Hydrogel-forming microneedles increase in volume during swelling in skin, but skin barrier function recovery is unaffected

Suprachoroidal space-inducing hydrogel-forming microneedles (SI-HFMN): An innovative platform for drug delivery to the posterior segment of the eye

The suprachoroidal space (SCS), which exists between the sclera and choroid, offers a promising delivery route to the posterior segment of the eye (PSE) and is integrated with hollow microneedles (HMNs) for minimally invasive delivery. However, HMNs are limited by backflow owing to their narrow channel. Therefore, this study proposes a biocompatible SCS-inducing hydrogel-forming microneedle (SI-HFMN) with a specially designed candlelit shape that swells to separate the sclera from the choroid. The induced SCS provides a route for delivering loaded drugs to the PSE upon application. The optimized formulation of 20 % (w/w) poly(methyl vinyl ether-alt-maleic acid) (PMVE/MA) crosslinked with 7.5 % (w/w) polyethylene glycol (PEG) possesses sufficient mechanical strength (5.1 ± 0.7 N) to penetrate both the sclera and swell by 356 ± 28 %, to mechanically stimulate SCS formation. The formulation also recorded a drug absorption amount of 101 ± 9 μg/mg of hydrogel. Furthermore, in vitro and ex vivo experiments demonstrated the ability of the SI-HFMN to deliver drugs to the PSE via the formed SCS. Thus, this system offers an innovative method for drug delivery to PSE by inducing SCS formation.

Multifunctional Hydrogel Microneedles (HMNs) in Drug Delivery and Diagnostics

Hydrogel microneedles (HMNs) have emerged as a transformative platform for minimally invasive drug delivery and biosensing, offering enhanced bioavailability, controlled drug release, and real-time biomarker detection. By leveraging swelling hydrogels, nanomaterial integration, and stimuli-responsive properties, HMNs provide precision medicine capabilities across diverse therapeutic and diagnostic applications. However, challenges remain in mechanical stability, as hydrogel-based MNs must balance flexibility with sufficient strength for skin penetration. Drug retention and controlled release require optimization to prevent premature diffusion and ensure sustained therapeutic effects. Additionally, biosensing accuracy is influenced by variability in interstitial fluid extraction and signal transduction. Clinical translation is hindered by regulatory hurdles, scalability concerns, and the need for extensive safety validation in human trials. This review critically examines the key materials, fabrication techniques, functional properties, and testing frameworks of HMNs while addressing these limitations. Furthermore, we explore future research directions in smart wearable MNs, AI-assisted biosensing, and hybrid drug-device platforms to optimize transdermal medicine. Overcoming these barriers will drive the clinical adoption of HMNs, paving the way for next-generation patient-centered therapeutics and diagnostics.

Potential of the Nano-Encapsulation of Antioxidant Molecules in Wound Healing Applications: An Innovative Strategy to Enhance the Bio-Profile

Naturally available antioxidants offer remarkable medicinal applications in wound healing. However, the encapsulation of these phytoactive moieties into suitable nano-scale drug delivery systems has always been challenging due to their inherent characteristics, such as low molecular weight, poor aqueous solubility, and inadequate skin permeability. Here, we provide a systematic review focusing on the major obstacles hindering the development of various lipid and polymer-based drug transporters to carry these cargos to the targeted site. Additionally, this review covers the possibility of combining the effects of a polymer and a lipid within one system, which could increase the skin permeability threshold. Moreover, the lack of suitable physical characterization techniques and the challenges associated with scaling up the progression of these nano-carriers limit their utility in biomedical applications. In this context, consistent progressive approaches for addressing these shortcomings are introduced, and their prospects are discussed in detail.

Transdermal delivery of bisphosphonates using dissolving and hydrogel-forming microarray patches: Potential for enhanced treatment of osteoporosis

As of 2023, more than 200 million people worldwide are living with osteoporosis. Oral bisphosphonates (BPs) are the primary treatment but can cause gastrointestinal (GI) side effects, reducing patient compliance. Microarray (MAP) technology has the potential to overcome GI irritation by facilitating the transdermal delivery of BPs. This study examines the delivery of alendronic acid (ALN) and risedronate sodium (RDN) using dissolving and hydrogel-forming MAPs for osteoporosis treatment. In vivo testing on osteoporotic female Sprague Dawley rats demonstrated the efficacy of MAPs, showing significant improvements in mean serum and bone alkaline phosphatase levels, bone volume, and porosity compared to untreated bilateral ovariectomy (OVX) controls. Specifically, MAP treatment increased mean bone volume to 55.04 ± 2.25 % versus 47.16 ± 1.71 % in OVX controls and reduced porosity to 44.30 ± 2.97 % versus 52.84 ± 1.70 % in the distal epiphysis of the femur. In the distal metaphysis, bone volume increased to 43.32 ± 3.24 % in MAP-treated rats compared to 24.31 ± 3.21 % in OVX controls, while porosity decreased to 55.39 ± 5.81 % versus 75.69 ± 3.21 % in OVX controls. This proof-of-concept study indicates that MAP technology has the potential to be a novel, patient-friendly alternative for weekly osteoporosis management.

Hydrogel-Forming Microneedles in the Management of Dermal Disorders Through a Non-Invasive Process: A Review

Microneedle (MN) technology has emerged as a promising approach for delivering therapeutic agents to the skin, offering significant potential in treating various dermal conditions. Among these technologies, hydrogel-forming microneedles (HFMNs) represent a transformative advancement in the management of dermal diseases through non-invasive drug delivery. These innovative devices consist of micrometer-sized needles made of native or crosslinked hydrophilic polymers, capable of penetrating the stratum corneum without damaging underlying tissues. Upon insertion, HFMNs rapidly absorb interstitial fluid, swelling to form a hydrogel conduit that enables the efficient transport of therapeutic agents directly into the dermal microcirculation. The non-invasive nature of HFMNs enhances patient compliance by eliminating the pain and discomfort associated with traditional hypodermic needles. This technology allows for the delivery of a wide range of drugs, including macromolecules and biomacromolecules, which are often difficult to administer dermally due to their size and polarity. Moreover, HFMNs provide controlled and regulated release profiles, enabling sustained therapeutic effects while minimizing systemic side effects. Additionally, HFMNs can be used for both drug delivery and real-time interstitial fluid monitoring, offering valuable insights into disease states and treatment responses. This dual functionality positions HFMNs as a versatile dermatology tool capable of effectively addressing various dermal complications. This review explores the potential use of polymeric biomaterials in HFMN fabrication and their application in treating major dermal disorders, such as acne, psoriasis, and other skin conditions. Furthermore, the review highlights the non-invasive nature of MN-based treatments, underscoring their potential to reduce patient discomfort and improve treatment adherence, as supported by the recent literature.

3D Polymeric Lattice Microstructure-Based Microneedle Array for Transdermal Electrochemical Biosensing

Microneedles (MNs) or microneedle arrays (MNAs) are critical components of minimally invasive devices comprised of a single or a series of micro-scale projections. MNs can bypass the outermost layer of the skin and painlessly access microcirculation of the epidermis and dermis layers, attracting great interest in the development of personalized healthcare monitoring and diagnostic devices. However, MN technology has not yet reached its full potential since current micro- and nanofabrication methods do not address the need of fabricating MNs with complex surfaces to facilitate the development of clinically adequate devices. This work presents a new approach that combines 3D printing technology based on two-photon polymerization with soft lithography for cost-effective and time-saving fabrication of complex MNAs. Specifically, this method relies on printing complex 3D objects efficiently replicated into polymeric substrates via soft lithography, resulting in a free-standing polymeric lattice (PL) membrane that can be transferred onto gold-coated MNs and used for electrochemical biosensing. This platform shows excellent electrochemical performance in detecting metabolite (glucose) and protein (insulin) biomarkers with a dynamic linear range sufficient for detecting biomarkers in healthy individuals and patients. The approach holds great potential for fabricating next-generationMNs, including their transfer into clinically adequate devices.

Atorvastatin-Loaded Dissolving Microarray Patches for Long-Acting Microdepot Delivery: Comparison of Nanoparticle and Microparticle Drug Formulations

The increasing popularity of prolonged-release dosage forms, owing to their ability to provide continuous drug release after administration, has significantly improved patient compliance and overall quality of life. However, achieving prolonged release beyond 24 h frequently requires the use of invasive methods, including injections or implants, which may prove challenging for people suffering from needle phobia. This study introduces atorvastatin (ATR) microparticles (MPs) or nanocrystal (NCs) dissolving microarray patches (D-MAPs) as a noninvasive alternative for intradermal drug delivery over a two-week period for the management of hyperlipidemia. The MP-loaded D-MAPs exhibited an average drug loading of 5.15 ± 0.4 mg of ATR per patch, surpassing the 2.4 ± 0.11 mg/patch observed with NC-loaded D-MAPs. Skin deposition studies demonstrated the superior performance of MP D-MAPs, which delivered 2.0 ± 0.33 mg of ATR per 0.75 cm2 patch within 24 h, representing 38.76% of the initial amount of drug loaded. In contrast, NC D-MAPs delivered approximately 0.89 ± 0.12 mg of ATR per 0.75 cm2 patch at 24 h, equivalent to 38.42 ± 5.13% of the initial ATR loaded. Due to their favorable results, MP D-MAPs were chosen for an in vivo study using Sprague-Dawley rats. The findings demonstrated the capacity of D-MAPs to deliver and attain therapeutically relevant ATR concentrations (>20 ng/mL) for 14 days after a single 24-h application. This study is the first to successfully demonstrate the long-acting transdermal delivery of ATR using MP-loaded D-MAPs after a 24-h single-dose application. The innovative D-MAP system, particularly when loaded with MP, arises as a promising, minimally invasive, long-acting substitute for ATR delivery. This technology has the potential to improve patient compliance and therapeutic outcomes while also significantly advancing the field of transdermal drug delivery.

Transdermal Delivery of Pramipexole Using Microneedle Technology for the Potential Treatment of Parkinson's Disease

Parkinson's disease (PD) is a debilitating neurodegenerative disease primarily impacting neurons responsible for dopamine production within the brain. Pramipexole (PRA) is a dopamine agonist that is currently available in tablet form. However, individuals with PD commonly encounter difficulties with swallowing and gastrointestinal motility, making oral formulations less preferable. Microneedle (MN) patches represent innovative transdermal drug delivery devices capable of enhancing skin permeability through the creation of microconduits on the surface of the skin. MNs effectively reduce the barrier function of skin and facilitate the permeation of drugs. The work described here focuses on the development of polymeric MN systems designed to enhance the transdermal delivery of PRA. PRA was formulated into both dissolving MNs (DMNs) and directly compressed tablets (DCTs) to be used in conjunction with hydrogel-forming MNs (HFMNs). In vivo investigations using a Sprague-Dawley rat model examined, for the first time, if it was beneficial to prolong the application of DMNs and HFMNs beyond 24 h. Half of the patches in the MN cohorts were left in place for 24 h, whereas the other half remained in place for 5 days. Throughout the entire 5 day study, PRA plasma levels were monitored for all cohorts. This study confirmed the successful delivery of PRA from DMNs (Cmax = 511.00 ± 277.24 ng/mL, Tmax = 4 h) and HFMNs (Cmax = 328.30 ± 98.04 ng/mL, Tmax = 24 h). Notably, both types of MNs achieved sustained PRA plasma levels over a 5 day period. In contrast, following oral administration, PRA remained detectable in plasma for only 48 h, achieving a Cmax of 159.32 ± 113.43 ng/mL at 2 h. The HFMN that remained in place for 5 days demonstrated the most promising performance among all investigated formulations. Although in the early stages of development, the findings reported here offer a hopeful alternative to orally administered PRA. The sustained plasma profile observed here has the potential to reduce the frequency of PRA administration, potentially enhancing patient compliance and ultimately improving their quality of life. This work provides substantial evidence advocating the development of polymeric MN-mediated drug delivery systems to include sustained plasma levels of hydrophilic pharmaceuticals.

Wearable Microneedle Patch for Transdermal Electrochemical Monitoring of Urea in Interstitial Fluid

Microneedle-based wearable electrochemical biosensors are the new frontier in personalized health monitoring and disease diagnostic devices that provide an alternative tool to traditional blood-based invasive techniques. Advancements in micro- and nanofabrication technologies enabled the fabrication of microneedles using different biomaterials and morphological features with the aim of overcoming existing challenges and enhancing sensing performance. In this work, we report a microneedle array featuring conductive recessed microcavities for monitoring urea levels in the interstitial fluid of the skin. Microcavities are small pockets on the tip of each microneedle that can accommodate the sensing layer, provide protection from delamination during skin insertion or removal, and position the sensing layer in a deep layer of the skin to reach the interstitial fluid. The wearable urea patch has shown to be highly sensitive and selective in monitoring urea, with a sensitivity of 2.5 mV mM-1 and a linear range of 3 to 18 mM making it suitable for monitoring urea levels in healthy individuals and patients. Our ex vivo experiments have shown that recessed microcavities can protect the sensing layer from delamination during skin insertion and monitor changing urea levels in interstitial fluid. This biocompatible platform provides alternative solutions to the critical issue of maintaining the performance of the biosensor upon skin insertion and holds great potential for advancing transdermal sensor technology.

Microneedle systems: cell, exosome, and nucleic acid based strategies

Cells, exosomes, and nucleic acids play crucial roles in biomedical engineering, holding substantial clinical potential. However, their utility is often hindered by various drawbacks, including cellular immunogenicity, and instability of exosomes and nucleic acids. In recent years, microneedle (MN) technology has revolutionized drug delivery by offering minimal invasiveness and remarkable versatility. MN has emerged as an ideal platform for the extraction, storage, and delivery of these biological components. This review presents a comprehensive overview of the historical progression and recent advances in the field of MN. Specifically, it highlights the current applications of cell-, exosome-, and nucleic acid-based MN systems, while presenting prevailing research challenges. Additionally, the review provides insights into the prospects of MN in this area, aiming to provide new ideas for researchers and facilitate the clinical translation of MN technology.

Advances and Prospects for Hydrogel-Forming Microneedles in Transdermal Drug Delivery

Transdermal drug delivery (TDD) is one of the key approaches for treating diseases, avoiding first-pass effects, reducing systemic adverse drug reactions and improving patient compliance. Microneedling, iontophoresis, electroporation, laser ablation and ultrasound facilitation are often used to improve the efficiency of TDD. Among them, microneedling is a relatively simple and efficient means of drug delivery. Microneedles usually consist of micron-sized needles (50-900 μm in length) in arrays that can successfully penetrate the stratum corneum and deliver drugs in a minimally invasive manner below the stratum corneum without touching the blood vessels and nerves in the dermis, improving patient compliance. Hydrogel-forming microneedles (HFMs) are safe and non-toxic, with no residual matrix material, high drug loading capacity, and controlled drug release, and they are suitable for long-term, multiple drug delivery. This work reviewed the characteristics of the skin structure and TDD, introduced TDD strategies based on HFMs, and summarized the characteristics of HFM TDD systems and the evaluation methods of HFMs as well as the application of HFM drug delivery systems in disease treatment. The HFM drug delivery system has a wide scope for development, but the translation to clinical application still has more challenges.

Hydrogel-forming microarray patches with solid dispersion reservoirs for transdermal long-acting microdepot delivery of a hydrophobic drug

Hydrogel-forming microarray patches (HF-MAPs) are used to circumvent the skin barrier and facilitate the noninvasive transdermal delivery of many hydrophilic substances. However, their use in the delivery of hydrophobic agents is a challenging task. This work demonstrates, for the first time, the successful transdermal long-acting delivery of the hydrophobic atorvastatin (ATR) via HF-MAPs using poly(ethylene)glycol (PEG)-based solid dispersion (SD) reservoirs. PEG-based SDs of ATR were able to completely dissolve within 90 s in vitro. Ex vivo results showed that 2.05 ± 0.23 mg of ATR/0.5 cm² patch was delivered to the receiver compartment of Franz cells after 24 h. The in vivo study, conducted using Sprague Dawley rats, proved the versatility of HF-MAPs in delivering and maintaining therapeutically-relevant concentrations (> 20 ng·mL^-1) of ATR over 14 days, following a single HF-MAP application for 24 h. The long-acting delivery of ATR suggests the successful formation of hydrophobic microdepots within the skin, allowing for the subsequent sustained delivery as they gradually dissolve over time, as shown in this work. When compared to the oral group, the use of the HF-MAP formulation improved the overall pharmacokinetics profile of ATR in plasma, where significantly higher AUC values resulting in ∼10-fold higher systemic exposure levels were obtained. This novel system offers a promising, minimally-invasive, long-acting alternative delivery system for ATR that is capable of enhancing patient compliance and therapeutic outcomes. It also proposes a unique promising platform for the long-acting transdermal delivery of other hydrophobic agents.

3D Printed Hydrogel Microneedle Arrays for Interstitial Fluid Biomarker Extraction and Colorimetric Detection

To treat and manage chronic diseases, it is necessary to continuously monitor relevant biomarkers and modify treatment as the disease state changes. Compared to other bodily fluids, interstitial skin fluid (ISF) is a good choice for identifying biomarkers because it has a molecular composition most similar to blood plasma. Herein, a microneedle array (MNA) is presented to extract ISF painlessly and bloodlessly. The MNA is made of crosslinked poly(ethylene glycol) diacrylate (PEGDA), and an optimal balance of mechanical properties and absorption capability is suggested. Besides, the effect of needles’ cross-section shape on skin penetration is studied. The MNA is integrated with a multiplexed sensor that provides a color change in a biomarker concentration-dependent manner based on the relevant reactions for colorimetric detection of pH and glucose biomarkers. The developed device enables diagnosis by visual inspection or quantitative red, green, and blue (RGB) analysis. The outcomes of this study show that MNA can successfully identify biomarkers in interstitial skin fluid in a matter of minutes. The home-based long-term monitoring and management of metabolic diseases will benefit from such practical and self-administrable biomarker detection.

Hydrogel-Crosslinked Microneedles Based on Microwave-Assisted Drying Method

We present a method and several applications for the synthesis of hydrogel-crosslinked microneedle arrays utilizing microwave-assisted drying, ensuring a significant reduction in reaction preparation time while maintaining quality. We demonstrate the feasibility of drying hydrogels using microwaves and thus extend to crosslinked microneedle fabrication. Crosslinking was performed using 1,4-butanediol diglycidyl ether (BDDE) as a crosslinking agent. Infrared spectra of the microneedle arrays were measured with attenuated total reflection-Fourier transform infrared (ATR-FTIR). The surface morphology of the microneedle arrays was observed with scanning electron microscopy (SEM). The microneedle arrays were evaluated in terms of mechanical strength, swelling kinetics, rheological properties, degradation rate, and glucose iontophoresis. The results show that this method can shorten the reaction preparation time by 5 hours, and the prepared crosslinked microneedle array has better crosslinking efficiency, swelling effect, and greater mechanical strength than traditional methods.

Evaluation of 3D Printability and Biocompatibility of Microfluidic Resin for Fabrication of Solid Microneedles

In this study, we have employed Digital Light Processing (DLP) printing technology for the fabrication of solid microneedle (MN) arrays. Several arrays with various geometries, such as cones, three-sided pyramids and four-sided pyramids, with different height to aspect ratios of 1:1, 2:1 and 3:1, were printed. Post-processing curing optimizations showed that optimal mechanical properties of the photocurable resin were obtained at 40 °C and 60 min. Ex vivo skin studies showed that piercing forces, penetration depth and penetration width were affected by the MN geometry and height to aspect ratio. Cone-shaped MNs required lower applied forces to penetrate skin and showed higher penetration depth with increasing height to aspect ratio, followed by three-sided and four-sided printed arrays. Cytotoxicity studies presented 84% cell viability of human fibroblasts after 2.5 h, suggesting the very good biocompatibility of the photocurable resin. Overall, DLP demonstrated excellent printing capacity and high resolution for a variety of MN designs.

Celecoxib nanocrystal-loaded dissolving microneedles with highly efficient for osteoarthritis treatment

Osteoarthritis (OA) is a prevalent degenerative disease that has a significant impact on patients' lives. Celecoxib (CXB) is now primarily used to treat OA with oral dosing. CXB's limited water solubility, on the other hand, restricts its therapeutic application. We developed a delivery system of dissolving microneedles (DMNs) loaded with CXB-nanocrystals (CXB-NCs) for the treatment of OA. Oral administration's inefficiency and injectable administration's poor compliance might be solved using DMNs. Furthermore, carrier-free NCs may dramatically increase the dissolution of drugs with poorly water-solubility, as well as the drug load of DMNs. Antisolvent precipitation was used to make CXB-NCs. CXB-NC@DMNs were prepared by mixing CXB-NCs with hyaluronic acid (HA) that had high mechanical qualities and could permeate the skin efficiently in vitro. The therapeutic effect of oral CXB-NCs was substantially better than that of the same dose of oral CXB in an in vivo pharmacodynamic trial, demonstrating that the preparation of CXB into NCs might greatly increase CXB bioavailability. Furthermore, we discovered that DMNs loaded with low-dose CXB-NCs had similar or even better efficacy than the oral CXB-NCs group. The findings suggested that CXB-NC@DMNs may be a very efficient and promising drug delivery strategy in the treatment of OA.

Colorimetric microneedle patches for multiplexed transdermal detection of metabolites

Skin Interstitial Fluid (ISF) is an alternative source for biomarkers. Herein, a highly swellable microneedle patch (MNP) to rapidly extract ISF painlessly and bloodlessly is presented. The MNP is made of crosslinked methacrylated hyaluronic acid (MeHA) and dissolvable hyaluronic acid (HA) with the optimal balance of mechanical strength (0.6 N/MN) and absorption capability (16.22 μL in 20 min). Incorporated with wax-patterned and sensing-reagent-decorated test paper (TP) for multiplexed colorimetric detection of metabolites (glucose, lactate, cholesterol, and pH), this TP-MNP biosensor gives rapid color change in biomarker concentration-dependent manner based on specific enzymatic reactions, whereby allowing diagnosis by the naked eye or quantitative RGB analysis. Both the in vitro and in vivo experiments demonstrate the feasibility of TP-MNPs to detect multiple biomarkers in skin interstitial fluid within minutes. Such convenient and self-administrable profiling of metabolites shall be instrumental for home-based long-term monitoring and management of metabolic diseases.

Process optimization of Ca2+ cross-linked alginate-based swellable microneedles for enhanced transdermal permeability: More applicable to acidic drugs

We describe a swellable microneedle (SMN) consisting of Ca²⁺ cross-linked alginate, which expands the types of natural polymers available for SMN fabrication. After investigation of different fabrication methods, the alginate in situ hydrogel-based SMN with a flat substrate was successfully constructed, whose gelation was triggered by ethylenediaminetetraacetic acid calcium disodium salt and D-(+)-glucono-1,5-lactone. With the addition of polyvinyl alcohol and trehalose, SMN possessed good mechanical properties. The biocompatibility of SMN was demonstrated through the tests of in vitro cytotoxicity and in vivo skin irritation. With the assistance of SMN, the in vitro transdermal delivery efficiencies of drugs were significantly improved throughout 16 h. 3-O-ethyl ascorbic acid (EAA, pH = 4.81) exhibited a cumulative release of up to 83.83 ± 6.30%, which was consistent with zero-order kinetics, while tranexamic acid (TA, pH = 6.90) showed the most significant increase in delivery efficiency, which was consistent with the Higuchi model and Ritger-Peppas model. The SMN remained intact after the 16 h of EAA transdermal delivery, indicating its better suitability for acidic drugs. We believe that this technology has the potential to expand the range of drugs available for transdermal administration as well as the breadth of patient care applications.

Microneedle-mediated transdermal nanodelivery systems: a review

The greatest limitation in the development of transdermal drug delivery systems is that only a few drugs can permeate the skin due to the barrier function of the stratum corneum. Active and passive methods are generally available for improving the ability of drug transdermal delivery. However, nanoparticles, as a passive approach, exhibit capacity-constrained permeation enhancement. Thus, microneedle-mediated nanoparticles possess enormous potential and broad prospects. Microneedles promote the penetration of macromolecules by creating microchannels on the skin surface. In this review, the prevailing subknowledge on microneedles (mechanism, classification, and applications of microneedles combined with nanoparticles) is discussed to provide a guideline for readers and a basic reference for further in-depth studies of this novel drug delivery system.

Comprehensive Review on Hydrogels

The conventional drug delivery systems have a long list of issues of repeated dosing and toxicity arising due to it. The hydrogels are the answer to them and offer a result that minimizes such activities and optimizes therapeutic benefits. The hydrogels proffer tunable properties that can withstand degradation, metabolism, and controlled release moieties. Some of the areas of applications of hydrogels involve wound healing, ocular systems, vaginal gels, scaffolds for tissue, bone engineering, etc. They consist of about 90% of the water that makes them suitable bio-mimic moiety. Here, we present a birds-eye view of various perspectives of hydrogels, along with their applications.

Microneedle Arrays for Sampling and Sensing Skin Interstitial Fluid

Dermal interstitial fluid (ISF) is a novel source of biomarkers that can be considered as an alternative to blood sampling for disease diagnosis and treatment. Nevertheless, in vivo extraction and analysis of ISF are challenging. On the other hand, microneedle (MN) technology can address most of the challenges associated with dermal ISF extraction and is well suited for long-term, continuous ISF monitoring as well as in situ detection. In this review, we first briefly summarise the different dermal ISF collection methods and compare them with MN methods. Next, we elaborate on the design considerations and biocompatibility of MNs. Subsequently, the fabrication technologies of various MNs used for dermal ISF extraction, including solid MNs, hollow MNs, porous MNs, and hydrogel MNs, are thoroughly explained. In addition, different sensing mechanisms of ISF detection are discussed in detail. Subsequently, we identify the challenges and propose the possible solutions associated with ISF extraction. A detailed investigation is provided for the transport and sampling mechanism of ISF in vivo. Also, the current in vitro skin model integrated with the MN arrays is discussed. Finally, future directions to develop a point-of-care (POC) device to sample ISF are proposed.

Enhancement strategies for transdermal drug delivery systems: current trends and applications

Transdermal drug delivery systems have become an intriguing research topic in pharmaceutical technology area and one of the most frequently developed pharmaceutical products in global market. The use of these systems can overcome associated drawbacks of other delivery routes, such as oral and parenteral. The authors will review current trends, and future applications of transdermal technologies, with specific focus on providing a comprehensive understanding of transdermal drug delivery systems and enhancement strategies. This article will initially discuss each transdermal enhancement method used in the development of first-generation transdermal products. These methods include drug/vehicle interactions, vesicles and particles, stratum corneum modification, energy-driven methods and stratum corneum bypassing techniques. Through suitable design and implementation of active stratum corneum bypassing methods, notably microneedle technology, transdermal delivery systems have been shown to deliver both low and high molecular weight drugs. Microneedle technology platforms have proven themselves to be more versatile than other transdermal systems with opportunities for intradermal delivery of drugs/biotherapeutics and therapeutic drug monitoring. These have shown that microneedles have been a prospective strategy for improving transdermal delivery systems.

Progress and perspective of microneedle system for anti-cancer drug delivery

Transdermal drug delivery exhibited encouraging prospects, especially through superficial drug administration routes. However, only a few limited lipophilic drug molecules could cross the skin barrier, those are with low molecular weight and rational Log P value. Microneedles (MNs) can overcome these limitations to deliver numerous drugs into the dermal layer by piercing the outermost skin layer of the body. In the case of superficial cancer treatments, topical drug administration faces severely low transfer efficiency, and systemic treatments are always associated with side effects and premature drug degradation. MN-based systems have achieved excellent technical capabilities and been tested for pre-clinical chemotherapy, photothermal therapy, photodynamic therapy, and immunotherapy. In this review, we will focus on the features, progress, and opportunities of MNs in the anticancer drug delivery system. Then, we will discuss the strategies and advantages in these works and summarize challenges, perspectives, and translational potential for future applications.

Evaluation of the clinical impact of repeat application of hydrogel-forming microneedle array patches

Hydrogel-forming microneedle array patches (MAPs) have been proposed as viable clinical tools for patient monitoring purposes, providing an alternative to traditional methods of sample acquisition, such as venepuncture and intradermal sampling. They are also undergoing investigation in the management of non-melanoma skin cancers. In contrast to drug or vaccine delivery, when only a small number of MAP applications would be required, hydrogel MAPs utilised for sampling purposes or for tumour eradication would necessitate regular, repeat applications. Therefore, the current study was designed to address one of the key translational aspects of MAP development, namely patient safety. We demonstrate, for the first time in human volunteers, that repeat MAP application and wear does not lead to prolonged skin reactions or prolonged disruption of skin barrier function. Importantly, concentrations of specific systemic biomarkers of inflammation (C-reactive protein (CRP); tumour necrosis factor-α (TNF-α)); infection (interleukin-1β (IL-1β); allergy (immunoglobulin E (IgE)) and immunity (immunoglobulin G (IgG)) were all recorded over the course of this fixed study period. No biomarker concentrations above the normal, documented adult ranges were recorded over the course of the study, indicating that no systemic reactions had been initiated in volunteers. Building upon the results of this study, which serve to highlight the safety of our hydrogel MAP, we are actively working towards CE marking of our MAP technology as a medical device.

Microneedle-mediated gene delivery for the treatment of ischemic myocardial disease

Cardiovascular disorders are still the primary cause of mortality worldwide. Although intramyocardial injection can effectively deliver agents to the myocardium, this approach is limited because of its restriction to needle-mediated injection and the minor retention of agents in the myocardium. Here, we engineered phase-transition microneedles (MNs) coated with adeno-associated virus (AAV) and achieved homogeneous distribution of AAV delivery. Bioluminescence imaging revealed the successful delivery and transfection of AAV-luciferase. AAV-green fluorescent protein-transfected cardiomyocytes were homogeneously distributed on postoperative day 28. AAV-vascular endothelial growth factor (VEGF)-loaded MNs improved heart function by enhancing VEGF expression, promoting functional angiogenesis, and activating the Akt signaling pathway. The results indicated the superiority of MNs over direct muscle injection. Consequently, MNs might emerge as a promising tool with great versatility for delivering various agents to treat ischemic myocardial disease.

Topical and Transdermal Drug Delivery: From Simple Potions to Smart Technologies

This overview on skin delivery considers the evolution of the principles of percutaneous ab-sorption and skin products from ancient times to today. Over the ages, it has been recognised that products may be applied to the skin for either local or systemic effects. As our understanding of the anatomy and physiology of the skin has improved, this has facilitated the development of technologies to effectively and quantitatively deliver solutes across this barrier to specific target sites in the skin and beyond. We focus on these technologies and their role in skin delivery today and in the future.

Implantable microneedles with an immune-boosting function for effective intradermal influenza vaccination

This study details effective influenza vaccination via sustained intradermal (ID) release of vaccines using implantable and patch-free chitosan microneedles (MNs). The microneedle (MN) patch is composed of vaccine-loaded chitosan MNs with a dissolvable supporting array that gives extra length for complete insertion of MNs and is dissolved within the skin during insertion. Chitosan MNs can be quickly and entirely implanted into the dermis to function as a depot and an immune-boosting agent for the extended release of vaccines and simultaneous activation of the immune system. We found the influenza virus-specific antibody levels induced by chitosan MN vaccination were significantly higher than those elicited by intramuscular (IM) immunization with influenza vaccine alone. The MN induced immune-enhancing effect was obvious 4 week after the vaccination and lasted for at least 16 weeks. Most importantly, MN-immunized mice were completely protected from H1N1 viral challenge without major weight loss, whereas mice receiving IM injection at the same dose had a mortality rate of 60% and experienced notable weight loss after challenge. Our results suggest that the chitosan MNs cannot only be a viable tool for precise ID vaccine delivery but also exert strong adjuvanticity to enhance vaccine potency and induce protective immunity against influenza virus infections. STATEMENT OF SIGNIFICANCE: There is an urgent need for generating a new vaccination strategy to address the threat of global pandemic influenza. This study presents implantable chitosan microneedles (MNs) with immune-boosting function for effective influenza vaccination. We demonstrate that the chitosan MN can not only be an efficient tool for sustained intradermal delivery but also serve as an immunological adjuvant to boost vaccine efficacy. Continuous antigen exposure and immune stimulation provided by the implanted MNs may enhance the immunogenicity of influenza vaccines and evoke long-lasting immune responses to completely protect mice from lethal influenza challenge. The proposed MN system has great potential to be used as a new adjuvanted vaccine formulation and make influenza vaccination more effective and more accessible.

Hydrogel-Coated Microneedle Arrays for Minimally Invasive Sampling and Sensing of Specific Circulating Nucleic Acids from Skin Interstitial Fluid

Minimally invasive technologies that can sample and detect cell-free nucleic acid biomarkers from liquid biopsies have recently emerged as clinically useful for early diagnosis of a broad range of pathologies, including cancer. Although blood has so far been the most commonly interrogated bodily fluid, skin interstitial fluid has been mostly overlooked despite containing the same broad variety of molecular biomarkers originating from cells and surrounding blood capillaries. Emerging technologies to sample this fluid in a pain-free and minimally-invasive manner often take the form of microneedle patches. Herein, we developed microneedles that are coated with an alginate-peptide nucleic acid hybrid material for sequence-specific sampling, isolation, and detection of nucleic acid biomarkers from skin interstitial fluid. Characterized by fast sampling kinetics and large sampling capacity (∼6.5 μL in 2 min), this platform technology also enables the detection of specific nucleic acid biomarkers either on the patch itself or in solution after light-triggered release from the hydrogel. Considering the emergence of cell-free nucleic acids in bodily fluids as clinically informative biomarkers, platform technologies that can detect them in an automated and minimally invasive fashion have great potential for personalized diagnosis and longitudinal monitoring of patient-specific disease progression.

Functionalized microneedles for continuous glucose monitoring

Microneedles (MNs) have been established as promising medical devices as they are minimally invasive, cause less pain, and can be utilized for self-administration of drugs by patients. There has been rapid development in MNs for transdermal monitoring and diagnostic systems, following the active research on fabrication methods and applications for drug delivery. In this paper, recent investigations on bio-sensing using MNs are reviewed in terms of the applicability to continuous glucose monitoring system (CGMS), which is one of the main research focuses of medical engineering technologies. The trend of the functionalized MNs can be categorized as follows: (i) as a sensing probe, and (ii) as a biological fluid collector. MNs as in vivo sensors are mainly integrated or coated with conductive materials to have the function as electrodes. MNs as fluid collectors are given a certain geometrical design, such as a hollow and porous structure aided by a capillary action or negative pressure, to extract the interstitial fluids or blood for ex vivo analysis. For realization of CGMS with MNs, a long-term accurate measurement by the MN-based sensing probe or a fluidic connection between the MN-based fluid collector and the existing microfluidic measurement systems should be investigated.

In vivo and qualitative studies investigating the translational potential of microneedles for use in the older population

Microneedles (MNs) are a novel transdermal drug delivery platform, rapidly progressing from a substantive evidence base, towards commercialisation. As part of this transition, it is important to consider the future use of MNs by older people in order to ensure optimal therapeutic outcomes for this unique and increasing population group. This paper, therefore, considers the use of MNs by those aged over 65 years, investigating insertion parameters in ageing skin, alongside the feasibility and acceptability of the technology. Hydrogel-forming MN arrays were applied to seven subjects aged over 65 years, with breach of the stratum corneum confirmed using optical coherence tomography. Insertion depths recorded in each case were similar to a comparative group, aged 20–30 years. Skin recovery was, however, demonstrated to occur at a slower rate in the older subjects, as measured using transepidermal water loss. Qualitative methods, including focus groups and semi-structured interviews, were employed to collect the views and opinions of older people and community pharmacists respectively. The overall consensus was positive, with a number of benefits to MN-mediated drug delivery identified, such as reduced dosing frequency, improved adherence and an alternative delivery route where oral or injectable medication was precluded. Concerns centred on practical issues associated with age-related functional decline, including, for example, reduced dexterity and skin changes. The presentation of this work collectively provides the first convincing report of the importance of further translational research in this area to support future MN use in older people, ensuring an age-appropriate delivery platform.

Preparation, properties and challenges of the microneedles-based insulin delivery system

Microneedle technology relates to pharmacy, polymer chemistry and micromachining. Microneedle can effectively deliver insulin into systemic circulation across the skin. This process does not affect the activity of insulin. Compared to subcutaneous injection, microneedles cause less pain for their special structure. This review thoroughly discusses the preparation technologies of the microneedles-based insulin delivery system including solid, hollow, dissolving, phase transition, glucose-responsive microneedle patches. In the meantime, the properties, challenges and clinical/commercial status of the microneedles-based insulin delivery system are also discussed in this review.

Human studies with microneedles for evaluation of their efficacy and safety

INTRODUCTION

During the past two decades, many studies have documented the development of microneedles (MNs) as a feasible technique for the effective administration of drugs. More and more human studies have been done with MNs to bridge the gap between research and market applications that provide efficacious techniques for clinical implementation.

AREAS COVERED

The aim of this review is provide a brief description of the status of human study with MNs and to demonstrate progress for the right use of microneedle arrays in clinical settings. It also describes the considerations for clinical application with each type of MNs.

EXPERT OPINION

Microneedle systems were introduced to overcome the limitations of conventional methods of drug administration. Lots of microneedle systems have undergone clinical evaluation to determine their efficacy and safety, and many studies have demonstrated positive results. The successful clinical use of the microneedle in vaccine therapy is remarkable and supports the importance of conducting further tests in a wide range of medical applications. Self-administered MNs appeared to be an attractive alternative method that needs further research to become a reality in the near future.

Transdermal delivery of gentamicin using dissolving microneedle arrays for potential treatment of neonatal sepsis

Neonatal infections are a leading cause of childhood mortality in low-resource settings. World Health Organization guidelines for outpatient treatment of possible serious bacterial infection (PSBI) in neonates and young infants when referral for hospital treatment is not feasible include intramuscular gentamicin (GEN) and oral amoxicillin. GEN is supplied as an aqueous solution of gentamicin sulphate in vials or ampoules and requires health care workers to be trained in dose calculation or selection of an appropriate dose based on the patient's weight band and to have access to safe injection supplies and appropriate sharps disposal. A simplified formulation, packaging, and delivery method to treat PSBI in low-resource settings could decrease user error and expand access to lifesaving outpatient antibiotic treatment for infants with severe infection during the neonatal period. We developed dissolving polymeric microneedles (MN) arrays to deliver GEN transdermally. MN arrays were produced from aqueous blends containing 30% (w/w) of GEN and two polymers approved by the US Food and Drug Administration: sodium hyaluronate and poly(vinylpyrrolidone). The arrays (19 × 19 needles and 500 μm height) were mechanically strong and were able to penetrate a skin simulant to a depth of 378 μm. The MN arrays were tested in vitro using a Franz Cell setup delivering approximately 4.45 mg of GEN over 6 h. Finally, three different doses (low, medium, and high) of GEN delivered by MN arrays were tested in an animal model. Maximum plasma levels of GEN were dose-dependent and ranged between 2 and 5 μg/mL. The time required to reach these levels post-MN array application ranged between 1 and 6 h. This work demonstrated the potential of dissolving MN arrays to deliver GEN transdermally at therapeutic levels in vivo.

The Use of a Pressure-Indicating Sensor Film to Provide Feedback upon Hydrogel-Forming Microneedle Array Self-Application In Vivo

PURPOSE

To evaluate the combination of a pressure-indicating sensor film with hydrogel-forming microneedle arrays, as a method of feedback to confirm MN insertion in vivo.

METHODS

Pilot in vitro insertion studies were conducted using a Texture Analyser to insert MN arrays, coupled with a pressure-indicating sensor film, at varying forces into excised neonatal porcine skin. In vivo studies involved twenty human volunteers, who self-applied two hydrogel-forming MN arrays, one with a pressure-indicating sensor film incorporated and one without. Optical coherence tomography was employed to measure the resulting penetration depth and colorimetric analysis to investigate the associated colour change of the pressure-indicating sensor film.

RESULTS

Microneedle insertion was achieved in vitro at three different forces, demonstrating the colour change of the pressure-indicating sensor film upon application of increasing pressure. When self-applied in vivo, there was no significant difference in the microneedle penetration depth resulting from each type of array, with a mean depth of 237 μm recorded. When the pressure-indicating sensor film was present, a colour change occurred upon each application, providing evidence of insertion.

CONCLUSIONS

For the first time, this study shows how the incorporation of a simple, low-cost pressure-indicating sensor film can indicate microneedle insertion in vitro and in vivo, providing visual feedback to assure the user of correct application. Such a strategy may enhance usability of a microneedle device and, hence, assist in the future translation of the technology to widespread clinical use.

Hydrogel-forming microneedle arrays: Potential for use in minimally-invasive lithium monitoring

We describe, for the first time, hydrogel-forming microneedle (s) (MN) arrays for minimally-invasive extraction and quantification of lithium in vitro and in vivo. MN arrays, prepared from aqueous blends of hydrolysed poly(methyl-vinylether-co-maleic anhydride) and crosslinked by poly(ethyleneglycol), imbibed interstitial fluid (ISF) upon skin insertion. Such MN were always removed intact. In vitro, mean detected lithium concentrations showed no significant difference following 30min MN application to excised neonatal porcine skin for lithium citrate concentrations of 0.9 and 2mmol/l. However, after 1h application, the mean lithium concentrations extracted were significantly different, being appropriately concentration-dependent. In vivo, rats were orally dosed with lithium citrate equivalent to 15mg/kg and 30mg/kg lithium carbonate, respectively. MN arrays were applied 1h after dosing and removed 1h later. The two groups, having received different doses, showed no significant difference between lithium concentrations in serum or MN. However, the higher dosed rats demonstrated a lithium concentration extracted from MN arrays equivalent to a mean increase of 22.5% compared to rats which received the lower dose. Hydrogel-forming MN clearly have potential as a minimally-invasive tool for lithium monitoring in outpatient settings. We will now focus on correlation between serum and MN lithium concentrations.

Microneedle-based sensors for medical diagnosis

The field of microneedle sensors is reviewed discussing current trends and future applications.

Hydrogel-Forming Microneedle Arrays Allow Detection of Drugs and Glucose In Vivo: Potential for Use in Diagnosis and Therapeutic Drug Monitoring

We describe, for the first time the use of hydrogel-forming microneedle (MN) arrays for minimally-invasive extraction and quantification of drug substances and glucose from skin in vitro and in vivo. MN prepared from aqueous blends of hydrolysed poly(methyl-vinylether-co-maleic anhydride) (11.1% w/w) and poly(ethyleneglycol) 10,000 daltons (5.6% w/w) and crosslinked by esterification swelled upon skin insertion by uptake of fluid. Post-removal, theophylline and caffeine were extracted from MN and determined using HPLC, with glucose quantified using a proprietary kit. In vitro studies using excised neonatal porcine skin bathed on the underside by physiologically-relevant analyte concentrations showed rapid (5 min) analyte uptake. For example, mean concentrations of 0.16 μg/mL and 0.85 μg/mL, respectively, were detected for the lowest (5 μg/mL) and highest (35 μg/mL) Franz cell concentrations of theophylline after 5 min insertion. A mean concentration of 0.10 μg/mL was obtained by extraction of MN inserted for 5 min into skin bathed with 5 μg/mL caffeine, while the mean concentration obtained by extraction of MN inserted into skin bathed with 15 μg/mL caffeine was 0.33 μg/mL. The mean detected glucose concentration after 5 min insertion into skin bathed with 4 mmol/L was 19.46 nmol/L. The highest theophylline concentration detected following extraction from a hydrogel-forming MN inserted for 1 h into the skin of a rat dosed orally with 10 mg/kg was of 0.363 μg/mL, whilst a maximum concentration of 0.063 μg/mL was detected following extraction from a MN inserted for 1 h into the skin of a rat dosed with 5 mg/kg theophylline. In human volunteers, the highest mean concentration of caffeine detected using MN was 91.31 μg/mL over the period from 1 to 2 h post-consumption of 100 mg Proplus^® tablets. The highest mean blood glucose level was 7.89 nmol/L detected 1 h following ingestion of 75 g of glucose, while the highest mean glucose concentration extracted from MN was 4.29 nmol/L, detected after 3 hours skin insertion in human volunteers. Whilst not directly correlated, concentrations extracted from MN were clearly indicative of trends in blood in both rats and human volunteers. This work strongly illustrates the potential of hydrogel-forming MN in minimally-invasive patient monitoring and diagnosis. Further studies are now ongoing to reduce clinical insertion times and develop mathematical algorithms enabling determination of blood levels directly from MN measurements.

Transdermal Delivery of Drugs with Microneedles-Potential and Challenges

Transdermal drug delivery offers a number of advantages including improved patient compliance, sustained release, avoidance of gastric irritation, as well as elimination of pre-systemic first-pass effect. However, only few medications can be delivered through the transdermal route in therapeutic amounts. Microneedles can be used to enhance transdermal drug delivery. In this review, different types of microneedles are described and their methods of fabrication highlighted. Microneedles can be fabricated in different forms: hollow, solid, and dissolving. There are also hydrogel-forming microneedles. A special attention is paid to hydrogel-forming microneedles. These are innovative microneedles which do not contain drugs but imbibe interstitial fluid to form continuous conduits between dermal microcirculation and an attached patch-type reservoir. Several microneedles approved by regulatory authorities for clinical use are also examined. The last part of this review discusses concerns and challenges regarding microneedle use.

The role of microneedles for drug and vaccine delivery

INTRODUCTION

Transdermal drug delivery offers a number of advantages for the patient, not only due to its non-invasive and convenient nature, but also due to factors such as avoidance of first-pass metabolism and prevention of gastrointestinal degradation. It has been demonstrated that microneedles (MNs) can increase the number of compounds amenable to transdermal delivery by penetrating the skin's protective barrier, the stratum corneum, and creating a pathway for drug permeation to the dermal tissue below.

AREAS COVERED

MNs have been extensively investigated for drug and vaccine delivery. The different types of MN arrays and their delivery capabilities are discussed in terms of drugs, including biopharmaceutics and vaccines. Patient usage and effects on the skin are also considered.

EXPERT OPINION

MN research and development is now at the stage where commercialisation is a viable possibility. There are a number of long-term safety questions relating to patient usage which will need to be addressed moving forward. Regulatory guidance is awaited to direct the scale-up of the manufacturing process alongside provision of clearer patient instruction for safe and effective use of MN devices.