Erythritol-based dry powder of glucagon for pulmonary administration

Dry Powder for Pulmonary Delivery: A Comprehensive Review

The pulmonary route has long been used for drug administration for both local and systemic treatment. It possesses several advantages, which can be categorized into physiological, i.e., large surface area, thin epithelial membrane, highly vascularized, limited enzymatic activity, and patient convenience, i.e., non-invasive, self-administration over oral and systemic routes of drug administration. However, the formulation of dry powder for pulmonary delivery is often challenging due to restrictions on aerodynamic size and the lung’s lower tolerance capacity in comparison with an oral route of drug administration. Various physicochemical properties of dry powder play a major role in the aerosolization, deposition, and clearance along the respiratory tract. To prepare suitable particles with optimal physicochemical properties for inhalation, various manufacturing methods have been established. The most frequently used industrial methods are milling and spray-drying, while several other alternative methods such as spray-freeze-drying, supercritical fluid, non-wetting templates, inkjet-printing, thin-film freezing, and hot-melt extrusion methods are also utilized. The aim of this review is to provide an overview of the respiratory tract structure, particle deposition patterns, and possible drug-clearance mechanisms from the lungs. This review also includes the physicochemical properties of dry powder, various techniques used for the preparation of dry powders, and factors affecting the clinical efficacy, as well as various challenges that need to be addressed in the future.

Excipient Interactions in Glucagon Dry Powder Inhaler Formulation for Pulmonary Delivery

PURPOSE

This study describes the development and characterization of glucagon dry powder inhaler (DPI) formulation for pulmonary delivery. Lactose monohydrate, as a carrier, and L-leucine and magnesium stearate (MgSt) were used as dispersibility enhancers for this formulation.

METHODS

Using Fourier-transform infrared (FTIR) spectroscopy, Differential Scanning Calorimetry (DSC), and Raman confocal microscopy, the interactions between glucagon and all excipients were characterized. The fine particle fractions (FPFs) of glucagon in different formulations were determined by a twin stage impinger (TSI) using a 2.5% glucagon mixture, and the glucagon concentration was measured by a validated LC-MS/MS method.

RESULTS

The FPF of the glucagon was 6.4%, which increased six-fold from the formulations with excipients. The highest FPF (36%) was observed for the formulation containing MgSt and large carrier lactose. The FTIR, Raman, and DSC data showed remarkable physical interactions of glucagon with leucine and a minor interaction with lactose; however, there were no interactions with MgSt alone or mixed with lactose.

CONCLUSION

Due to the interaction between L-leucine and glucagon, leucine was not a suitable excipient for glucagon formulation. In contrast, the use of lactose and MgSt could be considered to prepare an efficient DPI formulation for the pulmonary delivery of glucagon.

Respirable powder formulation of a shortened vasoactive intestinal peptide analog for treatment of airway inflammatory diseases

The aim of present study was to develop a respirable powder (RP) of a shortened vasoactive intestinal peptide (VIP) analog for inhalation. VIP and C-terminally truncated VIP analogs were synthesized with a solid-phase method. A structure-activity relationship (SAR) study was carried out in terms with binding and relaxant activities of the peptides. Prepared RP formulation of a shortened VIP analog was physicochemically characterized by morphological, in vitro aerodynamic, and pharmacological assessments. The SAR study demonstrated that the N-terminal 23 amino acid residues were required for biological activity of VIP. Upon chemical modification of VIP(1-23), [R^{15, 20, 21} , L¹⁷ ]-VIP(1-23) was newly developed, which had higher binding activity in rat lung and smooth muscle relaxant effect in mouse stomach than VIP(1-23). The [R^{15, 20, 21} , L¹⁷ ]-VIP(1-23)-based RP, [R^{15, 20, 21} , L¹⁷ ]-VIP(1-23)/RP, exhibited fine in vitro inhalation performance. Airway inflammation evoked by sensitization of antigen in rats was attenuated by pre-treatment with the [R^{15, 20, 21} , L¹⁷ ]-VIP(1-23)/RP at a dose of 50 μg-[R^{15, 20, 21} , L¹⁷ ]-VIP(1-23)/rat as evidenced by a 70% reduction of recruited inflammatory cells in bronchoalveolar lavage fluid. On the basis of these results, [R^{15, 20, 21} , L¹⁷ ]-VIP(1-23)/RP might be a promising agent for treatment of airway inflammatory diseases.

Imagine the Superiority of Dry Powder Inhalers from Carrier Engineering

Inhalation therapy has strong history of more than 4000 years and it is well recognized around the globe within every culture. In early days, inhalation therapy was designed for treatment of local disorders such as asthma and other pulmonary diseases. Almost all inhalation products composed a simple formulation of a carrier, usually α-lactose monohydrate orderly mixed with micronized therapeutic agent. Most of these formulations lacked satisfactory pulmonary deposition and dispersion. Thus, various alternative carrier's molecules and powder processing techniques are increasingly investigated to achieve suitable aerodynamic performance. In view of this fact, more suitable and economic alternative carrier's molecules with advanced formulation strategies are discussed in the present review. Furthermore, major advances, challenges, and the future perspective are discussed.

Dry Powder Inhalers: A Focus on Advancements in Novel Drug Delivery Systems

Administration of drug molecules by inhalation route for treatment of respiratory diseases has the ability to deliver drugs, hormones, nucleic acids, steroids, proteins, and peptides, particularly to the site of action, improving the efficacy of the treatment and consequently lessening adverse effects of the treatment. Numerous inhalation delivery systems have been developed and studied to treat respiratory diseases such as asthma, COPD, and other pulmonary infections. The progress of disciplines such as biomaterials science, nanotechnology, particle engineering, molecular biology, and cell biology permits further improvement of the treatment capability. The present review analyzes modern therapeutic approaches of inhaled drugs with special emphasis on novel drug delivery system for treatment of various respiratory diseases.

Alternative carriers in dry powder inhaler formulations

The aerosolization efficiency of a powder is highly dependent on carrier characteristics, such as particle size distribution, shape and surface properties. The main objective in the inhalation field is to achieve a high and reproducible pulmonary deposition. This can be provided by successful carrier selection and careful process optimization for carrier modification. Lactose is the most common and frequently used carrier in dry powder inhaler (DPI) formulations. But lactose shows some limitations in formulation with certain drugs and peptides that prohibit its usage as a carrier in DPI formulations. Here, we criticality review the most important alternative carriers to lactose with merits, demerits and applications in DPI formulations.

Engineered mannitol ternary additives improve dispersion of lactose-salbutamol sulphate dry powder inhalations

The aim of this study was to evaluate the influence of novel engineered fine mannitol particles (4.7%, w/w) on the performance of lactose-salbutamol sulphate dry powder inhaler (DPI) formulations to obtain promising aerosolisation properties. The results showed that the more elongated the fine mannitol particles, the weaker the drug-carrier adhesion, the better the drug content homogeneity, the higher the amount of drug expected to be delivered to the lower airways and the higher the total DPI formulation desirability. Linear relationships were established showing that mannitol particles with a more elongated shape generated powders with broader size distributions and that were less uniform in shape. The weaker the drug-carrier adhesion, the higher the fine particle fraction of the drug is upon aerosolisation. It is believed that more elongated fine mannitol particles reduce the number of drug-carrier and drug-drug physical contact points and increase the ability of the drug particles to travel into the lower airways. Additionally, a lower drug-carrier contact area, lower drug-carrier press-on forces and easier drug-carrier detachment are suggested in the case of formulations containing more elongated fine mannitol particles. Ternary 'drug-coarse carrier-elongated fine ternary component' DPI formulations were more favourable than both 'drug-coarse carrier' and 'drug-elongated coarse carrier' binary formulations. This study provides a comprehensive approach for formulators to overcome the undesirable properties of dry powder inhalers, as both improved aerosolisation performance and reasonable flow characteristics were obtained using only a small amount of elongated engineered fine mannitol particles.

Inhalable powder formulation of a stabilized vasoactive intestinal peptide (VIP) derivative: anti-inflammatory effect in experimental asthmatic rats

Vasoactive intestinal peptide (VIP) exerts immunomodulating and anti-inflammatory activities through its specific receptors, such as VPAC1 and 2 receptors. Previously, a stabilized VIP derivative, [R(15,20,21), L(17)]-VIP-GRR (IK312532), was proposed as a candidate of anti-asthma drug, and a dry powder inhaler system of IK312532 was also developed for inhalation therapy with minimal systemic side-effects. In the present study, the anti-inflammatory properties of IK312532 respirable powder (RP) were characterized in an asthma/COPD-like animal model, with the use of newly developed ovalbumin (OVA)-RP for lung inflammation. Marked inflammatory events in the lung were observed after OVA-RP challenge in rats as evidenced by significant increase of inflammatory biomarkers such as eosinophil peroxidase (EPO), myeloperoxidase (MPO) and lactate dehydrogenase (LDH). However, intratracheal administration of IK312532-RP led to significant attenuation of plasma EPO, MPO and LDH activities, as well as significant reduction of recruited inflammatory cells in BALF, especially macrophages and eosinophils. In the rats pretreated with IK312532-RP, histochemical examinations revealed that the inflammatory cells infiltrating to the lung and the epithelial wall thickness decreased significantly by 85% and 58%, respectively. Thus, inhalable powder formulation of IK312532 exerts its anti-inflammatory activity by suppressing granulocyte recruitment to the lung and epithelial hyperplasia, followed by the reduction of cytotoxic peroxidases.

New treatments for chronic obstructive pulmonary disease and viable formulation/device options for inhalation therapy

Chronic obstructive pulmonary disease (COPD) is an increasingly important cause of morbidity and mortality, pathological features of which are pulmonary inflammation and irreversible airflow obstruction. Current therapies for COPD are aimed at improvement of clinical symptoms and reduction of inflammation in the respiratory systems. There is a pressing need for the development of new COPD medication, particularly as no existing treatment has been shown to reduce disease progression. In spite of a better understanding of the underlying disease process, there have been limited advances in the drug therapy of COPD, in contrast to the enormous advances in asthma management. Several new therapeutic targets and strategies have been proposed, and new drug candidates, including bronchodilators, protease inhibitors anti-inflammatory drugs and mediator antagonists, are now in clinical development for COPD treatment. New dry powder inhaler (DPI) systems for inhaled COPD therapy have also been developed to maximize drug concentrations in the airway systems, while minimizing systemic exposure and associated toxicity. This article aims to review recent developments in COPD drugs and the delivery systems for inhalation therapy, with particular emphasis on device options and formulations of DPI systems.

Novel dry powder inhaler formulation of glucagon with addition of citric acid for enhanced pulmonary delivery

Glucagon, a gut hormone, is one of the key regulatory elements in glucose homeostasis, and is clinically used for treatment of hypoglycemia and premedication in peroral endoscopy. Dry powder inhaler (DPI) form of glucagon is believed to be a promising new dosage form, and the present study aimed to develop a novel glucagon-DPI using absorption enhancer for improved pharmacological effects. The cytotoxicity of citric and capric acids, the potential absorption enhancers, at 1 and 10 mM was assessed by monitoring extracellular LDH levels in rat alveolar L2 cells, and a concentration- and time-dependent release of LDH was observed in capric acid, but not in citric acid-treated cells. DPI form of glucagon containing citric acid was prepared with a jet mill, and laser diffraction and cascade impactor analyses of the newly developed glucagon-DPI suggested high dispersion and deposition in the respiratory organs with an emitted dose and fine particle fraction of 99.5 and 25%, respectively. Addition of citric acid in glucagon-DPI improved the dissolution behavior, and did not impair the solid-state stability of glucagon-DPI. Intratracheal administration of glucagon-DPI (50 microg-glucagon/kg body weight of rat) containing citric acid led to 2.9-fold more potent hyperglycemic effect in rats, as compared to inhaled glucagon-DPI without citric acid. Based on these physicochemical and pharmacological characterization, the dry powder inhaler of glucagon with addition of citric acid would be of use as an alternative to injection form.

In vitro and in vivo characterization on amorphous solid dispersion of cyclosporine A for inhalation therapy

Cyclosporine A (CsA) has been clinically used as immunosuppressant, and new application for airway inflammation was also proposed. However, the clinical use of CsA was limited due to severe adverse effects after systemic exposure and the poor solubility. In the present investigation, novel respirable powder (RP) of CsA was developed for pulmonary administration with use of solid dispersion of wet-milled CsA (WM/CsA), and the physicochemical and pharmacological properties of the WM/CsA and its RP formulation were characterized. CsA in the solid dispersion was found to be amorphous by X-ray powder diffraction and differential scanning calorimetry. It exhibited the improved dissolution behavior as compared to active pharmaceutical ingredients. Laser diffraction and cascade impactor analysis of newly developed WM/CsA-RP, consisting of jet-milled WM/CsA and lactose carriers, suggested high dispersion and deposition in the respiratory organs with the emitted dose and the fine particle fraction of 96 and 54%, respectively. Intratracheal administration of WM/CsA-RP (100 microg CsA) in experimental inflammatory rats led to 71 and 85% reduction of granulocyte recruitment in bronchoalveolar lavage fluids and lung tissues, respectively, with showing ca 10(2)-fold reduced AUC and C(max) values of plasma CsA as compared to the oral dosage form of CsA at toxic concentration (10 mg/kg). Upon these findings, WM/CsA-RP would be efficacious dosage form for clinical treatment of airway inflammations with minimal systemic side effects.

Novel dry powder formulation of ovalbumin for development of COPD-like animal model: Physicochemical characterization and biomarker profiling in rats

This study was directed toward the development of novel ovalbumin dry powder inhalation system (OVA-DPI) for preparing experimental animal models of chronic obstructive pulmonary disease, with the aim of aiding the drug discovery. OVA-DPI, prepared with jet mill, showed high dispersion and emission from capsule as evaluated by cascade impactor. Based on the results from long term stability studies employing scanning electron microscopy, UPLC/ESI-MS analysis, powder X-ray diffraction and TG/DTA analyses, the OVA-DPI, stored at room temperature, was found to be stable for more than 3 years as evidenced by no significant degradation and crystal polymorphism. Intratracheal administration of OVA-DPI in OVA-sensitized rats resulted in 11-fold increase of infiltrated granulocytes, especially neutrophil, which would be characteristics of severe asthma/COPD symptoms. Of all plasma biomarkers monitored, myeloperoxidase activity and lactate dehydrogenase leakage into blood seemed to be sensitive indicators of lung injury in this model. In addition, biphasic increase of LDH was observed with peak responses at 3 and 24h after antigen challenge, suggesting that OVA-DPI could cause both acute and delayed inflammatory reactions. Upon these findings, OVA-DPI can be useful and reproducible research tool for the development of experimental asthma/COPD model.

Dry powder inhalers (DPIs)--a review of device reliability and innovation

A wide range of dry powder inhaler (DPI) devices are currently available on the market to deliver drugs into lungs with a view to maximise drug delivery with low variability. DPIs also face numerous clinical challenges, particularly related to variable patient factors such as age, clinical condition and inspiratory flow. Due to the drug formulation and the design of devices, different DPIs do not show the same performance and manufacturers are taking a variety of device design approaches. The characteristics of an ideal DPI, recent innovations in powder formulation and device design are not universally reliable in terms of dose variability, clinical efficacy, user friendliness and economy. This mini review examines whether device reliability is more important than innovation. This study enables a comparison of the relative merits of optimising existing DPIs or seeking to develop novel devices.

The Influence of Fine Excipient Particles on the Performance of Carrier-Based Dry Powder Inhalation Formulations

The inclusion of a small amount of fine particle excipient in a carrier-based dry powder inhalation system is a well researched technique to improve formulation performance and is employed in the pharmaceutical industry. The removal of intrinsic fines from a lactose carrier has been found to decrease formulation performance, whereas adding fines of many different materials into formulations increased performance. Changing the particle size of these fines, the amount added and the technique by which they were prepared also affected formulation behaviour. Despite this body of research, there is disagreement as to the mechanism by which fines improved formulation performance, with two main hypotheses presented in the literature. The first hypothesis suggested that fines prevent the drug from adhering to the strongest binding sites on the carrier, whilst the second proposed that fine particles of drug and excipient form mixed agglomerates that are more easily dispersed and deaggregated during aerosolisation. The evidence in support of each hypothesis is limited and it is clear that future research should aim to produce stronger mechanistic evidence. The investigation of interparticulate interactions using techniques such as atomic force microscopy and inverse gas chromatography may prove useful in achieving this aim.

Development of dry powder inhalation system of novel vasoactive intestinal peptide (VIP) analogue for pulmonary administration

Vasoactive intestinal peptide (VIP) exerts a relaxing action on tracheal smooth muscle which is mediated through interaction with VIP receptors. The deficiency of VIP in the airways has been implicated in the pathogenesis of asthma. Thus, the administration of VIP may be useful for the therapy of pulmonary diseases. However, the therapeutic application of VIP is largely limited by its rapid degradation in addition to the systemic adverse effects due to the wide distribution of VIP receptors. To overcome these problems, we succeeded to synthesize a novel VIP derivative of VIP, [R15, 20, 21, L17]-VIP-GRR (IK312532), and to prepare its dry powder for the topical administration to the lung. The physicochemical properties of dry powder were evaluated by laser diffraction and cascade impactor. The laser diffraction analysis indicated that the carrier and fine particles had median diameter of 65.6 and 4.5 microm, respectively, and the air flow at the pressure of 0.15 MPa or higher resulted in the high dispersion and significant separation of fine particle containing peptide from the carrier molecule. The cascade impactor analysis clearly showed the high emission of dry powder from capsule and the deposition of peptide on stages 3 of the cascade impactor. The intratracheal administration of dry powder inhaler (DPI) of VIP or IK312532 brought about a significant decrease of maximal number of binding sites (Bmax) for [125I]VIP in anterior and posterior lobes of rat right lung, suggesting a significant occupancy of lung VIP receptors. This effect by IK312532-DPI compared with VIP-DPI lasted for a longer period. Thus, IK312532-DPI may be a pharmacologically useful drug delivery system for the VIP therapy of pulmonary diseases such as asthma.

Comparative study of erythritol and lactose monohydrate as carriers for inhalation: atomic force microscopy and in vitro correlation

The adhesion of micronised salbutamol sulphate to two carrier excipients, lactose monohydrate and erythritol, was investigated using the atomic force microscope (AFM) colloid probe technique and correlated with their respective physico-mechanical properties and aerosolisation performance. The particle size, morphology and moisture sorption properties of the carriers were similar thereby allowing direct comparison of functionality. AFM force measurements (n = 1024 force curves) were obtained between salbutamol sulphate drug probes (n = 4) and the excipients, as 63-90 microm sieve fractions and atomically smooth crystals. In general, significant differences in drug adhesion to lactose monohydrate and erythritol were observed (ANOVA, p<0.05), with erythritol exhibiting relatively greater adhesiveness. A linear relationship between drug probe adhesion to lactose monohydrate and drug probe adhesion to erythritol was established with salbutamol sulphate-lactose monohydrate adhesion being 60-70% of that of the erythritol system. In vitro analysis suggested good correlation with the adhesion measurements. The aerosolisation of salbutamol sulphate from erythritol carrier particles was significantly less (ANOVA, p<0.05) than from lactose monohydrate, with a fine particle dose (<6.4 microm) of 41.9 +/- 7.4 microg and 24.9 +/- 3.1 microg for the lactose monohydrate and erythritol carriers, respectively (n = 3).

Enthalpy of Sublimation in the Study of the Solid State of Organic Compounds. Application to Erythritol and Threitol

The enthalpies of sublimation of erythritol and L-threitol have been determined at 298.15 K by calorimetry. The values obtained for the two diastereomers differ from one another by 17 kJ mol(-1). An interpretation of these results is based on the decomposition of this thermodynamic property in a term coming from the intermolecular interactions of the molecules in the crystal (delta(int)H degrees) and another one related with the conformational change of the molecules on going from the crystal lattice to the most stable forms in the gas phase (delta(conf)H degrees). This last term was calculated from the values of the enthalpy of the molecules in the gas state and of the enthalpy of the isolated molecules with the crystal conformation. Both quantities were obtained by density functional theory (DFT) calculations at the B3LYP/6-311G++(d,p) level of theory. The results obtained in this study show that the most important contribution to the differences observed in the enthalpy of sublimation are the differences in the enthalpy of conformational change (13 kJ mol(-1)) rather than different intermolecular forces exhibited in the solid phase. This is explained by the lower enthalpy of threitol in the gas phase relative to erythritol, which is attributed to the higher strength of the intramolecular hydrogen bonds in the former. The comparison of the calculated infrared spectra obtained for the two compounds in the gas phase supports this interpretation.