Structural biomechanics modulate intramuscular distribution of locally delivered drugs

Breaking through the barrier: Modelling and exploiting the physical microenvironment to enhance drug transport and efficacy

Pharmaceutical compounds are the main pillar in the treatment of various illnesses. To administer these drugs in the therapeutic setting, multiple routes of administration have been defined, including ingestion, inhalation, and injection. After administration, drugs need to find their way to the intended target for high effectiveness, and this penetration is greatly dependent on obstacles the drugs encounter along their path. Key hurdles include the physical barriers that are present within the body and knowledge of those is indispensable for progress in the development of drugs with increased therapeutic efficacy. In this review, we examine several important physical barriers, such as the blood-brain barrier, the gut-mucosal barrier, and the extracellular matrix barrier, and evaluate their influence on drug transport and efficacy. We explore various in vitro model systems that aid in understanding how parameters within the barrier model affect drug transfer and therapeutic effect. We conclude that physical barriers in the body restrict the quantity of drugs that can pass through, mainly as a consequence of the barrier architecture. In addition, the specific physical properties of the tissue can trigger intracellular changes, altering cell behavior in response to drugs. Though the barriers negatively influence drug distribution, physical stimulation of the surrounding environment may also be exploited as a mechanism to control drug release. This drug delivery approach is explored in this review as a potential alternative to the conventional ways of delivering therapeutics.

Heparinoid Complex-Based Heparin-Binding Cytokines and Cell Delivery Carriers

Heparinoid is the generic term that is used for heparin, heparan sulfate (HS), and heparin-like molecules of animal or plant origin and synthetic derivatives of sulfated polysaccharides. Various biological activities of heparin/HS are attributed to their specific interaction and regulation with various heparin-binding cytokines, antithrombin (AT), and extracellular matrix (ECM) biomolecules. Specific domains with distinct saccharide sequences in heparin/HS mediate these interactions are mediated and require different highly sulfated saccharide sequences with different combinations of sulfated groups. Multivalent and cluster effects of the specific sulfated sequences in heparinoids are also important factors that control their interactions and biological activities. This review provides an overview of heparinoid-based biomaterials that offer novel means of engineering of various heparin-binding cytokine-delivery systems for biomedical applications and it focuses on our original studies on non-anticoagulant heparin-carrying polystyrene (NAC-HCPS) and polyelectrolyte complex-nano/microparticles (N/MPs), in addition to heparin-coating devices.

Targeted imaging of bacterial infections: advances, hurdles and hopes

Bacterial infections represent an increasing problem in modern health care, in particular due to ageing populations and accumulating bacterial resistance to antibiotics. Diagnosis is rarely straightforward and consequently treatment is often delayed or indefinite. Therefore, novel tools that can be clinically implemented are urgently needed to accurately and swiftly diagnose infections. Especially, the direct imaging of infections is an attractive option. The challenge of specifically imaging bacterial infections in vivo can be met by targeting bacteria with an imaging agent. Here we review the current status of targeted imaging of bacterial infections, and we discuss advantages and disadvantages of the different approaches. Indeed, significant progress has been made in this field and the clinical implementation of targeted imaging of bacterial infections seems highly feasible. This was recently highlighted by the use of so-called smart activatable probes and a fluorescently labelled derivative of the antibiotic vancomycin. A major challenge remains the selection of the best imaging probes, and we therefore present a set of target selection criteria for clinical implementation of targeted bacterial imaging. Altogether, we conclude that the spectrum of potential applications for targeted bacterial imaging is enormous, ranging from fundamental research on infectious diseases to diagnostic and therapeutic applications.

Noninvasive imaging of Staphylococcus aureus infections with a nuclease-activated probe

Technologies that enable the rapid detection and localization of bacterial infections in living animals could address an unmet need for infectious disease diagnostics. We describe a molecular imaging approach for the specific, non-invasive detection of S. aureus based on the activity of its secreted nuclease, micrococcal nuclease (MN). Several short, synthetic oligonucleotides, rendered resistant to mammalian serum nucleases by various chemical modifications, flanked with a fluorophore and quencher, were activated upon degradation by recombinant MN and in S. aureus culture supernatants. A probe consisting of a pair of deoxythymidines flanked by several 2′-O-methyl-modified nucleotides was activated in culture supernatants of S. aureus but not in culture supernatants of several other pathogenic bacteria. Systemic administration of this probe to mice bearing bioluminescent S. aureus muscle infections resulted in probe activation at the infection sites in an MN-dependent manner. This novel bacterial imaging approach has potential clinical applicability for S. aureus and several other medically significant pathogens.

The anisotropic mechanical behaviour of passive skeletal muscle tissue subjected to large tensile strain

The passive mechanical properties of muscle tissue are important for many biomechanics applications. However, significant gaps remain in our understanding of the three-dimensional tensile response of passive skeletal muscle tissue to applied loading. In particular, the nature of the anisotropy remains unclear and the response to loading at intermediate fibre directions and the Poisson's ratios in tension have not been reported. Accordingly, tensile tests were performed along and perpendicular to the muscle fibre direction as well as at 30°, 45° and 60° to the muscle fibre direction in samples of Longissimus dorsi muscle taken from freshly slaughtered pigs. Strain was measured using an optical non-contact method. The results show the transverse or cross fibre (TT') direction is broadly linear and is the stiffest (77 kPa stress at a stretch of 1.1), but that failure occurs at low stretches (approximately λ=1.15). In contrast the longitudinal or fibre direction (L) is nonlinear and much less stiff (10 kPa stress at a stretch of 1.1) but failure occurs at higher stretches (approximatelyλ=1.65). An almost sinusoidal variation in stress response was observed at intermediate angles. The following Poisson's ratios were measured: VLT=VLT'=0.47, VTT'=0.28 and VTL=0.74. These observations have not been previously reported and they contribute significantly to our understanding of the three dimensional deformation response of skeletal muscle tissue.

Local epicardial inotropic drug delivery allows targeted pharmacologic intervention with preservation of myocardial loading conditions

Local myocardial application of inotropes may allow the study of pharmacologically augmented central myocardial contraction in the absence of confounding peripheral vasodilating effects and alterations in heart loading conditions. Novel alginate epicardial (EC) drug releasing platforms were used to deliver dobutamine to the left ventricle of rats. Pressure-volume analyses indicated that although both local and systemic intravenous (i.v.) use of inotropic drugs increase stroke volume and contractility, systemic infusion does so through heart unloading. Conversely, EC application preserves heart load and systemic blood pressure. EC dobutamine increased indices of contractility with minimal rise in heart rate and lower reduction in systemic vascular resistance than i.v. infusion. Drug sampling showed that dobutamine concentration was 650-fold higher in the anterior wall than in the inferior wall. The plasma dobutamine concentration with local delivery was about half as much as with systemic infusion. These data suggest that inotropic EC delivery has a localized effect and augments myocardial contraction by different mechanisms than systemic infusion, with far fewer side effects. These studies demonstrate a pharmacologic paradigm that may improve heart function without interference from effects on the vasculature, alterations in heart loading, and may ultimately improve the health of heart failure patients.

Validation of SPAMM tagged MRI based measurement of 3D soft tissue deformation

PURPOSE

This study presents and validates a novel (non-ECG-triggered) MRI sequence based on spatial modulation of the magnetization (SPAMM) to noninvasively measure 3D (quasistatic) soft tissue deformations using only six acquisitions (three static and three indentations). In the current SPAMM tagged MRI approaches, data are typically constructed from many repeated motion cycles. This has so far restricted its application to the measurement of highly repeatable and periodic movements (e.g., cardiac deformation). In biomechanical applications where soft tissue deformation is artificially induced, often by indentation, significant repeatability constraints exist, and for clinical applications, discomfort and health issues generally preclude a large number of repetitions.

METHODS

A novel (non-ECG-triggered) SPAMM tagged MRI sequence is presented, whereby a single 1-1 (first order) SPAMM set is acquired following a 3D transient field echo acquisition. Full 3D deformation measurement is achieved through the combination of only six acquisitions (three static and three motion cycles). The 3D deformation measurements were validated using quasistatic indentation tests and marker tracking in a silicone gel soft tissue phantom. In addition, the technique's ability to measure 3D soft tissue deformation in vivo was evaluated using indentation of the biceps region of the upper arm in a volunteer.

RESULTS

Following comparison to marker tracking in the silicone gel phantom, the SPAMM tagged MRI based displacement measurement demonstrated subvoxel accuracy with a mean displacement difference of 72 microm and a standard deviation of 289 microm. In addition, precision of displacement magnitude was evaluated for both the phantom and the volunteer data. The standard deviations of the displacement magnitude with respect to the average displacement magnitude were 75 and 169 microm for the phantom and volunteer data, respectively.

CONCLUSIONS

The subvoxel accuracy and precision demonstrated in the phantom in combination with the precision comparison between the phantom and the volunteer data provide confidence in the methods presented for measurement of soft tissue deformation in vivo. To the author's knowledge, since only six acquisitions are required, the presented methodology is the fastest SPAMM tagged MRI method currently available for the noninvasive measurement of quasistatic 3D soft tissue deformation.

Intramuscular drug transport under mechanical loading: resonance between tissue function and uptake

Dynamic architecture and motion in mechanically active target tissues can influence the pharmacokinetics of locally delivered agents. Drug transport in skeletal muscle under controlled mechanical loads was investigated. Static (0-20%) and cyclic (+/-2.5% amplitude, 0-20% mean, 1-3 Hz) strains and electrically paced isometric contractions (0.1-3 Hz, 0% strain) were applied to rat soleus incubated in 1 mM 20 kDa FITC-dextran. Dextran penetration, tissue porosity, and active force-length relationship over 0-20% strain correlated (r=0.9-1.0), and all increased 1.5-fold from baseline at 0% to a maximum at 10% (Lo), demonstrating biologic significance of Lo and impact of fiber size and distribution on function and pharmacokinetics. Overall penetration decreased but relative enhancement of penetration at Lo increased with dextran size (4-150 kDa). Penetration increased linearly (0.084 mm/Hz) with cyclic stretch, demonstrating dispersion. Penetration increased with contraction rate by 1.5-fold from baseline to a maximum at 0.5 Hz, revealing architectural modulation of dispersion. Impact of architecture and dispersion on intramuscular transport was computationally modeled. Mechanical architecture and function underlie intramuscular pharmacokinetics and act in concert to effect resonance between optimal physiologic performance and drug uptake. Therapeutic management of characteristic function in tissue targets may enable a physiologic mechanism for controlled drug transport.