Abstract

Dry mouth or xerostomia is a frequent medical condition among the polymedicated elderly population. Systemic pilocarpine is included in the first line of pharmacological therapies for xerostomia. However, the efficacy of existing pilocarpine formulations is limited due to its adverse side effects and multiple daily dosages. To overcome these drawbacks, a localized formulation of pilocarpine targeting the salivary glands (SG) was developed in the current study. The proposed formulation consisted of pilocarpine-loaded Poly(lactic-co-glycolic acid) (PLGA)/poly(ethylene glycol) (PEG) nanofiber mats via an electrospinning technique. The nanofiber mats were fully characterized for their size, mesh porosity, drug encapsulation efficiency, and in vitro drug release. Mat biocompatibility and efficacy was evaluated in the SG organ ex vivo, and the expression of proliferation and pro-apoptotic markers at the cellular level was determined. In vivo short-term studies were performed to evaluate the saliva secretion after acute SG treatment with pilocarpine-loaded nanofiber mats, and after systemic pilocarpine for comparison purposes. The outcomes demonstrated that the pilocarpine-loaded mats were uniformly distributed (diameter: 384 ± 124 nm) in a highly porous mesh, and possessed a high encapsulation efficiency (~81%). Drug release studies showed an initial pilocarpine release of 26% (4.5 h), followed by a gradual increase (~46%) over 15 d. Pilocarpine-loaded nanofiber mats supported SG growth with negligible cytotoxicity and normal cellular proliferation and homeostasis. Salivary secretion was significantly increased 4.5 h after intradermal SG treatment with drug-loaded nanofibers in vivo. Overall, this study highlights the strengths of PLGA/PEG nanofiber mats for the localized daily delivery of pilocarpine and reveals its potential for future clinical translation in patients with xerostomia.

Highlights

  • Dry mouth syndrome or xerostomia is a common global health problem that arises most commonly within an ageing population [1,2,3]

  • It was found that using acetone as the solvent gave the most homogeneous and stable polymer solution/emulsion, compared to other organic solvents tested

  • At Poly(lactic-co-glycolic acid) (PLGA) concentration of

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Summary

Introduction

Dry mouth syndrome or xerostomia is a common global health problem that arises most commonly within an ageing population [1,2,3]. Half of the patients respond well to pilocarpine tablets, probably due to its short duration of action (3–5 h), requiring multiple daily administrations [8]. To this end, a localized pilocarpine formulation, targeting the SG and bypassing systemic adsorption, is mandatory to make the saliva secretion more long-lasting. Major SG located underneath the facial skin should be targeted instead, potentially via an intradermal or transdermal route [14]. To meet this need, a new localized and SG-targeted pilocarpine drug delivery system is needed

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