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Morton DAV, Barling D. Developing Dry Powder Inhaler Formulations. J Aerosol Med Pulm Drug Deliv 2024; 37:90-99. [PMID: 38640447 DOI: 10.1089/jamp.2024.29109.davm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
This section aims to provide a concise and contemporary technical perspective and reference resource covering dry powder inhaler (DPI) formulations. While DPI products are currently the leading inhaled products in terms of sales value, a number of confounding perspectives are presented to illustrate why they are considered surprisingly, and often frustratingly, poorly understood on a fundamental scientific level, and most challenging to design from first principles. At the core of this issue is the immense complexity of fine cohesive powder systems. This review emphasizes that the difficulty of successful DPI product development should not be underestimated and is best achieved with a well-coordinated team who respect the challenges and who work in parallel on device and formulation and with an appreciation of the handling environment faced by the patient. The general different DPI formulation types, which have evolved to address the challenges of aerosolizing fine cohesive drug-containing particles to create consistent and effective DPI products, are described. This section reviews the range of particle engineering processes that may produce micron-sized drug-containing particles and their subsequent assembly as either carrier-based or carrier-free compositions. The creation of such formulations is then discussed in the context of the material, bulk, interfacial and ultimately drug-delivery properties that are considered to affect formulation performance. A brief conclusion then considers the future DPI product choices, notably the issue of technology versus affordability in the evolving inhaler market.
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Affiliation(s)
- David A V Morton
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
| | - David Barling
- Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
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2
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Sudduth ER, Kolewe EL, Graf J, Yu Y, Somma J, Fromen CA. Nebulization of Model Hydrogel Nanoparticles to Macrophages at the Air-Liquid Interface. FRONTIERS IN CHEMICAL ENGINEERING 2023; 4:1086031. [PMID: 37859802 PMCID: PMC10586456 DOI: 10.3389/fceng.2022.1086031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Nanoparticle evaluation within the pulmonary airspace has increasingly important implications for human health, with growing interest from drug delivery, environmental, and toxicology fields. While there have been widespread investigations of nanoparticle physiochemical properties following many routes of administration, nanoparticle behavior at the air-liquid interface (ALI) is less well-characterized. In this work, we fabricate two formulations of poly(ethylene)-glycol diacrylate (PEGDA)-based model nanoparticles to establish an in vitro workflow allowing evaluation of nanoparticle charge effects at the ALI. Both cationic and anionic PEGDA formulations were synthesized with similar hydrodynamic diameters around ~225 nm and low polydispersity, with expected surface charges corresponding with the respective functional co-monomer. We find that both formulations are readily nebulized from an aqueous suspension in a commercial Aeroneb® Lab Nebulizer, but the aqueous delivery solution served to slightly increase the overall hydrodynamic and geometric size of the cationic particle formulation. However, nanoparticle loading at 50 μg/ml of either formulation did not influence the resultant aerosol diameter from the nebulizer. To assess aerosol delivery in vitro, we designed a 3D printed adapter capable of ensuring aerosol delivery to transwell 24-well culture plates. Nanoparticle uptake by macrophages was compared between traditional cell culture techniques and that of ALI-cultured macrophages following aerosol delivery. Cell viability was unaffected by nanoparticle delivery using either method. However, only traditional cell culture methods demonstrated significant uptake that was dependent on the nanoparticle surface charge. Concurrently, ALI culture resulted in lower metabolic activity of macrophages than those in traditional cell culture, leading to lower overall nanoparticle uptake at ALI. Overall, this work demonstrates that base-material similarities between both particle formulations provide an expected consistency in aerosol delivery regardless of the nanoparticle surface charge and provides an important workflow that enables a holistic evaluation of aerosolizable nanoparticles.
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Affiliation(s)
- Emma R. Sudduth
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
| | - Emily L. Kolewe
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
| | - Jodi Graf
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
| | - Yinkui Yu
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
| | - Joaquina Somma
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
| | - Catherine A. Fromen
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE, USA
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Japiassu KB, Fay F, Marengo A, Louaguenouni Y, Cailleau C, Denis S, Chapron D, Tsapis N, Nascimento TL, Lima EM, Fattal E. Interplay between mucus mobility and alveolar macrophage targeting of surface-modified liposomes. J Control Release 2022; 352:15-24. [PMID: 36209941 DOI: 10.1016/j.jconrel.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
Alveolar macrophages play a crucial role in the initiation and resolution of the immune response in the lungs. Pro-inflammatory M1 alveolar macrophages are an interesting target for treating inflammatory and infectious pulmonary diseases. One commune targeting strategy is to use nanoparticles conjugated with hyaluronic acid, which interact with CD44 overexpressed on the membrane of those cells. Unfortunately, this coating strategy may be countered by the presence on the surface of the nanoparticles of a poly(ethylene glycol) corona employed to improve nanoparticles' diffusion in the lung mucus. This study aims to measure this phenomenon by comparing the behavior in a murine lung inflammation model of three liposomal platforms designed to represent different poly(ethylene glycol) and hyaluronic acid densities (Liposome-PEG, Liposome-PEG-HA and Liposome-HA). In this work, the liposomes were obtained by a one-step ethanol injection method. Their interaction with mucin and targeting ability toward pro-inflammatory macrophages were then investigated in vitro and in vivo in a LPS model of lung inflammation. In vitro, poly(ethylene glycol) free HA-liposomes display a superior targeting efficiency toward M1 macrophages, while the addition of poly(ethylene glycol) induces better mucus mobility. Interestingly in vivo studies revealed that the three liposomes showed distinct cell specificity with alveolar macrophages demonstrating an avidity for poly(ethylene glycol) free HA-liposomes, while neutrophils favored PEGylated liposomes exempt of HA. Those results could be explained by the presence of two forces exercising a balance between mucus penetration and receptor targeting. This study corroborates the importance of considering the site of action and the targeted cells when designing nanoparticles to treat lung diseases.
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Affiliation(s)
- Kamila Bohne Japiassu
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France; Center for RD&I in Pharmaceutical Nano/Technology (FarmaTec), Federal University of Goias, Goiania, 74605-220, Goias, Brazil
| | - Francois Fay
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Alessandro Marengo
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Younès Louaguenouni
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Catherine Cailleau
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Stéphanie Denis
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - David Chapron
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Nicolas Tsapis
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France
| | - Thais Leite Nascimento
- Center for RD&I in Pharmaceutical Nano/Technology (FarmaTec), Federal University of Goias, Goiania, 74605-220, Goias, Brazil
| | - Eliana Martins Lima
- Center for RD&I in Pharmaceutical Nano/Technology (FarmaTec), Federal University of Goias, Goiania, 74605-220, Goias, Brazil
| | - Elias Fattal
- University Paris-Saclay, CNRS, Institut Galien Paris-Saclay (UMR 8612), Châtenay-Malabry, France.
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Ke WR, Chang RYK, Chan HK. Engineering the right formulation for enhanced drug delivery. Adv Drug Deliv Rev 2022; 191:114561. [PMID: 36191861 DOI: 10.1016/j.addr.2022.114561] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/30/2022] [Accepted: 09/24/2022] [Indexed: 01/24/2023]
Abstract
Dry powder inhalers (DPIs) can be used with a wide range of drugs such as small molecules and biologics and offer several advantages for inhaled therapy. Early DPI products were intended to treat asthma and lung chronic inflammatory disease by administering low-dose, high-potency drugs blended with lactose carrier particles. The use of lactose blends is still the most common approach to aid powder flowability and dose metering in DPI products. However, this conventional approach may not meet the high demand for formulation physical stability, aerosolisation performance, and bioavailability. To overcome these issues, innovative techniques coupled with modification of the traditional methods have been explored to engineer particles for enhanced drug delivery. Different particle engineering techniques have been utilised depending on the types of the active pharmaceutical ingredient (e.g., small molecules, peptides, proteins, cells) and the inhaled dose. This review discusses the challenges of formulating DPI formulations of low-dose and high-dose small molecule drugs, and biologics, followed by recent and emerging particle engineering strategies utilised in developing the right inhalable powder formulations for enhanced drug delivery.
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Affiliation(s)
- Wei-Ren Ke
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Rachel Yoon Kyung Chang
- Advanced Drug Delivery Group, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
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Clathrate Hydrates of Organic Solvents as Auxiliary Intermediates in Pharmaceutical Research and Development: Improving Dissolution Behaviour of a New Anti-Tuberculosis Drug, Perchlozon. Pharmaceutics 2022; 14:pharmaceutics14030495. [PMID: 35335870 PMCID: PMC8954777 DOI: 10.3390/pharmaceutics14030495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023] Open
Abstract
There is an urgent need for new drugs to overcome the challenge of the ever-growing drug resistance towards tuberculosis. A new, highly efficient anti-tuberculosis drug, Perchlozone (thioureidoiminomethylpyridinium perchlorate, Pz), is only available in an oral dosage form, though injectable forms and inhalation solutions could be better alternatives, offering higher bioavailability. To produce such forms, nano- and micro-particles of APIs would need to be prepared as dispersions with carriers. We use this case study to illustrate the principles of selecting solvents and excipients when preparing such formulations. We justify the choice of water–THF (19.1 wt % THF) as solvent and mannitol as carrier to prepare formulations of Pz—a poorly soluble compound—that are suitable for injection or inhalation. The formulations could be prepared by conventional freeze-drying in vials, making the proposed method suitable for industrial scaling. A similar strategy for selecting the organic solvent and the excipient can be applied to other compounds with low water solubility.
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Computational Fluid Dynamics (CFD) Guided Spray Drying Recommendations for Improved Aerosol Performance of a Small-Particle Antibiotic Formulation. Pharm Res 2022; 39:295-316. [PMID: 35147870 PMCID: PMC8958016 DOI: 10.1007/s11095-022-03180-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/24/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE The objective of this study was to implement computational fluid dynamics (CFD) simulations and aerosol characterization experiments to determine best-case spray drying conditions of a tobramycin excipient enhanced growth (Tobi-EEG) formulation for use in a pediatric air-jet dry powder inhaler (DPI). METHODS An iterative approach was implemented in which sets of spray drying conditions were explored using CFD simulations followed by lead candidate selection, powder production and in vitro aerosol testing. CFD simulations of a small-particle spray dryer were performed to capture droplet drying parameters and surface-averaged temperature and relative humidity (RH) conditions in the powder collection region. In vitro aerosol testing was performed for the selected powders using the pediatric air-jet DPI, cascade impaction, and aerosol transport through a pediatric mouth-throat (MT) model to a tracheal filter. RESULTS Based on comparisons of CFD simulations and in vitro powder performance, recommended drying conditions for small-particle powders with electrostatic collection include: (i) reducing the CFD-predicted drying parameters of κavg and κmax to values below 3 μm2/ms and 114 μm2/ms, respectively; (ii) maintaining the Collector Surface RH within an elevated range, which for the Tobi-EEG formulation with l-leucine was 20-30 %RH; and (iii) ensuring that particles reaching the collector were fully dried, based on a mass fraction of solute CFD parameter. CONCLUSIONS Based on the newly recommended spray dryer conditions for small particle aerosols, delivery performance of the lead Tobi-EEG formulation was improved resulting in >60% of the DPI loaded dose passing through the pediatric MT model.
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Plaunt AJ, Nguyen TL, Corboz MR, Malinin VS, Cipolla DC. Strategies to Overcome Biological Barriers Associated with Pulmonary Drug Delivery. Pharmaceutics 2022; 14:pharmaceutics14020302. [PMID: 35214039 PMCID: PMC8880668 DOI: 10.3390/pharmaceutics14020302] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 02/01/2023] Open
Abstract
While the inhalation route has been used for millennia for pharmacologic effect, the biological barriers to treating lung disease created real challenges for the pharmaceutical industry until sophisticated device and formulation technologies emerged over the past fifty years. There are now several inhaled device technologies that enable delivery of therapeutics at high efficiency to the lung and avoid excessive deposition in the oropharyngeal region. Chemistry and formulation technologies have also emerged to prolong retention of drug at the active site by overcoming degradation and clearance mechanisms, or by reducing the rate of systemic absorption. These technologies have also been utilized to improve tolerability or to facilitate uptake within cells when there are intracellular targets. This paper describes the biological barriers and provides recent examples utilizing formulation technologies or drug chemistry modifications to overcome those barriers.
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Advancements in Particle Engineering for Inhalation Delivery of Small Molecules and Biotherapeutics. Pharm Res 2022; 39:3047-3061. [PMID: 36071354 PMCID: PMC9451127 DOI: 10.1007/s11095-022-03363-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/06/2022] [Indexed: 12/27/2022]
Abstract
Dry powder inhalation formulations have become increasingly popular for local and systemic delivery of small molecules and biotherapeutics. Powder formulations provide distinct advantages over liquid formulations such as elimination of cold chain due to room temperature stability, improved portability, and the potential for increasing patient adherence. To become a viable product, it is essential to develop formulations that are stable (physically, chemically and/or biologically) and inhalable over the shelf-life. Physical particulate properties such as particle size, morphology and density, as well as chemical properties can significantly impact aerosol performance of the powder. This review will cover these critical attributes that can be engineered to enhance the dispersibility of inhalation powder formulations. Challenges in particle engineering for biotherapeutics will be assessed, followed by formulation strategies for overcoming the hurdles. Finally, the review will discuss recent examples of successful dry powder biotherapeutic formulations for inhalation delivery that have been clinically assessed.
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Dry powder inhaler formulation of Cu,Zn-superoxide dismutase by spray drying: A proof-of-concept. POWDER TECHNOL 2021. [DOI: 10.1016/j.powtec.2021.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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10
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La Zara D, Sun F, Zhang F, Franek F, Balogh Sivars K, Horndahl J, Bates S, Brännström M, Ewing P, Quayle MJ, Petersson G, Folestad S, van Ommen JR. Controlled Pulmonary Delivery of Carrier-Free Budesonide Dry Powder by Atomic Layer Deposition. ACS NANO 2021; 15:6684-6698. [PMID: 33769805 PMCID: PMC8155342 DOI: 10.1021/acsnano.0c10040] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
Ideal controlled pulmonary drug delivery systems provide sustained release by retarding lung clearance mechanisms and efficient lung deposition to maintain therapeutic concentrations over prolonged time. Here, we use atomic layer deposition (ALD) to simultaneously tailor the release and aerosolization properties of inhaled drug particles without the need for lactose carrier. In particular, we deposit uniform nanoscale oxide ceramic films, such as Al2O3, TiO2, and SiO2, on micronized budesonide particles, a common active pharmaceutical ingredient for the treatment of respiratory diseases. In vitro dissolution and ex vivo isolated perfused rat lung tests demonstrate dramatically slowed release with increasing nanofilm thickness, regardless of the nature of the material. Ex situ transmission electron microscopy at various stages during dissolution unravels mostly intact nanofilms, suggesting that the release mechanism mainly involves the transport of dissolution media through the ALD films. Furthermore, in vitro aerosolization testing by fast screening impactor shows a ∼2-fold increase in fine particle fraction (FPF) for each ALD-coated budesonide formulation after 10 ALD process cycles, also applying very low patient inspiratory pressures. The higher FPFs after the ALD process are attributed to the reduction in the interparticle force arising from the ceramic surfaces, as evidenced by atomic force microscopy measurements. Finally, cell viability, cytokine release, and tissue morphology analyses verify a safe and efficacious use of ALD-coated budesonide particles at the cellular level. Therefore, surface nanoengineering by ALD is highly promising in providing the next generation of inhaled formulations with tailored characteristics of drug release and lung deposition, thereby enhancing controlled pulmonary delivery opportunities.
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Affiliation(s)
- Damiano La Zara
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Feilong Sun
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Fuweng Zhang
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Frans Franek
- Advanced
Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Kinga Balogh Sivars
- Clinical
Testing and Precision Medicine, Global Procurement, Operations, AstraZeneca, Gothenburg, Sweden
| | - Jenny Horndahl
- Bioscience
COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Stephanie Bates
- Functional
and Mechanistic Safety, Clinical Pharmacology
and Safety Sciences, R&D, AstraZeneca, Cambridge U.K.
| | - Marie Brännström
- Drug
Metabolism and Pharmacokinetics, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D,
AstraZeneca, Gothenburg, Sweden
| | - Pär Ewing
- Drug
Metabolism and Pharmacokinetics, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D,
AstraZeneca, Gothenburg, Sweden
| | - Michael J. Quayle
- New Modalities
and Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - Gunilla Petersson
- Innovation
Strategy and External Liaison, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - Staffan Folestad
- Innovation
Strategy and External Liaison, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - J. Ruud van Ommen
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
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Bass K, Farkas D, Hassan A, Bonasera S, Hindle M, Longest PW. High-Efficiency Dry Powder Aerosol Delivery to Children: Review and Application of New Technologies. JOURNAL OF AEROSOL SCIENCE 2021; 153:105692. [PMID: 33716317 PMCID: PMC7945982 DOI: 10.1016/j.jaerosci.2020.105692] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
While dry powder aerosol formulations offer a number of advantages, their use in children is often limited due to poor lung delivery efficiency and difficulties with consistent dry powder inhaler (DPI) usage. Both of these challenges can be attributed to the typical use of adult devices in pediatric subjects and a lack of pediatric-specific DPI development. In contrast, a number of technologies have recently been developed or progressed that can substantially improve the efficiency and reproducibility of DPI use in children including: (i) nose-to-lung administration with small particles, (ii) active positive-pressure devices, (iii) structures to reduce turbulence and jet momentum, and (iv) highly dispersible excipient enhanced growth particle formulations. In this study, these technologies and their recent development are first reviewed in depth. A case study is then considered in which these technologies are simultaneously applied in order to enable the nose-to-lung administration of dry powder aerosol to children with cystic fibrosis (CF). Using a combination of computational fluid dynamics (CFD) analysis and realistic in vitro experiments, device performance, aerosol size increases and lung delivery efficiency are considered for pediatric-CF subjects in the age ranges of 2-3, 5-6 and 9-10 years old. Results indicate that a new 3D rod array structure significantly improves performance of a nasal cannula reducing interface loss by a factor of 1.5-fold and produces a device emitted mass median aerodynamic diameter (MMAD) of 1.67 μm. For all ages considered, approximately 70% of the loaded dose reaches the lower lung beyond the lobar bronchi. Moreover, significant and rapid size increase of the aerosol is observed beyond the larynx and illustrates the potential for targeting lower airway deposition. In conclusion, concurrent CFD and realistic in vitro analysis indicates that a combination of multiple new technologies can be implemented to overcome obstacles that currently limit the use of DPIs in children as young as two years of age.
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Affiliation(s)
- Karl Bass
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
| | - Dale Farkas
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
| | - Amr Hassan
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - Serena Bonasera
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
| | - P. Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA
- Author Contact Information: Dr. Worth Longest, PhD, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA 23284-3015, Phone: (804)-827-7023, Fax: (804)-827-7030,
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Engineering Preclinical Tools and Therapeutics to Understand and Treat COVID-19. Dela J Public Health 2020; 6:32-35. [PMID: 34467105 PMCID: PMC8389820 DOI: 10.32481/djph.2020.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Shetty N, Cipolla D, Park H, Zhou QT. Physical stability of dry powder inhaler formulations. Expert Opin Drug Deliv 2020; 17:77-96. [PMID: 31815554 PMCID: PMC6981243 DOI: 10.1080/17425247.2020.1702643] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/05/2019] [Indexed: 12/29/2022]
Abstract
Introduction: Dry powder inhalers (DPIs) are popular for pulmonary drug delivery. Various techniques have been employed to produce inhalation drug particles and improve the delivery efficiency of DPI formulations. Physical stability of these DPI formulations is critical to ensure the delivery of a reproducible dose to the airways over the shelf-life.Areas covered: This review focuses on the impact of solid-state stability on aerosolization performance of DPI drug particles manufactured by powder production approaches and particle-engineering techniques. It also highlights the different analytical tools that can be used to characterize the physical instability originating from production and storage.Expert opinion: A majority of the DPI literature focuses on the effects of physico-chemical properties such as size, morphology, and density on aerosolization. While little has been reported on the physical stability, particularly the stability of engineered drug particles for use in DPIs. Literature data have shown that different particle-engineering methods and storage conditions may cause physical instability of dry powders for inhalation and can significantly change the aerosol performance. A systematic examination of physical instability mechanisms in DPI formulations is necessary during formulation development in order to select the optimum formulation with satisfactory stability. In addition, the use of appropriate characterization tools is critical to detect and understand physical instability during the development of DPI formulations.
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Affiliation(s)
- Nivedita Shetty
- Department of Industrial and Physical Pharmacy, College of Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
| | - David Cipolla
- Insmed Incorporated, Bridgewater, NJ 08807-3365, USA
| | - Heejun Park
- Department of Industrial and Physical Pharmacy, College of Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
| | - Qi Tony Zhou
- Department of Industrial and Physical Pharmacy, College of Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
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The effect of metal salts on aerosol performance of spray dried carrier-free formulations of levofloxacin. ACTA ACUST UNITED AC 2019; 28:75-85. [PMID: 31808069 DOI: 10.1007/s40199-019-00317-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Metal salts are used in formulation of dry powder inhalers (DPIs) for different purposes. Recently the role of these salts in production of small, dense but highly dispersible particles has emerged. In this study the effect of some such salts on dispersibility and respirability of spray dried levofloxacin formulations was evaluated in normal and reduced inhalation air flow or by increasing powder filling in capsules. METHODS levofloxacin was co-spray dried with different concentrations of common metal chlorides (NaCl, KCl, CaCl2 and MgCl2) either with or without leucine as dispersibility enhancer. Particle size, moisture, morphology, triboelectrification tendency and fine particle fraction (FPF) of resulting powders were evaluated. In addition, the effect of these salts and leucine on dispersibility of resulting powders in reduced air flow rate and increased capsule filling mass were evaluated. RESULTS Presence of higher tested concentrations of divalent cations increased water content, and reduced FPF significantly. Addition of leucine reduced water content and electrostatic charge, increased particle size and FPF and improved spray drying yield significantly. Lower concentrations of salts did not affect FPF of leucine containing powders significantly, but presence of 2.5% NaCl or MgCl2 preserved the dispersibility in higher capsule fillings. A 2.5% concentration of NaCl in such formulations preserved dispersibility in lower air flows. CONCLUSION Higher amounts of divalent salts increases triboelectrification and moisture absorption, and reduces FPF. Lower concentrations of NaCl could not improve FPF of leucine containing formulations significantly, but preserves dispersibility in low air flows and high capsule fillings. Graphical abstract.
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15
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Weers JG, Son YJ, Glusker M, Haynes A, Huang D, Kadrichu N, Le J, Li X, Malcolmson R, Miller DP, Tarara TE, Ung K, Clark A. Idealhalers Versus Realhalers: Is It Possible to Bypass Deposition in the Upper Respiratory Tract? J Aerosol Med Pulm Drug Deliv 2019; 32:55-69. [DOI: 10.1089/jamp.2018.1497] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
| | - Yoen-Ju Son
- Merck Research Laboratories, Merck & Co., Rahway, New Jersey
| | | | | | | | | | - John Le
- iPharma, Ltd., Union City, California
| | - Xue Li
- Bristol-Myers Squibb, Hopewell, New Jersey
| | | | | | | | - Keith Ung
- iPharma, Ltd., Union City, California
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Perry J, Trautman B, Takher-Smith J, Kramer S, Kane K, Silverman M, Tan L, Haughie S, Richter W, Kirkov V, Arsova S, Ward J, Hava DL. Particle size and gastrointestinal absorption influence tiotropium pharmacokinetics: a pilot bioequivalence study of PUR0200 and Spiriva HandiHaler. Br J Clin Pharmacol 2019; 85:580-589. [PMID: 30521129 DOI: 10.1111/bcp.13831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/16/2018] [Accepted: 11/29/2018] [Indexed: 12/23/2022] Open
Abstract
AIMS Plasma pharmacokinetics permit the assessment of efficacy and safety of inhaled drugs, and possibly their bioequivalence to other inhaled products. Correlating drug product attributes to lung deposited dose is important to achieving equivalence. PUR0200 is a spray-dried formulation of tiotropium that enables more efficient lung delivery than Spiriva® HandiHaler® (HH). The ratio of tiotropium lung-to-oral deposition in PUR0200 was varied to investigate the impact of particle size on tiotropium pharmacokinetics, and the contribution of oral absorption to tiotropium exposure was assessed using charcoal block. METHODS A seven-period, single-dose, crossover study was performed in healthy subjects. PUR0200 formulations differing in dose and aerodynamic particle size were administered in five periods and Spiriva HH in two periods. In one period, Spiriva HH gastrointestinal absorption was blocked with oral charcoal. Tiotropium plasma concentrations were assessed over 8 h after inhalation. RESULTS PUR0200 pharmacokinetics were influenced by aerodynamic particle size and the ratio of lung-to-oral deposition, with impactor sized mass (ISM) correlating most strongly with exposure. Formulation PUR0217a (3 μg tiotropium) lung deposition was similar to Spiriva HH (18 μg) with and without charcoal block, but total PUR0200 exposure was lower without charcoal. The Cmax and AUC0-0.5h of Spiriva HH with and without charcoal block were bioequivalent; however, Spiriva HH AUC0-8h was lower when gastrointestinal absorption was inhibited with oral charcoal administration. CONCLUSIONS Pharmacokinetic bioequivalence indicative of lung deposition and efficacy can be achieved by matching the reference product ISM. Due to reduced oral deposition and more efficient lung delivery, PUR0200 results in a lower AUC0-t than Spiriva HH due to reduced absorption of drug from the gastrointestinal tract.
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Affiliation(s)
- Jason Perry
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Brian Trautman
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | | | - Steve Kramer
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Katie Kane
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | | | - Lisa Tan
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
| | - Scott Haughie
- Mylan Global Respiratory Group, Discovery Park, Sandwich, UK
| | - Wolfram Richter
- Cooperative Clinical Drug Research and Development, Hoppegarten, Germany
| | - Valentin Kirkov
- Clinic for Internal Diseases, MHAT Tokuda Hospital, Sofia, Bulgaria
| | - Sacha Arsova
- Cooperative Clinical Drug Research and Development, Hoppegarten, Germany
| | - Jonathan Ward
- Mylan Global Respiratory Group, Discovery Park, Sandwich, UK
| | - David L Hava
- Pulmatrix Inc, 99 Hayden Ave, Suite 390, Lexington, MA, 02421, USA
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Newman SP. Delivering drugs to the lungs: The history of repurposing in the treatment of respiratory diseases. Adv Drug Deliv Rev 2018; 133:5-18. [PMID: 29653129 DOI: 10.1016/j.addr.2018.04.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 04/01/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
The repurposing of drug delivery by the pulmonary route has been applied to treatment and prophylaxis of an increasingly wide range of respiratory diseases. Repurposing has been most successful for the delivery of inhaled bronchodilators and corticosteroids in patients with asthma and chronic obstructive pulmonary disease (COPD). Repurposing utilizes the advantages that the pulmonary route offers in terms of more targeted delivery to the site of action, the use of smaller doses, and a lower incidence of side-effects. Success has been more variable for other drugs and treatment indications. Pulmonary delivery is now well established for delivery of inhaled antibiotics in cystic fibrosis (CF), and in the treatment of pulmonary arterial hypertension (PAH). Other inhaled treatments such as those for idiopathic pulmonary fibrosis (IPF), lung transplant rejection or tuberculosis may also become routine. Repurposing has progressed in parallel with the development of new drugs, inhaler devices and formulations.
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18
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Dosing challenges in respiratory therapies. Int J Pharm 2018; 548:659-671. [PMID: 30033395 DOI: 10.1016/j.ijpharm.2018.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/20/2018] [Accepted: 07/01/2018] [Indexed: 01/16/2023]
Abstract
The pulmonary route of administration has been commonly used for local lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). Recently, with the advent of new technologies available for both formulation and device design, molecules usually delivered at high doses, such as antibiotics and insulin to treat cystic fibrosis (CF) and diabetes, respectively, can now be delivered by inhalation as a dry powder. These molecules are generally delivered in milligrams instead of traditional microgram quantities. High dose delivery is most commonly achieved via dry powder inhalers (DPIs), breath activated devices designed with a formulated powder containing micronized drug with aerodynamic diameters between 1 and 5 µm. The powder formulation may also contain other excipients and/or carrier particles to improve the flowability and aerosol dispersion of the powder. A drawback with high doses is that the formulation contains a great number of fine particles, leading to a greater degree of cohesive forces, producing strongly bound agglomerates. With greater cohesive forces holding fine particles together, higher dispersion forces are needed for efficient de-agglomeration and aerosolisation. This requirement of greater dispersion forces has led to different dry powder formulations and vastly different inhaler designs. The purpose of this review is to evaluate the different formulation types, various DPI devices currently available, and how these affect the aerosolisation process and delivery of high dosed inhalable dry powder formulations to the lungs.
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Effect of pH and leucine concentration on aerosolization properties of carrier-free formulations of levofloxacin. Eur J Pharm Sci 2018; 118:13-23. [DOI: 10.1016/j.ejps.2018.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 11/19/2022]
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Abstract
Pulmonary drug delivery is relatively complex because the respiratory tract has evolved defense mechanisms to keep inhaled drug particles out of the lungs and to remove or inactivate them once deposited. In addition to these mechanical, chemical and immunological barriers, pulmonary drug delivery is adversely affected by the behavioral barriers of poor adherence and poor inhaler technique. Strategies to mitigate the effects of these barriers include use of inhaler devices and formulations that deliver drug to the lungs efficiently, appropriate inhaler technique and improved education of patients. Owing to the advantages offered by the pulmonary route, the challenges that the route poses are worth addressing, and if successfully addressed, the pulmonary route offers huge opportunities, often fulfilling unmet clinical needs.
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21
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Liu T, Han M, Tian F, Cun D, Rantanen J, Yang M. Budesonide nanocrystal-loaded hyaluronic acid microparticles for inhalation: In vitro and in vivo evaluation. Carbohydr Polym 2018; 181:1143-1152. [DOI: 10.1016/j.carbpol.2017.11.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/03/2017] [Accepted: 11/03/2017] [Indexed: 11/28/2022]
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22
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Dhand R. The Rationale and Evidence for Use of Inhaled Antibiotics to Control Pseudomonas aeruginosa Infection in Non-cystic Fibrosis Bronchiectasis. J Aerosol Med Pulm Drug Deliv 2017; 31:121-138. [PMID: 29077527 PMCID: PMC5994662 DOI: 10.1089/jamp.2017.1415] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Non-cystic fibrosis bronchiectasis (NCFBE) is a chronic inflammatory lung disease characterized by irreversible dilation of the bronchi, symptoms of persistent cough and expectoration, and recurrent infective exacerbations. The prevalence of NCFBE is on the increase in the United States and Europe, but no licensed therapies are currently available for its treatment. Although there are many similarities between NCFBE and cystic fibrosis (CF) in terms of respiratory symptoms, airway microbiology, and disease progression, there are key differences, for example, in response to treatment, suggesting differences in pathogenesis. This review discusses possible reasons underlying differences in response to inhaled antibiotics in people with CF and NCFBE. Pseudomonas aeruginosa infections are associated with the most severe forms of bronchiectasis. Suboptimal levels of antibiotics in the lung increase the mutation frequency of P. aeruginosa and lead to the development of mucoid strains characterized by formation of a protective polysaccharide biofilm. Mucoid strains of P. aeruginosa are associated with a chronic infection stage, requiring long-term antibiotic therapy. Inhaled antibiotics provide targeted delivery to the lung with minimal systemic toxicity and adverse events compared with oral/intravenous routes of administration, and they could be alternative treatment options to help address some of the treatment challenges in the management of severe cases of NCFBE. This review provides an overview of completed and ongoing trials that evaluated inhaled antibiotic therapy for NCFBE. Recently, several investigators conducted phase 3 randomized controlled trials with inhaled aztreonam and ciprofloxacin in patients with NCFBE. While the aztreonam trial results were not associated with significant clinical benefit in NCFBE, initial results reported from the inhaled ciprofloxacin (dry powder for inhalation and liposome-encapsulated/dual-release formulations) trials hold promise. A more targeted approach could identify specific populations of NCFBE patients who benefit from inhaled antibiotics.
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Affiliation(s)
- Rajiv Dhand
- Department of Medicine, University of Tennessee Graduate School of Medicine , Knoxville, Tennessee
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23
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Ogienko AG, Bogdanova EG, Trofimov NA, Myz SA, Ogienko AA, Kolesov BA, Yunoshev AS, Zubikov NV, Manakov AY, Boldyrev VV, Boldyreva EV. Large porous particles for respiratory drug delivery. Glycine-based formulations. Eur J Pharm Sci 2017; 110:148-156. [PMID: 28479348 DOI: 10.1016/j.ejps.2017.05.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/17/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
Abstract
Large porous particles are becoming increasingly popular as carriers for pulmonary drug delivery with both local and systemic applications. These particles have high geometric diameters (5-30μm) but low bulk density (~0.1g/cm3 or less) such that the aerodynamic diameter remains low (1-5μm). In this study salbutamol and budesonide serve as model inhalable drugs with poor water solubility. A novel method is proposed for the production of dry powder inhaler formulations with enhanced aerosol performance (e.g. for salbutamol-glycine formulation the fine particle fraction (FPF≤4.7μm) value is 67.0±1.3%) from substances that are poorly soluble in water. To overcome the problems related to extremely poor aqueous solubility of the APIs, not individual solvents are used for spray freeze-drying of API solutions, but organic-water mixtures, which can form clathrate hydrates at low temperatures and release APIs or their complexes as fine powders, which form large porous particles after the clathrates are removed by sublimation. Zwitterionic glycine has been used as an additive to API directly in solutions prior to spray freeze-drying, in order to prevent aggregation of powders, to enhance their dispersibility and improve air-flow properties. The clathrate-forming spray freeze-drying process in the multi-component system was optimized using low-temperature powder X-ray diffraction and thermal analysis.
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Affiliation(s)
- A G Ogienko
- Nikolaev Institute of Inorganic Chemistry SB RAS, Novosibirsk, Russia; Novosibirsk State University, Novosibirsk, Russia.
| | | | | | - S A Myz
- Institute of Solid State Chemistry and Mechanochemistry SB RAS, Novosibirsk, Russia
| | - A A Ogienko
- Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - B A Kolesov
- Nikolaev Institute of Inorganic Chemistry SB RAS, Novosibirsk, Russia; Novosibirsk State University, Novosibirsk, Russia
| | - A S Yunoshev
- Novosibirsk State University, Novosibirsk, Russia; Lavrentiev Institute of Hydrodynamics SB RAS, Novosibirsk, Russia
| | | | - A Yu Manakov
- Nikolaev Institute of Inorganic Chemistry SB RAS, Novosibirsk, Russia; Novosibirsk State University, Novosibirsk, Russia
| | - V V Boldyrev
- Novosibirsk State University, Novosibirsk, Russia; Institute of Solid State Chemistry and Mechanochemistry SB RAS, Novosibirsk, Russia
| | - E V Boldyreva
- Novosibirsk State University, Novosibirsk, Russia; Institute of Solid State Chemistry and Mechanochemistry SB RAS, Novosibirsk, Russia.
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Moore JE, Mastoridis P. Clinical implications of Pseudomonas aeruginosa location in the lungs of patients with cystic fibrosis. J Clin Pharm Ther 2017; 42:259-267. [PMID: 28374433 DOI: 10.1111/jcpt.12521] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/05/2017] [Indexed: 12/18/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Pseudomonas aeruginosa is the leading cause of lung infection in patients with cystic fibrosis (CF) and is associated with significant morbidity and mortality. Antibiotics are regarded as the foundational pharmacological treatment for the suppressive management of chronic P. aeruginosa infections and to eradicate the first infection by P. aeruginosa. Inhalation remains a preferred route for drug administration, providing direct access to the site of infection while minimizing systemic side effects. Effective suppressive management of P. aeruginosa infections, however, requires an understanding of the location of the bacteria in the lungs and consideration of the factors that could limit access of the inhaled antibiotic to the infected area. This review provides a systematic assessment of the scientific literature to gain insight into the location of P. aeruginosa in the lungs of patients with CF and its clinical implications. The characteristics of antibiotic inhalation systems are also discussed in this context. METHODS We reviewed evidence-based literature from both human and animal studies in which P. aeruginosa lung location was reported. Relevant publications were identified through a screening strategy and summarized by reported P. aeruginosa location. RESULTS AND DISCUSSION Most areas of the conductive and respiratory zones of the lungs are susceptible to P. aeruginosa colonization. Deposition of an inhaled antibiotic is dependent on the device and formulation characteristics, as well as the ability of the patient to generate sufficient inhaled volume. As patients with CF often experience a decline in lung function, the challenge is to ensure that the inhaled antibiotic can be delivered throughout the bronchial tree. WHAT IS NEW AND CONCLUSION An effective drug delivery system that can target P. aeruginosa in both the respiratory and conductive zones is required. The chosen inhalation device should also offer a drug formulation that can be quickly and effectively delivered to specific lung locations, with minimal inspiratory effort from the patient.
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Affiliation(s)
- J E Moore
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, UK
| | - P Mastoridis
- Respiratory Department, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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25
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Morales JO, Fathe KR, Brunaugh A, Ferrati S, Li S, Montenegro-Nicolini M, Mousavikhamene Z, McConville JT, Prausnitz MR, Smyth HDC. Challenges and Future Prospects for the Delivery of Biologics: Oral Mucosal, Pulmonary, and Transdermal Routes. AAPS JOURNAL 2017; 19:652-668. [DOI: 10.1208/s12248-017-0054-z] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/01/2017] [Indexed: 12/25/2022]
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Haynes A, Geller D, Weers J, Ament B, Pavkov R, Malcolmson R, Debonnett L, Mastoridis P, Yadao A, Heuerding S. Inhalation of tobramycin using simulated cystic fibrosis patient profiles. Pediatr Pulmonol 2016; 51:1159-1167. [PMID: 27133552 DOI: 10.1002/ppul.23451] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 04/14/2016] [Accepted: 04/18/2016] [Indexed: 11/11/2022]
Abstract
INTRODUCTION TOBI® Podhaler™ is a capsule-based drug-device combination (tobramycin inhalation powder [TIP] 28 mg capsules via unit-dose dry powder T-326 Inhaler [Podhaler™]) developed for treatment of Pseudomonas aeruginosa infection in cystic fibrosis (CF). We explored how inspiratory flow profiles and mouth-throat geometries affect drug delivery with the T-326 Inhaler. METHODS Inspiratory flow profiles were recorded from 38 subjects aged 6-71 who had CF and varying degrees of lung function impairment. Ten of the inspiratory flow profiles were simulated in the laboratory using a custom breath simulator to determine delivered dose (DD) from the T-326 Inhaler. In vitro total lung dose (TLDin vitro ) was measured using four anatomical throat models, ranging from a child to a large adult. RESULTS Aerosol performance was assessed across a range of inspiratory flow profiles. Mean DD ranged from 88.8% to 97.0% of declared capsule content. TLDin vitro ranged from 54.8% to 72.4% of capsule content between the flow profile/throat options tested, and the mean TLDin vitro across the range of flow profiles and anatomical throats tested was 63 ± 5%. CONCLUSIONS Our findings indicate that the T-326 Inhaler provides reliable drug delivery at flow rates likely to be achieved by a broad spectrum of patients with CF. Importantly, forceful inhalation was not required to achieve a robust TLDin vitro . Pediatr Pulmonol. 2016;51:1159-1167. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Alfred Haynes
- Novartis Pharmaceuticals Corporation, San Carlos, California
| | - David Geller
- Florida State University College of Medicine, Orlando, Florida
| | - Jeffry Weers
- Novartis Pharmaceuticals Corporation, San Carlos, California.
| | - Brian Ament
- Novartis Pharmaceuticals Corporation, San Carlos, California
| | - Richard Pavkov
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | | | | | - Paul Mastoridis
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Anthony Yadao
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
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The Impact of Inspiratory Flow Rate on Drug Delivery to the Lungs with Dry Powder Inhalers. Pharm Res 2016; 34:507-528. [PMID: 27738953 DOI: 10.1007/s11095-016-2050-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/05/2016] [Indexed: 12/29/2022]
Abstract
Current marketed dry powder inhalers utilize the energy from patient inspiration to fluidize and disperse bulk powder agglomerates into respirable particles. Variations in patient inspiratory flow profiles can lead to marked differences in total lung dose (TLD), and ultimately patient outcomes for an inhaled therapeutic. The present review aims to quantitate the flow rate dependence in TLD observed for a number of drug/device combinations using a new metric termed the Q index. With this data in hand, the review explores key attributes in the design of the formulation and device that impact flow rate dependence. The review also proposes alternative in vitro methods to assess flow rate dependence that more closely align with in vivo observations. Finally, the impact of variations in flow rate on lung function for inhaled bronchodilators is summarized.
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28
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Dekhuijzen PNR, Lavorini F, Usmani OS. Patients' perspectives and preferences in the choice of inhalers: the case for Respimat(®) or HandiHaler(®). Patient Prefer Adherence 2016; 10:1561-72. [PMID: 27574405 PMCID: PMC4993394 DOI: 10.2147/ppa.s82857] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Poor inhaler technique hampers the efficacy of drug therapy in asthma and chronic obstructive pulmonary disease. Not only does this affect individual patient care, but it also impacts on the wider health care economics associated with these conditions. Treatment guidelines recommend a systematic approach to drug class selection; however, standardization of inhaler selection is currently difficult owing to the complexity of the interaction between the inhaler device and the patient. Specifically, individual patient preference can influence how successful a treatment is overall. This article reviews inhaler devices from the patient perspective, with a particular focus on the dry powder inhaler HandiHaler(®) and Respimat(®) Soft Mist™ Inhaler. It discusses factors that influence device preference and treatment compliance and reviews tools that can aid health care professionals to better match inhaler devices to individual patients' needs.
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Affiliation(s)
| | - Federico Lavorini
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Omar S Usmani
- National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, UK
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29
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Cipolla D. Will pulmonary drug delivery for systemic application ever fulfill its rich promise? Expert Opin Drug Deliv 2016; 13:1337-40. [DOI: 10.1080/17425247.2016.1218466] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Beck-Broichsitter M, Samsonova O, Nguyen J, Schmehl T, Seeger W, Kissel T. Influence of amine-modified poly(vinyl alcohol)s on vibrating-membrane nebulizer performance and lung toxicity. Eur J Pharm Sci 2016; 86:34-40. [PMID: 26946442 DOI: 10.1016/j.ejps.2016.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/05/2016] [Accepted: 02/29/2016] [Indexed: 01/05/2023]
Abstract
A suitable aerosol droplet size and formulation output rate is essential for the therapy of lung diseases under application of nebulizers. The current study investigated the potential of amine-modified poly(vinyl alcohol)s as excipients for inhalation delivery. A change of conductivity (effective at <0.1mg/ml) and viscosity (effective at >0.1mg/ml) of samples that were supplemented with charge-modified polymers had a significant influence on the generated droplet size (shift from ~8 to ~4 μm) and formulation throughput rate (shift from ~0.2 to ~1.0 g/min), where polymers with a higher amine density (and molecular weight) showed an elevated activity. Biocompatibility assessment of polymers in A549 cells and an isolated lung model resulted in cell lysis and lung edema formation dependent on the type (degree of amine substitution) and dose of polymer applied. Suitable compositions and concentrations of amine-modified poly(vinyl alcohol)s were identified with respect to an optimized nebulizer performance and acceptable biocompatibility. Charge-modified polymers represent novel excipients with potential to improve inhalation therapy.
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Affiliation(s)
- Moritz Beck-Broichsitter
- Medical Clinic II, Department of Internal Medicine, Justus-Liebig-Universität, Giessen, Germany; Department of Pharmaceutics and Biopharmacy, Philipps-Universität, Marburg, Germany.
| | - Olga Samsonova
- Department of Pharmaceutics and Biopharmacy, Philipps-Universität, Marburg, Germany
| | - Juliane Nguyen
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, USA
| | - Thomas Schmehl
- Medical Clinic II, Department of Internal Medicine, Justus-Liebig-Universität, Giessen, Germany
| | - Werner Seeger
- Medical Clinic II, Department of Internal Medicine, Justus-Liebig-Universität, Giessen, Germany
| | - Thomas Kissel
- Department of Pharmaceutics and Biopharmacy, Philipps-Universität, Marburg, Germany
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Potential of the isolated lung technique for the examination of sildenafil absorption from lung-delivered poly(lactide- co -glycolide) microparticles. J Control Release 2016; 226:15-20. [DOI: 10.1016/j.jconrel.2016.01.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/29/2016] [Accepted: 01/31/2016] [Indexed: 12/11/2022]
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32
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High shear mixing of lactose and salmeterol xinafoate dry powder blends: Biopharmaceutic and aerodynamic performances. J Drug Deliv Sci Technol 2015. [DOI: 10.1016/j.jddst.2015.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hertel SP, Winter G, Friess W. Protein stability in pulmonary drug delivery via nebulization. Adv Drug Deliv Rev 2015; 93:79-94. [PMID: 25312674 DOI: 10.1016/j.addr.2014.10.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 08/22/2014] [Accepted: 10/01/2014] [Indexed: 10/24/2022]
Abstract
Protein inhalation is a delivery route which offers high potential for direct local lung application of proteins. Liquid formulations are usually available in early stages of biopharmaceutical development and nebulizers are the device of choice for atomization avoiding additional process steps like drying and enabling fast progression to clinical trials. While some proteins were proven to remain stable throughout aerosolization e.g. DNase, many biopharmaceuticals are more susceptible towards the stresses encountered during nebulization. The main reason for protein instability is unfolding and aggregation at the air-liquid interface, a problem which is of particular challenge in the case of ultrasound and jet nebulizers due to recirculation of much of the generated droplets. Surfactants are an important formulation component to protect the sensitive biomolecules. A second important challenge is warming of ultrasound and vibrating mesh devices, which can be overcome by overfilling, precooled solutions or cooling of the reservoir. Ultimately, formulation development has to go hand in hand with device evaluation.
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Weers JG, Miller DP. Formulation Design of Dry Powders for Inhalation. J Pharm Sci 2015; 104:3259-88. [DOI: 10.1002/jps.24574] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/09/2022]
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Sugianto TD, Chan HK. Inhaled antibiotics in the treatment of non-cystic fibrosis bronchiectasis: clinical and drug delivery perspectives. Expert Opin Drug Deliv 2015; 13:7-22. [DOI: 10.1517/17425247.2015.1078309] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Lin S, Racz J, Tai MF, Brooks KM, Rzeczycki P, Heath LJ, Newstead MW, Standiford TJ, Rosania GR, Stringer KA. A Role for Low Density Lipoprotein Receptor-Related Protein 1 in the Cellular Uptake of Tissue Plasminogen Activator in the Lungs. Pharm Res 2015; 33:72-82. [PMID: 26231141 DOI: 10.1007/s11095-015-1763-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/21/2015] [Indexed: 01/10/2023]
Abstract
PURPOSE To gain knowledge of lung clearance mechanisms of inhaled tissue plasminogen activator (tPA). METHODS Using an in vivo mouse model and ex vivo murine whole organ cell suspensions, we examined the capability of the lungs to utilize LRP1 receptor-mediated endocytosis (RME) for the uptake of exogenous tPA with and without an LRP1 inhibitor, receptor associated protein (RAP), and quantitatively compared it to the liver. We also used a novel imaging technique to assess the amount LRP1 in sections of mouse liver and lung. RESULTS Following intratracheal administration, tPA concentrations in the bronchoalveolar lavage fluid (BALF) declined over time following two-compartment pharmacokinetics suggestive of a RME clearance mechanism. Ex vivo studies showed that lung and liver cells are similarly capable of tPA uptake via LRP1 RME which was reduced by ~50% by RAP. The comparable lung and liver uptake of tPA is likely due to equivalent amounts of LRP1 of which there was an abundance in the alveolar epithelium. CONCLUSIONS Our findings indicate that LRP1 RME is a candidate clearance mechanism for inhaled tPA which has implications for the development of safe and effective dosing regimens of inhaled tPA for the treatment of plastic bronchitis and other fibrin-inflammatory airway diseases in which inhaled tPA may have utility.
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Affiliation(s)
- Swan Lin
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer Racz
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa F Tai
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristina M Brooks
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Phillip Rzeczycki
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren J Heath
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael W Newstead
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Theodore J Standiford
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gus R Rosania
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Kathleen A Stringer
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
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Kuehl PJ, Boyden T, Dobry DE, Doyle-Eisele M, Friesen DT, McDonald JD, Murri BG, Vodak DT, Lyon DK. Inhaled PYY(3-36) dry-powder formulation for appetite suppression. Drug Dev Ind Pharm 2015; 42:150-156. [PMID: 26006332 DOI: 10.3109/03639045.2015.1036067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Peptide YY3-36 [PYY(3-36)] has shown efficacy in appetite suppression when dosed by injection modalities (intraperitoneal (IP)/subcutaneous). Transitioning to needle-free delivery, towards inhalation, often utilizes systemic pharmacokinetics as a key endpoint to compare different delivery methods and doses. Systemic pharmacokinetics were evaluated for PYY3-36 when delivered by IP, subcutaneous, and inhalation, the systemic pharmacokinetics were then used to select doses in an appetite suppression pharmacodynamic study. METHODS Dry-powder formulations were manufactured by spray drying and delivered to mice via nose only inhalation. The systemic plasma, lung tissue, and bronchoalveolar lavage fluid pharmacokinetics of different inhalation doses of PYY(3-36) were compared to IP and subcutaneous efficacious doses. Based on these pharmacokinetic data, inhalation doses of 70:30 PYY(3-36):Dextran T10 were evaluated in a mouse model of appetite suppression and compared to IP and subcutaneous data. RESULTS Inhalation pharmacokinetic studies showed that plasma exposure was similar for a 2 × higher inhalation dose when compared to subcutaneous and IP delivery. Inhalation doses of 0.22 and 0.65 mg/kg were for efficacy studies. The results showed a dose-dependent (not dose proportional) decrease in food consumption over 4 h, which is similar to IP and subcutaneous delivery routes. CONCLUSIONS The pharmacokinetic and pharmacodynamics results substantiate the ability of pharmacokinetic data to inform pharmacodynamics dose selection for inhalation delivery of the peptide PYY(3-36). Additionally, engineered PYY(3-36):Dextran T10 particles delivered to the respiratory tract show promise as a non-invasive therapeutic for appetite suppression.
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Affiliation(s)
- Philip J Kuehl
- a Lovelace Respiratory Research Institute , Albuquerque , NM , USA
| | | | | | | | | | - Jacob D McDonald
- a Lovelace Respiratory Research Institute , Albuquerque , NM , USA
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38
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Generation of tailored aerosols for inhalative drug delivery employing recent vibrating-mesh nebulizer systems. Ther Deliv 2015; 6:621-36. [DOI: 10.4155/tde.15.18] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Direct drug delivery to the lungs is considered the gold standard for the treatment of a variety of respiratory diseases, owing to the increased therapeutic selectivity of the inhalative approach. Airborne formulations with defined size characteristics are required to improve the deposition pattern within the airways. In this respect, different nebulizer systems have been conceived, which has enabled the generation of respirable medicament mists. Here, vibrating-mesh technology revealed significant potential to overcome the main shortcomings associated with ‘traditional’ devices. Tailored orifice dimensions and defined formulation characteristics are of special interest for the generation of suitable aerosol droplets for inhalative purposes. Ongoing developments in device and formulation design will optimize the clinical outcome of inhalative drug delivery under application of vibrating-mesh technology.
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39
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Weers J. Reply to the comment by de Boer and Hoppentocht on: inhaled antimicrobial therapy - barriers to effective treatment, by J. Weers, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013. Adv Drug Deliv Rev 2015; 85:e3-5. [PMID: 25913567 DOI: 10.1016/j.addr.2015.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jeffry Weers
- Novartis Pharmaceuticals Corporation, 150 Industrial Road, San Carlos, CA, USA.
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40
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Inhaled antimicrobial therapy – Barriers to effective treatment. Adv Drug Deliv Rev 2015; 85:24-43. [DOI: 10.1016/j.addr.2014.08.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/20/2014] [Accepted: 08/25/2014] [Indexed: 02/08/2023]
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41
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Zhou QT, Leung SSY, Tang P, Parumasivam T, Loh ZH, Chan HK. Inhaled formulations and pulmonary drug delivery systems for respiratory infections. Adv Drug Deliv Rev 2015; 85:83-99. [PMID: 25451137 DOI: 10.1016/j.addr.2014.10.022] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/15/2014] [Accepted: 10/18/2014] [Indexed: 11/16/2022]
Abstract
Respiratory infections represent a major global health problem. They are often treated by parenteral administrations of antimicrobials. Unfortunately, systemic therapies of high-dose antimicrobials can lead to severe adverse effects and this calls for a need to develop inhaled formulations that enable targeted drug delivery to the airways with minimal systemic drug exposure. Recent technological advances facilitate the development of inhaled anti-microbial therapies. The newer mesh nebulisers have achieved minimal drug residue, higher aerosolisation efficiencies and rapid administration compared to traditional jet nebulisers. Novel particle engineering and intelligent device design also make dry powder inhalers appealing for the delivery of high-dose antibiotics. In view of the fact that no new antibiotic entities against multi-drug resistant bacteria have come close to commercialisation, advanced formulation strategies are in high demand for combating respiratory 'super bugs'.
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Affiliation(s)
- Qi Tony Zhou
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sharon Shui Yee Leung
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Patricia Tang
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Thaigarajan Parumasivam
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
| | - Zhi Hui Loh
- GEA-NUS Pharmaceutical Processing Research Laboratory, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia.
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42
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El-Sherbiny IM, El-Baz NM, Yacoub MH. Inhaled nano- and microparticles for drug delivery. Glob Cardiol Sci Pract 2015; 2015:2. [PMID: 26779496 PMCID: PMC4386009 DOI: 10.5339/gcsp.2015.2] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/28/2015] [Indexed: 12/23/2022] Open
Abstract
The 21st century has seen a paradigm shift to inhaled therapy, for both systemic and local drug delivery, due to the lung's favourable properties of a large surface area and high permeability. Pulmonary drug delivery possesses many advantages, including non-invasive route of administration, low metabolic activity, control environment for systemic absorption and avoids first bypass metabolism. However, because the lung is one of the major ports of entry, it has multiple clearance mechanisms, which prevent foreign particles from entering the body. Although these clearance mechanisms maintain the sterility of the lung, clearance mechanisms can also act as barriers to the therapeutic effectiveness of inhaled drugs. This effectiveness is also influenced by the deposition site and delivered dose. Particulate-based drug delivery systems have emerged as an innovative and promising alternative to conventional inhaled drugs to circumvent pulmonary clearance mechanisms and provide enhanced therapeutic efficiency and controlled drug release. The principle of multiple pulmonary clearance mechanisms is reviewed, including mucociliary, alveolar macrophages, absorptive, and metabolic degradation. This review also discusses the current approaches and formulations developed to achieve optimal pulmonary drug delivery systems.
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Affiliation(s)
- Ibrahim M El-Sherbiny
- Zewail City of Science and Technology, Center for Materials Science, 6 October City, 12588 Giza, Egypt
| | - Nancy M El-Baz
- Zewail City of Science and Technology, Center for Materials Science, 6 October City, 12588 Giza, Egypt
| | - Magdi H Yacoub
- Harefield Heart Science Centre, National Heart and Lung Institute, Imperial College, London, UK
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Patel B, Gupta N, Ahsan F. Particle engineering to enhance or lessen particle uptake by alveolar macrophages and to influence the therapeutic outcome. Eur J Pharm Biopharm 2015; 89:163-74. [DOI: 10.1016/j.ejpb.2014.12.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 11/26/2014] [Accepted: 12/02/2014] [Indexed: 12/23/2022]
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44
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Meenach SA, Anderson KW, Hilt JZ, McGarry RC, Mansour HM. High-performing dry powder inhalers of paclitaxel DPPC/DPPG lung surfactant-mimic multifunctional particles in lung cancer: physicochemical characterization, in vitro aerosol dispersion, and cellular studies. AAPS PharmSciTech 2014; 15:1574-87. [PMID: 25139763 PMCID: PMC4245438 DOI: 10.1208/s12249-014-0182-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/23/2014] [Indexed: 11/30/2022] Open
Abstract
Inhalable lung surfactant-based carriers composed of synthetic phospholipids, dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylglycerol (DPPG), along with paclitaxel (PTX), were designed and optimized as respirable dry powders using organic solution co-spray-drying particle engineering design. These materials can be used to deliver and treat a wide variety of pulmonary diseases with this current work focusing on lung cancer. In particular, this is the first time dry powder lung surfactant-based particles have been developed and characterized for this purpose. Comprehensive physicochemical characterization was carried out to analyze the particle morphology, surface structure, solid-state transitions, amorphous character, residual water content, and phospholipid bilayer structure. The particle chemical composition was confirmed using attenuated total reflectance-Fourier-transform infrared (ATR-FTIR) spectroscopy. PTX loading was high, as quantified using UV-VIS spectroscopy, and sustained PTX release was measured over weeks. In vitro cellular characterization on lung cancer cells demonstrated the enhanced chemotherapeutic cytotoxic activity of paclitaxel from co-spray-dried DPPC/DPPG (co-SD DPPC/DPPG) lung surfactant-based carrier particles and the cytotoxicity of the particles via pulmonary cell viability analysis, fluorescent microscopy imaging, and transepithelial electrical resistance (TEER) testing at air-interface conditions. In vitro aerosol performance using a Next Generation Impactor™ (NGI™) showed measurable powder deposition on all stages of the NGI and was relatively high on the lower stages (nanometer aerodynamic size). Aerosol dispersion analysis of these high-performing DPIs showed mass median diameters (MMADs) that ranged from 1.9 to 2.3 μm with excellent aerosol dispersion performance as exemplified by high values of emitted dose, fine particle fractions, and respirable fractions.
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MESH Headings
- 1,2-Dipalmitoylphosphatidylcholine/chemistry
- Administration, Inhalation
- Aerosols
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/chemistry
- Calorimetry, Differential Scanning
- Cell Line, Tumor
- Cell Survival/drug effects
- Chemistry, Pharmaceutical
- Crystallography, X-Ray
- Delayed-Action Preparations
- Dose-Response Relationship, Drug
- Drug Carriers
- Dry Powder Inhalers
- Electric Impedance
- Equipment Design
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Microscopy, Fluorescence
- Paclitaxel/administration & dosage
- Paclitaxel/chemistry
- Particle Size
- Phosphatidylglycerols/chemistry
- Powder Diffraction
- Powders
- Solubility
- Spectrophotometry, Ultraviolet
- Spectroscopy, Fourier Transform Infrared
- Surface Properties
- Technology, Pharmaceutical/methods
- Time Factors
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Affiliation(s)
- Samantha A. Meenach
- />Drug Development Division, Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536 USA
- />Department of Chemical and Materials Engineering, College of Engineering, University of Kentucky, Lexington, Kentucky 40506 USA
| | - Kimberly W. Anderson
- />Department of Chemical and Materials Engineering, College of Engineering, University of Kentucky, Lexington, Kentucky 40506 USA
- />Center of Membrane Sciences, University of Kentucky, Lexington, Kentucky USA
| | - J. Zach Hilt
- />Department of Chemical and Materials Engineering, College of Engineering, University of Kentucky, Lexington, Kentucky 40506 USA
- />Center of Membrane Sciences, University of Kentucky, Lexington, Kentucky USA
| | - Ronald C. McGarry
- />Department of Radiation Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky 40536 USA
| | - Heidi M. Mansour
- />Skaggs Pharmaceutical Sciences Center, College of Pharmacy, The University of Arizona, 1703 E. Mabel St, Tucson, Arizona 85721 USA
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45
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Du J, El-Sherbiny IM, Smyth HD. Swellable ciprofloxacin-loaded nano-in-micro hydrogel particles for local lung drug delivery. AAPS PharmSciTech 2014; 15:1535-44. [PMID: 25079240 DOI: 10.1208/s12249-014-0176-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 06/27/2014] [Indexed: 12/24/2022] Open
Abstract
Incorporation of drug-loaded nanoparticles into swellable and respirable microparticles is a promising strategy to avoid rapid clearance from the lung and achieve sustained drug release. In this investigation, a copolymer of polyethylene glycol grafted onto phthaloyl chitosan (PEG-g-PHCs) was synthesized and then self-assembled with ciprofloxacin to form drug-loaded nanoparticles. The nanoparticles and free drug were encapsulated into respirable and swellable alginate micro hydrogel particles and assessed as a novel system for sustained pulmonary drug delivery. Particle size, morphology, dynamic swelling profile, and in vitro drug release were investigated. Results showed that drug-loaded nanoparticles with size of 218 nm were entrapped into 3.9-μm micro hydrogel particles. The dry nano-in-micro hydrogel particles exhibited a rapid initial swelling within 2 min and showed sustained drug release. Preliminary in vivo pharmacokinetic studies were performed with formulations delivered to rats by intratracheal insufflation. Ciprofloxacin concentrations in plasma and in lung tissue and lavage were measured up to 7 h. The swellable particles showed lower ciprofloxacin levels in plasma than the controlled group (a mixture of lactose with micronized ciprofloxacin), while swellable particles achieved higher concentrations in lung tissue and lavage, indicating the swellable particles could be used for controlling drug release and prolonging lung drug concentrations.
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46
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Pulmonary drug delivery by powder aerosols. J Control Release 2014; 193:228-40. [DOI: 10.1016/j.jconrel.2014.04.055] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/27/2014] [Accepted: 04/29/2014] [Indexed: 12/24/2022]
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47
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Cipolla D, Shekunov B, Blanchard J, Hickey A. Lipid-based carriers for pulmonary products: preclinical development and case studies in humans. Adv Drug Deliv Rev 2014; 75:53-80. [PMID: 24819218 DOI: 10.1016/j.addr.2014.05.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 04/16/2014] [Accepted: 05/01/2014] [Indexed: 12/31/2022]
Abstract
A number of lipid-based technologies have been applied to pharmaceuticals to modify their drug release characteristics, and additionally, to improve the drug loading for poorly soluble drugs. These technologies, including solid-state lipid microparticles, many of which are porous in nature, liposomes, solid lipid nanoparticles and nanostructured lipid carriers, are increasingly being developed for inhalation applications. This article provides a review of the rationale for the use of these technologies in the pulmonary delivery of drugs, and summarizes the manufacturing processes and their limitations, the in vitro and in vivo performance of these systems, the safety of these lipid-based systems in the lung, and their promise for commercialization.
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Affiliation(s)
- David Cipolla
- Aradigm Corporation, 3929 Point Eden Way, Hayward, CA 94545, USA.
| | - Boris Shekunov
- Shire Corporation, 725 Chesterbrook Blvd, Wayne, PA 19087, USA
| | - Jim Blanchard
- Aradigm Corporation, 3929 Point Eden Way, Hayward, CA 94545, USA
| | - Anthony Hickey
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
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48
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Chan JGY, Wong J, Zhou QT, Leung SSY, Chan HK. Advances in device and formulation technologies for pulmonary drug delivery. AAPS PharmSciTech 2014; 15:882-97. [PMID: 24728868 DOI: 10.1208/s12249-014-0114-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/13/2014] [Indexed: 12/31/2022] Open
Abstract
Inhaled pharmaceuticals are formulated and delivered differently according to the therapeutic indication. However, specific device-formulation coupling is often fickle, and new medications or indications also demand new strategies. The discontinuation of chlorofluorocarbon propellants has seen replacement of older metered dose inhalers with dry powder inhaler formulations. High-dose dry powder inhalers are increasingly seen as an alternative dosage form for nebulised medications. In other cases, new medications have completely bypassed conventional inhalers and been formulated for use with unique inhalers such as the Staccato® device. Among these different devices, integration of software and electronic assistance has become a shared trend. This review covers recent device and formulation advances that are forming the current landscape of inhaled therapeutics.
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49
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d'Angelo I, Conte C, La Rotonda MI, Miro A, Quaglia F, Ungaro F. Improving the efficacy of inhaled drugs in cystic fibrosis: challenges and emerging drug delivery strategies. Adv Drug Deliv Rev 2014; 75:92-111. [PMID: 24842473 DOI: 10.1016/j.addr.2014.05.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/23/2014] [Accepted: 05/09/2014] [Indexed: 02/06/2023]
Abstract
Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians associated with early death. Although the faulty gene is expressed in epithelia throughout the body, lung disease is still responsible for most of the morbidity and mortality of CF patients. As a local delivery route, pulmonary administration represents an ideal way to treat respiratory infections, excessive inflammation and other manifestations typical of CF lung disease. Nonetheless, important determinants of the clinical outcomes of inhaled drugs are the concentration/permanence at the lungs as well as the ability of the drug to overcome local extracellular and cellular barriers. This review focuses on emerging delivery strategies used for local treatment of CF pulmonary disease. After a brief description of the disease and formulation rules dictated by CF lung barriers, it describes current and future trends in inhaled drugs for CF. The most promising advanced formulations are discussed, highlighting the advantages along with the major challenges for researchers working in this field.
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Affiliation(s)
- Ivana d'Angelo
- Di.S.T.A.B.i.F., Second University of Napoli, Via Vivaldi 43, 81100 Caserta, Italy
| | - Claudia Conte
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Maria Immacolata La Rotonda
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Agnese Miro
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Fabiana Quaglia
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy
| | - Francesca Ungaro
- Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
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50
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Titosky JTF, Morin CMD, Suderman JD, Olfert JS, Finlay WH, Vehring R. The effect of altitude on inhaler performance. J Pharm Sci 2014; 103:2116-2124. [PMID: 24890630 DOI: 10.1002/jps.24032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 05/01/2014] [Accepted: 05/09/2014] [Indexed: 11/05/2022]
Abstract
The purpose of the study is to understand the effect of altitude on the performance of selected pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs). A testing apparatus that created consistent breath profiles through the Alberta Idealized Throat was designed to test five pMDIs and two DPIs at altitudes of 670, 2450, 3260, and 4300 m. Both gravimetric and chemical assays were conducted to determine the in vitro lung dose. Additionally, spray duration and shot weight for pMDIs and device resistance for DPI were measured. There was no significant change in in vitro lung dose for any of the pMDIs tested. Shot weight and spray duration were unaffected. The device resistance of the DPIs decreased with increasing altitude and was successfully modeled as a function of ambient pressure. The in vitro lung dose of both DPIs showed no significant change when operated with an inhaler pressure drop of 4 kPa, but for the Bricanyl(®) Turbuhaler(®), a significant decrease occurred when matching the volumetric inspiratory flow rate to that of the baseline altitude.
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Affiliation(s)
- Jordan T F Titosky
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada
| | - Chelsea M D Morin
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada
| | - Jonathan D Suderman
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada
| | - Jason S Olfert
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada
| | - Reinhard Vehring
- Department of Mechanical Engineering, University of Alberta, Edmonton, AlbertaT6G 2T8, Canada.
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