PEGylated starch acetate nanoparticles and its potential use for oral insulin delivery

Oral Insulin Delivery: A Review on Recent Advancements and Novel Strategies

BACKGROUND

Due to the lifestyle of people in the community in recent years, the prevalence of diabetes mellitus has increased, so New drugs and related treatments are also being developed.

INTRODUCTION

One of the essential treatments for diabetes today is injectable insulin forms, which have their problems and limitations, such as invasive and less admission of patients and high cost of production. According to the mentioned issues, Theoretically, Oral insulin forms can solve many problems of injectable forms.

METHODS

Many efforts have been made to design and introduce Oral delivery systems of insulin, such as lipid-based, synthetic polymer-based, and polysaccharide-based nano/microparticle formulations. The present study reviewed these novel formulations and strategies in the past five years and checked their properties and results.

RESULTS

According to peer-reviewed research, insulin-transporting particles may preserve insulin in the acidic and enzymatic medium and decrease peptide degradation; in fact, they could deliver appropriate insulin levels to the intestinal environment and then to blood. Some of the studied systems increase the permeability of insulin to the absorption membrane in cellular models. In most investigations, in vivo results revealed a lower ability of formulations to reduce BGL than subcutaneous form, despite promising results in in vitro and stability testing.

CONCLUSION

Although taking insulin orally currently seems unfeasible, future systems may be able to overcome mentioned obstacles, making oral insulin delivery feasible and producing acceptable bioavailability and treatment effects in comparison to injection forms.

Reinvention of starch for oral drug delivery system design

Starch is a polysaccharide with varying amylose-to-amylopectin ratios as a function of its biological sources. It is characterized by low shear stress resistance, poor aqueous/organic solubility and gastrointestinal digestibility which limit its ease of processing and functionality display as an oral drug delivery vehicle. Modulation of starch composition through genetic engineering primarily alters amylose-to-amylopectin ratio. Greater molecular properties changes require chemical and enzymatic modifications of starch. Acetylation reduces water solubility and enzymatic digestibility of starch. Carboxymethylation turns starch acid-insoluble and aggregative at low pHs. The summative effects are sustaining drug release in the upper gut. Acid-insoluble carboxymethylated starch can be aminated to provide an ionic character essential for hydrogel formation which further reduces its drug release. Ionic starch can coacervate with oppositely charged starch, non-starch polyelectrolyte or drug into insoluble, controlled-release complexes. Enzymatically debranched and resistant starch has a small molecular size which confers chain aggregation into a helical hydrogel network that traps the drug molecules, protecting them from biodegradation. The modified starch has been used to modulate the intestinal/colon-specific or controlled systemic delivery of oral small molecule drugs and macromolecular therapeutics. This review highlights synthesis aspects of starch and starch derivatives, and their outcomes and challenges of applications in oral drug delivery.

Starch-based controlled release fertilizers: A review

Starch, as a widely available renewable resource, has the potential to be used in the production of controlled-release fertilizers (CRFs) that support sustainable agriculture. These CRFs can be formed by incorporating nutrients through coating or absorption, or by chemically modifying the starch to enhance its ability to carry and interact with nutrients. This review examines the various methods of creating starch-based CRFs, including coating, chemical modification, and grafting with other polymers. In addition, the mechanisms of controlled release in starch-based CRFs are discussed. Overall, the potential benefits of using starch-based CRFs in terms of resource efficiency and environmental protection are highlighted.

Starches in the encapsulation of plant active ingredients: state of the art and research trends

As a natural polymer, starches and their derivatives have received widespread attention in the cosmetic and pharmaceutical industries, particularly for their use as a coating material. In this sense, as an encapsulating agent, starches stand out, considering the number of compounds that they can trap. Additionally, they provide a nutritional contribution and may improve acceptance by patients. As such, this type of material may serve as an alternative to overcome gaps such as loss of activity of the active principles, low assimilation, or deterioration under environmental and physiological conditions. In this paper, we aim to present the state of the art and research trends on the use of starch as a wall material for the encapsulation of active principles of plant origin. It was found that the most-encapsulated active principles are essential oils and polyphenols; native or modified starches are typically used, either as the sole wall material or in combination with other polymers; and the most widely used methodology is spray drying. The reviewed studies indicate the potential of starches for their use in active ingredient encapsulation processes, improving their viability and expanding their range of applications in different industries, as well as showing a clearly increasing publication trend over the last 10 years.

Graphical abstract

Effects of acid-ethanol hydrolysis and debranch on acetylated starch and its potential used for curcumin carrier

Acetylated acid-ethanol hydrolyzed (AHS) and acetylated debranched starch (ADS) were investigated as prospective nanocarriers. Both acid-ethanol hydrolysis and debranching decreased the molecular weight and viscosity of starch. Acid-ethanol hydrolyzed starch remained the original microstructure, which was confirmed by results of scanning electron microscopy. New absorption peaks in FTIR spectra of starch confirmed the occurrence of acetylation. The substitution degree (DS) of ADS could reach up to 1.18, while that of AHS could be improved by increasing the ethanol concentration. The developed nanoparticles showed uniform spherical structure and the size of that approximated 180-260 nm. The critical micelle concentration was 0.049 mg/mL, and the shift in fluorescence spectra confirmed the interaction between starch and curcumin. These results indicate show that high DS of AHS and ADS could be used as a potential carrier for curcumin delivery.

Novel strategies to oral delivery of insulin: Current progress of nanocarriers for diabetes management

Diabetes mellitus is one of the most serious public health problems in the world. Repeated daily injections of subcutaneous insulin is the standard treatment for patients with type 1 diabetes mellitus; however, subcutaneous insulin injections can potentially cause local discomfort, patient noncompliance, hypoglycemia, failure to regulate glucose homeostasis, infections, and fat deposits at the injection sites. In recent years, numerous attempts have been made to produce safe and efficient nanoparticles for oral insulin delivery. Oral administration is considered the most effective alternative route to insulin injection, but it is accompanied by several challenges related to enzymatic proteolysis, digestive breakdown, and absorption barriers. A number of natural and synthetic polymeric, lipid-based, and inorganic nanoparticles have been investigated for use. Although improvements have recently been made in potential oral insulin delivery systems, these require further investigation before clinical trials are conducted. In this review, new approaches to oral insulin delivery for diabetes treatment are discussed, including polymeric, lipid-based, and inorganic nanoparticles, as well as the clinical trials performed for this purpose.

NANO-BIOTECHNOLOGY AND ITS INNOVATIVE PERSPECTIVE IN DIABETES MANAGEMENT

Diabetes occurs due to the imbalance of glucose in the body known as glucose homeostasis, thus leading to metabolic changes in the body. The two stages hypoglycemia or hyperglycemia classify diabetes into various categories. Various bio-nanotechnological approaches are coupled up with nano particulates, polymers, liposome, various gold plated and solid lipid particulates, regulating transcellular transport, non specific cellular uptake, and paracellular transport, leading to oral, trans-dermal , pulmonary, buccal , nasal , specific gene oriented administration to avoid the patient's non compliance with the parental routes of administration. Phytochemicals are emerging strategies for the future prospects of diabetes management.

Role of lipid nanocarriers for enhancing oral absorption and bioavailability of insulin and GLP-1 receptor agonists

Growing demand for insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RA) is observed, considering the progressive nature of diabetes and the potential therapeutic role of peptides in its treatment. However, chronic parenteral administration is responsible for pain and rashes at the site of injection. Oral delivery of insulin and GLP-1 RA promises better patient compliance owing to their ease of administration and reduction in chances of peripheral hypoglycaemia and weight gain. The review article discusses the potential of lipid carriers in combination with different strategies such as absorption enhancers, PEGylation, lipidisation, etc. The lipid nanocarriers improve the membrane permeability and oral bioavailability of high molecular weight peptides. Additionally, the clinical status of different nanocarriers for anti-diabetic peptides is discussed. Previous research on nanocarriers showed significant hypoglycaemic activity and safety in animal studies; however, extrapolation of the same in human subjects is not validated. With the rising global burden of diabetes, the lipid nanocarriers show the potential to revolutionise treatment with oral delivery of insulin and GLP-1 RA.

Starch modified alginate nanoparticles for drug delivery application

Natural polymers have been widely studied as vehicles that have gained much interest in the encapsulation and delivery of drugs and bioactive molecules. In this study, we developed starch-modified alginate nanoparticles using a green facile technique for drug delivery application. The potential of the prepared nanoparticles for controlled drug delivery applications is demonstrated using theophylline and bovine serum albumin as model drugs. The nanoparticles possessed the encapsulation efficiency of 60 to 75%. The results of in vitro drug release studies showed the pH dependent characteristics of the prepared nanoparticles. In vitro cytotoxicity test revealed the biocompatibility of the developed nanoparticles against L929 fibroblast cell lines. The in vitro cellular uptake of nanoparticles was visualized in L929 fibroblast cells using fluorescent microscopy. The preliminary investigation suggests the developed nanoparticle is a promising candidate for drug delivery application.

The role of polysaccharides from natural resources to design oral insulin micro- and nanoparticles intended for the treatment of Diabetes mellitus: A review

Oral administration of insulin (INS) would represent a revolution in the treatment of diabetes, considering that this route mimics the physiological dynamics of endogenous INS. Nano- and microencapsulation exploiting the advantageous polysaccharides properties has been considered an important technological strategy to protect INS against harsh conditions of gastrointestinal tract, in the same time that improve the permeability via transcellular and/or paracellular pathways, safety and in some cases even selectivity for targeting delivery of INS. In fact, some polysaccharides also give to the systems functional properties such as pH-responsiveness, mucoadhesiveness under specific physiological conditions and increased intestinal permeability. In general, all polysaccharides can be functionalized with specific molecules becoming more selective to the cells to which INS is delivered. The present review highlights the advances in the past 10 years on micro- and nanoencapsulation of INS exploiting the unique natural properties of polysaccharides, including chitosan, starch, alginate, pectin, and dextran, among others.

Advances in research on preparation, characterization, interaction with proteins, digestion and delivery systems of starch-based nanoparticles

Starch-based nanoparticles (SNPs) have attracted great interest for their ability to encapsulate, protect, and orally deliver bioactive components because of their diverse functionality, high biocompatibility, and environmental friendliness. SNPs can be synthesized with a broad range of particle sizes, ranging from a few nanometers to a few hundred nanometers (approximately 8-448 nm), which is comparable to the dimensions of proteins (1-10 nm), nucleic acids (2 nm wide, 5-100 nm long), viruses (10-500 nm), and cell organelles (5-100 mm). The ability to tune the dimensions and properties of SNPs allows them to be used to construct complexes with various biological entities, thereby altering their functional performance. SNPs can also be used to enhance the solubility of hydrophobic substances and to improve the nutritional attributes of bioactives. For instance, SNPs can be designed to increase the bioavailability of bioactives or to target their delivery to specific regions of the gastrointestinal tract. In this review, we provide an overview of the methods available for preparing SNPs, the application of SNPs for encapsulating and delivering bioactives, and the potential gastrointestinal fate of SNPs.

Nitrilotriacetic Acid-Functionalized Glucose-Responsive Complex Micelles for the Efficient Encapsulation and Self-Regulated Release of Insulin

Insulin plays a significant role in diabetes treatment. Although a huge number of insulin-loaded, glucose-responsive nanocarriers have been developed in past decades, most of them showed a lower loading capacity and efficiency due to the weak interaction between insulin and nanocarriers. In this work, a novel insulin-encapsulated glucose-responsive polymeric complex micelle (CM) is devised, showing (i) enhanced insulin-loading efficiency owing to the zinc ions' chelation by nitrilotriacetic acid (NTA) groups of NTA-functioned glycopolymer and the histidine imidazole of insulin, (ii) the glucose-triggered pulse release of insulin, and (iii) long stability under physiological conditions. This CM was fabricated by the self-assembly of block copolymer PEG- b-P(Asp- co-AspPBA) and glycopolymer P(Asp- co-AspGA- co-AspNTA), resulting in complex micelles with a PEG shell and a cross-linked core composed of phenylboronic acid (PBA)/glucose complexations. Notably, the modified nitrilotriacetic acid (NTA) groups of CM could specifically bind insulin via chelated zinc ions, thus enhancing the loading efficacy of insulin compared to that of nonmodified CM. The dynamic PBA/glucose complexation core of CM dissociates under the trigger of high glucose concentration (>2 g/L) while being quite stable in low glucose concentrations (<2 g/L), as demonstrated by the pulse release of insulin in vitro. Finally, in a murine model of type 1 diabetes, NTA-modified complex micelles loading an insulin (NTA-CM-INS) group exhibited a long hypoglycemic effect which is superior to that of free insulin in the PBS (PBS-INS) group and insulin-loaded complex micelles without an NTA modification (CM-INS) group. This long-term effect benefited from Zn(II) chelation by NTA-modified complex micelles and could avoid hypoglycemia caused by the burst release of insulin. Taken together, this constitutes a highly effective way to encapsulate insulin and release insulin via an on-demand manner for blood glucose control in diabetes.

Advance in oral delivery systems for therapeutic protein

Oral delivery is the most common method of drug administration with high safety and good compliance for patients. However, delivering therapeutic proteins to the target site via oral route involves tremendous challenge due to unfavourable conditions like biochemical barrier, mucus barrier and epithelial barriers. According to the functional differences of various protein drug delivery systems, the recent advances in pH responsive polymer-based drug delivery system, mucoadhesive polymer-based drug delivery system, absorption enhancers-based drug delivery system and composite polymer-based delivery system all were briefly summarised in this review, which not only clarified the clinic potential of these novel drug delivery systems, but also described the way for increasing oral bioavailability of therapeutic protein.

Development of resistant corn starch for use as an oral colon-specific nanoparticulate drug carrier

Starch is constituted of amylose and amylopectin. Debranching of amylopectin converts it into amylose thereby producing resistant starch which is known to be less digestible by the amylase. This study designed resistant starch using acid hydrolysis and heat-moisture treatment methods with native corn starch as the starting material. Both native and processed starches were subjected to Fourier transform infrared spectroscopy, X-ray diffractometry, differential scanning calorimetry and molecular weight analysis. They were nanospray-dried into nanoparticles with 5-fluorouracil as the drug of interest for colon cancer treatment. These nanoparticles were subjected to size, zeta potential, morphology, drug content and in vitro drug release analysis. Heat-moisture treatment of native corn starch enabled the formation of resistant starch through amylopectin debranching and molecular weight reduction thereby enhancing hydrogen bonding between the starch molecules at the amorphous phase and gelatinization capacity. The nanoparticles prepared from resistant starch demonstrated similar drug release as those of native starch in spite of the resistant starch had a lower molecular weight. The resistant starch is envisaged to be resistant to the digestive action of amylase in intestinal tract without the formed nanoparticles exhibiting excessively fast drug release in comparison to native starch. With reduced branching, it represents an ideal precursor for targeting ligand conjugation in design of oral colon-specific nanoparticulate drug carrier.

Binary and Tertiary Complex Based on Short-Chain Glucan and Proanthocyanidins for Oral Insulin Delivery

The present study was performed to investigate binary and tertiary nanocomposites between short-chain glucan (SCG) and proanthocyanidins (PAC) for the oral delivery of insulin. There was a large decrease in fluorescence intensity of insulin in the presence of SCG or the combination of SCG with PAC. Fourier transform infrared spectroscopy revealed that the binary and tertiary nanocomposites were synthesized due to the hydrogen bonding and hydrophobic interactions. The insulin entrapped in the nanocomposites was in an amorphous state confirmed by X-ray diffraction. The cell culture demonstrated that both the nanocomposites showed no detectable cytotoxicity with relative cell viability all above 85%. The pharmacological bioavailability after oral administration of insulin-SCG-PAC at a dose of 100 IU/kg was found to be 6.98 ± 1.20% in diabetic rats without any sharp fluctuations in 8 h.

Intestinal micropatches for oral insulin delivery

Diabetes mellitus has become a major public health issue that has almost reached epidemic proportions worldwide. Injectable insulin has been typically utilized for the management of this chronic disease. However, lack of patient compliance with injectable formulations has spurred the development of oral insulin formulations, which although appealing, face several delivery challenges. We have developed novel mucoadhesive intestinal patches, several hundred micrometers in dimension (micropatches) that address the challenges of oral insulin delivery. The micropatches adhere to the intestinal mucosa, release their drug load rapidly within 30 min and are effective in lowering blood glucose levels in vivo. When insulin-loaded micropatches were administered with a permeation enhancer and protease inhibitor, a peak efficacy of 34% drop in blood glucose levels was observed within 3 h. Efficacy further improved to 41% when micropatches were administered in multiple doses. Here, we describe the design of micropatches as an oral insulin formulation and report their in vivo efficacy.

A review of biodegradable polymeric systems for oral insulin delivery

Currently, repeated routine subcutaneous injections of insulin are the standard treatment for insulin-dependent diabetic patients. However, patients' poor compliance for injections often fails to achieve the stable concentration of blood glucose. As a protein drug, the oral bioavailability of insulin is low due to many physiological reasons. Several carriers, such as macromolecules and liposomes have been used to deliver drugs in vivo. In this review article, the gastrointestinal barriers of oral insulin administration are described. Strategies for increasing the bioavailability of oral insulin, such absorption enhancers, enzyme inhibitors, enteric coatings are also introduced. The potential absorption mechanisms of insulin-loaded nanoparticles across the intestinal epithelium, including intestinal lymphatic route, transcellular route and paracellular route are discussed in this review. Natural polymers, such as chitosan and its derivates, alginate derivatives, γ-PGA-based materials and starch-based nanoparticles have been exploited for oral insulin delivery; synthetic polymers, such as PLGA, PLA, PCL and PEA have also been developed for oral administration of insulin. This review focuses on recent advances in using biodegradable natural and synthetic polymers for oral insulin delivery along with their future prospects.

Polysaccharide nanoparticles for protein and Peptide delivery: exploring less-known materials

Finding adequate carriers for protein and peptide delivery has become an urgent need, owing to the growing number of macromolecules identified as having therapeutic potential. Nanoparticles have emerged in the field as very promising vehicles and much work has been directed to testing the capacity of different materials to compose the matrix of these carriers. Natural materials and, specifically, polysaccharides have been taking the forefront of the challenge, because of several favoring properties that include the higher propensity to exhibit biodegradability and biocompatibility, and also the high structural flexibility. The majority of works found in the literature regarding polysaccharide nanoparticles uses very popular materials like chitosan or hyaluronic acid. This review is aimed at describing and exploring the potential of polysaccharides that are not so well known or that are less explored. For those, the main properties will be described, together with an overview of the reported applications as nanoparticle matrix materials.