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Maikawa CL, d'Aquino AI, Lal RA, Buckingham BA, Appel EA. Engineering biopharmaceutical formulations to improve diabetes management. Sci Transl Med 2021; 13:eabd6726. [PMID: 33504649 PMCID: PMC8004356 DOI: 10.1126/scitranslmed.abd6726] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
Insulin was first isolated almost a century ago, yet commercial formulations of insulin and its analogs for hormone replacement therapy still fall short of appropriately mimicking endogenous glycemic control. Moreover, the controlled delivery of complementary hormones (such as amylin or glucagon) is complicated by instability of the pharmacologic agents and complexity of maintaining multiple infusions. In this review, we highlight the advantages and limitations of recent advances in drug formulation that improve protein stability and pharmacokinetics, prolong drug delivery, or enable alternative dosage forms for the management of diabetes. With controlled delivery, these formulations could improve closed-loop glycemic control.
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Affiliation(s)
- Caitlin L Maikawa
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Andrea I d'Aquino
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Rayhan A Lal
- Department of Medicine (Endocrinology), Stanford University, Stanford, CA 94305, USA
- Department of Pediatrics (Endocrinology), Stanford University, Stanford, CA 94305, USA
- Diabetes Research Center, Stanford University, Stanford, CA 94305, USA
| | - Bruce A Buckingham
- Department of Pediatrics (Endocrinology), Stanford University, Stanford, CA 94305, USA
- Diabetes Research Center, Stanford University, Stanford, CA 94305, USA
| | - Eric A Appel
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA.
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
- Department of Pediatrics (Endocrinology), Stanford University, Stanford, CA 94305, USA
- Diabetes Research Center, Stanford University, Stanford, CA 94305, USA
- ChEM-H Institute, Stanford University, Stanford, CA 94305, USA
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Østergaard M, Mishra NK, Jensen KJ. The ABC of Insulin: The Organic Chemistry of a Small Protein. Chemistry 2020; 26:8341-8357. [DOI: 10.1002/chem.202000337] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/15/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Mads Østergaard
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Narendra Kumar Mishra
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Knud J. Jensen
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
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Maikawa CL, Smith AAA, Zou L, Meis CM, Mann JL, Webber MJ, Appel EA. Stable Monomeric Insulin Formulations Enabled by Supramolecular PEGylation of Insulin Analogues. ADVANCED THERAPEUTICS 2020; 3:1900094. [PMID: 32190729 PMCID: PMC7079736 DOI: 10.1002/adtp.201900094] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Indexed: 12/17/2022]
Abstract
Current "fast-acting" insulin analogues contain amino acid modifications meant to inhibit dimer formation and shift the equilibrium of association states toward the monomeric state. However, the insulin monomer is highly unstable and current formulation techniques require insulin to primarily exist as hexamers to prevent aggregation into inactive and immunogenic amyloids. Insulin formulation excipients have thus been traditionally selected to promote insulin association into the hexameric form to enhance formulation stability. This study exploits a novel excipient for the supramolecular PEGylation of insulin analogues, including aspart and lispro, to enhance the stability and maximize the prevalence of insulin monomers in formulation. Using multiple techniques, it is demonstrated that judicious choice of formulation excipients (tonicity agents and parenteral preservatives) enables insulin analogue formulations with 70-80% monomer and supramolecular PEGylation imbued stability under stressed aging for over 100 h without altering the insulin association state. Comparatively, commercial "fast-acting" formulations contain less than 1% monomer and remain stable for only 10 h under the same stressed aging conditions. This simple and effective formulation approach shows promise for next-generation ultrafast insulin formulations with a short duration of action that can reduce the risk of post-prandial hypoglycemia in the treatment of diabetes.
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Affiliation(s)
- Caitlin L Maikawa
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Anton A A Smith
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Lei Zou
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Catherine M Meis
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Joseph L Mann
- Department of Materials Science and Engineering, Stanford University, Stanford, CA 94305, USA
| | - Matthew J Webber
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Eric A Appel
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
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D'Addio SM, Bothe JR, Neri C, Walsh PL, Zhang J, Pierson E, Mao Y, Gindy M, Leone A, Templeton AC. New and Evolving Techniques for the Characterization of Peptide Therapeutics. J Pharm Sci 2016; 105:2989-3006. [DOI: 10.1016/j.xphs.2016.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/06/2016] [Accepted: 06/17/2016] [Indexed: 01/31/2023]
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Jensen MH, Wahlund PO, Toft KN, Jacobsen JK, Steensgaard DB, van de Weert M, Havelund S, Vestergaard B. Small Angle X-ray Scattering-Based Elucidation of the Self-Association Mechanism of Human Insulin Analogue LysB29(Nεω-carboxyheptadecanoyl) des(B30). Biochemistry 2013; 52:282-94. [DOI: 10.1021/bi3008615] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Malene Hillerup Jensen
- Department of Drug Design and
Pharmacology, University of Copenhagen,
Copenhagen, Denmark
- Department
of Pharmacy, University of Copenhagen,
Copenhagen, Denmark
- Novo Nordisk A/S, Måløv, Denmark
| | | | - Katrine Nørgaard Toft
- Department of Drug Design and
Pharmacology, University of Copenhagen,
Copenhagen, Denmark
| | | | | | | | | | - Bente Vestergaard
- Department of Drug Design and
Pharmacology, University of Copenhagen,
Copenhagen, Denmark
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Jorgensen L, Groenning M, Roest N, Pinholt C, van de Weert M. The challenges in and importance of analysing protein structure and physical stability in complex formulations. J Drug Deliv Sci Technol 2013. [DOI: 10.1016/s1773-2247(13)50051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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