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92 J. Aparicio-Blan co and A. I. Torres-Suárez
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Fig. 5.1 Distinct formulation approaches exploited so far with LNCs: (a) Oily core LNCs. (b) Reverse micelle-loaded LNCs. (c) LNC-based hydrogels. (d) LNCs as a cargo
Commonly, LNCs prepared by the phase inversion temperature method have a particle size of between 20 and 100 nm with a very low polydispersity index (<0.1), which eventually enables the sterilization of the formulations by ltration.
In summary, LNCs are core-shell structures composed of an oily liquid triglyc­eride core surrounded by a surfactant rigid membrane (Heurtault et al. 2002, 2003). As a result, LNCs are usually used to encapsulate lipophilic substances in their oily core, with the oily core acting as a drug reservoir. However, alternative formulation strategies have also been developed to produce LNCs with an aqueous core that can encapsulate hydrophilic substances. Additionally, LNCs have been used to formu­late LNC-derived hydrogels to improve their extended-release properties and have nally been used as a cargo for inclusion in other dosage forms (such as gels, microparticles or microneedles). Altogether, these formulation strategies make LNCs a versatile platform for drug delivery (Fig. 5.1). All these four distinct formulation approaches and their main explored applications are described in detail in the following sections.
5.2 Latest Advances and Applications in Oily Core LNCs
As mentioned, LNCs are primarily well suited for the encapsulation of hydrophobic drugs within their oily core with high encapsulation efciencies reported in nearly all cases (Table 5.1).
For example, various hydrophobic cytotoxic drugs have been encapsulated within the oily core of LNCs to be tested in preclinical cancer models following distinct routes of administration (i.e. intravenous, intracarotid or convection enhanced
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Table 5.1 Latest advances and applications in oily – core LNCs in animal models
Formulation description Route of administration Animal model Ref. Combination regimen of
SN38-loaded LNCs (1 mg/ kg) and regorafenib-loaded LNCs (10 mg/kg)
Combination regimen of SN38-loaded LNCs (1 mg/ kg) and salinomycin-loaded LNCs (2 mg/kg)
Triamcinolone-acetonide­loaded LNCs
Cannabidiol-decorated LNCs
Retinoic acid-loaded NFL-targeted LNCs
Prostaglandin D2-TAT-targeted-loaded LNCs
Tetrathiatriarylmethyl radical-loaded LNCs
Blank LNCs Intravenous and stereo-
Intravenous administra­tion (3 weekly cycles of two doses of each drug on alternate days)
Intravenous administra­tion (3 weekly cycles of two doses of each drug on alternate days)
Subconjunctival administration
Intravenous Healthy ICR mice Aparicio-
Intraventricular injection Lysolecithin-induced rat
Nasal Lipopolysaccharide-
Intratumoural Subcutaneous FSaII
tactic injection, respectively
Subcutaneous CT26 mouse colon tumour model in Balb/C mice
Subcutaneous HCT116 colorectal human xeno­graft model in nude mice
Endotoxin-induced uve­itis rabbit model
model of white matter focal demyelination
induced neuroinammation mouse model Experi­mental autoimmune encephalomyelitis mouse model
tumours in mice Subcutaneous FSaII
brosarcoma and intra­cerebral C6 glioblastoma models in mice
Tsakiris et al. (
2019)
Tsakiris et al. (2020)
Formica et al. (2020)
Blanco et al.
2019c)
( Carradori
et al. (2020)
Mwema et al.
2023)
(
Nel et al.
2019a)
( Nel et al.
(
2019b)
delivery) as already reviewed elsewhere (Aparicio-Blanco and Torres-Suarez 2015). More recently, combination therapies with drug-loaded LNCs have also been tested in murine models of colorectal cancer following intravenous admi nistration (Tsakiris et al. 2019, 2020). Notably, these studies were enabled because the encapsulation of SN38 (i.e. the active form of irinotecan) or salinomycin within LNCs signicantly reduced their intrinsic drug-induced haemolysis.
First, the antitumour efcacy of the combination regimen of SN38-loaded LNCs at a dose of 1 mg of SN38 per kg of body weight and regorafenib-loaded LNCs at a dose of 10 mg of regorafenib per kg of body weight has been tested in a subcuta­neous tumour model initiated by CT26 mouse colon cancer cell s in Balb/C mice following intravenous administration (Tsakiris et al. 2019). The mice were treated with 3 weekly cycles of two doses of SN38 on days 1 and 3 and/or two doses of regorafenib on days 2 and 4. In this model, the combination regimen signicantly slowed tumour growth and signicantly extended the median survival time
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(32.6 days) in comparison with all other groups (including the monotherapy SN38­loaded LNCs or regorafenib-loaded LNC groups). Altogether, and although the efcacy of the free drugs in combination was not evaluated in this study, these results seemed to indicate that this combination therapy may help overcome the resistance to specic cytotoxic drugs. These results were explained both by the distinct mechanism of action of both drugs (i.e. SN-38 is a topoisomerase I i while regora serve as an adjuvant therapy since it also inhibits key enzymes (UGT1A1 and UGT1A9) that are respon sible for the metabolism of SN-38 to its inactive glucuroconjugate form, thereby ultimately increasing SN-38 concentration over time.
To gain further insight, an alternative combination regimen that rationally targets both quiescent (i.e. dormant cancer stem cells) and proliferating cells was subse­quently tested (Tsakiris et al. 2020). For this purpose, SN38-loaded LNCs, which mainly act on proliferating cancer cells, were combined with salinomycin-loaded LNCs given the activity of the latter against cancer stem cells. The antitumour efcacy of the combination regimen of SN38-loaded LNCs at a dose of 1 mg of SN38 per kg of body weight and salinomycin-loaded LNCs at a dose of 2 mg of salinomycin per kg of body weight has been tested in a subcutaneous HCT116 colorectal human xenograft model in nude mice following intravenous administra­tion. The administration scheme was analogous to that of the previous study. The combination of SN38-loaded LNCs and salinomycin-loaded LNC signicantly delayed tumour growth and increased the median survival time (49.6 days) in mice, even in comparison with the combination of free drugs, which was ev aluated in this case. Nonetheless, the evaluation of the efcacy of combination therapies encapsulated within a single LNC formulation is still pending. The co-encapsulation would represent an added value to overcome potential differences in biodistribution of each drug when loaded and administered separately.
Alternatively, anti-inammatory drugs have also been encapsulated within the oily core of LNCs to be tested in preclinical models of uveitis following subconjunctival administration (Formica et al. of LNCs loaded with triamcinolone acetonide has been tested in an endotoxin­induced uveitis rabbit model. Importantly, a single dose of the triamcinolone-loaded LNCs signicantly alleviated the clinical signs of the inammatory response (i.e. slight conjunctival redness and iris vessel congestion and a signicant attenu­ation of the fogginess of the aqueous humour) 24 h after administration in compar­ison with both the untreated rabbits and the rabbits treated with an equipotent marketed triamcinolone acetonide suspension following also subconjunctival administration. This demonstrated the formulations therapeutic efcacy in this ocular inammatory in vivo model. These improved results were attributed both to the high solubilization of the triamcinolone acetonide, which could result in a more available dose than in the case of the drug administered as suspension and to the small size of the LNCs, which could enhance drug access to the target site. Co-loading of two distinct drugs in LNCs has also been described for combination therapy in ocular pathologies that entail both inammation and neovascularization.
fenib is a multikinase inhibitor) and by the fact that regorafenib could
). In fact, the therapeutic efcacy
2020
nhibitor
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The therapeutic antibody bevacizumab was added to the LNC surface using click chemistry and the corticosteroid triamcinolone acetonide in the oily core (Formica et al. 2021). However, the evaluation of the in vivo efcacy of this formulation has not yet been explored.
Last, LNCs have also been applied to enhance drug delivery to the central nervous system (Moura et al. 2020). Diseases affecting the central nervous system remain one of the greatest unmet medical needs because the blood-brain barrier (BBB) prevents efcient drug delivery to the central nervous system (Aparicio­Blanco et al. administration, active targeting strategies have been applied to LNCs with the purpose of boosting the transcellular delivery across the BBB. In this regard, the adsorption of the non-psychotropic cannabinoid, cannabidiol, on the LNC surface enhanced by 2.5-fold the passage of LNCs across the BBB in vivo in healthy mice following intravenous administration (Aparicio-Blanco et al. port extent across the BBB conditions the efcacy of treatments for brain diseases, cannabinoid-decorated LNCs seem a promising platform for the development of novel therapies for these diseases. However, in vivo efcacy testing of this strategy for brain drug delivery has not been reported.
Another active targeting strategy intended to boost drug delivery to certain areas of the central nervous system has been applied, but in this case, following a stereotactic injection (i.e. an invasive local administration). In this regard, the adsorption of the peptide NFL-TBS.40-63 on the LNC surface system was able to target neural stem cells from the subventricular zone following stereotactic admin­istration in the lateral ventricle of rats (Carradori et al. targeting strategy has been tested in a lysolecithin-induced rat model of white matter focal demyelination to induce neural stem cell differentiation upon loading of retinoic acid within LNCs (Carradori et al. NFL-targeted LNCs were injected into the lateral ventricle directly below the lesion site. Five days after a single injection of this formulation, mature oligodendrocyte repopulation was enhanced in comparison with vehicle-treated rats, stimulating oligodendrogenesis nearly to the prelesion levels. However, similar therapeuti c effects were observed for both targeted and untargeted LNCs, which raised some doubt on the benecial effect of NFL grafting. Altogether, these data support the use of LNCs for stimulation of endogenous differentiation of neural stem cells to restore neurological function in distinct neurodegenerative diseases, but less invasive routes of administration must be investigated to boost their trans lational potential.
Alternatively, the nasal administration route has also been explored with LNCs for non-invasive nose-to-brain drug delivery (Formica et al. route of administration enables direct brain drug delivery because, unlike with systemic administration routes, the BBB is avoided. Delivery along both the trigem­inal and olfactory nerves have been proposed to account for the direct transport from the nasal cavity to the brain. Through this route, the efcacy of prostaglandin D2-glycerol ester-loaded LNCs has been tested in distinct in vivo neuroinammation models (Mwema et al.
2016). To enhance brain distribution following systemic intravenous
2019c). As the trans-
2016). Subsequently, this
2020). For that, retinoic acid-loaded
2022). The intranasal
2023).
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First, the impact of intranasal administration of prostaglandin D2-loaded LNCs was tested after a single nasal administration at a dose of 0.4 mg of prostaglandin D2-glycerol ester per kg of body weight on a lipopolysaccharide-induced neuroinammation mouse model. This single administration reduced the expression of proinammatory cytokines like monocyte chemoattractant protein-1 (MCP-1) in several regions of the brain (olfactory bulb, prefrontal cortex, brainstem) in compar­ison with their unloaded LNCs counterparts and to a similar extent to the free drug.
Then, the impact of prostaglandin D2-loaded LNCs, functionalized in this case with the cell penetrating peptide transactivator of transcription (TAT) to increase accumulation in the central nervous system, was tested on an experiment al autoim­mune encephalomyelitis (EAE) mouse model to evaluate the effect of these LNCs on a chronic form of neuroinammation. Treatments were administered intranasally at a dose of 0.4 mg of prostaglandin D2-glycerol ester per kg of body weight once every 2 days. Treatments started in all cases 10 days after immunization once the symp­toms of the disease had appeared. Although neither the mice clinical score or the extent of demyelination were signicantly reduced with the treatment, intranasal administration of TAT-targeted prostaglandin D2-loaded LNCs signicantly reduced the expression of the most common inammatory markers associated to the pathology (MIP-1α and MIP-1β mRNA) and increased the expression of a cytokine known to inuence recovery and promote myelin repair (IL-33) in the lumbar spinal cord. Nonetheless, these effects were also observed for the blank TAT-targeted LNCs. This latter nding deserves further research on the potential therapeutic action on neuroinammation of the carrier itself together with other therapeutic regimens in order to nd the most efcient dose and administration scheme in this experimental setting.
Apart from therapeutic purposes, LNCs have also been designed to serve as diagnostic tools (Nel et al.
2019a, b). For example, the assessment of hypoxia is a
key feature in oncolo gy that often preludes more aggressive tumours and resistance to chemotherapy. Therefore, several techniques have been used to assess the hypoxic tumour environment. In this context, LNCs loaded with hydrophobic paramagnetic spin probes have been used to measure tissue oxygenation through electron para­magnetic resonance oxim etry (Nel et al.
2019a). The encapsulation of lipophilic
oxygen sensors in LNCs is of particular interest because it can enhance the sensi­tivity of spin probes to oxygen given the high solubility of oxygen in lipids. The performance of tetrathiatriarylmethyl radical-loaded LNCs as oxygen sensors was evaluated in subcutaneous FSaII tumours in mice following intratumoural adminis­tration. The encapsulation of the probes within LNCs signicantly extended their half-life, which ultimately enabled the sensitivity of LNCs loaded with the spin probe to be assessed during 20-min carbogen respiratory challenges (i.e. exposure to a mixture of carbon dioxide and oxygen gas, 95% O
, 5% CO2). Overall, LNCs
2
responded well to changes in the oxygen environment in terms of increased electron paramagnetic resonance line width. Analogously, LNCs have been used to measure tissue oxygenation through magnetic resonance imaging in two murine tumour models (i.e. subcutaneous FSaII brosarcoma and intracerebral C6 glioblastoma models) (Nel et al.
2019b). These models were chosen to represent two types of
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severely hypoxic tumours together with two distinct administration routes of LNCs: intravenous and stereotactic injection, respectively. LNCs were able to probe the oxygen level of both tumoural tissues after a carbogen challenge with a signicant global longitudinal relaxation time (R1) increase (3% and 6% mean change for the subcutaneous and intracranial tumour, respectively). In both cases, LNCs increased the lipid content of tumours to enable the mapping of ox signal-to-noise ratio. theranostic platforms (Aparicio-Blanco and Torres-Suarez
Finally, LNCs have also been exploited for the co-encapsulation of a pair of uorescent carbocyanine dyes, which enabled the biodistribution of the intact LNCs following intravenous administration in rats to be directly tracked using quantitative Förster resonance energy transfer (FRET) (Kaeokhamloed et al. 2022). FRET relies on the interaction between the co-encapsulated dyes to monitor intact LNCs because the FRET signal can only be detected while both dyes remain together inside the intact LNCs. As shown by population pharmacokinetics modelling, this approach resulted in the observation that the elimination of intact LNCs is non-linear and dependent on particle size, with reduced maximum elimination rate for bigger LNCs (Lebreton et al. 2022).
Altogether, these results illustrate the potential of LNCs also as
ygen with an improved
2018).
5.3 Latest Advances and Applications in Reverse
Micelle-Loaded LNCs
The use of LNCs is no longer restricted to the encapsu lation of lipophilic drugs since the phase inversion method has been repurposed to obtain LNCs with an aqueous core so that the encapsulation of hydrophilic drugs is eventually enabled (Tsakiris
2019; Vrignaud et al. 2012; Groo et al. 2018). This alternative formulation
et al. procedure is based on the initial development of reverse micelles within which the hydrophilic drug is encapsulated. Reverse micelles are micellar entities in which the non-polar and polar phases are inverted so that the head groups of a low HLB amphiphilic surfactant point towards the encased volume containing the polar phase wherein water-soluble mol ecules can be solubilized. Then, reverse micelle-loaded LNCs are prepared by adding a reverse micelle nonaqueous dispersion during the cooling step of the phase inversion method before the nal water quench, so that the reverse micelles with their hydrophilic cargo are encapsulated within the oily core of the LNCs.
Even if the formulation of reverse micelle-loaded LNCs has been applied to encapsulate various hydrophilic drugs, only reverse micelle-loaded LNCs encapsu­lating the incretin-mimetic peptide exenatide have been tested in preclinical models of disease to evaluate their suitability for oral peptide delivery, namely, one of the greatest unmet challenges in the pharmaceutical technology (Table 5.2).
Xu et al. utilized a Span 80 (as low HLB surfactant):Labrafac WL 1349 (as nonpolar dispersion phase) mixture (1:5 w/w) to form the reverse micelles
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Table 5.2 Latest advances and applications in reverse micelle-loaded LNCs in animal models
Route of
Formulation description Exenatide-reverse micelle-loaded LNCs
(500 μg/kg single dose or daily administra­tion in chronic treatment)
Exenatide-loaded reverse micelle PEGylated LNCs (500 μg/kg single dose or once every 2 days administration in chronic treatment)
administration Oral High-fat diet-induced
Oral High-fat diet-induced
Animal model Ref.
type 2 diabetes mouse model
type 2 diabetes mouse model
Xu et al. (2020a)
Xu et al. (2020b)
upon addition of an aqueous exenatide solution for subsequent encapsulation within 200-nm-sized LNCs following the modied phase inversion formulation strategy previously described (Xu et al. 2020a). The drug delivery system was designed to synergize the intrinsic stimulating effect on endogenous glucagon-like peptide 1 (GLP1) secretion of 200-nm-sized LNCs themselves (Xu et al.
2018) with the
GLP-1 analogue exenatide.
The resulting exenatide-reverse micelle-loaded LNCs were tested in a murine high-fat diet-induced type 2 diabetes model follow ing oral administration (Xu et al.
2020a). The study was conducted following both acute and chronic treatment.
In the acute treatment, a single oral dose of 500 μg/kg exenatide encapsulated within reverse micelle-loaded LNCs administered 1 h before conducting an oral glucose tolerance test displayed equivalent glycaemia in diabetic mice to that observed in norm oglycemic control mice upon oral glucose challenge. These results were reproducible in 3-, 8- and 10-week high-fat diet-fed mice, that is, regardless of the chronicity of the disease. Moreover, total GLP-1 levels were signicantly increased with both empty and exenat ide-reverse micelle-loaded LNCs (conrming the ability of the nanocarrier per se to stimulate GLP-1 release under pathological conditions), although only the exenatide-reverse micelle-loaded LNCs signicantly reduced the insulin resistanc e index in comparison with the untreated group. Addi­tionally, a pharmacokinetic study in diabetic mice conrmed the increased relative bioavailability of exenatide (4.32%) when orally administered within reverse micelle LNCs compared with exenatide in solution. Altogether, these data demonstrated the efcacy of reverse micelle LNCs in ameliorating glycaemia by simultaneously increasing endogenous GLP-1 levels and exenatide bioavailability.
In the chronic treatment, a daily oral dose of 500 μg/kg exenatide encapsulated within reverse micelle LNCs was compared with a daily administration of a marketed subcutaneous exenatide solution at a dose of 10 μg/kg for 5 weeks. Notably, after the 5 weeks of treatment, only the exenatide-reverse micelle-loaded LNCs were able to display equivalent glycaemia in diabetic mice to that observed in normoglycemic control mice. Furthermore, mice treated orally with the exenatide­reverse micelle-loaded LNCs exhibited insulin plasma levels and insulin resistance values comparable to those of both the normoglycemic control mice and the mice treated subcutaneously with the marketed exenatide solution.
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Altogether, the oral treatment with exenatide-reverse micelle-loaded LNCs allowed not only normalized glycaemia and insulin levels to be achieved following either acute or chronic treatment, but also comparable effects to those observed for marketed products given subcutaneously to be obtained, with the added benetof administration via the oral route, more suitable for chronic treatments. As a result, the reverse micelle LNC formulation strategy seems to be promising to enable oral incretin-mimetic delivery for diabetes treatment.
Subsequently, exenatide-reverse micelle-loaded LNCs have been further modi­ed to strengthen their GLP-1 secretory effect and prolong their antidiabetic effect to boost their clinical translation in oral type 2 diabetes treatment. The previous exenatide-reverse micelle-loaded LNCs were surface modied with polyethylene glycol (PEG) (Xu et al.
2020b). A post-insertion PEGylation method which involved
incubating reverse micelle LNCs with 1,2-distearoyl-sn-glycero-3­phosphoethanolamine (DSPE)-PEG
was used to ensure that the PEG chains
2000
were located on the LNC surface.
Analogously, the resulting exenatide-reverse micelle-loaded PEGylated LNCs were tested orally in a murine high-fat diet-induced type 2 diabet es model following both acute and chronic treatment.
In the acute treatment, a single oral dose of 500 μg/kg exenatide encapsulated within PEGylated reverse micelle LNCs administered 1 h before conducting an oral glucose tolerance test signicantly decreased glycaemia throughout the glucose tolerance test in comparison with untreated diabetic mice. Besides, exenatide-reverse micelle-loaded PEGylated LNCs signicantly increased the active GLP-1 levels and reduced the insulin resistance index in comparison with untreated diabetic mice. Moreover, a pharmacokinetic study in chronic diabetic mice indicated that PEGylation extended by 3.5-fold the half-life and doubled the systemic absorption of the encapsulated peptide in comparison with exenatide-reverse micelle­loaded LNCs.
Notably, as a proof of the prolonged effect of the exenatide administered in the PEGylated LNCs, in the chronic treatment over 1 month, PEGylation enabled the oral administration frequency of exenatide-reverse micelle-loaded LNCs (at a dose of 500 μg/kg of exenatide) to be reduced from once daily to once every 2 days. Indeed, the exenatide-reverse micelle-loaded PEGylated LNCs following either daily administration or administered every other day displayed equivalent glycaemia and insulin resistance in diabetic mice to that observed in normoglycemic control mice. Interestingly, when administered daily, the unloaded PEGylated reverse micelle-loaded LNCs were also able to reach basal glucose levels and signicantly reduce insulin resistance, demonstrating that the increase in GLP-1 secretion achieved with PEGylation was a sufcient stimulus for lowering glucose levels.
Altogether, these ndings on reverse micelle LNCs bring hope for oral peptide delivery strategies for the treatment of many other diseases (Xu et al.
2021).
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5.4 Latest Advances and Applications in LNC-Based
Hydrogels
Alternatively, to enhance their prolonged release properties, LNCs have been for­mulated as injectable hydrogels suitable for both subcutaneous and local adminis­tration (Table polar phase immobilized within the spaces available of a three-dimensional network that ultimately provides a platform suitable for extended drug release. Nanoparticle­loaded hydrogels can combine consequently the advantages of both nanomedicines and hydrogels.
Whereas the design of nanoparticle-loaded hydrogels conventionally consists of the dispersion of nanoparticles in the polymeric network that forms the hydrogel (Wu et al. 2023; Li et al. 2022; Yu et al. 2020), LNC-based hydrogels are the LNCs themselves that form the characteristic three-dimensional network of the hydrogel (Moysan et al. amphiphilic molecule to the LNC mixture, which drives sol-gel transition in an aqueous solvent through self-assembly via H-bond cross linking. Indeed, the hydro­philic part of these amphiphilic molecules spontaneously localizes at the oil–water interphase of the LNC during the formulation process and interacts with each other through H-bonds.
To formulate the LNC-based hydrogel, two distinct amphiphilic molecules have been used; namely, lauroyl-gemcitabine (GemC12), composed of a lauroyl chain covalently bound via an amide function to gemcitabine (Bastiancich et al. palmitoyl-cytidine (CytC16), composed of a palmitic chain covalently bound via an amide function to cytidine (Pitorre et al. molecules was performed using a longer aliphatic chain than that of gemcitabine to maintain a similar hydrophilic–lipophilic balance given the higher hydrophilic character of cytidine than that of gemcitabine due to an additional hydroxyl function on the cytidine cycle. In both cases, the non-polar alkyl chain is inserted in the LNC structure while the nucleo side, polar in nature, is orien ted towards the aqueous phase forming H-bond cross linkings and immobilizing the water phase to form a gel.
5.3). Hydrogels are semi-solid drug delivery systems that consist of a
2014). Indeed, physical gelation of LNCs occurs upon addition of an
2016a)or
2021). The synthesis of modi ed cytidine
Table 5.3 Latest advances and applications in LNC-based hydrogels in animal models
Formulation description
GemC12­LNC-based hydrogel
GemC12­LNC-based hydrogel
GemC12­LNC-based hydrogel
Route of administration Animal model Ref.
Subcutaneous Orthotopic Ma44-3 patient-like xenograft
Intratumoral (by stereotactic injec­tion)/Perisurgical
Perisurgical
of mediastinal metastases in a non-small­cell lung tumor model in nude mice
Orthotopic U-87 MG human xenograft model in nude mice Orthotopic subtotal U-87 MG human xenograft resection model in nude mice
Orthotopic subtotal 9L gliosarcoma resection model in Fisher rats
Wauthoz et al. (2015)
Bastiancich et al. (2017)
Bastiancich et al. (
2018)
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Overall, the viscoelastic properties of the CytC16-LNC-based hydrogels were enhanced in comparison with those of GemC12-LNC-based hydrogels for a given concentration of amphiphilic molecule, which might be due to the additional hydroxyl function of the cytidine moieties at the surface of the LNCs (Pitorre et al.
2021). Regardless of the amphiphilic molecule used to induce gelation, LNCs in
suspension are recovered upon gel dilution in water, showing the physical character of the gel association.
An advantage of these hydrogels for biomedical applications is that their subcu­taneous or local injection is enabled, unlike other imp lantable devices that require surgical procedures for implantation. Indeed, the LNC-based hydrogels retained the gel property following extrusion through thin (18 and 21 G (Moysan et al. down to 26 or 30 G (Bastiancich et al. 2016a; Pitorre et al. 2021)) needles with either no loss of viscoelastic properties (in the case of GemC12-LNC hydrogels) or with only a slight loss of the viscoelastic properties after extrusion (in the case of CytC12­LNC hydrogels). The viscoelastic properties were also maintained upon storage in syringes at 4 °C over 6 months. Nevertheless, despite its stable viscoelastic proper­ties, one limitation of the CytC12-LNC hydroge l is the loss of stability during storage in terms of LNC size (Pitorre et al. 2021). This increase in size and polydispersity index, which was not observed in the case of the GemC12-LNC hydrogel, would affect the distribution of the LNCs following disruption of the LNC-based hydrogel structure.
Another advantage of this system is that the degradation of the gel corresponds to the release of the LNC, as no other polymers have been added to the formulation, reducing the risk of side effects and simplifying the formulation procedure. The release proles of LNCs from the hydrogels correlated with their viscoelastic properties, that is, slower release proles correlated with higher viscoelasticity (Pitorre et al. 2021). Once LNC release is completed, no gel matrix remains at the injection site.
Altogether, LNC-based hydrogels hold promise as injectable implants for phar­maceutical applications. Whereas the antimetabolite nature of gemcitabine allows the GemC12-LNC-based hydrogels to be used for anticancer applications (Bastiancich et al. CytC16-LNC-based hydrogels open new therapeutic avenues for diseases other than cancer that require subcutaneous or local injection for extended drug release.
Even though CytC16-LNC-based hydrogels showed good biocompatibility over 1 month following subcutaneous administration, with a local in ammatory response similar to that induced by an approved excipient for parenteral injection (Pitorre et al.
2021), only GemC12-LNC-based hydrogels have been tested in preclinical models
of disease.
Gem-C12-LNC-based hydroge ls were rst tested in mice bearing orthotopic patient-like mediastinal metastases of non-small-cell lung tumour xenografts (Ma44-3) following subcutaneous administration (Wauthoz et al. ment (at a Gem-C12 dose of 40 mg/kg of body weight) resulted in an equivalent survival increase in mice to that following intravenous administration of GemC12­loaded LNCs in suspension with a lower administration frequency (twice a week
2016b, 2021), due to the endogenous character of cytidine,
2015). This treat-
2014)