Oral Delivery Of Macromolecular Drugs Research Articles

Dynamic omnidirectional adhesive microneedle system for oral macromolecular drug delivery.

Oral drug administration remains the preferred route for patients and health care providers. Delivery of macromolecules through this route remains challenging because of limitations imposed by the transport across the gastrointestinal epithelium and the dynamic and degradative environment. Here, we present the development of a delivery system that combines physical (microneedle) and nonphysical (enhancer) modes of drug delivery enhancement for a macromolecule in a large animal model. Inspired by the thorny-headed intestinal worm, we report a dynamic omnidirectional mucoadhesive microneedle system capable of prolonged gastric mucosa fixation. Moreover, we incorporate sodium N-[8-(2-hydroxybenzoyl) amino] caprylate along with semaglutide and demonstrate enhanced absorption in swine resistant to physical displacement in the gastric cavity. Meanwhile, we developed a targeted capsule system capable of deploying intact microneedle-containing systems. These systems stand to enable the delivery of a range of drugs through the generation and maintenance of a privileged region in the gastrointestinal tract.

Modulation of Gastrointestinal Mucus Properties with Ionic Liquids for Drug Delivery.

The mucus barrier lining the gastrointestinal tract poses a significant barrier to the oral delivery of macromolecular drugs. Successful approaches to overcoming this barrier have primarily focused on reducing drug and carrier interactions with mucus or disrupting the mucus layer directly. Choline-based ionic liquids (ILs) such as choline geranate and choline glycolate (CGLY) have recently been shown to be effective in enhancing the intestinal absorption of macromolecules such as insulin and immunoglobulin (IgG), respectively. Herein, the use of choline-based ILs as mucus-modulating agents for safely improving drug penetration through mucus is described. Choline-based ILs significantly increase the diffusion rates of cationic dextrans through mucin solution. Choline-maleic acid (CMLC 2:1) enhances the diffusion of 4 kDa cationic dextran in mucin solution by more than fourfold when compared to phosphate-buffered saline control. Choline-based ILs also reduce mucus viscosity without significantly impacting the native mucus gel structure. In vitro studies in a mucus-secreting coculture model with Caco-2 and HT29MTX-E12 cells further demonstrate the effectiveness of ILs in improving transport of cationic molecules in the presence of secreted mucus. This work demonstrates the potential for choline-based ionic liquids to be used as nondestructive mucus-modulating agents for enabling enhanced oral delivery of macromolecular drugs.

The enhanced intestinal permeability of infant mice enables oral protein and macromolecular absorption without delivery technology.

Oral delivery of macromolecular drugs is the most patient-preferred route of administration because it is painless and convenient. Over the past 30years, significant attention has been paid to oral protein delivery in adults. Unfortunately, there is an outstanding need for similar efforts in infants, a patient population with distinct intestinal physiology and treatment needs. Here, we assess the intestinal permeability of neonatal and infant mice to determine the feasibility of orally delivering peptide and protein drugs without permeation enhancers or other assistance. Using the non-everted gut sac model, we found that macromolecular permeability depended on molecular size, mouse age, and intestinal tissue type using model dextrans. For example, the apparent permeability of 70kDa FITC-Dextran (FD70) in infant small intestinal tissue was 2-5-fold higher than in adult tissue. As mice aged, the expression of barrier-forming and pore-forming tight junction proteins increased and decreased, respectively. The in vivo oral absorption of 4kDa FITC-Dextran (FD4) and FD70 was significantly higher in younger mice, and there was a fourfold increase in oral absorption of the 80kDa protein lactoferrin compared to adults. Oral gavage of insulin (5IU/kg) reduced blood glucose levels in infants by >20% at 2 and 3h but had no effect in adults. Oral insulin had 35% and <1% of the pharmacodynamic effect of a 1IU/kg subcutaneous dose in infants and adults, as measured by area above the curve. These data indicate that the uniquely leaky nature of the infantile intestine may support the oral delivery of biologics without the need for traditional oral delivery technology.

The pH of Piperazine Derivative Solutions Predicts Their Utility as Transepithelial Permeation Enhancers.

The oral delivery of macromolecular drugs, including proteins and nucleic acids, is one of the greatest unmet needs in modern biomedicine. Although engineering solutions have been used to overcome enzymatic degradation and the low pH in the stomach, poor absorption across the intestinal epithelium into the bloodstream continues to pose the most significant challenge to clinical translation. One common approach to increase the flux of macromolecules across the intestinal epithelium is the use of chemical permeation enhancers. Unfortunately, the vast majority of effective enhancers have been thwarted by toxicity, and the structural and molecular parameters that contribute to this behavior are poorly understood. Previous work has shown that select piperazine-derived molecules favorably affect transepithelial and intracellular delivery outcomes, suggesting that piperazine-derived molecules interface uniquely with cellular barriers. To gain a better understanding of piperazine-mediated permeation enhancement, this work examined piperazine and 13 of its simple, hydrocarbon-substituted derivatives using Caco-2 monolayers as a model of the intestinal epithelium. After evaluating each piperazine for permeation enhancement efficacy and cytotoxicity at three concentrations, it became clear that piperazine derivatives consistently enhance permeability with each derivative resulting in noncytotoxic permeation enhancement at one or more concentrations. In attempting to identify structure-function relationships for the piperazine derivatives, it was found that treatment concentration, structural characteristics, and molecular pKa were not reliable indicators of permeation potential. Interestingly, the pH of the enhancer solution was identified as a controlling parameter even when accounting for the effects from pH change alone. Specifically, piperazine treatments with a pH between 9.2 and 9.6 guaranteed noncytotoxic efficacy. Furthermore, all effective treatments resulted in pH values between 8.7 and 9.6, behavior that was not shared by the other small, noncyclic amines studied. These data have important implications in the design of oral biologic delivery systems that employ permeation enhancers and underscore the need to carefully control the final treatment pH of the local intestinal epithelial environment.

Mechanism Study of Cellular Uptake and Tight Junction Opening Mediated by Goblet Cell-Specific Trimethyl Chitosan Nanoparticles

Modifying nanoparticles with targeting peptides which can specifically bind to intestinal epithelium was recently suggested as a strategy to further enhance their ability for the oral delivery of macromolecular drugs. However, few studies were focused on comprehensive understanding of the uptake and transport processes as well as the underlying molecular signaling pathways mediated by the ligand modification. In the present study, the mechanisms of cellular uptake and the tight junction opening associated with the trimethyl chitosan based nanoparticles (M-NPs) and their goblet cell-targeting CSK (CSKSSDYQC) peptide modified nanoparticles (CSK-M-NPs) were investigated. Compared with single ion cross-linked nanoparticles (S NPs), M-NPs and CSK-M-NPs, prepared with multiple agents, exhibited superior stability which could effectively protect drugs against the degradation of trypsin. Caveolae-mediated endocytosis and macropinocytosis were involved in the intracellular uptake of both M-NPs and CSK-M-NPs on Caco-2/HT29-MTX cocultured cells. However, CSK peptide modification could further induce clathrin-mediated endocytosis of the NPs. Intriguingly, most endocytosis subpathways have been altered after CSK peptide modification. Moreover, the opening of epithelial tight junctions was investigated at both protein and gene levels. The results indicated that both M-NPs and CSK-M-NPs could transiently and reversibly open the epithelial tight junctions via the C-Jun NH2-terminal kinase-dependent pathway. However, CSK peptide modification enabled a more rapid opening and recovering of the tight junctions. In all, the enhanced uptake and transport capacity of nanoparticles after CSK peptide modification may be attributed to the alteration of internalization pathways and the stronger ability of opening tight junctions.

Functional transformations of bile acid transporters induced by high-affinity macromolecules

Apical sodium-dependent bile acid transporters (ASBT) are the intestinal transporters that form intermediate complexes with substrates and its conformational change drives the movement of substrates across the cell membrane. However, membrane-based intestinal transporters are confined to the transport of only small molecular substrates. Here, we propose a new strategy that uses high-affinity binding macromolecular substrates to functionally transform the membrane transporters so that they behave like receptors, ultimately allowing the apical-basal transport of bound macromolecules. Bile acid based macromolecular substrates were synthesized and allowed to interact with ASBT. ASBT/macromolecular substrate complexes were rapidly internalized in vesicles, localized in early endosomes, dissociated and escaped the vesicular transport while binding of cytoplasmic ileal bile acid binding proteins cause exocytosis of macromolecules and prevented entry into lysosomes. This newly found transformation process of ASBT suggests a new transport mechanism that could aid in further utilization of ASBT to mediate oral macromolecular drug delivery.

Oral Delivery of Macromolecules: Rationale Underpinning Gastrointestinal Permeation Enhancement Technology (GIPET ® )

Oral delivery of macromolecular drugs, particularly peptides and proteins, is the focus of many academic and industrial laboratories. Armed with an increased understanding of the structure and regulation of intestinal epithelial junctional complexes of the paracellular barrier, the development of permeation enhancement technology initially focused on the specific and reversible opening of tight junctions in order to enable oral delivery. Despite intense research, none of these specific tight junction-opening technologies has yet been approved in an oral drug product, likely because of poor efficacy. Less specific enhancer technologies with a long history of safe use in man have additional surfactant-like effects on the transcellular pathway that lead to improved efficacy. These are likely to be the first to market for selected poorly permeable peptides. This review presents a summary of some approaches taken to intestinal permeation enhancement and explores in detail the oral delivery system developed by Merrion Pharmaceuticals, Gastrointestinal Permeation Enhancement Technology (GIPET).

ChemInform Abstract: The Development of Delivery Agents that Facilitate the Oral Absorption of Macromolecular Drugs

Macromolecules comprise a growing group of new drugs with great clinical promise. To date, the therapeutic application of these drugs has been limited, because they are effective only when administered parenterally. Unfortunately, macromolecular drugs are not absorbed following nonparenteral dosing, because the mechanisms of the human body are designed to degrade and/or exclude them. To overcome the numerous obstacles to the noninvasive delivery of these drugs, various approaches are under investigation including the use of delivery agents to promote drug absorption. This review provides a summary of the novel approaches currently in progress in the areas of transdermal, transmucosal, and oral delivery of macromolecular drugs facilitated by delivery agents. We review our own novel work in this area in some detail, including the methods developed for the synthesis of the delivery agents, in vitro screening techniques developed to select compounds for in vivo testing, and the results of in vivo screening in both rats and primates, including preliminary safety and efficacy studies. Finally, the results of Phase I clinical studies showing the oral delivery of heparin are presented. © 2000 John Wiley & Sons, Inc. Med Res Rev, 20, No. 2, 169–186, 2000

Challenges for the oral delivery of macromolecules.

The rapid integration of new technologies by the pharmaceutical industry has resulted in numerous breakthroughs in the discovery, development and manufacturing of pharmaceutical products. In particular, the commercial-scale production of high-purity recombinant proteins has resulted in important additions to treatment options for many large therapeutic areas. In addition to proteins, other macromolecules, such as the animal-derived mucopolysaccharide heparins, have also seen dramatic growth as injectable pharmaceutical products. To date, macromolecules have been limited as therapeutics by the fact that they cannot be orally delivered. This article will address the current status and future possibilities of oral macromolecular drug delivery.

Physical properties of compounds promoting oral delivery of macromolecular drugs

Physical properties of compounds promoting oral delivery of macromolecular drugs

Physical properties of compounds promoting oral delivery of macromolecular drugs.

The spectroscopic and solution properties of a series of amidated acids (delivery agents), which promote the gastrointestinal absorption of USP heparin and other drugs that show poor oral bioavailability, are investigated using Raman and NMR spectroscopy. The results show evidence for self-association at low concentrations of delivery agents that increases as the concentration of the delivery agent is increased. The self-associate is characterized by ring-ring stacking interactions, and the best geometrical arrangement for the stacking is the parallel-shifted arrangement of the rings. In addition, the amide group participates in the formation of intermolecular hydrogen bonds in the self-associate. Unlike the rigid ring, the tails of these delivery agents remain relatively flexible in the self-associate. It is suggested that the limited solubility of the delivery agents at physiological pH arises from a percentage of protonated carboxyls. Their presence promotes the formation of intermolecular hydrophobic and ring stacking interactions, which are otherwise weakened by an ionized carboxyl group.

The development of delivery agents that facilitate the oral absorption of macromolecular drugs.

Macromolecules comprise a growing group of new drugs with great clinical promise. To date, the therapeutic application of these drugs has been limited, because they are effective only when administered parenterally. Unfortunately, macromolecular drugs are not absorbed following nonparenteral dosing, because the mechanisms of the human body are designed to degrade and/or exclude them. To overcome the numerous obstacles to the noninvasive delivery of these drugs, various approaches are under investigation including the use of delivery agents to promote drug absorption. This review provides a summary of the novel approaches currently in progress in the areas of transdermal, transmucosal, and oral delivery of macromolecular drugs facilitated by delivery agents. We review our own novel work in this area in some detail, including the methods developed for the synthesis of the delivery agents, in vitro screening techniques developed to select compounds for in vivo testing, and the results of in vivo screening in both rats and primates, including preliminary safety and efficacy studies. Finally, the results of Phase I clinical studies showing the oral delivery of heparin are presented.

Recent advances in intestinal macromolecular drug delivery via receptor-mediated transport pathways.

Receptor-mediated transport mechanisms provide a pathway for the trafficking of extracellular macromolecules into (endocytosis) and across (transcytosis) the cell. This comprises the binding of a ligand to a specific cell-surface receptor, clustering of the ligand-receptor complexes in endocytotic vesicles and vesicular sorting. This review focuses on recent advances in cellular and molecular biology pertaining to receptor-mediated endocytosis. A concise overview is presented of current and potential future applications of targeting to RME mechanisms to improve oral macromolecular drug delivery.