TR146 cells grown on filters as a model of human buccal epithelium: V. Enzyme activity of the TR146 cell culture model, human buccal epithelium and porcine buccal epithelium, and permeability of leu-enkephalin

Oral Mucosa Models to Evaluate Drug Permeability

Due to its numerous advantages, such as excellent drug accessibility, rapid absorption, and bypass of first-pass metabolism, the route of drug administration that involves crossing the oral mucosa is highly favored. As a result, there is significant interest in investigating the permeability of drugs through this region. The purpose of this review is to describe the various ex vivo and in vitro models used to study the permeability of conveyed and non-conveyed drugs through the oral mucosa, with a focus on the most effective models. Currently, there is a growing need for standardized models of this mucosa that can be used for developing new drug delivery systems. Oral Mucosa Equivalents (OMEs) may provide a promising future perspective as they are capable of overcoming limitations present in many existing models.

Nanocomposite systems for precise oral delivery of drugs and biologics

Oral delivery is considered the favoured route of administration for both local and systemic delivery of active molecules. Formulation of drugs in conventional systems and nanoparticles has provided opportunities for targeting the gastrointestinal (GI) tract, increasing drug solubility and bioavailability. Despite the achievements of these delivery approaches, the development of a product with the ability of delivering drug molecules at a specific site and according to patients' needs remains a challenging endeavour. The complexity of the physicochemical properties of colloidal systems, their stability in different regions of the gastrointestinal tract, and interaction with the restrictive biological barriers hampered their success for oral precise medicine. To overcome these issues, nanoparticles have been combined with polymers to create hybrid nanosystems, namely nanocomposites. They offer enormous possibilities of structural and mechanical modifications to both nanoparticles and polymeric matrixes to generate systems with new properties, functions, and applications for oral delivery. In this review, nanocomposites' physicochemical and functional properties intended to target specific regions of the GI tract-oral cavity, stomach, small bowel, and colon-are analysed. In parallel, it is provided an insight in the nanocomposite solutions for oral delivery intended for systemic and local absorption, together with a focus on inflammatory bowel diseases (IBDs). Additional difficulties in managing IBD related to the alteration in the physiology of the intestine are described. Finally, future perspectives and opportunities for advancement in this field are discussed.

Optimization of an oral mucosa in vitro model based on cell line TR146

During the last years, the popularity of saliva has been increasing for its applicability as a diagnostic fluid. Blood biomarker molecules have to cross the blood-saliva barrier (BSB) in order to appear in saliva. The BSB consists of all oral and salivary gland epithelial barriers. Within this context, the optimization of in vitro models for mechanistic studies about the transport of molecules across the oral mucosa is an important task. Here, we describe the optimization and comprehensive characterization of a Transwell model of the oral mucosa based on the epithelial cell line TR146. Through systematic media optimization investigating 12 different set-ups, a significant increase of barrier integrity upon airlift cultivation is described here for TR146 cell layers. The distinct improvement of the paracellular barrier was described by measurements of transepithelial electrical resistance (TEER) and carboxyfluorescein permeability assays. Histological characterization supported TEER data and showed a stratified, non-keratinized multilayer of the optimized TR146 model. High-Throughput qPCR using 96 selected markers for keratinization, cornification, epithelial-mesenchymal transition, aquaporins, mucins, tight junctions, receptors, and transporter proteins was applied to comprehensively characterize the systematic optimization of the cellular model and validate against human biopsy samples. Data revealed the expression of several genes in the oral mucosa epithelium for the first time and elucidated novel regulations dependent on culture conditions. Moreover, functional activity of ABC-transporters ABCB1 and ABCC4 was shown indicating the applicability of the model for drug transport studies. In conclusion, a Transwell model of the oral mucosa epithelium was optimized suitably for transport studies.

[Cerebrolysin peptides as mood stabilizers]

AIM

To establish the molecular mechanisms of the mood stabilizing (normothymic) action of the neuroprotector Cerebrolysin.

MATERIAL AND METHODS

Mass-spectrometric analysis of the peptide composition of cerebrolysin followed by a complex bioinformatics analysis was utilized.

RESULTS

Cerebrolysin contains considerable amounts of Leu- and Met-enkephalins, partial analogues of enkephalins, peptide fragments of beta-lipotropin. These peptides stimulate the endorphinergic system thus contributing to normothymic action and an increase in the levels of the brain-derived neurotrophic factor (BDNF). Specific inhibition of kinases ABL1, PINK1, CDK5 and arginine N-methyltransferase PRMT5 by the peptides of cerebrolysin has a multidirectional effect on the dopaminergic system, also helping to stabilize mood. Cerebrolysin peptides do not directly affect neither the serotonergic, adrenergic, nor GABAergic systems.

CONCLUSION

The normothymic effect of Cerebrolysin is due to the stabilization of endorphinergic and dopaminergic neurotransmission.

In vivo, ex vivo and in vitro assessment of buccal permeation of drugs from delivery systems

Introduction: Buccal mucosa has been described as an attractive site for local and systemic drug delivery, owing its accessibility, safety, and excellent blood supply. The absorption of drugs through buccal mucosa has been assessed by in vivo, ex vivo and in vitro permeability studies, using animal and cell-based models with close resemblance to the human buccal mucosa.Areas covered: This paper focuses on the current in vivo, ex vivo and in vitro permeability studies to analyze the absorption of compounds of interest through buccal mucosa, as well as their advantages and limitations in the preclinical studies of the drugs absorption profiles. The techniques for preparation and preservation of the animal buccal tissue are also discussed to evaluate their interference in the integrity and permeability of the tissues.Expert opinion: Overall, the permeability studies have been useful to evaluate the drugs absorption and to clarify the mechanism of transport of drugs across human buccal mucosa, as well as to explain the enhancement of permeability provided by certain dosage forms. Currently, several researchers have demonstrated particular interest in ex vivo permeability studies, due to their effectiveness in the evaluation of drug absorption and low costs in the acquisition of buccal mucosa samples.

Cell culture models of oral mucosal barriers: A review with a focus on applications, culture conditions and barrier properties

Understanding the function of oral mucosal epithelial barriers is essential for a plethora of research fields such as tumor biology, inflammation and infection diseases, microbiomics, pharmacology, drug delivery, dental and biomarker research. The barrier properties are comprised by a physical, a transport and a metabolic barrier, and all these barrier components play pivotal roles in the communication between saliva and blood. The sum of all epithelia of the oral cavity and salivary glands is defined as the blood-saliva barrier. The functionality of the barrier is regulated by its microenvironment and often altered during diseases. A huge array of cell culture models have been developed to mimic specific parts of the blood-saliva barrier, but no ultimate standard in vitro models have been established. This review provides a comprehensive overview about developed in vitro models of oral mucosal barriers, their applications, various cultivation protocols and corresponding barrier properties.

Challenges in the local delivery of peptides and proteins for oral mucositis management

Oral mucositis, a common inflammatory side effect of oncological treatments, is a disorder of the oral mucosa that can cause painful ulcerations, local motor disabilities, and an increased risk of infections. Due to the discomfort it produces and the associated health risks, it can lead to cancer treatment restrains, such as the need for dose reduction, cycle delays or abandonment. Current mucositis management has low efficiency in prevention and treatment. A topical drug application for a local action can be a more effective approach than systemic routes when addressing oral cavity pathologies. Local delivery of growth factors, antibodies, and anti-inflammatory cytokines have shown promising results. However, due to the peptide and protein nature of these novel agents, and the several anatomic, physiological and environmental challenges of the oral cavity, their local action might be limited when using traditional delivering systems. This review is an awareness of the issues and strategies in the local delivery of macromolecules for the management of oral mucositis.

Permeability Barriers for Nicotine and Mannitol in Porcine Buccal Mucosa Studied by High-Resolution MALDI Mass Spectrometry Imaging

Improved nicotine permeability across buccal mucosa may enable more effective oromucosal nicotine replacement therapy products. It is essential to know the location and composition of the main barrier for drug diffusion to enhance the drug permeability. Matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI MSI) is a rapidly evolving technique that can be used to image the spatial distribution of drugs and drug metabolites in tissue cryo-sections, without prior labeling of the drug. In this study, the distribution of nicotine and mannitol in porcine buccal mucosa was imaged with 10 μm spatial resolution after apical as well as submucosal application of the drugs in order to localize the main permeability barrier(s). This was supported by ex vivo permeability studies across separated porcine buccal epithelium and submucosa. Lastly, the metabolism of nicotine in porcine buccal mucosa was evaluated by imaging of the main metabolite, cotinine. The results showed that the main permeability barrier to both nicotine and mannitol was located in the outer fourth of the epithelium. Further, it was shown that cotinine was sparsely distributed in excised porcine buccal mucosa, indicating that nicotine metabolism in excised porcine buccal mucosa was negligible. MALDI MSI was shown to be a useful method for imaging spatial distribution of drugs in buccal mucosa.

Poloxamer bioadhesive hydrogel for buccal drug delivery: Cytotoxicity and trans-epithelial permeability evaluations using TR146 human buccal epithelial cell line

A salbutamol sulfate (SS)-Poloxamer bioadhesive hydrogel specially developed for buccal administration was investigated by studying interactions with TR146 human buccal epithelium cells (i.e. cellular toxicity (i) and trans-epithelial SS diffusion (ii)). The assessment of cell viability (MTT, Alamar Blue), membrane integrity (Neutral Red), and apoptosis assay (Hoechst 33342), were performed and associated to Digital Holographic Microscopy analysis. After the treatment of 2h, SS solution induced drastic cellular alterations that were prevented by hydrogels in relation with the concentrations of poloxamer and xanthan gum. The formulation containing P407 19%/P188 1%/Satiaxane 0.1% showed the best tolerance after single and multiple administrations and significantly reduced the trans-epithelial permeability from 5.00±0.29 (×10(3)) (SS solution) to 1.83±0.22 cm/h. Digital Holographic Microscopy images in good agreement with the viability data confirmed the great interest of this direct technique. In conclusion, the proposed hydrogels represent a safe and efficient buccal drug delivery platform.

Establishment and first characterization of a sublingual epithelial and immune cell co-culture model

We describe here the establishment and first characterization of a co-culture model of human epithelial sublingual cells (HO-1-u-1 cell line) and human dendritic cells derived from human peripheral blood monocytes (PBMC). Cell culture conditions for HO-1-u-1 cells were optimized. First characterization of phenotypic features by electron microscopy and fluorescence imaging revealed resemblance to sublingual tissue specimen from healthy donors. Successful co-culturing of epithelial and dendritic cells (DCs) was confirmed by confocal laser scanning microscopy. Stimulation of HO-1-u1 cells alone and the epithelial/DC co-culture by incubation with liposomes, virosomes and influenza virus lead reproducibly to the release of inflammatory cytokine GM-CSF. This co-culture model may be suitable for elucidation of mechanisms involved in the immune response at the sublingual epithelium as well as for the evaluation of novel topical vaccines, potentially replacing cumbersome ex vivo and in vivo methods currently in place.

S-glutathionylation of buccal cell proteins as biomarkers of exposure to hydrogen peroxide

Background

Exogenous or endogenous hydrogen peroxide (H₂O₂) is a reactive oxygen species (ROS) that can lead to oxidation of cellular nucleophiles, particularly cysteines in proteins. Commercial mouthwashes containing H₂O₂ provide the opportunity to determine clinically whether changes in S-glutathionylation of susceptible proteins in buccal mucosa cells can be used as biomarkers of ROS exposure.

Methods

Using an exploratory clinical protocol, 18 disease-free volunteers rinsed with a mouthwash containing 1.5% H₂O₂ (442 mM) over four consecutive days. Exfoliated buccal cell samples were collected prior and post-treatment and proteomics were used to identify S-glutathionylated proteins.

Results

Four consecutive daily treatments with the H₂O₂-containing mouthwash induced significant dose and time-dependent increases in S-glutathionylation of buccal cell proteins, stable for at least 30 min following treatments. Elevated levels of S-glutathionylation were maintained with subsequent daily exposure. Increased S-glutathionylation preceded and correlated with transcriptional activation of ROS sensitive genes, such as ATF3, and with the presence of 8-hydroxy deoxyguanosine. Data from a human buccal cell line TR146 were consistent with the trial results. We identified twelve proteins that were S-glutathionylated following H₂O₂ exposure.

Conclusions

Buccal cells can predict exposure to ROS through increased levels of S-glutathionylation of proteins. These post-translationally modified proteins serve as biomarkers for the effects of H₂O₂ in the oral cavity and in the future, may be adaptable as extrapolated pharmacodynamic biomarkers for assessing the impact of other systemic drugs that cause ROS and/or impact redox homeostasis.

General significance

S-glutathionylation of buccal cell proteins can be used as a quantitative measure of exposure to ROS.

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Hydrogen peroxide is both a toxin and an endogenous signaling molecule.

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The use of hydrogen peroxide mouthwash causes ROS mediated damage in cheek cells.

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S-glutathionylated proteins are biomarkers for this damage.

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S-glutathionylated proteins may be of future value as pharmacodynamic markers.

Buccal drug delivery: A challenge already won?

The main obstacles that drugs meet when administered via the buccal route derive from the limited absorption area and the barrier properties of the mucosa. The effective physiological removal mechanisms of the oral cavity that take the formulation away from the absorption site are the other obstacles that have to be considered. The strategies studied to overcome such obstacles include the employment of new materials that, possibly, combine mucoadhesive, enzyme inhibitory and penetration enhancer properties and the design of innovative drug delivery systems which, besides improving patient compliance, favor a more intimate contact of the drug with the absorption mucosa.:

Promoting effects of chemical permeation enhancers on insulin permeation across TR146 cell model of buccal epithelium in vitro

To find potential enhancers for facilitating the buccal delivery of insulin, a TR146 cell-culture model of buccal epithelium, cultured on commercially available insert plates, was used to evaluate the permeability-enhancing effects of several traditional and new types of chemical enhancers, including N-acetyl-L-cysteine (NAC), sodium deoxycholate (SDC), sodium nitroprusside (SNP), reduced glutathione (GSH), glutamine (Gln), chitosan (CS), L-arginine (Arg), 1-dodecylazacycloheptan-2-one (Azone), and soybean lecithin (SPC) (50 and 10 μg/mL respectively). Permeability studies were performed to determine the enhancing effects of these compounds on insulin permeation across the cell-culture model. The enhancing effects of the enhancers were assessed by calculating the apparent permeability coefficients and enhancement ratio. Cytotoxicity of the permeation enhancers at different concentrations was investigated by using the methylthiazolydiphenyl-tetrazolium bromide (MTT) assay. Results showed that 50 μg/mL of NAC, SDC, GSH, CS, Arg, Azone, SPC, SNP, and 10 μg/mL of SNP had a significant enhancing effect on promoting the transport of insulin across the TR146 cell model. MTT assays showed that 50 μg/mL of Gln, Azone, SDC, SNP, Arg, 10 μg/mL SDC, and Arg had obvious toxic effects on TR146 cells. Therefore, NAC, GSH, CS, SPC, and SNP appear to be safe, effective permeability enhancers that promote the transport of insulin across the TR146 cell-culture model of buccal epithelium and may be potential enhancers for buccal delivery of insulin with both low toxicity and high efficiency.

Metabolic cleavage of cell-penetrating peptides in contact with epithelial models: human calcitonin (hCT)-derived peptides, Tat(47-57) and penetratin(43-58)

We assessed the metabolic degradation kinetics and cleavage patterns of some selected CPP (cell-penetrating peptides) after incubation with confluent epithelial models. Synthesis of N-terminal CF [5(6)-carboxyfluorescein]-labelled CPP, namely hCT (human calcitonin)-derived sequences, Tat(47-57) and penetratin(43-58), was through Fmoc (fluoren-9-ylmethoxycarbonyl) chemistry. Metabolic degradation kinetics of the tested CPP in contact with three cell-cultured epithelial models, MDCK (Madin-Darby canine kidney), Calu-3 and TR146, was evaluated by reversed-phase HPLC. Identification of the resulting metabolites of CF-hCT(9-32) was through reversed-phase HPLC fractionation and peak allocation by MALDI-TOF-MS (matrix-assisted laser-desorption ionization-time-of-flight mass spectrometry) or direct MALDI-TOF-MS of incubates. Levels of proteolytic activity varied highly between the investigated epithelial models and the CPP. The Calu-3 model exhibited the highest proteolytic activity. The patterns of metabolic cleavage of hCT(9-32) were similar in all three models. Initial cleavage of this peptide occurred at the N-terminal domain, possibly by endopeptidase activity yielding both the N- and the C-terminal counterparts. Further metabolic degradation was by aminopeptidase, endopeptidase and/or carboxypeptidase activities. In conclusion, when in contact with epithelial models, the studied CPP were subject to efficient metabolism, a prerequisite of cargo release on the one hand, but with potential for premature cleavage and loss of the cargo as well on the other. The results, particularly on hCT(9-32), may be used as a template to suggest structural modifications towards improved CPP performance.

Comparative permeability of various chemical markers through human vaginal and buccal mucosa as well as porcine buccal and mouth floor mucosa

A number of drugs undergo extensive first-pass metabolism after oral administration, necessitating large doses for effective therapeutic responses in the body. Buccal administration of drugs is becoming more popular because the drugs diffuse into the systemic circulation directly, circumventing the first-pass metabolism. Lower concentrations thus need to be administered and side effects may be minimized. In this study, one of the classic models for human buccal permeability, i.e. the porcine buccal mucosal model, is compared with the more recent human vaginal model and both these are in turn further compared to porcine mouth floor mucosa. To determine the permeability of the different markers (arecoline, 17beta-estradiol, water and vasopressin), a continuous flow-through perfusion system was used (20 degrees C, 24h). Mean steady state flux values were compared statistically using a t-test at a significance level of 5%. Porcine buccal mucosa showed a consistently lower permeability towards all the markers than the other mucosae tested. Porcine mouth floor mucosa was found to be more permeable than porcine buccal mucosa. From these studies we concluded that human vaginal and porcine mouth floor mucosae were superior models for human buccal mucosa than porcine buccal mucosa, using in vitro permeability studies with various chemical markers.

Buccal Delivery Systems

The oral cavity is an attractive site for drug delivery due to ease of administration and avoidance of possible drug degradation in gastrointestinal tract and first-pass metabolism. Buccal drug delivery specifically refers to the delivery of drugs within/ through buccal mucosa to affect local/systemic pharmacological actions. This review briefly describes advantages and limitations of buccal drug delivery, anatomical structure of oral mucosa, and methodology in evaluating buccal drug delivery system, focusing on physiology, pharmacology, pathology, and formulation design in line with recent developments in buccal delivery systems.

Peptidase activity on the surface of the porcine buccal mucosa

Peptide drugs in buccal bioadhesive delivery systems are exposed to the surface of the buccal mucosa at high concentrations over long periods of time. The peptidase activity on the surface of the buccal mucosa has not been evaluated as a barrier to peptide buccal delivery. The in vitro stability of various synthetic substrates on the surface of intact porcine buccal mucosa was determined. No carboxypeptidase or dipeptidyl peptidase IV activity was detected on the buccal mucosa, while aminopeptidase N activity was detected using Leu-p-nitroanilide. No endopeptidase activity was observed towards the peptide substrates. Insulin and insulin B-chain were intact at the 2 h time point at 37 degrees C, while the percent of parent Leu-enkephalin remaining was 18+/-9 (mean+/-S.D., n=9). In the presence of aminopeptidase inhibitors, amastatin, sodium deoxycholate and EDTA, the degradation of Leu-enkephalin was dramatically reduced. This work suggests that the buccal route maybe advantageous for the delivery of peptides that are susceptible to such activities. The inclusion of aminopeptidase inhibitors in buccal bioadhesive delivery systems could improve buccal bioavailability of Leu-enkephalin. We suggest that compared with the existing in vitro metabolism methods, the analysis of peptide or protein metabolism on intact buccal mucosa could better predict the degradation of the drug as it crosses the tissue.

Transbuccal peptide delivery: stability and in vitro permeation studies on endomorphin-1

The purpose of this study was to investigate the feasibility of buccal delivery of a model peptide, endomorphin-1 (ENI), using stability and in vitro permeation studies. ENI is a recently isolated mu-opiate receptor agonist with high selectivity and specificity for this receptor subtype. Stability studies were conducted in various buffers and the drug was shown to be stable in both acidic and basic buffer systems. In the presence of full thickness porcine buccal epithelium, ENI was unstable with only 23.4+/-15.7% intact drug present after 6 h. The region responsible for this degradation was found to coincide with the major barrier region of the buccal epithelium as delineated through stability experiments in the presence of partial thickness buccal epithelium. Various peptidase inhibitors were used to isolate the enzyme(s) responsible for this degradation. Diprotin-A, a potent inhibitor of dipeptidyl peptidase IV, provided significant inhibition of the degradation of ENI in the presence of buccal epithelium. In vitro permeation studies revealed that the permeability coefficient of ENI across porcine buccal epithelium was 5.67+/-4.74x10(-7) cm/s. The enzymatic degradation of ENI was found not to be rate limiting to the drug's permeation across buccal epithelium, as diprotin-A did not increase the permeation of ENI. Sodium glycocholate as well as sodium taurocholate were also ineffective in enhancing the permeation of ENI across porcine buccal epithelium.