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Introduction to Drug Delivery System: Past, Present, and Future Perspectives 9
Liposomes, derived from the term “lipid body,” are micro­scopic spherical vesicles composed of one or more concentric lipid bilayers, with water or aqueous buffer compartments in between, and diameters ranging from 25 nm to 10,000 nm. These structures form through the self-assembly of phospholipid molecules in an aqueous environment. Liposomes typically consist of one or more amphiphilic phospholipid bilayer membranes, also known as phos­pholipid vesicles, capable of encapsulating both hydrophilic and hydrophobic drugs. Hydrophilic drugs are enclosed within the aqueous center of the liposome, while the phospholipid membrane comprising the liposome’s wall can accommodate hydrophobic agents.
Sphingosomes can be described as vesicles with concentric, bilayer structures where an aqueous compartment is completely enclosed by a lipid bilayer primarily made up of natural or synthetic sphingolipids. These sphingosomes can be administered through various routes, including parenteral routes such as intravenous, intramuscular, subcutaneous, and intra-arterial methods.
Transfersomes represent a recent advancement in drug delivery systems and are a specialized form of liposomes. They consist of phosphatidylcholine along with an edge activator. These structures possess an extremely flexible membrane, enabling them to consis­tently deliver drugs either into or through the skin. The effective­ness of drug delivery using this system depends on the method of administration or application chosen. Transferosomes exhibit sig­nificantly greater elasticity and flexibility compared to conventional liposomal drug delivery systems. This enhanced flexibility facilitates efficient penetration of the skin, making transferosomes a promising option for novel drug delivery systems. They are essen­tially highly adaptable and optimized mixed lipid complexes.
Niosomes r
epresent a
n innovative drug delivery approach where the medication is enclosed within a vesicle. These vesicles are constructed from a bilayer of non-ionic surface-active agents, giving rise to their name “niosomes.” Niosomes are characterized by their minute size, falling within the nanometric scale, making them microscopic.
Ethosomes are
liposomes containing ethanol. They serve as noninvasive carriers facilitating the penetration of drugs into deep skin layers or systemic circulation. Ethosomes are flexible vesicles designed to enhance the delivery of active agents. These vesicles have long been recognized for their significance in cellular commu­nication and particle transport. Additionally, they enable the con­trol of drug release rates over extended periods, protecting the drug from immune responses or elimination systems. Consequently, they can maintain optimal drug concentrations for prolonged durations.
10 Santanu Pal et al.

5 Recent Drug Delivery Systems

5.1 Red Blood Cell Membrane­Camouflaged Nanoparticles Drug Delivery System
5.2 Hyaluronic Acid­Based Drug Nanocarriers Drug Delivery Systems
The inherent properties and biological importance of red blood cells (RBCs) make them an effective choice for concealing nano­particles and serving as a camouflage material. Due to their abun­dance as the most prevalent circulating cells in the body, red blood cells (RBCs) possess biocompatibility, biodegradability, and an extended circulating half-life, rendering them well suited as an optimal carrier for drug delivery. Numerous approaches have been devised to load therapeutic substances onto red blood cells (RBCs) while preserving their structural integrity and physiological functions. Coated nanoparticles are designed to imitate RBCs, allowing for prolonged systemic circulation upon injection and interaction with the surrounding environment. Sonication stands out as the predominant technique for producing RBC-camouflaged nanoparticles. Alter native methods for combining RBCs with nanoparticles include in-situ polymeriza­tion, microfluidic electroporation, and extrusion. The utilization of RBCM-NP drug delivery systems holds great promise and pre­sents several advantages, primarily stemming from their minimal immunogenicity and capacity for sustaining prolonged systemic circulation, lasting up to 120 days.
Hyaluronic acid represents a novel polymer suitable for crafting medication delivery systems. This linear macromolecular muco­polysaccharide consists of interconnected glucuronic acid and N-acetylglucosamine saccharide units. It possesses attributes such as biocompatibility, biodegradability, and high viscoelasticity, and it can bind to specific cell surface receptors. Given its natural presence in eye tissue and its role in wound healing, utilizing hyaluronic acid as a carrier for ocular drug delivery seems logical, provided that it ensures consistent release of the incorporated pharmaceuticals. The use of active targeted hyaluronic acid (HA)-based drug nanocar­riers has significantly enhanced drug distribution to cancer cells. Furthermore, lipid nanoparticles coated with appropriate HA have been engineered as biocompatible drug carriers, showing promising potential for targeted drug delivery to specific tissues while mitigating side effects on other tissues. Employing HA-based nanocarriers for cancers exhibiting elevated CD44 receptor expres­sion offers several advantages, including enhanced drug delivery, improved therapeutic effectiveness, heightened cytotoxicity, a nota­ble reduction in tumor growth, and considerable potential for targeted chemotherapy.

5.3 Hexagonal Boron Nitride Nanosheet Drug Delivery System

Jedrzejczak-Silicka and her team have demonstrated the utility of hexagonal boron nitride (H-BN) in drug research and delivery systems. Their study revealed a decrease in the proliferation of
Introduction to Drug Delivery System: Past, Present, and Future Perspectives 11
MCF-7 cell line cultures compared to normal L929 cell lines when exposed to H-BN loaded with gold particles. The process involved exfoliating H-BN through chemical treatment using a modified Hummers’ method and sonication treatment, followed by functio­nalization with gold particles for analysis using the neutral red (NR) uptake assay.

5.4 Polymer-Lipid Hybrid Nanoparticles Drug Delivery System

5.5 Self-Micro Emulsifying Drug Delivery System

This hybrid system successfully meets various criteria including biocompatibility, long storage stability, sustained drug release, min­imal drug leakage, small particle size, and efficient encapsulation. Due to its effectiveness, this system is currently utilized for diverse therapeutic purposes and diagnostic applications. PLHNPs consist of three key components: a polymeric core capable of effectively encapsulating both hydrophilic and hydrophobic drugs due to its dual nature, resulting in sustained release; a lipid shell ensuring biocompatibility and high stability; and a lipid-polyethylene glycol (PEG) outer layer covered by a lipid shell, enhancing steric stability, preventing immune recognition, and prolonging circulation time. PLHNPs find wide-ranging applications in delivering various che­motherapeutic agents, and gene transfer (siRNA, DNA), as well as in photothermal, photodynamic therapy, and ultrasound applications.
Lipid-based carriers are available in various forms, including sus­pensions, dry emulsions, microemulsions, and self-emulsifying drug delivery systems (SEDDS) (Table 3). SEDDS have been recognized for their capability to incorporate hydrophobic dr ugs. SEDDS has evolved into self-micro emulsifying drug-delivery sys­tems (SMEDDS) and self-nano emulsifying drug delivery systems (SNEDDS). Emulsions, on the other hand, are formed by
Table 3 Important categories of lipid-based drug delivery systems (LBDDS) along with their advantages and disadvantages
Sl. No. Characteristics SMEDDS SNEDDS SEDDS
1. Size of the globule <250 nm <100 nm >300 nm
2. The system appearance High optical clarity High optical clarity Cloudy
3. The surfactant HLB value >12 >12 <12
4. LFCS classification Type IIIB Type IIIB Type II
5. Oil phase >20% >20% 40–80%
6. Surfactants concentration 40–80% 40–80% 30–
Key: HLB hydrophilic/lipophilic balance; LFCS lipid formulation classification system; SEDDS Self-emulsifying drug­delivery systems; SMEDDS self-microemulsifying drug-delivery systems; SNEDDS self-nanoemulsifying drug-delivery system
40%
12 Santanu Pal et al.
dispersing a liquid phase containing macroscopic particles into a different liquid phase–containing surfactant. They represent a ther­modynamically unstable solution that appears semi-transparent (occasionally hazy) and exhibits properties resembling viscous liquids. Emulsions come in three types: water-in-oil, oil-in-water, and multiple emulsions. Moreover, conventional micro- or nano­emulsions differ from SMEDDS in that they self-emulsify followi
ng
oral ingestion.

5.6 In Situ Gel Drug Delivery System

5.7 Microelectrome­chanical Systems (MEMS) for Drug Delivery
The in situ gel drug delivery system has emerged as a highly innovative approach to medication administration. Its distinctive property of transitioning from a solution to a gel enables prolonged and controlled release of medications, along with enhancing patient compliance and comfort. Typically, formulations in solution form undergo a transition into gel form under specific physiological conditions before administration. Various stimuli, including pH alterations, temperature changes, and solvent exchange, contribute to this transfor mation from solution to gel form. Four mechanisms are recognized for generating in situ gel biomaterials, including temperature and pH fluctuations, alterations in the physical char­acteristics of biomaterials such as solvent exchange and swelling, biochemical modifications like enzymatic and chemical reactions, and photo-polymerization.
This technology
utilizes microfabrication techniques to create micro-/nano-scale electromechanical and mechanical devices or implants. MEMS-based devices are designed using a wide array of materials and processes, with the most commonly employed approach involving a creative combination of different microma­chining techniques. These techniques include deposition (an additive process), etching (a subtractive process), lithography (a patterning process), ink jetting, ion implantation, oxidation, and micro molding. In drug delivery systems, MEMS technology con­structs miniature systems composed of diverse materials such as silicon, glass, metals, nitrides, and polymers. These systems may incorporate micropumps, sensors, microvalves, reservoirs, actua­tors, and high-performance processors. MEMS-based devices are crucial for achieving targeted and precise drug delivery through controlled and pulsatile release of enclosed pharmaceuticals. These devices can be designed as either electric-powered or non-electric­powered systems. Electric-powered devices enable selective drug release from reservoirs via electric potential, whereas non-powered devices utilize diffusion and osmotic environmental stimulus mechanisms to facilitate drug release. Among MEMS technologies applicable in drug delivery, microchips are the most widely utilized, followed by microfluidic devices, particularly micropumps. Drug delivery devices produced through MEMS technologies present numerous advantages compared to traditional delivery methods.
Introduction to Drug Delivery System: Past, Present, and Future Perspectives 13
These include improved performance, automation, precision, and efficacy resulting from the integration of miniaturized sizes with multifunctional components. Moreover, MEMS-based devices contribute to reduced pain and invasiveness during use. Addition­ally, they enable drug stability maintenance during encapsulation, adjustable and continuous delivery, and facilitate the automated release of multiple drugs from reservoirs.

5.8 Targeted Drug Delivery

The demand for targeted drug delivery (TDD) over conventional drug delivery systems (DSS) stems from four key factors: the inad­equate per formance of drugs concerning pharmacodynamic, phar­macokinetic, pharmaceutical, and pharmacotherapeutic aspects with conventional delivery methods (Fig.
4). Delivering drugs to
specific areas using optimized drug delivery methods is essential not only for improving therapeutic effectiveness but also for minimiz­ing toxicity linked to drugs with a narrow therapeutic index and high doses. Targeting is necessary to address the limitations and inherent drawbacks of conventional drug delivery systems (DDSs). Parenteral delivery is invasive, oral administration is unsuitable for protein- or peptide-based drugs, and topical creams and ointments are primarily restricted to local effects. Moreover, the efficacy of drug-target interactions is diminished unless the drug is trans­ported to its intended site of action at a dosage and rate that minimizes side effects while maximizing therapeutic benefits
7]. Moreover, simpler drug administration processes, reduced
[ drug quantities leading to lower therapeutic costs, and the ability to significantly enhance drug concentration in target areas without adversely affecting non-target areas are all promising advantages of targeted drug delivery (TDD). Overall, drug targeting results in improved effectiveness, regulated pharmacokinetics, controlled
Fig. 4 The illustration of the necessity for targeted drug delivery over conventional drug delivery systems
14 Santanu Pal et al.
distribution throughout the body, heightened specificity in locali­zation, decreased toxicity, lowered dosage requirements, and enhanced patient adherence to treatment regimens.
The fundamental concept of drug targeting involves delivering a concentrated amount of dr ug to the intended site while minimiz­ing its presence in non-targeted areas. This approach helps maxi­mize the therapeutic effects of the dr ug while reducing side effects resulting from interactions with multiple targets, high doses, and unintended concentrations in non-targeted regions. Additionally, targeting helps mitigate unwanted interactions between the drug and biological environmental factors that may hinder its access to targeted sites within the body. Drug targeting involves the synchro­nized actions of the drug, the target site, and the pharmaceutical carrier. The target refers to the particular organ, cell, or group of cells, either in a chronic or acute condition requiring treatment, with which the drug will interact. The carrier is a specially designed molecule or system crucial for efficiently transporting the loaded drug to predetermined sites. Ideally, a drug-targeting complex should be non-toxic, non-immunogenic, biochemically inactive, biodegradable, biocompatible, and exhibit stability both in vivo and in vitro. To ensure that these ideal characteristics are met, targeted drug products should be formulated while taking into account the unique proper ties of target cells and the characteristics of transport carriers or vehicles responsible for delivering the drug to specific receptors. While targeted drug delivery (TDD) can address various chronic and infectious diseases, its primary signifi­cance lies in cancer treatment, attributed to its improved penetra­tion of tumors and enhanced concentration at the infection site. Promising applications and objectives of TDD encompass cancer therapy, vaccine enhancement, delivery to ocular and brain regions, DNA and oligonucleotide transport, targeting intracellularly and systemically, administering orally and transdermally, conducting enzyme immunoassays, and performing radioimaging.
Dru
argeting can be categorized into three (or four) distinct
g t levels of targeting. First-order targeting involves restricting the distribution of the drug-carrier system to the capillary bed of the target site. Second-order targeting entails delivering drugs selec­tively to specific cell types, such as tumor cells. Third-order target­ing focuses on directing drugs to intracellular sites specifically, while fourth-order targeting is occasionally referred to as drugs targeting macromolecules like DNA and proteins.
Physical targeting
involves systems that concentrate agents in target regions due to their size, composition, or other inherent characteristics, rather than being specifically designed for a biological receptor. Chemical targeting entails directing agents to targeted areas using site-specific prodrugs. Agents can also be guided to specific areas through enzymatic or chemical reactions, leading to the targeting of a vehicle or the controlled release or
Introduction to Drug Delivery System: Past, Present, and Future Perspectives 15
action of the agent. Biological targeting allows localized agents to concentrate in target areas using antibodies (Abs), peptides, pro­teins, or other biomolecules that possess affinity with receptors, sites, or other biological targets in a specific manner. Gene expres­sion can also be localized to target areas using cells, tissue, or specific promoters within vector systems.
Locally targeted systems are noninvasive targeting approaches primarily aimed at delivering drugs to a specific local site to manage local pathologies. In contrast, systemic targeting involves delivering therapeutic systems via an invasive route, such as intravenous administration of nanotechnological systems. These systems dis­tribute the drug throughout the body via systemic circulation. The primary limitations of systemic targeting stem from the adverse effects of drugs on nonspecific tissues.
Targeted drug delivery (TDD) employing location-based stra­tegies involves delivering drugs to specific cells, organs, and orga­nelles. Examples of location-based targeting include intracellular targeting, gastrointestinal tract (GIT) targeting, brain targeting, and targeting the respiratory tract. Intracellular delivery of pharma­ceutical agents, such as proteins, antibodies (Abs), and drug-loaded nanocarriers, ensures that therapeutic action is specifically directed to the nucleus or specific organelles. Floating drug delivery (DD) exemplifies this targeting approach, where antiviral, antifun­gal, and antibiotic agents are absorbed from specific regions of the GIT. Various site-specific oral controlled-release systems have been developed to target the stomach/duodenum, small intestine, lymph nodes, and colon. Polymer-based drug delivery systems (DDSs), such as dopamine-liposome conjugates, demonstrate effective brain targeting with reduced degradation during circula­tion. Additionally, disease-based targeted delivery involves site­specific therapy targeting tumors and other treatable infectious diseases.

6 Ceramic-Based Drug Delivery System

Ceramic materials possess numerous desirable properties, including ease of preparation, adjustable size and structure, high surface area to volume ratio, stability under physiological conditions, and excel­lent biocompatibility (Fig. utilized in the field of drug delivery systems (DDS) for many years, serving as drug carriers. Traditional ceramic materials are com­prised of inorganic solid compounds, primarily consisting of car­bides, and oxides such as hydroxyapatite, tricalcium phosphate, silica, zeolite, and zirconia. The need for effective dose require­ments (ED50) may diminish due to the enhanced delivery effi­ciency of controlled, sustained, and targeted drug delivery systems (DDS), potentially leading to cost reductions for patients.
Consequently, they have been widely
5).
16 Santanu Pal et al.
Fig. 5 Ceramic-based drug delivery system working on the principle of using ceramic materials to encapsulate and release therapeutic agents in a controlled manner
There is a growing demand for local, homogeneous, controlled, and sustained drug release [
17]. Therefore, it is crucial to develop
carriers with adjustable size and structure, favorable stability under physiological conditions, excellent biocompatibility, and high uptake efficiency. In this regard, ceramics emerge as an attractive material choice for carriers.
Ceramic-based drug carriers have garnered growing interest alongside advancements in medicine, pharmaceutics, and material science. Prominent bioceramics include beta-tricalcium phosphate (β-TCP), hydroxyapatite, mesoporous silica, and zirconia hydroxy­apatite composite, among others. Additionally, bioceramics consti­tute integral components of certain inorganic-organic composites employed as drug carriers. The benefits of ceramic-based drug carriers include the following:
1. They offer adjustable size and structure, making them suitable for accommodating nano-sized drugs.
2. They exhibit low toxicity, as ceramics typically possess good biocompatibility, biodegradability, and biological stability.
3. Certain ceramics demonstrate sensitivity to environmental fac­tors such as light, magnetism, or heat, allowing them to respond accordingly.

7 Polysaccharide-Based Drug Delivery System

Numerous surface coatings derived from polysaccharides have been suggested to confer antimicrobial attributes to implantable materi­als, primarily metals and polymers. Medical surface functionaliza­tion with antimicrobial agents provides an alternative to conventional drug delivery methods. This delivery system can be employed for systemic and topical applications and can be
Introduction to Drug Delivery System: Past, Present, and Future Perspectives 17
administered through various routes, including oral, buccal, sub­lingual, ocular, and transdermal, based on the intended purpose. Hence, designing effective coatings requires a comprehensive understanding of the pharmacological characteristics of drugs and polysaccharides, along with a careful selection of manufacturing techniques. Polysaccharides serve various functions, including facil­itating rapid drug absorption in the gastrointestinal tract or ering dr suitable for drugs with high mucosal permeability, commonly uti­lized in buccal and sublingual delivery methods. Ophthalmic coat­ings are primarily employed to treat anterior segment diseases. Orodispersible films, also known as soluble films, dissolve quickly in the oral cavity. Fast-dissolving oral films have very thin dimen­sions and dissolve within a minute in the mouth. Buccal adhes films deliver circulation post-absorption. Wafers are thin polymeric films used as carriers for pharmaceutical agents and do not require water for drug absorption. Polysaccharide coatings are also applied for sur­face modification of medical devices, particularly in prosthetic applications for orthopedics and dentistry, enabling controlled drug release. Thin films for drug delivery can be formulated throug saccharide thin integral components during preparation [
ugs directly to the administration site. They are particularly
drugs directly through the buccal mucosa for systemic
h two methods: loading drugs directly onto pre-made poly-
films or creating thin films by incorporating drugs as
8].
deliv-
ive

8 Closed Loop Insulin Delivery System

Glucose-responsive insulin delivery systems had their beginnings in the 1960s and 1970s when early versions relied on venous glucose readings to regulate intravenous infusions of insulin and dextrose to keep blood sugar levels stable. It’s only in recent years that these large, stationary technologies have evolved into compact, wearable devices. Today’s closed-loop systems utilize interstitial glucose monitoring, insulin pumps implanted under the skin, and advanced algorithms to manage blood sugar levels more effectively [ early 1960s, Arnold Kadish pioneered the first closed-loop insulin delivery system. Kadish’s creation, referred to as a “servomecha­nism for blood glucose control,” consisted of an autoanalyzer for ongoing monitoring of blood glucose levels through an intrave­nous catheter. Additionally, it included two intravenous syringe pumps containing insulin and either glucose or glucagon [ 2005, the Juvenile Diabetes Research Foundation (JDRF) initiated the Artificial Pancreas Project. The primary goal of this endeavor was to support research, facilitate regulatory approval processes, and ultimately encourage the widespread adoption of closed-loop technologies for diabetes management [ (LGS) systems represent the most basic form of closed-loop
Low-glucose suspend
17].
9]. In the
17]. In
18 Santanu Pal et al.
systems. These systems are comprised of a combined glucose sensor and insulin pump, which can autonomously halt insulin infusion when blood glucose levels drop below a predetermined threshold, without needing confirmation from the user. The advancement of LGS technology led to the development of predictive low-glucose suspend (PLGS) systems. These systems incorporate algorithms capable of forecasting impending hypoglycemia, such as within the next 30 minutes, an the onset designed to mitigate both hypoglycemia and hyperglycemia by regulating glucose levels within a specified target range. These systems employ a computerized algorithm to modify the basal insulin rate and administer corrective bolus doses as needed. They are termed “hybrid” systems because, unlike fully closed-loop sys­tems, users are still responsible for manuall boluses when opposed to hybrid systems, are engineered to automate insulin delivery entirely, eliminating the need for user input regarding mealtime boluses. The primary obstacle in fully closed-loop systems lies in managing postprandial hyperglycemia, given the absence of manually provided data regarding meal timing and carbohydrate intake. These instances of postprandial glucose elevation f lead to current rapid-acting insulins. Two early closed-loop systems, pio­neered by Kadish and Shichiri, employed a dual-hormone strategy, utilizing both insulins to counteract hyperglycemia and glucagon to counteract hypoglycemia. However, the use of glucagon in closed-loop systems became less common during the Biostator era and only reappeared in subcutaneous closed-loop systems in research ar hormone alongside continuous insulin infusion, stems from the notion that preventing hypoglycemia is more effective through glucagon administration rather than suspending insulin delivery. This is pri­marily due to the pharmacokinetic properties of subcutaneous insulin and glucagon: currently, available rapid-acting insulins have a relatively slow onset reach maximum of action (up to 4–6 hours), whereas glucagon exhibits a rapid onset within 5 minutes [
of hypoglycemia. Hybrid closed-loop systems are
consuming meals. Fully closed-loop systems, as
subsequent hypoglycemia due to the delayed effects of
ound the mid-2000s. The main rationale behind dual­systems, capable of administering glucagon boluses
effect (40–60 minutes), and extended duration
d proactively pause insulin delivery before
y inputting insulin
requently
(10–15 minutes), delayed time to
.
17]

9 Liposome-Mediated Drug Delivery

Liposomes are tiny vesicles containing an aqueous core surrounded by a lipid bilayer membrane. A.D. Bangham and R.W. Thorne initially observed these structures in 1964 through electron micros­copy while studying the dispersion of phospholipids in water. They