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Ramsay E, Montaser AB, Niitsu K, Urtti A, Auriola S, Huttunen KM, Uchida Y, Kidron H, Terasaki T. Transporter Protein Expression of Corneal Epithelium in Rabbit and Porcine: Evaluation of Models for Ocular Drug Transport Study. Mol Pharm 2024; 21:3204-3217. [PMID: 38809137 DOI: 10.1021/acs.molpharmaceut.3c01210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
The transcorneal route is the main entry route for drugs to the intraocular parts, after topical administration. The outer surface, the corneal epithelium (CE), forms the rate-limiting barrier for drug permeability. Information about the role and protein expression of drug and amino acid transporter proteins in the CE is sparse and lacking. The aim of our study was to characterize transporter protein expression in rabbit and porcine CE to better understand potential drug and nutrient absorption after topical administration. Proteins, mainly Abc and Slc transporters, were characterized with quantitative targeted absolute proteomics and global untargeted proteomics methods. In the rabbit CE, 24 of 48 proteins were detected in the targeted approach, and 21 of these were quantified. In the porcine CE, 26 of 58 proteins were detected in the targeted approach, and 20 of these were quantified. Among these, 15 proteins were quantified in both animals: 4f2hc (Slc3a2), Aqp0, Asct1 (Slc1a4), Asct2 (Slc1a5), Glut1 (Slc2a1), Hmit (Slc2a13), Insr, Lat1 (Slc7a5), Mct1 (Slc16a1), Mct2 (Slc16a7), Mct4 (Slc16a3), Mrp 4 (Abcc4), Na+/K+-ATPase, Oatp3a1 (Slco3a1), and Snat2 (Slc38a2). Overall, the global proteomics results supported the targeted proteomics results. Organic anion transporting polypeptide Oatp3a1 was detected and quantified for the first time in both rabbit (1.4 ± 0.4 fmol/cm2) and porcine (11.1 ± 5.3 fmol/cm2) CE. High expression levels were observed for L-type amino acid transporter, Lat1, which was quantified with newly selected extracellular domain peptides in rabbit (48.9 ± 11.8 fmol/cm2) and porcine (37.6 ± 11.5 fmol/cm2) CE. The knowledge of transporter protein expression in ocular barriers is a key factor in the successful design of new ocular drugs, pharmacokinetic modeling, understanding ocular diseases, and the translation to human.
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Affiliation(s)
- Eva Ramsay
- Drug Research Programme, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland
| | - Ahmed B Montaser
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
| | - Kanako Niitsu
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
| | - Arto Urtti
- Drug Research Programme, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
| | - Kristiina M Huttunen
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
| | - Yasuo Uchida
- Department of Molecular Systems Pharmaceutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-0037, Japan
| | - Heidi Kidron
- Drug Research Programme, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland
| | - Tetsuya Terasaki
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 C, 70211 Kuopio, Finland
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Hsieh HH, Chang YA, Chan S, Lin ZQ, Lin CT, Hu FR, Hung KF, Sun YC. Characterizing the Robustness of Distinct Clinical Assessments in Identifying Dry Eye Condition of Animal Models. Curr Eye Res 2024; 49:565-573. [PMID: 38299568 DOI: 10.1080/02713683.2024.2310614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE The study aims to characterize the robustness of distinct clinical assessments in identifying the underlying conditions of dry eye disease (DED), with a specific emphasis on the involvement of conjunctival goblet cells. METHODS Seven rabbits receiving surgical removal of the lacrimal and Harderian glands were divided into two groups, one with ablation of conjunctival goblet cells by topical soaking of trichloroacetic acid (TCA) to the bulbar conjunctiva (n = 3) and one without (n = 4), and the conditions of DED were assessed weekly using Schirmer test, tear breakup time (TBUT), tear osmolarity, and National Eye Institute (NEI) fluorescein staining grading. After 8 weeks, the rabbits were sacrificed, and the eyes were enucleated for histopathological examination. RESULTS Histopathological analysis revealed corneal epithelial thinning in both groups. While TCA soaking significantly decreased the density of conjunctival goblet cells, DED rabbits without TCA also showed a partial reduction in goblet cell density, potentially attributable to dacryoadenectomy. Both groups showed significant decreases in Schirmer test and TBUT, as well as an increase in tear osmolarity. In DED rabbits with TCA soaking, tear osmolarity increased markedly, suggesting that tear osmolarity is highly sensitive to loss and/or dysfunction of conjunctival goblet cells. Fluorescein staining was gradually and similarly increased in both groups, suggesting that fluorescein staining may not reveal an early disruption of the tear film until the prolonged progression of DED. CONCLUSION The Schirmer test, TBUT, tear osmolarity, and NEI fluorescein grading are distinct, yet complementary, clinical assessments for the evaluation of DED. By performing these assessments in definitive DED rabbit models, both with and without ablation of conjunctival goblet cells, the role of these cells in the homeostasis of tear osmolarity is highlighted. Characterizing the robustness of these assessments in identifying the underlying conditions of DED will guide a more appropriate management for patients with DED.
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Affiliation(s)
- Hsiu-Hui Hsieh
- Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Yu-An Chang
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Szemin Chan
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Zhi-Qian Lin
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Tien Lin
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kai-Feng Hung
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chen Sun
- Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Sarmento C, Duarte ARC, Rita Jesus A. Can (Natural) deep eutectic systems increase the efficacy of ocular therapeutics? Eur J Pharm Biopharm 2024; 198:114276. [PMID: 38582179 DOI: 10.1016/j.ejpb.2024.114276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
The eye is one of the most complex organs in the human body, with a unique anatomy and physiology, being divided into anterior and posterior segments. Ocular diseases can occur in both segments, but different diseases affect different segments. Glaucoma and cataracts affect the anterior segment, while macular degeneration and diabetic retinopathy occur in the posterior segment. The easiest approach to treat ocular diseases, especially in the anterior segment, is through the administration of topical eye drops, but this route presents many constraints, namely precorneal dynamic and static ocular barriers. On the other hand, the delivery of drugs to the posterior segment of the eye is far more challenging and is mainly performed by the intravitreal route. However, it can lead to severe complications such as retinal detachment, endophthalmitis, increased intraocular pressure and haemorrhage. The design of new drug delivery systems for the anterior segment is very challenging, but targeting the posterior one is even more difficult and little progress has been made. In this review we will discuss various strategies including the incorporation of additives in the formulations, such as viscosity, permeability, and solubility enhancers, namely based on Deep eutectic systems (DES). Natural deep eutectic systems (NADES) have emerged to solve several problems encountered in pharmaceutical industry, regarding the pharmacokinetic and pharmacodynamic properties of drugs. NADES can contribute to the design of advanced technologies for ocular therapeutics, including hydrogels and nanomaterials. Here in, we revise some applications of (NA)DES in the development of new drug delivery systems that can be translated into the ophthalmology field.
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Affiliation(s)
- Célia Sarmento
- LAQV-REQUIMTE, Chemistry Department, NOVA - School of Science and Technology, 2829-516 Caparica, Portugal
| | - Ana Rita C Duarte
- LAQV-REQUIMTE, Chemistry Department, NOVA - School of Science and Technology, 2829-516 Caparica, Portugal
| | - Ana Rita Jesus
- LAQV-REQUIMTE, Chemistry Department, NOVA - School of Science and Technology, 2829-516 Caparica, Portugal.
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Wang W(J, Snider N. Discovery and Potential Utility of a Novel Non-Invasive Ocular Delivery Platform. Pharmaceutics 2023; 15:2344. [PMID: 37765311 PMCID: PMC10535219 DOI: 10.3390/pharmaceutics15092344] [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: 08/11/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
To this day, the use of oily eye drops and non-invasive retinal delivery remain a major challenge. Oily eye drops usually cause ocular irritation and interfere with the normal functioning of the eye, while ocular injections for retinal drug delivery cause significant adverse effects and a high burden on the healthcare system. Here, the authors report a novel topical non-invasive ocular delivery platform (NIODP) through the periorbital skin for high-efficiency anterior and posterior ocular delivery in a non-human primate model (NHP). A single dose of about 7 mg JV-MD2 (omega 3 DHA) was delivered via the NIODP and reached the retina at a Cmax of 111 µg/g and the cornea at a Cmax of 66 µg/g. The NIODP also delivered JV-DE1, an anti-inflammatory agent in development for dry eye diseases, as efficiently as eye drops did to the anterior segments of the NHP. The topical NIODP seems to transport drug candidates through the corneal pathway to the anterior and via the conjunctiva/sclera pathway to the posterior segments of the eye. The novel NIODP method has the potential to reshape the landscape of ocular drug delivery. This is especially the case for oily eye drops and retinal delivery, where the success of the treatment lies in the ocular tolerability and bioavailability of drugs in the target tissue.
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Toffoletto N, Saramago B, Serro AP, Chauhan A. A Physiology-Based Mathematical Model to Understand Drug Delivery from Contact Lenses to the Back of the Eye. Pharm Res 2023; 40:1939-1951. [PMID: 37498499 PMCID: PMC10447275 DOI: 10.1007/s11095-023-03560-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/02/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Therapeutic contact lenses, able to store drug and deliver it to the eye surface in a sustained fashion, gained interest as an effective and patient-friendly alternative to eye drops. Recent animal studies also demonstrated the presence of therapeutic drug levels in the back of the eye after wearing drug-loaded contact lenses, thus opening the possibility of treating the posterior segment without need of invasive intraocular injections. The drug pathways from contact lenses to the back of the eye require further investigation. METHODS A mechanistic mathematical model was developed to evaluate the drug concentration over time in the tears, sclera and choroid, retina, aqueous humor and vitreous humor after the application of a therapeutic contact lens. The main drug transport mechanisms of the eye and the barrier properties of the different tissues were included in the model. Validation was performed by comparison with experimental data in literature. RESULTS The model predictions of drug concentration over time reflected the experimental data both in the anterior and posterior segment of the eye. The model can differentiate between contributions to transport from different pathways. CONCLUSIONS The model constitutes a first step towards the possibility of predicting the ocular drug distribution and the treatment efficacy in the early stage of contact lens development, and it may help reduce both the need for in vivo tests (with ethical and economic advantages) and the gap between the lens design and clinical application. It also allows for an improved understanding of drug transport in the eye.
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Affiliation(s)
- Nadia Toffoletto
- Centro de Química Estrutural, Institute of Molecular Sciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal.
| | - Benilde Saramago
- Centro de Química Estrutural, Institute of Molecular Sciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal
| | - Ana Paula Serro
- Centro de Química Estrutural, Institute of Molecular Sciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal
| | - Anuj Chauhan
- Chemical and Biological Engineering Department, Colorado School of Mines, Golden, CO, 80401, USA
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Li S, Chen L, Fu Y. Nanotechnology-based ocular drug delivery systems: recent advances and future prospects. J Nanobiotechnology 2023; 21:232. [PMID: 37480102 PMCID: PMC10362606 DOI: 10.1186/s12951-023-01992-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023] Open
Abstract
Ocular drug delivery has constantly challenged ophthalmologists and drug delivery scientists due to various anatomical and physiological barriers. Static and dynamic ocular barriers prevent the entry of exogenous substances and impede therapeutic agents' active absorption. This review elaborates on the anatomy of the eye and the associated constraints. Followed by an illustration of some common ocular diseases, including glaucoma and their current clinical therapies, emphasizing the significance of drug therapy in treating ocular diseases. Subsequently, advances in ocular drug delivery modalities, especially nanotechnology-based ocular drug delivery systems, are recommended, and some typical research is highlighted. Based on the related research, systematic and comprehensive characterizations of the nanocarriers are summarized, hoping to assist with future research. Besides, we summarize the nanotechnology-based ophthalmic drugs currently on the market or still in clinical trials and the recent patents of nanocarriers. Finally, inspired by current trends and therapeutic concepts, we provide an insight into the challenges faced by novel ocular drug delivery systems and further put forward directions for future research. We hope this review can provide inspiration and motivation for better design and development of novel ophthalmic formulations.
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Affiliation(s)
- Shiding Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Liangbo Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China
| | - Yao Fu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200011, China.
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Paterson T, Azizoglu S, Gokhale M, Chambers M, Suphioglu C. Preserved Ophthalmic Anti-Allergy Medication in Cumulatively Increasing Risk Factors of Corneal Ectasia. BIOLOGY 2023; 12:1036. [PMID: 37508465 PMCID: PMC10376818 DOI: 10.3390/biology12071036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
The prevalence of allergies is rising every year. For those who suffer from it, ocular inflammation and irritation can be inconvenient and unpleasant. Anti-allergy eyedrops are a readily available treatment for symptoms of ocular allergy (OA) and can help allergy sufferers regain normal function. However, the eye is a delicate organ, and multiuse eyedrops often utilise preservatives to deter microbial growth. Preservatives such as benzalkonium chloride (BAK) have been shown to induce decreased cell viability. Therefore, during a period of high localised inflammation and eye rubbing, it is important that the preservatives used in topical medicines do not contribute to the weakening of the corneal structure. This review explores ocular allergy and the thinning and protrusion of the cornea that is characteristic of the disease keratoconus (KC) and how it relates to a weakened corneal structure. It also describes the use of BAK and its documented effects on the integrity of the cornea. It was found that atopy and eye rubbing are significant risk factors for KC, and BAK can severely decrease the integrity of the corneal structure when compared to other preservatives and preservative-free alternatives.
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Affiliation(s)
- Tom Paterson
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Serap Azizoglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
- Deakin Optometry, School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Moneisha Gokhale
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
- Deakin Optometry, School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Madeline Chambers
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
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Wu Y, Tao Q, Xie J, Lu L, Xie X, Zhang Y, Jin Y. Advances in Nanogels for Topical Drug Delivery in Ocular Diseases. Gels 2023; 9:gels9040292. [PMID: 37102904 PMCID: PMC10137933 DOI: 10.3390/gels9040292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Nanotechnology has accelerated the development of the pharmaceutical and medical technology fields, and nanogels for ocular applications have proven to be a promising therapeutic strategy. Traditional ocular preparations are restricted by the anatomical and physiological barriers of the eye, resulting in a short retention time and low drug bioavailability, which is a significant challenge for physicians, patients, and pharmacists. Nanogels, however, have the ability to encapsulate drugs within three-dimensional crosslinked polymeric networks and, through specific structural designs and distinct methods of preparation, achieve the controlled and sustained delivery of loaded drugs, increasing patient compliance and therapeutic efficiency. In addition, nanogels have higher drug-loading capacity and biocompatibility than other nanocarriers. In this review, the main focus is on the applications of nanogels for ocular diseases, whose preparations and stimuli-responsive behaviors are briefly described. The current comprehension of topical drug delivery will be improved by focusing on the advances of nanogels in typical ocular diseases, including glaucoma, cataracts, dry eye syndrome, and bacterial keratitis, as well as related drug-loaded contact lenses and natural active substances.
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Affiliation(s)
- Yongkang Wu
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Qing Tao
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Jing Xie
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Lili Lu
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Xiuli Xie
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Yang Zhang
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
| | - Yong Jin
- School of Pharmacy, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei 230032, China
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Kim TY, Lee GH, Mun J, Cheong S, Choi I, Kim H, Hahn SK. Smart Contact Lens Systems for Ocular Drug Delivery and Therapy. Adv Drug Deliv Rev 2023; 196:114817. [PMID: 37004938 DOI: 10.1016/j.addr.2023.114817] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
Ocular drug delivery and therapy systems have been extensively investigated with various methods including direct injections, eye drops and contact lenses. Nowadays, smart contact lens systems are attracting a lot of attention for ocular drug delivery and therapy due to their minimally invasive or non-invasive characteristics, highly enhanced drug permeation, high bioavailability, and on-demand drug delivery. Furthermore, smart contact lens systems can be used for direct light delivery into the eyes for biophotonic therapy replacing the use of drugs. Here, we review smart contact lens systems which can be classified into two groups of drug-eluting contact lens and ocular device contact lens. More specifically, this review covers smart contact lens systems with nanocomposite-laden systems, polymeric film-incorporated systems, micro and nanostructure systems, iontophoretic systems, electrochemical systems, and phototherapy systems for ocular drug delivery and therapy. After that, we discuss the future opportunities, challenges and perspectives of smart contact lens systems for ocular drug delivery and therapy.
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Affiliation(s)
- Tae Yeon Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Geon-Hui Lee
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Jonghwan Mun
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Sunah Cheong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Inhoo Choi
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Hyemin Kim
- Department of Cosmetics Engineering, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea.
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea; PHI BIOMED Co., 168 Yeoksam-ro, Gangnamgu, Seoul 06248, Republic of Korea.
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Onugwu AL, Nwagwu CS, Onugwu OS, Echezona AC, Agbo CP, Ihim SA, Emeh P, Nnamani PO, Attama AA, Khutoryanskiy VV. Nanotechnology based drug delivery systems for the treatment of anterior segment eye diseases. J Control Release 2023; 354:465-488. [PMID: 36642250 DOI: 10.1016/j.jconrel.2023.01.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/07/2023] [Accepted: 01/07/2023] [Indexed: 01/17/2023]
Abstract
Diseases affecting the anterior segment of the eye are the primary causes of vision impairment and blindness globally. Drug administration through the topical ocular route is widely accepted because of its user/patient friendliness - ease of administration and convenience. However, it remains a significant challenge to efficiently deliver drugs to the eye through this route because of various structural and physiological constraints that restrict the distribution of therapeutic molecules into the ocular tissues. The bioavailability of topically applied ocular medications such as eye drops is typically less than 5%. Developing novel delivery systems to increase the retention time on the ocular surfaces and permeation through the cornea is one of the approaches adopted to boost the bioavailability of topically administered medications. Drug delivery systems based on nanotechnology such as micelles, nanosuspensions, nanoparticles, nanoemulsions, liposomes, dendrimers, niosomes, cubosomes and nanowafers have been investigated as effective alternatives to conventional ocular delivery systems in treating diseases of the anterior segment of the eye. This review discussed different nanotechnology-based delivery systems that are currently investigated for treating and managing diseases affecting the anterior ocular tissues. We also looked at the challenges in translating these systems into clinical use and the prospects of nanocarriers as a vehicle for the delivery of phytoactive compounds to the anterior segment of the eye.
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Affiliation(s)
- Adaeze Linda Onugwu
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chinekwu Sherridan Nwagwu
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Obinna Sabastine Onugwu
- Department of Pharmacognosy, Enugu State University of Science and Technology, Agbani, Enugu State, Nigeria
| | - Adaeze Chidiebere Echezona
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chinazom Precious Agbo
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Stella Amarachi Ihim
- Department of Pharmacology and Toxicology, University of Nigeria, Nsukka, Enugu State, Nigeria; Pharmacology and Physiology Unit, Department of Science Laboratory Technology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Prosper Emeh
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Petra Obioma Nnamani
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Anthony Amaechi Attama
- Drug Delivery & Nanomedicines Research Laboratory, Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria; Department of Pharmaceutics and Pharmaceutical Technology, Enugu State University of Science and Technology, Agbani, Enugu State, Nigeria.
| | - Vitaliy V Khutoryanskiy
- Reading School of Pharmacy, University of Reading, Whiteknights, Reading, RG6 6AD, United Kingdom.
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Wang Y, Wang C. Novel Eye Drop Delivery Systems: Advance on Formulation Design Strategies Targeting Anterior and Posterior Segments of the Eye. Pharmaceutics 2022; 14:pharmaceutics14061150. [PMID: 35745723 PMCID: PMC9229693 DOI: 10.3390/pharmaceutics14061150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
Eye drops are the most common and convenient route of topical administration and the first choice of treatment for many ocular diseases. However, the ocular bioavailability of traditional eye drops (i.e., solutions, suspensions, and ointments) is very low because of ophthalmic physiology and barriers, which greatly limits their therapeutic effect. Over the past few decades, many novel eye drop delivery systems, such as prodrugs, cyclodextrins, in situ gels, and nanoparticles, have been developed to improve ophthalmic bioavailability. These novel eye drop delivery systems have good biocompatibility, adhesion, and propermeation properties and have shown superior performance and efficacy over traditional eye drops. Therefore, the purpose of this review was to systematically present the research progress on novel eye drop delivery systems and provide a reference for the development of dosage form, clinical application, and commercial transformation of eye drops.
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12
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Peng C, Kuang L, Zhao J, Ross AE, Wang Z, Ciolino JB. Bibliometric and visualized analysis of ocular drug delivery from 2001 to 2020. J Control Release 2022; 345:625-645. [PMID: 35321827 DOI: 10.1016/j.jconrel.2022.03.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To perform a bibliometric analysis in the field of ocular drug delivery research to characterize the current international trends and to present visual representations of the past and emerging trends on ocular drug delivery research over the past decade. METHOD In this cross-sectional study, a bibliometric analysis of data retrieved and extracted from the Web of Science Core Collection (WoSCC) database was performed to analyze evolution and theme trends on ocular drug delivery research from January 1, 2001, to December 31, 2020. A total of 4334 articles on ocular drug delivery were evaluated for specific characteristics, such as publication year, journals, authors, institutions, countries/regions, references, and keywords. Co-authorship analysis, co-occurrence analysis, co-citation analysis, and network visualization were constructed by VOSviewer. Some important subtopics identified by bibliometric characterization were further discussed and reviewed. RESULTS From 2001 to 2020, the annual global publications increased by 746.15%, from 52 to 440. International Journal of Pharmaceutics published the most manuscripts (250 publications) and produced the highest citations (9509 citations), followed by Investigative Ophthalmology & Visual Science (202 publications) and Journal of Ocular Pharmacology and Therapeutics (136 publications). The United States (1289 publications, 31,512 citations), the University of Florida (82 publications, 2986 citations), and Chauhan, Anuj (52 publications, 2354 citations) were the most productive and impactful institution, country, and author respectively. The co-occurrence cluster analysis of the top 100 keywords form five clusters: (1) micro/nano ocular drug delivery systems; (2) the treatment of inflammation and posterior diseases; (3) macroscopic ocular drug delivery systems/devices; (4) the characteristics of drug delivery systems; (5) and the ocular drug delivery for glaucoma treatment. Diabetic macular edema, anti-VEGF, ranibizumab, bevacizumab, micelles and latanoprost, were the latest high-frequency keywords, indicating the emerging frontiers of ocular drug delivery. Further discussions into the subtopics were provided to assist researchers to determine the range of research topics and plan research direction. CONCLUSIONS Over the last two decades there has been a progressive increase in the number of publications and citations on research related to ocular drug delivery across many countries, institutions, and authors. The present study sheds light on current trends, global collaboration patterns, basic knowledge, research hotspots, and emerging frontiers of ocular drug delivery. Novel solutions for ocular drug delivery and the treatment of inflammation and posterior diseases were the major themes over the last 20 years.
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13
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Yang Y, Lockwood A. Topical ocular drug delivery systems: Innovations for an unmet need. Exp Eye Res 2022; 218:109006. [DOI: 10.1016/j.exer.2022.109006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/06/2022] [Accepted: 02/20/2022] [Indexed: 02/07/2023]
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14
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Understanding dexamethasone kinetics in the rabbit tear fluid: drug release and clearance from solution, suspension and hydrogel formulations. Eur J Pharm Biopharm 2022; 172:53-60. [PMID: 35121080 DOI: 10.1016/j.ejpb.2022.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 01/15/2023]
Abstract
Rapid precorneal loss of topically applied eye drops limits ocular drug absorption. Controlling release and precorneal residence properties of topical formulations may improve ocular drug bioavailability and duration of action. In this study, we evaluated in vivo ocular pharmacokinetics of dexamethasone in rabbits after application of a drug solution (0.01%), suspension (Maxidex® 0.1%), and hydrogels of 2-hydroxyethyl methacrylate (HEMA) and acrylic acid (AAc) copolymers. The rabbits received a single eyedrop (solution or suspension) or dexamethasone-loaded hydrogel topically. Dexamethasone in tear fluid was sampled with glass capillaries and quantitated by LC-MS/MS. Higher dexamethasone exposure (AUC) in the tear fluid was observed with the suspension (≈ 3.6-fold) and hydrogel (12.8-fold) as compared to the solution. During initial 15 min post-application, the highest AUC of dissolved dexamethasone was seen after hydrogel application (368 min*µg/mL) followed by suspension (109.9 min*µg/mL) and solution (28.7 min*µg/mL. Based on kinetic simulations, dexamethasone release from hydrogels in vivo and in vitro is comparable. Our data indicate that prolonged exposure of absorbable dexamethasone in tear fluid is reached with hydrogels and suspensions. Pharmacokinetic understanding of formulation behavior in the lacrimal fluid helps in the design of dexamethasone delivery systems with improved ocular absorption and prolonged duration of action.
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15
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Lee J, Rhee YS. Ophthalmic dosage forms for drug delivery to posterior segment. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2022. [DOI: 10.1007/s40005-021-00554-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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16
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Davis G, Li K, Thankam FG, Wilson DR, Agrawal DK. Ocular transmissibility of COVID-19: possibilities and perspectives. Mol Cell Biochem 2022; 477:849-864. [PMID: 35066705 PMCID: PMC8783769 DOI: 10.1007/s11010-021-04336-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022]
Abstract
Since the initial outbreak of coronavirus disease 2019 (COVID-19), extensive research has emerged from across the globe to understand the pathophysiology of this novel coronavirus. Transmission of this virus is a subject of particular interest as researchers work to understand which protective and preventative measures are most effective. Despite the well understood model of aerosol-respiratory mediated transmission, the exact mechanism underlying the inoculation, infection and spread of COVID-19 is currently unknown. Given anatomical positioning and near constant exposure to aerosolized pathogens, the eye may be a possible gateway for COVID-19 infection. This critical review explores the possibility of an ocular-systemic or ocular-nasal-pulmonic pathway of COVID-19 infection and includes novel insights into the possible immunological mechanisms leading to cytokine surge.
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Affiliation(s)
- Gavin Davis
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second Street, Pomona, CA, 91766, USA
| | - Kin Li
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second Street, Pomona, CA, 91766, USA
| | - Finosh G Thankam
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second Street, Pomona, CA, 91766, USA
| | - Daniel R Wilson
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second Street, Pomona, CA, 91766, USA
| | - Devendra K Agrawal
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second Street, Pomona, CA, 91766, USA.
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17
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Topical Pharmacokinetics of Dexamethasone Suspensions in the Rabbit Eye: Bioavailability Comparison. Int J Pharm 2022; 615:121515. [DOI: 10.1016/j.ijpharm.2022.121515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 11/21/2022]
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18
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Karami TK, Hailu S, Feng S, Graham R, Gukasyan HJ. Eyes on Lipinski's Rule of Five: A New "Rule of Thumb" for Physicochemical Design Space of Ophthalmic Drugs. J Ocul Pharmacol Ther 2021; 38:43-55. [PMID: 34905402 PMCID: PMC8817695 DOI: 10.1089/jop.2021.0069] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The study objective was to investigate molecular thermodynamic properties of approved ophthalmic drugs and derive a framework outlining physicochemical design space for product development. Unlike the methodology used to obtain molecular descriptors for assessment of drug-like properties by Lipinski's Rule of 5 (Ro5), this work presents a retrospective approach based on in silico analysis of molecular thermodynamic properties beyond Ro5 parameters (ie, free energy of distribution/partitioning in octanol/water, dynamic polar surface area, distribution coefficient, and solubility at physiological pH) by using 145 marketed ophthalmic drugs. The study's focus was to delineate inherent molecular parameters explicitly important for ocular permeability and absorption from topical eye drops. A comprehensive parameter distribution analysis on ophthalmic drugs’ molecular properties was performed. Frequencies in distribution analyses provided groundwork for physicochemical parameter limits of molecular thermodynamic properties having impact on corneal permeability and topical ophthalmic drug delivery. These parameters included free energy of partitioning (ΔGo/w) calculated based on thermodynamic free energy equation, distribution coefficient at physiological pH (clog DpH7.4), topological polar surface area (TPSA), and aqueous solubility (Sint, SpH7.4) with boundaries of clog DpH7.4 ≤4.0, TPSA ≤250 Å2, ΔGo/w ≤20 kJ/mol (4.8 kcal/mol), and solubility (Sint and SpH7.4) ≥1 μM, respectively. The theoretical free energy of partitioning model streamlined calculation of changes in the free energy of partitioning, Δ(ΔGo/w), as a measure of incremental improvements in corneal permeability for congeneric series. The above parameter limits are proposed as “rules of thumb” for topical ophthalmic drugs to assess risks in developability.
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Affiliation(s)
- Thomas K Karami
- Pharmaceutical Sciences, Allergan plc, an AbbVie Company, Irvine, California, USA
| | - Shumet Hailu
- Pharmaceutical Sciences, Allergan plc, an AbbVie Company, Irvine, California, USA
| | - Shaoxin Feng
- Pharmaceutical Sciences, Allergan plc, an AbbVie Company, Irvine, California, USA
| | - Richard Graham
- Pharmaceutical Sciences, Allergan plc, an AbbVie Company, Irvine, California, USA
| | - Hovhannes J Gukasyan
- Pharmaceutical Sciences, Allergan plc, an AbbVie Company, Irvine, California, USA
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Development and Characterization of Nanoemulsions for Ophthalmic Applications: Role of Cationic Surfactants. MATERIALS 2021; 14:ma14247541. [PMID: 34947136 PMCID: PMC8706710 DOI: 10.3390/ma14247541] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
The eye is a very complex organ comprising several physiological and physical barriers that compromise drug absorption into deeper layers. Nanoemulsions are promising delivery systems to be used in ocular drug delivery due to their innumerous advantages, such as high retention time onto the site of application and the modified release profile of loaded drugs, thereby contributing to increasing the bioavailability of drugs for the treatment of eye diseases, in particular those affecting the posterior segment. In this review, we address the main factors that govern the development of a suitable nanoemulsion formulation for eye administration to increase the patient’s compliance to the treatment. Appropriate lipid composition and type of surfactants (with a special emphasis on cationic compounds) are discussed, together with manufacturing techniques and characterization methods that are instrumental for the development of appropriate ophthalmic nanoemulsions.
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20
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Vaneev A, Tikhomirova V, Chesnokova N, Popova E, Beznos O, Kost O, Klyachko N. Nanotechnology for Topical Drug Delivery to the Anterior Segment of the Eye. Int J Mol Sci 2021; 22:12368. [PMID: 34830247 PMCID: PMC8621153 DOI: 10.3390/ijms222212368] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 02/07/2023] Open
Abstract
Topical drug delivery is one of the most challenging aspects of eye therapy. Eye drops are the most prevalent drug form, especially for widely distributed anterior segment eye diseases (cataracts, glaucoma, dry eye syndrome, inflammatory diseases, etc.), because they are convenient and easy to apply by patients. However, conventional drug formulations are usually characterized by short retention time in the tear film, insufficient contact with epithelium, fast elimination, and difficulties in overcoming ocular tissue barriers. Not more than 5% of the total drug dose administered in eye drops reaches the interior ocular tissues. To overcome the ocular drug delivery barriers and improve drug bioavailability, various conventional and novel drug delivery systems have been developed. Among these, nanosize carriers are the most attractive. The review is focused on the different drug carriers, such as synthetic and natural polymers, as well as inorganic carriers, with special attention to nanoparticles and nanomicelles. Studies in vitro and in vivo have demonstrated that new formulations could help to improve the bioavailability of the drugs, provide sustained drug release, enhance and prolong their therapeutic action. Promising results were obtained with drug-loaded nanoparticles included in in situ gel.
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Affiliation(s)
- Alexander Vaneev
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
- Research Laboratory of Biophysics, National University of Science and Technology “MISIS”, 119991 Moscow, Russia
| | - Victoria Tikhomirova
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Natalia Chesnokova
- Department of Pathophysiology and Biochemistry, Helmholtz National Medical Research Center of Eye Diseases, 105062 Moscow, Russia; (N.C.); (O.B.)
| | - Ekaterina Popova
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Olga Beznos
- Department of Pathophysiology and Biochemistry, Helmholtz National Medical Research Center of Eye Diseases, 105062 Moscow, Russia; (N.C.); (O.B.)
| | - Olga Kost
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Natalia Klyachko
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Research Institute “Nanotechnology and Nanomaterials”, G.R. Derzhavin Tambov State University, 392000 Tambov, Russia
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21
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Mofidfar M, Abdi B, Ahadian S, Mostafavi E, Desai TA, Abbasi F, Sun Y, Manche EE, Ta CN, Flowers CW. Drug delivery to the anterior segment of the eye: A review of current and future treatment strategies. Int J Pharm 2021; 607:120924. [PMID: 34324989 PMCID: PMC8579814 DOI: 10.1016/j.ijpharm.2021.120924] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/03/2023]
Abstract
Research in the development of ophthalmic drug formulations and innovative technologies over the past few decades has been directed at improving the penetration of medications delivered to the eye. Currently, approximately 90% of all ophthalmic drug formulations (e.g. liposomes, micelles) are applied as eye drops. The major challenge of topical eye drops is low bioavailability, need for frequent instillation due to the short half-life, poor drug solubility, and potential side effects. Recent research has been focused on improving topical drug delivery devices by increasing ocular residence time, overcoming physiological and anatomical barriers, and developing medical devices and drug formulations to increase the duration of action of the active drugs. Researchers have developed innovative technologies and formulations ranging from sub-micron to macroscopic size such as prodrugs, enhancers, mucus-penetrating particles (MPPs), therapeutic contact lenses, and collagen corneal shields. Another approach towards the development of effective topical drug delivery is embedding therapeutic formulations in microdevices designed for sustained release of the active drugs. The goal is to optimize the delivery of ophthalmic medications by achieving high drug concentration with prolonged duration of action that is convenient for patients to administer.
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Affiliation(s)
| | - Behnam Abdi
- Institute of Polymeric Materials (IPM), Sahand University of Technology, New Town of Sahand, Tabriz, Iran; Faculty of Polymer Engineering, Sahand University of Technology, New Town of Sahand, Tabriz, Iran
| | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, USA
| | - Ebrahim Mostafavi
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Stanford Cardiovascular Institute, Stanford University, CA, USA
| | - Tejal A Desai
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Farhang Abbasi
- Institute of Polymeric Materials (IPM), Sahand University of Technology, New Town of Sahand, Tabriz, Iran; Faculty of Polymer Engineering, Sahand University of Technology, New Town of Sahand, Tabriz, Iran
| | - Yang Sun
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Edward E Manche
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Christopher N Ta
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Charles W Flowers
- USC Roski Eye Institute, University of Southern California, Los Angeles, CA, USA.
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22
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Jansook P, Hnin HM, Loftsson T, Stefánsson E. Cyclodextrin-based formulation of carbonic anhydrase inhibitors for ocular delivery - A review. Int J Pharm 2021; 606:120955. [PMID: 34332063 DOI: 10.1016/j.ijpharm.2021.120955] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Carbonic anhydrase inhibitors (CAIs) are used as systemic and topical agents for lowering intraocular pressure (IOP) in patients with glaucoma. Owing to the wide distribution of CAs and their physiological functions in various tissues, systemic administration of CAIs may lead to unwanted side effects. Thus, exploration of drugs targeting the specific CA isoenzyme in ocular tissues and application of the same as topical eye drops would be desirable. However, the anatomical and physiological barriers of the eyes can limit drug availability at the site. The very low aqueous solubility of CAI agents can further hamper drug bioavailability, consequently resulting in insufficient therapeutic efficacy. Solubilization of drugs using cyclodextrin (CD) complexes can enhance both solubility and permeability of the drugs. The use of CD for such purposes and development and testing of topical CAI eye drops containing CD have been discussed in detail. Further, pharmaceutical nanotechnology platforms were discussed in terms of investigation of their IOP-lowering efficacies. Future prospects in drug discovery and the use of CD nanoparticles and CD-based nanocarriers to develop potential topical CAI formulations have also been described here.
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Affiliation(s)
- Phatsawee Jansook
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phyathai Road, Pathumwan, Bangkok 10330, Thailand.
| | - Hay Marn Hnin
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phyathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland
| | - Einar Stefánsson
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Landspitalinn, IS-101 Reykjavik, Iceland
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23
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Van Meenen J, Ní Dhubhghaill S, Van den Bogerd B, Koppen C. An Overview of Advanced In Vitro Corneal Models: Implications for Pharmacological Testing. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:506-516. [PMID: 33878935 DOI: 10.1089/ten.teb.2021.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The cornea is an important barrier to consider when developing ophthalmic formulations, but proper modeling of this multilayered tissue remains a challenge. This is due to the varying properties associated with each layer in addition to the dynamics of the tear film. Hence, the most representative models to date rely on animals. Animal models, however, differ from humans in several aspects and are subject to ethical limitations. Consequently, in vitro approaches are being developed to address these issues. This review focuses on the barrier properties of the cornea and evaluates the most advanced three-dimensional cultures of human corneal equivalents in literature. Their application potential is subsequently assessed and discussed in the context of preclinical testing along with our perspective toward the future. Impact statement Most ocular drugs are applied topically, with the transcorneal pathway as the main administration route. Animal corneas are currently the only advanced models available, contributing to the drug attrition rate. Anatomical and physiological interspecies differences might account for a poor translatability of preclinical results to clinical trials, urging researchers to devise better corneal equivalents. This review elaborates on the emerging generation of three-dimensional in vitro models, which comprises spheroids, organoids, and organs-on-chips, which can serve as a stepping stone for advancements in this field.
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Affiliation(s)
- Joris Van Meenen
- Antwerp Research Group for Ocular Science, Department of Translational Neurosciences, University of Antwerp, Wilrijk, Belgium
| | - Sorcha Ní Dhubhghaill
- Antwerp Research Group for Ocular Science, Department of Translational Neurosciences, University of Antwerp, Wilrijk, Belgium.,Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Bert Van den Bogerd
- Antwerp Research Group for Ocular Science, Department of Translational Neurosciences, University of Antwerp, Wilrijk, Belgium
| | - Carina Koppen
- Antwerp Research Group for Ocular Science, Department of Translational Neurosciences, University of Antwerp, Wilrijk, Belgium.,Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
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Chen A, Virk A, Harris Z, Abazari A, Honkanen R, Arbab MH. Non-contact terahertz spectroscopic measurement of the intraocular pressure through corneal hydration mapping. BIOMEDICAL OPTICS EXPRESS 2021; 12:3438-3449. [PMID: 34221670 PMCID: PMC8221940 DOI: 10.1364/boe.423741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 05/03/2023]
Abstract
Elevated intraocular pressure (IOP) results in endothelial layer damage that can induce corneal hydration perturbations. We investigated the potential of terahertz spectroscopy in measuring the IOP levels through mapping corneal water content. We controlled the IOP levels in ex vivo rabbit and porcine eye samples while monitoring the change in corneal hydration using a terahertz time-domain spectroscopy (THz-TDS) scanner. Our results showed a statistically significant increase in the THz reflectivity between 0.4 and 0.6 THz corresponding to the increase in the IOP. Endothelial layer damage was confirmed using scanning electron microscopy (SEM) of the corneal biopsy samples. Our empirical results indicate that the THz-TDS can be used to track IOP levels through the changes in corneal hydration.
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Affiliation(s)
- Andrew Chen
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Arjun Virk
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Zachery Harris
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Azin Abazari
- Department of Ophthalmology, Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Robert Honkanen
- Department of Ophthalmology, Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - M. Hassan Arbab
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
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25
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Wuchte LD, DiPasquale SA, Byrne ME. In vivo drug delivery via contact lenses: The current state of the field from origins to present. J Drug Deliv Sci Technol 2021; 63:102413. [PMID: 34122626 PMCID: PMC8192067 DOI: 10.1016/j.jddst.2021.102413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Over the past half century, contact lenses have been investigated for their potential as drug delivery devices for ocular therapeutics. Hundreds of studies have been published in the pursuit of the most effective and efficient release strategies and methods for contact lens drug delivery. This paper provides a thorough overview of the various contact lens drug delivery strategies, with a specific, comprehensive focus on in vivo studies that have been published since the field began in 1965. Significant accomplishments, current trends, as well as future strategies and directions are highlighted. In vivo study analysis provides a straightforward perspective and assessment of method success and commercialization potential in comparison to benchtop, in vitro studies. Analysis of the majority of published work indicates in vitro and in vivo studies do not correlate with a correlation coefficient of 0.25, with many in vitro studies grossly overestimating drug release duration and not showing appreciable drug release control. However, there has been an increase in activity in the last decade, and some methods have generated promising results exhibiting controlled release with commercialization potential. Clinical translation of drug releasing lenses is on the horizon and has high potential to impact a large number of patients providing efficacious treatment compared to current topical treatments.
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Affiliation(s)
- Liana D. Wuchte
- Biomimetic & Biohybrid Materials, Biomedical Devices, & Drug Delivery Laboratories, Department of Biomedical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
| | - Stephen A. DiPasquale
- Biomimetic & Biohybrid Materials, Biomedical Devices, & Drug Delivery Laboratories, Department of Biomedical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
- OcuMedic, Inc, 107 Gilbreth Parkway, Mullica Hill, NJ, 08062, USA
| | - Mark E. Byrne
- Biomimetic & Biohybrid Materials, Biomedical Devices, & Drug Delivery Laboratories, Department of Biomedical Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
- OcuMedic, Inc, 107 Gilbreth Parkway, Mullica Hill, NJ, 08062, USA
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26
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Brouwer NJ, Verdijk RM, Heegaard S, Marinkovic M, Esmaeli B, Jager MJ. Conjunctival melanoma: New insights in tumour genetics and immunology, leading to new therapeutic options. Prog Retin Eye Res 2021; 86:100971. [PMID: 34015548 DOI: 10.1016/j.preteyeres.2021.100971] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
Recent developments in oncology have led to a better molecular and cellular understanding of cancer, and the introduction of novel therapies. Conjunctival melanoma (CoM) is a rare but potentially devastating disease. A better understanding of CoM, leading to the development of novel therapies, is urgently needed. CoM is characterized by mutations that have also been identified in cutaneous melanoma, e.g. in BRAF, NRAS and TERT. These mutations are distinct from the mutations found in uveal melanoma (UM), affecting genes such as GNAQ, GNA11, and BAP1. Targeted therapies that are successful in cutaneous melanoma may therefore be useful in CoM. A recent breakthrough in the treatment of patients with metastatic cutaneous melanoma was the development of immunotherapy. While immunotherapy is currently sparsely effective in intraocular tumours such as UM, the similarities between CoM and cutaneous melanoma (including in their immunological tumour micro environment) provide hope for the application of immunotherapy in CoM, and preliminary clinical data are indeed emerging to support this use. This review aims to provide a comprehensive overview of the current knowledge regarding CoM, with a focus on the genetic and immunologic understanding. We elaborate on the distinct position of CoM in contrast to other types of melanoma, and explain how new insights in the pathophysiology of this disease guide the development of new, personalized, treatments.
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Affiliation(s)
- Niels J Brouwer
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Robert M Verdijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Pathology, Leiden University Medica Center, Leiden, the Netherlands; Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Pathology, Eye Pathology Section, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Bita Esmaeli
- Department of Plastic Surgery, Orbital Oncology and Ophthalmic Plastic Surgery, M.D. Anderson Cancer Center, Houston, TX, USA.
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
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Partitioning and Spatial Distribution of Drugs in Ocular Surface Tissues. Pharmaceutics 2021; 13:pharmaceutics13050658. [PMID: 34064499 PMCID: PMC8147976 DOI: 10.3390/pharmaceutics13050658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Abstract
Ocular drug absorption after eye drop instillation has been widely studied, but partitioning phenomena and spatial drug distribution are poorly understood. We investigated partitioning of seven beta-blocking drugs in corneal epithelium, corneal stroma, including endothelium and conjunctiva, using isolated porcine tissues and cultured human corneal epithelial cells. The chosen beta-blocking drugs had a wide range (-1.76-0.79) of n-octanol/buffer solution distribution coefficients at pH 7.4 (Log D7.4). In addition, the ocular surface distribution of three beta-blocking drugs was determined by matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS) after their simultaneous application in an eye drop to the rabbits in vivo. Studies with isolated porcine corneas revealed that the distribution coefficient (Kp) between the corneal epithelium and donor solution showed a positive relationship and good correlation with Log D7.4 and about a 50-fold range of Kp values (0.1-5). On the contrary, Kp between corneal stroma and epithelium showed an inverse (negative) relationship and correlation with Log D7.4 based on a seven-fold range of Kp values. In vitro corneal cell uptake showed a high correlation with the ex vivo corneal epithelium/donor Kp values. Partitioning of the drugs into the porcine conjunctiva also showed a positive relationship with lipophilicity, but the range of Kp values was less than with the corneal epithelium. MALDI-IMS allowed simultaneous detection of three compounds in the cornea, showed data in line with other experiments, and revealed uneven spatial drug distribution in the cornea. Our data indicate the importance of lipophilicity in defining the corneal pharmacokinetics and the Kp values are a useful building block in the kinetic simulation models for topical ocular drug administration.
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Yu L, Bhattacharya D, Wang Z, Wang M. Topical administration of ambroxol eye drops augments tear secretion in rabbits. Graefes Arch Clin Exp Ophthalmol 2021; 259:1529-1538. [DOI: 10.1007/s00417-020-05043-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022] Open
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Coroneo MT. The eye as the discrete but defensible portal of coronavirus infection. Ocul Surf 2021; 19:176-182. [PMID: 32446866 PMCID: PMC7241406 DOI: 10.1016/j.jtos.2020.05.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 12/23/2022]
Abstract
Oculo-centric factors may provide a key to understanding invasion success by SARS-CoV-2, a highly contagious, potentially lethal, virus with ocular tropism. Respiratory infection transmission via the eye and lacrimal-nasal pathway elucidated during the 1918 influenza pandemic, remains to be explored in this crisis. The eye and its adnexae represent a large surface area directly exposed to airborne viral particles and hand contact. The virus may bind to corneal and conjunctival angiotensin converting enzyme 2 (ACE2) receptors and potentially to the lipophilic periocular skin and superficial tear film with downstream carriage into the nasopharynx and subsequent access to the lungs and gut. Adenoviruses and influenza viruses share this ocular tropism and despite differing ocular and systemic manifestations and disease patterns, common lessons, particularly in management, emerge. Slit lamp usage places ophthalmologists at particular risk of exposure to high viral loads (and poor prognosis) and as for adenoviral epidemics, this may be a setting for disease transmission. Local, rather than systemic treatments blocking virus binding in this pathway (advocated for adenovirus) are worth considering. This pathway is accessible with eye drops or aerosols containing drugs which appear efficacious via systemic administration. A combination such as hydroxychloroquine, azithromycin and zinc, all of which have previously been used topically in the eye and which work at least in part by blocking ACE2 receptors, may offer a safe, cost-effective and resource-sparing intervention.
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Affiliation(s)
- Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Hospital/University of New South Wales, Sydney, Australia; Ophthalmic Surgeons, 2 St Pauls St, Randwick, NSW, 2031, Australia.
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30
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The cornea in keratoconjunctivitis sicca. Exp Eye Res 2020; 201:108295. [PMID: 33038387 DOI: 10.1016/j.exer.2020.108295] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 12/22/2022]
Abstract
The lacrimal functional unit (LFU) regulates tear production, composition, distribution and clearance to maintain a stable protective tear layer that is essential for maintaining corneal epithelial health. Dysfunction of the LFU, commonly referred to as dry eye, leads to increased tear osmolarity and levels of inflammatory mediators in tears that cause ocular surface epithelial disease, termed keratoconjunctivitis sicca (KCS). Corneal changes in KCS include glycocalyx loss, barrier disruption, surface irregularity inflammatory cytokine/chemokine production, cornification and apoptosis. These can reduce visual function and the increased shear force on the corneal epithelium can stimulate nociceptors sensitized by inflammation causing irritation and pain that may precede frank clinical signs. Therapy of keratoconjunctivitis sicca should be tailored to improve tear stability, normalize tear composition, improve barrier function and minimize shear forces and damaging inflammation to improve corneal epithelial health.
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Zhang X, Li S, Tang Y, Guo Y, Gao S. Intractable Ocular Diseases and Treatment Progress. AAPS PharmSciTech 2020; 21:236. [PMID: 32803351 DOI: 10.1208/s12249-020-01774-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, with the aging of the population and the frequent use of electronic devices, many eye diseases have shown a linear upward trend, such as dry eye disease, glaucoma, cataract, age-related macular degeneration, and diabetic retinopathy. These diseases are often chronic and difficult to cure. Based on the structure and barrier of the human eye, this review describes the pathogenesis and treatments of several intractable eye diseases and summarizes the advanced ocular drug delivery systems to provide new treatment ideas for these diseases. Finally, we also look forward to the prospect of RNAi therapy in the treatment of eye diseases.
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Sebbag L, Mochel JP. An eye on the dog as the scientist's best friend for translational research in ophthalmology: Focus on the ocular surface. Med Res Rev 2020; 40:2566-2604. [PMID: 32735080 DOI: 10.1002/med.21716] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022]
Abstract
Preclinical animal studies provide valuable opportunities to better understand human diseases and contribute to major advances in medicine. This review provides a comprehensive overview of ocular parameters in humans and selected animals, with a focus on the ocular surface, detailing species differences in ocular surface anatomy, physiology, tear film dynamics and tear film composition. We describe major pitfalls that tremendously limit the translational potential of traditional laboratory animals (i.e., rabbits, mice, and rats) in ophthalmic research, and highlight the benefits of integrating companion dogs with clinical analogues to human diseases into preclinical pharmacology studies. This One Health approach can help accelerate and improve the framework in which ophthalmic research is translated to the human clinic. Studies can be conducted in canine subjects with naturally occurring or noninvasively induced ocular surface disorders (e.g., dry eye disease, conjunctivitis), reviewed herein, and tear fluid can be easily retrieved from canine eyes for various bioanalytical purposes. In this review, we discuss common tear collection methods, including capillary tubes and Schirmer tear strips, and provide guidelines for tear sampling and extraction to improve the reliability of analyte quantification (drugs, proteins, others).
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Affiliation(s)
- Lionel Sebbag
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Jonathan P Mochel
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
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33
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Lanier OL, Christopher KG, Macoon RM, Yu Y, Sekar P, Chauhan A. Commercialization challenges for drug eluting contact lenses. Expert Opin Drug Deliv 2020; 17:1133-1149. [DOI: 10.1080/17425247.2020.1787983] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Olivia L. Lanier
- Chemical and Biological Engineering, Colorado School of Mines, Golden, CO, USA
| | | | - Russell M. Macoon
- Department of Chemical Engineering, University of Florida, Gainesville, FL, USA
| | - Yifan Yu
- Department of Chemical Engineering, University of Florida, Gainesville, FL, USA
| | - Poorvajan Sekar
- Department of Chemical Engineering, University of Florida, Gainesville, FL, USA
| | - Anuj Chauhan
- Chemical and Biological Engineering, Colorado School of Mines, Golden, CO, USA
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Abstract
PURPOSE To compare the neuroprotective properties of retinalamin administered in different ways among open-angle glaucoma patients with compensated intraocular pressure. MATERIAL AND METHODS The study included 498 patients (eyes) with initial, moderate and advanced stages of glaucoma. Patients were divided into 3 groups: group I (n=110) received 5 mg intramuscular and 5 mg retrobulbar injections of retinalamin; group II (n=171) received 5 mg retrobulbar injection of retinalamin; group III received 5 mg intramuscular injection of retinalamin. The overall treatment dose contained 50 mg of retinalamin. All the patients underwent tonometry and static perimetry. Patients of group II with initial glaucoma and patients of group III with moderate glaucoma also underwent contrast sensitivity tests. The examinations were conducted before the treatment, and on months 3 and 6. RESULTS Visual acuity did not change significantly. In group I, after 3 months of treatment total threshold retinal sensitivity increased by 122 dB in patients with initial glaucoma, by 166 dB in moderate and by 124 dB in advanced glaucoma. Positive trend was observed in patients with initial and moderate stages of glaucoma by month 6. In group II, total threshold retinal sensitivity increased by 123 dB in initial glaucoma and by 110 dB in moderate; the result did not change by month 6. No significant changes were observed in patients with advanced glaucoma. In group III, total threshold retinal sensitivity increased by 142 dB in initial glaucoma, by 274 dB in moderate and by 148 dB in advanced glaucoma. Regression began on the sixth month. In group II, patients with initial glaucoma were observed to have decreased sensorimotor reaction times to achromatic stimuli within the studied areas of central visual field. In group III, patients with advanced glaucoma were also observed to have decreased sensorimotor reaction times to achromatic stimuli detected within 1° and 5° areas from the fixation point, but not in the 10° area. CONCLUSION Retinalamin is most effective in initial and moderate glaucoma stages. Intramuscular, retrobulbar and combined administration methods have comparable efficacy.
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Affiliation(s)
- V P Erichev
- Research Institute of Eye Diseases, Moscow, Russia
| | | | - T V Yaremenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Varela-Fernández R, Díaz-Tomé V, Luaces-Rodríguez A, Conde-Penedo A, García-Otero X, Luzardo-Álvarez A, Fernández-Ferreiro A, Otero-Espinar FJ. Drug Delivery to the Posterior Segment of the Eye: Biopharmaceutic and Pharmacokinetic Considerations. Pharmaceutics 2020; 12:E269. [PMID: 32188045 PMCID: PMC7151081 DOI: 10.3390/pharmaceutics12030269] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 01/22/2023] Open
Abstract
The treatment of the posterior-segment ocular diseases, such as age-related eye diseases (AMD) or diabetic retinopathy (DR), present a challenge for ophthalmologists due to the complex anatomy and physiology of the eye. This specialized organ is composed of various static and dynamic barriers that restrict drug delivery into the target site of action. Despite numerous efforts, effective intraocular drug delivery remains unresolved and, therefore, it is highly desirable to improve the current treatments of diseases affecting the posterior cavity. This review article gives an overview of pharmacokinetic and biopharmaceutics aspects for the most commonly-used ocular administration routes (intravitreal, topical, systemic, and periocular), including information of the absorption, distribution, and elimination, as well as the benefits and limitations of each one. This article also encompasses different conventional and novel drug delivery systems designed and developed to improve drug pharmacokinetics intended for the posterior ocular segment treatment.
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Affiliation(s)
- Rubén Varela-Fernández
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Neurosciences Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Victoria Díaz-Tomé
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Andrea Conde-Penedo
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Molecular Imaging Group. University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
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Lin W, Zhao L, Huang X, Tan Q, Peng M, Khan MA, Lin D. Comparative Assessment of Distribution Characteristics and Ocular Pharmacokinetics of Norvancomycin Between Continuous Topical Ocular Instillation and Hourly Administration of Eye Drop. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:867-879. [PMID: 32161446 PMCID: PMC7049745 DOI: 10.2147/dddt.s233047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/13/2020] [Indexed: 01/04/2023]
Abstract
Background The aim of this study was to compare the distribution characteristics and ocular pharmacokinetics of norvancomycin (NVCM) in ocular tissues of the anterior segment between continuous topical ocular instillation and hourly administration of eye drop in rabbits. Methods Sixty rabbits were randomly divided into two groups: continuous topical ocular instillation drug delivery (CTOIDD) group and eye drop (control) group. In the CTOIDD group, NVCM solution (50 mg/mL) was perfused to the ocular surface using the CTOIDD system at 2 mL/h up to 10 h and the same solution was administered at one drop (50 μL) per hour for 10 h in the control group. Animals (N=6 per time-point per group) were humanely killed at 2, 4, 6, 10, and 24 h to analyze their ocular tissues and plasma. The concentrations of NVCM in the conjunctiva, cornea, aqueous humour, iris, ciliary body and plasma were measured by HPLC with photodiode array detector. The pharmacokinetic parameters were calculated by Kinetica 5.1. Results The highest concentrations of NVCM for the CTOIDD group and control group were 2105.45±919.89 μg/g and 97.18±43.14 μg/g in cornea, 3033.92±1061.95 μg/g and 806.99±563.02 μg/g in conjunctiva, 1570.19±402.87 μg/g and 46.93±23.46 μg/g in iris, 181.94±47.11 μg/g and 15.38±4.00 μg/g in ciliary body, 29.78±4.90 μg/mL and 3.20±1.48 μg/mL in aqueous humour, and 26.89±5.57 μg/mL and 1.90±1.87 μg/mL in plasma, respectively. The mean NVCM levels significantly increased at all time-points in cornea, iris, and ciliary body (p<0.05) in the CTOIDD group. The AUC0–24 values in the CTOIDD group were 27,543.70 μg·h/g in cornea, 32,514.48 μg·h/g in conjunctiva, 8631.05 μg·h/g in iris, 2194.36 μg·h/g in ciliary body and 343.9 μg·h/mL in aqueous humour, which were higher than for the eye drop group in all tissues. Conclusion Since continuous instillation of NVCM with CTOIDD could reach significantly higher concentrations and was sustained for a longer period compared with hourly administration of eye drop, CTOIDD administered NVCM could be a possible method to treat bacterial keratitis. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/mh0eyzHYgRE
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Affiliation(s)
- Wenxiang Lin
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
| | - Libei Zhao
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
| | - Xuetao Huang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Qian Tan
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
| | - Manqiang Peng
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
| | - Muhammad Ahmad Khan
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
| | - Ding Lin
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, People's Republic of China
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Current market trends in anterior ocular inflammatory disease landscape. Curr Opin Allergy Clin Immunol 2019; 19:503-509. [DOI: 10.1097/aci.0000000000000562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ross AE, Bengani LC, Tulsan R, Maidana DE, Salvador-Culla B, Kobashi H, Kolovou PE, Zhai H, Taghizadeh K, Kuang L, Mehta M, Vavvas DG, Kohane DS, Ciolino JB. Topical sustained drug delivery to the retina with a drug-eluting contact lens. Biomaterials 2019; 217:119285. [DOI: 10.1016/j.biomaterials.2019.119285] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 02/01/2023]
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Subrizi A, del Amo EM, Korzhikov-Vlakh V, Tennikova T, Ruponen M, Urtti A. Design principles of ocular drug delivery systems: importance of drug payload, release rate, and material properties. Drug Discov Today 2019; 24:1446-1457. [DOI: 10.1016/j.drudis.2019.02.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/10/2019] [Accepted: 02/01/2019] [Indexed: 12/26/2022]
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40
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Current Approaches to Use Cyclodextrins and Mucoadhesive Polymers in Ocular Drug Delivery—A Mini-Review. Sci Pharm 2019. [DOI: 10.3390/scipharm87030015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Ocular drug delivery provides a challenging opportunity to develop optimal formulations with proper therapeutic effects and acceptable patient compliance because there are many restricting factors involved, such as complex anatomical structures, defensive mechanisms, rapid drainage, and applicability issues. Fortunately, recent advances in the field mean that these problems can be overcome through the formulation of innovative ophthalmic products. Through the addition of solubility enhancer cyclodextrin derivatives and mucoadhesive polymers, the permeability of active ingredients is improved, and retention time is increased in the ocular surface. Therefore, preferable efficacy and bioavailability can be achieved. In this short review, the authors describe the theoretical background, technological possibilities, and the current approaches in the field of ophthalmology.
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Sharma M, Deohra A, Reddy KR, Sadhu V. Biocompatible in-situ gelling polymer hydrogels for treating ocular infection. J Microbiol Methods 2019. [DOI: 10.1016/bs.mim.2019.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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42
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Optimized Protocol for Regeneration of the Conjunctival Epithelium Using the Cell Suspension Technique. Cornea 2018; 38:469-479. [DOI: 10.1097/ico.0000000000001670] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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43
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Controlled delivery of pirfenidone through vitamin E-loaded contact lens ameliorates corneal inflammation. Drug Deliv Transl Res 2018; 8:1114-1126. [DOI: 10.1007/s13346-018-0541-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Nguyen H, Eng S, Ngo T, Dass CR. Delivery of therapeutics for deep-seated ocular conditions - status quo. ACTA ACUST UNITED AC 2018; 70:994-1001. [PMID: 29675844 DOI: 10.1111/jphp.12924] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/24/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES There is a need for research into designing effective pharmaceutical systems for delivering therapeutic drugs to the posterior of the eye for glaucoma-related pathology, macular degeneration, diabetic retinopathy, macular oedema, retinitis and choroiditis. Conventionally, eye drops have been extensively utilised for topical drug delivery to the anterior segment of the eye, but are less effective for delivery of therapeutics to the back of the eye due to significant barriers hampering drug penetration into the target intraocular tissue. This review explores some of the current and novel delivery systems employed to deliver therapeutics to the back of the eye such as those using liposomes, ocular implants, in situ gels, and nanoparticles, and how they can overcome some of these limitations. KEY FINDINGS Issues such as blinking, precorneal fluid drainage, tear dilution and turnover, conjunctiva and nasal drug absorption, the corneal epithelium, vitreous drug clearance, and the blood-ocular barriers are reviewed and discussed. SUMMARY Further studies are needed to address their shortcomings such as drug compatibility and stability, economic viability and patient compliance.
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Affiliation(s)
- Hubert Nguyen
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Shawn Eng
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Thanh Ngo
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia
| | - Crispin R Dass
- School of Pharmacy and Biomedical Science, Curtin University, Bentley, WA, Australia.,Curtin Health Innovation Research Institute, Bentley, WA, Australia
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Ramsay E, Del Amo EM, Toropainen E, Tengvall-Unadike U, Ranta VP, Urtti A, Ruponen M. Corneal and conjunctival drug permeability: Systematic comparison and pharmacokinetic impact in the eye. Eur J Pharm Sci 2018; 119:83-89. [PMID: 29625211 DOI: 10.1016/j.ejps.2018.03.034] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/31/2018] [Indexed: 10/17/2022]
Abstract
On the surface of the eye, both the cornea and conjunctiva are restricting ocular absorption of topically applied drugs, but barrier contributions of these two membranes have not been systemically compared. Herein, we studied permeability of 32 small molecular drug compounds across an isolated porcine cornea and built a quantitative structure-property relationship (QSPR) model for the permeability. Corneal drug permeability (data obtained for 25 drug molecules) showed a 52-fold range in permeability (0.09-4.70 × 10-6 cm/s) and the most important molecular descriptors in predicting the permeability were hydrogen bond donor, polar surface area and halogen ratio. Corneal permeability values were compared to their conjunctival drug permeability values. Ocular drug bioavailability and systemic absorption via conjunctiva were predicted for this drug set with pharmacokinetic calculations. Drug bioavailability in the aqueous humour was simulated to be <5% and trans-conjunctival systemic absorption was 34-79% of the dose. Loss of drug across the conjunctiva to the blood circulation restricts significantly ocular drug bioavailability and, therefore, ocular absorption does not increase proportionally with the increasing corneal drug permeability.
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Affiliation(s)
- Eva Ramsay
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland; Centre for Drug Research, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, P.O. Box 56, FI-00014 Helsinki, Finland.
| | - Eva M Del Amo
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Elisa Toropainen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Unni Tengvall-Unadike
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Veli-Pekka Ranta
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Arto Urtti
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland; Centre for Drug Research, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, P.O. Box 56, FI-00014 Helsinki, Finland
| | - Marika Ruponen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
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Willshire C, Bron AJ, Gaffney EA, Pearce EI. Basal Tear Osmolarity as a metric to estimate body hydration and dry eye severity. Prog Retin Eye Res 2018; 64:56-64. [PMID: 29476817 DOI: 10.1016/j.preteyeres.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/02/2018] [Accepted: 02/20/2018] [Indexed: 01/28/2023]
Abstract
The osmolarities of various bodily fluids, including tears, saliva and urine, have been used as indices of plasma osmolality, a measure of body hydration, while tear osmolarity is used routinely in dry eye diagnosis, the degree of tear hyperosmolarity providing an index of disease severity. Systemic dehydration, due to inadequate water intake or excessive water loss is common in the elderly population, has a high morbidity and may cause loss of life. Its diagnosis is often overlooked and there is a need to develop a simple, bedside test to detect dehydration in this population. We hypothesize that, in the absence of tear evaporation and with continued secretion, mixing and drainage of tears, tear osmolarity falls to a basal level that is closer to that of the plasma than that of a tear sample taken in open eye conditions. We term this value the Basal Tear Osmolarity (BTO) and propose that it may be measured in tear samples immediately after a period of evaporative suppression. This value will be particular to an individual and since plasma osmolarity is controlled within narrow limits, it is predicted that it will be stable and have a small variance. It is proposed that the BTO, measured immediately after a defined period of eye closure, can provide a new metric in the diagnosis of systemic dehydration and a yardstick against which to gauge the severity of dry eye disease.
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Affiliation(s)
- C Willshire
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - A J Bron
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK; Nuffield Department of Clinical Neurosciences and Nuffield Laboratory of Ophthalmology, University of Oxford, UK.
| | - E A Gaffney
- Wolfson Centre of Mathematical Biology, Mathematical Institute, University of Oxford, UK
| | - E Ian Pearce
- School of Health and Life Sciences, Glasgow Caledonian University, UK
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Huang D, Chen YS, Rupenthal ID. Overcoming ocular drug delivery barriers through the use of physical forces. Adv Drug Deliv Rev 2018; 126:96-112. [PMID: 28916492 DOI: 10.1016/j.addr.2017.09.008] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 06/30/2017] [Accepted: 09/08/2017] [Indexed: 12/25/2022]
Abstract
Overcoming the physiological barriers in the eye remains a key obstacle in the field of ocular drug delivery. While ocular barriers naturally have a protective function, they also limit drug entry into the eye. Various pharmaceutical strategies, such as novel formulations and physical force-based techniques, have been investigated to weaken these barriers and transport therapeutic agents effectively to both the anterior and the posterior segments of the eye. This review summarizes and discusses the recent research progress in the field of ocular drug delivery with a focus on the application of physical methods, including electrical fields, sonophoresis, and microneedles, which can enhance penetration efficiency by transiently disrupting the ocular barriers in a minimally or non-invasive manner.
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48
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Janagam DR, Wu L, Lowe TL. Nanoparticles for drug delivery to the anterior segment of the eye. Adv Drug Deliv Rev 2017; 122:31-64. [PMID: 28392306 PMCID: PMC6057481 DOI: 10.1016/j.addr.2017.04.001] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 04/02/2017] [Accepted: 04/03/2017] [Indexed: 02/07/2023]
Abstract
Commercially available ocular drug delivery systems are effective but less efficacious to manage diseases/disorders of the anterior segment of the eye. Recent advances in nanotechnology and molecular biology offer a great opportunity for efficacious ocular drug delivery for the treatments of anterior segment diseases/disorders. Nanoparticles have been designed for preparing eye drops or injectable solutions to surmount ocular obstacles faced after administration. Better drug pharmacokinetics, pharmacodynamics, non-specific toxicity, immunogenicity, and biorecognition can be achieved to improve drug efficacy when drugs are loaded in the nanoparticles. Despite the fact that a number of review articles have been published at various points in the past regarding nanoparticles for drug delivery, there is not a review yet focusing on the development of nanoparticles for ocular drug delivery to the anterior segment of the eye. This review fills in the gap and summarizes the development of nanoparticles as drug carriers for improving the penetration and bioavailability of drugs to the anterior segment of the eye.
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Affiliation(s)
- Dileep R Janagam
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Linfeng Wu
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Tao L Lowe
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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Awwad S, Mohamed Ahmed AHA, Sharma G, Heng JS, Khaw PT, Brocchini S, Lockwood A. Principles of pharmacology in the eye. Br J Pharmacol 2017; 174:4205-4223. [PMID: 28865239 PMCID: PMC5715579 DOI: 10.1111/bph.14024] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/14/2017] [Accepted: 08/17/2017] [Indexed: 12/18/2022] Open
Abstract
The eye is a highly specialized organ that is subject to a huge range of pathology. Both local and systemic disease may affect different anatomical regions of the eye. The least invasive routes for ocular drug administration are topical (e.g. eye drops) and systemic (e.g. tablets) formulations. Barriers that subserve as protection against pathogen entry also restrict drug permeation. Topically administered drugs often display limited bioavailability due to many physical and biochemical barriers including the pre-corneal tear film, the structure and biophysiological properties of the cornea, the limited volume that can be accommodated by the cul-de-sac, the lacrimal drainage system and reflex tearing. The tissue layers of the cornea and conjunctiva are further key factors that act to restrict drug delivery. Using carriers that enhance viscosity or bind to the ocular surface increases bioavailability. Matching the pH and polarity of drug molecules to the tissue layers allows greater penetration. Drug delivery to the posterior segment is a greater challenge and, currently, the standard route is via intravitreal injection, notwithstanding the risks of endophthalmitis and retinal detachment with frequent injections. Intraocular implants that allow sustained drug release are at different stages of development. Novel exciting therapeutic approaches include methods for promoting transscleral delivery, sustained release devices, nanotechnology and gene therapy.
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Affiliation(s)
- Sahar Awwad
- UCL School of PharmacyLondonUK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
| | - Abeer H A Mohamed Ahmed
- UCL School of PharmacyLondonUK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
| | - Garima Sharma
- UCL School of PharmacyLondonUK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
| | - Jacob S Heng
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
| | - Peng T Khaw
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
| | - Steve Brocchini
- UCL School of PharmacyLondonUK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
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Coroneo MT. Paradigm shifts, peregrinations and pixies in ophthalmology. Clin Exp Ophthalmol 2017; 46:280-297. [PMID: 28715851 DOI: 10.1111/ceo.13023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/28/2017] [Accepted: 07/05/2017] [Indexed: 12/21/2022]
Abstract
Human ingenuity is challenged by defending vision, our highest bandwidth sense. Special challenges are presented by the replacement or repair of highly specialized but scarce tissue within the constraints of transparency, tissue shape and alignment, tissue borders and pressure maintenance. Many, mostly destructive, surgical procedures were developed prior to an understanding of underlying pathophysiology. For a number of conditions, both reconstructive and destructive procedures co-exist, yet there are few guidelines as to the better approach. Because the consequences of these procedures may take many years to surface (consistent with a stem cell role in long-term tissue maintenance), guidance may be provided by the elucidation of underlying principles from these approaches. Illustrative examples from clinical, basic research and biotechnology, particularly relating to pterygium, ocular surface squamous neoplasia, dry-eye syndrome, corneal rehabilitation and replacement, cataract surgery, strabismus surgery and bionic eye research, are described. An unexpected consequence of bionic device development has been an appreciation of the sophistication of tissues being replaced, given the limitations of available biomaterials. Examples of how this has provided insights into ocular disease will be illustrated. Stem cell and biomaterial technologies are starting to impact at a time when cost-effectiveness is under scrutiny. Both efficacy and cost will need to be considered as these interventions are introduced. It appears that the paradigm shift rate is accelerating and there is evidence of this in ophthalmology. Lessons learned from the areas of destructive versus reconstructive surgery and the limitations of development of bionic replacements will be used to illustrate how new procedures and technologies can be developed.
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Affiliation(s)
- Minas T Coroneo
- Department of Ophthalmology, University of New South Wales at Prince of Wales Hospital, Sydney, Australia.,Ophthalmic Surgeons, Sydney, Australia.,East Sydney Private Hospital, Sydney, Australia.,Look for Life Foundation, Sydney, Australia
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