Abstract

Toxicity studies for conventional oral drug formulations are standardized and well documented, as required by the guidelines of administrative agencies such as the US Food & Drug Administration (FDA), the European Medicines Agency (EMA) or European Medicines Evaluation Agency (EMEA), and the Japanese Pharmaceuticals and Medical Devices Agency (PMDA). Researchers tend to extrapolate these standardized protocols to evaluate nanoformulations (NFs) because standard nanotoxicity protocols are still lacking in nonclinical studies for testing orally delivered NFs. However, such strategies have generated many inconsistent results because they do not account for the specific physicochemical properties of nanomedicines. Due to their tiny size, accumulated surface charge and tension, sizeable surface-area-to-volume ratio, and high chemical/structural complexity, orally delivered NFs may generate severe topical toxicities to the gastrointestinal tract and metabolic organs, including the liver and kidney. Such toxicities involve immune responses that reflect different mechanisms than those triggered by conventional formulations. Herein, we briefly analyze the potential oral toxicity mechanisms of NFs and describe recently reported in vitro and in vivo models that attempt to address the specific oral toxicity of nanomedicines. We also discuss approaches that may be used to develop nontoxic NFs for oral drug delivery.

Highlights

  • Oral administration is one of the most popular routes for delivering drug formulations due to its convenience of dosing and excellent patient compliance

  • As we continue to discover the mechanisms through which NFs interact with biological systems, we are learning about their potential toxicity, which may result in serious adverse effects in late-stage trials

  • This is a serious issue in clinical settings, where NFs are increasingly being used as therapeutics or as drug delivery systems

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Summary

Introduction

Oral administration is one of the most popular routes for delivering drug formulations due to its convenience of dosing and excellent patient compliance. The toxicity of NFs can originate from pristine NFs, partially degraded NFs, nanocomposite chemicals, or premature release of the loaded drug [13,14,15,16]. As scientists tend to employ biocompatible chemicals to construct NFs and the loaded drug is generally present at a much lower dose compared to the conventional formulations [17], current toxicity studies mainly focus on the harmful effects that originate from intact and partially degraded NFs. Intact NFs have unique physicochemical properties, including their size, aspect ratio, microstructure, surface charge, and surface chemistry. Intact NFs have unique physicochemical properties, including their size, aspect ratio, microstructure, surface charge, and surface chemistry These properties determine their in vivo efficacy and toxicity upon oral administration [18,19].

Mechanisms of Oral Nanotoxicity
Nanotoxicity of Intracellular Organelles
Genotoxicity
Nanotoxicity of Gut Barrier
Nanotoxicity and Luminal Environment
Nanotoxicity Involves Microbiota
In Vitro Toxicity Models for Orally Delivered NFs
Static and Dynamic Culture Models
Models that Involve the Gut Microbiome
In Vivo Models
Invertebrates
Rodent Models
Nonhuman Primate Models
Toxicological Endpoints of Observing
Detecting the Oxidative Stress and Inflammation
Detecting the Oxidative Stress-Induced Damages
The Oxidative Response System
Detections with the Multi-Omics Platform
Cell Monolayer Permeability and Tight Junction Assays
Clonogenic Assay
Chromosome Aberration
Histochemical Approach
Immunohistochemical Approach
Measurements of the Gene Expression Changes
Measuring Oxidized Guanosine
Method Validation
Findings
Strategies for Making Nontoxic Oral NFs
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