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Conroy LJ, McCann A, Zhang N, de Gaetano M. The role of nanosystems in the delivery of glucose-lowering drugs for the preemption and treatment of diabetes-associated atherosclerosis. Am J Physiol Cell Physiol 2024; 326:C1398-C1409. [PMID: 38525540 DOI: 10.1152/ajpcell.00695.2023] [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: 12/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
Diabetes is one of the most prevalent diseases worldwide. In recent decades, type-2 diabetes has become increasingly common, particularly in younger individuals. Diabetes leads to many vascular complications, including atherosclerosis. Atherosclerosis is a cardiovascular disease characterized by lipid-rich plaques within the vasculature. Plaques develop over time, restricting blood flow, and can, therefore, be the underlying cause of major adverse cardiovascular events, including myocardial infarction and stroke. Diabetes and atherosclerosis are intrinsically linked. Diabetes is a metabolic syndrome that accelerates atherosclerosis and increases the risk of developing other comorbidities, such as diabetes-associated atherosclerosis (DAA). Gold standard antidiabetic medications focus on attenuating hyperglycemia. Though recent evidence suggests that glucose-lowering drugs may have broader applications, beyond diabetes management. This review mainly evaluates the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as liraglutide and semaglutide in DAA. These drugs mimic gut hormones (incretins), which inhibit glucagon secretion while stimulating insulin secretion, thus improving insulin sensitivity. This facilitates delayed gastric emptying and increased patient satiety; hence, they are also indicated for the treatment of obesity. GLP-1 RAs have significant cardioprotective effects, including decreasing low-density lipoprotein (LDL) cholesterol and triglycerides levels. Liraglutide and semaglutide have specifically been shown to decrease cardiovascular risk. Liraglutide has displayed a myriad of antiatherosclerotic properties, with the potential to induce plaque regression. This review aims to address how glucose-lowering medications can be applied to treat diseases other than diabetes. We specifically focus on how nanomedicines can be used for the site-specific delivery of antidiabetic medicines for the treatment of diabetes-associated atherosclerosis.
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Affiliation(s)
- Luke James Conroy
- Diabetes Complications Research Centre, Conway Institute & School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
| | - Alyssa McCann
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Nan Zhang
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Monica de Gaetano
- Diabetes Complications Research Centre, Conway Institute & School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
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2
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Niloy KK, Lowe TL. Injectable systems for long-lasting insulin therapy. Adv Drug Deliv Rev 2023; 203:115121. [PMID: 37898336 DOI: 10.1016/j.addr.2023.115121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Insulin therapy is the mainstay to treat diabetes characterizedd by hyperglycemia. However, its short half-life of only 4-6 min limits its effectiveness in treating chronic diabetes. Advances in recombinant DNA technology and protein engineering have led to several insulin analogue products that have up to 42 h of glycemic control. However, these insulin analogues still require once- or twice-daily injections for optimal glycemic control and have poor patient compliance and adherence issues. To achieve insulin release for more than one day, different injectable delivery systems including microspheres, in situ forming depots, nanoparticles and composite systems have been developed. Several of these delivery systems have advanced to clinical trials for once-weekly insulin injection. This review comprehensively summarizes the developments of injectable insulin analogs and delivery systems covering the whole field of injectable long-lasting insulin technologies from prototype design, preclinical studies, clinical trials to marketed products for the treatment of diabetes.
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Affiliation(s)
- Kumar Kulldeep Niloy
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
| | - Tao L Lowe
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD 20742, USA.
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Curreri AM, Kim J, Dunne M, Angsantikul P, Goetz M, Gao Y, Mitragotri S. Deep Eutectic Solvents for Subcutaneous Delivery of Protein Therapeutics. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2205389. [PMID: 36642846 PMCID: PMC9982585 DOI: 10.1002/advs.202205389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/17/2022] [Indexed: 05/14/2023]
Abstract
Proteins are among the most common therapeutics for the treatment of diabetes, autoimmune diseases, cancer, and metabolic diseases, among others. Despite their common use, current protein therapies, most of which are injectables, have several limitations. Large proteins such as monoclonal antibodies (mAbs) suffer from poor absorption after subcutaneous injections, thus forcing their administration by intravenous injections. Even small proteins such as insulin suffer from slow pharmacokinetics which poses limitations in effective management of diabetes. Here, a deep eutectic-based delivery strategy is used to offer a generalized approach for improving protein absorption after subcutaneous injections. The lead formulation enhances absorption of mAbs after subcutaneous injections by ≈200%. The same composition also improves systemic absorption of subcutaneously injected insulin faster than Humalog, the current gold-standard of rapid acting insulin. Mechanistic studies reveal that the beneficial effect of deep eutectics on subcutaneous absorption is mediated by their ability to reduce the interactions of proteins with the subcutaneous matrix, especially collagen. Studies also confirm that these deep eutectics are safe for subcutaneous injections. Deep eutectic-based formulations described here open new possibilities for subcutaneous injections of therapeutic proteins.
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Affiliation(s)
- Alexander M. Curreri
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Jayoung Kim
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Michael Dunne
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Pavimol Angsantikul
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
- Present address:
The Population CouncilOne Dag Hammarskjold PlazaNew YorkNY10017USA
| | - Morgan Goetz
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Yongsheng Gao
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
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Kesharwani P, Kumari K, Gururani R, Jain S, Sharma S. Approaches to Address PK-PD Challenges of Conventional Liposome Formulation with Special Reference to Cancer, Alzheimer's, Diabetes, and Glaucoma: An Update on Modified Liposomal Drug Delivery System. Curr Drug Metab 2022; 23:678-692. [PMID: 35692131 DOI: 10.2174/1389200223666220609141459] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/03/2022] [Accepted: 03/31/2022] [Indexed: 01/05/2023]
Abstract
Liposomes nowadays have become a preferential drug delivery system since they provide facilitating properties to drugs, such as improved therapeutic index of encapsulated drug, target and controlled drug delivery, and less toxicity. However, conventional liposomes have shown some disadvantages, such as less drug loading capacity, poor retention, clearance by kidney or reticuloendothelial system, and less release of hydrophilic drugs. Thus, to overcome these disadvantages recently, scientists have explored new approaches and methods, viz., ligand conjugation, polymer coating, and liposome hybrids, including surface-modified liposomes, biopolymer-incorporated liposomes, guest-in-cyclodextrin-in-liposome, liposome-in-hydrogel, liposome-in-film, liposome-in-nanofiber, etc. These approaches have been shown to improve the physiochemical and pharmacokinetic properties of encapsulated drugs. Lately, pharmacokinetic-pharmacodynamic (PK-PD) computational modeling has emerged as a beneficial tool for analyzing the impact of formulation and system-specific factors on the target disposition and therapeutic efficacy of liposomal drugs. There has been an increasing number of liposome-based therapeutic drugs, both FDA approved and those undergoing clinical trials, having application in cancer, Alzheimer's, diabetes, and glaucoma. To meet the continuous demand of health sectors and to produce the desired product, it is important to perform pharmacokinetic studies. This review focuses on the physical, physicochemical, and chemical factors of drugs that influence the target delivery of drugs. It also explains various physiological barriers, such as systemic clearance and extravasation. A novel approach, liposomal-hybrid complex, an innovative approach as a vesicular drug delivery system to overcome limited membrane permeability and bioavailability, has been discussed in the review. Moreover, this review highlights the pharmacokinetic considerations and challenges of poorly absorbed drugs along with the applications of a liposomal delivery system in improving PKPD in various diseases, such as cancer, Alzheimer's, diabetes, and glaucoma.
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Affiliation(s)
- Payal Kesharwani
- Department of Pharmacy, Banasthali Vidyapith University, Banasthali, P.O. Rajasthan, India
| | - Kajal Kumari
- Department of Pharmacy, Banasthali Vidyapith University, Banasthali, P.O. Rajasthan, India
| | - Ritika Gururani
- Department of Pharmacy, Banasthali Vidyapith University, Banasthali, P.O. Rajasthan, India
| | - Smita Jain
- Department of Pharmacy, Banasthali Vidyapith University, Banasthali, P.O. Rajasthan, India
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali Vidyapith University, Banasthali, P.O. Rajasthan, India
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Ali F, Khan I, Chen J, Akhtar K, Bakhsh EM, Khan SB. Emerging Fabrication Strategies of Hydrogels and Its Applications. Gels 2022; 8:gels8040205. [PMID: 35448106 PMCID: PMC9024659 DOI: 10.3390/gels8040205] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 12/19/2022] Open
Abstract
Recently, hydrogels have been investigated for the controlled release of bioactive molecules, such as for living cell encapsulation and matrices. Due to their remote controllability and quick response, hydrogels are widely used for various applications, including drug delivery. The rate and extent to which the drugs reach their targets are highly dependent on the carriers used in drug delivery systems; therefore the demand for biodegradable and intelligent carriers is progressively increasing. The biodegradable nature of hydrogel has created much interest for its use in drug delivery systems. The first part of this review focuses on emerging fabrication strategies of hydrogel, including physical and chemical cross-linking, as well as radiation cross-linking. The second part describes the applications of hydrogels in various fields, including drug delivery systems. In the end, an overview of the application of hydrogels prepared from several natural polymers in drug delivery is presented.
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Affiliation(s)
- Fayaz Ali
- Department of Chemistry, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia; (F.A.); (K.A.); (E.M.B.)
- Centre of Excellence for Advance Materials Research, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia
| | - Imran Khan
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science & Technology Avenida Wai Long, Taipa, Macau 999078, China;
| | - Jianmin Chen
- School of Pharmacy and Medical Technology, Putian University, No. 1133 Xueyuan Zhong Jie, Putian 351100, China
- Correspondence: (J.C.); (S.B.K.)
| | - Kalsoom Akhtar
- Department of Chemistry, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia; (F.A.); (K.A.); (E.M.B.)
| | - Esraa M. Bakhsh
- Department of Chemistry, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia; (F.A.); (K.A.); (E.M.B.)
| | - Sher Bahadar Khan
- Department of Chemistry, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia; (F.A.); (K.A.); (E.M.B.)
- Centre of Excellence for Advance Materials Research, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia
- Correspondence: (J.C.); (S.B.K.)
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Wang R, Jiang G, Aharodnikau UE, Yunusov K, Sun Y, Liu T, Solomevich SO. Recent advances in polymer microneedles for drug transdermal delivery: Design strategies and applications. Macromol Rapid Commun 2022; 43:e2200037. [PMID: 35286762 DOI: 10.1002/marc.202200037] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/25/2022] [Indexed: 11/08/2022]
Abstract
In recent years, the transdermal drug delivery based on microneedles (MNs) technology has received extensive attention, which offers a safer and painless alternative to hypodermic needle injection. They can pierce the stratum corneum and deliver drugs to the epidermis and dermis-structures of skin, showing prominent properties such as minimally invasive, bypassing first-pass metabolism, and self-administered. A range of materials have been used to fabricate MNs, such as silicon, metal, glass, and polymers. Among them, polymer MNs have gained increasing attention from pharmaceutical and cosmetic companies as one of the promising drug delivery methods. Microneedle products have recently become available on the market, and some of them are under evaluation for efficacy and safety. This paper focuses on current state of polymer MNs in the drug transdermal delivery. The materials and methods for the fabrication of polymer MNs and their drug administration are described. The recent progresses of polymer MNs for treatment of cancer, vaccine delivery, blood glucose regulation, androgenetic alopecia, obesity, tissue healing, myocardial infarction and gout are reviewed. The challenges of MNs technology are summarized and the future development trend of MNs is also prospected. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rui Wang
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China.,International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Zhejiang Sci-Tech University, Hangzhou, China.,Zhejiang-Mauritius Joint Research Center for Biomaterials and Tissue Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Guohua Jiang
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China.,International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Zhejiang Sci-Tech University, Hangzhou, China.,Zhejiang-Mauritius Joint Research Center for Biomaterials and Tissue Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | | | - Khaydar Yunusov
- Institute of Polymer Chemistry and Physics, Uzbekistan Academy of Sciences, Tashkent, Uzbekistan
| | - Yanfang Sun
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang, China
| | - Tianqi Liu
- School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China.,International Scientific and Technological Cooperation Base of Intelligent Biomaterials and Functional Fibers, Zhejiang Sci-Tech University, Hangzhou, China.,Zhejiang-Mauritius Joint Research Center for Biomaterials and Tissue Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Sergey O Solomevich
- Institute of Polymer Chemistry and Physics, Uzbekistan Academy of Sciences, Tashkent, Uzbekistan
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Abstract
Insulin therapy has a long history at the cutting edge of technological development through purification, extended-action, molecular chemistry, and devices, and in support technologies including self-measurement and patient education. But unmet needs remain large. Today's therapy cannot deliver minute-to-minute control of glucose levels, and cannot imitate the reflex/incretin driven physiological insulin delivery at mealtimes. Further it depends on a raft of devices for administration several times a day, devices liked for their functionality, but disliked as an intrusive reminder of the condition, several times a day. Approaches to overcoming these barriers include closed-loop systems and further modification of insulin formulations, but are limited by fundamental underlying difficulties. While clinical studies of oral insulin are in progress, the barriers to success look daunting. Development of small-molecule approaches (insulin-mimetic tablets) appears to have stalled, while concepts for glucose-responsive insulin as yet fail to deliver the necessary insulin-to-glucose gradient. Gene therapy, feasible in animals in preliminary studies, is not capable of providing feedback control. Transplantation of cultured islets and islet B-cells from stem cells thus looks to the be the best long-term prospect for insulin delivery in terms of overcoming the above barriers, but is a true biotechnological tour-de-force which will take time to mature.
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Affiliation(s)
- Philip Home
- Translational and Clinical Research Institute, Newcastle University, UK.
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Zhao J, Xu G, Yao X, Zhou H, Lyu B, Pei S, Wen P. Microneedle-based insulin transdermal delivery system: current status and translation challenges. Drug Deliv Transl Res 2021; 12:2403-2427. [PMID: 34671948 PMCID: PMC8528479 DOI: 10.1007/s13346-021-01077-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 01/27/2023]
Abstract
Diabetes mellitus is a metabolic disease manifested by hyperglycemia. For patients with type 1 and advanced type 2 diabetes mellitus, insulin therapy is essential. Subcutaneous injection remains the most common administration method. Non-invasive insulin delivery technologies are pursued because of their benefits of decreasing patients' pain, anxiety, and stress. Transdermal delivery systems have gained extensive attention due to the ease of administration and absence of hepatic first-pass metabolism. Microneedle (MN) technology is one of the most promising tactics, which can effectively deliver insulin through skin stratum corneum in a minimally invasive and painless way. This article will review the research progress of MNs in insulin transdermal delivery, including hollow MNs, dissolving MNs, hydrogel MNs, and glucose-responsive MN patches, in which insulin dosage can be strictly controlled. The clinical studies about insulin delivery with MN devices have also been summarized and grouped based on the study phase. There are still several challenges to achieve successful translation of MNs-based insulin therapy. In this review, we also discussed these challenges including safety, efficacy, patient/prescriber acceptability, manufacturing and scale-up, and regulatory authority acceptability.
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Affiliation(s)
- Jing Zhao
- Prinbury Biopharm Co, 538 Cailun Road Zhangjiang Hi-Tech Park Shanghai, Ltd, 200120 No China
| | - Genying Xu
- Department of Pharmacy, Zhongshan Hospital Fudan University, No. 180 Fenglin Road, Shanghai, 200032 China
| | - Xin Yao
- Prinbury Biopharm Co, 538 Cailun Road Zhangjiang Hi-Tech Park Shanghai, Ltd, 200120 No China
| | - Huirui Zhou
- Prinbury Biopharm Co, 538 Cailun Road Zhangjiang Hi-Tech Park Shanghai, Ltd, 200120 No China
| | - Boyang Lyu
- Prinbury Biopharm Co, 538 Cailun Road Zhangjiang Hi-Tech Park Shanghai, Ltd, 200120 No China
| | - Shuangshuang Pei
- Prinbury Biopharm Co, 538 Cailun Road Zhangjiang Hi-Tech Park Shanghai, Ltd, 200120 No China
| | - Ping Wen
- School of Pharmacy, Fudan University, No. 826 Zhangheng Road Zhangjiang Hi-Tech Park , Shanghai, 200120 China
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Home PD, Mehta R. Insulin therapy development beyond 100 years. Lancet Diabetes Endocrinol 2021; 9:695-707. [PMID: 34480874 DOI: 10.1016/s2213-8587(21)00182-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022]
Abstract
The first insulin preparation capable of consistently lowering blood glucose was developed in 1921. But 100 years later, blood glucose control with insulin in people with diabetes is nearly universally suboptimal, with essentially the same molecule still delivered by the same inappropriate subcutaneous injection route. Bypassing this route with oral administration appears to have become technologically feasible, accelerating over the past 50 years, either with packaged insulin peptides or by chemical insulin mimetics. Some of the problems of prospective unregulated absorption of insulin into the circulation from subcutaneous depots might be overcome with glucose-responsive insulins. Approaches to these problems could be modification of the peptide by adducts, or the use of nanoparticles or insulin patches, which deliver insulin according to glucose concentration. Some attention has been paid to targeting insulin preferentially to different organs, either by molecular engineering of insulin, or with adducts. But all these approaches still have problems in even beginning to match the responsiveness of physiological insulin delivery to metabolic requirements, both prandially and basally. As would be expected, for all these technically complex approaches, many examples of abandoned development can be found. Meanwhile, it is becoming possible to change the duration of action of subcutaneous injected insulin analogues to act even more rapidly for meals, and towards weekly insulin for basal administration. The state of the art of all these approaches, and the barriers to success, are reviewed here.
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Affiliation(s)
- Philip D Home
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Roopa Mehta
- Metabolic Diseases Research Unit, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
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