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Jemni-Damer N, Guedan-Duran A, Fuentes-Andion M, Serrano-Bengoechea N, Alfageme-Lopez N, Armada-Maresca F, Guinea GV, Pérez-Rigueiro J, Rojo F, Gonzalez-Nieto D, Kaplan DL, Panetsos F. Biotechnology and Biomaterial-Based Therapeutic Strategies for Age-Related Macular Degeneration. Part I: Biomaterials-Based Drug Delivery Devices. Front Bioeng Biotechnol 2020; 8:549089. [PMID: 33224926 PMCID: PMC7670958 DOI: 10.3389/fbioe.2020.549089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 10/06/2020] [Indexed: 12/22/2022] Open
Abstract
Age-related Macular Degeneration (AMD) is an up-to-date untreatable chronic neurodegenerative eye disease of multifactorial origin, and the main causes of blindness in over 65 years old people. It is characterized by a slow progression and the presence of a multitude of factors, highlighting those related to diet, genetic heritage and environmental conditions, present throughout each of the stages of the illness. Current therapeutic approaches, mainly consisting of intraocular drug delivery, are only used for symptoms relief and/or to decelerate the progression of the disease. Furthermore, they are overly simplistic and ignore the complexity of the disease and the enormous differences in the symptomatology between patients. Due to the wide impact of the AMD and the up-to-date absence of clinical solutions, the development of biomaterials-based approaches for a personalized and controlled delivery of therapeutic drugs and biomolecules represents the main challenge for the defeat of this neurodegenerative disease. Here we present a critical review of the available and under development AMD therapeutic approaches, from a biomaterials and biotechnological point of view. We highlight benefits and limitations and we forecast forthcoming alternatives based on novel biomaterials and biotechnology methods. In the first part we expose the physiological and clinical aspects of the disease, focusing on the multiple factors that give origin to the disorder and highlighting the contribution of these factors to the triggering of each step of the disease. Then we analyze available and under development biomaterials-based drug-delivery devices (DDD), taking into account the anatomical and functional characteristics of the healthy and ill retinal tissue.
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Affiliation(s)
- Nahla Jemni-Damer
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Atocha Guedan-Duran
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - María Fuentes-Andion
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Nora Serrano-Bengoechea
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Silk Biomed SL, Madrid, Spain
| | - Nuria Alfageme-Lopez
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Silk Biomed SL, Madrid, Spain
| | | | - Gustavo V Guinea
- Silk Biomed SL, Madrid, Spain.,Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Material Science, Civil Engineering Superior School, Universidad Politécnica de Madrid, Madrid, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - José Pérez-Rigueiro
- Silk Biomed SL, Madrid, Spain.,Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Material Science, Civil Engineering Superior School, Universidad Politécnica de Madrid, Madrid, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Francisco Rojo
- Silk Biomed SL, Madrid, Spain.,Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Material Science, Civil Engineering Superior School, Universidad Politécnica de Madrid, Madrid, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Daniel Gonzalez-Nieto
- Silk Biomed SL, Madrid, Spain.,Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA, United States
| | - Fivos Panetsos
- Neuro-Computing and Neuro-Robotics Research Group, Complutense University of Madrid, Madrid, Spain.,Innovation Group, Institute for Health Research San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Silk Biomed SL, Madrid, Spain
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Humayun M, Santos A, Altamirano JC, Ribeiro R, Gonzalez R, de la Rosa A, Shih J, Pang C, Jiang F, Calvillo P, Huculak J, Zimmerman J, Caffey S. Implantable MicroPump for Drug Delivery in Patients with Diabetic Macular Edema. Transl Vis Sci Technol 2014; 3:5. [PMID: 25653883 PMCID: PMC4315583 DOI: 10.1167/tvst.3.6.5] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/11/2014] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To demonstrate the safety and surgical feasibility of the first-in-man ocular implant of a novel Posterior MicroPump Drug Delivery System (PMP) in patients with diabetic macular edema (DME) and to report on the device capabilities for delivering a programmable microdose. METHODS This was a single center, single arm, open-label, prospective study. Eleven patients with DME and visual acuity equal to or worse than 20/40 were included. The PMP prefilled with ranibizumab was implanted into the subconjunctival space. After implantation, the PMP was wirelessly controlled to deliver a programmed microdose. Comprehensive ophthalmic exams and optical coherence tomography were performed biweekly for 90 days. At the end of the study, the PMP was explanted and the subjects thereafter received standard of care for DME (i.e., laser or intravitreal injections). RESULTS All 11 surgical implantations were without complications and within the skill sets of a retinal surgeon. No serious adverse events occurred during the follow-up period. At no point were visual acuity and central foveal thickness worse than baseline in the implanted eye. The PMP delivered the programmed ranibizumab dosage in seven subjects. The remaining four patients received a lower than target dose, and the treatment was complemented with standard intravitreal injection. CONCLUSIONS This study demonstrates the first-in-man safety of the Replenish MicroPump implant for a period of 90 days and its capability to deliver a microdose into the vitreous cavity. Further studies to enable longer-term safety and to demonstrate the feasibility of multiple programmable drug delivery are necessary.
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Affiliation(s)
- Mark Humayun
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Arturo Santos
- Medical School, Technologic University of Monterrey, Guadalajara, Mexico
- Centro de Retina Médica y Quirúrgica SC, Guadalajara, Mexico
| | - Juan Carlos Altamirano
- Medical School, Technologic University of Monterrey, Guadalajara, Mexico
- Centro de Retina Médica y Quirúrgica SC, Guadalajara, Mexico
| | - Ramiro Ribeiro
- Replenish, Inc., Pasadena, CA, USA
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Roberto Gonzalez
- Medical School, Technologic University of Monterrey, Guadalajara, Mexico
- Centro de Retina Médica y Quirúrgica SC, Guadalajara, Mexico
| | - Alejandro de la Rosa
- Medical School, Technologic University of Monterrey, Guadalajara, Mexico
- Centro de Retina Médica y Quirúrgica SC, Guadalajara, Mexico
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