Transport studies of insulin across rat jejunum in the presence of chicken and duck ovomucoids

Challenges and Opportunities in the Oral Delivery of Recombinant Biologics

Recombinant biological molecules are at the cutting-edge of biomedical research thanks to the significant progress made in biotechnology and a better understanding of subcellular processes implicated in several diseases. Given their ability to induce a potent response, these molecules are becoming the drugs of choice for multiple pathologies. However, unlike conventional drugs which are mostly ingested, the majority of biologics are currently administered parenterally. Therefore, to improve their limited bioavailability when delivered orally, the scientific community has devoted tremendous efforts to develop accurate cell- and tissue-based models that allow for the determination of their capacity to cross the intestinal mucosa. Furthermore, several promising approaches have been imagined to enhance the intestinal permeability and stability of recombinant biological molecules. This review summarizes the main physiological barriers to the oral delivery of biologics. Several preclinical in vitro and ex vivo models currently used to assess permeability are also presented. Finally, the multiple strategies explored to address the challenges of administering biotherapeutics orally are described.

A Brief Overview of the Oral Delivery of Insulin as an Alternative to the Parenteral Delivery

Diabetes mellitus greatly affects the quality of life of patients and has a worldwide prevalence. Insulin is the most commonly used drug to treat diabetic patients and is usually administered through the subcutaneous route. However, this route of administration is ineffective due to the low concentration of insulin at the site of action. This route of administration causes discomfort to the patient and increases the risk of infection due to skin barrier disturbance caused by the needle. The oral administration of insulin has been proposed to surpass the disadvantages of subcutaneous administration. In this review, we give an overview of the strategies to deliver insulin by the oral route, from insulin conjugation to encapsulation into nanoparticles. These strategies are still under development to attain efficacy and effectiveness that are expected to be achieved in the near future.

In vivo testing of mucus-permeating nanoparticles for oral insulin delivery using Caenorhabditis elegans as a model under hyperglycemic conditions

The aim was to evaluate the potential of mucus-permeating nanoparticles for the oral administration of insulin. These nanocarriers, based on the coating of zein nanoparticles with a polymer conjugate containing PEG, displayed a size of 260 nm with a negative surface charge and an insulin payload of 77 μg/mg. In intestinal pig mucus, the diffusivity of these nanoparticles (PPA-NPs) was found to be 20-fold higher than bare nanoparticles (NPs). These results were in line with the biodistribution study in rats, in which NPs remained trapped in the mucus, whereas PPA-NPs were able to cross this layer and reach the epithelium surface. The therapeutic efficacy was evaluated in Caenorhabditis elegans grown under high glucose conditions. In this model, worms treated with insulin-loaded in PPA-NPs displayed a longer lifespan than those treated with insulin free or nanoencapsulated in NPs. This finding was associated with a significant reduction in the formation of reactive oxygen species (ROS) as well as an important decrease in the glucose and fat content in worms. These effects would be related with the mucus-permeating ability of PPA-NPs that would facilitate the passage through the intestinal peritrophic-like dense layer of worms (similar to mucus) and, thus, the absorption of insulin.

Bioactive Egg Proteins

The nutritional excellence of chicken egg is derived from its task as a life-giving medium, supplying the necessary nutrients to the hen's embryo while protecting it from external threats. Additionally, egg proteins possess unique biological activities above and beyond their known functional and nutritional roles. In the last few decades, extensive research has been done to evaluate the various biological activities of egg proteins and protein-derived peptides. Egg proteins and protein-derived peptides have been attributed to diverse biological activities, the most well-known being their antimicrobial properties. However, egg proteins and peptides have been shown to have other biological activities, such as antihypertensive, antioxidant, anticancer, immunomodulatory, and protease inhibitory activity. Egg-derived bioactive proteins have had a relevant scientific impact and exhibit promising applicability as an ingredient for the development of functional foods and nutraceuticals. However, it is critical to understand the effects of these proteins in signaling pathways to delineate their molecular mechanisms of action. Further studies are required to fill the current knowledge gaps. Therefore, the purpose of the chapter is to illustrate the present knowledge of the bioactivity of different egg proteins and their physiological effects.

Challenges in oral peptide delivery: lessons learnt from the clinic and future prospects

Therapeutic peptides have become very successful drugs due to their specificity, potency and low toxicity, but they show challenges for their delivery, due to their short half-life and rapid plasma clearance. For these reasons, peptides are usually administered using injectable sustained-release formulations. Oral peptide route is highly compelling from a patient and commercial point of view. However, poor peptide stability and low permeability across the intestinal epithelium still make it very challenging to effectively deliver peptides by the oral route. In this paper, biopharmaceutical and formulation features of oral peptides, as well as key clinical outcomes, are reviewed and discussed in the perspective of designing next generation of oral peptide formulations for a true paradigm shift.

Intestinal permeation enhancers for oral peptide delivery

Intestinal permeation enhancers (PEs) are one of the most widely tested strategies to improve oral delivery of therapeutic peptides. This article assesses the intestinal permeation enhancement action of over 250 PEs that have been tested in intestinal delivery models. In depth analysis of pre-clinical data is presented for PEs as components of proprietary delivery systems that have progressed to clinical trials. Given the importance of co-presentation of sufficiently high concentrations of PE and peptide at the small intestinal epithelium, there is an emphasis on studies where PEs have been formulated with poorly permeable molecules in solid dosage forms and lipoidal dispersions.

Lessons learned from the clinical development of oral peptides

The oral delivery of peptides and proteins has been hampered by an array of obstacles. However, several promising novel oral delivery systems have been developed. This paper reviews the most advanced oral formulation technologies, and highlights key lessons and implications from studies undertaken to date with these oral formulations. Special interest is given to oral salmon calcitonin (CT), glucagon-like peptide-1 (GLP-1), insulin, PYY-(3-36), recombinant human parathyroid hormone (rhPTH(1-31)-NH2) and PTH(1-34), by different technologies. The issues addressed include (i) interaction with water, (ii) interaction with food, (iii) diurnal variation, (iv) inter- and intra-subject variability, (v) correlation between efficacy and exposure and (vi) key deliverables of different technologies. These key lessons may aid research in the development of other oral formulations.

Oral biodrug delivery using cell-penetrating peptide

During the past few decades, the novel biotherapeutic agents such as peptides and proteins have been contributed to the treatment of several diseases. However, their oral absorption is significantly limited due to their poor delivery through the intestinal mucosa. Therefore, the feasible approaches are needed for improving the oral bioavailability of biodrugs. Recently, cell-penetrating peptides (CPPs) such as HIV-1 Tat, penetratin and oligoarginine are considered as a useful tool for the intracellular delivery of therapeutic macromolecules. Hence, it was expected that the ability of CPPs may be applicable to enhance the absorption of biodrugs through intestinal epithelial membrane. CPPs are likely to become powerful tools for overcoming the low permeability of therapeutic peptides and proteins through the intestinal membrane, the major barrier to their oral delivery. Further advantage of this promising strategy is that this successful intestinal absorption could be achieved by more convenient methodology, coadministration of CPP with drugs via intermolecular interaction among them. Hereafter, the further establishment of delivery system based on CPPs is required to realize the development of the oral forms of therapeutic peptides and proteins. The aim here is to introduce our vision focusing on oral biodrug delivery by the use of CPPs as potential peptide carrier in order to provide new information in the design and development of new oral delivery systems for novel biotherapeutics.

Oral delivery of therapeutic protein/peptide for diabetes--future perspectives

Diabetes is a metabolic disease and is a major cause of mortality and morbidity in epidemic proportions. A type I diabetic patient is dependent on daily injections of insulin, for survival and also to maintain a normal life, which is uncomfortable, painful and also has deleterious effects. Extensive efforts are being made worldwide for developing noninvasive drug delivery systems, especially via oral route. Oral route is the most widely accepted means of administration. However it is not feasible for direct delivery of peptide and protein drugs. To overcome the gastro-intestinal barriers various types of formulations such as polymeric micro/nanoparticles, liposomes, etc. are investigated. In the recent years lot of advances have taken place in developing and understanding the oral peptide delivery systems. Simultaneously, the development and usage of other peptides having anti-diabetic potentials are also considered for diabetes therapy. In this review we are focusing on the advances reported during the past decade in the field of oral insulin delivery along with the possibility of other peptidic incretin hormones such as GLP-1, exendin-4, for diabetes therapy.

Proteomic characterization of IgY preparations purified with a water dilution method

Antigen-specific chicken IgY antibodies have been used for oral immunotherapy as an alternative or complement to antibiotics in several studies. The water dilution (WD) method has several advantages for purifying IgY. It is rapid, efficient, suitable for large-scale production, and nothing but water is added. The water-soluble fraction contains other proteins and lipids besides IgY. The protein content was characterized by two-dimensional gel electrophoresis (2DGE) and nanoflow liquid chromatography coupled offline to matrix-assisted laser desorption/ionization time-of-flight tandem mass spectrometry (nanoLC-MALDI TOF/TOF MS). Protein analysis was complicated due to the large dynamic concentration range, but 26 proteins could be identified. The relative protein concentrations in different batches were very similar according to protein patterns on 1D gels and protein concentration determinations. Thus, the purification method has a high reproducibility. The concentrations of cholesterols and triglycerides were low and should not have an effect on the plasma levels of treated patients. Purification of IgY for oral use with WD is therefore a recommended method.

Improving the stability of insulin in solutions containing intestinal proteases in vitro

Degradation of insulin was studied in this work. Casein and protamine could obviously suppress degradation of insulin by intestinal enzymes, and could protect insulin from degradation by the mechanism of competition and combination with proteolysis enzyme. What is more, co-incubated with HP-β-CD-casein or HP-β-CD-protamine, most insulin was protected from degradation by intestinal enzymes. In addition, it was found that the complexation of insulin with HP-β-CD was characterized by UV absorption spectra. These results indicated that HP-β-CD, casein and protamine could offer some positive and useful results, and could protect insulin from degradation during their transit through the intestinal tract.

Transport of Insulin in Modified Valia-Chien Chambers and Caco-2 Cell Monolayers

The transport characteristics of insulin were investigated using two different absorption models. Using the modified Valia-Chien chambers, permeability coefficients of insulin in the duodenum, jejunum, and ileum were 0.71x10(-7), 7.11x10(-7) and 9.45x10(-7) cm/s, respectively. In the Caco-2 cell monolayers, the bidirectional transepithelial fluxes of insulin across Caco-2 cell line showed symmetry. Confocal laser scanning microscopy visualized that FD-4 and FITC-insulin were mainly located in the paracellular route. It is evident that the lower intestine might be an advantageous region, and absorption enhancer that helps open tight junctions between cells should be used for oral delivery of insulin.

Current challenges in non-invasive insulin delivery systems: a comparative review

The quest to eliminate the needle from insulin delivery and to replace it with non- or less-invasive alternative routes has driven rigorous pharmaceutical research to replace the injectable forms of insulin. Recently, various approaches have been studied involving many strategies using various technologies that have shown success in delivering insulin, which are designed to overcome the inherent barriers for insulin uptake across the gastrointestinal tract, mucosal membranes and skin. This review examines some of the many attempts made to develop alternative, more convenient routes for insulin delivery to avoid existing long-term dependence on multiple subcutaneous injections and to improve the pharmacodynamic properties of insulin. In addition, this article concentrates on the successes in this new millennium in developing potential non-invasive technologies and devices, and on major new milestones in modern insulin delivery for the effective treatment of diabetes.

Characterization of insulin protection properties of complexation hydrogels in gastric and intestinal enzyme fluids

The objective of this study was to elucidate the mechanisms contributing to oral bioavailability of insulin by poly(methacrylic acid grafted with poly(ethylene glycol)) (P(MAA-g-EG)) hydrogels using the gastric and intestinal fluids from rats. P(MAA-g-EG) hydrogels successfully protected the incorporated insulin from enzymatic degradation by forming interpolymer complexes in the gastric fluid. The hydrogels also showed the insulin protection ability by itself. In the intestinal fluid, P(MAA-g-EG) hydrogels significantly decreased the insulin degradation rate and calcium ion levels, while protein levels was not changed. Insulin protecting effects were dependent on the fraction of the carboxylic group in the polymer networks. Moreover, the insulin degradation inhibitory effect was significantly correlated with Ca2+ deprivation ability of P(MAA-g-EG) hydrogels in the intestinal fluid, implying that the Ca2+ deprivation ability plays an important role in the inhibition of the intestinal enzyme activities. Insulin-loaded P(MAA-g-EG) (ILPs) hydrogels showed a rapid and almost complete insulin release even in the presence of intestinal proteases. These results suggested that the insulin protection ability of the hydrogels contributed to improve oral insulin absorption and that P(MAA-g-EG) hydrogels can be an excellent carrier for protecting insulin during their transit through the GI tract.

Oral delivery of beta-lactamase by Lactococcus lactis subsp. lactis transformed with Plasmid ss80

The objective was to use normal flora to deliver protein/peptide drugs orally. A probiotic bacterium, Lactococcus lactis subsp. lactis (L. lactis) transformed with Plasmid ss80, which made it able to synthesize and secrete beta-lactamase, a 29 kDa protein, was used as the delivery system for beta-lactamase. Oral absorption of beta-lactamase in rats when delivered by this L. lactis system was investigated. The oral bioavailability of beta-lactamase delivered by 3x10(7) of the L. lactis was equivalent to 209 mU of i.v. dose, and the estimated relative bioavailability was 16.7%. When delivered by beta-lactamase free solution form, the relative oral bioavailability was 4.7%, which increased to 6.0% when co-administered with 3x10(7) of the untransformed L. lactis. The results demonstrated that the L. lactis significantly increased the beta-lactamase oral bioavailability by 2-3-folds (p<0.01), the mean residence time (MRT) by 3-4 times (p<0.01), and the mean absorption time (MAT) by 6-14 times (p<0.01), as compared to the free solution form with/without the untransformed L. lactis. In conclusion, the L. lactis is more efficient in delivering beta-lactamase orally compared with the free solution form. It also provides a sustained delivery mechanism for beta-lactamase. Gene-transformed normal flora may be used as an efficient and sustained delivery system for protein drugs through oral route.

Determination of diffusion coefficients of peptides and prediction of permeability through a porous membrane

The diffusion coefficient (D) of peptide and protein drugs needs to be determined to examine the permeability through biological barriers and to optimize delivery systems. In this study, the D values of fluorescein isothiocyanate (FITC)-labelled dextrans (FDs) and peptides were determined and the permeability through a porous membrane was discussed. The observed D values of FDs and peptides, except in the case of insulin, were similar to those calculated based on a relationship previously reported between the molecular weight and D of lower-molecular-weight compounds, although the molecular weight range was completely different. The observed D value of insulin was between the calculated values for the insulin monomer and hexamer. The permeability of poly-lysine and insulin through the membrane was determined and the observed values were compared with predicted values by using the relationship between molecular weight and D and an equation based on the Renkin function. The observed permeability of insulin through the membrane was between that of the predicted permeability for the insulin monomer and hexamer. For the permeation of insulin, the determination of D was useful for estimating the permeability because of the irregular relationship between molecular weight and D. The methodology used in this study will be useful for a more quantitative evaluation of the absorption of peptide and protein drugs applied to mucous membranes.

Regional permeability of salmon calcitonin in isolated rat gastrointestinal tracts: transport mechanism using Caco-2 cell monolayer

The objective of the study was to determine the region of maximum permeation of salmon calcitonin (sCT) through the gastrointestinal tract and to investigate the mechanism of permeation. For regional permeability determination, male Sprague-Dawley rats (250-300 g) were anesthetized and the gastrointestinal tissues were isolated. Stomach, duodenum, jejunum, ileum, or colon tissues were mounted on Navicyte side-by-side diffusion apparatus. Salmon calcitonin solutions (50 microm in phosphate-buffered saline, pH 7.4, 37 degrees C) were added to the donor side, and the samples were removed from the receiver compartment and analyzed by competitive radioimmunoassay (RIA). For mechanistic studies, Caco-2 cells were grown on Transwell inserts (0.4-microm pore size, 0.33 cm2 area) in a humidified 37 degrees C incubator (with 5% CO2). Transport experiments were conducted for sCT solutions (50 microm in Dulbecco's modified eagle's medium [DMEM], pH 7.4) from the apical-to-basolateral (A-to-B) direction and B-to-A direction at 37 degrees C and from the A-to-B direction at 4 degrees C. Cell monolayer integrity was monitored by mannitol permeability and transepithelial electrical resistance (TEER) measurements. The permeability coefficients (x 10(-9), cm/sec) for sCT through rat stomach, duodenum, jejunum, ileum, and colon tissues were 0.482 +/- 0.086, 0.718 +/- 0.025, 0.830 +/- 0.053, 1.537 +/- 0.32, and 0.934 +/- 0.15, respectively. The region of maximum sCT permeability is ileum followed by colon, jejunum, duodenum, and stomach. The permeability coefficients (x 10(-6), cm/sec) for sCT through Caco-2 cell monolayer were 8.57 +/- 2.34 (A-to-B, 37 degrees C), 8.01 +/- 1.22 (A-to-B, 4 degrees C), and 6.15 +/- 1.97 (B-to-A, 37 degrees C). The mechanism of its permeation is passive diffusion through the mucosa as determined from the Caco-2 monolayer permeability of sCT.

Waiting to inhale: noninjectable insulin, are we there yet?

Subcutaneous injection has been the only route of insulin administration for patients with type 1 or type 2 diabetes for the past 80 years. Although research and development in this time has improved the insulin treatments themselves, it is only now that alternative routes of insulin administration are becoming viable. Many avenues of insulin administration have been explored, including oral, buccal, and pulmonary routes. However, these methods of noninvasive insulin delivery are not free from difficulties and only preliminary data are available for oral insulin pills and buccal insulin sprays. The most promising alternative route of delivery appears to be inhaled insulin and two devices are already in phase III testing. Nevertheless, inhaled insulin devices will still have to overcome some problems and recent studies show that these challenges are currently being confronted. It appears that years of research into noninvasive methods of insulin administration are close to fruition and this review outlines the most recent findings in this area.

Oral insulin delivery using P(MAA-g-EG) hydrogels: effects of network morphology on insulin delivery characteristics

Hydrogels of poly(methacrylic acid-g-ethylene glycol) were prepared using different reaction water contents in order to vary the network mesh size, swelling behavior and insulin loading/release kinetics. Gels prepared with greater reaction solvent contents swelled to a greater degree and had a larger network mesh size. All of the hydrogels were able to incorporate insulin and protected it from release in acidic media. At higher pH (7.4), the release rates increased with reaction solvent content. Using a closed loop animal model, all of the insulin loaded formulations produced significant insulin absorption in the upper small intestine combined with hypoglycemic effects. In these studies, bioavailabilities ranged from 4.6% to 7.2% and were dependent on reaction solvent content.

Protection of salmon calcitonin breakdown with serine proteases by various ovomucoid species for oral drug delivery

The current work compared protective effects of various ovomucoid species against salmon calcitonin (sCT) metabolism by serine proteases. sCT solutions (50 microM) were incubated at 37 degrees C with trypsin (0.5 microM), alpha-chymotrypsin (0.1 microM), or elastase (0.48 microM) in 50 mM Tris buffer (pH 8.0) containing or lacking different concentrations of turkey ovomucoid (tOVM), duck ovomucoid (dOVM), or chicken ovomucoid (cOVM) and aprotinin. Caco-2 cell homogenate was also incubated with sCT and the contents of the proteases were assayed by using their specific substrates. Metabolites were identified by high-performance liquid chromatography, gel electrophoresis, and matrix-assisted laser desorption ionization mass spectrometry techniques. In the absence of inhibitors, there was a considerable degradation of sCT by the proteases. dOVM and tOVM increased the half-life of sCT with trypsin and alpha-chymotrypsin at enzyme-to-inhibitor ratio of 1:4 showing similar efficacy. dOVM was found to be superior to tOVM in protecting sCT from elastase. cOVM was ineffective in protecting sCT against alpha-chymotrypsin. Caco-2 cell homogenate degraded sCT, which was prevented by tOVM. sCT was cleaved into different molecular weight fragments with different proteases. In general, the metabolite formation decreased when inhibitor concentration increased. dOVM and tOVM effectively stabilized sCT against all three proteases. However, cOVM could not prevent the degradation by alpha-chymotrypsin.