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- •PEGylated Nanocarriers in Medicine and Pharmacy
- •Preface
- •Contents
- •Editors and Contributors
- •About the Editors
- •Contributors
- •1.1.3.1 Passive Targeting Agent
- •1.1.3.2 Solubility Enhancers
- •1. PEGylated Pharmaceutical Nanocarriers
- •1.1 PEGylation
- •1.1.1 PEG Characteristics
- •1.2 PEGylation Determination
- •1.2.2.1 Thermal Gravimetric Analysis (TGA)
- •1.2.2.2 Nuclear Magnetic Resonance (NMR)
- •1.2.2.4 X-Ray Photoelectron Spectroscopy
- •1.3.1 Nanoparticulate System
- •1.3.1.1 Solid Lipid Nanoparticles
- •1.3.1.2 Nanostructured Lipid Carriers (NLCs)
- •1.3.1.3 Polymeric Nanoparticles
- •1.3.2 Metal Nanoparticles
- •1.3.2.1 Silver Nanoparticles
- •1.3.2.2 Gold Nanoparticles
- •1.3.2.3 Titanium Dioxide Nanoparticles
- •1.3.2.4 Copper Nanoparticles
- •1.3.3 Vesicular Systems
- •1.3.3.1 Liposomes
- •1.3.3.2 Niosomes
- •1.3.3.3 Ethosomes
- •1.4.1 Cancer
- •1.4.2 Gene Delivery
- •1.4.3 Diagnostics Imaging
- •1.4.4 Vaccines
- •1.4.5 Rheumatoid Arthritis
- •1.4.6 Hemophilia
- •1.4.7 Pain Therapy
- •1.4.8 Diabetes
- •1.4.9 Others
- •1.6 Conclusion
- •References
- •2.1 Introduction
- •Nanoprecipitation (Solvent Diffusion)
- •Emulsification (Solvent Evaporation or Nanoemulsion)
- •Physical Adsorption Strategy
- •2.2.2.1 Pre-Insertion PEGylation
- •2.2.2.2 Post-Insertion PEGylation
- •2.3.1 Indirect Assessment (Qualitative Assessment)
- •2.3.1.1 Particle Size
- •2.3.1.2 Zeta Potential
- •2.3.1.3 Surface Hydrophilicity
- •2.3.1.4 Microscopic Techniques
- •2.3.1.5 Fourier Transform-Infrared Spectroscopy (FT-IR)
- •2.3.2 Direct Assessment (Quantitative Assessment)
- •2.3.2.1 Colorimetric Methods
- •2.3.2.2 Chromatographic Methods
- •2.3.2.4 Nuclear Magnetic Resonance (NMR)
- •2.3.2.5 X-Ray Photoelectron Spectroscopy (XPS)
- •References
- •3.1 Introduction
- •3.2 Characterization Techniques
- •3.3 Infrared Spectroscopy
- •3.4 Raman Spectroscopy
- •3.5 X-Ray Photoelectron Spectroscopy
- •3.6 Nuclear Magnetic Resonance
- •3.7 Energy-Dispersive X-Ray Spectroscopy
- •3.8 Mass Spectroscopy (MS)
- •3.9 Thermogravimetric Analysis
- •3.10 Differential Scanning Calorimetry
- •3.11 Atomic Force Microscopy
- •3.12 Scanning Electron Microscopy
- •3.13 Transmission Electron Microscopy
- •3.14 Conclusion
- •References
- •4.1 Introduction
- •4.3.1 Nanoparticles PEGylation
- •4.3.2 Polyplexes (PP) PEGylation
- •4.5.1 Systemic Drug Delivery
- •4.5.2 Nonsystemic Drug Delivery
- •4.5.2.3 PEGylated Intravaginal Nanocarriers
- •4.5.2.6 Vaccines Entrapped PEGylated Nanocarriers
- •4.6.2 PEG Molecular Weight (MW)
- •4.7 PEGylated Nanocarriers Products
- •4.8.3 Disadvantageous Physicochemical Properties
- •4.8.5 Limited RES Evasion Capacity
- •4.9 Conclusion
- •References
- •5.1 Introduction
- •5.1.2 PEG Solubility Characteristics
- •5.2 Water-Soluble PEGylated Small Molecule Drugs
- •5.3 Soluble PEGylated Proteins/Enzymes
- •5.3.2 Organic Solvent–Soluble PEGylated Proteins/Enzymes
- •5.4 Water-Soluble PEGylated Drug Nanocarriers
- •5.4.1 Water-Soluble PEGylated Silicon Nanocarriers
- •5.4.2 Water-Soluble PEGylated Carbon Nanotubes
- •5.4.4 Water-Soluble PEGylated Dendrimers
- •5.4.5 Water-Soluble PEGylated Polymeric Micelles
- •5.5 Hydrated or Hydrophilic PEGylated Drug Nanocarriers
- •5.5.1 Hydrated PEGylated Lipid Nanocarriers
- •5.5.2 Hydrophilic PEG-Coated Zein Nanocarriers
- •References
- •5.6.4.1 PEG Chain Length/Molecular Weight
- •6.1 Introduction
- •Increased Solubility
- •Improved Stability
- •Reduced Immunogenicity
- •Enhanced Circulation Time
- •Heterogeneity
- •6.3.1 Enhancing Immune Responses
- •6.3.2 Suppressing Immune Responses
- •6.3.3 Immune Evasion
- •6.4.1 Strategies to Overcome Immunological Barriers
- •6.4.1.1 PEGylation
- •6.4.1.2 Cell Membranes
- •6.4.1.3 Carbohydrates
- •6.4.1.4 Proteins
- •6.6.1 Cancer Therapy
- •6.6.2 Gene Therapy
- •6.6.3 Immunotherapy
- •6.6.4 Central Nervous System (CNS) Drug Delivery
- •6.6.5 Pulmonary Drug Delivery
- •6.6.6 Ocular Drug Delivery
- •6.6.7 Cardiovascular (CVS) Drug Delivery
- •6.8 Conclusion
- •References
- •7.1 Introduction
- •7.3 Nanocarrier-Based Targeted Drug Delivery
- •7.4.1 Covalent Approach
- •7.4.2 Non-covalent Approach
- •7.4.2.1 PEGylation Via Monovalent Interactions
- •High-Affinity Host-Guest Interactions
- •7.4.2.2 PEGylation Via Multivalent Interactions
- •PEGylated Block Copolymers
- •PEGylated Graft Copolymers
- •Polyelectrolyte Complex-Based Systems
- •Non-ionic Interaction-Based Systems
- •PEGylated Dendritic Copolymers
- •PEGylated Copolymers Utilizing Mobile Side Groups
- •7.5 Various Targeting Strategies
- •7.5.1 Active Targeting
- •7.5.2 Passive Targeting
- •7.5.2.1 PEG Dilemma
- •7.7.1 Brain Disorders
- •7.7.2 Pulmonary Disorders
- •7.7.3 Cancer
- •7.7.4 Inflammatory Disorders
- •7.7.5 Bone Disorders
- •7.7.6 Blood Disorders
- •7.8 Stimuli-Sensitive Nanocarriers
- •7.8.1 External-Responsive Nanocarriers
- •7.8.1.1 Ultrasound-Responsive PEGylated Nanocarriers
- •7.8.1.2 Thermal-Responsive PEGylated Nanocarriers
- •7.8.1.3 Magnetic Responsive PEGylated Nanocarriers
- •7.8.2 Internal-Responsive Nanocarriers
- •7.8.2.1 pH-Responsive Systems
- •7.8.2.2 Redox-Responsive Systems
- •7.8.2.3 Enzyme-Responsive Systems
- •7.8.2.4 Hypoxia-Responsive Systems
- •7.8.3 Multimodal Responsive Nanocarriers
- •7.9 Conclusion
- •References
- •8.1 Introduction
- •8.3.1 PEGylated Liposome
- •8.3.2 PEGylated Micelles
- •8.3.3 PEGylated Nanogels
- •8.3.4 PEGylated Inorganic Nanoparticles
- •8.3.5 PEGylated Polymeric Nanoparticles
- •8.4.1 Cancer
- •8.4.1.1 Breast Cancer
- •8.4.1.2 Lung Cancer
- •8.4.1.3 Colon Cancer
- •8.4.1.4 Brain Cancer
- •8.4.2 Autoimmune Diseases
- •8.4.3 Inflammatory Disorders
- •8.4.4 Cardiovascular Diseases
- •8.4.5 Ocular Diseases
- •8.5 Conclusion
- •References
- •9.1 Introduction
- •9.4.1.1 Amino Acid Modifications
- •9.4.1.3 Cysteine Thiol Residue Conjugation
- •9.4.2 Releasable PEGs
- •9.7.1.1 Cationic Lipid Toxicology
- •9.8 RNA Lipid Nanoparticle
- •9.13 Conclusion
- •References
- •10.2.1 PEGylated Nanocarriers
- •10.2.1.1 Polymeric NPs
- •10.2.1.2 Liposomes
- •10.2.1.3 Dendrimers
- •10.2.1.4 Polymeric Micelles
- •10.6 Conclusion
- •References
- •11.1 Introduction
- •11.1.2 Factors Influencing PPDs’ Short-Term Efficiency
- •11.2 What Is PEGylation?
- •11.3.1 Random PEGylation
- •11.3.2 Site-Specific PEGylation
- •11.3.2.1 Amine Conjugation
- •11.3.2.2 Cysteine Conjugation
- •11.4.1 Binding Affinity
- •11.4.2 Altered Biological Activity
- •11.4.3 Physicochemical Modifications
- •11.4.4 PEG Size
- •11.4.5 PEG Structure
- •11.6 PK Profiling
- •11.9 FDA-Approved PEGylated Products
- •11.11 Conclusion
- •References
- •12.1 Introduction
- •12.1.2 Current Market Scenario
- •12.2.1 PEGylated Iron Oxide Nanoparticles
- •References
- •13.1 Introduction
- •13.2.1 PEGylated Lipid-Based NPs
- •13.2.2 PEGylated Polymeric Nanoparticles
- •13.2.3 PEGylated Metal-Based Nanoparticles
- •13.2.4 Multifunctional PEGylated Nanocarriers
- •13.2.5 Targeted PEGylated Nanocarriers
- •13.3.1 Surface Modification Chemistry
- •13.3.2 Polymer Chemistry
- •13.3.4 Characterization Techniques
- •13.4.1 Longer Circulation Time
- •13.4.2 Enhanced Cellular Uptake
- •13.4.3 Controlled Drug Release
- •13.5.1 Cancer Theragnostic
- •13.5.2 Cardiovascular Theragnostic
- •13.7.2 Prolonged Circulation Time
- •13.7.3 Improved Drug Delivery
- •13.7.4 Diagnostic Functionality
- •13.8 Technical Challenges
- •13.8.4 Limited Clinical Validation
- •13.10 Conclusion
- •References
- •14.1 Introduction
- •14.2 Reversible PEGylation Strategies
- •14.2.1 Reversible PEGylation Chemistry
- •14.2.2.1 Aromatic Linkers
- •14.2.2.2 Aliphatic Linkers
- •14.2.3 Cleavage Linkers
- •14.2.3.1 Hydrolyzable Linkers
- •14.2.3.2 Enzymatically Cleavable Linkers
- •14.2.4 pH-Responsive PEGylation
- •14.2.4.1 Proteasome Inhibitor MG132
- •14.2.5 Temperature-Responsive PEGylation
- •14.2.6 Light-Responsive PEGylation
- •14.3.1 Analytical Techniques
- •Zeta Potential
- •Hydrophobic Interaction Chromatography (HIC)
- •Near Infrared (NIR) Spectroscopy
- •Fourier Transform-Infrared Spectroscopy (FT-IR)
- •13C-NMR
- •Mass Spectrometry
- •High-Performance Liquid Chromatography (HPLC)
- •Calorimetry
- •X-Ray Photoelectron Spectroscopy (XPS)
- •Nuclear Magnetic Resonance (NMR)
- •TGA-DSC
- •14.3.2.1 Protein Adsorption
- •14.3.2.2 Cellular Association
- •14.3.2.5 Bioactivity Assay
- •14.3.2.6 Enzyme-Linked Immunosorbent Assay (ELISA)
- •14.3.2.7 Sandwich ELISA
- •14.3.2.8 Anti-PEG ELISA
- •14.3.3.1 In Vivo Blood Circulation Half-Life
- •14.3.3.2 Radiolabeling
- •14.4.1 Therapeutic Applications
- •14.4.1.1 Anticancer Activity
- •14.4.1.2 Antibiotic Administration
- •14.4.1.3 Enzyme-Replacement Therapy
- •14.4.1.4 Red Blood Cell Substitution
- •14.4.1.5 Oxygen Toxicity Diseases
- •14.4.2 Pharmaceutical Applications
- •14.4.2.1 PEGylated Liposomes
- •14.4.2.2 PEGylated Proteins
- •14.4.2.3 Targeted Delivery
- •14.5.1 Design Complexity
- •14.5.3 Biological Environment Stability
- •14.5.4 Trigger Selection
- •14.5.5 Immunogenicity
- •14.5.6 Scale-up Difficulties
- •14.5.8 Cost
- •14.6 Conclusion
- •References
- •15. Stimuli-Responsive PEGylated Nanocarriers
- •15.1 Introduction
- •15.2 External Stimuli-Responsive Systems
- •15.2.1 Thermoresponsive Systems
- •15.2.2 Magnetically Responsive Systems
- •15.2.3 Ultrasound-Triggered Drug Delivery
- •15.2.4 Light-Triggered Drug Delivery
- •15.2.5 Electroresponsive Systems
- •15.3 Internal Stimuli-Responsive Systems
- •15.3.1 pH-Responsive Systems
- •15.3.2 Redox-Responsive Systems
- •15.3.3 Enzyme-Responsive Systems
- •15.3.4 Self-Regulated Systems
- •15.4.3 Multistimuli Responsive Systems
- •15.7 Conclusion
- •References
- •16.1 Introduction
- •16.3 PEGylated Products
- •16.3.1 PEGylated Liposomes
- •16.3.2 PEGylated G-CSF
- •16.3.3 PEGylated Proteins
- •16.3.4 PEGylated Nanoparticles
- •16.5.1 Poly(Zwitterions)
- •16.5.2 Poly(Glycerols)
- •16.5.3 Poly(Amino Acids)
- •16.5.4 Poly(Oxazolines)
- •16.5.6 Poly(Vinylpyrrolidones)
- •16.5.8 Polypeptides
- •16.5.9 Carbohydrate-Based Systems
- •16.5.10 Hydrophilic Polymers
- •16.5.11 Non-PEGylated Nanoparticles
- •16.6 Future Prospects
- •16.7 Conclusion
- •References

PEGylation ofTherapeutic Proteins
andPeptides
NatashaAkojwar, AnkitMishra , PranaliMishra ,
MuktikaTekade, ShubhamRamdasMule,
andRakeshKumarTekade
Abstract
PEGylation refers to the technique of modifying protein and peptide drugs with
PEG, which offers numerous advantages over their unmodied counterparts in
terms of physicochemical properties and therapeutic efcacy. This book chapter
N. Akojwar
Department of Pharmaceutical Sciences, Rashtrasant Tukdoji Maharaj Nagpur University,
Nagpur, MS, India
A. Mishra (*)
Department of Pharmaceutics, VNS Group of Institutions, Faculty of Pharmacy, Bhopal, MP,
India
P. Mishra
Department of Pharmaceutics, VNS Group of Institutions, Faculty of Pharmacy, Bhopal, MP,
India
Swami Vivekanand College of Pharmacy, Bhopal, MP, India
M. Tekade
School of Pharmacy, Devi Ahilya Vishwavidyalaya, Takshila Campus,
Indore, Madhya Pradesh, India
School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
S. R. Mule
National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, An
Institute of National Importance, Government of India, Department of Pharmaceuticals,
Ministry of Chemicals and Fertilizers, Palaj, Opp. Air Force Station,
Gandhinagar, Gujarat, India
R. K. Tekade
National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An
Institute of National Importance, Government of India, Department of Pharmaceuticals,
Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar,
Gujarat, India
11
317

318
N. Akojwar et al.
aims to equip the readers with detailed insights into objectives, methods, and end
applications of PEGylation. The chemistry-related aspects of PEGylation, with
special emphasis on the site of PEGylation, is the central theme of this piece of
literature. Various critical factors affecting the process of PEGylation and its out-
comes, such as the structure of PEG and size of PEG, have been emphasized in
this manuscript. The applications of PEGylation in active and passive targeting
and various FDA-approved PEGylated products are thoroughly discussed.
Keywords
PEG · PEGylation · Proteins · Peptides · PK proling
11.1 Introduction
The advancements in the modern technologies of production, modication, and
analytical advancements have helped in the development of protein and peptide
drugs (PPDs) signicantly during the past 10 years (Henninot etal. 2018). Countless
therapeutic applications for natural and synthetic peptides have been discovered and
explored. The application of PPDs as therapeutics has been viewed as an appealing
strategy to tackle numerous diseases since the isolation of insulin in 1922 (Bliss
1982). Recent advancements in biotechnology and pharmaceutical sciences, espe-
cially recombinant technology, have made it feasible to develop PPDs commercially
as promising therapeutics (Gupta etal. 2016; Seif etal. 2017). Protein and peptide
medications are intriguing biological molecules in drug research because they offer
great efcacy, minimal toxicity, and strong specicity compared to conventional
chemically manufactured pharmaceuticals (Dimitrov 2012).
By far, the FDA has approved more than 240 PPDs. Other potential therapeutic
PPD candidates undergo clinical trials (Chen etal. 2022). PPDs have been synthesized and modied utilizing both biological and chemical techniques. Although protein and peptide medications offer unrivaled benets in treating disease conditions
at the cellular and extracellular levels, they are not the ideal treatment choice owing
to their molecular makeup. These macro-molecules are difcult to administer
because of their large size, complex structure, hydrophilicity, immunogenicity, and
susceptibility to enzymatic cleavage, leading to shorter half-life necessitating frequent administration (Joseph etal. 2017).
Researchers attempt various approaches to recongure these PPDs to address
the above issues, and many of these techniques can drastically enhance their stability and safety and improve their pharmacokinetic prole while lowering the
dose and frequency of administration. The novel design and delivery technologies
assisted in overcoming the inherent limitations of PPDs, permitting the continuous expansion of this industry. The following section will review PEGylation as
one of the strategies researchers employ to combat the shortcomings of protein
and peptide drugs.

11 PEGylation ofTherapeutic Proteins andPeptides
319
11.1.1 Clinical andResearch Status ofPPDs
From the 1980s to the 1990s, peptide products with 2–10 amino acids comprise a
large portion of the amino acid composition of polypeptide drugs. However, as peptide synthesis and purication technology have advanced in the twenty-rst century,
polypeptide products with more than ten amino acids have gradually emerged, and the
myriad of polypeptide drugs has expanded (Lau and Dunn 2018). According to global
industry research on peptide treatments, peptide medicine sales surpassed 70 billion
USD in 2019; this research forecasted a compound annual growth rate (CAGR) reaching 9.1% from 2016 to 2024. Over 100 peptide therapeutics have entered clinical trials, over 400 peptide-based drugs are in the pre-clinical research phase, and more than
70 peptide drug types have been certied globally for commercialization (Lee etal.
2019). On studying the intended uses of these licensed peptide medications, it appears
that the most frequently targeted disease groups are cancer and metabolic disorders. It
can be said that the robust expansion of this industry is probably due to the anticipated
rise in the prevalence of malignancies and metabolic diseases (Li etal. 2021; Cheetham
etal. 2016). Liraglutide (Victoza) and glucagon-like peptide 1 (GLP-1) are top-selling
peptide medications for metabolic disorders, total sales of at least two billion USD
annually. Over four billion USD in sales were also attributed to well-known peptide
medications like leuprolide (Lupron), gosarelin (Zoladex), and somatostatin analogs
like octreotide and lanreotide (Ibeanu etal. 2020).
Correspondingly, there is an increase in the variety of protein and peptide therapeutic
molecular targets. G-protein-coupled receptors (GPCRs) are the most prominent extracellular targets, preceded by the natriuretic peptide receptor and cytokine receptor family. These three receptor families are the primary targets of 70–90% of the peptide
medicines tested in clinical studies (Sriram and Insel 2018; Davenport etal. 2020).
Thus, drug research currently focuses on identifying the role of proteins and peptides in
the etiology of a disease; these proteins include enzymes, viral proteins, receptors, and
channel molecules. Therefore, conducting an in-depth analysis of protein and peptide
therapeutic targets is crucial for developing these novel medicines (Lagassé etal. 2017).
11.1.2 Factors Influencing PPDs’ Short-Term Efficiency
Major drawbacks of these peptide and protein therapies include limited bioavailability and higher metabolic sensitivity. The GI tract’s digestion of peptides and their
failure to cross the epithelium limits their oral bioavailability (Alqahtani etal. 2019).
These PPDs frequently have high molecular weights (MWs), minimal lipophilicity,
and charged moiety within their structure, all hindering absorption (Han etal. 2019).
These properties cause most orally given peptides to have low bioavailability (2%)
and brief half-lives (30min). The problem of absorption is resolved by intravenous
(IV) or subcutaneous (SC) delivery of these therapeutic agents, but other factors,
such as systemic proteolytic enzymes, rapid clearance, opsonization, structural rearrangements, separation of subunit protein molecules, complex formation with blood
components, and destabilization of susceptible side-groups, limit the bioavailability
of these therapeutics (Craik etal. 2013). Another challenge is that the PPDs are difcult to manufacture and store because of poor stability (Bruno etal. 2013).

320
Fig. 11.1 Various factors affecting the half-lives of protein and peptide drugs
N. Akojwar et al.
Furthermore, every protein therapy has the potential to cause immunogenicity
complications in patients, and antibody formation is one such concern that poses
serious safety issues and lowers the efcacy of PPDs (Szlachcic etal. 2011; Fu etal.
2020). Above all, the short half-lives of the PPDs limit their potential application.
The most common causes of the short half-life of PPDs are depicted in Fig.11.1.
The hepatic and renal tissues and bloodstream all contain signicant numbers of
peptidases and proteases, which cause the peptide or protein to be swiftly broken
down by the enzyme’s function. Renal ltration, on the other hand, leads to quick
elimination of PPDs with low molecular weights. Liver metabolism is another factor inuencing the half-life of PPDs. The particular sequence of amino acids of a
polypeptide chain also signicantly impacts their hepatocyte intake and the rate at
which the liver metabolizes them; this uptake is a crucial step as the liver largely
metabolizes them. Various drug delivery systems and administration routes may
impact the drugs’ pharmacokinetics (ADME) and metabolic processes, ultimately
affecting the half-life of PPDs (Cao etal. 2020).
11.2 What Is PEGylation?
PEGylation is the non-covalent or covalent modication of other molecules utilizing polyethylene-glycol (PEG). This PEGylation produces interesting outcomes in
PPDs. It has produced a revolutionary product line that has already hit the market,
and others will be accessible soon. PEGylation enables the therapeutic use of PPDs
with poor pharmacokinetics to be clinically applicable (Pasut and Veronese 2006).

11 PEGylation ofTherapeutic Proteins andPeptides
321
Frank Davis’s laboratories conducted early research on PEGylated proteins and
enzymes in the late 1970s. Researchers today established the groundwork for protein PEGylation as a targeted delivery mechanism. In a series of experiments by
Davis etal., cyanuric chloride was used to couple a methoxy-PEG to the amino
acids in proteins. Their research showed that PEGylated proteins exhibited lower
immunogenicity and longer circulatory half-lives. PEGylation has been a widely
used technique in targeted drug delivery systems due to the recently discovered use
of proteins in therapeutics (Dozier and Distefano 2015).
In PEGylation, proteins, peptides, antibodies, and vesicles are biochemically
modied using PEG to give them numerous desired qualities that are useful for cell
genetic modication or therapy. Nevertheless, PEGylation of proteins is a complicated procedure that can be accomplished using a variety of approaches (enzymatic,
entrapping, physical, and chemical methods), depending on the type of the protein
and the intended application. Inert PEG strings are covalently or non-covalently
complexed with proteins of interest. Several PEGylated medications are used for
conditions such as anemia, kidney dysfunction, multiple sclerosis, hemophilia, and
malignancies (Awwad etal. 2018).
The increased hydrodynamic volume of the PEG–protein conjugate, which is a
result of the potential of PEG to co-ordinate water molecules as well as from the
exibility of the PEG chain, can be used to explain why the physicochemical properties of a protein have signicantly improved after coupling of PEG to a protein. As
a result, the PEG protein conjugate has an apparent molecular weight that is roughly
ve to ten times more than the protein’s nominal molecular weight (Gupta etal.
2019). Besides, PEG chains can wrap around a protein to cloak and protect it from
exposure to the environment. Still, they can also affect how the protein interacts
with other proteins, which affects how well the protein performs its biological function. Typically, in biological systems, these adverse impacts are counterbalanced by
important positive consequences they offer, viz., enhanced blood circulation,
increased drug bioavailability by evading the digestive system, reduced toxicity,
decreased immunogenicity, and enhanced passive drug delivery (Jevsevar et al.
2010). Figure11.2 gives detailed insights into the process of PEGylation.
11.2.1 Ideal Properties ofPEG
PEG are inert, long-chain amphiphilic molecules synthesized by connecting ethylene
oxide repeating units. Many possible PEG molecules can be made in various arrangements, such as linear or branched architectures, and with different molecular weights.
The immunologic, pharmacokinetic, and pharmacodynamic characteristics of a target
protein are altered by PEGylation, which can expand the protein’s possible applications (Harris etal. 2001). Although PEG is typically considered a non- biodegradable
polymer, certain studies have shown that it can be oxidatively broken down by various
enzymes, including alcohol and aldehyde dehydrogenases and CYP450-dependent
oxidases (Beranová etal. 1990). Reports presented that Alcohol dehydrogenases convert PEG chains under 400Da invivo into harmful metabolites. The elimination of
longer PEG chains, utilized for PEGylate proteins, depends on their molecular mass

322
Fig. 11.2 Overview of the process of PEGylation
N. Akojwar et al.
and is not susceptible to metabolism. Renal ltration eliminates PEG and PEG–protein complexes with PEGs smaller than 20kDa. In contrast, protein complexes with
bigger PEG molecules are eliminated from the body through different pathways, such
as hepatic uptake, immune system interaction, and proteolytic metabolism of the protein component of the conjugate (Caliceti and Veronese 2003).
PEG has a longstanding experience of being a non-toxic, non-immunogenic,
water-loving, neutral, and non-degradable polymer and has been given the “generally regarded as safe” certication by the US FDA (Alconcel etal. 2011). PEGs and
PEG reagents with wide polydispersity have been utilized; today, the acceptable
standard for PEG reagents up to 30 kDa is polydispersity indices of about 1.05
(Wang etal. 2020a). A polydispersity around 1.1 might be appropriate for higher
molecular weight forms, but the current trend is to use PEGs with narrower distributions. High doses of PEG as an intravenous therapeutic agent have been demonstrated to cause dose-dependent and molecular mass-dependent systemic immune
toxic reactions. PEGylated therapies utilize 10,000 to 1000-fold lower amounts of
PEG. Hence, therapeutic doses of PEGylated medications are generally signicantly lower than those needed to cause PEG toxicity (Webster etal. 2009).
In toxicity studies, it has been shown that extremely high dosages of PEG–protein conjugates can cause nephron vacuolization, which is not accompanied by
functional problems and goes away after the therapy (Rudmann etal. 2013). As a
result, PEG–protein conjugates continue to be considered non-toxic, safe, and
immunologically harmless. It has also been shown that the attachment of longer,
branching PEGs is preferable to shorter, linear PEGs for reducing possible protein
immunogenicity. PEG’s minimal immunogenicity and the comparatively low doses

11 PEGylation ofTherapeutic Proteins andPeptides
323
of PEG-conjugates greatly limit the chance of an immunogenic reaction (Qi and
Chilkoti 2015).
11.2.2 Advantages ofPEGylation
The PPD’s physicochemical characteristics are changed due to PEGylation, including its conformational, steric impediment, electrostatic interaction capabilities, and
lipophilicity. The improvement in the therapeutic efciency that PEGylation offers
because of the several advantages over non-PEGylated products is summed up in this
section. Figure11.3 enlists the benets of PEGylation. PEGylation expands the size
and molecular mass of PPDs, boosts their water solubility, and improves their pharmacokinetics and pharmacodynamics. PEG polymer interacts with two or more
water molecules for every ethylene glycol subunit when coupled to a protein (Delgado
etal. 1992). This property produces a bulky hydrophilic shielding that effectively
hides the conjugated protein from immune detection and enzymatic breakdown.
Additionally, the conjugated protein is ve to ten times bigger and more soluble
than an equivalent soluble protein of the same mass. The shield produced by the
PEG moiety and linked water molecules signicantly reduces renal clearance (Milla
etal. 2012). This last characteristic seems to be especially benecial for smaller
proteins and peptides, which the kidneys lter quickly. To lengthen the body’s residence period, PEGylation with a PEG mass of 40–50kDa can be accomplished by
conjugating either a single large PEG molecule or numerous smaller PEG molecules (Vargason etal. 2021).
PEGylation increases the plasma half-life of proteins and prevents phagocytic
system clearance by producing a steric obstacle to opsonization. Proteases are hindered by PEG, which increases the proteins’ resistance to proteolytic breakdown.
PEGylation can maintain the protein structure and function this way (Veronese
2001). Additionally, PEGylation can mask antigenic regions of foreign proteins,
preventing the development of antibodies directed against the same, thereby lowering their immunogenicity (Knop etal. 2010). Adenosine deaminase became the rst
PEGylated PPD commercialized and licensed by the FDA to manage immunodeciency illnesses in 1990. Ever since, numerous conjugates have received approval
Fig. 11.3 Advantages of PEGylation of proteins and peptides

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and gone on the market, including epotein protein for treating renal failure,
PEGylated interferon for treating hepatitis C, and granulated stimulating factor for
treating neutropenia (Villegas etal. 2018).
Shorter half-lives invivo, which lead to much lower potency as demonstrated
invitro, limit the biological agent’s incredible potential. These frequently needed
short-acting therapeutic drugs, specically for chronic illnesses, can limit their
application in the clinic. To enable better biological treatments, half-life augmentation approaches are now available in clinical settings (Swierczewska etal. 2015).
The most well-established half-life extension technique today is PEGylation, which
has been safe in humans for over two decades. It also helps reduce the dose and
frequency of application, enhancing patient compliance. Nevertheless, it will be
among the most cutting-edge systems used during the next 20years.
11.2.3 Generations ofPEGylation Process
The key trait of low molecular weight linear PEGs denes the rst-generation PEGconjugated therapeutic proteins. The activation of PEG is required before it is conjugated to a protein. This activation is done utilizing a functional group located on
one of its terminal sides appropriate for interaction with an available active site on
the protein (typically the amino groups). This activation could be achieved by reacting the PEG with a proper initiator or termination reagent (Swierczewska etal.
2015). Because of the availability to create reactive PEGs that stop the synthesis of
cross-linked polypeptides, monomethoxy PEG (mPEG) is more appropriate for
conjugating proteins (Monfardini et al. 1995). It is hypothesized that the PEG’s
amphiphilic property, ability to bind to water molecules, and exibility of the backbone chain are related to its capacity to induce precipitation of proteins, reduce
immunogenicity and antigenicity, keep proteins and cells away from surfaces, and
prevent degradation by enzyme activity or mammalian cells.
Furthermore, irreversible conjugation is necessary to achieve the primary goal of
rst-generation PEGylation. Due to the removal of the PEG coating, the method’s widespread use is restricted. Regulators approved several rst-generation pegylated medications despite these restrictions. Pegaspargase (Oncaspar), a pegylated form of the
enzyme asparaginase employed for leukemia, and pegademase (Adagen), a pegylated
derivative of the enzyme adenosine deaminase for the treatment of severe combined
immunodeciency disease (SCID), are still in use today (Harris and Chess 2003).
The second generation of PEGylation has developed from the rst generation,
and it uses a site-specic PEGylation technique to strengthen the specicity between
PEG with different protein moieties. Chemically stable bonds are indeed sitespecically created during covalent PEGylation, which is a most desirable and
potentially economical method. Some techniques used to carry out site-specic
PEGylation include thiol, N-terminal, and histidine markers. Constantly reversible
conjugation, which does not impede conjugate activity, is the primary method of
site-specic PEGylation (Belén etal. 2019). As a result, the conjugates could be
liberated per a predetermined period attributable to the use of the cleavable linkages, which enable temporary anchoring of PEG molecules. However, a covalent

11 PEGylation ofTherapeutic Proteins andPeptides
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approach has signicant drawbacks; it may not always be practical and could take
the longest to develop.
Like random PEGylation, multiple target-specic sites in the molecule may also
form PEGylated species with different degrees of modication and isomerism positions (Zuma etal. 2022). Creating larger PEG polymers is a general objective of
second-generation PEGylation techniques to enhance the pharmacokinetic and
pharmacodynamic consequences observed following relatively low molecular mass
PEGs. Some of the changes are signicant, such as the PEGylation of interleukin-6
(IL-6), which caused a 100-fold increase in half-life and a 500-fold increase in
thrombopoietin activity (Harris etal. 2001).
Using branching structures instead of the only linear structures present in rstgeneration PEGs is another advancement in second-generation PEG polymers.
There have been developed branched PEGs with signicantly higher molecular
weights (up to 60kDa or above) than the 12kDa or fewer observed in rst- generation
PEGs. A branching PEG is much larger than a linear PEG with the same molecular
mass (Fee 2007).
Additionally, branched PEGs are more effective at shielding the connected polypeptide drug again from immune cells and digestive enzymes, lowering its antigenicity and reducing the probability that it will be destroyed. To attain better potency and
a circulation half-life focused on fast-acting, site-specic, and lower doses, third-generation PEGylation is being developed (Kursa etal. 2003). With an aim to establish
longer-acting therapeutics, third-generation PEGylation seeks to reduce the struggle
to nd a balance between efciency and circulatory half-life. Releasable PEG conjugates, a prodrug strategy invented by Enzon Pharmaceuticals, are one method. After
being administered invivo, the medication can be converted to its active form owing
to specially designed linkers between PPD active molecules and PEG.Another strategy to reduce the API’s steric barrier is constructing modiable PEGylation regions
on proteins using technologies like Ambrx’s ReCODE and EuCODE to support therapeutic candidates with problematic PK characteristics (Manandhar etal. 2021).
11.3 Chemistry ofPEGylation
Proteins and appropriately activated PEGylation reagents often interact chemically
to PEGylate proteins. There are many chemical groups on the side chains of amino
acids that might feasibly be used for the interaction with PEG, including disulde
(-S-S-) bonds, -NH2, -NH-, -COOH, -OH, and -SH groups. The location of attachment upon the protein, the nature of bonding, the size and form of the linker, and the
PEG reagent are all factors that must be considered when discussing PEGylation,
particularly when considering their modied properties (Zalipsky 1995).
11.3.1 Random PEGylation
In the 1970s, the historical background of “random” PEGylation reagents commenced with PEG-chlorotriazine. It proceeded with PEG-benzotriazole carbonate,

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PEG-tosylate, PEG-nitrophenyl carbonate, PEG-carbonyl imidazole, succinimidyl
succinate (SS-PEG), as well as succinimidyl carbonate PEG reagents (SC-PEGs).
Although SS-PEG reagents form strong amide bonds with protein, the subsequent
PEG-protein adducts are vulnerable to hydrolysis because of an additional ester linkage in the polymer’s backbone. In addition to reacting with lysine residues, SC-PEG
reagents also react with histidine residues, forming urethane linkages, which lead to
hydrolytically weak bonds (Zalipsky etal. 1992). The weak connection could be
advantageous when designing control release or prodrug compositions, but if conjugation instability is not desired, it could be a severe drawback (Warren etal. 2012).
Looking back at the development of PEGylation, it is apparent that, until recently,
the preponderance of PEGylation reagents primarily targeted the amino groups on
side chains of lysine residues in proteins, which is considered random PEGylation.
Lysines are relatively numerous, polar amino acid residues typically found on the
surface of proteins, making them susceptible to chemical interactions with PEG
reagents. As a result, these reactions proceed rapidly and produce complex mixes of
conjugates that vary in the quantity and location of the attached PEG chains (Cheng
etal. 2019). These reactions are not conned to the amino groups of lysine residues;
they also somewhat react with certain other protein nucleophiles, such as the side
chains of serine, threonine, and tyrosine cysteine residues, the N-terminal amino
groups and the imidazolyl nitrogens of histidine residues. Although the pH of the
medium can inuence the reaction to some degree, these conjugation processes
typically result in complex PEGylation mixes (Maiser et al. 2014). Also, rstgeneration high molecular weight, pure monofunctional PEG reagents are challenging to construct and ineffective for protein conjugation because they have a 15%
maximum diol concentration (Zhang etal. 2007).
11.3.2 Site-Specific PEGylation
The issues of diol contaminants, connement to low-molecular-weight mPEG,
instability of links, side-reactions, and lack of substitution selectivity have been
avoided by site-specic PEGylation chemistry (Xu etal. 2021). N-terminal, serine,
threonine, tryptophan, and cysteine PEGylations are examples of traditional, wellknown methods for site-specic PEGylation reactions discussed in the following
section.
11.3.2.1 Amine Conjugation
mPEG-propionaldehyde is one of the earliest instances of second-generation chemistry. Given the PEG acetaldehyde’s susceptibility to dimerization, mPEGpropionaldehyde is simpler to manufacture and employ. Because the N-terminal
alpha-amine has a lower pKa than other nucleophiles, mPEG-propionaldehyde is
mainly selected for it under acidic circumstances (about pH5). The nucleophilicity
of every amino acid residue plays a critical role in attaching electrophilic PEG to
amino acid residue on protein. Only after the pH of the solution containing protein is
close to or higher than the residue’s pKa will a nucleophilic attack occur. As a result,
each residue’s reactivity is also inuenced by its nearby amino acid residues. The
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