In vitro tolerability of human nasal mucosa: histopathological and scanning electron-microscopic evaluation of nasal forms containing Sandostatin

Overview of intranasally delivered peptides: key considerations for pharmaceutical development

INTRODUCTION

Intranasal (IN) delivery for peptides provides unique advantages compared to other invasive systemic delivery routes. However, there still lacks a clear understanding on how to evaluate the potential of the peptides for nasal delivery and key considerations for the nasal formulation development.

AREAS COVERED

A retrospective analysis of intranasally delivered peptides was conducted. The goals of this undertaking were 1) to build a database of the key physicochemical and pharmacokinetic properties of peptides delivered by the nasal route, 2) to evaluate formulation attributes applied to IN peptide delivery systems, and 3) to provide key considerations for IN delivery of peptides.

EXPERT OPINION/COMMENTARY

Extensive data mining showed that peptides with molecular weights up to 6000 Da have been delivered intranasally. The high solubility of some peptides highlighted the possibility of delivering sufficient amounts of peptide in the limited volume available for nasal sprays. Permeation enhancers and mucoadhesives have shown promise in improving the IN bioavailability of peptides. Other formulation considerations, such as the type of formulation, pH, osmolality, as well as drug deposition, are reviewed herein. Based on this retrospective analysis, key considerations for nasal peptides formulations were proposed to guide drug discovery and development for IN delivery of peptides.

The inhalers of the future? A review of dry powder devices on the market today

International agreements to ban the use of environmentally damaging chlorofluorocarbons (CFCs) have signalled an end to the traditional CFC-propelled pressurised metered dose inhaler (pMDI) which has long been the mainstay of topical asthma therapy. The need for acceptable and cost-effective replacement inhalers, combined with opportunities to develop generic formulations of patent-expired drugs, has fueled a lively response from the pharmaceutical industry. Improvements in pMDI design and reformulation with propellants such as hydrofluoroalkanes may offer significant advantages over CFC-pMDIs and prolong the widespread use of pressurised drug delivery systems for many years to come. In the longer term, however, another likely candidate for success in providing economical, efficient and acceptable inhaled therapies is the breath-actuated, multiple-dose dry powder inhaler (DPI). This review concentrates on the multiple-dose DPIs available within Europe today.

The effect of different concentrations of lactose powder on the airway function of adult asthmatics

Lactose is widely used as a carrier of drugs in inhalation devices for asthmatic patients, but some clinicans have suspected that it may cause bronchoconstriction. Only a few studies have been done to examine this and the results are not uniform. This study was conducted to determine the effects of inhalation grade lactose delivered by Diskhaler on lung function and airway conductance in asthmatic subjects. The effect of five doses of lactose ranging from 6.25 mg to 100 mg and placebo were investigated using spirometry and constant volume plethysmography. Nineteen subjects (nine females) with stable asthma and a proven reversibility of at least 12% in forced expiratory volume in 1 sec (FEV) (compared to baseline) in the last 6 months, were included in this single-centre, randomized, placebo-controlled, double-blind, cross-over study. The subjects received placebo plus five doses of lactose on one study day and six doses of placebo on another study day. Both doses and study days were assigned in a random order, and intervals of 1 h were allowed between each dose and at least 36 h between study days. Specific airways conductance (sGaw) and FEV were measured periodically over the course of 1 h after each dose of lactose or placebo. Administration of lactose at four or eight times the concentration in the Diskus and Diskhaler dry powder inhalers did not result in any statistically significant changes in FEV1. sGaw also showed no statistical difference between lactose and placebo at 1 or 3 min post-dosing. Both placebo and lactose produced both dilatation and constriction of the airways in the same patients, with no consistency in direction and no dose-response relationship. No adverse effect of lactose on a rways conductance or FEV1 of stable asthmatic patients was found in this study when given at higher than normal clinical doses.

Toxicological investigations of the effects carboxymethylcellulose on ciliary beat frequency of human nasal epithelial cells in primary suspension culture and in vivo on rabbit nasal mucosa

The objective of this study was to investigate the safety of a mucoadhesive carboxymethylcellulose (CMC) formulation for intranasal administration of apomorphine. The effect of different concentrations of CMC on ciliary beat frequency (CBF) was studied using a human nasal epithelial suspension cell culture system. The CBF was determined by computerized microscope photometry. The in vivo rabbit nasal mucosal tolerance of the mucoadhesive polymer was investigated using light microscopy. Twice daily, six rabbits received CMC powder in one nostril and CMC/apomorphine powder in the alternate nostril for 4 weeks. Two control rabbits received air puffs in one nostril and nothing in the alternate nostril. The rabbits were subsequently sacrificed and the stained nasal sections examined microscopically. CMC showed both concentration- and time-dependent inhibitory effects on the CBF. Only mild-to-moderate cilio-inhibition was recorded with the different concentrations of the polymer. CMC (both with and without apomorphine) caused mild-to-moderate inflammation after 4 weeks. Necrosis, squamous metaplasia or ciliary degeneration was not observed. Based on: (1) the mild-to-moderate cilio-inhibition induced by different concentrations of CMC; and (2) the mild-to-moderate nasal mucosal inflammation caused by CMC with and without apomorphine, we conclude that this polymer can be considered as a safe carrier for short-term intranasal administration. However, further investigations are required for its use in the treatment of chronic diseases such as with apomorphine in Parkinson's disease.

Validation of excised bovine nasal mucosa as in vitro model to study drug transport and metabolic pathways in nasal epithelium

The present work aims at the validation of excised bovine nasal mucosa as an in vitro model to address transport and metabolism pathways relative to the nasal mucosal uptake of therapeutic peptides. Preservation of the viability of the excised tissue in the course of in vitro studies of up to 3 h was demonstrated by (i) positive viability staining, (ii) constant transepithelial electrical resistance (42 +/- 12 Omega cm(2)), (iii) constant rates of metabolic turnover, and (iv) linear permeation profiles of therapeutic peptides and (3)H-mannitol. Using 1-leucine-4-methoxy-2-naphthylamide as a model substrate, we observed no difference between bovine and human nasal aminopeptidase activity. By a series of therapeutic peptides, no direct correlation was found between their effective permeability coefficients (from 0. 1 x 10(-5) to 5 x 10(-5) cm s(-1)) and their respective molecular masses (from 417 to 3,432 Da), indicating that other factors dominate nasal permeability. For instance, the permeabilities of metabolically labile peptides were concentration dependent and saturable, as demonstrated for two short thymopoietin fragments, Arg-Lys-Asp (TP3) and Arg-Lys-Asp-Val (TP4). By permeation studies using gonadorelin and two gonadorelin derivatives, buserelin and Hoe 013, without and in the presence of the chemical enhancer bacitracin, we also verified the ability of the model to assess chemical enhancer effects and their reversibility. In conclusion, our work demonstrates the potential of the investigated in vitro model, excised bovine nasal mucosa, to explore mechanistic aspects of nasal transport and metabolism of therapeutic peptides.

Nasal toxicological investigations of Carbopol 971P formulation of apomorphine: effects on ciliary beat frequency of human nasal primary cell culture and in vivo on rabbit nasal mucosa

OBJECTIVE

The objective of this study was to investigate the nasal toxicity of a mucoadhesive Carbopol 971P formulation of apomorphine.

MATERIALS AND METHODS

The effects of different concentrations of Carbopol 971P and apomorphine on ciliary beat frequency (CBF) were studied in suspension cultures of human nasal epithelial cells. The rabbit nasal mucosal tolerance of the formulation and its components were investigated using light microscopy. Different groups of the rabbits received twice daily, air puffs, glucose, glucose/apomorphine, Carbopol 971P or Carbopol 971P/apomorphine for 1 week (glucose-treated rabbits) or 1, 2 and 4 weeks (other treatments).

RESULTS

Both Carbopol 971P and apomorphine showed both concentration- and time-dependent inhibitory effects on the CBF. The effects on CBF were: apomorphine, 1.0% w/v, irreversible ciliostasis; 0.1 and 0.5% w/v, reversible cilio-inhibition; 0.01%w/v, irreversible cilio-stimulation; and Carbopol 971P, 0.1 and 0.25% w/v, partially-reversible cilio-inhibition. Glucose and glucose/apomorphine physical mixture caused mild inflammation. Carbopol 971P (both with and without apomorphine) caused severe inflammation, which increased with duration of treatment. Necrosis, squamous metaplasia or ciliary degeneration was not observed.

CONCLUSIONS

Due to the severe inflammation caused by Carbopol 971P with and without apomorphine, we conclude that this polymer is not a suitable carrier for intranasal administration of apomorphine. This is in spite of the reversible effects of Carbopol 971P (0.1 and 0. 25% w/v) and apomorphine (0.1 and 0.5% w/v) on CBF.

Dry powder inhalers: the influence of device resistance and powder formulation on drug and lactose deposition in vitro

It is a principal in the formulation of a dry powder aerosol that the device should enable a high fine particle fraction (FPF) of drug to be delivered to the lung whilst any carrier, such as lactose, should remain in the upper airways. Both the device and the dry powder formulation itself contribute to the resultant FPF and few studies have considered the deposition of lactose carrier. It was the purpose of this study to determine the effect of the resistance of the device and the influence of powder formulation on the deposition of drug and carrier. Measurement of the pressure drop across the devices investigated in this study showed that the two types of Inhalator Ingelheim had the highest resistance, whilst lower pressure drops were found across the Diskhaler, Cyclohaler and Accuhaler devices. The lowest pressure drops were measured across the Rotahaler and Spinhaler devices. Employing Rotacaps 400 capsules as the formulated salbutamol product, the FPF of drug was greater from the high resistance devices, being in the order Inhalators Ingelheim>Cyclohaler>Rotahaler=Spinhaler. However, the Diskhaler, employing its own developed formulation, produced the highest FPF, approximately twice that from the Accuhaler. There was no statistical difference between the FPF of salbutamol (approximately 20% nominal dose) from the Rotacaps formulation when aerosolised using high resistance devices (Inhalators Ingelheim) operated at 30 l min-1, a medium resistance device (Cyclohaler) operated at 60 l min-1 and low resistance devices (Spinhaler and Rotahaler) operated at a flow-rate of 90 l min-1. The Ventolin Diskhaler using its own formulation operated at 60 l min-1 gave a FPF of 40.33%, but the FPF obtained was sensitive to flow, being only 25.65% of the nominal dose at 30 l min-1. Whereas no lactose was found in the FPF from the Accuhaler operated at 60 l min-1, 100, 400 and 3500 microg were obtained from the Diskhaler, Rotacaps and micronised lactose formulation, respectively, when operated at the same flow-rate. An in-house formulation comprising salbutamol sulphate blended with micronised lactose in a weight ratio of 1:67.5 and aerosolised from a Cyclohaler produced a similar FPF to the Diskhaler at 60 l min-1. When air flow was reduced to 30 l min-1, the FPF from the in-house formulation was reduced considerably less than that from the Diskhaler formulation.

In vitro cell models to study nasal mucosal permeability and metabolism

Whereas in vivo studies represent the most crucial test for any nasal drug application or formulation, mechanistic aspects of nasal absorption may be more clearly approached by well defined and controlled in vitro studies. In this review the progress of nasal in vitro models to investigate drug permeation and metabolism in the epithelium is summarized and their potential and limitations are discussed. The following subjects will be covered: (i) primary cell cultures of human nasal epithelium, including sampling techniques and culture conditions, (ii) human nasal cell lines (in particular the human nasal cell line RPMI 2650), and (iii) excised nasal epithelium (rabbit, bovine, ovine, canine, human), also summarizing suitable preparation techniques and tissue characterization, test media, tissue equilibration, viability testing, and integrity tests. Furthermore, an overview on the various experimental set-ups suitable for in vitro transport studies (permeation rates; identification of permeation pathways; mechanisms and toxicity of absorption enhancers) and for metabolism studies (rates, saturation and pathways of enzymatic cleavage) is presented. Some attention is given to identify potential endocytotic uptake mechanisms. To date, the permeation and metabolic barrier function of excised nasal tissue derived from various animals has shown to mimic the in vivo situation 'ex vivo' at the highest degree possible. Supply of human tissue will continue to be short. Therefore, further studies are necessary to evaluate and improve culture conditions, handling, performance and physiologic relevance of primary human cell and cell line cultures.