Abstract

Vaginally applied microbicide products offer a female-controlled strategy for preventing sexual transmission of HIV. Microbicide transport processes are central to their functioning, and there is a clear need for a better understanding of them. To contribute to that end, we developed an assay to analyze mass transport rates of microbicide molecules within the epithelial and stromal layers of polarized vaginal mucosal tissue during contact with a gel vehicle. The assay utilizes a new diffusion chamber mounted in a custom instrument that combines confocal Raman spectroscopy and optical coherence tomography. This measures depth-resolved microbicide concentration distributions within epithelium and stroma. Data for a tenofovir gel were fitted with a compartmental diffusion model to obtain fundamental transport properties: the molecular diffusion and partition coefficients in different compartments. Diffusion coefficients in epithelium and stroma were computed to be 6.10 ± 2.12 x 10−8 and 4.52 ± 1.86 x 10−7 cm2/sec, respectively. The partition coefficients between epithelium and gel and between stroma and epithelium were found to be 0.53 ± 0.15 and 1.17 ± 0.16, respectively. These drug transport parameters are salient in governing the drug delivery performance of different drug and gel vehicle systems. They can be used to contrast drugs and vehicles during product design, development and screening. They are critical inputs to deterministic transport models that predict the gels’ pharmacokinetic performance, which can guide improved design of products and optimization of their dosing regimens.

Highlights

  • Microbicides are virus-neutralizing molecules used in biomedical products being developed for women and men to protect themselves against sexual transmission of Human Immunodeficiency Virus (HIV) and other pathogens [1]

  • We have developed and applied an optical assay based on the integrated performance of confocal Raman spectroscopy and optical coherence tomography to analyze microbicide transport from gel vehicles into and through tissue specimens

  • We measured drug transport in tissue which was incubated under a gel delivery layer in a Transwell configuration, removing the gel delivery layer, and using confocal Raman spectroscopy (RS) to quantify the drug concentration versus depth in each tissue specimen [23, 24]

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Summary

Introduction

Microbicides are virus-neutralizing molecules used in biomedical products being developed for women and men to protect themselves against sexual transmission of Human Immunodeficiency Virus (HIV) and other pathogens [1]. 1% tenofovir gel effectively reduced HIV sexual transmission in women by 39% in a first phase III study (CAPRISA 004) [2], it failed to demonstrate efficacy in its second (VOICE, MTN003) [6] and third efficacy trials (FACTS 001) [7]. The failures in those latter two trials were associated with poor subject adherence [8, 9]. Improved understanding of mechanisms of how gel volume and dosage regimen govern microbicide pharmacokinetics and consequent pharmacodynamics will clearly contribute to this.

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