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Parashar R, Vyas A, Sah AK, Hemnani N, Thangaraju P, Suresh PK. Recent Updates on Nanocarriers for Drug Delivery in Posterior Segment Diseases with Emphasis on Diabetic Retinopathy. Curr Diabetes Rev 2024; 20:e171023222282. [PMID: 37855359 DOI: 10.2174/0115733998240053231009060654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/24/2023] [Accepted: 07/18/2023] [Indexed: 10/20/2023]
Abstract
In recent years, various conventional formulations have been used for the treatment and/or management of ocular medical conditions. Diabetic retinopathy, a microvascular disease of the retina, remains the leading cause of visual disability in patients with diabetes. Currently, for treating diabetic retinopathy, only intraocular, intravitreal, periocular injections, and laser photocoagulation are widely used. Frequent administration of these drugs by injections may lead to serious complications, including retinal detachment and endophthalmitis. Although conventional ophthalmic formulations like eye drops, ointments, and suspensions are available globally, these formulations fail to achieve optimum drug therapeutic profile due to immediate nasolacrimal drainage, rapid tearing, and systemic tearing toxicity of the drugs. To achieve better therapeutic outcomes with prolonged release of the therapeutic agents, nano-drug delivery materials have been investigated. These nanocarriers include nanoparticles, solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC), dendrimers, nanofibers, in-situ gel, vesicular carriers, niosomes, and mucoadhesive systems, among others. The nanocarriers carry the potential benefits of site-specific delivery and controlled and sustained drug release profile. In the present article, various nanomaterials explored for treating diabetic retinopathy are reviewed.
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Affiliation(s)
- Ravi Parashar
- University Institute of Pharmacy, Faculty of Technology, Pt. Ravishankar Shukla University, Raipur, 492010, (C.G.), India
| | - Amber Vyas
- University Institute of Pharmacy, Faculty of Technology, Pt. Ravishankar Shukla University, Raipur, 492010, (C.G.), India
| | - Abhishek K Sah
- Department of Pharmacy, Shri Govindram Seksariya Institute of Technology & Science (SGSITS), 23-Park Road, Indore, 452003 (M.P.), India
| | - Narayan Hemnani
- University Institute of Pharmacy, Faculty of Technology, Pt. Ravishankar Shukla University, Raipur, 492010, (C.G.), India
| | | | - Preeti K Suresh
- University Institute of Pharmacy, Faculty of Technology, Pt. Ravishankar Shukla University, Raipur, 492010, (C.G.), India
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Amrutkar CS, Patil SB. Nanocarriers for ocular drug delivery: Recent advances and future opportunities. Indian J Ophthalmol 2023; 71:2355-2366. [PMID: 37322644 PMCID: PMC10418032 DOI: 10.4103/ijo.ijo_1893_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/27/2022] [Accepted: 04/06/2023] [Indexed: 06/17/2023] Open
Abstract
Topical route of administration is very important and the most commonly used method of drug delivery for treatment of ocular diseases. However, due to unique anatomical and physiological barriers of eye, it is difficult to achieve the therapeutic concentration in the targeted tissue within the eye. To overcome the effect of these barriers in absorption and to provide targeted and sustained drug delivery, various advances have been made in developing safe and efficient drug delivery systems. Various formulation strategies for ocular drug delivery are used, like basic formulation techniques for improving availability of drugs, viscosity enhancers, and use of mucoadhesives for drug retention and penetration enhancers to promote drug transport to the eye. In this review, we present a summary of the current literature to understand the anatomical and physiological limitations in achieving adequate ocular bioavailability and targeted drug delivery of topically applied drugs and use of new techniques in formulating dosage forms in overcoming these limitations. The recent and future advances in nanocarrier-mediated drug delivery may have the potential to provide patient-friendly and noninvasive techniques for the treatment of diseases related to the anterior and posterior segments of the eye.
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Affiliation(s)
- Chetan S Amrutkar
- Department of Pharmaceutics, SNJB’s Shriman Sureshdada Jain College of Pharmacy, Nashik, Maharashtra, India
| | - Sanjay B Patil
- Department of Pharmaceutics, SNJB’s Shriman Sureshdada Jain College of Pharmacy, Nashik, Maharashtra, India
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Gonzalez-Cortes JH, Martinez-Pacheco VA, Gonzalez-Cantu JE, Bilgic A, de Ribot FM, Sudhalkar A, Mohamed-Hamsho J, Kodjikian L, Mathis T. Current Treatments and Innovations in Diabetic Retinopathy and Diabetic Macular Edema. Pharmaceutics 2022; 15:pharmaceutics15010122. [PMID: 36678750 PMCID: PMC9866607 DOI: 10.3390/pharmaceutics15010122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023] Open
Abstract
Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide. Multiple treatment options have been used over time to attempt to modify the natural progression of the disease in both proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). These two retinal complications are the result of microvascular occlusions and vascular hyperpermeability and are considered one of the leading causes of irreversible blindness in patients of working age. It is now well demonstrated that PDR and DME are associated with increased levels of inflammatory and pro-angiogenic factors in the ocular compartment. To date, laser photocoagulation, vascular endothelial growth factor (VEGF) inhibitors, and corticosteroids have demonstrated efficacy in their treatment in large randomized controlled trials and in real-life observational studies. This manuscript aims to provide a comprehensive review of current treatments, including the main drugs used in diabetic pathologic manifestations, as well as new therapeutic alternatives, such as extended-release intraocular devices.
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Affiliation(s)
- Jesus H. Gonzalez-Cortes
- Ophthalmology Department, School of Medicine, University Hospital “Dr. Jose Eleuterio Gonzalez”, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico
- Correspondence: ; Tel.: +52-8182545652
| | - Victor A. Martinez-Pacheco
- Retina and Vitreous Department, Hospital de Nuestra Señora de la Luz, Universidad Nacional Autónoma de México, Mexico City 06030, Mexico
| | - Jesus E. Gonzalez-Cantu
- Ophthalmology Department, Instituto Avalos, University Galileo, Guatemala City 01010, Guatemala
| | - Alper Bilgic
- Alphavision Augenarztpraxis, 27568 Bremerhaven, Germany
| | - Francesc March de Ribot
- Department of Ophthalmology, Otago University, Dunedin 9016, New Zealand
- Department of Ophthalmology, Girona University, 17004 Girona, Spain
| | | | - Jesus Mohamed-Hamsho
- Ophthalmology Department, School of Medicine, University Hospital “Dr. Jose Eleuterio Gonzalez”, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico
| | - Laurent Kodjikian
- Service d’Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69004 Lyon, France
- Unité Mixte de Recherche—Centre National de la Recherche Scientifique 5510, Matéis, Villeurbanne, 69004 Lyon, France
| | - Thibaud Mathis
- Service d’Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69004 Lyon, France
- Unité Mixte de Recherche—Centre National de la Recherche Scientifique 5510, Matéis, Villeurbanne, 69004 Lyon, France
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Markan A, Neupane S, Agrawal R, Gupta V. Newer therapeutic agents for retinal diseases. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2030709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ashish Markan
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Swechya Neupane
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rupesh Agrawal
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Sen Hospital, Novena, Singapore
| | - Vishali Gupta
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Nirmal J, Barathi VA, Dickescheid A, Wey YS, Nirmal S, Raja MM, Venkatraman S, Agrawal R. Potential of subconjunctival aflibercept in treating choroidal neovascularization. Exp Eye Res 2020; 199:108187. [PMID: 32795527 DOI: 10.1016/j.exer.2020.108187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 11/17/2022]
Abstract
The study aimed to evaluate the intraocular pharmacokinetics and efficacy of aflibercept after subconjunctival injection in animal models for treating choroidal neovascularization (CNV) associated with Age-Related Macular Degeneration (AMD). New Zealand albino rabbits received aflibercept (2000 μg/50 μl) in one eye, and the other eye was used as control. At 7, 14, 21 and 28 days, the animals were sacrificed to dissect the ocular tissues, and serum was collected at 1hr, 3 h, 1, 7, 14, 21 and 28 days. The concentration of aflibercept in various ocular tissues and serum were measured using the immunoassay technique. The concentration maximum (Cmax) at the Retinal Pigment Epithelium (RPE)-choroid complex and retina in treated eyes was 261.55 and 33.83 ng/gm, respectively. The area under the curve (AUC0-last) for RPE-Choroid and retina were 2094.02 and 290.33 days. ng/gm respectively. The time maximum (Tmax) for the ocular tissues was reached on day 7. In the vitreous humour, a lower level of aflibercept was retrieved. The Cmax (1766.84 ng/mL) in the serum was reached on day 1, followed by a decline in the concentration till the end of the study period. In treated eyes, the levels of aflibercept in most of the ocular tissues were maintained for at least 21 days above the invitro IC50 concentration. The results of the efficacy study show that subconjunctival aflibercept could reach the therapeutic target to inhibit CNV. The subconjunctival aflibercept could be a less invasive route for treating CNV with AMD.
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Affiliation(s)
- Jayabalan Nirmal
- Translational Pharmaceutics Laboratory, Department of Pharmacy, Birla Institute of Technology & Science, Pilani, Hyderabad Campus, Hyderabad, India; Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore.
| | - Veluchamy A Barathi
- Singapore Eye Research Institute, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, DUKE-NUS Graduate Medical School, Singapore
| | - Andreas Dickescheid
- Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore
| | | | - Sonali Nirmal
- Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore
| | - Miguel Moreno Raja
- Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore
| | - Subbu Venkatraman
- Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore
| | - Rupesh Agrawal
- Nanyang Technological University-Northwestern Institute for Nanomedicine, School of Material Science & Engineering, Nanyang Technological University, Singapore; Singapore Eye Research Institute, Singapore; Tan Tock Seng Hospital, Singapore.
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Radhakrishnan K, Vincent A, Joseph RR, Moreno M, Dickescheid A, Agrawal R, Venkatraman S. Hollow Microcapsules as Periocular Drug Depot for Sustained Release of Anti-VEGF Protein. Pharmaceutics 2019; 11:E330. [PMID: 31336771 PMCID: PMC6680760 DOI: 10.3390/pharmaceutics11070330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 01/30/2023] Open
Abstract
Diseases affecting the posterior segment of the eye such as age-related macular degeneration and diabetic retinopathy are leading causes of blindness all over the world. The current treatment regimen for such diseases involves repeated intravitreal injections of anti- Vascular Endothelial Growth Factor (VEGF) proteins. This method is highly invasive and can lead to severe complications. In an attempt to develop less invasive alternatives, we propose the use of a controlled release system consisting of anti-VEGF loaded hollow microcapsules that can be administered periocularly to form drug eluting depots on the episcleral surface. The microcapsules with either positive or negative surface charge were prepared by a layer by layer approach and showed pH responsive permeability switching. An ex vivo experiment using porcine sclera indicated positively charged microcapsules remained on the episcleral surface over four days while the negatively charged microcapsules were washed away. These positively charged microcapsules were then loaded with anti-VEGF protein ranibizumab using pH dependent permeability switching and protein release from the microcapsules were studied using an in vitro setup. An ex vivo experiment utilizing porcine sclera demonstrated sustained release of ranibizumab over seven days with zero-order kinetics.
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Affiliation(s)
- Krishna Radhakrishnan
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore.
| | - Anita Vincent
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore
| | - Rini Rachel Joseph
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore
| | - Miguel Moreno
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore
| | - Andreas Dickescheid
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore
| | - Rupesh Agrawal
- Tan Tock Seng Hospital, Novena, Singapore 308433, Singapore
| | - Subbu Venkatraman
- NTU-Northwestern Institute for Nanomedicine (NNIN), School of Materials Science and Engineering, Nanyang Technological University (NTU), 50, Nanyang Avenue, Singapore 639798, Singapore.
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Therapeutic targeting of angiogenesis molecular pathways in angiogenesis-dependent diseases. Biomed Pharmacother 2018; 110:775-785. [PMID: 30554116 DOI: 10.1016/j.biopha.2018.12.022] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/02/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023] Open
Abstract
Angiogenesis is a critical step in the progression of almost all human malignancies and some other life-threatening diseases. Anti-angiogenic therapy is a novel and effective approach for treatment of angiogenesis-dependent diseases such as cancer, diabetic retinopathy, and age-related macular degeneration. In this article, we will review the main strategies developed for anti-angiogenic therapies beside their clinical applications, the major challenges, and the latest advances in the development of anti-angiogenesis-based targeted therapies.
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Nayak K, Misra M. A review on recent drug delivery systems for posterior segment of eye. Biomed Pharmacother 2018; 107:1564-1582. [DOI: 10.1016/j.biopha.2018.08.138] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 12/12/2022] Open
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Moreno M, Pow PY, Tabitha TST, Nirmal S, Larsson A, Radhakrishnan K, Nirmal J, Quah ST, Geifman Shochat S, Agrawal R, Venkatraman S. Modulating release of ranibizumab and aflibercept from thiolated chitosan-based hydrogels for potential treatment of ocular neovascularization. Expert Opin Drug Deliv 2017. [PMID: 28643528 DOI: 10.1080/17425247.2017.1343297] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND This paper describes the synthesis of thiolated chitosan-based hydrogels with varying degrees of crosslinking that has been utilized to modulate release kinetics of two clinically relevant FDA-approved anti-VEGF protein drugs, ranibizumab and aflibercept. These hydrogels have been fabricated into disc shaped structures for potential use as patches on ocular surface. METHODS Protein conformational changes and aggregation after loading and release was evaluated by circular dichroism (CD), steady-state tryptophan fluorescence spectroscopy, electrophoresis and size-exclusion chromatography (SEC). Finally, the capacity of both released proteins to bind to VEGF was tested by ELISA and surface plasmon resonance (SPR) technology. RESULTS The study demonstrates the versatility of thiolated chitosan-based hydrogels for delivering proteins. The effect of various parameters of the hydrogel on protein release kinetics and mechanism of protein release was studied using the Korsmeyer-Peppas release model. Furthermore, we have studied the stability of released proteins in detail while comparing it with non-entrapped proteins under physiological conditions to understand the effect of formulation conditions on protein stability. CONCLUSIONS The disc-shaped thiolated chitosan-based hydrogels provide a potentially useful platform to deliver ranibizumab and aflibercept for the treatments of ocular diseases such as wet AMD, DME and corneal neovascularization.
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Affiliation(s)
- Miguel Moreno
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Poh Yih Pow
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Tan Su Teng Tabitha
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Sonali Nirmal
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Andreas Larsson
- b School of Biological Sciences , Nanyang Technological University , Singapore
| | - Krishna Radhakrishnan
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Jayabalan Nirmal
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
| | - Soo Tng Quah
- b School of Biological Sciences , Nanyang Technological University , Singapore
| | | | | | - Subbu Venkatraman
- a NTU-Northwestern Institute for Nanomedicine (NNIN), School of Material Science & Engineering (MSE) , Nanyang Technological University (NTU) , Singapore
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Bisht R, Mandal A, Jaiswal JK, Rupenthal ID. Nanocarrier mediated retinal drug delivery: overcoming ocular barriers to treat posterior eye diseases. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2017; 10. [DOI: 10.1002/wnan.1473] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/05/2017] [Accepted: 03/11/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Rohit Bisht
- Buchanan Ocular Therapeutics Unit (BOTU), Department of Ophthalmology, New Zealand National Eye Center, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Abhirup Mandal
- Division of Pharmaceutical Sciences, School of Pharmacy; University of Missouri-Kansas City; Kansas City MO USA
| | - Jagdish K. Jaiswal
- Auckland Cancer Society Research Center, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Ilva D. Rupenthal
- Buchanan Ocular Therapeutics Unit (BOTU), Department of Ophthalmology, New Zealand National Eye Center, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
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