Mucoadhesive drug delivery systems which are being used from 1980’s to avoid first pass metabolism of drugs, commercially exist for only systemic drug delivery with fast erosion times (15-60 min), that may not be appropriate for local oral disorders. The goal of this research was to develop and characterize mucoadhesive films with flexibility of carrying different drugs and proteins and provide sustained release for local treatment of oral disorders. Mucoadhesive films composed of polyvinylpyrrolidone (PVP) and carboxymethlycellulose (CMC) were formulated with imiquimod, an immune response modifier. Problems such as solubilization of imiquimod to increase drug loading, uniformity in films and total amount of drug released into supernatants were addressed by use of acetate buffer after investigating multiple methods. Subsequently, other relevant properties of mucoadhesive systems, such as adhesion (shear, pull-off), tensile properties, swelling profiles, transport kinetics, and subsequent changes in release profiles as a function of film composition were characterized. The potential of the system for local retention of imiquimod, determined in oral mucosa of hamsters showed time dependent decrease in imiquimod amount through 12 hours, with no traces of drug in blood. Further testing in humans revealed that the residence time of the mucoadhesive films depended on the application site, increasing in the order of tongue < cheek < gingiva. In parallel, mucoadhesive films loaded with epidermal growth factor (EGF) were developed to promote treatment of oral mucosal wounds. Bioactivity was tested in vitro on buccal tissues by creating a wound followed by application of films. Although EGF-loaded films did not accelerate wound healing, but rather elicited a hyperparakeratotic response. In vitro buccal tissues may not be appropriate for testing the effects of EGF in wound healing without incorporation of other biochemical factors. Overall, a mucoadhesive system capable of delivering bioactive small molecules and proteins in sustained manner was developed in this work. A thorough understanding of the system properties was achieved to further tune for future applications. In vitro studies and in vivo studies in hamsters and humans clearly showed the potential and usefulness of the system to translate in to clinic for treatment of oral precancerous lesions.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Le glioblastome constitue la tumeur primitive maligne la plus fréquente et la plus agressive du système nerveux central, caractérisée par un pronostic sombre. L’infusion locale dans le parenchyme cérébral du cisplatine a présenté des résultats encourageants sur des modèles précliniques. La nanovectorisation permet de concentrer l’efficacité thérapeutique d’agents anticancéreux à leur cible. Leur fonctionnalisation par des unités d’imagerie offre la possibilité de suivre de façon non invasive par imagerie par résonance magnétique (IRM) leur biodistribution au sein du tissu lésé. Dans cette optique, un copolymère tribloc amphiphile biocompatible a été synthétisé par polymérisations par ouverture de cycle successives à partir d’un oxyde de polyéthylène (PEO). Après micellisation dans l’eau, des complexes de gadolinium ont été greffés sur la couronne de PEO et les fonctions carboxylates situées en périphérie du coeur micellaire se sont réticulées sur le cisplatine, conduisant à la formation d’une prodrogue macromoléculaire de taille nanométrique stable dans le temps. Le potentiel de ces nanoparticules bifonctionnelles comme agents de contraste IRM a été exploré à haut champ magnétique. Une telle vectorisation du cisplatine a en outre permis d’augmenter de façon significative l’accumulation du platine dans deux lignées humaines de glioblastome ainsi que la formation d’adduits à l’ADN par rapport à la drogue libre. L’implication de mécanismes biologiques sous-jacents à cette étude pose la question de l’existence d’autres cibles alternatives critiques des dérivés du platine, remettant en cause le paradigme établi depuis un demi-siècle définissant l’ADN comme la cible ultime du cisplatine. / Glioblastoma is the most frequent and aggressive primary malignant tumor of the central nervous system with a gloomy prognosis. Local infusion of cisplatin within the brain parenchyma exhibited promising results in preclinical models. Nanovectorization of anticancer agents even promotes the concentration of their therapeutic efficiency on their target. Anchorage ofimaging moieties on such smart drug delivery systems further enables the non-invasive monitoring of their biodistribution within the damaged tissue by magnetic resonance imaging (MRI). From this perspective, a biocompatible amphiphilic triblock copolymer was synthesized by successive ring-opening polymerizations from a polyethylene oxide (PEO). After micellization in water, gadolinium complexes were grafted to the PEO corona and the carboxylate functions located at the surface of the micelle’s core were able to cross-link with cisplatin. A stable nano-sized macromolecular prodrug was therefore recovered. Relaxomety measurements at a high magnetic field confirmed the intrinsic potential of these hybrid nanoparticles as alternative MRI contrast agents. Besides, cisplatin vectorization allowed for substantially increasing the accumulation of platinum compounds in two human glioblastoma cell lines as well as the subsequent formation of DNA adducts in comparison with the free drug. Biological mechanisms below this study raise the question whether critical alternative targets of platinum derivatives might exist, thus undermining the old-established paradigm that defines DNA as the ultimate target of cisplatin.