1
|
Chen YS, Jin E, Day PJ. Use of Drug Sensitisers to Improve Therapeutic Index in Cancer. Pharmaceutics 2024; 16:928. [PMID: 39065625 PMCID: PMC11279903 DOI: 10.3390/pharmaceutics16070928] [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: 05/30/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
The clinical management of malignant tumours is challenging, often leading to severe adverse effects and death. Drug resistance (DR) antagonises the effectiveness of treatments, and increasing drug dosage can worsen the therapeutic index (TI). Current efforts to overcome DR predominantly involve the use of drug combinations, including applying multiple anti-cancerous drugs, employing drug sensitisers, which are chemical agents that enhance pharmacokinetics (PK), including the targeting of cellular pathways and regulating pertinent membrane transporters. While combining multiple compounds may lead to drug-drug interactions (DDI) or polypharmacy effect, the use of drug sensitisers permits rapid attainment of effective treatment dosages at the disease site to prevent early DR and minimise side effects and will reduce the chance of DDI as lower drug doses are required. This review highlights the essential use of TI in evaluating drug dosage for cancer treatment and discusses the lack of a unified standard for TI within the field. Commonly used benefit-risk assessment criteria are summarised, and the critical exploration of the current use of TI in the pharmaceutical industrial sector is included. Specifically, this review leads to the discussion of drug sensitisers to facilitate improved ratios of effective dose to toxic dose directly in humans. The combination of drug and sensitiser molecules might see additional benefits to rekindle those drugs that failed late-stage clinical trials by the removal of detrimental off-target activities through the use of lower drug doses. Drug combinations and employing drug sensitisers are potential means to combat DR. The evolution of drug combinations and polypharmacy on TI are reviewed. Notably, the novel binary weapon approach is introduced as a new opportunity to improve TI. This review emphasises the urgent need for a criterion to systematically evaluate drug safety and efficiency for practical implementation in the field.
Collapse
Affiliation(s)
- Yu-Shan Chen
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK; (Y.-S.C.); (E.J.)
| | - Enhui Jin
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK; (Y.-S.C.); (E.J.)
| | - Philip J. Day
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK; (Y.-S.C.); (E.J.)
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| |
Collapse
|
2
|
Gomaa E, Eissa NG, Ibrahim TM, El-Bassossy HM, El-Nahas HM, Ayoub MM. Development of depot PLGA-based in-situ implant of Linagliptin: Sustained release and glycemic control. Saudi Pharm J 2023; 31:499-509. [PMID: 37063437 PMCID: PMC10102447 DOI: 10.1016/j.jsps.2023.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
High percentage of diabetic people are diagnosed as type 2 who require daily dosing of an antidiabetic drug such as Linagliptin (Lina) to manage their blood glucose levels. This study aimed to develop injectable Lina-loaded biodegradable poly (lactic-co-glycolic acid) (PLGA) in-situ implants (ISIs) to deliver a desired burst effect of Lina followed by a sustained release over several days for controlling the blood glucose levels over prolonged time periods. The morphological, pharmacokinetic, and pharmacodynamic assessments of the Lina-loaded ISIs were performed. Scanning electron microscopy (SEM) study revealed the rapid exchange between the water miscible solvent (N-methyl-2-pyrrolidone; NMP) and water during the ISI preparation, hence enhancing the initial burst Lina release. While, triacetin of lower water affinity could lead to formation of more compact and dense ISI structure with slower drug release. By comparing various ISI formulations containing different solvents and different PLGA concentrations, the ISI containing 40 % PLGA and triacetin was selected for its sustained release of Lina (93.06 ± 1.50 %) after 21 days. The pharmacokinetic results showed prolonged half life (t1/2) and higher area under the curve (AUC) values of the selected Lina-loaded ISI when compared to those of oral Lina preparation. The single Lina-ISI injection produced a hypoglycemic control in the diabetic rats very similar to the daily oral administration of Lina after 7 and 14 days. In conclusion, PLGA-based ISIs confirmed their suitability for prolonging Lina release in patients receiving long-term antidiabetic therapy, thereby achieving more enhanced patient compliance and reduced dosing frequency.
Collapse
Affiliation(s)
- Eman Gomaa
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Noura G. Eissa
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Tarek M. Ibrahim
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
- Corresponding author.
| | - Hany M. El-Bassossy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Hanan M. El-Nahas
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Margrit M. Ayoub
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| |
Collapse
|
3
|
Onyekanne CE, Salifu AA, Obayemi JD, Ani CJ, Ashouri Choshali H, Nwazojie CC, Onwudiwe KC, Oparah JC, Ezenwafor TC, Ezeala CC, Odusanya OS, Rahbar N, Soboyejo WO. Laser-induced heating of polydimethylsiloxane-magnetite nanocomposites for hyperthermic inhibition of triple-negative breast cancer cell proliferation. J Biomed Mater Res B Appl Biomater 2022; 110:2727-2743. [PMID: 35799416 DOI: 10.1002/jbm.b.35124] [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: 01/05/2022] [Revised: 03/23/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022]
Abstract
This paper presents the results of an experimental and computational study of the effects of laser-induced heating provided by magnetite nanocomposite structures that are being developed for the localized hyperthermic treatment of triple-negative breast cancer. Magnetite nanoparticle-reinforced polydimethylsiloxane (PDMS) nanocomposites were fabricated with weight percentages of 1%, 5%, and 10% magnetite nanoparticles. The nanocomposites were exposed to incident Near Infrared (NIR) laser beams with well-controlled powers. The laser-induced heating is explored in: (i) heating liquid media (deionized water and cell growth media [Leibovitz L15+]) to characterize the photothermal properties of the nanocomposites, (ii) in vitro experiments that explore the effects of localized heating on triple-negative breast cancer cells, and (iii) experiments in which the laser beams penetrate through chicken tissue to heat up nanocomposite samples embedded at different depths beneath the chicken skin. The resulting plasmonic laser-induced heating is explained using composite theories and heat transport models. The results show that the laser/nanocomposite interactions decrease the viability of triple-negative breast cancer cells (MDA-MB-231) at temperatures in the hyperthermia domain between 41 and 44°C. Laser irradiation did not cause any observed physical damage to the chicken tissue. The potential in vivo performance of the PDMS nanocomposites was also investigated using computational finite element models of the effects of laser/magnetite nanocomposite interactions on the temperatures and thermal doses experienced by tissues that surround the nanocomposite devices. The implications of the results are then discussed for the development of implantable nanocomposite devices for localized treatment of triple-negative breast cancer tissue via hyperthermia.
Collapse
Affiliation(s)
- Chinyerem E Onyekanne
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Ali A Salifu
- Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA.,Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - John D Obayemi
- Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA.,Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Chukwuemeka J Ani
- Department of Physics, Nile University of Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Habibeh Ashouri Choshali
- Department of Civil and Environmental Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Chukwudalu C Nwazojie
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Killian C Onwudiwe
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Josephine C Oparah
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Theresa C Ezenwafor
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Chukwudi C Ezeala
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria
| | - Olushola S Odusanya
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria.,Biotechnology and Genetic Engineering Advanced Laboratory, Sheda Science and Technology Complex, Abuja, Federal Capital Territory, Nigeria
| | - Nima Rahbar
- Department of Civil and Environmental Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Winston O Soboyejo
- Department of Materials Science and Engineering, Biomaterials Lab, African University of Science and Technology, Abuja, Federal Capital Territory, Nigeria.,Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA.,Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| |
Collapse
|
4
|
Picco CJ, Domínguez-Robles J, Utomo E, Paredes AJ, Volpe-Zanutto F, Malinova D, Donnelly RF, Larrañeta E. 3D-printed implantable devices with biodegradable rate-controlling membrane for sustained delivery of hydrophobic drugs. Drug Deliv 2022; 29:1038-1048. [PMID: 35363100 PMCID: PMC8979538 DOI: 10.1080/10717544.2022.2057620] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Implantable drug delivery systems offer an alternative for the treatments of long-term conditions (i.e. schizophrenia, HIV, or Parkinson’s disease among many others). The objective of the present work was to formulate implantable devices loaded with the model hydrophobic drug olanzapine (OLZ) using robocasting 3D-printing combined with a pre-formed rate controlling membrane. OLZ was selected as a model molecule due to its hydrophobic nature and because is a good example of a molecule used to treat a chronic condition schizophrenia. The resulting implants consisted of a poly(ethylene oxide) (PEO) implant coated with a poly(caprolactone) (PCL)-based membrane. The implants were loaded with 50 and 80% (w/w) of OLZ. They were prepared using an extrusion-based 3D-printer from aqueous pastes containing 36–38% (w/w) of water. The printing process was carried out at room temperature. The resulting implants were characterized by using infrared spectroscopy, scanning electron microscopy, thermal analysis, and X-ray diffraction. Crystals of OLZ were present in the implant after the printing process. In vitro release studies showed that implants containing 50% and 80% (w/w) of OLZ were capable of providing drug release for up to 190 days. On the other hand, implants containing 80% (w/w) of OLZ presented a slower release kinetics. After 190 days, total drug release was ca. 77% and ca. 64% for implants containing 50% and 80% (w/w) of OLZ, respectively. The higher PEO content within implants containing 50% (w/w) of OLZ allows a faster release as this polymer acts as a co-solvent of the drug.
Collapse
Affiliation(s)
- Camila J Picco
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | | | - Emilia Utomo
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | | | | | - Dessislava Malinova
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | | | | |
Collapse
|
5
|
Padmakumar S, Varghese MM, Menon D. Differential Drug Release Kinetics from Paclitaxel-Loaded Polydioxanone Membranes and Capsules. RECENT ADVANCES IN DRUG DELIVERY AND FORMULATION 2022; 16:241-252. [PMID: 35796448 DOI: 10.2174/2667387816666220707143330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Drug laden implantable systems can provide drug release over several hours to years, which eventually aid in the therapy of both acute and chronic diseases. The present study focuses on a fundamental evaluation of the influence of implant properties such as morphology, architecture, porosity, surface area, and wettability in regulating the drug release kinetics from drug-loaded polymeric matrices. METHODS For this, Polydioxanone (PDS) was selected as the polymer and Paclitaxel (Ptx) as the model drug. Two different forms of the matrix implants, viz., reservoir type capsules developed by dip coating and matrix type membranes fabricated by phase inversion and electrospinning, were utilized for the study. Drug release from all the four different matrices prepared by simple techniques was evaluated in vitro in PBS and ex vivo in peritoneal wash fluid for ~4 weeks. The drug release profiles were thereafter correlated with the physicochemical parameters of the polymeric implants. RESULTS Reservoir-type capsules followed a slow and steady zero-order kinetics, while matrix-type electrospun and phase inversion membranes displayed typical biphasic kinetics. CONCLUSION It was inferred that the slow degradation rate of PDS polymer as well as the implant properties like porosity and wettability play an important role in controlling the drug release rates.
Collapse
Affiliation(s)
- Smrithi Padmakumar
- Centre for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Merin Mary Varghese
- Centre for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Deepthy Menon
- Centre for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| |
Collapse
|
6
|
Mohamdeen YMG, Tabriz AG, Tighsazzadeh M, Nandi U, Khalaj R, Andreadis I, Boateng JS, Douroumis D. Development of 3D printed drug-eluting contact lenses. J Pharm Pharmacol 2021; 74:1467-1476. [PMID: 34928372 DOI: 10.1093/jpp/rgab173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/05/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of the work was to introduce 3D printing technology for the design and fabrication of drug-eluting contact lenses (DECL) for the treatment of glaucoma. The development of 3D printed lenses can effectively overcome drawbacks of existing approaches by using biocompatible medical grade polymers that provide sustained drug release of timolol maleate for extended periods. METHODS Hot melt extrusion was coupled with fusion deposition modelling (FDM) to produce printable filaments of ethylene-vinyl acetate copolymer-polylactic acid blends at various ratios loaded with timolol maleate. Physicochemical and mechanical characterisation of the printed filaments was used to optimise the printing of the contact lenses. KEY FINDINGS 3D printed lenses with an aperture (opening) and specified dimensions could be printed using FDM technology. The lenses presented a smooth surface with good printing resolution while providing sustained release of timolol maleate over 3 days. The findings of this study can be used for the development of personalised DECL in the future.
Collapse
Affiliation(s)
- Youssra Moustafa Gadelkareem Mohamdeen
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK.,Faculty of Biotechnology, October University for Modern Sciences and Arts (MSA), Cairo, Egypt
| | - Atabak Ghanizadeh Tabriz
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK.,CIPER: Centre for Innovation and Process Engineering Research, Kent, UK
| | - Mohammad Tighsazzadeh
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK
| | - Uttom Nandi
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK.,CIPER: Centre for Innovation and Process Engineering Research, Kent, UK
| | - Roxanne Khalaj
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK.,CIPER: Centre for Innovation and Process Engineering Research, Kent, UK
| | - Ioannis Andreadis
- Laboratory of Pharmaceutical Technology, Department of Pharmaceutical Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Joshua S Boateng
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK
| | - Dennis Douroumis
- Faculty of Engineering and Science, School of Science, University of Greenwich, Chatham, Kent, UK.,CIPER: Centre for Innovation and Process Engineering Research, Kent, UK
| |
Collapse
|
7
|
Gao G, Ahn M, Cho WW, Kim BS, Cho DW. 3D Printing of Pharmaceutical Application: Drug Screening and Drug Delivery. Pharmaceutics 2021; 13:1373. [PMID: 34575448 PMCID: PMC8465948 DOI: 10.3390/pharmaceutics13091373] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/20/2021] [Accepted: 08/29/2021] [Indexed: 12/22/2022] Open
Abstract
Advances in three-dimensional (3D) printing techniques and the development of tailored biomaterials have facilitated the precise fabrication of biological components and complex 3D geometrics over the past few decades. Moreover, the notable growth of 3D printing has facilitated pharmaceutical applications, enabling the development of customized drug screening and drug delivery systems for individual patients, breaking away from conventional approaches that primarily rely on transgenic animal experiments and mass production. This review provides an extensive overview of 3D printing research applied to drug screening and drug delivery systems that represent pharmaceutical applications. We classify several elements required by each application for advanced pharmaceutical techniques and briefly describe state-of-the-art 3D printing technology consisting of cells, bioinks, and printing strategies that satisfy requirements. Furthermore, we discuss the limitations of traditional approaches by providing concrete examples of drug screening (organoid, organ-on-a-chip, and tissue/organ equivalent) and drug delivery systems (oral/vaginal/rectal and transdermal/surgical drug delivery), followed by the introduction of recent pharmaceutical investigations using 3D printing-based strategies to overcome these challenges.
Collapse
Affiliation(s)
- Ge Gao
- Institute of Engineering Medicine, Beijing Institute of Technology, No. 5, South Street, Zhongguancun, Haidian District, Beijing 100081, China;
| | - Minjun Ahn
- Department of Mechanical Engineering, POSTECH, 77 Cheongam-ro, Nam-gu, Pohang 37673, Kyungbuk, Korea; (M.A.); (W.-W.C.)
| | - Won-Woo Cho
- Department of Mechanical Engineering, POSTECH, 77 Cheongam-ro, Nam-gu, Pohang 37673, Kyungbuk, Korea; (M.A.); (W.-W.C.)
| | - Byoung-Soo Kim
- School of Biomedical Convergence Engineering, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Kyungbuk, Korea
| | - Dong-Woo Cho
- Department of Mechanical Engineering, POSTECH, 77 Cheongam-ro, Nam-gu, Pohang 37673, Kyungbuk, Korea; (M.A.); (W.-W.C.)
| |
Collapse
|
8
|
Shape Memory Alloy Capsule Micropump for Drug Delivery Applications. MICROMACHINES 2021; 12:mi12050520. [PMID: 34066315 PMCID: PMC8148152 DOI: 10.3390/mi12050520] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/17/2021] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
We introduce a shape memory alloy (SMA) actuated micropump optimized for drug delivery applications. The proposed novel design integrates a built-in replaceable drug reservoir within the pump package forming a self-contained preloaded capsule pump with an overall pump volume of 424.7 μL. The new design results in a compact, simple, and inexpensive micropump and reduces the probability of contamination with attained almost zero dead volume values. The pump consists of NiTi-alloy SMA wires coiled on a flexible polymeric enclosure and actuated by joule heating. Unlike diaphragm and peristaltic SMA micropump designs that actuate transversely, our design is actuated longitudinally along the direction of the highest mechanical compliance resulting in large strokes in the order of 5.6 mm at 27% deflection ratio, actuation speed up to 11 mm/s, and static head pressures up to 14 kPa (105 mmHg) at 7.1 W input power; thus, high throughputs exceeding 2524 μL/min under free convention conditions could be achieved. A model was developed to optimize the pump’s geometrical parameters and the enclosure material. The model concluded that low stiffness enclosure material combined with thinner SMA wire diameter would result in the maximum deflection at the lowest power rating. To prove its viability for drug delivery applications, the pump was operated at a constant discharge volume at a relatively constant static head pressure. Furthermore, a design of bicuspid-inspired polymeric check-valves is presented and integrated onto the pump to regulate the flow. Since the built-in reservoir is replaceable, the pump capsule can be reused multiple times and for multiple drug types.
Collapse
|
9
|
Drug-Eluting Biodegradable Implants for the Sustained Release of Bisphosphonates. Polymers (Basel) 2020; 12:polym12122930. [PMID: 33297466 PMCID: PMC7762379 DOI: 10.3390/polym12122930] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
Despite being one of the first-line treatments for osteoporosis, the bisphosphonate drug class exhibits an extremely low oral bioavailability (<1%) due to poor absorption from the gastrointestinal tract. To overcome this, and to explore the potential for sustained drug release, bioerodible poly(lactic acid) (PLA) and poly(D,L-lactide-co-glycolide) (PLGA) implants loaded with the bisphosphonate alendronate sodium (ALN) were prepared via hot-melt extrusion. The rate of drug release in vitro was modulated by tailoring the ratio of lactide to glycolide in the polymer and by altering the ALN-loading of the implants. All investigated implants exhibited sustained ALN release in vitro between 25 to 130 days, where implants of greater glycolide composition and higher ALN-loadings released ALN more rapidly. All PLGA implants demonstrated a sigmoidal release profile, characterised by an initial surface dissolution phase, followed by a period of zero-order drug diffusion, then relaxation or erosion of the polymer chains that caused accelerated release over the subsequent days. Contrastingly, the PLA implants demonstrated a logarithmic release profile, characterised by a gradual decrease in ALN release over time.
Collapse
|
10
|
Rykowska I, Nowak I, Nowak R. Drug-Eluting Stents and Balloons-Materials, Structure Designs, and Coating Techniques: A Review. Molecules 2020; 25:E4624. [PMID: 33050663 PMCID: PMC7594099 DOI: 10.3390/molecules25204624] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 12/19/2022] Open
Abstract
Controlled drug delivery is a matter of interest to numerous scientists from various domains, as well as an essential issue for society as a whole. In the treatment of many diseases, it is crucial to control the dosing of a drug for a long time and thus maintain its optimal concentration in the tissue. Heart diseases are particularly important in this aspect. One such disease is an obstructive arterial disease affecting millions of people around the world. In recent years, stents and balloon catheters have reached a significant position in the treatment of this condition. Balloon catheters are also successfully used to manage tear ducts, paranasal sinuses, or salivary glands disorders. Modern technology is continually striving to improve the results of previous generations of stents and balloon catheters by refining their design, structure, and constituent materials. These advances result in the development of both successive models of drug-eluting stents (DES) and drug-eluting balloons (DEB). This paper presents milestones in the development of DES and DEB, which are a significant option in the treatment of coronary artery diseases. This report reviews the works related to achievements in construction designs and materials, as well as preparation technologies, of DES and DEB. Special attention was paid to the polymeric biodegradable materials used in the production of the above-mentioned devices. Information was also collected on the various methods of producing drug release coatings and their effectiveness in releasing the active substance.
Collapse
Affiliation(s)
- I. Rykowska
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland;
| | - I. Nowak
- Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland;
| | - R. Nowak
- Eye Department, J. Strus City Hospital, Szwajcarska 3, 61-285 Poznań, Poland;
| |
Collapse
|
11
|
Penhasi A, Gertler A, Baluashvili I, Elzinaty O, Shalev DE. High modulus thermoplastic segmented polyurethane/poly(L‐lactide) blends as potential candidates for structural implantable drug delivery systems: I. Structure‐properties relationship study. J Appl Polym Sci 2020. [DOI: 10.1002/app.49517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Adel Penhasi
- Department of Pharmaceutical EngineeringAzrieli College of Engineering Jerusalem Jerusalem Israel
- Department of Research and DevelopmentPolyCaps Ltd. Tel Aviv Israel
| | - Aharon Gertler
- Department of Research and DevelopmentTremco‐ Rubber and Plastic Products Netanya Israel
| | | | - Omar Elzinaty
- Department of Pharmaceutical EngineeringAzrieli College of Engineering Jerusalem Jerusalem Israel
| | - Deborah E. Shalev
- Department of Pharmaceutical EngineeringAzrieli College of Engineering Jerusalem Jerusalem Israel
- Wolfson Centre for Applied Structural BiologyThe Hebrew University of Jerusalem Jerusalem Israel
| |
Collapse
|
12
|
Stewart S, Domínguez-Robles J, McIlorum VJ, Gonzalez Z, Utomo E, Mancuso E, Lamprou DA, Donnelly RF, Larrañeta E. Poly(caprolactone)-Based Coatings on 3D-Printed Biodegradable Implants: A Novel Strategy to Prolong Delivery of Hydrophilic Drugs. Mol Pharm 2020; 17:3487-3500. [PMID: 32672976 PMCID: PMC7482401 DOI: 10.1021/acs.molpharmaceut.0c00515] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 01/18/2023]
Abstract
Implantable devices are versatile and promising drug delivery systems, and their advantages are well established. Of these advantages, long-acting drug delivery is perhaps the most valuable. Hydrophilic compounds are particularly difficult to deliver for prolonged times. This work investigates the use of poly(caprolactone) (PCL)-based implant coatings as a novel strategy to prolong the delivery of hydrophilic compounds from implantable devices that have been prepared by additive manufacturing (AM). Hollow implants were prepared from poly(lactic acid) (PLA) and poly(vinyl alcohol) (PVA) using fused filament fabrication (FFF) AM and subsequently coated in a PCL-based coating. Coatings were prepared by solution-casting mixtures of differing molecular weights of PCL and poly(ethylene glycol) (PEG). Increasing the proportion of low-molecular-weight PCL up to 60% in the formulations decreased the crystallinity by over 20%, melting temperature by over 4 °C, and water contact angle by over 40°, resulting in an increased degradation rate when compared to pure high-molecular-weight PCL. Addition of 30% PEG to the formulation increased the porosity of the formulation by over 50% when compared to an equivalent PCL-only formulation. These implants demonstrated in vitro release rates for hydrophilic model compounds (methylene blue and ibuprofen sodium) ranging from 0.01 to 34.09 mg/day, depending on the drug used. The versatility of the devices produced in this work and the range of release rates achievable show great potential. Implants could be specifically developed in order to match the specific release rate required for a number of drugs for a wide range of conditions.
Collapse
Affiliation(s)
- Sarah
A. Stewart
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Juan Domínguez-Robles
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Victoria J. McIlorum
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Zoilo Gonzalez
- Instituto
De Cerámica y Vidrio, CSIC, c/Kelsen, 5, 28049 Madrid, Spain
| | - Emilia Utomo
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Elena Mancuso
- Nanotechnology
and Integrated Bio-Engineering Centre (NIBEC), Ulster University, Jordanstown BT37 0QB, U.K.
| | - Dimitrios A. Lamprou
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Ryan F. Donnelly
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| | - Eneko Larrañeta
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, U.K.
| |
Collapse
|
13
|
Wallis M, Al-Dulimi Z, Tan DK, Maniruzzaman M, Nokhodchi A. 3D printing for enhanced drug delivery: current state-of-the-art and challenges. Drug Dev Ind Pharm 2020; 46:1385-1401. [DOI: 10.1080/03639045.2020.1801714] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Melissa Wallis
- School of Life Sciences, University of Sussex, Brighton, UK
| | | | | | - Mohammed Maniruzzaman
- Pharmaceutical Engineering and 3D Printing (PharmE3D) Lab, Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Ali Nokhodchi
- School of Life Sciences, University of Sussex, Brighton, UK
| |
Collapse
|
14
|
Stewart SA, Domínguez-Robles J, McIlorum VJ, Mancuso E, Lamprou DA, Donnelly RF, Larrañeta E. Development of a Biodegradable Subcutaneous Implant for Prolonged Drug Delivery Using 3D Printing. Pharmaceutics 2020; 12:E105. [PMID: 32013052 PMCID: PMC7076405 DOI: 10.3390/pharmaceutics12020105] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 12/31/2022] Open
Abstract
Implantable drug delivery devices offer many advantages over other routes of drug delivery. Most significantly, the delivery of lower doses of drug, thus, potentially reducing side-effects and improving patient compliance. Three dimensional (3D) printing is a flexible technique, which has been subject to increasing interest in the past few years, especially in the area of medical devices. The present work focussed on the use of 3D printing as a tool to manufacture implantable drug delivery devices to deliver a range of model compounds (methylene blue, ibuprofen sodium and ibuprofen acid) in two in vitro models. Five implant designs were produced, and the release rate varied, depending on the implant design and the drug properties. Additionally, a rate controlling membrane was produced, which further prolonged the release from the produced implants, signalling the potential use of these devices for chronic conditions.
Collapse
Affiliation(s)
- Sarah A. Stewart
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| | - Juan Domínguez-Robles
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| | - Victoria J. McIlorum
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| | - Elena Mancuso
- Nanotechnology and Integrated Bio-Engineering Centre (NIBEC), Ulster University, Jordanstown BT37 0QB, UK;
| | - Dimitrios A. Lamprou
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| | - Ryan F. Donnelly
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| | - Eneko Larrañeta
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (S.A.S.); (V.J.M.); (D.A.L.); (R.F.D.)
| |
Collapse
|
15
|
Pons-Faudoa FP, Ballerini A, Sakamoto J, Grattoni A. Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases. Biomed Microdevices 2019; 21:47. [PMID: 31104136 PMCID: PMC7161312 DOI: 10.1007/s10544-019-0389-6] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Chronic diseases account for the majority of all deaths worldwide, and their prevalence is expected to escalate in the next 10 years. Because chronic disorders require long-term therapy, the healthcare system must address the needs of an increasing number of patients. The use of new drug administration routes, specifically implantable drug delivery devices, has the potential to reduce treatment-monitoring clinical visits and follow-ups with healthcare providers. Also, implantable drug delivery devices can be designed to maintain drug concentrations in the therapeutic window to achieve controlled, continuous release of therapeutics over extended periods, eliminating the risk of patient non-compliance to oral treatment. A higher local drug concentration can be achieved if the device is implanted in the affected tissue, reducing systemic adverse side effects and decreasing the challenges and discomfort of parenteral treatment. Although implantable drug delivery devices have existed for some time, interest in their therapeutic potential is growing, with a global market expected to reach over $12 billion USD by 2018. This review discusses implantable drug delivery technologies in an advanced stage of development or in clinical use and focuses on the state-of-the-art of reservoir-based implants including pumps, electromechanical systems, and polymers, sites of implantation and side effects, and deployment in developing countries.
Collapse
Affiliation(s)
- Fernanda P Pons-Faudoa
- Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Avenida Eugenio Garza Sada 2501, 64849, Monterrey, NL, Mexico
| | - Andrea Ballerini
- Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA
- Department of Oncology and Onco-Hematology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Jason Sakamoto
- Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA
| | - Alessandro Grattoni
- Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA.
- Department of Surgery, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX, 77030, USA.
- Department of Radiation Oncology, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX, 77030, USA.
| |
Collapse
|
16
|
Challenges of using lipopolysaccharides for cancer immunotherapy and potential delivery-based solutions thereto. Ther Deliv 2019; 10:165-187. [DOI: 10.4155/tde-2018-0076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Despite being one of the earliest Toll-like receptor (TLR)-based cancer immunotherapeutics discovered and investigated, the full extent of lipopolysaccharide (LPS) potentials within this arena remains hitherto unexploited. In this review, we will debate the challenges that have complicated the improvement of LPS-based immunotherapeutic approaches in cancer therapy. Based on their nature, those will be discussed with a focus on side effect-related, tolerance-related and in vivo model-related challenges. We will then explore how drug delivery strategies can be integrated within this domain to address such challenges in order to improve the therapeutic outcome, and will present a summary of the studies that have been dedicated thereto. This paper may inspire further developments based on reconciling the advantages of drug delivery and LPS-based cancer immunotherapy.
Collapse
|
17
|
Stewart SA, Domínguez-Robles J, Donnelly RF, Larrañeta E. Implantable Polymeric Drug Delivery Devices: Classification, Manufacture, Materials, and Clinical Applications. Polymers (Basel) 2018; 10:E1379. [PMID: 30961303 PMCID: PMC6401754 DOI: 10.3390/polym10121379] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 12/10/2018] [Indexed: 12/27/2022] Open
Abstract
The oral route is a popular and convenient means of drug delivery. However, despite its advantages, it also has challenges. Many drugs are not suitable for oral delivery due to: first pass metabolism; less than ideal properties; and side-effects of treatment. Additionally, oral delivery relies heavily on patient compliance. Implantable drug delivery devices are an alternative system that can achieve effective delivery with lower drug concentrations, and as a result, minimise side-effects whilst increasing patient compliance. This article gives an overview of classification of these drug delivery devices; the mechanism of drug release; the materials used for manufacture; the various methods of manufacture; and examples of clinical applications of implantable drug delivery devices.
Collapse
Affiliation(s)
- Sarah A Stewart
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| | - Juan Domínguez-Robles
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| | - Eneko Larrañeta
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| |
Collapse
|
18
|
Soliman E, Ranjan S, Xu T, Gee C, Harker A, Barrera A, Geddes J. A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry. Biodes Manuf 2018; 1:161-170. [PMID: 30546922 PMCID: PMC6267269 DOI: 10.1007/s42242-018-0018-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/12/2018] [Indexed: 12/01/2022]
Abstract
There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.
Collapse
Affiliation(s)
- Erfan Soliman
- 1Department of Engineering Sciences, Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ UK
| | - Sarujan Ranjan
- 1Department of Engineering Sciences, Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ UK
| | - Tianyou Xu
- 1Department of Engineering Sciences, Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ UK
| | - Carol Gee
- 2Warneford Hospital, Oxford Health NHS Foundation Trust, Warneford Ln, Oxford, OX3 7JX UK
| | - Aidan Harker
- 2Warneford Hospital, Oxford Health NHS Foundation Trust, Warneford Ln, Oxford, OX3 7JX UK
| | - Alvaro Barrera
- 2Warneford Hospital, Oxford Health NHS Foundation Trust, Warneford Ln, Oxford, OX3 7JX UK
| | - John Geddes
- 3Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX UK
| |
Collapse
|
19
|
Abstract
Oral pre-exposure prophylaxis for the prevention of HIV-1 transmission (HIV PrEP) has been widely successful as demonstrated by a number of clinical trials. However, studies have also demonstrated the need for patients to tightly adhere to oral dosing regimens in order to maintain protective plasma and tissue concentrations. This is especially true for women, who experience less forgiveness from dose skipping than men in clinical trials of HIV PrEP. There is increasing interest in long-acting (LA), user-independent forms of HIV PrEP that could overcome this adherence challenge. These technologies have taken multiple forms including LA injectables and implantables. Phase III efficacy trials are ongoing for a LA injectable candidate for HIV PrEP. This review will focus on the design considerations for both LA injectable and implantable platforms for HIV PrEP. Additionally, we have summarized the existing LA technologies currently in clinical and pre-clinical studies for HIV PrEP as well as other technologies that have been applied to HIV PrEP and contraceptives. Our discussion will focus on the potential application of these technologies in low resource areas, and their use in global women's health.
Collapse
|
20
|
Dammerman R, Kim S, Adera M, Schwarz A. Pharmacokinetics and Safety of Risperidone Subcutaneous Implants in Stable Patients With Schizophrenia. Clin Pharmacol Drug Dev 2018; 7:298-310. [PMID: 29420868 DOI: 10.1002/cpdd.428] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 11/26/2017] [Indexed: 11/10/2022]
Abstract
A subcutaneous risperidone implant (RI) formulation was developed to improve medication adherence in schizophrenia. Two phase 1 studies were conducted to evaluate the pharmacokinetics of RI in adult patients with schizophrenia. In study 1, all subjects were stable on 4 mg oral risperidone; subsequently, the first subject received 375 mg RI for 1 month, and the remaining subjects received 375 mg RI for 3 months. In study 2, all subjects were stable on oral risperidone 4 mg, 6 mg, or 8 mg and subsequently received RI 480 mg, 720 mg, or 960 mg, respectively, for 6 months. Blood samples were collected at prespecified time points. Various pharmacokinetic parameters were determined in both studies. In both studies risperidone total active moiety plasma concentrations following RI increased slowly, reached therapeutic levels within approximately 2 days, and remained relatively stable. In study 1, the average concentration for RI was 81.3% of the oral trough concentration and 27.5% of the oral peak concentration. In study 2, the steady-state concentration for RI was comparable to the oral trough concentration of the corresponding dose. Patient disease status remained stable with no major safety issues. RI may represent an alternative formulation for schizophrenia treatment with a lower peak-to-trough plasma drug ratio than oral risperidone.
Collapse
Affiliation(s)
| | - Sonnie Kim
- Braeburn Pharmaceuticals, Princeton, NJ, USA
| | | | | |
Collapse
|
21
|
Malallah OS, Garcia CMA, Proctor GB, Forbes B, Royall PG. Buccal drug delivery technologies for patient-centred treatment of radiation-induced xerostomia (dry mouth). Int J Pharm 2018; 541:157-166. [PMID: 29425763 DOI: 10.1016/j.ijpharm.2018.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/29/2018] [Accepted: 02/04/2018] [Indexed: 01/01/2023]
Abstract
Radiotherapy is a life-saving treatment for head and neck cancers, but almost 100% of patients develop dry mouth (xerostomia) because of radiation-induced damage to their salivary glands. Patients with xerostomia suffer symptoms that severely affect their health as well as physical, social and emotional aspects of their life. The current management of xerostomia is the application of saliva substitutes or systemic delivery of saliva-stimulating cholinergic agents, including pilocarpine, cevimeline or bethanechol tablets. It is almost impossible for substitutes to replicate all the functional and sensory facets of natural saliva. Salivary stimulants are a better treatment option than saliva substitutes as the former induce the secretion of natural saliva from undamaged glands; typically, these are the minor salivary glands. However, patients taking cholinergic agents systemically experience pharmacology-related side effects including sweating, excessive lacrimation and gastrointestinal tract distresses. Local delivery direct to the buccal mucosa has the potential to provide rapid onset of drug action, i.e. activation of minor salivary glands within the buccal mucosa, while sparing systemic drug exposure and off-target effects. This critical review of the technologies for the local delivery of saliva-stimulating agents includes oral disintegrating tablets (ODTs), oral disintegrating films, medicated chewing gums and implantable drug delivery devices. Our analysis makes a strong case for the development of ODTs for the buccal delivery of cholinergic agents: these must be patient-friendly delivery platforms with variable loading capacities that release the drug rapidly in fluid volumes typical of residual saliva in xerostomia (0.05-0.1 mL).
Collapse
Affiliation(s)
- Osamah S Malallah
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK
| | | | - Gordon B Proctor
- Institute of Mucosal & Salivary biology, King's College London, Thomas Street, London SE1 9RT, UK
| | - Ben Forbes
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK
| | - Paul G Royall
- Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK.
| |
Collapse
|
22
|
Dsa J, Goswami M, Singh BR, Bhatt N, Sharma P, Chauhan MK. Design and fabrication of a magnetically actuated non-invasive reusable drug delivery device. Drug Dev Ind Pharm 2018; 44:1070-1077. [PMID: 29394117 DOI: 10.1080/03639045.2018.1434193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We present a novel approach of designing and fabricating a noninvasive drug delivery device which is capable of delivering the drug to the target site in a controlled manner. The device utilizes a reservoir which can be reused once the drug has completely diffused from it. This micro-reservoir based fabricated device has been successfully tested using niosomes of insulin drug filled in, which was then sealed with a magnetic membrane of 20 µm thick and was actuated by applying magnetic field. The deflection of the membrane on application of magnetic field results in the drug release from the reservoir. The discharge of the drug solution and the release rates was controlled by external magnetic field. The simulation of the membrane deflection using COMSOL software was carried out to optimize the concentration of the ferrous nanopowder in PDMS matrix. The characterization of the devices was implemented in-vitro on water and in-vivo on Wistar rats. It was also validated using high-performance liquid chromatography (HPLC) by observing characteristic peak of insulin. The blood samples showed the retention time of 2.79 min at λmax of 280 nm which further authenticated the effectiveness of the proposed work. This noninvasive fabricated device provides reusability, precise control and can enable the patient or a physician to actively administrate the drug when required.
Collapse
Affiliation(s)
- Joyline Dsa
- a Indian Institute of Information Technology-Allahabad , Allahabad , India
| | - Manish Goswami
- a Indian Institute of Information Technology-Allahabad , Allahabad , India
| | - B R Singh
- a Indian Institute of Information Technology-Allahabad , Allahabad , India
| | - Nidhi Bhatt
- b Delhi Institute of Pharmaceutical Sciences and Research , New Delhi , India
| | - Pankaj Sharma
- b Delhi Institute of Pharmaceutical Sciences and Research , New Delhi , India
| | - Meenakshi K Chauhan
- b Delhi Institute of Pharmaceutical Sciences and Research , New Delhi , India
| |
Collapse
|
23
|
On-demand antibiotic-eluting microchip for implanted spinal screws. J Orthop 2017; 14:565-570. [PMID: 28878518 DOI: 10.1016/j.jor.2017.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/30/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Surgical instrumentation of the spine is susceptible to infection. Intravenous antibiotics is a current mainstay of treating infection; however penetrating the bacterial biofilm and directly targeting the source of the infection is challenging. METHODS Using multiple reservoirs of discrete drug doses, microchips represent a new technology capable of on-demand drug release over long periods of time. RESULTS A novel solution of integrating vancomycin-eluting microchips into pedicle screws in order directly target and treat spinal infections is proposed. CONCLUSION This drug-releasing implant has the potential to provide the particular benefit to high-infection-risk patients in order to avoid reoperation.
Collapse
|
24
|
Microchips in Medicine: Current and Future Applications. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1743472. [PMID: 27376079 PMCID: PMC4914739 DOI: 10.1155/2016/1743472] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/04/2016] [Indexed: 11/23/2022]
Abstract
With the objective of improving efficacy and morbidity, device manufacturers incorporate chemicals or drugs into medical implants. Using multiple reservoirs of discrete drug doses, microchips represent a new technology capable of on-demand release of various drugs over long periods of time. Herein, we review drug delivery systems, how microchips work, recent investigations, and future applications in various fields of medicine.
Collapse
|
25
|
Chatzipirpiridis G, Ergeneman O, Pokki J, Ullrich F, Fusco S, Ortega JA, Sivaraman KM, Nelson BJ, Pané S. Electroforming of implantable tubular magnetic microrobots for wireless ophthalmologic applications. Adv Healthc Mater 2015; 4:209-14. [PMID: 24986087 DOI: 10.1002/adhm.201400256] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Indexed: 01/12/2023]
Abstract
Magnetic tubular implantable micro-robots are batch fabricated by electroforming. These microdevices can be used in targeted drug delivery and minimally invasive surgery for ophthalmologic applications. These tubular shapes are fitted into a 23-gauge needle enabling sutureless injections. Using a 5-degree-of-freedom magnetic manipulation system, the microimplants are conveniently maneuvered in biological environments. To increase their functionality, the tubes are coated with biocompatible films and can be successfully filled with drugs.
Collapse
Affiliation(s)
| | - Olgaç Ergeneman
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Juho Pokki
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Franziska Ullrich
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Stefano Fusco
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - José A. Ortega
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Kartik M. Sivaraman
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Bradley J. Nelson
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| | - Salvador Pané
- Institute of Robotics & Intelligent Systems (IRIS); ETH Zürich; Zurich Switzerland
| |
Collapse
|