.
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18
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Mazzoni C, Tentor F, Strindberg SA, Nielsen LH, Keller SS, Alstrøm TS, Gundlach C, Müllertz A, Marizza P, Boisen A. From concept to in vivo testing: Microcontainers for oral drug delivery. J Control Release 2017; 268:343-351. [DOI: 10.1016/j.jconrel.2017.10.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 11/16/2022]
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19
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Genina N, Boetker JP, Colombo S, Harmankaya N, Rantanen J, Bohr A. Anti-tuberculosis drug combination for controlled oral delivery using 3D printed compartmental dosage forms: From drug product design to in vivo testing. J Control Release 2017; 268:40-48. [PMID: 28993169 DOI: 10.1016/j.jconrel.2017.10.003] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/26/2022]
Abstract
The design and production of an oral dual-compartmental dosage unit (dcDU) was examined in vitro and in vivo with the purpose of physically isolating and modulating the release profile of an anti-tuberculosis drug combination. Rifampicin (RIF) and isoniazid (ISO) are first line combination drugs for treatment of tuberculosis (TB) that negatively interact with each other upon simultaneous release in acidic environment. The dcDUs were designed in silico by computer aided design (CAD) and fabricated in two steps; first three-dimensional (3D) printing of the outer structure, followed by hot-melt extrusion (HME) of the drug-containing filaments. The structure of the fabricated dcDUs was visualized by scanning electron microscopy (SEM). The 3D printed compartmentalized shells were loaded with filaments containing active pharmaceutical ingredient (API) and selectively sealed to modulate drug dissolution. The drug release profile of the dcDUs was characterized by pH-transfer dissolution in vitro and pharmacokinetics studies in rats, and resulted in modified release of the APIs from the dcDUs as compared to the free filaments. Furthermore, the selective physical sealing of the compartments resulted in an effective retardation of the in vitro API release. The findings of this study support the development of controllable-by-design dcDU systems for combination therapies to enable efficient therapeutic translation of oral dosage forms.
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Affiliation(s)
- Natalja Genina
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark.
| | - Johan Peter Boetker
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Stefano Colombo
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Necati Harmankaya
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Jukka Rantanen
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Adam Bohr
- University of Copenhagen, Department of Pharmacy, Universitetsparken 2, 2100 Copenhagen, Denmark
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20
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Nielsen LH, Rades T, Boyd B, Boisen A. Microcontainers as an oral delivery system for spray dried cubosomes containing ovalbumin. Eur J Pharm Biopharm 2017; 118:13-20. [DOI: 10.1016/j.ejpb.2016.12.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/21/2016] [Accepted: 12/14/2016] [Indexed: 02/08/2023]
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21
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Østergaard J. UV imaging in pharmaceutical analysis. J Pharm Biomed Anal 2017; 147:140-148. [PMID: 28797957 DOI: 10.1016/j.jpba.2017.07.055] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 12/12/2022]
Abstract
UV imaging provides spatially and temporally resolved absorbance measurements, which are highly useful in pharmaceutical analysis. Commercial UV imaging instrumentation was originally developed as a detector for separation sciences, but the main use is in the area of in vitro dissolution and release testing studies. The review covers the basic principles of the technology and summarizes the main applications in relation to intrinsic dissolution rate determination, excipient compatibility studies and in vitro release characterization of drug substances and vehicles intended for parenteral administration. UV imaging has potential for providing new insights to drug dissolution and release processes in formulation development by real-time monitoring of swelling, precipitation, diffusion and partitioning phenomena. Limitations of current instrumentation are discussed and a perspective to new developments and opportunities given as new instrumentation is emerging.
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Affiliation(s)
- Jesper Østergaard
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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22
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Sun Y, Østergaard J. Application of UV Imaging in Formulation Development. Pharm Res 2016; 34:929-940. [PMID: 27766463 DOI: 10.1007/s11095-016-2047-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/03/2016] [Indexed: 12/18/2022]
Abstract
Efficient drug delivery is dependent on the drug substance dissolving in the body fluids, being released from dosage forms and transported to the site of action. A fundamental understanding of the interplay between the physicochemical properties of the active compound and pharmaceutical excipients defining formulation behavior after exposure to the aqueous environments and pharmaceutical performance is critical in pharmaceutical development, manufacturing and quality control of drugs. UV imaging has been explored as a tool for qualitative and quantitative characterization of drug dissolution and release with the characteristic feature of providing real-time visualization of the solution phase drug transport in the vicinity of the formulation. Events occurring during drug dissolution and release, such as polymer swelling, drug precipitation/recrystallization, or solvent-mediated phase transitions related to the structural properties of the drug substance or formulation can be monitored. UV imaging is a non-intrusive and simple-to-operate analytical technique which holds potential for providing a mechanistic foundation for formulation development. This review aims to cover applications of UV imaging in the early and late phase pharmaceutical development with a special focus on the relation between structural properties and performance. Potential areas of future advancement and application are also discussed.
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Affiliation(s)
- Yu Sun
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Copenhagen Ø, Denmark
| | - Jesper Østergaard
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100, Copenhagen Ø, Denmark.
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23
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Polymeric microcontainers improve oral bioavailability of furosemide. Int J Pharm 2016; 504:98-109. [DOI: 10.1016/j.ijpharm.2016.03.050] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 03/25/2016] [Accepted: 03/26/2016] [Indexed: 12/18/2022]
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24
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Fox CB, Kim J, Le LV, Nemeth CL, Chirra HD, Desai TA. Micro/nanofabricated platforms for oral drug delivery. J Control Release 2015; 219:431-444. [PMID: 26244713 DOI: 10.1016/j.jconrel.2015.07.033] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 12/18/2022]
Abstract
The oral route of drug administration is most preferred due to its ease of use, low cost, and high patient compliance. However, the oral uptake of many small molecule drugs and biotherapeutics is limited by various physiological barriers, and, as a result, drugs suffer from issues with low solubility, low permeability, and degradation following oral administration. The flexibility of micro- and nanofabrication techniques has been used to create drug delivery platforms designed to address these barriers to oral drug uptake. Specifically, micro/nanofabricated devices have been designed with planar, asymmetric geometries to promote device adhesion and unidirectional drug release toward epithelial tissue, thereby prolonging drug exposure and increasing drug permeation. Furthermore, surface functionalization, nanotopography, responsive drug release, motion-based responses, and permeation enhancers have been incorporated into such platforms to further enhance drug uptake. This review will outline the application of micro/nanotechnology to specifically address the physiological barriers to oral drug delivery and highlight technologies that may be incorporated into these oral drug delivery systems to further enhance drug uptake.
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Affiliation(s)
- Cade B Fox
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Jean Kim
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Long V Le
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Cameron L Nemeth
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Hariharasudhan D Chirra
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Tejal A Desai
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA; UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA.
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