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Paleel F, Qin M, Tagalakis AD, Yu-Wai-Man C, Lamprou DA. Manufacturing and characterisation of 3D-printed sustained-release Timolol implants for glaucoma treatment. Drug Deliv Transl Res 2024:10.1007/s13346-024-01589-8. [PMID: 38578377 DOI: 10.1007/s13346-024-01589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
Timolol maleate (TML) is a beta-blocker drug that is commonly used to lower the intraocular pressure in glaucoma. This study focused on using a 3D printing (3DP) method for the manufacturing of an ocular, implantable, sustained-release drug delivery system (DDS). Polycaprolactone (PCL), and PCL with 5 or 10% TML implants were manufactured using a one-step 3DP process. Their physicochemical characteristics were analysed using light microscopy, scanning electronic microscopy (SEM), differential scanning calorimetry (DSC) / thermal gravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FTIR). The in vitro drug release was evaluated by UV-spectrophotometry. Finally, the effect of the implants on cell viability in human trabecular meshwork cells was assessed. All the implants showed a smooth surface. Thermal analysis demonstrated that the implants remained thermally stable at the temperatures used for the printing, and FTIR studies showed that there were no significant interactions between PCL and TML. Both concentrations (5 & 10%) of TML achieved sustained release from the implants over the 8-week study period. All implants were non-cytotoxic to human trabecular cells. This study shows proof of concept that 3DP can be used to print biocompatible and personalised ocular implantable sustained-release DDSs for the treatment of glaucoma.
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Affiliation(s)
- Fathima Paleel
- School of Pharmacy, Queen's University Belfast, BT9 7BL, Belfast, UK
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK
| | - Mengqi Qin
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK
| | | | - Cynthia Yu-Wai-Man
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK.
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2
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Appell MB, Pejavar J, Pasupathy A, Rompicharla SVK, Abbasi S, Malmberg K, Kolodziejski P, Ensign LM. Next generation therapeutics for retinal neurodegenerative diseases. J Control Release 2024; 367:708-736. [PMID: 38295996 PMCID: PMC10960710 DOI: 10.1016/j.jconrel.2024.01.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/05/2024] [Accepted: 01/28/2024] [Indexed: 02/13/2024]
Abstract
Neurodegenerative diseases affecting the visual system encompass glaucoma, macular degeneration, retinopathies, and inherited genetic disorders such as retinitis pigmentosa. These ocular pathologies pose a serious burden of visual impairment and blindness worldwide. Current treatment modalities include small molecule drugs, biologics, or gene therapies, most of which are administered topically as eye drops or as injectables. However, the topical route of administration faces challenges in effectively reaching the posterior segment and achieving desired concentrations at the target site, while injections and implants risk severe complications, such as retinal detachment and endophthalmitis. This necessitates the development of innovative therapeutic strategies that can prolong drug release, deliver effective concentrations to the back of the eye with minimal systemic exposure, and improve patient compliance and safety. In this review, we introduce retinal degenerative diseases, followed by a discussion of the existing clinical standard of care. We then delve into detail about drug and gene delivery systems currently in preclinical and clinical development, including formulation and delivery advantages/drawbacks, with a special emphasis on potential for clinical translation.
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Affiliation(s)
- Matthew B Appell
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Jahnavi Pejavar
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Ashwin Pasupathy
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Sri Vishnu Kiran Rompicharla
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Saed Abbasi
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Kiersten Malmberg
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Patricia Kolodziejski
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Laura M Ensign
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21231, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Departments of Gynecology and Obstetrics, Biomedical Engineering, Oncology, and Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
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3
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Meng T, Zheng J, Chen M, Zhao Y, Sudarjat H, M.R. AA, Kulkarni V, Oh Y, Xia S, Ding Z, Han H, Anders N, Rudek MA, Chow W, Stark W, Ensign LM, Hanes J, Xu Q. Six-month effective treatment of corneal graft rejection. SCIENCE ADVANCES 2023; 9:eadf4608. [PMID: 36947612 PMCID: PMC10032610 DOI: 10.1126/sciadv.adf4608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Topical corticosteroid eye drop is the mainstay for preventing and treating corneal graft rejection. While the frequent topical corticosteroid use is associated with risk of intraocular pressure (IOP) elevation and poor patient compliance that leads to graft failure and the requirement for a repeated, high-risk corneal transplantation. Here, we developed dexamethasone sodium phosphate (DSP)-loaded dicarboxyl-terminated poly(lactic acid) nanoparticle (PLA DSP-NP) formulations with relatively high drug loading (8 to 10 weight %) and 6 months of sustained intraocular DSP delivery in rats with a single dosing. PLA DSP-NP successfully reversed early signs of corneal rejection, leading to rat corneal graft survival for at least 6 months. Efficacious PLA DSP-NP doses did not affect IOP and showed no signs of ocular toxicity in rats for up to 6 months. Subconjunctival injection of DSP-NP is a promising approach for safely preventing and treating corneal graft rejection with the potential for improved patient adherence.
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Affiliation(s)
- Tuo Meng
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Jinhua Zheng
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China
| | - Min Chen
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong 266073, China
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Yang Zhao
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hadi Sudarjat
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Aji Alex M.R.
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Vineet Kulkarni
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Yumin Oh
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Shiyu Xia
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Zheng Ding
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Hyounkoo Han
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Nicole Anders
- Department of Medicine, The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Michelle A. Rudek
- Department of Medicine, The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Woon Chow
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Walter Stark
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Laura M. Ensign
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Justin Hanes
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Qingguo Xu
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA
- Center for Pharmaceutical Engineering and Institute for Structural Biology, Drug Discovery and Development (ISB3D), Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA
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4
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The Use of Polymer Blends in the Treatment of Ocular Diseases. Pharmaceutics 2022; 14:pharmaceutics14071431. [PMID: 35890326 PMCID: PMC9322751 DOI: 10.3390/pharmaceutics14071431] [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: 05/17/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 12/10/2022] Open
Abstract
The eye is an organ with limited drug access due to its anatomical and physiological barriers, and the usual forms of ocular administration are limited in terms of drug penetration, residence time, and bioavailability, as well as low patient compliance. Hence, therapeutic innovations in new drug delivery systems (DDS) have been widely explored since they show numerous advantages over conventional methods, besides delivering the content to the eye without interfering with its normal functioning. Polymers are usually used in DDS and many of them are applicable to ophthalmic use, especially biodegradable ones. Even so, it can be a hard task to find a singular polymer with all the desirable properties to deliver the best performance, and combining two or more polymers in a blend has proven to be more convenient, efficient, and cost-effective. This review was carried out to assess the use of polymer blends as DDS. The search conducted in the databases of Pubmed and Scopus for specific terms revealed that although the physical combination of polymers is largely applied, the term polymer blend still has low compliance.
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The Effect of Polymers on Drug Release Kinetics in Nanoemulsion In Situ Gel Formulation. Polymers (Basel) 2022; 14:polym14030427. [PMID: 35160417 PMCID: PMC8839451 DOI: 10.3390/polym14030427] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 02/07/2023] Open
Abstract
Glaucoma is an ocular condition characterized by elevated intraocular pressure (IOP). Conventional treatments of glaucoma face poor corneal permeability and bioavailability. To address these issues, a nanoemulsion in situ gel of Timolol maleate was developed in this study by adding the polymer Carbopol 934p. Using Carbopol 934p, a novel ophthalmic pH-induced nanoemulsion in situ gel was formulated. The formulation was liquid at pH 4 and quickly gelled when the pH was raised to 7.4 (Lacrimal pH). The pH-triggered in situ gelling mechanism demonstrated continuous drug release over a 24 h cycle. A total of nine trial formulations were prepared (NEI1–NEI9) and subjected to various physicochemical and in vitro evaluations. According to the in vitro release kinetics, the drug release of Timolol maleate nanoemulsion in situ gel NEI5 followed zero-order kinetics, with a release exponent value of 0.902, indicating that the mechanism of release was non-Fickian diffusion regulated. In vivo results showed that Timolol maleate nanoemulsion in situ gel NEI5 provided a better-sustained release of the drug, compared with the Timolet OD eye drops. The formulation is stable in storage, with no distinguishable change in appearance, physical properties, quality, and percentage drug release. NEI5 also reduces drug administration frequency, which improves patient compliance. Timolol maleate nanoemulsion in situ gel NEI5 achieved the goal of controlled drug delivery with extended-release and cost-effectiveness, lowering the dosage and frequency of drug administration, and thus may improve patient compliance. In conclusion, the stable nanoemulsion in situ gel of Timolol maleate NEI5 decreases intraocular pressure (IOP) over a prolonged period.
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Adrianto MF, Annuryanti F, Wilson CG, Sheshala R, Thakur RRS. In vitro dissolution testing models of ocular implants for posterior segment drug delivery. Drug Deliv Transl Res 2021; 12:1355-1375. [PMID: 34382178 PMCID: PMC9061687 DOI: 10.1007/s13346-021-01043-z] [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] [Accepted: 08/04/2021] [Indexed: 12/19/2022]
Abstract
The delivery of drugs to the posterior segment of the eye remains a tremendously difficult task. Prolonged treatment in conventional intravitreal therapy requires injections that are administered frequently due to the rapid clearance of the drug molecules. As an alternative, intraocular implants can offer drug release for long-term therapy. However, one of the several challenges in developing intraocular implants is selecting an appropriate in vitro dissolution testing model. In order to determine the efficacy of ocular implants in drug release, multiple in vitro test models were emerging. While these in vitro models may be used to analyse drug release profiles, the findings may not predict in vivo retinal drug exposure as this is influenced by metabolic and physiological factors. This review considers various types of in vitro test methods used to test drug release of ocular implants. Importantly, it discusses the challenges and factors that must be considered in the development and testing of the implants in an in vitro setup.
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Affiliation(s)
- Muhammad Faris Adrianto
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.,Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
| | - Febri Annuryanti
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.,Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
| | - Clive G Wilson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, Scotland
| | - Ravi Sheshala
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam Campus, 42300, Bandar Puncak Alam, Kuala Selangor, Malaysia
| | - Raghu Raj Singh Thakur
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
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Kompella UB, Hartman RR, Patil MA. Extraocular, periocular, and intraocular routes for sustained drug delivery for glaucoma. Prog Retin Eye Res 2021; 82:100901. [PMID: 32891866 PMCID: PMC8317199 DOI: 10.1016/j.preteyeres.2020.100901] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 08/22/2020] [Accepted: 08/30/2020] [Indexed: 02/07/2023]
Abstract
Although once daily anti-glaucoma drug therapy is a current clinical reality, most therapies require multiple dosing and there is an unmet need to develop convenient, safe, and effective sustained release drug delivery systems for long-term treatment to improve patient adherence and outcomes. One of the first sustained release drug delivery systems was approved for the reduction of intraocular pressure in glaucoma patients. It is a polymeric reservoir-type insert delivery system, Ocusert™, placed under the eyelid and on the ocular surface for zero-order drug release over one week. The insert, marketed in two strengths, released pilocarpine on the eye surface. While many clinicians appreciated this drug product, it was eventually discontinued. No similar sustained release non-invasive drug delivery system has made it to the market to date for treating glaucoma. Drug delivery systems under development include punctal plugs, ring-type systems, contact lenses, implants, microspheres, nanospheres, gels, and other depot systems placed in the extraocular, periocular, or intraocular regions including intracameral, supraciliary, and intravitreal spaces. This article discusses the advantages and disadvantages of the various routes of administration and delivery systems for sustained glaucoma therapy. It also provides the reader with some examples and discussion of drug delivery systems that could potentially be applied for glaucoma treatment. Interestingly, one intracamerally injected implant, Durysta™, was approved recently for sustained intraocular pressure reduction. However, long-term acceptance of such devices has yet to be established. The ultimate success of the delivery system will depend on efficacy relative to eye drop dosing, safety, reimbursement options, and patient acceptance. Cautious development efforts are warranted considering prior failed approaches for sustained glaucoma drug delivery. Neuroprotective approaches for glaucoma therapy including cell, gene, protein, and drug-combination therapies, mostly administered intravitreally, are also rapidly progressing towards assessment in humans.
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Affiliation(s)
- Uday B Kompella
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Colorado Center for Nanomedicine and Nanosafety, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Rachel R Hartman
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Madhoosudan A Patil
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Smith SM, Salmon JH, Abbaraju S, Amin R, Gilger BC. Tolerability, pharmacokinetics, and pharmacodynamics of a brinzolamide episcleral sustained release implant in normotensive New Zealand white rabbits. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kesav NP, Young CEC, Ertel MK, Seibold LK, Kahook MY. Sustained-release drug delivery systems for the treatment of glaucoma. Int J Ophthalmol 2021; 14:148-159. [PMID: 33469497 PMCID: PMC7790669 DOI: 10.18240/ijo.2021.01.21] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/17/2020] [Indexed: 12/27/2022] Open
Abstract
Glaucoma, a leading cause of irreversible blindness, affects more than 64 million people worldwide and is expected to grow in number due to the aging global population and enhanced methods of detection. Although topical therapies are often effective when used as prescribed, the drawbacks of current medical management methods include poor patient adherence, local and systemic side effects, and in some cases, limited therapeutic efficacy. Novel ocular drug delivery platforms promise to deliver differentiated drug formulations with targeted delivery leveraging patient-independent administration. Several platforms are in various stages of development with promising pre-clinical and clinical data. The Bimatoprost Sustained Release (SR) intracameral implant was approved in the United States in March of 2020, making it the first long-term injectable therapy available for the treatment of glaucoma. This review aims to provide an update on novel sustained release drug delivery systems that are available today as well as those that might be commercialized in coming years.
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Affiliation(s)
- Natasha P. Kesav
- Department of Ophthalmology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | | | - Monica K. Ertel
- Department of Ophthalmology, University of Colorado School of Medicine, CO 80045, USA
| | - Leonard K. Seibold
- Department of Ophthalmology, University of Colorado School of Medicine, CO 80045, USA
| | - Malik Y. Kahook
- Department of Ophthalmology, University of Colorado School of Medicine, CO 80045, USA
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Suri R, Beg S, Kohli K. Target strategies for drug delivery bypassing ocular barriers. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101389] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Singh RB, Ichhpujani P, Thakur S, Jindal S. Promising therapeutic drug delivery systems for glaucoma: a comprehensive review. Ther Adv Ophthalmol 2020; 12:2515841420905740. [PMID: 32206746 PMCID: PMC7074511 DOI: 10.1177/2515841420905740] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023] Open
Abstract
The delivery of ophthalmic drugs is challenging despite easy accessibility via the ocular surface. Topical instillation of eye drops is a relatively easy and most commonly used as a conduit for drug delivery for treating a myriad of ocular morbidities, particularly involving the anterior segment, and has an additional benefit of avoiding the first-pass metabolism while passing through the systemic circulation. The primary challenges of drug administration through traditional methods include-inadequate patient education for proper drug instillation technique, compliance, adherence, and persistence. Various dynamic (choroidal and conjunctival blood flow, lymphatic clearance, and tear dilution) and static (namely, different layers of cornea, sclera, and retina including blood aqueous and blood-retinal barriers) ocular barriers limit drug delivery to the target ocular tissues. The maintenance of the therapeutic drug levels on the ocular surface for a prolonged duration is an added challenge, thus preventing persistent delivery for longer durations. These factors result in inadequate management, leading to poor prognosis in vision loss in as many as 27% of the patients diagnosed with glaucoma. We have reviewed the research and advancements in the development of novel and well-tolerated drug delivery systems with the common goal of overcoming the factors limiting adequate drug delivery to the target tissues in glaucomatous patients with traditional techniques. In the recent past, multiple research groups have successfully designed noninvasive, sustained drug delivery systems, promoting the efficacy as well as the feasibility of delivering topical drugs to the anterior segment.
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Affiliation(s)
- Rohan B. Singh
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Parul Ichhpujani
- Department of Ophthalmology, Government Medical College & Hospital, Chandigarh, Chandigarh, India
| | - Sahil Thakur
- Department of Ophthalmology, Government Medical College & Hospital, Chandigarh, Chandigarh, India; Singapore Eye Research Institute, Singapore
| | - Sumeet Jindal
- Department of Ophthalmology Virginia Commonwealth University School of Medicine Richmond, VA, USA
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Souto EB, Dias-Ferreira J, López-Machado A, Ettcheto M, Cano A, Camins Espuny A, Espina M, Garcia ML, Sánchez-López E. Advanced Formulation Approaches for Ocular Drug Delivery: State-Of-The-Art and Recent Patents. Pharmaceutics 2019; 11:pharmaceutics11090460. [PMID: 31500106 PMCID: PMC6781321 DOI: 10.3390/pharmaceutics11090460] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 12/17/2022] Open
Abstract
The eye presents extensive perspectives and challenges for drug delivery, mainly because of the extraordinary capacity, intrinsic to this path, for drugs to permeate into the main circulatory system and also for the restrictions of the ocular barriers. Depending on the target segment of the eye, anterior or posterior, the specifications are different. The ocular route experienced in the last decades a lot of progresses related with the development of new drugs, improved formulations, specific-designed delivery and even new routes to administer a drug. Concomitantly, new categories of materials were developed and adapted to encapsulate drugs. With such advances, a multiplicity of parameters became possible to be optimized as the increase in bioavailability and decreased toxic effects of medicines. Also, the formulations were capable to easily adhere to specific tissues, increase the duration of the therapeutic effect and even target the delivery of the treatment. The ascending of new delivery systems for ocular targeting is a current focus, mainly because of the capacity to extend the normal time during which the drug exerts its therapeutic effect and, so, supplying the patients with a product which gives them fewer side effects, fewer number of applications and even more effective outcomes to their pathologies, surpassing the traditionally-used eye drops. Depending on the systems, some are capable of increasing the duration of the drug action as gels, emulsions, prodrugs, liposomes, and ocular inserts with hydrophilic properties, improving the absorption by the cornea. In parallel, other devices use as a strategy the capacity to sustain the release of the carried drugs by means of erodible and non-erodible matrices. This review discusses the different types of advanced formulations used for ocular delivery of therapeutics presenting the most recent patents according to the clinical applications.
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Affiliation(s)
- Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal.
- CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar 4710-057 Braga, Portugal.
| | - João Dias-Ferreira
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
| | - Ana López-Machado
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Miren Ettcheto
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Amanda Cano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain
| | - Antonio Camins Espuny
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Maria Luisa Garcia
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain
| | - Elena Sánchez-López
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal.
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, University of Barcelona, 08028 Barcelona, Spain.
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, 08028 Barcelona, Spain.
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13
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Yang C, Gao L, Liu X, Yang T, Yin G, Chen J, Guo H, Yu B, Cong H. Injectable Schiff base polysaccharide hydrogels for intraocular drug loading and release. J Biomed Mater Res A 2019; 107:1909-1916. [DOI: 10.1002/jbm.a.36677] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/10/2019] [Accepted: 03/15/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Chao Yang
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
- Institute of Complexity Science, Automation CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Lilong Gao
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Xiyan Liu
- Marine Chemical Research Institute Qingdao Shandong, 266071 People's Republic of China
| | - Ting Yang
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Guangming Yin
- Material Science and Engineering CollegeBeijing University of Chemical Technology Beijing, 100029 People's Republic of China
| | - Jianyu Chen
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Haiyong Guo
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Bing Yu
- Chemistry and Chemical Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Hailin Cong
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
- Chemistry and Chemical Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
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14
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Nguyen H, Eng S, Ngo T, Dass CR. Delivery of therapeutics for deep-seated ocular conditions - status quo. ACTA ACUST UNITED AC 2018; 70:994-1001. [PMID: 29675844 DOI: 10.1111/jphp.12924] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/24/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES There is a need for research into designing effective pharmaceutical systems for delivering therapeutic drugs to the posterior of the eye for glaucoma-related pathology, macular degeneration, diabetic retinopathy, macular oedema, retinitis and choroiditis. Conventionally, eye drops have been extensively utilised for topical drug delivery to the anterior segment of the eye, but are less effective for delivery of therapeutics to the back of the eye due to significant barriers hampering drug penetration into the target intraocular tissue. This review explores some of the current and novel delivery systems employed to deliver therapeutics to the back of the eye such as those using liposomes, ocular implants, in situ gels, and nanoparticles, and how they can overcome some of these limitations. KEY FINDINGS Issues such as blinking, precorneal fluid drainage, tear dilution and turnover, conjunctiva and nasal drug absorption, the corneal epithelium, vitreous drug clearance, and the blood-ocular barriers are reviewed and discussed. SUMMARY Further studies are needed to address their shortcomings such as drug compatibility and stability, economic viability and patient compliance.
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Affiliation(s)
- Hubert Nguyen
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Shawn Eng
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Thanh Ngo
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Crispin R Dass
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia.,Curtin Health Innovation Research Institute, Bentley, WA, Australia
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15
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Pitha I, Kimball EC, Oglesby EN, Pease ME, Fu J, Schaub J, Kim YC, Hu Q, Hanes J, Quigley HA. Sustained Dorzolamide Release Prevents Axonal and Retinal Ganglion Cell Loss in a Rat Model of IOP-Glaucoma. Transl Vis Sci Technol 2018; 7:13. [PMID: 29616152 PMCID: PMC5879766 DOI: 10.1167/tvst.7.2.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/21/2017] [Indexed: 01/13/2023] Open
Abstract
Purpose To determine if one injection of a sustained release formulation of dorzolamide in biodegradable microparticles (DPP) reduces retinal ganglion cell (RGC) loss in a rat model of glaucoma. Methods We injected either DPP or control microparticles intravitreally in rats. Two days later, unilateral ocular hypertension was induced by translimbal, diode laser treatment by a surgeon masked to treatment group. IOP and clinical exams were performed until sacrifice 6 weeks after laser treatment. RGC loss was measured by masked observers in both optic nerve cross-sections and RGC layer counts from retinal whole mounts. Results Cumulative IOP exposure was significantly reduced by DPP injection (49 ± 48 mm Hg × days in treated versus 227 ± 191 mm Hg × days in control microparticle eyes; P = 0.012, t-test). While control-injected eyes increased in axial length by 2.4 ± 1.7%, DPP eyes did not significantly enlarge (0.3 ± 2.2%, difference from control, P = 0.03, t-test). RGC loss was significantly less in DPP eyes compared with control microparticle injection alone (RGC axon count reduction: 21% vs. 52%; RGC body reduction: 25% vs. 50% [beta tubulin labeling]; P = 0.02, t-test). Conclusions A single injection of sustained release DPP protected against RGC loss and axial elongation in a rat model of IOP glaucoma. Translational Relevance Sustained release IOP-lowering medications have the potential to stop glaucoma progression.
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Affiliation(s)
- Ian Pitha
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth C Kimball
- Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ericka N Oglesby
- Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary Ellen Pease
- Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jie Fu
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julie Schaub
- Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yoo-Chun Kim
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Qi Hu
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Justin Hanes
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harry A Quigley
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Nanomedicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Li K, Zhong X, Yang S, Luo Z, Li K, Liu Y, Cai S, Gu H, Lu S, Zhang H, Wei Y, Zhuang J, Zhuo Y, Fan Z, Ge J. HiPSC-derived retinal ganglion cells grow dendritic arbors and functional axons on a tissue-engineered scaffold. Acta Biomater 2017; 54:117-127. [PMID: 28216299 DOI: 10.1016/j.actbio.2017.02.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/08/2017] [Accepted: 02/15/2017] [Indexed: 12/21/2022]
Abstract
Numerous therapeutic procedures in modern medical research rely on the use of tissue engineering for the treatment of retinal diseases. However, the cell source and the transplantation method are still a limitation. Previously, it was reported that a self-organizing three-dimensional neural retina can be induced from human-induced pluripotent stem cells (hiPSCs). In this study, we disclose the generation of retinal ganglion cells (RGCs) from the neural retina and their seeding on a biodegradable poly (lactic-co-glycolic acid) (PLGA) scaffold to create an engineered RGC-scaffold biomaterial. Moreover, we explored the dendritic arbor, branching point, functional axon and action potential of the biomaterial. Finally, the cell-scaffold was transplanted into the intraocular environment of rabbits and rhesus monkeys. STATEMENT OF SIGNIFICANCE As a part of the mammalian central nervous system (CNS), the retinal ganglion cell (RGC) shows little regenerative capacity. With the use of medical biomaterial for cells seeding and deliver, a new domain is now emerging that uses tissue engineering therapy for retinal disease. However, previous studies utilized RGCs from rodent model, which has limitations for human disease treatment. In the present study, we generated RGCs from hiPSCs-3D neural retina and then seeded these RGCs on PLGA scaffold to create an engineered RGC-scaffold biomaterial. Moreover, we assessed the transplantation method for biomaterial in vivo. Our study provides a technique to produce the engineered human RGC-scaffold biomaterial.
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Affiliation(s)
- Kangjun Li
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Xiufeng Zhong
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Sijing Yang
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Ziming Luo
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Kang Li
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Ying Liu
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Song Cai
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Yet-Sen University, Guangzhou, Guangdong, China
| | - Huaiyu Gu
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Yet-Sen University, Guangzhou, Guangdong, China
| | - Shoutao Lu
- Bai Duoan Medical Equipment Company, Qihe, Shandong, China
| | - Haijun Zhang
- Bai Duoan Medical Equipment Company, Qihe, Shandong, China
| | - Yantao Wei
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Zhigang Fan
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China
| | - Jian Ge
- State Key Laboratory of Ophthalmology, Key Lab of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yet-Sen University, Guangzhou, Guangdong, China.
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17
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Joseph RR, Venkatraman SS. Drug delivery to the eye: what benefits do nanocarriers offer? Nanomedicine (Lond) 2017; 12:683-702. [PMID: 28186436 DOI: 10.2217/nnm-2016-0379] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Ocular drug delivery has seen several advances in the past few decades, with respect to new drugs, improved formulations, targeted delivery, as well as exploration of new routes of drug administration. New materials have been explored for encasing existing drugs, which can enhance treatment by increasing bioavailability, decreasing toxicity, providing better tissue adherence, targeted delivery as well as increased duration of action. The challenges and requirements are different for the anterior and posterior ocular segments. This review summarizes the recent advances in sustained ocular therapy, both to the anterior and posterior segments, which have been made possible, thanks to nanotechnology. We also discuss the distribution and fate of these nanocarriers themselves, postadministration, as well as clearance from ocular tissues.
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Affiliation(s)
- Rini Rachel Joseph
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Subbu S Venkatraman
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.,NTU-Northwestern Institute for Nanomedicine, School of Materials Science & Engineering (MSE), Nanyang Technological University, Singapore 639798, Singapore
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18
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Szigiato AA, Podbielski DW, Ahmed IIK. Sustained drug delivery for the management of glaucoma. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1280393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Dominik W. Podbielski
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Iqbal Ike K. Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
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19
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Lavik E, Kuehn MH, Shoffstall AJ, Atkins K, Dumitrescu AV, Kwon YH. Sustained Delivery of Timolol Maleate for Over 90 Days by Subconjunctival Injection. J Ocul Pharmacol Ther 2016; 32:642-649. [PMID: 27835065 PMCID: PMC5165680 DOI: 10.1089/jop.2016.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/03/2016] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Medical treatment of glaucoma relies on intraocular pressure (IOP)-lowering medications, typically administered daily by the patient. While these medications are effective when applied correctly, patient adherence is a major obstacle in glaucoma treatment. We have developed a sustained-release formulation of timolol maleate that can be injected subconjunctivally to avoid patient noncompliance. METHODS A biodegradable microsphere formulation for timolol maleate was injected subconjunctivally in normal rabbits. We measured timolol levels in tears, aqueous humor, vitreous humor, and serum of study rabbits. Furthermore, IOP profiles were recorded longitudinally. Tissue compatibility and side effects were evaluated using histochemistry. RESULTS The microsphere formulation led to measureable amounts of timolol in the aqueous humor and the tear film for up to 90 days. Timolol was not detectable in the serum at any time. A significant reduction of IOP was observed in treated eyes. Clinically, the subconjunctival administration of the microspheres was well tolerated with no signs of inflammation or infection. The absence of local inflammation was confirmed by histology. CONCLUSIONS A single subconjunctival administration of timolol microspheres achieved delivery and IOP reduction in rabbits for up to 90 days without local or systemic inflammation or toxicity. This approach has the potential to improve the management of glaucoma in patient populations, who are challenged to adhere to a regimen of daily eye drops.
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Affiliation(s)
- Erin Lavik
- Department of Chemical, Biochemical, and Environmental Engineering, University of Maryland-Baltimore County, Baltimore, Maryland
| | - Markus H. Kuehn
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
- Iowa City Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa
| | - Andrew J. Shoffstall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Kristyn Atkins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Alina V. Dumitrescu
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
| | - Young H. Kwon
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
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20
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Prasanna G, Li B, Mogi M, Rice DS. Pharmacology of novel intraocular pressure-lowering targets that enhance conventional outflow facility: Pitfalls, promises and what lies ahead? Eur J Pharmacol 2016; 787:47-56. [DOI: 10.1016/j.ejphar.2016.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/15/2016] [Accepted: 03/01/2016] [Indexed: 12/18/2022]
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21
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Fu J, Sun F, Liu W, Liu Y, Gedam M, Hu Q, Fridley C, Quigley HA, Hanes J, Pitha I. Subconjunctival Delivery of Dorzolamide-Loaded Poly(ether-anhydride) Microparticles Produces Sustained Lowering of Intraocular Pressure in Rabbits. Mol Pharm 2016; 13:2987-95. [PMID: 27336794 DOI: 10.1021/acs.molpharmaceut.6b00343] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Topical medications that inhibit the enzyme carbonic anhydrase (CAI) are widely used to lower intraocular pressure in glaucoma; however, their clinical efficacy is limited by the requirement for multiple-daily dosing, as well as side effects such as blurred vision and discomfort on drop instillation. We developed a biodegradable polymer microparticle formulation of the CAI dorzolamide that produces sustained lowering of intraocular pressure after subconjunctival injection. Dorzolamide was ion paired with sodium dodecyl sulfate (SDS) and sodium oleate (SO) with 0.8% and 1.5% drug loading in poly(lactic-co-glycolic acid) (PLGA), respectively. Encapsulating dorzolamide into poly(ethylene glycol)-co-poly(sebacic acid) (PEG3-PSA) microparticles in the presence of triethylamine (TEA) resulted in 14.9% drug loading and drug release that occurred over 12 days in vitro. Subconjunctival injection of dorzolamide-PEG3-PSA microparticles (DPP) in Dutch belted rabbits reduced IOP as much as 4.0 ± 1.5 mmHg compared to untreated fellow eyes for 35 days. IOP reduction after injection of DPP microparticles was significant when compared to baseline untreated IOPs (P < 0.001); however, injection of blank microparticles (PEG3-PSA) did not affect IOP (P = 0.9). Microparticle injection was associated with transient clinical vascularity and inflammatory cell infiltration in conjunctiva on histological examination. Fluorescently labeled PEG3-PSA microparticles were detected for at least 42 days after injection, indicating that in vivo particle degradation is several-fold longer than in vitro degradation. Subconjunctival DPP microparticle delivery is a promising new platform for sustained intraocular pressure lowering in glaucoma.
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Affiliation(s)
- Jie Fu
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Fengying Sun
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Wenhua Liu
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Yanfei Liu
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Manasee Gedam
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Qi Hu
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Colleen Fridley
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Harry A Quigley
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Justin Hanes
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
| | - Ian Pitha
- Department of Ophthalmology, ‡Center for Nanomedicine, and ∥Glaucoma Center of Excellence, The Johns Hopkins University School of Medicine , Baltimore, Maryland 21287, United States
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22
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Sah AK, Suresh PK. Medical management of glaucoma: focus on ophthalmologic drug delivery systems of timolol maleate. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2016; 45:448-459. [DOI: 10.3109/21691401.2016.1160917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Abhishek K. Sah
- Faculty of Technology, University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattishgarh, India
| | - Preeti K. Suresh
- Faculty of Technology, University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattishgarh, India
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