Toward closed-loop drug delivery: Integrating wearable technologies with transdermal drug delivery systems

Wearable dual-drug controlled release patch for psoriasis treatment

Wearable drug delivery systems (DDS) have made significant advancements in the field of precision medicine, offering precise regulation of drug dosage, location, and timing. The performance qualities that wearable DDS has always strived for are simplicity, efficiency, and intelligence. This paper proposes a wearable dual-drug synergistic release patch. The patch is powered by a built-in magnesium battery and utilizes a hydrogel containing viologen-based hyperbranched polyamidoamine as both a cathode material and an integrated drug reservoir. This design allows for the simultaneous release of both dexamethasone and tannic acid, overcoming the limitations of monotherapy and ensuring effective synergy for on-demand therapy. In a mouse model with praziquimod-induced psoriasis, the patch demonstrated therapeutic efficacy at a low voltage. The inflammatory skin returned to normal after 5 days with the on-demand release of dual drugs. This work provides a promising treatment option considering its straightforward construction and the therapeutic advantages of dual-drug synergy.

Design, optimization, and evaluation for a long-time-released transdermal microneedle delivery system containing estradiol

Transdermal drug delivery systems (TDDS) have drawbacks such as poor absorption, low blood concentration, and delayed effects. Dissolving microneedle has sharp tips and short length, which overcome patients' pain and improve transdermal efficiency but has low mechanical strength and drug loading capacity. This study thereby proposes a microemulsion-encapsulated and long-time-released transdermal microneedle (MN) delivery system with estradiol (Es) as the model drug. The microemulsion (ME) was optimized by utilizing the pseudo-ternary phase diagram and D-optimal mixture design. The estradiol microemulsion-encapsulated microneedle (Es-ME-MN) was optimized by Box-Behnken design and prepared by freeze-thaw method. The Es-ME-MN obtained was characterized and evaluated through a large variety of studies. Es-ME-MN had sufficient mechanical strength to pierce skin and was safe enough, the length of which was 600 μm, and the Es content was 177.12 ± 0.72 μg/patch without drug-excipient chemical interaction. In vitro permeation study showed that Es-ME-MN has a higher transdermal efficiency and lower retention capacity than commercial estradiol patch and conventional MN. Es plasma concentration began to increase at 3 h and remained at 12.98-23.52 ng/mL until 72 h by pharmacokinetic experiments in the Es-ME-MN group. Es-ME-MN rapidly achieves effective blood concentrations through needle puncture and microemulsion delivery and maintains blood concentrations through the baseplate long-time release. Microemulsion-encapsulated, organic solvent-free, and long-time-released transdermal microneedle will make progress and provide a new idea for transdermal delivery of lipophilic drugs.

A comprehensive review on the biomedical frontiers of nanowire applications

This comprehensive review examines the immense capacity of nanowires, nanostructures characterized by unbounded dimensions, to profoundly transform the field of biomedicine. Nanowires, which are created by combining several materials using techniques such as electrospinning and vapor deposition, possess distinct mechanical, optical, and electrical properties. As a result, they are well-suited for use in nanoscale electronic devices, drug delivery systems, chemical sensors, and other applications. The utilization of techniques such as the vapor-liquid-solid (VLS) approach and template-assisted approaches enables the achievement of precision in synthesis. This precision allows for the customization of characteristics, which in turn enables the capability of intracellular sensing and accurate drug administration. Nanowires exhibit potential in biomedical imaging, neural interfacing, and tissue engineering, despite obstacles related to biocompatibility and scalable manufacturing. They possess multifunctional capabilities that have the potential to greatly influence the intersection of nanotechnology and healthcare. Surmounting present obstacles has the potential to unleash the complete capabilities of nanowires, leading to significant improvements in diagnostics, biosensing, regenerative medicine, and next-generation point-of-care medicines.

Photonics-powered augmented reality skin electronics for proactive healthcare: multifaceted opportunities

Rapid technological advancements have created opportunities for new solutions in various industries, including healthcare. One exciting new direction in this field of innovation is the combination of skin-based technologies and augmented reality (AR). These dermatological devices allow for the continuous and non-invasive measurement of vital signs and biomarkers, enabling the real-time diagnosis of anomalies, which have applications in telemedicine, oncology, dermatology, and early diagnostics. Despite its many potential benefits, there is a substantial information vacuum regarding using flexible photonics in conjunction with augmented reality for medical purposes. This review explores the current state of dermal augmented reality and flexible optics in skin-conforming sensing platforms by examining the obstacles faced thus far, including technical hurdles, demanding clinical validation standards, and problems with user acceptance. Our main areas of interest are skills, chiroptical properties, and health platform applications, such as optogenetic pixels, spectroscopic imagers, and optical biosensors. My skin-enhanced spherical dichroism and powerful spherically polarized light enable thorough physical inspection with these augmented reality devices: diabetic tracking, skin cancer diagnosis, and cardiovascular illness: preventative medicine, namely blood pressure screening. We demonstrate how to accomplish early prevention using case studies and emergency detection. Finally, it addresses real-world obstacles that hinder fully realizing these materials' extraordinary potential in advancing proactive and preventative personalized medicine, including technical constraints, clinical validation gaps, and barriers to widespread adoption.

A Wearable Device Towards Automatic Detection and Treatment of Opioid Overdose

Opioid-induced overdose is one of the leading causes of death among the US population under the age of 50. In 2021 alone, the death toll among opioid users rose to a devastating number of over 80,000. The overdose process can be reversed by the administration of naloxone, an opioid antagonist that rapidly counteracts the effects of opioid-induced respiratory depression. The idea of a closed-loop opioid overdose detection and naloxone delivery has emerged as a potential engineered solution to mitigate the deadly effects of the opioid epidemic. In this work, we introduce a wrist-worn wearable device that overcomes the portability issues of our previous work to create a closed-loop drug-delivery system, which includes (1) a Near-Infrared Spectroscopy (NIRS) sensor to detect a hypoxia-driven opioid overdose event, (2) a MOSFET switch, and (3) a Zero-Voltage Switching (ZVS) electromagnetic heater. Using brachial artery occlusion (BAO) with human subjects (n = 8), we demonstrated consistent low oxygenation events. Furthermore, we proved our device's capability to release the drug within 10 s after detecting a hypoxic event. We found that the changes in the oxyhemoglobin, deoxyhemoglobin and oxygenation saturation levels ( SpO2) were different before and after the low-oxygenation events ( 0.001). Although additional human experiments are needed, our results to date point towards a potential tool in the battle to mitigate the effects of the opioid epidemic.

Smart Physical-Based Transdermal Drug Delivery System:Towards Intelligence and Controlled Release

Transdermal drug delivery systems based on physical principles have provided a stable, efficient, and safe strategy for disease therapy. However, the intelligent device with real-time control and precise drug release is required to enhance treatment efficacy and improve patient compliance. This review summarizes the recent developments, application scenarios, and drug release characteristics of smart transdermal drug delivery systems fabricated with physical principle. Special attention is paid to the progress of intelligent design and concepts in of physical-based transdermal drug delivery technologies for real-time monitoring and precise drug release. In addition, facing with the needs of clinical treatment and personalized medicine, the recent progress and trend of physical enhancement are further highlighted for transdermal drug delivery systems in combination with pharmaceutical dosage forms to achieve better transdermal effects and facilitate the development of smart medical devices. Finally, the next generation and future application scenarios of smart physical-based transdermal drug delivery systems are discussed, a particular focus in vaccine delivery and tumor treatment.

Regulating Size and Charge of Liposomes in Microneedles to Enhance Intracellular Drug Delivery Efficiency in Skin for Psoriasis Therapy

The stratum corneum (SC) and cell membrane are two major barriers that hinder the therapeutic outcomes of transdermal drug delivery for the treatment of skin diseases. While microneedles (MNs) can efficiently penetrate the SC to deliver nanomedicines, the optimization of physicochemical properties of nanomedicines in MNs to enhance their in vivo cellular delivery efficiency remains unclear. Here, how the size and surface charge of drug-loaded liposomes in MNs influence the retention time and cellular delivery in psoriatic skin is systematically investigated. The results indicate that while 100 nm negatively-charged liposomes in MNs show higher cellular uptake in vitro, 250 and 450 nm liposomes could enhance skin retention and the long-term in vivo cellular delivery efficiency of drugs. Moreover, 250 nm cationic liposomes with a stronger positive charge show an extraordinarily long skin retention time of 132 h and significantly higher in vivo cellular internalization. In the treatment study, dexamethasone (dex)-loaded cationic liposomes-integrated MNs show better therapeutic outcomes than dex-loaded anionic liposomes-integrated MNs in a psoriasis-like animal model. The design principles of liposomes in MN drug delivery systems explored in the study hold the potential for enhancing the therapeutic outcomes of psoriasis and are instrumental for successful translation.

In Vitro and In Vivo Evaluation of Metformin Hydrochloride Hydrogels Developed with Experimental Design in the Treatment of Burns

Burns alter the normal skin barrier and affect various host defense processes that help prevent infections. An ineffective repair process can lead to serious damage, such as the onset of an infection or skin loss, which can then harm the surrounding tissues and ultimately the entire organism. This study aims to prepare in situ gels containing metformin hydrochloride, a compound known for its wound healing properties. To achieve this, in situ gels were prepared using three different gelling agents (Poloxamer 407®, Carbopol 934®, and sodium carboxymethyl cellulose (Na-CMC)) and three different concentrations of metformin hydrochloride (4 mg/g, 6 mg/g, and 8 mg/g), which were optimized through experimental design. Metformin concentration and gelling agent type were independent variables, and the loaded amount and the percentage of metformin released after 150 min were chosen as dependent variables in the optimization process. After determining the optimum values of the dependent variables according to the ANOVA analysis results, in vivo studies were conducted with optimized hydrogel formulations. Two groups, each consisting of seven Wistar rats with a burn model, were treated with metformin-poloxamer 407® gels at doses of 4 mg/g and 8 mg/g for 29 days. The results were then compared to untreated and placebo gel groups. Rats treated with in situ Poloxamer 407® hydrogels containing metformin hydrochloride showed a significant reduction in the size of the burned area after 29 days of treatment. However, for a comprehensive understanding of the wound healing mechanism, further studies such as immuno-histochemical and cell culture studies are needed.

The Use of Nanoneedles in Drug Delivery: an Overview of Recent Trends and Applications

Nanoneedles (NN) are growing rapidly as a means of navigating biological membranes and delivering therapeutics intracellularly. Nanoneedle arrays (NNA) are among the most potential resources to achieve therapeutic effects by administration of drugs through the skin. Although this is based on well-established approaches, its implementations are rapidly developing as an important pharmaceutical and biological research phenomenon. This study intends to provide a broad overview of current NNA research, with an emphasis on existing approaches, applications, and types of compounds released by these systems. A nanoneedle-based delivery device with great spatial and temporal accuracy, minimal interference, and low toxicity could transfer biomolecules into living organisms. Due to its vast potential, NN has been widely used as a capable transportation system of many therapeutic active substances, from cancer therapy, vaccine delivery, cosmetics, and bio-sensing nanocarrier drugs to genes. The use of nanoneedles for drug delivery offers new opportunities for the rapid, targeted, and exact administration of biomolecules into cell membranes for high-resolution research of biological systems, and it can treat a wide range of biological challenges. As a result, the literature has analyzed existing patents to emphasize the status of NNA in biological applications.

Artificial Intelligence's Impact on Drug Discovery and Development From Bench to Bedside

Artificial intelligence (AI) techniques have the potential to revolutionize drug release modeling, optimize therapy for personalized medicine, and minimize side effects. By applying AI algorithms, researchers can predict drug release profiles, incorporate patient-specific factors, and optimize dosage regimens to achieve tailored and effective therapies. This AI-based approach has the potential to improve treatment outcomes, enhance patient satisfaction, and advance the field of pharmaceutical sciences. International collaborations and professional organizations play vital roles in establishing guidelines and best practices for data collection and sharing. Open data initiatives can enhance transparency and scientific progress, facilitating algorithm validation.

Entangling of Peptide Nanofibers Reduces the Invasiveness of SARS-CoV-2

The viral spike (S) protein on the surface of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to angiotensin-converting enzyme 2 (ACE2) receptors on the host cells, facilitating its entry and infection. Here, functionalized nanofibers targeting the S protein with peptide sequences of IRQFFKK, WVHFYHK and NSGGSVH, which are screened from a high-throughput one-bead one-compound screening strategy, are designed and prepared. The flexible nanofibers support multiple binding sites and efficiently entangle SARS-CoV-2, forming a nanofibrous network that blocks the interaction between the S protein of SARS-CoV-2 and the ACE2 on host cells, and efficiently reduce the invasiveness of SARS-CoV-2. In summary, nanofibers entangling represents a smart nanomedicine for the prevention of SARS-CoV-2.

Drug Delivery Systems for Personal Healthcare by Smart Wearable Patch System

Smart wearable patch systems that combine biosensing and therapeutic components have emerged as promising approaches for personalized healthcare and therapeutic platforms that enable self-administered, noninvasive, user-friendly, and long-acting smart drug delivery. Sensing components can continuously monitor physiological and biochemical parameters, and the monitoring signals can be transferred to various stimuli using actuators. In therapeutic components, stimuli-responsive carrier-based drug delivery systems (DDSs) provide on-demand drug delivery in a closed-loop manner. This review provides an overview of the recent advances in smart wearable patch systems, focusing on sensing components, stimuli, and therapeutic components. Additionally, this review highlights the potential of fully integrated smart wearable patch systems for personalized medicine. Furthermore, challenges associated with the clinical applications of this system and future perspectives are discussed, including issues related to drug loading and reloading, biocompatibility, accuracy of sensing and drug delivery, and largescale fabrication.

Electro-responsive silk fibroin microneedles for controlled release of insulin

To date, very limited work has been done on convenient and active control of insulin release. Herein, we report an electro-responsive insulin delivery system based on thiolated silk fibroin. The disulfide cross-linking points in TSF were reduced and broken to form sulfhydryl groups under electrification, which led to the increase of microneedle swelling degree and promoted insulin release. After power failure, the sulfhydryl group is oxidised to form disulfide bond crosslinking point again, resulting in the reduction of microneedle swelling degree and thus the reduction of release rate. The insulin loaded in the electro-responsive insulin delivery system showed good reversible electroresponsive release performance. The addition of graphene reduced the microneedle resistance and increased the drug release rate under current conditions. In vivo studies on type 1 diabetic mice show that electro-responsive insulin delivery system effectively controls the blood glucose before and after feeding by switching on and off the power supply, and this blood glucose control can be maintained within the safe range (100-200 mg/dL) for a long time (11h). Such electrically responsive delivery microneedles show potential for integration with glucose signal monitoring and are expected to build closed-loop insulin delivery systems.

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Topological Optimisation Structure Design for Personalisation of Hydrogel Controlled Drug Delivery System

Personalised controlled drug delivery systems (CDDSs) can adjust drug concentration levels according to patient needs, which has enormous research prospects in precision medicine. In this study, the topological optimisation method was utilised in the structural design of a hydrogel CDDS to achieve a parameter-based adjustment of the drug average concentration in the hydrogel. A polyacrylamide/sodium alginate dual-network hydrogel was selected as a drug carrier, and tetracycline hydrochloride was used as a model drug. The topological optimisation model of the hydrogel CDDS was developed. The effects of the mesh size, target concentration, and volume factor on the optimised results were investigated. Hydrogel flow channel structures were obtained, which satisfied the different target concentrations. To verify the rationality of the optimisation model, in vitro drug release experiments were carried out. The results show that the hydrogel CDDS can control drug release within 7 days, and the drug release tends to follow zero-order release behaviour. The adjustable average concentration of tetracycline hydrochloride in hydrogel CDDS is recommended in the range of 20.79 to 31.04 mol/m³. This novel method provides a reference for personalised structure design of CDDS in the context of precision medicine.

Research progress of physical transdermal enhancement techniques in tumor therapy

The advancement and popularity of transdermal drug delivery (TDD) based on the physical transdermal enhancement technique (PTET) has opened a new paradigm for local tumor treatment. The drug can be directly delivered to the tumor site through the skin, thus avoiding the toxic side effects caused by the first-pass effect and achieving high patient compliance. Further development of PTETs has provided many options for antitumor drugs and laid the foundation for future applications of wearable closed-loop targeting drug delivery systems. In this highlight, the different types of PTETs and related mechanisms, and applications of PTET-related tumor detection and therapy are highlighted. According to their type and characteristics, PTETs are categorized as follows: (1) iontophoresis, (2) electroporation, (3) ultrasound, (4) thermal ablation, and (5) microneedles. PTET-related applications in the local treatment of tumors are categorized as follows: (1) melanoma, (2) breast tumor, (3) squamous cell carcinoma, (4) cervical tumor, and (5) others. The challenges and future prospects of existing PTETs are also discussed. This highlight will provide guidance for the design of PTET-based wearable closed-loop targeting drug delivery systems and personalized therapy for tumors.

Microneedle system for tissue engineering and regenerative medicine

Global increasing demand for high life quality and length facilitates the development of tissue engineering and regenerative medicine, which apply multidisciplinary theories and techniques to achieve the structural reconstruction and functional recovery of disordered or damaged tissues and organs. However, the clinical performances of adopted drugs, materials, and powerful cells in the laboratory are inescapably limited by the currently available technologies. To tackle the problems, versatile microneedles are developed as the new platform for local delivery of diverse cargos with minimal invasion. The efficient delivery, as well as painless and convenient procedure endow microneedles with good patient compliance in clinic. In this review, we first categorize different microneedle systems and delivery models, and then summarize their applications in tissue engineering and regenerative medicine mainly involving maintenance and rehabilitation of damaged tissues and organs. In the end, we discuss the advantages, challenges, and prospects of microneedles in depth for future clinical translations.

Elastic Fibers/Fabrics for Wearables and Bioelectronics

Wearables and bioelectronics rely on breathable interface devices with bioaffinity, biocompatibility, and smart functionality for interactions between beings and things and the surrounding environment. Elastic fibers/fabrics with mechanical adaptivity to various deformations and complex substrates, are promising to act as fillers, carriers, substrates, dressings, and scaffolds in the construction of biointerfaces for the human body, skins, organs, and plants, realizing functions such as energy exchange, sensing, perception, augmented virtuality, health monitoring, disease diagnosis, and intervention therapy. This review summarizes and highlights the latest breakthroughs of elastic fibers/fabrics for wearables and bioelectronics, aiming to offer insights into elasticity mechanisms, production methods, and electrical components integration strategies with fibers/fabrics, presenting a profile of elastic fibers/fabrics for energy management, sensors, e-skins, thermal management, personal protection, wound healing, biosensing, and drug delivery. The trans-disciplinary application of elastic fibers/fabrics from wearables to biomedicine provides important inspiration for technology transplantation and function integration to adapt different application systems. As a discussion platform, here the main challenges and possible solutions in the field are proposed, hopefully can provide guidance for promoting the development of elastic e-textiles in consideration of the trade-off between mechanical/electrical performance, industrial-scale production, diverse environmental adaptivity, and multiscenario on-spot applications.

Electronically powered drug delivery devices: considerations and challenges

INTRODUCTION

Electronically powered drug delivery devices enable a controlled drug release route for a more convenient and painless way with reduced side effects. The current advances in microfabrication and microelectronics have facilitated miniaturization and intelligence with the integration of sensors and wireless communication modules. These devices have become an essential component of commercialized on-demand drug delivery.

AREAS COVERED

This review aims to provide a concise overview of current progress in electronically powered drug devices, focusing on delivery strategies, manufacturing techniques, and control circuit design with specific examples.

EXPERT OPINION

The application of electronically powered drug delivery systems is now considered a feasible therapeutic approach with improved drug release efficiency and increased patient comfort. It is anticipated that these technologies will gradually fulfill clinical needs and resolve commercialization challenges in the future. This review discusses the current advances in electronic drug delivery devices, especially focusing on designing strategies to achieve an effective drug release, as well as the perspectives and challenges for future applications in clinical therapy.

The development of wearable technologies and their potential for measuring nutrient intake: Towards precision nutrition

Appropriate food intake and nutritional status are crucial for the maintenance of health and disease prevention. Conventional dietary assessment is mainly based on comparisons of nutrient intakes with reference intakes, failing to meet the needs of personalised nutritional guidance based on individual nutritional status. Given their capability of providing insights into health information non-invasively in real time, wearable technologies offer great opportunities for nutrition monitoring. Nutrient metabolic profiles can be monitored immediately and continuously which could potentially offer the possibility for the tracking and guiding of nutrient intake. Here, we review and highlight the recent advances in wearable sensors from the perspective of sensing technologies for nutrient detection in biofluids. The integration of biosensors with wearable devices serves as an ideal platform for the analysis of biofluids including sweat, saliva and tears. The wearable sensing systems applied to the analysis of typical nutrients and important metabolites are demonstrated in terms of carbohydrates, proteins, lipids, vitamins, minerals and others. Taking advantage of their high flexibility and lightweight, wearable sensors have been widely developed for the in situ quantitative detection of metabolic biomarkers. The technical principles, detection methods and applications are summarised. The challenges and future perspectives for wearable nutrition monitoring devices are discussed including the need to better determine relationships among nutrient metabolic profile, nutrient intake and food intake. With the development of materials, sensing techniques and manufacturing processes, wearable technologies are paving the way towards personalised precision nutrition, although there is still a long way to go before they can be utilised for practical clinical applications. Joint research efforts between nutrition scientists, doctors, engineers and sensor researchers are essential to further accelerate the realisation of reliable and practical wearable nutrition monitoring platforms.

Fluidic enabled bioelectronic implants: opportunities and challenges

Bioelectronic implants are increasingly facilitating novel strategies for clinical diagnosis and treatment. The integration of fluidic technologies into such implants enables new complementary routes for sensing and therapy alongside electrical interaction. Indeed, these two technologies, electrical and fluidic, can work synergistically in a bioelectronics implant towards the fabrication of a complete therapeutic platform. In this perspective article, the leading applications of fluidic enabled bioelectronic implants are highlighted and methods of operation and material choices are discussed. Furthermore, a forward-looking perspective is offered on emerging opportunities as well as critical materials and technological challenges.

Recent Advances in Intelligent Wearable Medical Devices Integrating Biosensing and Drug Delivery

The primary roles of precision medicine are to perform real-time examination, administer on-demand medication, and apply instruments continuously. However, most current therapeutic systems implement these processes separately, leading to treatment interruption and limited recovery in patients. Personalized healthcare and smart medical treatment have greatly promoted research on and development of biosensing and drug-delivery integrated systems, with intelligent wearable medical devices (IWMDs) as typical systems, which have received increasing attention because of their non-invasive and customizable nature. Here, the latest progress in research on IWMDs is reviewed, including their mechanisms of integrating biosensing and on-demand drug delivery. The current challenges and future development directions of IWMDs are also discussed.

Advances in the Novel Nanotechnology for the Targeted Tumor Therapy by the Transdermal Drug Delivery

Despite modern medicine advances greatly, cancer remains a serious challenge to world health for which effective methods of treatment have hardly been developed yet. However, throughout the recent years, the rapid-developing nanotechnology has provided a new outlook of cancer therapy by transdermal drug delivery. By disrupting the stratum corneum, drugs are delivered through the skin and navigated to the tumor site by drug delivery systems such as nanogels, microneedles, etc. The superiorities include the improvement of drug pharmacokinetics as well as reduced side effects. This paper reviews the reported novel development of transdermal drug delivery systems for targeted cancer therapy. Advanced techniques for penetrating the skin will be discussed as well.