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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5894_Библиотеки_им_академика_М_И_Перельмана.pdf
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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

11 PEGylation ofTherapeutic Proteins andPeptides
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heterogeneity often observed with lysine chemistry is considerably reduced, even
though total selectivity is not seen. Because amino groups in proteins have a comparable propensity to PEG amines and may thus form cross-linked aggregates, reductive alkylation involving PEG-amine is challenging. In these circumstances,
PEG-hydrazides are more advantageous. The amino groups in proteins are mostly
protonated in an acidic environment (approximate pH 5). Still, because PEGhydrazide is a weaker base than primary amines (pKa, about 3), the reaction is selective for the synthesis of PEG-hydrazone (Wang etal. 2018). Using an N-terminal
serine or threonine, which may be oxidized by periodate into a glyoxylic derivative,
is another strategy for site-specic conjugation (Gaertner and Offord 1996).
11.3.2.2 Cysteine Conjugation
Because agents that preferentially react with cysteines have been created and
because there are far fewer free cysteine residues on the surface of proteins than
there are lysine residues, PEGylation targeting free cysteine in proteins is the primary method for site-specic modication (Gaertner and Offord 1996). Genetic
engineering can insert one or more free cysteines into native proteins that do not
contain any. This method can enable site-specic PEGylation in protein regions,
minimizing biological activity loss but reducing immunogenicity (Byrne et al.
2021). This tactic has several drawbacks, however. For instance, the possibility of
improper disulde generation and protein dimerization increases when free cysteines are inserted by genetic engineering (Gunnoo and Madder 2016).
Various PEG derivatives, each with unique benets and drawbacks, have been
produced using cysteine residues. Starting with PEG-vinyl sulfone (PEG-VS) at
mildly basic circumstances (pH7–8), PEG-VS slowly reacts with thiols to create a
robust thioether bond with the protein. The reaction will occur more rapidly if the
pH is raised. While stable in aqueous systems, PEG-VS may interact with lysine
residues at high pH levels (Morpurgo etal. 1996).
Unlike PEG-VS, the PEG-maleimide (PEG-MAL) is unstable in water and can
initiate ring-opening reactions or the addition of water molecules to the double
bond. The thioether bond between the PEG-MAL and proteins is stable, although
hydrolysis can slowly cleave one of the amide links. However, it is more active in
thiols even in slightly acidic pH6–7 (Fontaine etal. 2015). Through nucleophilic
substitution, PEG-iodoacetamide (PEG-IA) progressively interacts with free thiols
to form a persistent thioether bond. To prevent the production of free iodine, which
might react with other amino acids, the reaction should be carried out in a dark
container with a small molar excess of PEG-IA [74]. Lastly, to create a disulde
bond with the protein, ortho-pyridyl disulde-PEG (PEG-OPSS) can be used to
interact with sulfhydryl groups in both acidic and basic environments (pH3–10).
These disulde links are stable, except when transformed to thiols in a reducing
environment (Kunstelj etal. 2013).
11.3.2.3 Serine, Threonine, andTryptophan Conjugation
A periodate oxidation reaction can produce glyoxylic groups by targeting the N-terminal
positions of serines and threonines. The susceptibility of 1, 2- amino alcohols towards
periodate oxidation affects this process (Kolate etal. 2014). The N-terminal serine

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N. Akojwar et al.
residue was previously subjected to a site-specic PEGylation procedure, which
involved oxime ligation of aminooxy and hydrazide PEG derivatives and sodium peroxide for oxidation. Interleukin-8 (IL-8), granulocyte colony- stimulating factor
(G-CSF), and IL-1r preserved their biological activity after PEGylation.
Strong reaction conditions, which frequently cause protein denaturation in
conjugation protocols, or decreased reaction yields are the main problems.
Much focus has recently been placed on the bioorthogonal alteration of the side
chains of aromatic amino acids. Tyrosine, in particular, is a desirable target for
protein modication due to its relative rarity (as opposed to certain other sensitive endogenous amino acids like lysine) and capacity for alteration without
changing charge. The alkylation reaction of tyrosine residues catalyzed by palladium is one technique for modifying proteins. This process modies PPDs in
an aqueous medium at room temperature using electrophilic intermediates such
as π-allyl produced via allylic acetate and carbamate predecessors (Tilley and
Francis 2006).
Other strategies for tyrosine-targeted posttranslational modications using aniline derivatives were also developed, which allows the tyrosine’s phenol group to
react as a nucleophile. The diazonium coupling procedure has been discovered, in
which the phenol of tyrosine residues in proteins is coupled to a diazonium salt
made from aniline derivatives. Tyrosine residues have been targeted by diazonium
in the polymer coupling of medically necessary proteins and peptides (Jones etal.
2012). Another method is the Mannich-type reaction, which allows for highly
selective tyrosine residue alteration at the ortho position on the phenol group. At a
pH range of 5.5–6.5, Mannich-type reactions occur under gentle circumstances
with millimolar reagent concentration. Both techniques use aniline derivatives to
target tyrosine in milder, biocompatible, and metal-free environments (Szijj
etal. 2020).
Peptides with N-terminal tryptophan residues can be changed using the Pictet–
Spengler procedure with an aldehyde in a solution of glacial acetic acid. The creation of a stable C-C bond occurs in just one step as a result of this reaction, which
involves the oxidation of the N-terminal amino group to imine and the cyclic condensation of an aldehyde and the α-amine as well as the indole functionality of a
tryptophan residue (Turecek etal. 2016). For example, researchers created folic acid
(FA) and monoclonal antibody (mAb) conjugates utilizing a tryptophan (Trp)selective process, which produced relatively consistent results when compared to
other approaches. The mAb-FA conjugates signicantly killed cancer cells expressing the folate receptor, proving that the conjugates still carried out the Fc region’s
primary purpose (Tagawa etal. 2020).
11.3.2.4 Enzymatic Tools forSelective PEGylation
Enzymes have special selective, specic, and catalytic properties. They have not
been used to their full potential in chemistry up to this point, but enormous strides
could be made with this method soon (Sato 2002). Regarding the application of
enzymes for selective PEGylation, one method, namely transglutaminase, has produced signicant outcomes and sparked several PEGylation investigations. Recently,

11 PEGylation ofTherapeutic Proteins andPeptides
329
PEG chains were covalently linked at the glutamine (Gln) protein residue’s carboxamide group using the transglutaminase (TGase) enzyme (Mero etal. 2009). TGases
are an enzyme type that can catalyze an acyl transfer between two proteins using the
glutamyl group of glutamine as the acyl donor and a primary amine as the acyl
acceptor, typically the ε-amino of lysine. It is important to emphasize that glutamine
cannot be altered chemically without tagging other residues or impairing the structure of the protein. Because TGase has stringent constraints for the amino acid
sequence and substrate exibility, this enzymatic conjugation is selective (Fontana
etal. 2008). Thus, just one or two of the many glutamines in a protein typically meet
the requirements for TGase catalysis.
A new method known as glycopegylation for site-directed PEGylation that
attaches PEG to O-glycans using glycosyltransferases is proposed. Proteins produced in Escherichia coli without glycosylation undergo enzymatic GalNAc glycosylation at specied serine and threonine residues. Then, sialic acid conjugated
with PEG is transferred enzymatically to the GalNAc residues. The method was
used with three therapeutic polypeptides that are currently used in clinical settings:
granulocyte colony-stimulating factor (G-CSF), interferon-alpha2b (IFN-alpha2b),
and granulocyte/macrophage colony-stimulating factor (GM-CSF) (Defrees etal.
2006). Because between 80–90% of eukaryotic PPDs are acetylated at the
N-termini, the specic modication of the α-amine employing subtiligase is a
powerful method in proteomics to enrich novel N-termini originating from proteolytic recognition and fragmentation. This benet might be utilized for the novel
application of selectively attaching PEG-modied peptides and proteins to increase
conjugation effectiveness (Weeks and Wells 2020). Butelase 1, a productive asparagine and aspartate-specic cysteine-ligase, was discovered in the medicinal plant
Clitoria ternatea. Butelase 1 was only recently identied, yet it has already been
used for various things, including protein engineering and modication (Nguyen
etal. 2015). Other enzymes, such as tubulin tyrosine ligase, N-myristoyl transferase, biotin ligase, and lipoid acid ligase, have also been used for protein
bioconjugation.
11.4 Critical Parameters toConsider forProtein PEGylation
11.4.1 Binding Affinity
PEGylation may have a range of effects on a protein’s binding afnity, from an
increase to a decrease to having no effect at all. For instance, PEGylated Trypsin and
Amino Oxidase exhibit higher activity when used with low-molecular-weight substrates. These ndings were attributed to either a positive change in the threedimensional structure or an improved afnity for the substrates due to the altered
microenvironment the amphiphilic PEG produced (Monfardini etal. 1995). Pegaptanib
is an aptamer that targets vascular endothelial growth factor (VEGF). This protein
causes pathological neovascularization of the eye and increased vascular permeability, contributing to a particular type of macular degeneration. The rst anti-VEGF

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N. Akojwar et al.
aptamer used to bind the protein displayed the typical aptamer drawback of a limited
half-life caused by nuclease degradation and a fast kidney clearance rate. Conjugation
to a 40kDa branching PEG increased the plasma half-life and lengthened tissue retention while reducing binding afnity by a factor of four. PEGylation allows delayed
vitreous humor diffusion, increasing effectiveness and lowering systemic exposure
(Ng etal. 2006). A humanized antitumor necrosis factor (TNF) monoclonal antibody
marketed as certolizumab pegol is a PEGylated Fab fragment that binds to and neutralizes membrane-bound or soluble membrane TNFa. In this instance, the conjugation with a branching PEG allows for the retention of recognition ability, a long blood
circulation period, and perhaps even a decrease in immunogenicity.
Furthermore, because the Fab segment is targeted for site-specic PEGylation at
a location distant from the antigen-binding site, the compound retains biologic
activity while exhibiting the same afnity for TNF as the original antibody. PEG2
maleimide with a molecular weight of 40kDa serves as the reagent for the conjugation, which takes place at a single, free thiol cysteine residue. In April 2008, the
FDA authorized certolizumab pegol to treat people with moderate to severe Crohn’s
disease (Schreiber 2011). G120K, in which a lysine was put in place of glycine, was
the rst growth hormone mutant to be investigated as an antagonist. G120K, like the
growth hormone itself, had a relatively short half-life but binds the growth hormone
receptor with great afnity while blocking signal transmission. Its plasma circulation time was increased by performing a randomized conjugation with PEG 5kDa.
This conjugation resulted in a protein with a low afnity for the receptor and a halflife of roughly 100hours. Further mutations were added to lessen the number of
possible PEG binding sites to address this (Fishburn 2008).
11.4.2 Altered Biological Activity
PEGylation can occasionally change the biological features of the protein; for example, PEGylated cholesterol oxidase and esterase swap specicity from total cholesterol to HDL cholesterol (Sugiuchi etal. 1995). This concept has been exploited in
developing a commercial kit for HDL cholesterol assay. After being PEGylated,
IL-15 competes with other ligands for receptor binding (Pettit et al. 1997).
Peglgrastim’s self-regulating pharmacokinetics illustrates how PEGylation changes
biological characteristics (Finck etal. 2020). Similarly, the PEGylation of growth
hormone altered the activity from agonist to antagonist (Yowell and Blackwell 2002).
11.4.3 Physicochemical Modifications
PEGylation causes numerous physicochemical changes in biomolecules. Since
PEG comprises ethylene oxide subunits that absorb three water molecules, the
hydrodynamic volume has increased (Bailon and Won 2009). Furthermore, aggregation may result from charge alteration (such as acylation), which is more apparent

11 PEGylation ofTherapeutic Proteins andPeptides
331
when assessed after incubating at higher temperatures. Less aggregation occurs
when the charge on the alpha-amino group is preserved after PEGylation. PEGylation
may also conceal charges and glycosylation capabilities, reducing the ability of
RES and hepatocytes to phagocytose PEG-induced epitope shielding on proteins
may lessen immunogenicity and proteolytic breakdown (Baumann etal. 2014).
11.4.4 PEG Size
The only polymer used for several years was 5 kDa in size and was also end-capped
by the methoxyl group and terminated by the hydroxyl group. Despite it becoming
evident that the size of the polymer has a signicant impact on assessing the biological behavior of PEG conjugates, this has not been the case for many years. This
decision was made since the polymer is simple to activate, and conjugation may be
carried out not simply by professional polymer scientists but also in biological laboratories (Plesner etal. 2011).
Also, it was understood that the mass of attached PEG was crucial in determining
how long it remained in the blood. One large PEG chain, or several tiny PEG chains,
can be added to the protein to achieve the necessary mass. Due to the strong polydispersity and considerable amount of diol contaminants in the samples, conjugation was troublesome for a very long time creating heterogeneity in the nished
product (Wang etal. 2020a). Commercializing a puried, low polydisperse, activated, extremely high-weight polymer (30–40kDa) that was far more ideal for
medical applications helped solve this issue later in the 1990s. Pharmaceutical PEG
should range in polydispersity from 1.01 for a 5 kDa product to 1.1 for a 50kDa
product, considering that the value is 1.00 for a monodisperse product.
11.4.5 PEG Structure
PEGs can be created in linear, branching, Y-shaped geometries, or multi-arm. It was
discovered that the shape of the connected protein is just as crucial to its biological
function as its weight or the binding chemistry (Veronese etal. 1997). The “Y”-shaped
branched PEG substantially enhances the PEG shielding function on a protein surface,
making it more successful at defending the conjugated protein against proteolytic
enzymes and antibodies. The increased steric hindrance hinders the PEG from reaching
the enzyme’s active site or other less accessible locations vital to biological activity.
Enzyme active sites are frequently hidden in clefts inaccessible to bulky molecules. By
utilizing hindered branched PEGs, this property can be used to prevent the active site
from being modied during the PEGylation procedure. Compared to linear PEGs,
branching PEGs have limited access to buried sites due to their structure, which helps
preserve the enzymatic function. Also, the “umbrella-like” design of branching PEGs
shields the proteins from deterioration to a larger extent and provides a higher level of
surface protection per point of attachment (Veronese etal. 1997).

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N. Akojwar et al.
11.5 Purification ofPEGylated Proteins
PEGylated proteins must be puried to extract the end product from complex mixtures. It is necessary to separate the specic PEG–protein conjugate from unreacted
proteins, proteins that have been over-PEGylated, unreacted PEG reagent, and additional reagents that will eventually be incorporated into the PEGylation mixture.
Typically, one seeks to take advantage of variances in physicochemical features
while constructing a bioseparation method. Variability in charge, hydrodynamic
radii, hydrophobicity, and, in some circumstances, afnity is used for the separation
of the target PEG-protein. The complexity of the PEGylation mixture often determines how effectively the purication procedure produces the necessary homogeneity of the product (Veronese etal. 1997).
Column chromatography, particularly size exclusion chromatography (SEC) and
ion-exchange chromatography (IEC), is used to purify most PEGylated proteins.
The small amount of sample that can be loaded and the low mobile-phase ow
velocity are constraints on SEC, a technique focused on the solute difference in size.
As a result, it is typically utilized for analytical separations. IEC is centered around
charge differences, with uncharged PEG being able to protect the protein’s intrinsic
charge to a greater extent as PEGylation levels rise (Yoshimoto and Yamamoto
2012). Unfortunately, the separation speed is slowed down by the diffusion limita-
tion of column-based IEC based on porous particle chromatography. PEGylated
proteins typically have a binding capability on IEC media that is weaker than native
proteins. Both charge shielding and an increase in hydrodynamic radius, which
reduces diffusivity, have been used to explain this phenomenon. While this makes it
simple to separate native proteins and PEGylated proteins practically, it is challenging to fractionate multiple PEGylated forms.
A puried protein sample that has been PEGylated poses two different categories
of purifying difculties. In the rst, PEG-proteins are separated from other reaction
products, such as but not exclusively unreacted PEGs and proteins. The second
involves sub-fractionating PEG-proteins according to positional isomerism and the
amount of PEGylation in both. Making such separations may seem simple, but several
PEG polymer-related issues might make it more difcult (Fee and Van Alstine 2006).
11.6 PK Profiling
The two most crucial elements that affect the concentration of PEG-modied therapeutics in blood circulation are molecular weight and injection site. The elimination
rates from the injection point are intraperitoneal (IP)>subcutaneously (SC)>intramuscularly (IM) [109]. The drug delivered as IM injection forms a reservoir at the
injection site and progressively diffuses into the bloodstream; to a smaller degree,
the same is true for the drug administered SC.As PEG’s molecular mass increases,
the elimination rate for SC and IM reduces. The pharmacokinetic characteristic of
the PEG adducts is signicantly inuenced by the mode of delivery (Veronese and
Mero 2008).

11 PEGylation ofTherapeutic Proteins andPeptides
333
A two-compartment model of biodistribution suggests that the relatively small
PEG translocates readily between circulation to extravascular cells and back again
through diffusion. In contrast, large PEG translocates much more poorly (Hamidi
etal. 2006). On the other hand, relatively high-weight PEG circulates in the blood
for a prolonged period while urine clearance is lowered. Regardless of molecular
weight, PEG accumulates in tissues and organs (such as muscle, skin, bone, and, to
a greater extent, the liver). PEG uptake increases by the Küpffer cells when the
weight reaches 50kDa. Small and linear PEG are distributed all over the body with
a high distribution volume, whereas branched PEG is distributed to a lesser extent,
mainly in the liver and spleen (Witt etal. 2001).
The primary motivation for protein modication, especially PEGylation, is
regulating protein PK properties, focusing on the elimination and half-life extension. Rodents, usually rats that are big enough to provide the time course sampling necessary for PK prole determination, are typically used for the initial
screening of PK properties. A universal analytical approach for identifying the
conjugate in complicated biological materials is required to accurately and satisfactorily quantify the concentration of the PEG protein conjugate over time in
blood sera. Thus, the preferred technique continues to be the protein-specic
ELISA, which is typically sold commercially and has antibodies targeted to the
conjugated protein (Kozma etal. 2020). Since these ELISAs can only detect the
protein portion, they are less sensitive to PEGylated proteins than their counterparts that are not PEGylated. This reduced sensitivity is one of their fundamental
limitations.
Reduced sensitivity results from PEGs’ tendency to conceal crucial amino
acid positions for receptor binding, which reduces the strength of the interaction
between the receptor and the target antibody. The afnity for the antibodies is
typically reduced by large PEGs and multi-PEGs connected to protein, which
causes a less steep dose–response curve. It is crucial to utilize the same pure
PEG-conjugate for the standard plot to prevent errors in the concentration of
PEG–protein conjugates that are determined. Thus, the standard curve obtained
from puried PEG-conjugate should be used to compute the nal quantities of
PEG-conjugates in blood serum. Instead, the un-PEGylated protein should not be
utilized as a comparison .
11.7 Passive andActive Targeting
The targeting mechanisms of polymeric therapeutic PPDs might be passive or
active. This property is mainly exploited in the treatment of cancer. Passive targeting is demonstrated by the EPR-induced accumulation of PEG-modied drugs
inside permeable tumors. EPR’s passive targeting is enhanced by active targeting,
which also increases selectivity. By receptor-mediated endocytosis, targeting moieties attached to the polymer backbone can further distinguish between healthy and
malignant cells.

334
N. Akojwar et al.
The effectiveness of passive targeted drug delivery techniques mostly depends
on the concentration gradient between intracellular and extracellular areas. With
leaky vasculature and inadequate lymphatic drainage, PEG conjugates take advantage of the increased permeation and retention (EPR) phenomenon demonstrated by
tumors and accumulate in the pathophysiological microenvironment of tumor arteries (Greish 2007). This size-dependent effect cannot be explored with lowmolecular- weight proteins that rapidly extravasate and cause systemic toxicity.
PEGylation enhances solubility, molecular mass, size, and serum stability.
PEGylation is regarded as one of the most remarkable techniques for the passive
targeted delivery of anticancer treatments for all these reasons.
The idea behind active drug targeting is to couple drug molecules to targeting
agents (antibodies, ligands, etc.) to specically engage with the structures on the
cell surface and deliver an anticancer agent where needed. The targeting and linker
molecules on the prodrug govern how it will behave within the body. Also, based on
the linker molecules, the drug can enter the tumor cell in one of two ways: either
receptor-mediated endocytosis, which involves internalizing the entire prodrug for
later destruction by the endosomal/lysosomal route, or receptor-independent internalization, which occurs following extracellular dissociation of the prodrug (Filpula
and Zhao 2008). Figure 11.4 represents the mechanism of internalization of the
PEGylated PPDs.
Fig. 11.4 The mechanism of internalization of PEGylated PPDs

11 PEGylation ofTherapeutic Proteins andPeptides
335
11.8 Analytical Methods forCharacterization
Analysis techniques for PEG protein adducts and PEG reagents are needed at different phases of the development process to create a safe and effective PEGylated therapy. To successfully develop PEGylated therapies, properly characterizing PEG
reagents, which serve as a critical raw material, is imperative. PEG reagent quality can
vary signicantly depending on molecular weights, polydispersity, impurity presence,
and activation degree. NMR is often employed to determine the functional groups
both qualitatively and quantitatively, and it is the release method chosen by all manufacturers to determine the terminal activity of activated PEGs. A derivatization process is required to achieve UV absorbance because most PEG reagents are UV
transparent and non-uorescent. Reversed-phase (RP)-HPLC, for instance, can be
used to test methoxy-PEG aldehyde after it has been derivatized with 4-aminobenzoic
acid (Zhang et al. 2014b). The variation in molecular mass of PEG chains can be
determined using reverse phase chromatography and Size Exclusion Chromatography
in conjunction with corona detection mode, enabling impurity detection in the nal
PEG reagent. The molecular weight of PEG, which affects the protein’s nal half-life
and directly impacts the bioavailability of PEGylated medicines, is another aspect of
PEG that needs to be carefully managed (Wang etal. 2020b). The same technique is
employed to identify polydispersity and the major peak fraction in PEG.
The complete characterization of the PEG-protein conjugates during the
PEGylated therapeutics production process is a very challenging job. Beginning with
the evaluation of PEGylated reaction mixtures, it continues with the analysis of each
fraction throughout purication and ends with thorough nal product characterization. The characterization of PEGylated PPDs is affected by the reality that the associated PEG signicantly modies the protein’s properties. As was already mentioned,
the most noticeable effects of PEGylation are a higher hydrodynamic volume and
larger molecular size. Many techniques, including SEC, electrophoretic techniques,
light scattering, and mass spectrometry, can be used to measure the molecular weight
of proteins and PEG-protein conjugates (Caserman etal. 2009). Peptide mapping
and MS are utilized to identify and quantify PEGylation sites via analyzing PEGylated
and unPEGylated counterparts as well as to characterize impurities that are not
always resolved and detected using simpler techniques (Kemptner etal. 2010).
11.9 FDA-Approved PEGylated Products
PEGylated medications treat conditions like cancer, chronic renal disease, hepatitis,
hemophilia, and gastrointestinal issues. FDA approved the sale of ADAGEN, a
PEGylated protein Enzon Pharmaceuticals produced in March 1990. Several
PEGylated PPDs have followed in ADAGEN’s footsteps since its release, and many
more are currently through clinical trials or other phases of research. Neulasta and
Cimzia, two of the FDA-approved medications, reached $3.221 billion and $1.953
billion in sales in 2019. It is important to note that all medications approved by the
FDA involve methoxypolyethylene glycol. Table 11.1 represents the marketed
PEGylated PPDs.

336
Reference
(2020)
Year of
approval
Average MW of
PEGs
N. Akojwar et al.
etal. (2021)
4 × 10kDa 2021 Maniatis etal. (2022)
40kDa 2021 Shah etal. (2022)
20kDa 2020 Yang etal. (2021)
20kDa 2019 (Cornes etal. 2020)
20kDa 2018 Webster etal. (2020)
20kDa 2018 Selby etal. (2021)
G-CSF Febrile neutropenia 3.4kDa 2022 Schwartzberg etal.
Company PEGylated entity Indications
Trade Name
Table 11.1 Marketed PEGylated products
Rolvedon Spectrum
G-CSF Neutropenia 20kDa 2022 Humphreys etal. (2022)
Pharmaceuticals
Stimufend Fresenius Kabi G-CSF Neutropenia 20kDa 2022 Panda etal. (2023)
Fylnetra Amneal pharmaceuticals
LLC
deciency
BESREMi PharmaEssentia Corp Interferon Polycythemia vera 40kDa 2021 Okikiolu etal. (2023)
Skytrofa Ascendis Human growth hormone Growth hormone
hemoglobinuria (PNH)
with chemotherapy
Hemophilia A 40kDa 2019 Ezban etal. (2020)
antihemophilic factor
Empaveli Apellis Pentadecapeptide Paroxysmal nocturnal
Nyvepria Pzer Inc. G-CSF Neutropenia associated
Esperoct Novo Nordisk Recombinant
Ziextenzo Sandoz G-CSF Infection during
chemotherapy
chemotherapy
Phenylketonuria ~ 9 X 20kDa 2018 Patrawala etal. (2020)
Recombinant
Udenyca Coherus biosciences G-CSF Infection during
Palynziq BioMarin
ADA-SCID 80kDa 2018 Carbonaro- Sarracino
phenylalanine ammonia
lyase
Pharmaceutical
Revcovi Leadiant bioscience Recombinant adenosine
chemotherapy
deaminase
Fulphila Mylan GmbH G-CSF Infection during
Asparlas Servier pharma L-asparaginase Leukemia 31–39 × 5kDa 2018 Bender etal. (2021)
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