Programmable drug delivery from an erodible association polymer system

A temperature and pH dual-responsive injectable self-healing hydrogel prepared by chitosan oligosaccharide and aldehyde hyaluronic acid for promoting diabetic foot ulcer healing

Chronic wound, such as skin defect after burn, pressure ulcer, and diabetic foot ulcer is very difficult to cure. Its pathological process is often accompanied with local temperature rise, pH decrease, and other phenomena. Owing to their outstanding hydrophilic, biocompatibility, and responsive properties, hydrogels could accelerate the healing process. In this study, we chose chitosan oligosaccharide (COS) grafted with Pluronic F127 (F127-COS). Aldehyde hyaluronic acid (A-HA) oxidized by NaIO4. And added boric acid (BA) to prepare a thermosensitive and pH-responsive injectable self-healing F127-COS/A-HA/COS/BA (FCAB) hydrogel, loaded with drug deferoxamine (DFO) in order to have an accurate release and promote angiogenesis of diabetic foot ulcer. In vitro experiments had verified that the FCAB hydrogel system loaded with DFO (FCAB/D) could promote migration and angiogenesis of HUVEC. A diabetes rat back wound model further confirmed its role in promoting angiogenesis in wound repair process. The results showed that the FCAB/D hydrogel exhibited unique physicochemical properties, excellent biocompatibility, and significantly enhanced therapeutic effects for diabetic foot ulcer.

High dose, dual-release polymeric films for extended surgical bed paclitaxel delivery

While surgery represents a major therapy for most solid organ cancers, local recurrence is clinically problematic for cancers such as sarcoma for which adjuvant radiotherapy and systemic chemotherapy provide minimal local control or survival benefit and are dose-limited due to off-target side effects. We describe an implantable, biodegradable poly(1,2-glycerol carbonate) and poly(caprolactone) film with entrapped and covalently-bound paclitaxel enabling safe, controlled, and extended local delivery of paclitaxel achieving concentrations 10,000× tissue levels compared to systemic administration. Films containing entrapped and covalently-bound paclitaxel implanted in the tumor bed, immediately after resection of human cell line-derived chondrosarcoma and patient-derived xenograft liposarcoma and leiomyosarcoma in mice, improve median 90- or 200-day recurrence-free and overall survival compared to control mice. Furthermore, mice in the experimental film arm show no film-related morbidity. Continuous, extended, high-dose paclitaxel delivery via this unique polymer platform safely improves outcomes in three different sarcoma models and provides a rationale for future incorporation into human trials.

Interval delivery of 5HT2A agonists using multilayered polymer films

There is an urgent unmet medical need to develop therapeutic options for the ~50% of depression patients suffering from treatment-resistant depression, which is difficult to treat with existing psycho- and pharmaco-therapeutic options. Classical psychedelics, such as the 5HT2A agonists, have re-emerged as a treatment paradigm for depression. Recent clinical trials highlight the potential effectiveness of 5HT2A agonists to improve mood and psychotherapeutic growth in treatment-resistant depression patients, even in those who have failed a median of four previous medications in their lifetime. Moreover, microdosing could be a promising way to achieve long-term alleviation of depression symptoms without a hallucinogenic experience. However, there are a gamut of practical barriers that stymie further investigation of microdosing 5HT2A agonists, including: low compliance with the complicated dosing regimen, high risk of diversion of controlled substances, and difficulty and cost administering the long-term treatment regimens in controlled settings. Here, we developed a drug delivery system composed of multilayered cellulose acetate phthalate (CAP)/Pluronic F-127 (P) films for the encapsulation and interval delivery of 5HT2A agonists from a fully biodegradable and biocompatible implant. CAPP film composition, thickness, and layering strategies were optimized, and we demonstrated three distinct pulses from the multilayered CAPP films in vitro. Additionally, the pharmacokinetics and biodistribution of the 5HT2A agonist 2,5-Dimethoxy-4-iodoamphetamine (DOI) were quantified following the subcutaneous implantation of DOI-loaded single and multilayered CAPP films. Our results demonstrate, for the first time, the interval delivery of psychedelics from an implantable drug delivery system and open the door to future studies into the therapeutic potential of psychedelic delivery.

Current and Future Directions of Drug Delivery for the Treatment of Mental Illnesses

Mental illnesses including anxiety disorders, autism spectrum disorder, post-traumatic stress disorder, schizophrenia, depression, and others exact an immense toll on the healthcare system and society at large. Depression alone impacts 21 million adults and costs over $200 billion annually in the United States. However, pharmaceutical strategies to treat mental illnesses are lagging behind drug development in many other disease areas. Because many of the shortcomings of therapeutics for mental illness relate to delivery problems, drug delivery technologies have the potential to radically improve the effectiveness of therapeutics for these diseases. This review describes the current pharmacotherapeutic approaches to treating mental illnesses as well as drug delivery approaches that have improved existing therapies. Approaches to improve drug bioavailability, provide controlled release of therapeutics, and enable drug targeting to the central nervous system (CNS) will be highlighted. Moreover, next-generation delivery approaches such as environmentally-controlled release and interval/sequential drug release will be addressed. Based on the evolving landscape of the treatment of mental illnesses, the nascent field of drug delivery in mental health has tremendous potential for growth in terms of both economic and patient impact.

Design and in vitro/in vivo evaluations of a multiple-drug-containing gingiva disc for periodontotherapy

In the current work, we set out to develop and evaluate a gingiva disc of cellulose acetate phthalate and poloxamer F-127 for the simultaneous delivery of multiple drugs, namely minocycline, celecoxib, doxycycline hyclate, and simvastatin, to abolish infection, impede inflammation, avert collagen destruction, and promote alveolar bone regeneration, respectively. In vitro release studies revealed the sustained release profiles of the drugs for 12 h and that they were active against Staphylococcus aureus, Escherichia coli and Streptococcus mutans. The in vivo bioactivity levels of these drugs were assessed by comparing the number of colony forming units during different phases of a study on Wistar rats, and the results showed a reduction in the number of bacterial colonies with the applied formulation. A mucosal irritation study conducted on Wistar rat gingiva confirmed the non-irritancy of the optimal gingiva disc. Hence, this customized, non-invasive polymeric gingiva disc displaying a sustained release of drugs can be a useful tool to treat acute to moderate stages of periodontitis.

A gingiva disc of cellulose acetate phthalate and poloxaner F-127 was developed for the simultaneous delivery of multiple drugs, including minocycline, to promote alveolar bone regeneration by abolishing infection, impeding inflammation and averting collagen destruction.

A Hydrophobically Modified Bioadhesive Polymeric Carrier for Controlled Drug Delivery to Mucosal Surfaces

We have synthesized and studied a new type of polymeric drugcarrier based on hydrophobically modified bioadhesive graft copolymers. Two different hydrophobic oligomers, an oligo(methyl methacrylate) (oMMA) and a random co-oligomer of MMA with hydroxyethyl methacrylate (HEMA) were separately grafted to a polyacrylic acid (PAAc) backbone. This system forms a physical hydrogel network containing hydrophobic domains. The in vitro release of hydrophilic drugs such as theophylline and a model protein drug, lysozyme, and moderately hydrophobic drugs such as propranolol hydrochloride has been investigated. The results suggest the existence of a macroporous structure at higher levels of oMMA grafting. The introduction of HEMA into the graft chain slowed the release of propranolol hydrochloride, which suggests that the release rate of a moderately hydrophobic drug could be controlled by adjusting the hydrophobicity of the grafted chain. In the case of release of lysozyme, a cationic protein used as a model protein drug, the graft copolymers of oMMA retained increasing amounts of the protein as the graft level increased. This supported the concept of formation of a macroporous structure at higher MMA graft levels, with a cationic protein such as lysozyme being attracted to and bound by the hydrophobic domain interfacial regions. The introduction of as little as 10 mol% of HEAIA into the graft chain gave rise to rapid and complete release of lysozyme.

Combined Effects of Drugs and Plasticizers on the Properties of Drug Delivery Films

Formation of scar tissue may be reduced or prevented if wounds were locally treated with a combination of molecules tuned to the different healing phases, guiding tissue regeneration along a scar free path. To this end, drug delivery devices made of cellulose acetate phthalate and Pluronic F-127 were loaded with either quercetin or pirfenidone and plasticized with either triethyl citrate (TEC) or tributyl citrate (TBC). Quercetin inhibits oxidative stress, and pirfenidone has been shown to reduce production of pro-inflammatory and fibrogenic molecules. The combined effects of drug and plasticizer on erosion, release, and mechanical properties of the drug delivery films were investigated. TEC-plasticized films containing quercetin released drug at a slower rate than did TBC films. Pirfenidone-loaded films released drug at a faster rate than erosion occurred for both types of plasticizers. Higher plasticizer contents of both TEC and TBC increased the elongation and decreased the elastic modulus. In contrast, increased pirfenidone loading in both TEC and TBC films resulted in a significantly higher modulus, an anti-plasticizer effect. Adding pirfenidone significantly decreased elongation for all film types, but quercetin-loaded samples had significantly greater elongation with increasing drug content. Films containing quercetin elongated more than did pirfenidone-loaded films. Quercetin is over 1.5 times larger than pirfenidone, has water solubility over 12 times lower, and has 6 times more bonding sites than pirfenidone. These differences affected how the two drugs interacted with cellulose acetate phthalate and Pluronic F-127 and thereby determined polymer properties. Drug release, erosion, and mechanical properties of association polymer films can be tailored by the characteristics of the drugs and plasticizers included in the system.

Bioerodible system for sequential release of multiple drugs

Because many complex physiological processes are controlled by multiple biomolecules, comprehensive treatment of certain disease conditions may be more effectively achieved by administration of more than one type of drug. Thus, the objective of the present research was to develop a multilayered, polymer-based system for sequential delivery of multiple drugs. The polymers used were cellulose acetate phthalate (CAP) complexed with Pluronic F-127 (P). After evaluating morphology of the resulting CAPP system, in vitro release of small molecule drugs and a model protein was studied from both single and multilayered devices. Drug release from single-layered CAPP films followed zero-order kinetics related to surface erosion of the association polymer. Release studies from multilayered CAPP devices showed the possibility of achieving intermittent release of one type of drug as well as sequential release of more than one type of drug. Mathematical modeling accurately predicted the release profiles for both single layer and multilayered devices. The present CAPP association polymer-based multilayer devices can be used for localized, sequential delivery of multiple drugs for the possible treatment of complex disease conditions, and perhaps for tissue engineering applications, that require delivery of more than one type of biomolecule.

Design of a multiple drug delivery system directed at periodontitis

Periodontal disease is highly prevalent, with 90% of the world population affected by either periodontitis or its preceding condition, gingivitis. These conditions are caused by bacterial biofilms on teeth, which stimulate a chronic inflammatory response that leads to loss of alveolar bone and, ultimately, the tooth. Current treatment methods for periodontitis address specific parts of the disease, with no individual treatment serving as a complete therapy. The present research sought to demonstrate development of a multiple drug delivery system for stepwise treatment of different stages of periodontal disease. More specifically, multilayered films were fabricated from an association polymer comprising cellulose acetate phthalate and Pluronic F-127 to achieve sequential release of drugs. The four types of drugs used were metronidazole, ketoprofen, doxycycline, and simvastatin to eliminate infection, inhibit inflammation, prevent tissue destruction, and aid bone regeneration, respectively. Different erosion times and adjustable sequential release profiles were achieved by modifying the number of layers or by inclusion of a slower-eroding polymer layer. Analysis of antibiotic and anti-inflammatory bioactivity showed that drugs released from the devices retained 100% bioactivity. The multilayered CAPP delivery system offers a versatile approach for releasing different drugs based on the pathogenesis of periodontitis and other conditions.

The effect of plasticizers on the erosion and mechanical properties of polymeric films

Cellulose acetate phthalate and Pluronic F-127 combined together (70:30 wt:wt) create a rigid, surface-eroding association polymer. To impart flexibility into the polymer system and allow for a drug delivery film that can contour to varying wound shapes, plasticizers were added. Triethyl citrate or tributyl citrate was combined with cellulose acetate phthalate and Pluronic F-127 at 0, 10, or 20 wt%. Mechanical analysis was performed on the films as they were prepared and following a 2-h incubation in phosphate-buffered saline. Tensile tests showed that higher plasticizer content increased the % elongation but decreased the elastic modulus and ultimate tensile strength. The effect triethyl citrate had on the % elongation was twice as much than that of tributyl citrate. After incubation, % elongation, elastic modulus, and ultimate tensile strength all increased because plasticizer leached out of the films. Microcomputed tomography and scanning electron microscopy were performed on the samples both before and after incubation to determine how erosion and leaching of plasticizer affected the interior and exterior structure of the films. Porosity increased as plasticizer content increased; however, plasticizer content did not have a significant effect on the rate of erosion. The mechanical properties of cellulose acetate phthalate-Pluronic films can be adjusted by the type and amount of plasticizer added to the system and therefore can be tailored for different drug delivery applications.

Therapeutic strategies based on polymeric microparticles

The development of the field of materials science, the ability to perform multidisciplinary scientific work, and the need for novel administration technologies that maximize therapeutic effects and minimize adverse reactions to readily available drugs have led to the development of delivery systems based on microencapsulation, which has taken one step closer to the target of personalized medicine. Drug delivery systems based on polymeric microparticles are generating a strong impact on preclinical and clinical drug development and have reached a broad development in different fields supporting a critical role in the near future of medical practice. This paper presents the foundations of polymeric microparticles based on their formulation, mechanisms of drug release and some of their innovative therapeutic strategies to board multiple diseases.

A new bioerodible system for sustained local drug delivery based on hydrolytically activated in situ macromolecular association

To prolong the duration of polymer erosion over existing approaches for sustained local drug delivery, we investigated a new bioerodible system based on hydrolytically activated in situ formation of interpolymer complexes in binary blends of high MW poly(vinyl methyl ether-co-maleic anhydride) (PVMMA) and poly(ethylene oxide) (PEO). In an aqueous environment of use, the hydrophobic PVMMA component of the blend undergoes hydrolysis converting the anhydride to free carboxylic acid groups which in turn form in situ intermolecular complexes with the PEO component of the blend. The formation of such hydrogen-bonded complexes with a condensed structure at the blend surface helps to retard the further progression of polymer erosion and drug release. The effects of PVMMA/PEO composition on blend morphology, polymer erosion and drug release were evaluated with the aid of fluorescence labeled PVMMA. The results show a decrease in miscibility in PVMMA/PEO blend with increasing PEO content. At low PEO contents (below 40%), the in vitro rate of release of a model drug metronidazole decreases with increasing PEO content, resulting in extended release duration over several days. On the other hand, excessive phase separation at PEO contents above 40% gives rise to higher rate and shorter duration of drug release.

Formulations for intermittent release of parathyroid hormone (1-34) and local enhancement of osteoblast activities

The objective of these studies was to develop simple, implantable devices that intermittently release PTH(1-34) and thus could be used for locally stimulating bone formation. The formulations were based on the association polymer system of cellulose acetate phthalate and Pluronic F-127. Release profiles for intermittent devices showed five discrete peaks, whereas sustained devices exhibited zero-order kinetics. Osteoblastic activity was greater for cells intermittently treated with PTH(1-34) compared to sustained exposure. These controlled release devices delivering PTH(1-34) in an intermittent manner may be useful for affecting osteoblast activities in a localized area.

Alternating release of different bioactive molecules from a complexation polymer system

Regeneration of bone is driven by the action of numerous biomolecules. However, most osteobiologic devices mainly depend on delivery of a single molecule. The present studies were directed at investigating a polymeric system that enables localized, alternating delivery of two or more biomolecules. The osteotropic biomolecules studied were simvastatin hydroxyacid (Sim) and parathyroid hormone (1-34) (PTH(1-34)), and the antimicrobial peptide cecropin B (CB) was also incorporated. Loaded microspheres were made using the complexation polymer system of cellulose acetate phthalate and Pluronic F-127 (blend ratio, 7:3). By alternating layers of the different types of microspheres, 10-layer devices were made to release CB and Sim, CB and PTH, or Sim and PTH. In vitro experiments showed five discrete peaks for each molecule over a release period of approximately two weeks. MC3T3-E1 osteoblastic cells alternately exposed to the osteotropic biomolecules showed enhanced proliferation and early osteoblastic activity. Alternating delivery of 10nm Sim and either 500pg/ml or 5ng/ml PTH showed additive effects compared to the CB/Sim or CB/PTH devices. These implantable formulations may be useful for alternating delivery of different biomolecules to stimulate concurrent biological effects in focal tissue regeneration applications.

Bioerodible devices for intermittent release of simvastatin acid

The association polymer system of cellulose acetate phthalate (CAP) and Pluronic F-127 (PF-127) was used to create intermittent release devices for mimicking the daily injection of simvastatin that has been reported to stimulate bone formation. To enhance solubility in water, prodrug simvastatin was modified by lactone ring opening, which converts the molecule to its hydroxyacid form. CAP/PF-127 microspheres incorporating simvastatin acid were prepared by a water-acetone-oil-water (W/A/O/W) triple emulsion process. Devices were then fabricated by pressure-sintering UV-treated blank and drug-loaded microspheres. Using a multilayered fabrication approach, pulsatile release profiles were obtained. Delivery was varied by changing loading, number of layers, blend ratio, and incubation conditions. To determine the cellular effects of intermittent exposure to simvastatin acid, MC3T3-E1 cells were cultured with either alternating or sustained concentrations of simvastatin acid in the medium, and DNA content, alkaline phosphatase activity, and osteocalcin secretion were measured. For all three cell responses, cultures exposed to simvastatin acid showed higher activity than did control cultures. Furthermore, cell activity was greater for cells cultured with intermittent concentrations of simvastatin acid compared to cells that were constantly treated. These results imply that devices intermittently releasing simvastatin acid warrant further study for locally promoting osteogenesis.

A review of poloxamer 407 pharmaceutical and pharmacological characteristics

Poloxamer 407 copolymer (ethylene oxide and propylene oxide blocks) shows thermoreversible properties, which is of the utmost interest in optimising drug formulation (fluid state at room temperature facilitating administration and gel state above sol-gel transition temperature at body temperature promoting prolonged release of pharmacological agents). Pharmaceutical evaluation consists in determining the rheological behaviour (flow curve or oscillatory studies), sol-gel transition temperature, in vitro drug release using either synthetic or physiological membrane and (bio)adhesion characteristics. Poloxamer 407 formulations led to enhanced solubilisation of poorly water-soluble drugs and prolonged release profile for many galenic applications (e.g., oral, rectal, topical, ophthalmic, nasal and injectable preparations) but did not clearly show any relevant advantages when used alone. Combination with other excipients like Poloxamer 188 or mucoadhesive polymers promotes Poloxamer 407 action by optimising sol-gel transition temperature or increasing bioadhesive properties. Inclusion of liposomes or micro(nano)particles in Poloxamer 407 formulations offers interesting prospects, as well. Besides these promising data, Poloxamer 407 has been held responsible for lipidic profile alteration and possible renal toxicity, which compromises its development for parenteral applications. In addition, new findings have demonstrated immuno-modulation and cytotoxicity-promoting properties of Poloxamer 407 revealing significant pharmacological interest and, hence, human trials are in progress to specify these potential applications.

Optimization and development of a core-in-cup tablet for modulated release of theophylline in simulated gastrointestinal fluids

A triple-layer core-in-cup tablet that can release theophylline in simulated gastrointestinal (GI) fluids at three distinct rates has been developed. The first layer is an immediate-release layer; the second layer is a sustained-release layer; and the last layer is a boost layer, which was designed to coincide with a higher nocturnal dose of theophylline. The study consisted of two stages. The first stage optimized the sustained-release layer of the tablet to release theophylline over a period of 12 hr. Results from this stage indicated that 30% w/w acacia gum was the best polymer and concentration to use when compressed to a hardness of 50 N/m2. The second stage of the study involved the investigation of the final triple-layer core-in-cup tablet to release theophylline at three different rates in simulated GI fluids. The triple-layer modulated core-in-cup tablet successfully released drug in simulated fluids at an initial rate of 40 mg/min, followed by a rate of 0.4085 mg/min, in simulated gastric fluid TS, 0.1860 mg/min in simulated intestinal fluid TS, and finally by a boosted rate of 0.6952 mg/min.

The pH-dependent biphasic release of azidothymidine from a layered composite of PVA disks and P(MMA/MAA) spheres

A composite device was developed to provide a biphasic drug release using poly(vinyl alcohol) (PVA) and poly(methylmethacrylate-co-methacrylic acid) (P(MMA/MAA)) spheres. Azidothymidine (AZT), an anti-HIV agent with a short biological half-life, was used as the model drug. Dynamic and equilibrium swelling of the polymers, and kinetics of AZT release from these polymers were determined in pH 1.2 and 6.8 buffer solutions. The swelling of PVA and release of AZT from PVA disks were fast and nearly pH-independent, whereas the swelling behavior and drug release kinetics of P(MMA/MAA) spheres were strongly pH-dependent. A swelling interface number for the spheres at pH 6.8 was determined to be Sw&z.Lt;1 and time dependent. Nevertheless, Fickian diffusion might also contribute to the drug release in this system. The composite disks consisting of PVA matrix and P(MMA/MAA) spheres provided prolonged (over 20 h) and more steady release profiles, differing profoundly from individual components. Such release profiles resulted from the second phase release at pH 6.8 and the presence of PVA layer. The relative drug loading in the matrix could be tailored to produce release profiles varying from a distinct bimodal release to a pseudo zero-order release with an initial burst.

Photopolymerized, multilaminated matrix devices with optimized nonuniform initial concentration profiles to control drug release

This paper describes a novel approach to obtain desired release profiles from diffusion-controlled matrix devices by employing nonuniform initial concentration profiles theoretically and experimentally. Theoretically, a model was developed to examine the effect of nonuniform initial concentration profiles on matrix release behavior, and an optimization technique was investigated to determine suitable nonuniform initial concentration profiles which provide desired release patterns. Experimentally, release rates of an organic dye from photopolymerized matrix devices were measured to test the application of these mathematical techniques and the efficacy of photolaminated matrices in approximating the optimized release behavior. All system parameters were measured by independent experiments, and the experimental release data agree very well with the computed results.

Programmable drug release of highly water-soluble pentoxifylline from dry-coated wax matrix tablets

The programmable release of pentoxifylline from a dry-coated wax matrix tablet containing behenic acid as wax matrix was investigated at 37 degrees C in Japanese Pharmacopeia XII 1st (pH 1.2) and 2nd (pH 6.8) fluids. The dry-coated tablet consisted of a low drug concentration (33% w/w) in the outer layer tablet and a high concentration (50-67% w/w) in the core. The drug release from the wax matrix significantly increased after penetrating the core; therefore, the drug release profiles showed specific biphasic curves. Because the contact angle of the wax matrix tablet increased with a decrease in the drug concentration, the fluid penetration in wax matrix tablet increased with an increase of the drug concentration. The time required for 75% drug release (T75) decreased with an increasing drug concentration in the core, and the T75 at pH 6.8 was slightly longer than that in pH 1.2. The larger core tablet had a shorter T75, indicating that the drug release rate was controlled by regulating the drug concentration and/or the weight of the core tablet.

A new bioerodible polymer insert for the controlled release of metronidazole

This study evaluates a new class of bioerodible polymers as periodontal inserts for the controlled release of metronidazole. The system is based on association polymers formed from compatible blends of cellulose acetate phthalate (CAP) and a hydrophobic block copolymer of polyoxyethylene and polyoxypropylene, Pluronic L101. In addition to characterizing these polymers by thermal analysis, their erosion and metronidazole release characteristics were determined both in vitro, and in vivo using a rat model. The results show that increasing the concentration of Pluronic L101 in the blend to 50% and above leads to a sharp reduction in the rates of polymer erosion and metronidazole release. The characteristics of these slowly eroding films are potentially suitable for use as periodontal drug inserts with an effective duration of up to several days. Depending on the blend composition, the mechanism of metronidazole release was found to range from a surface erosion-controlled process to an erosion-modulated diffusion process. In all in vivo experiments, no signs of adverse tissue reactions were detected. Based on these results, prototype delivery inserts were designed and subsequently evaluated in volunteer patients. Preliminary results from this pilot study show that the metronidazole concentration in the gingival crevicular fluid was significant throughout the sampling period of up to 3 hr and remained well above the minimum inhibitory concentration for most periodontal pathogens. In addition, no discomfort or irritation was reported by the test subjects.