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Desai P, Dasgupta A, Sofias AM, Peña Q, Göstl R, Slabu I, Schwaneberg U, Stiehl T, Wagner W, Jockenhövel S, Stingl J, Kramann R, Trautwein C, Brümmendorf TH, Kiessling F, Herrmann A, Lammers T. Transformative Materials for Interfacial Drug Delivery. Adv Healthc Mater 2023; 12:e2301062. [PMID: 37282805 DOI: 10.1002/adhm.202301062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/25/2023] [Indexed: 06/08/2023]
Abstract
Drug delivery systems (DDS) are designed to temporally and spatially control drug availability and activity. They assist in improving the balance between on-target therapeutic efficacy and off-target toxic side effects. DDS aid in overcoming biological barriers encountered by drug molecules upon applying them via various routes of administration. They are furthermore increasingly explored for modulating the interface between implanted (bio)medical materials and host tissue. Herein, an overview of the biological barriers and host-material interfaces encountered by DDS upon oral, intravenous, and local administration is provided, and material engineering advances at different time and space scales to exemplify how current and future DDS can contribute to improved disease treatment are highlighted.
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Affiliation(s)
- Prachi Desai
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
| | - Anshuman Dasgupta
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
| | - Alexandros Marios Sofias
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
| | - Quim Peña
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
| | - Robert Göstl
- DWI - Leibniz Institute for Interactive Materials, 52074, Aachen, Germany
| | - Ioana Slabu
- Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty, RWTH Aachen University, 52074, Aachen, Germany
| | - Ulrich Schwaneberg
- Institute of Biotechnology, RWTH Aachen University, 52074, Aachen, Germany
| | - Thomas Stiehl
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Institute for Computational Biomedicine - Disease Modeling, RWTH Aachen University, 52074, Aachen, Germany
| | - Wolfgang Wagner
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, Medical Faculty of RWTH Aachen University, 52074, Aachen, Germany
- Institute for Stem Cell Biology, University Hospital of RWTH Aachen, 52074, Aachen, Germany
| | - Stefan Jockenhövel
- Department of Biohybrid & Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute Aachen, RWTH Aachen University, 52074, Aachen, Germany
| | - Julia Stingl
- Institute of Clinical Pharmacology, University Hospital RWTH Aachen, 52074, Aachen, Germany
| | - Rafael Kramann
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, 52074, Aachen, Germany
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, 52074, Aachen, Germany
| | - Christian Trautwein
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Department of Medicine III (Gastroenterology, Metabolic diseases and Intensive Care), University Hospital RWTH Aachen, 52074, Aachen, Germany
| | - Tim H Brümmendorf
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University Medical School, 52074, Aachen, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, Medical Faculty of RWTH Aachen University, 52074, Aachen, Germany
| | - Andreas Herrmann
- DWI - Leibniz Institute for Interactive Materials, 52074, Aachen, Germany
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 1, 52074, Aachen, Germany
| | - Twan Lammers
- Institute for Experimental Molecular Imaging, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIOABCD), 52074, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, Medical Faculty of RWTH Aachen University, 52074, Aachen, Germany
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Salvi S, Jain A, Pontrelli G, McGinty S. Modeling Dual Drug Delivery from Eluting Stents: The Influence of Non-Linear Binding Competition and Non-Uniform Drug Loading. Pharm Res 2023; 40:215-230. [PMID: 36473984 DOI: 10.1007/s11095-022-03419-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE There is increasing interest in simultaneous endovascular delivery of more than one drug from a drug-loaded stent into a diseased artery. There may be an opportunity to obtain a therapeutically desirable uptake profile of the two drugs over time by appropriate design of the initial drug distribution in the stent. Due to the non-linear, coupled nature of diffusion and reversible specific/non-specific binding of both drugs as well as competition between the drugs for a fixed binding site density, a comprehensive numerical investigation of this problem is critically needed. METHODS This paper presents numerical computation of dual drug delivery in a stent-artery system, accounting for diffusion as well as specific and non-specific reversible binding. The governing differential equations are discretized in space, followed by integration over time using a stiff numerical solver. Three different cases of initial dual drug distribution are considered. RESULTS For the particular case of sirolimus and paclitaxel, results show that competition for a limited non-specific binding site density and the significant difference in the forward/backward reaction coefficients play a key role in determining the nature of drug uptake. The nature of initial distribution of the two drugs in the stent is also found to influence the binding process, which can potentially be used to engineer a desirable dual drug uptake profile. CONCLUSIONS These results help improve the fundamental understanding of endovascular dual drug delivery. In addition, the numerical technique and results presented here may be helpful for designing and optimizing other drug delivery problems as well.
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Affiliation(s)
- Swapnil Salvi
- Mechanical and Aerospace Engineering Department, University of Texas at Arlington, 500 W First St, Rm 211, Arlington, TX, 76019, USA
| | - Ankur Jain
- Mechanical and Aerospace Engineering Department, University of Texas at Arlington, 500 W First St, Rm 211, Arlington, TX, 76019, USA.
| | - Giuseppe Pontrelli
- Istituto per le Applicazioni del Calcolo - CNR, Via dei Taurini 19, 00185, Rome, Italy
| | - Sean McGinty
- Division of Biomedical Engineering, University of Glasgow, Glasgow, UK.,Glasgow Computational Engineering Centre, University of Glasgow, Glasgow, UK
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Ren Y, Wu W, Zhang X. The feasibility of oral targeted drug delivery: gut immune to particulates? Acta Pharm Sin B 2022. [DOI: 10.1016/j.apsb.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Arafat M, Song Y, Brewer K, Fouladian P, Parikh A, Albrecht H, Blencowe A, Garg S. Pharmaceutical Development of 5-Fluorouracil-Eluting Stents for the Potential Treatment of Gastrointestinal Cancers and Related Obstructions. Drug Des Devel Ther 2021; 15:1495-1507. [PMID: 33859473 PMCID: PMC8043784 DOI: 10.2147/dddt.s299401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Drug-eluting gastrointestinal (GI) stents are emerging as promising platforms for the treatment of GI cancers and provide the combined advantages of mechanical support to prevent lumen occlusion and as a reservoir for localized drug delivery to tumors. Therefore, in this work we present a detailed quality assurance study of 5-fluorouracil (5FU) drug-eluting stents (DESs) as potential candidates for the treatment of obstructive GI cancers. METHODS The 5FU DESs were fabricated via a simple two-step sequential dip-coating process of commercial GI self-expanding nitinol stents with a 5FU-loaded polyurethane basecoat and a drug-free protective poly(ethylene-co-vinyl acetate) topcoat. The drug loading, content uniformity and drug stability were determined using a validated high-performance liquid chromatography (HPLC) method, which is also recommended in the United States Pharmacopeia. In vitro drug release studies were performed in phosphate buffered saline to determine the drug releasing properties of the two 5FU-loaded stents. Gas chromatography (GC) and HPLC were employed to determine total residual tetrahydrofuran and N,N-dimethylformamide in the stents remaining from the manufacturing process. Sterilization of the stents was performed using gamma radiation and stability testing was carried out for 3 months. RESULTS The drug loading analysis revealed excellent uniformity in the distribution of 5FU between and within individual stents. Determination of drug stability in the biorelevant release media confirmed that 5FU remains stable over 100 d. In vitro drug release studies from the stents revealed sustained release of 5FU across two different time scales (161 and 30 d), and mathematical modeling of drug release profiles revealed a diffusion-controlled mechanism for the sustained 5FU release. GC and HPLC analysis revealed that the daily residual solvent leached from the stents was below the United States (US) Food and Drug Administration (FDA) guidelines, and therefore, unlikely to cause localized/systemic toxicities. Sterilization of the stents with gamma radiation and accelerated stability tests over a period of 3 months revealed no significant effect on the stability or in vitro release of 5FU. CONCLUSION Our results demonstrate that the 5FU DESs meet relevant quality standards and display favourable drug release characteristics for the potential treatment of GI cancers and related obstructions.
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Affiliation(s)
- Mohammad Arafat
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Yunmei Song
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Kyle Brewer
- Applied Chemistry and Translational Biomaterials (ACTB) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Paris Fouladian
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Ankit Parikh
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Hugo Albrecht
- Drug Discovery and Development Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Anton Blencowe
- Applied Chemistry and Translational Biomaterials (ACTB) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Sanjay Garg
- Pharmaceutical Innovation and Development (PIDG) Group, Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
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Ha DH, Chae S, Lee JY, Kim JY, Yoon J, Sen T, Lee SW, Kim HJ, Cho JH, Cho DW. Therapeutic effect of decellularized extracellular matrix-based hydrogel for radiation esophagitis by 3D printed esophageal stent. Biomaterials 2020; 266:120477. [PMID: 33120198 DOI: 10.1016/j.biomaterials.2020.120477] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/26/2020] [Accepted: 10/18/2020] [Indexed: 02/07/2023]
Abstract
Radiation esophagitis, the most common acute adverse effect of radiation therapy, leads to unwanted consequences including discomfort, pain, an even death. However, no direct cure exists for patients suffering from this condition, with the harmful effect of ingestion and acid reflux on the damaged esophageal mucosa remaining an unresolved problem. Through the delivery of the hydrogel with stent platform, we aimed to evaluate the regenerative capacity of a tissue-specific decellularized extracellular matrix (dECM) hydrogel on damaged tissues. For this, an esophagus-derived dECM (EdECM) was developed and shown to have superior biofunctionality and rheological properties, as well as physical stability, potentially providing a better microenvironment for tissue development. An EdECM hydrogel-loaded stent was sequentially fabricated using a rotating rod combined 3D printing system that showed structural stability and protected a loaded hydrogel during delivery. Finally, following stent implantation, the therapeutic effect of EdECM was examined in a radiation esophagitis rat model. Our findings demonstrate that EdECM hydrogel delivery via a stent platform can rapidly resolve an inflammatory response, thus promoting a pro-regenerative microenvironment. The results suggest a promising therapeutic strategy for the treatment of radiation esophagitis.
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Affiliation(s)
- Dong-Heon Ha
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea; EDmicBio, Inc., South Korea
| | - Suhun Chae
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea
| | - Jae Yeon Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea; Department of Companion Animal Health, Daegu Haany University, Gyeongsan, South Korea
| | - Jae Yun Kim
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang, South Korea
| | - Jungbin Yoon
- Center for Rapid Prototyping based 3D Tissue/Organ Printing, Pohang University of Science and Technology, Pohang, South Korea
| | - Tugce Sen
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea
| | - Sung-Woo Lee
- Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, South Korea; Combinatorial Tumor Immunotherapy Medical Research Center, Chonnam National University Medical School, Hwasun, South Korea
| | - Hak Jae Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Ho Cho
- Combinatorial Tumor Immunotherapy Medical Research Center, Chonnam National University Medical School, Hwasun, South Korea; CNU Biomed Center, Chonnam National University Hwasun Hospital, Hwason, South Korea
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, South Korea; School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang, South Korea; Center for Rapid Prototyping based 3D Tissue/Organ Printing, Pohang University of Science and Technology, Pohang, South Korea; Postech-Catholic Biomedical Engineering Institute, Pohang University of Science and Technology, Pohang, South Korea; Institute of Convergence Science, Yonsei University, Seoul, South Korea.
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Karanasiou GS, Rigas GA, Kyriakidis SK, Tachos NS, Sakellarios AI, Fotiadis DI. InSilc: 3D Reconstruction and plaque characterization tool. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:4528-4531. [PMID: 30441358 DOI: 10.1109/embc.2018.8513126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Coronary artery disease (CAD) is the leading cause of mortality in Europe and worldwide. Atherosclerosis is the most common pathologic process that is highly related with CAD, while the implantation of drug-eluting Bioresorbable Vascular Scaffolds (BVS) is the most promising procedure for treating patients with CAD. InSilc is an textbfin silico clinical trial (ISCT) platform for the development and assessment of drugeluting BVS. The InSilc platform provides insight in the performance of drug-eluting BVS in their short term and medium/long term through the Mechanical Modelling Module, the Deployment Module, the Fluid Dynamics Module, the Myocardial Perfusion Module, the Drug-delivery Module and the Degradation Module. In order for the aforementioned modules to be developed, the utilization of the reconstructed patient specific arterial segment and the BVS design are required, which is achieved through the 3D reconstruction and plaque characterization tool.In this study, the overall architecture of the InSilc platform is presented with special emphasis on the 3D reconstruction and plaque characterization tool. The tool will be able to implement different medical image processing workflows. The workflows will require minimum user intervention in order to be used in large scale clinical trials.
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Verdoia M, Kedhi E, Suryapranata H, Galasso G, Dudek D, De Luca G. Polymer-Free vs. Polymer-Coated Drug-Eluting Stents for the Treatment of Coronary Artery Disease: A Meta-Analysis of 16 Randomized Trials. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 21:745-753. [PMID: 31669109 DOI: 10.1016/j.carrev.2019.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Polymer-coating represents one of components of drug-eluting stents (DES) to have experienced a more intensive technological evolution. Polymer-free DES (PF-DES) have offered promising angiographic results, with earlier complete re-endothelization, potentially reducing the thrombotic risk and offering the option of a shorter antiplatelet therapy. However, contrasting prognostic data have been reported so far with PF-DES. Therefore, the aim of the present study was to perform a comprehensive updated meta-analysis of randomized trials (RCT) comparing the impact of PF-DES vs polymer- coated DES (PC-DES) on clinical outcome. METHODS Literature and main scientific session abstracts were searched for RCTs comparing PF-DES vs PC-DES for the treatment of CAD. The primary efficacy endpoint was mortality, secondary endpoints were cardiovascular death, myocardial infarction, target lesion revascularization (TLR) and stent thrombosis. RESULTS We included 16 randomized clinical trials, with a total of 15,689 patients, including 50.6% randomized to PF-DES. At a median follow-up of 24 months, PF-DES were associated to a significant reduction in mortality as compared to PC-DES (0.82 [0.68, 0.99], p = .03, I2 = 0%; phet = 0.93). However, no significant benefit was observed in terms of cardiovascular death or major ischemic endpoints (respectively CV death: OR [95% CI] = 0.92 [0.71, 1.18] p = .50, I2 = 0.50; phet = 0.84; MI: OR [95% CI] = 1.08 [0.90, 1.29], p = .42; I2 = 0%, phet = 0.98; TLR: OR [95% CI] = 1.02 [0.78, 1.32], p = .91; I2 = 0.63 phet = 0.0003; ST: OR [95% CI] = 0.98 [0.87, 1.10], p = .72; I2 = 0% phet = 0.64). By meta-regression analysis, the mortality benefits of PF-DES were not conditioned by the rate of diabetes mellitus or acute coronary syndromes. CONCLUSIONS Based on the current meta-analysis, PF-DES are associated to a significant reduction in mortality as compared to PC-DES, but not in the occurrence of major ischemic events. Future larger studies are certainly needed to further investigate and confirm our findings, especially in particular subsets of patients, such as those with high bleeding risk or acute myocardial infarction.
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Affiliation(s)
- Monica Verdoia
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Eastern Piedmont University, Novara, Italy
| | - Elvin Kedhi
- Department of Cardiology, ISALA Hospital, Zwolle, the Netherlands
| | | | - Gennaro Galasso
- Divisione di Cardiologia, Università degli Studi di Salerno, Italy
| | - Dariusz Dudek
- Department of Interventional Cardiology, Jagellonian University Krakow, Poland
| | - Giuseppe De Luca
- Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Eastern Piedmont University, Novara, Italy.
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Arafat M, Fouladian P, Blencowe A, Albrecht H, Song Y, Garg S. Drug-eluting non-vascular stents for localised drug targeting in obstructive gastrointestinal cancers. J Control Release 2019; 308:209-231. [DOI: 10.1016/j.jconrel.2019.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 02/08/2023]
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Wu K, Liu J, lei L, Shen Y, Guo S. A stent film of paclitaxel presenting extreme accumulation of paclitaxel in tumor tissue and excellent antitumor efficacy after implantation beneath the subcutaneous tumor xenograft in mice. Int J Pharm 2018; 553:29-36. [DOI: 10.1016/j.ijpharm.2018.09.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/12/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023]
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Selin V, Albright V, Ankner JF, Marin A, Andrianov AK, Sukhishvili SA. Biocompatible Nanocoatings of Fluorinated Polyphosphazenes through Aqueous Assembly. ACS APPLIED MATERIALS & INTERFACES 2018; 10:9756-9764. [PMID: 29505245 DOI: 10.1021/acsami.8b02072] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Nonionic fluorinated polyphosphazenes, such as poly[bis(trifluoroethoxy)phosphazene] (PTFEP), display superb biocompatibility, yet their deposition to surfaces has been limited to solution casting from organic solvents or thermal molding. Herein, hydrophobic coatings of fluorinated polyphosphazenes are demonstrated through controlled deposition of ionic fluorinated polyphosphazenes (iFPs) from aqueous solutions using the layer-by-layer (LbL) technique. Specifically, the assemblies included poly[(carboxylatophenoxy)(trifluoroethoxy)phosphazenes] with varied content of fluorine atoms as iFPs (or poly[bis(carboxyphenoxy)phosphazene] (PCPP) as a control nonfluorinated polyphosphazene) and a variety of polycations. Hydrophobic interactions largely contributed to the formation of LbL films of iFPs with polycations, leading to linear growth and extremely low water uptake. Hydrophobicity-enhanced ionic pairing within iFP/BPEI assemblies gave rise to large-amplitude oscillations in surface wettability as a function of capping layer, which were the largest for the most fluorinated iFP, while control PCPP/polycation systems remained hydrophilic regardless of the film top layer. Neutron reflectometry (NR) studies indicated superior layering and persistence of such layering in salt solution for iFP/BPEI films as compared to control PCPP/polycation systems. Hydrophobicity of iFP-capped LbL coatings could be further enhanced by using a highly porous polyester surgical felt rather than planar substrates for film deposition. Importantly, iFP/polycation coatings displayed biocompatibility which was similar to or superior to that of solution-cast coatings of a clinically validated material (PTFEP), as demonstrated by the hemolysis of the whole blood and protein adsorption studies.
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Affiliation(s)
- Victor Selin
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
| | - Victoria Albright
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
| | - John F Ankner
- Spallation Neutron Source , Oak Ridge National Laboratory , Oak Ridge , Tennessee 37831 , United States
| | - Alexander Marin
- Institute for Bioscience and Biotechnology Research , University of Maryland , Rockville , Maryland 20850 , United States
| | - Alexander K Andrianov
- Institute for Bioscience and Biotechnology Research , University of Maryland , Rockville , Maryland 20850 , United States
| | - Svetlana A Sukhishvili
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
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Chen W, Clauser J, Thiebes AL, McGrath DJ, Kelly N, van Steenbergen MJ, Jockenhoevel S, Steinseifer U, McHugh PE, Hennink WE, Kok RJ. Gefitinib/gefitinib microspheres loaded polyurethane constructs as drug-eluting stent coating. Eur J Pharm Sci 2017; 103:94-103. [PMID: 28179132 DOI: 10.1016/j.ejps.2017.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 01/28/2017] [Accepted: 02/02/2017] [Indexed: 12/16/2022]
Abstract
One of the complications of bronchotracheal cancer is obstruction of the upper airways. Local tumor resection in combination with an airway stent can suppress intraluminal tumor (re)growth. We have investigated a novel drug-eluting stent coating for local release of the anticancer drug gefitinib. A polyurethane (PU) sandwich construct was prepared by a spray coating method in which gefitinib was embedded between a PU support layer of 200μm and a PU top layer of 50-200μm. Gefitinib was either embedded in the construct as small crystals or as gefitinib-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres (MSP). The drug was incorporated in the PU constructs with high recovery (83-93%), and the spray coating procedure did not affect the morphologies of the embedded microspheres as demonstrated by scanning electron microscopy (SEM), confocal laser scanning microscopy and fluorescence microscopy analysis. PU constructs loaded with gefitinib crystals released the drug for 7-21days and showed diffusion based release kinetics. Importantly, directional release of the drug towards the top layer, which is supposed to face the tumor mass, was controlled by the thicknesses of the PU top layer. PU constructs loaded with gefitinib microspheres released the drug in a sustained manner for >6months indicating that drug release from the microspheres became the rate limiting step. In conclusion, the sandwich structure of drug-loaded PLGA microspheres in PU coating is a promising coating for airway stents that release anticancer drugs locally for a prolonged time.
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Affiliation(s)
- Weiluan Chen
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Johanna Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Pauwelsstraße 20, 52074, Germany
| | - Anja Lena Thiebes
- Department of Biohybrid & Medical Textiles (BioTex), AME-Helmholtz Institute for Biomedical Engineering, ITA-Institut für Textiltechnik, RWTH Aachen University, Aachen, Germany
| | - Donnacha J McGrath
- Biomechanics Research Centre, Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, University Road, Galway, Ireland
| | - Nicola Kelly
- Biomechanics Research Centre, Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, University Road, Galway, Ireland
| | - Mies J van Steenbergen
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles (BioTex), AME-Helmholtz Institute for Biomedical Engineering, ITA-Institut für Textiltechnik, RWTH Aachen University, Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Pauwelsstraße 20, 52074, Germany
| | - Peter E McHugh
- Biomechanics Research Centre, Biomedical Engineering, College of Engineering and Informatics, National University of Ireland, University Road, Galway, Ireland
| | - Wim E Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Robbert J Kok
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
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Rychter M, Baranowska-Korczyc A, Lulek J. Progress and perspectives in bioactive agent delivery via electrospun vascular grafts. RSC Adv 2017. [DOI: 10.1039/c7ra04735e] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The review discusses the progress in the design and synthesis of bioactive agents incorporated into vascular grafts obtained by the electrospinning process.
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Affiliation(s)
- Marek Rychter
- Department of Pharmaceutical Technology
- Faculty of Pharmacy
- Poznan University of Medical Sciences
- 60-780 Poznan
- Poland
| | | | - Janina Lulek
- Department of Pharmaceutical Technology
- Faculty of Pharmacy
- Poznan University of Medical Sciences
- 60-780 Poznan
- Poland
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Zamani M, Prabhakaran MP, Varshosaz J, Mhaisalkar PS, Ramakrishna S. Electrosprayed Montelukast/poly (lactic-co-glycolic acid) particle based coating: A new therapeutic approach towards the prevention of in-stent restenosis. Acta Biomater 2016; 42:316-328. [PMID: 27397493 DOI: 10.1016/j.actbio.2016.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 06/06/2016] [Accepted: 07/06/2016] [Indexed: 01/18/2023]
Abstract
UNLABELLED Drug-eluting stents (DESs), have shown promising results in prevention of in-stent restenosis after percutaneous coronary intervention (PCI). The elevated level of leukotrienes (LTs) detected in injured arteries after PCI, together with the potential role of LTs in inflammatory cascades and structural alterations in arterial wall provides the rationale for development of therapeutic strategies for prevention of in-stent restenosis using LTs receptor antagonists. Montelukast (MK) is a selective cysLT1 receptor antagonist, with anti-inflammatory and anti-proliferative properties, which has been used for treatment of various diseases. Here, we report on the fabrication of MK/PLGA particles by electrospraying, aiming towards the development of particle based coating of DESs. The electrosprayed particles incorporated with 3% and 6% w/w MK exhibited fairly spherical shape with smooth surfaces and narrow size distribution. Sustained release of MK for up to 40days was obtained for both formulations, with higher initial burst release and drug release rate for the particles with higher drug loading. The LTD4 induced proliferation and migration of human coronary artery smooth muscle cells (HCASMCs) by 35% and 85%, respectively, which was substantially antagonized using MK incorporated particles. Nevertheless, MK antagonism preserved the normal proliferation and migration of human coronary artery endothelial cells (HCAECs). Moreover, MK antagonism inhibited the LTD4 induced phenotypic transition of HCASMCs from contractile to synthetic type. The electrosprayed MK-PLGA particles can be employed as a coating for DESs to inhibit the formation of neointimal hyperplasia responsible for in-stent restenosis, yet preserve the healing rate of the stented vessel. STATEMENT OF SIGNIFICANT Montelukast (MK) is a selective cysLT1 receptor antagonist, with anti-inflammatory and anti-proliferative properties. The LTD4 induced proliferation and migration of human coronary artery smooth muscle cells by 35% and 85%, respectively, which was substantially antagonized using MK incorporated particles. MK antagonism preserved the normal proliferation and migration of human coronary artery endothelial cells. The MK antagonism inhibited the phenotypic transition of human coronary artery smooth muscle cells from contractile to synthetic one induced by LTD4. The electrosprayed MK-PLGA particles can be employed as coating for DESs to inhibit formation of neointimal hyperplasia, responsible for in-stent restenosis.
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Affiliation(s)
- Maedeh Zamani
- Department of Mechanical Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576, Singapore.
| | - Molamma P Prabhakaran
- Department of Mechanical Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576, Singapore.
| | - Jaleh Varshosaz
- Department of Pharmaceutics, Novel Drug Delivery Systems Research Centre and School of Pharmacy, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran.
| | - Priyadarshini S Mhaisalkar
- School of Materials and Science Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore.
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576, Singapore.
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Chen W, Habraken TCJ, Hennink WE, Kok RJ. Polymer-Free Drug-Eluting Stents: An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents. Bioconjug Chem 2015; 26:1277-88. [PMID: 26041505 DOI: 10.1021/acs.bioconjchem.5b00192] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Clinical evaluations have proven the efficacy of drug-elution stents (DES) in reduction of in-stent restenosis rates as compared to drug-free bare metal stents (BMS). Typically, DES are metal stents that are covered with a polymer film loaded with anti-inflammatory or antiproliferative drugs that are released in a sustained manner. However, although favorable effects of the released drugs have been observed, the polymer coating as such has been associated with several adverse clinical effects, such as late stent thrombosis. Elimination of the polymeric carrier of DES may therefore potentially lead to safer DES. Several technologies have been developed to design polymer-free DES, such as the use of microporous stents and inorganic coatings that can be drug loaded. Several drugs, including sirolimus, tacrolimus, paclitaxel, and probucol have been used in the design of carrier-free stents. Due to the function of the polymeric coating to control the release kinetics of a drug, polymer-free stents are expected to have a faster drug elution rate, which may affect the therapeutic efficacy. However, several polymer-free stents have shown similar efficacy and safety as the first-generation DES, although the superiority of polymer-free DES has not been established in clinical trials.
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Affiliation(s)
- Weiluan Chen
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
| | - Tom C J Habraken
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
| | - Wim E Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
| | - Robbert J Kok
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
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15
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Bozsak F, Gonzalez-Rodriguez D, Sternberger Z, Belitz P, Bewley T, Chomaz JM, Barakat AI. Optimization of Drug Delivery by Drug-Eluting Stents. PLoS One 2015; 10:e0130182. [PMID: 26083626 PMCID: PMC4470631 DOI: 10.1371/journal.pone.0130182] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/18/2015] [Indexed: 01/30/2023] Open
Abstract
Drug-eluting stents (DES), which release anti-proliferative drugs into the arterial wall in a controlled manner, have drastically reduced the rate of in-stent restenosis and revolutionized the treatment of atherosclerosis. However, late stent thrombosis remains a safety concern in DES, mainly due to delayed healing of the endothelial wound inflicted during DES implantation. We present a framework to optimize DES design such that restenosis is inhibited without affecting the endothelial healing process. To this end, we have developed a computational model of fluid flow and drug transport in stented arteries and have used this model to establish a metric for quantifying DES performance. The model takes into account the multi-layered structure of the arterial wall and incorporates a reversible binding model to describe drug interaction with the cells of the arterial wall. The model is coupled to a novel optimization algorithm that allows identification of optimal DES designs. We show that optimizing the period of drug release from DES and the initial drug concentration within the coating has a drastic effect on DES performance. Paclitaxel-eluting stents perform optimally by releasing their drug either very rapidly (within a few hours) or very slowly (over periods of several months up to one year) at concentrations considerably lower than current DES. In contrast, sirolimus-eluting stents perform optimally only when drug release is slow. The results offer explanations for recent trends in the development of DES and demonstrate the potential for large improvements in DES design relative to the current state of commercial devices.
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Affiliation(s)
- Franz Bozsak
- Laboratoire d’Hydrodynamique (LadHyX), École Polytechnique—CNRS, Palaiseau cedex, France
| | | | - Zachary Sternberger
- Laboratoire d’Hydrodynamique (LadHyX), École Polytechnique—CNRS, Palaiseau cedex, France
| | - Paul Belitz
- UCSD Flow Control and Coordinated Robotics Labs Dept of MAE, UC San Diego, La Jolla, CA, USA
| | - Thomas Bewley
- UCSD Flow Control and Coordinated Robotics Labs Dept of MAE, UC San Diego, La Jolla, CA, USA
| | - Jean-Marc Chomaz
- Laboratoire d’Hydrodynamique (LadHyX), École Polytechnique—CNRS, Palaiseau cedex, France
| | - Abdul I. Barakat
- Laboratoire d’Hydrodynamique (LadHyX), École Polytechnique—CNRS, Palaiseau cedex, France
- * E-mail:
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16
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Creation of a functional graded nanobiomembrane using a new electrospinning system for drug release control and an in vitro validation of drug release behavior of the coating membrane. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 50:133-40. [PMID: 25746254 DOI: 10.1016/j.msec.2015.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/01/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
Abstract
Functional graded nanobiomembranes (FGMs) with multiple layers were created by a single process using a novel electrospinning system equipped with a generator and a PCI type motion board as a controller in order to control the drug release rate. By varying physical apparatus-related parameters such as nozzle-to-collector distance via a robot and the collector moving velocity the FGMs were formed. For the membrane base layer, poly-(ε-caprolactone) (PCL) with paclitaxel (PTX) was dissolved in a solvent (dichloromethane, N,N-dimethylformamide) and electrospun. For the top layers, the PCL solution was electrospun according to the distance and FGM system parameters, which can move the collector location at a constant ratio. It was observed that pore size, porosity, and permeability were higher when the membrane was spun at the far distance. The top surface of FGM is more porous, rougher, more permeable, and more hydrophilic so as to be active to the surrounding tissue cells. Meanwhile, the porous inside membrane was as low as the membrane spun at a close distance. Thus it induced a slow drug release due to the internal structure of FGM, which is considered to be very effective for slow drug release as well as bioactivity and bioconductivity.
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17
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Navarese EP, Kowalewski M, Cortese B, Kandzari D, Dias S, Wojakowski W, Buffon A, Lansky A, Angelini P, Torguson R, Kubica J, Kelm M, de Boer MJ, Waksman R, Suryapranata H. Short and long-term safety and efficacy of polymer-free vs. durable polymer drug-eluting stents. A comprehensive meta-analysis of randomized trials including 6178 patients. Atherosclerosis 2014; 233:224-31. [DOI: 10.1016/j.atherosclerosis.2013.12.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 10/25/2022]
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18
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Lupi A, Gabrio Secco G, Rognoni A, Lazzero M, Fattori R, Sheiban I, Sante Bongo A, Bolognese L, Agostoni P, Porto I. Meta-analysis of bioabsorbable versus durable polymer drug-eluting stents in 20,005 patients with coronary artery disease: an update. Catheter Cardiovasc Interv 2014; 83:E193-206. [PMID: 24478247 DOI: 10.1002/ccd.25416] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 01/21/2014] [Accepted: 01/25/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To perform an updated meta-analysis comparing biodegradable polymer drug eluting stents (BP-DES) and durable polymer drug eluting stents (DP-DES). BACKGROUND BP-DES have been suggested to reduce late stent thrombosis (LST) rates as compared to first generation DP-DES. Recently, second generation DP-DES have replaced older DES, but comparison of these stents with BP-DES has not yielded consistent results. METHODS Medline/Web databases were searched for studies comparing BP-DES and DP-DES, and reporting rates of overall/cardiac mortality, myocardial infarction (MI), LST, target lesion revascularization (TLR) and target vessel revascularization (TVR) and late lumen loss (LLL), with a follow-up ≥6 months. RESULTS Twenty studies (20,005 patients) were included in the meta-analysis. Median follow-up time was 1 year. Compared with DP-DES, BP-DES showed lower LLL (in stent: weighted mean difference WMD -0.45 mm, 95% CI -0.66 to -0.24 mm, P = 0.00001; in segment: WMD -0.15 mm, 95% CI = -0.24 to -0.06 mm, P = 0.001) and lower rates of LST (OR 0.51, 95% CI = 0.30 to 0.86, P = 0.01), although they did not improve mortality, MI, TLR, and TVR rates. BP-DES coated with sirolimus or novolimus, in comparison with biolimus or paclitaxel, were associated with reduced LLL (P < 0.0001 for subgroups). CONCLUSIONS In comparison with DP-DES, BP-DES significantly reduce LLL and LST rates, without clear benefits on harder endpoints. The efficacy of BP-DES in preserving lumen patency seems larger for sirolimus and novolimus DES.
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Affiliation(s)
- Alessandro Lupi
- Hospital Cardiology, "Maggiore della Carità" Hospital, Novara, Italy
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19
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Zhu Y, Hu C, Li B, Yang H, Cheng Y, Cui W. A highly flexible paclitaxel-loaded poly(ε-caprolactone) electrospun fibrous-membrane-covered stent for benign cardia stricture. Acta Biomater 2013; 9:8328-36. [PMID: 23770223 DOI: 10.1016/j.actbio.2013.06.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 05/16/2013] [Accepted: 06/03/2013] [Indexed: 02/04/2023]
Abstract
In benign esophageal strictures, inflammation reaction and tissue hyperplasia after stent placement greatly limit the stent retention time and affect subsequent scar formation, which is one of the main influences on long-term recurrence rate. A newly developed biodegradable electrospun drug-fiber-coated stent (DFCS) was fabricated to inhibit inflammation and scar formation. The electrospun paclitaxel/poly(ε-caprolactone) (PCL) fibers integrally covered the bare stent using the rotating collection method. The paclitaxel entrapment did not significantly affect the physical properties of electrospun PCL fibrous membranes. The mechanical results demonstrated that electrospun fibers containing paclitaxel covering the stent maintained the original mechanical characteristics of the stent, and no membrane tearing or ablation was observed after hundreds of repeated compressions. Paclitaxel release profiles were controlled mainly via diffusion of drug through the drug content, and stable release of paclitaxel continued up to 32 days at pH 4.0. Higher inhibition of smooth muscle cell proliferation rates was observed on fibrous membranes with higher paclitaxel content. DFCS showed a significant decrease in tissue inflammation and collagen fiber proliferation, and was easily removed from the esophageal part, which had almost no damage to the tissues in the dog model. Therefore, DFCSs may have great potential to markedly attenuate stent-induced inflammation and scar formation in esophageal stenosis therapy.
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Affiliation(s)
- Yueqi Zhu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi St, Suzhou, Jiangsu 215006, People's Republic of China
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20
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Zhu YQ, Cui WG, Cheng YS, Chang J, Chen NW, Yan L. Evaluation of biodegradable paclitaxel-eluting nanofibre-covered metal stents for the treatment of benign cardia stricture in an experimental model. Br J Surg 2013; 100:784-93. [PMID: 23553755 DOI: 10.1002/bjs.9106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Benign strictures at the cardia are troublesome for patients and often require repeated endoscopic treatments. Paclitaxel can reduce fibrosis. This study evaluated a biodegradable paclitaxel-eluting nanofibre-covered metal stent for the treatment of benign cardia stricture in vitro and in vivo. METHODS Drug release was investigated in vitro at pH 7·4 and 4·0. Eighty dogs were divided randomly into four groups (each n = 20): controls (no stent), bare stent (retained for 1 week), and two drug-eluting stent (DES) groups with retention for either 1 week (DES-1w) or 4 weeks (DES-4w). Lower oesophageal sphincter pressure (LOSP) and 5-min barium height (5-mBH) were assessed before, immediately after stent deployment, at 1 week, and 1, 3 and 6 months later. Five dogs in each group were killed for histological examination at each follow-up point. RESULTS Stent migration rates were similar (0 bare stent versus 2 DES; P = 0·548). The percentage and amount of paclitaxel released in vitro was higher at pH 4·0 than at pH 7·4. After 6 months, LOSP and 5-mBH were both improved in the DES-1w (P = 0·004 and P = 0·049) and DES-4w (both P < 0·001) groups compared with the bare-stent group, with better relief when the stent was retained for 4 weeks (P = 0·004 and P = 0·007). The DES was associated with a reduced peak inflammatory reaction and less scar formation compared with bare stents, especially when inserted for 4 weeks. CONCLUSION The DES was more effective for the treatment of benign cardia stricture than bare stents in a canine model. Retention of the DES for 4 weeks led to a better clinical and pathological outcome than 1 week.
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Affiliation(s)
- Y-Q Zhu
- Department of Radiology, Sixth Affiliated People's Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
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21
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Alvarez-Lorenzo C, Concheiro A. Drug/Medical Device Combination Products with Stimuli-responsive Eluting Surface. SMART MATERIALS FOR DRUG DELIVERY 2013. [DOI: 10.1039/9781849734318-00313] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Drug-eluting medical devices are designed to improve the primary function of the device and at the same time offer local release of drugs which otherwise might find it difficult to reach the insertion/implantation site. The incorporation of the drug enables the tuning of the host/microbial responses to the device and the management of device-related complications. On the other hand, the medical device acts as platform for the delivery of the drug for a prolonged period of time just at the site where it is needed and, consequently, the efficacy and the safety of the treatment, as well as its cost-effectiveness are improved. This chapter begins with an introduction to the combination products and then focuses on the techniques available (compounding, impregnation, coating, grafting of the drug or of polymers that interact with it) to endow medical devices with the ability to host drugs/biological products and to regulate their release. Furthermore, the methods for surface modification with stimuli-responsive polymers or networks are analyzed in detail and the performance of the modified materials as drug-delivery systems is discussed. A wide range of chemical-, irradiation- and plasma-based techniques for grafting of brushes and networks that are sensitive to changes in temperature, pH, light, ionic strength or concentration of certain biomarkers, from a variety of substrate materials, is currently available. Although in vivo tests are still limited, such a surface functionalization of medical devices has already been shown useful for the release on-demand of drugs and biological products, being switchable on/off as a function of the progression of certain physiological or pathological events (e.g. healing, body integration, biofouling or biofilm formation). Improved knowledge of the interactions among the medical device, the functionalized surface, the drug and the body are expected to pave the way to the design of drug-eluting medical devices with optimized and novel performances.
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Affiliation(s)
- C. Alvarez-Lorenzo
- Departamento de Farmacia y Tecnología Farmacéutica Facultad de Farmacia, Universidad de Santiago de Compostela, 15782-Santiago de Compostela Spain
| | - A. Concheiro
- Departamento de Farmacia y Tecnología Farmacéutica Facultad de Farmacia, Universidad de Santiago de Compostela, 15782-Santiago de Compostela Spain
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22
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Lupi A, Rognoni A, Secco GG, Lazzero M, Nardi F, Fattori R, Bongo AS, Agostoni P, Sheiban I. Biodegradable versus durable polymer drug eluting stents in coronary artery disease: insights from a meta-analysis of 5,834 patients. Eur J Prev Cardiol 2012; 21:411-24. [PMID: 23152364 DOI: 10.1177/2047487312467745] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Biodegradable polymer drug eluting stents (BP-DES) have been developed to overcome the limitations of first generation durable polymer DES (DP-DES) but the clinical results of different BP-DES are not consistent. We performed a meta-analysis to compare the outcomes of BP-DES and DP-DES in the treatment of coronary artery disease (CAD). METHODS AND RESULTS Online databases including MEDLINE were searched for studies comparing BP-DES and DP-DES for obstructive CAD that reported rates for overall mortality, myocardial infarction (MI), late stent thrombosis (LST), target lesion revascularization (TLR) and late lumen loss (LLL) with a follow-up of ≥ 6 months. Ten studies (5834 patients) with a 1-year median follow-up were included in the meta-analysis. When comparing patients treated with DP-DES and BP-DES those treated with BP-DES had lower LLL (in-stent: weighted mean difference (WMD) -0.10 mm, 95% CI = -0.17 to -0.03 mm, p = 0.004; in-segment: WMD -0.06 mm, 95% CI = -0.10 to -0.01 mm, p = 0.01) with lower TLR rates (OR 0.67, 95% CI = 0.47 to 0.98, p = 0.04). However, BP-DES did not improve mortality (OR 0.97, 95% CI = 0.73 to 1.29, p = 0.83), MI (OR 1.13, 95% CI = 0.87 to 1.46, p = 0.36) or LST rates (OR 0.64, 95% CI = 0.36 to 1.16, p = 0.14). A pre-specified subgroup analysis of Biolimus BP-DES confirmed significant LLL reduction without differences in other clinical endpoints. Meta-regression analysis demonstrated a strong significant inverse correlation between LLL and reference coronary diameter (p < 0.001). CONCLUSIONS Our present meta-analysis showed that BP-DES when compared with DP-DES significantly reduced LLL and TVR but without clear benefits on mortality, MI and LST rates. (Clinicaltrials.gov identifier: NCT01466634).
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Affiliation(s)
- Alessandro Lupi
- Hospital Cardiology, "Maggiore della Carità" Hospital, Novara, Italy
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Park YM, Han SH, Lee K, Suh SY, Oh PC, Chung WJ, Kang WC, Koh KK, Ahn TH, Choi IS, Shin EK. Dexamethasone-eluting stents had sustained favorable ischemic driven target lesion revascularization rates over 5 years: a randomized controlled prospective study. Int J Cardiol 2012; 165:359-62. [PMID: 22974726 DOI: 10.1016/j.ijcard.2012.08.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 08/23/2012] [Indexed: 10/27/2022]
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Shen Y, Lu F, Hou J, Shen Y, Guo S. Incorporation of paclitaxel solid dispersions with poloxamer188 or polyethylene glycol to tune drug release from poly(ϵ-caprolactone) films. Drug Dev Ind Pharm 2012; 39:1187-96. [DOI: 10.3109/03639045.2012.704042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rossi F, Casalini T, Raffa E, Masi M, Perale G. Bioresorbable Polymer Coated Drug Eluting Stent: A Model Study. Mol Pharm 2012; 9:1898-910. [DOI: 10.1021/mp200573f] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Filippo Rossi
- Department
of Chemistry, Materials and Chemical Engineering
“Giulio Natta”, Politecnico di Milano, Via Mancinelli 7, 20131 Milano, Italy
| | - Tommaso Casalini
- Department
of Chemistry, Materials and Chemical Engineering
“Giulio Natta”, Politecnico di Milano, Via Mancinelli 7, 20131 Milano, Italy
| | - Edoardo Raffa
- Department
of Chemistry, Materials and Chemical Engineering
“Giulio Natta”, Politecnico di Milano, Via Mancinelli 7, 20131 Milano, Italy
| | - Maurizio Masi
- Department
of Chemistry, Materials and Chemical Engineering
“Giulio Natta”, Politecnico di Milano, Via Mancinelli 7, 20131 Milano, Italy
| | - Giuseppe Perale
- Department
of Chemistry, Materials and Chemical Engineering
“Giulio Natta”, Politecnico di Milano, Via Mancinelli 7, 20131 Milano, Italy
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26
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Rong HJ, Chen WL, Guo SR, Lei L, Shen YY. PCL films incorporated with paclitaxel/5-fluorouracil: Effects of formulation and spacial architecture on drug release. Int J Pharm 2012; 427:242-51. [DOI: 10.1016/j.ijpharm.2012.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/12/2012] [Accepted: 02/05/2012] [Indexed: 11/29/2022]
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27
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Complement monitoring of nanomedicines and implants. Adv Drug Deliv Rev 2011; 63:963-4. [PMID: 21745510 DOI: 10.1016/j.addr.2011.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 06/15/2011] [Indexed: 01/19/2023]
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