Nanoparticle based inner ear therapy

Local Delivery of Therapeutics to the Cochlea Using Nanoparticles and Other Biomaterials

Hearing loss negatively impacts the well-being of millions of people worldwide. Systemic delivery of ototherapeutics has limited efficacy due to severe systemic side effects and the presence of the blood–labyrinth barrier that selectively limits or enables transfer of molecules between plasma and inner ear tissues and fluids. Local drug delivery into the middle and inner ear would be preferable for many newly emerging classes of drugs. Although the cochlea is a challenging target for drug delivery, recent technologies could provide a safe and efficacious delivery of ototherapeutics. Local drug delivery routes include topical delivery via the external auditory meatus, retroauricular, transtympanic, and intracochlear delivery. Many new drug delivery systems specifically for the inner ear are under development or undergoing clinical studies. Future studies into these systems may provide a means for extended delivery of drugs to preserve or restore hearing in patients with hearing disorders. This review outlines the anatomy of the (inner) ear, describes the various local delivery systems and routes, and various quantification methodologies to determine the pharmacokinetics of the drugs in the inner ear.

Computational methodology for drug delivery to the inner ear using magnetic nanoparticle aggregates

BACKGROUND AND OBJECTIVE

The main goal of the proposed study is to improve the efficiency of the ear treatment via targeted drug delivery to the inner ear, i.e. the cochlea. Although pharmacotherapy has been proposed as a solution to prevent damage or restore functionality to hair cells, the main challenge in such treatments is ensuring adequate drug delivery to the cells. To this end, we present a methodology for the evaluation of the magnetic forces needed to move magnetic particle nanorobots (abbreviated as MNP) and their aggregates through the cochlea round window membrane (RWM).

METHODS

The FEM - Lagrangian-Eulerian approach (Abaqus software) was used to determine the specific parameters of movement of the nanoparticles crossing the RWM. This method results in a high consistency of FEM simulations and in-vivo experimental results in regards to the required magnetic force during the movement of spherical nanoparticles with a given viscosity η_ave. Based on the analysis of the experimental studies found in subject literature, the sizes of the MNPs and their aggregates able to cross RWM with and without the application of magnetic force F_M have been determined.

RESULTS

The present work accounts for both the experimental and theoretical aspects of these investigations. Presented research confirms the definite usability of the Lagrange-Euler method for the precise determination of the required magnetic force value FM to control the accelerated motion of MNP aggregates of complex shapes through RWM. It is possible to determine the predominant parameters with a precision of less than 5% for single-layer aggregates and spatial aggregates crossing the RWM. It can be concluded that the MNPs and their aggregates should not be larger than 500-750 nm to cross the RWM with high velocities of penetration close to 800 nm/s for magnetic forces of hundreds 10^-14 Newtons.

CONCLUSIONS

The proposed Lagrangian-Eulerian approach is capable of accurately predicting the movement parameters of MNP aggregates of irregular shape that are close to the experimental test cases. The presented method can serve as a supplementary tool for the design of drug delivery systems to the inner ear using MNPs.

Inner Ear Drug Delivery for Sensorineural Hearing Loss: Current Challenges and Opportunities

Most therapies for treating sensorineural hearing loss are challenged by the delivery across multiple tissue barriers to the hard-to-access anatomical location of the inner ear. In this review, we will provide a recent update on various pharmacotherapy, gene therapy, and cell therapy approaches used in clinical and preclinical studies for the treatment of sensorineural hearing loss and approaches taken to overcome the drug delivery barriers in the ear. Small-molecule drugs for pharmacotherapy can be delivered via systemic or local delivery, where the blood-labyrinth barrier hinders the former and tissue barriers including the tympanic membrane, the round window membrane, and/or the oval window hinder the latter. Meanwhile, gene and cell therapies often require targeted delivery to the cochlea, which is currently achieved via intra-cochlear or intra-labyrinthine injection. To improve the stability of the biomacromolecules during treatment, e.g., RNAs, DNAs, proteins, additional packing vehicles are often required. To address the diverse range of biological barriers involved in inner ear drug delivery, each class of therapy and the intended therapeutic cargoes will be discussed in this review, in the context of delivery routes commonly used, delivery vehicles if required (e.g., viral and non-viral nanocarriers), and other strategies to improve drug permeation and sustained release (e.g., hydrogel, nanocarriers, permeation enhancers, and microfluidic systems). Overall, this review aims to capture the important advancements and key steps in the development of inner ear therapies and delivery strategies over the past two decades for the treatment and prophylaxis of sensorineural hearing loss.

Nanoparticles for the Treatment of Inner Ear Infections

The inner ear is sensitive to various infections of viral, bacterial, or fungal origin, which, if left untreated, may lead to hearing loss or progress through the temporal bone and cause intracranial infectious complications. Due to its isolated location, the inner ear is difficult to treat, imposing an acute need for improving current therapeutic approaches. A solution for enhancing antimicrobial treatment performance is the use of nanoparticles. Different inorganic, lipidic, and polymeric-based such particles have been designed, tested, and proven successful in the controlled delivery of medication, improving drug internalization by the targeted cells while reducing the systemic side effects. This paper makes a general presentation of common inner ear infections and therapeutics administration routes, further focusing on newly developed nanoparticle-mediated treatments.

Local Delivery of Therapeutics to the Inner Ear: The State of the Science

Background: Advances in the understanding of the genetic and molecular etiologies of inner ear disorders have enabled the identification of therapeutic targets and innovative delivery approaches to the inner ear. As this field grows, the need for knowledge about effective delivery of therapeutics to the inner ear has become a priority. This review maps all clinical and pre-clinical research published in English in the field to date, to guide both researchers and clinicians about local drug delivery methods in the context of novel therapeutics. Methods: A systematic search was conducted using customized strategies in Cochrane, pubmed and EMBASE databases from inception to 30/09/2018. Two researchers undertook study selection and data extraction independently. Results: Our search returned 12,200 articles, of which 837 articles met the inclusion criteria. 679 were original research and 158 were reviews. There has been a steady increase in the numbers of publications related to inner ear therapeutics delivery over the last three decades, with a sharp rise over the last 2 years. The intra-tympanic route accounts for over 70% of published articles. Less than one third of published research directly assesses delivery efficacy, with most papers using clinical efficacy as a surrogate marker. Conclusion: Research into local therapeutic delivery to the inner ear has undergone a recent surge, improving our understanding of how novel therapeutics can be delivered. Direct assessment of delivery efficacy is challenging, especially in humans, and progress in this area is key to understanding how to make decisions about delivery of novel hearing therapeutics.