Materials and structure of polysaccharide-based delivery carriers for oral insulin: A review

Chitosan/Sodium Tripolyphosphate Microemulsion Enhanced Oral Insulin Delivery via Intestinal Lymphoid

Oral insulin delivery systems are currently being explored as the best alternative to subcutaneous injections, aiming to overcome gastrointestinal barriers and achieve efficient oral insulin delivery. This study presents a microemulsion delivery system that utilizes chitosan/sodium tripolyphosphate (CS/STPP) to enhance the stability of kernel-loaded insulin and increase bioavailability via intestinal absorption and lymphatic transport. The insulin/chitosan/sodium tripolyphosphate-microemulsion (Ins/CS/STPP-ME) is a particle size of (81.03 ± 7.19) nm and a polydispersity index (PDI) of (0.313 ± 0.013). Infrared spectroscopy confirms insulin encapsulation. Ins/CS/STPP-ME exhibits favorable stability and releasesproperties in gastrointestinal fluids, retaining a maximum of (53.076 ± 12.587)% insulin in a pepsin environment and (62.982 ± 13.105)% in a trypsin environment after 60 min. In vivo studies have demonstrated that the addition of CS/STPP to the internal phase of Ins/CS/STPP-ME results in a rapid onset of action and sustained hypoglycaemic effect in diabetic rats. Lymphatic blockade by cycloheximide verified Ins/CS/STPP-ME and its ability to cross the gut and enter the bloodstream via lymphatic transport. This work demonstrates that Ins/CS/STPP-ME can stabilize proteins in the gastrointestinal environment, facilitate lymphatic absorption, enhance bioavailability, and provide longer-lasting hypoglycemic effects, thus providing the possibility for oral biomacromolecule delivery.

Fabrication of starch-based nanoparticles to enhance the stability and in vivo release of insulin

Oral delivery of insulin could provide a great convenience for the type-1 diabetics and type-2 diabetics when compared to subcutaneous injections. This study aimed to prepare nanoparticle based on starch and explore their potential use in oral delivery of insulin. Nanoparticles with a spherical micromorphology and particle size between 200 and 300 nm were formed based on the electrostatic interactions. The particle size and encapsulation ability could be adjusted by altering the pH. Compared to carboxymethyl starch (CMS) with a substitution degree (DS) of 0.1 (NP1), the nanoparticle (NP2) formed by CMS with high DS 0.2 showed higher stability in a range of pH and better release properties. The results hemolytic activity below 5 % and cell viability above 75 % indicated that the starch-based nanoparticles exhibited good biocompatibility. The cell uptake amount of NP1 and NP2 were approximately 4.78 and 4.35-fold that of the free insulin, respectively. Moreover, NP1 and NP2 exhibited better hypoglycemic response in diabetic mice after oral administration. The nanoparticles prepared using the organic solvent free method and their potential insulin-loading capacity indicated that they may be a potential carrier for oral delivery of insulin.

Advances in Oral Biomacromolecule Therapies for Metabolic Diseases

Metabolic diseases like obesity and diabetes are on the rise, and therapies with biomacromolecules (such as proteins, peptides, antibodies, and oligonucleotides) play a crucial role in their treatment. However, these drugs are traditionally injected. For patients with chronic diseases (e.g., metabolic diseases), long-term injections are accompanied by inconvenience and low compliance. Oral administration is preferred, but the delivery of biomacromolecules is challenging due to gastrointestinal barriers. In this article, we introduce the available biomacromolecule drugs for the treatment of metabolic diseases. The gastrointestinal barriers to oral drug delivery and strategies to overcome these barriers are also explored. We then discuss strategies for alleviating metabolic defects, including glucose metabolism, lipid metabolism, and energy metabolism, with oral biomacromolecules such as insulin, glucagon-like peptide-1 receptor agonists, proprotein convertase subtilisin/kexin type 9 inhibitors, fibroblast growth factor 21 analogues, and peptide YY analogues.

An environment-responsive platform based on acid-resistant metal organic framework for efficient oral insulin delivery

Oral insulin delivery is considered a revolutionary alternative to daily subcutaneous injections in terms of compliance and convenience. However, significant challenges remain in terms of inactivation in gastrointestinal environment and limited permeation across the intestinal epithelium. Herein, we used acid-resistant metal-organic framework (PCN-222) to load insulin and modified the exterior with sodium dodecyl sulfate (SDS) to achieve efficient oral insulin delivery. The PCN-222 nanocarrier with ordered mesoporous cage structure and suitable pore size achieved a high insulin loading of 75 %. The SDS on the surface of nanocarrier reduces its hydrophilicity while reversibly altering cell morphology and increasing epithelial cell permeability, thereby promoting intestinal epithelial absorption. The constructed particle (I@P@S) was encapsulated in sodium alginate (SA) microspheres to protect it from gastric acid degradation and releases it upon entry into the intestinal tract. Through an uptake pathway dominated by clathrin-mediated endocytosis, the released I@P@S realized efficient intestinal permeability and controlled insulin release under physiological conditions due to the phosphate sensitivity of PCN-222, leading to an in vivo bioavailability of 12.9 %. This work provides a valuable reference for the design of oral insulin delivery systems.

A pH-responsive microneedle patch for the transdermal delivery of biomineralized insulin nanoparticles to diabetes treatment

Diabetes mellitus is a chronic metabolic disease, and insulin injection administration remains the most commonly used treatment approach in clinical practice. However, this method faces the risks of insufficient specificity and high toxic side effects on normal tissues. Therefore, developing more effective drug administration methods is crucial for improving the safety and bioavailability of insulin. In this study, a swellable composite microneedle delivery system loaded with biomineralized insulin nanoparticles was constructed for effective diabetes treatment via percutaneous administration. The microneedle arrays were prepared by using N-2-hydroxypropyl trimethyl ammonium chloride chitosan (N-2-HACC) and hyaluronic acid (HA) with the assistance of β-Glycerophosphate Tetrahydrate (β-GP). Glucose oxidase (GOx) and calcium phosphate-biomineralized insulin nanoparticles (BINPs) were co-encapsulated in the microneedle arrays. After insertion into the skin, the interstitial fluid and high glucose concentration facilitated the sustained transdermal delivery of BINPs from the tips of the microneedle patches and the glucose-responsive release of insulin. The constructed composite microneedle patches demonstrated desirable therapeutic effects for diabetes with high biosafety, biodegradation and long-lasting effects. This study proposes a new strategy for developing intelligent drug delivery systems based on polymeric microneedle patches, and it is expected to be used in the broader biomedical field with potential applications.

pH and glucose dual-responsive phenylboronic acid hydrogels for smart insulin delivery

Phenylboronic acid (PBA) is a widely exploited glucose-sensitive element for constructing glucose-responsive hydrogels to enable smart insulin delivery. However, its relatively high intrinsic pKa affects its binding with glucose under physiological conditions and thus limits its application. Herein, we developed a series of boronate-containing PLP-PBA polymers by conjugating glucose-sensitive 3-aminophenylboronic acid (3-PBA) onto the backbone of a metabolite-derived, pH-responsive poly-L-lysine isophthalamide (PLP) polymer with a pKa value of 4.4 at various substitution degrees. Dual-responsive LME-(PLP-PBA) hydrogels were further synthesized by crosslinking the PLP-PBA polymers with L-lysine methyl ester (LME). The rheological properties and swelling ratio of the hydrogel could be manipulated by the PBA grafting degree and crosslinking ratio. With the increase of pH and glucose concentration, the pore size of the hydrogel enhanced, thus promoting the release of loaded insulin. Under physiological conditions, the hydrogel with optimal formulation could establish acute pH-responsive and glucose-responsive insulin release. The development of this dual-responsive hydrogel suggests a strategy to overcome the high pKa problem associated with PBA and provide a promising delivery system for smart insulin delivery.

Amphotericin B Ocular Films for Fungal Keratitis and a Novel 3D-Printed Microfluidic Ocular Lens Infection Model

Fungal keratitis (FK), a severe eye infection that leads to vision impairment and blindness, poses a high risk to contact lens users, and Candida albicans remains the most common underpinning fungal pathogen in temperate climates. Patients are initially treated empirically (econazole 1% drops hourly for 24-48 h), and if there is no response, amphotericin B (AmB) 0.15% eye drops (extemporaneously manufactured to be stable for a week) are the gold-standard treatment. Here, we aim to develop a sustained-release AmB ocular film to treat FK with an enhanced corneal retention time. As there is a paucity of reliable in vitro models to evaluate ocular drug release and antifungal efficacy under flow, we developed a 3D-printed microfluidic device based on four chambers stacked in parallel, in which lenses previously inoculated with a C. albicans suspension were placed. Under the flow of a physiological fluid over 24 h, the release from the AmB-loaded film that was placed dry onto the surface of the wetted contact lenses was quantified, and their antifungal activity was assessed. AmB sodium deoxycholate micelle (dimeric form) was mixed with sodium alginate and hyaluronic acid (3:1 w/w) and cast into films (0.48 or 2.4%), which showed sustained release over 24 h and resulted in a 1.23-fold reduction and a 5.7-fold reduction in CFU/mL of C. albicans, respectively. This study demonstrates that the sustained delivery of dimeric AmB can be used for the treatment of FK and provides a facile in vitro microfluidic model for the development and testing of ophthalmic antimicrobial therapies.

The carrier function and inhibition effect on benign prostatic hyperplasia of a glucan from Epimedium brevicornu Maxim

Epimedium, a traditional Chinese medicine commonly used as a dietary supplement, contains polysaccharides and flavonoids as its main bioactive ingredients. In this study, a neutral homogeneous polysaccharide (EPSN-1) was isolated from Epimedium brevicornu Maxim. EPSN-1 was identified as a glucan with a backbone of →4)-α-D-Glcp-(1→, branched units comprised α-D-Glcp-(1→6)-α-D-Glcp-(1→, β-D-Glcp-(1→6)-β-D-Glcp-(1→ and α-D-Glcp-(1→ connected to the C6 position of backbone. The conformation of EPSN-1 in aqueous solution indicated its potential to form nanoparticles. This paper aims to investigate the carrier and pharmacodynamic activity of EPSN-1. The findings demonstrated that, on the one hand, EPSN-1, as a functional ingredient, may load Icariin (ICA) through non-covalent interactions, improving its biopharmaceutical properties such as solubility and stability, thereby improving its intestinal absorption. Additionally, as an effective ingredient, EPSN-1 could help maintain the balance of the intestinal environment by increasing the abundance of Parabacteroides, Lachnospiraceae UGG-001, Anaeroplasma, and Eubacterium xylanophilum group, while decreasing the abundance of Allobaculum, Blautia, and Adlercreutzia. Overall, this dual action of EPSN-1 sheds light on the potential applications of natural polysaccharides, highlighting their dual role as carriers and contributors to biological activity.

Nanomedicine in the Treatment of Diabetes

Nanomedicine could improve the treatment of diabetes by exploiting various therapeutic mechanisms through the use of suitable nanoformulations. For example, glucose-sensitive nanoparticles can release insulin in response to high glucose levels, mimicking the physiological release of insulin. Oral nanoformulations for insulin uptake via the gut represent a long-sought alternative to subcutaneous injections, which cause pain, discomfort, and possible local infection. Nanoparticles containing oligonucleotides can be used in gene therapy and cell therapy to stimulate insulin production in β-cells or β-like cells and modulate the responses of T1DM-associated immune cells. In contrast, viral vectors do not induce immunogenicity. Finally, in diabetic wound healing, local delivery of nanoformulations containing regenerative molecules can stimulate tissue repair and thus provide a valuable tool to treat this diabetic complication. Here, we describe these different approaches to diabetes treatment with nanoformulations and their potential for clinical application.

Formulation and Evaluation of Insulin-Loaded Sodium-Alginate Microparticles for Oral Administration

The development of oral insulin drug delivery systems is still an ongoing challenge for pharmaceutical technology researchers, as the formulation process has to overcome a number of obstacles due to the adverse characteristics of peptides. The aim of this study was to formulate different sodium-alginate microparticles as a possible method for oral insulin administration. In our previous studies, the method has been successfully optimized using a small model peptide. The incorporation of insulin into alginate carriers containing nonionic surfactants has not been described yet. In order to enhance the absorption of insulin through biological barriers, Labrasol ALF and Labrafil M 2125 CS were selected as permeation-enhancing excipients. They were applied at a concentration of 0.10% (v/v%), along with various combinations of the two, to increase oral bioavailability. Encapsulation efficiency showed sufficient drug incorporation, as it resulted in over 80% in each composition. In vitro dissolution and enzymatic stability test results proved that, as a pH-responsive polymer, alginate bead swelling and drug release occur at higher pH, thus protecting insulin against the harsh environment of the gastrointestinal tract. The remaining insulin content was 66% due to SIF degradation after 120 min. Permeability experiments revealed the impact of permeation enhancers and natural polymers on drug absorption, as they enhanced drug transport significantly through Caco-2 cells in the case of alginate microparticle formulations, as opposed to the control insulin solution. These results suggest that these formulations are able to improve the oral bioavailability of insulin.