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Lam, Ming Yiu. / "September 2011." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 149-169). / Abstracts in English and Chinese. / Thesis / Assessment Committee --- p.ii / Abstract (English) --- p.iii / Abstract (Chinese) --- p.vi / Acknowledgements --- p.viii / Table of contents --- p.x / List of figures --- p.xvi / List of tables --- p.xix / Abbreviations --- p.xx / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Cerebral stroke --- p.1 / Chapter 1.2 --- Epidemiology --- p.2 / Chapter 1.3 --- Risk factors and symptoms --- p.5 / Chapter 1.3.1 --- Non-modifiable risks --- p.5 / Chapter 1.3.2 --- Modifiable risks --- p.6 / Chapter 1.3.3 --- Symptoms --- p.9 / Chapter 1.4 --- Mechanisms of cell injury --- p.10 / Chapter 1.4.1 --- Energy failure and loss of ionic homeostasis --- p.10 / Chapter 1.4.2 --- Excitotoxicity and calcium-modulated cell damage --- p.11 / Chapter 1.4.3 --- Oxidative stress --- p.13 / Chapter 1.4.4 --- Inflammation --- p.16 / Chapter 1.4.5 --- Apoptosis --- p.18 / Chapter 1.5 --- Current treatment of ischemia --- p.19 / Chapter 1.6 --- Chinese herbal medicine --- p.21 / Chapter 1.6.1 --- Traditional Chinese medicine theory on stroke --- p.21 / Chapter 1.6.2 --- Danshen --- p.22 / Chapter 1.6.3 --- Gegen --- p.25 / Chapter 1.6.4 --- Danshen-Gegen formula --- p.28 / Chapter 1.7 --- Aim of study --- p.30 / Chapter Chapter 2 --- General methodology --- p.31 / Chapter 2.1 --- Induction of transient focal cerebral ischemia by middle cerebral artery occlusion (MCAO) --- p.31 / Chapter 2.1.1 --- Intraluminal filament production --- p.32 / Chapter 2.1.2 --- Cerebral blood flow measurement by laser Doppler flowmetry --- p.33 / Chapter 2.1.3 --- Middle cerebral artery occlusion --- p.35 / Chapter 2.2 --- Neurological scoring --- p.38 / Chapter 2.3 --- Brain infarction measurement by triphenyltetrazolium chloride (TTC) staining --- p.40 / Chapter 2.4 --- Statistical analyses --- p.42 / Chapter Chapter 3 --- Preparation of herbal medicine --- p.43 / Chapter 3.1 --- Authentication of Chinese herbs --- p.43 / Chapter 3.1.1 --- Morphological authentication --- p.43 / Chapter 3.1.2 --- Chemical authentication using thin layer chromatography --- p.44 / Chapter 3.1.2.1 --- Danshen --- p.44 / Chapter 3.1.2.2 --- Gegen --- p.48 / Chapter 3.2 --- Danshen-Gegen (DG) extract preparation --- p.50 / Chapter 3.3 --- Chemical analysis of DG extract --- p.51 / Chapter 3.3.1 --- TLC --- p.51 / Chapter 3.3.2 --- HPLC --- p.54 / Chapter 3.4 --- Conclusion --- p.57 / Chapter Chapter 4 --- Protective effect of DG extract on cerebral ischemia --- p.58 / Chapter 4.1 --- Introduction --- p.58 / Chapter 4.1.1 --- Different models of ischemia --- p.58 / Chapter 4.1.2 --- Anti-oxidative enzymes in cerebral ischemia --- p.61 / Chapter 4.1.2.1 --- Superoxide dismutase (SOD) --- p.61 / Chapter 4.1.2.2 --- Catalase --- p.62 / Chapter 4.1.2.3 --- Glutathione peroxidase (GPX) --- p.62 / Chapter 4.2 --- Materials and methods --- p.64 / Chapter 4.2.1 --- "DG extract treatment, neurological deficit and brain infarction" --- p.64 / Chapter 4.2.2 --- Anti-oxidative enzymes activity determination --- p.65 / Chapter 4.2.2.1 --- Treatment with DG extract and induction of cerebral ischemia --- p.65 / Chapter 4.2.2.2 --- Extraction of enzymes from the brain --- p.66 / Chapter 4.2.2.3 --- Determination of protein concentration --- p.66 / Chapter 4.2.2.4 --- Assay kits --- p.67 / Chapter 4.3 --- Results --- p.70 / Chapter 4.4 --- Discussion --- p.80 / Chapter 4.4.1 --- Neurological score and percentage brain infarction --- p.80 / Chapter 4.4.2 --- Anti-oxidative enzyme induction --- p.82 / Chapter Chapter 5 --- Behavioral assessment using the shuttle box avoidance test on rats suffering from cerebral ischemia: effect of DG extract treatment --- p.86 / Chapter 5.1 --- Introduction --- p.86 / Chapter 5.1.1 --- Behavioral tests --- p.86 / Chapter 5.1.2 --- Theory of the test --- p.90 / Chapter 5.2 --- Materials and methods --- p.91 / Chapter 5.2.1 --- DG extract treatment --- p.91 / Chapter 5.2.2 --- Shuttle box training and MCAO --- p.92 / Chapter 5.2.3 --- Shuttle box testing --- p.96 / Chapter 5.2.4 --- Neurological score and brain infarction --- p.96 / Chapter 5.3 --- Results --- p.97 / Chapter 5.3.1 --- Shuttle box performance --- p.97 / Chapter 5.3.2 --- Neurological score --- p.105 / Chapter 5.3.3 --- Brain infarction --- p.109 / Chapter 5.4 --- Discussion --- p.112 / Chapter 5.4.1 --- The shuttle box protocol --- p.112 / Chapter 5.4.2 --- Shuttle box performance --- p.114 / Chapter 5.4.2.1 --- Pretreatment groups --- p.114 / Chapter 5.4.2.2 --- Pre + post treatment groups --- p.115 / Chapter 5.4.2.3 --- Comparison of pretreatment and pre + post treatment groups --- p.116 / Chapter 5.4.3 --- Neurological score --- p.117 / Chapter 5.4.4 --- Brain infarction --- p.118 / Chapter 5.4.5 --- Conclusion --- p.119 / Chapter Chapter 6 --- Anti-blood coagulation effect of DG extract --- p.121 / Chapter 6.1 --- Introduction --- p.121 / Chapter 6.2 --- Materials and methods --- p.125 / Chapter 6.2.1 --- Treatment with DG extract and warfarin --- p.125 / Chapter 6.2.2 --- Tail bleeding time and volume --- p.126 / Chapter 6.2.3 --- Prothrombin time --- p.127 / Chapter 6.2.4 --- Platelet aggregation --- p.127 / Chapter 6.3 --- Results --- p.128 / Chapter 6.4 --- Discussion --- p.138 / Chapter Chapter 7 --- General discussion --- p.141 / Chapter 7.1 --- General discussion and conclusion --- p.141 / Chapter 7.2 --- Clinical significance of the study --- p.145 / Chapter 7.3 --- Limitations of the study --- p.146 / Chapter 7.4 --- Future work --- p.147 / References --- p.149 / Publications --- p.170

Cerebral ischaemia, traumatic injury to the brain, inflammatory neurological disorders and HIV infections are amongst the most prevalent causes of neurodegeneration. Neuroprotective strategies are usually to limit the progressive secondary injury that generally occurs, thus limiting overall tissue damage. Neuroprotective strategies are usually to limit the progressive secondary injury that generally occurs, thus limiting overall tissue damage. Sodium channel blockers have been often used for this matter as they prevent the cascade of events culminating in free radical generation and eventually neuronal apoptosis. Newer compounds, such as antiperoxidants and free radical scavengers, show encouraging experimental results, but their clinical use is still very limited. Phenytoin being a popular drug in the treatment of epilepsy has also been used as a neuroprotectant during certain neurological emergencies and in pharmacological prophylaxis of post-traumatic epilepsy. Furthermore this agent functions by prolonging inactivation of voltage gated sodium channels. In these sets of experiment the neuroprotective properties of phenytoin were examined. The histological study revealed that phenytoin confers protection to the CA1 and CA3 regions of the hippocampus under the insult of QUIN. Cells maintain their characteristic shape and minimal tissue necrosis occurs in the presence of this agent. The in vitro effect of this antiepileptic drug on free radicals generation shows that phenytoin does not reduce or prevent the formation of these reactive species. Lipid peroxidation was induced using QUIN and iron (II), two known neurotoxins. The study reveals that only lipid peroxidation induced using iron (II) is reduced by phenytoin. These experiments were carried out in whole rat brain homogenate. These studies show that phenytoin possesses poor free radical scavenging properties. However, the dose-related reduction of iron-induced lipid peroxidation allows for speculation that phenytoin interacts with iron in order to reduce neuronal damage. Metal binding studies were performed using UV, IR and electrochemical analysis to examine the interaction of phenytoin with iron (II) and iron (III). Phenytoin, when added to iron (II) in solution, first oxidises the latter to iron (III) and maintains it in that form. A shift in the peak was observed in the UV spectrum when iron was added to phenytoin. Moreover, electrochemical studies indicate that the interaction between the metal and the ligand is very weak. The IR analysis it shows that phenytoin may be coordinating with iron through the Nitrogen atom on the phenytoin molecule. These studies show that phenytoin maintains iron in its oxidised form, which is a good property to possess as a neuroprotectants. Pineal organ culture showed that phenytoin does not increase melatonin production but slightly and non-significantly reduces the levels of this pineal hormone. However there is a significant rise in precursor NAS levels. As melatonin is known to possess antioxidant and free radical scavenging properties, this could mean that this drug can cause the CNS to become more susceptible to attacks by reactive oxygen species.

Diss.--Technische Hochschule, Brunswick.

Hyperprolactinemia (hyperPRL) is a highly prevalent adverse side effect in antipsychotic therapy as most antipsychotic drugs are dopamine D2 receptor antagonists. Peony-Glycyrrhiza Decoction (PGD, 芍藥甘草湯) is a classic Chinese herbal formula initially used to treat muscle pain and spasm. Our pilot clinical studies have confirmed the effectiveness of PGD in alleviating antipsychotic-induced hyperPRL in patients with schizophrenia. In the present study, we further examined the effects of PGD, its individual herbal preparations and major compounds in suppressing prolactin (PRL) hyperactivity in in vitro and in vivo models and underlying mechanisms. PGD treatment significantly suppressed PRL secretion in MMQ cells, an exemplary model of hyperPRL that is derived from pituitary adenoma cells. PGD also suppressed PRL synthesis of MMQ cells in a dose-dependent manner; however, these suppressive effects were completely abolished by pretreatment with 10 μM haloperidol, a dopamine D2 receptor antagonist. PGD did not affect hyperactive PRL in GH3 cells that lack the D2 receptor expression, but PGD significantly increased the expressions of the D2 receptor and dopamine transporters (DAT) in PC12 cells. In the rat model of hyperPRL produced by repeated injection with the dopamine blocker metoclopramide (MCP), PGD (5 - 10 g/kg daily) treatment for 14 days significantly reduced elevated serum PRL and the reduced magnitude was similar to that of 0.6 mg/kg bromocriptine (BMT), a dopamine D2 receptor agonist used for treating hyperPRL. Both PGD and BMT did not alter serum estradiol, but PGD reversed MCP-induced decreased serum progesterone to control level, whereas BMT did not. Similar to BMT, PGD treatment displayed a great effect in reversing the MCP-induced reduction of the expressions of D2 receptor, DAT and tyrosine hydroxylase in both the pituitary and the hypothalamus, in particular the arcuate nucleus, but both had least effects on the expressions of PRL in the pituitary and hypothalamus. The anti-hyperPRL effects of individual herbal preparation and major compounds of PGD were further examined in cultured cells. The three herbal preparations, Paeoniae Radix (PR) alone, Glycyrrhiza Radix (GR) alone and the pooled PR and GR individual preparation (PR+GR), and the three major constituents 18β-glycyrrhetinic acid (GA), liquiritigenin (LQ) and paeoniflorin (PF), were tested. All these preparations and constituents displayed significant effects in suppressing PRL hyperactivity and enhancing the expressions of dopamine mediators. However, PR had the most robust anti-hyperPRL effects compared to PGD and other preparations and constituents. The present study provides experimental evidence confirming the clinical effects of PGD in suppressing antipsychotic-associated hyperPRL. Not only D2 receptor is involved in the anti-hyperPRL effect of PGD, it is also associated with the modulation of other dopamine mediators and sex hormones. The finding that the magnitudes of the anti-hyperPRL effects of PGD and of combined PR and GR are similar suggests that boiling the herbs together or or separately shows the same effects. Additionally, PR preparation appears to be more efficacious in reducing hyperPRL compared to GR preparation which deserves to be further investigated. / published_or_final_version / Chinese Medicine / Doctoral / Doctor of Philosophy

Thesis, Basel.

Inaugural-Dissertation--Universität Basel, 1930. / Cover title. Vita. "Biographisches Register": p. 225-236. Bibliography: p. 237-247.

Osteoarthritis (OA) is a complex, multifactorial, and slowly progressive disease where there is currently no effective medical treatment. Research in understanding the mechanisms of OA has been advanced by preclinical studies in rodent models of OA. Recent evidence highlights the role of different classes of lipids in OA pathogenesis. Therefore, the main aim of this thesis was to apply both targeted and untargeted (global) lipidomics mass spectrometry based an alytical methods, in conjunction with univariate and multivariate statistical analysis, in various tissues from three established rodent models of OA; meniscal transection (MNX), monosodium iodoacetate (MIA), and destabilization of the medial meniscus (DMM). The overall goal was to identify statistically differentiated lipids between controls versus OA rodents that may reflect changes in the pathophysiology of OA and associated pain. In addition, a global lipidomics workflow was developed by me, following the latest trends used within the wider metabolomics community, ensuring robustness and reproducibility in the identification of putative metabolite/lipid biomarkers for diseases. Experiments in this thesis using a targeted oxylipin liquid chromatography tandem mass spectrometry (LC-MS/MS) method showed that statistical significant changes in the levels of certain oxylipins were observed. More specifically, 11,12-DHET (mean concentration: 0.26 pmol/g in control, 0.54 pmol/g in MNX; p < 0.01), 14,15-DHET (0.46 pmol/g in control, 0.75 pmol/g in MNX; p < 0.05) and 8-HETE (5.46 pmol/g in control, 7.40 pmol/g in MNX; p < 0.05) were statistically increased in the MNX compared to control (sham) rats in ventral spinal cord in the MNX rat model of OA. These findings are supported by literature since these three lipids exhibit pro-inflammatory properties and thus are expected to increase in the OA group where inflammation is the main feature of OA. Regarding the MIA rat model levels of other oxylipins in synovial fluid were differentially expressed in the MIA compared to saline (control) rats. Arachidonic acid (AA), (272.3 pmol/g in control, 435.3 pmol/g in MIA; p < 0.05) was increased in the MIA-treated compared to saline-treated rats, while 9-HODE (4.42 pmol/g in control; 1.21 pmol/g in MIA; p < 0.05) was statistically decreased in the MIA compared to saline rats. Since AA has been reported to be released from membrane phospholipids in OA, the observation that AA is statistically increased in synovial fluid in MIA- compared to saline-treated rats bears strong significance. In addition, maps of oxylipins metabolism were generated to visualize the pathways underlying the changes of lipid concentrations in plasma between control and OA rats for both MNX and MIA rat models. Therefore, applying a targeted oxylipin LC-MS/MS method in different tissues of MNX and MIA rat models of OA is a successful approach and informative about changes in pathophysiology of OA, underlying significant alterations in oxylipins concentrations. Although the global lipidomics approach was able to measure different classes of lipids that might account for differences in plasma between MNX/MIA and sham/saline-treated rats, this approach exhibited weak MVA (multivariate analysis) models. In contrast to MNX and MIA rat models, the global LC-MS lipidomics profile in plasma from a DMM mouse model of OA exhibited excellent MVA models with good prediction scores. Twenty-six statistically significant lipids were identified, using the lipidomics workflow that I have developed, and when four of these lipids were used to build Receiver Operative Curves (ROC) the model produced high prediction (84%) power in separating sham from DMM mice. The identity of these four lipids was classified as being fatty acids (FAs), sterols, sphingolipids, and diacylglycerols (DAG). In addition, MS/MS experiments were performed to confirm the identity of significant lipids. Thus, it was shown herein that applying a global lipidomics LC-MS approach in plasma from the mouse DMM model, using only a small number of mice (15 in total), can be informative about significant changes in the “lipidome” in OA and can be used as a robust means of predicting OA in mice based on their global lipidomics profile. Lastly, correlation statistical analysis was applied between levels of lipids in the various tissues, pain behaviour, and histopathology parameters in the three rodent models of OA. Although many oxylipins/lipids levels were found to be statistically correlated with the aforementioned parameters, the most striking finding is that 9-HODE and AA were both found to be positively correlated with Weight Bearing (WB), a parameter of pain behaviour, in plasma and synovial fluid in the MIA rat model of OA. Since plasma reflects systemic inflammation and synovial fluid reflects local (inflammation) 9-HODE (p < 0.01 in plasma; p < 0.05 in synovial fluid) and AA (p < 0.01 in plasma and synovial fluid) are oxylipins that potentially depict systemic and local changes in WB differences, and subsequently in OA related pain. This finding is supported by literature since both AA and 9-HODE are both agonists of a pain receptor (i.e. transient receptor potential vanilloid 1, TRPV-1). Thus, it was proved in this thesis that correlation analysis can be used as an additional and complementary statistical tool in an effort to determine the role of lipids in OA pathogenesis in rodent models of OA. In conclusion, applying both targeted oxylipin LC-MS/MS and global lipidomics LC-MS analytical methods capable of measuring either oxylipins or the whole “lipidome” in vivo, have provided novel findings to support the involvement of these lipids in OA and associated pain.

Drug delivery systems in the size range of ~ 10-250 nm are enabling tools for site-specific targeting and controlled release applications. To take advantage of these capabilities, various nanocarriers e.g., micelles, dendrimers, liposomes, nanoparticles, nanocapsules, nanotubes, and nanogels, have been designed for drug delivery. Specifically, micelle-based drug carrier systems have emerged as promising tools for site-specific delivery and controlled release applications. Despite several advantages over conventional drugs, some limitations of micelle-based drug delivery have also been reported. These drawbacks include low stability in vivo, poor penetration, modest accumulation in tumour tissues, and inadequate control over drug release. To overcome these limitations, stimuli-responsive or smart polymeric nanocarriers have been developed for drug delivery and tumour therapy, previously. The most well-known internal stimuli in cancerous regions include higher acidity associated with dysregulated metabolism in tumour tissues, elevated levels of glutathione in the cytosol and nucleus of cancer cells, and altered degradative enzymes in the lysosomes, and reactive oxygen species in the mitochondria. These intrinsic microenvironments can be exploited as internal stimuli to attain active drug release in the tumour tissues or cancer cells. In particular, the reducing potential inside the cancer cells is considerably higher than found in the extracellular environment and bloodstream. Such varying redox potential can be exploited for tumour-specific drug delivery and controlled release applications. Various types of redox-responsive micelles have been developed, previously. Generally, redox-responsive micelles have disulfide linkages that undergo rapid cleavage in the presence of reducing agents in the intracellular components, however, are stable at oxidising extracellular environment. The redox-responsive disulfide bridges can be incorporated into nanocarriers by placing multiple disulfide bonds in the hydrophobic backbone or by conjugating therapeutic agents to the side chain of the polymer via a disulfide linker. Another strategy to construct redox-responsive linkages is to crosslink the polymeric nanocarriers with a disulfide crosslinker. Studies have shown that polymeric micelles can dissociate, especially upon administration when they are diluted below their critical micelle concentration. The stability of polymeric micelles can be enhanced by chemical crosslinking. Various types of crosslinked micelles can be prepared subjected to the localisation of the crosslinking, e.g. shell crosslinked micelles, and core crosslinked micelles. Introducing redox-responsive bridges through disulfide crosslinkers may not only provide stability to nano-carriers against dilutions during circulation, but also render them responsive to reducing conditions. Specifically, redox-responsive core-crosslinked micelles have demonstrated good stability and better ‘stealth’ properties, nevertheless, the hydrophobic core of most of the existing core-crosslinked micelles have been based on non-degradable polymers such as polyacrylamide or polyacrylate. The non-degradable constituent of the block copolymer may cause complications in clinical applications. Therefore, reduction-responsive core-crosslinked micelles comprising entirely of biologically inert or biocompatible and biodegradable polymers would be better candidates for drug delivery and controlled release application. To overcome these limitations, micelles based on polyesters (a class of aliphatic biodegradable polymers) can used for drug delivery application. In the last few decades, various FDA approved aliphatic polyesters e.g. poly(lactic-co-glycolic acid) (PLGA), poly(ε-caprolactone), and poly(lactic acid), have been intensively studied to exploit their potential in drug, gene and protein delivery and controlled release applications. Nevertheless, most of these polyesters lack functional groups, making it difficult to incorporate redox-responsive linkages to core-crosslink their micelles. To address these issues, we have synthesised functional biodegradable and biocompatible block copolymers based on methoxypoly(ethyleneglycol)-b-poly(-caprolactone-co--azido--caprolactone) (mPEG-b-poly(CL-co-N3CL)). The pendent chloro groups of the block copolymer were converted into azides using nucleophilic substitution reaction to obtain mPEG-b-poly(CL-co-N3CL) block copolymer as a precursor of reactive polymeric micelles. The synthesised polymers were characterised by NMR, FT-IR and size exclusion chromatography (SEC). Micelles were prepared using the dialysis method and methotrexate (an anticancer drug) was loaded into the hydrophobic core of the reactive micelles. Micelles were subsequently crosslinked by a redox-responsive bis-alkyne ethyl disulfide crosslinker. The size distributions and morphology of core-crosslinked micelles were assessed using dynamic light scattering (DLS) and transmission electron microscopy. The drug release studies were performed under simulated non-reducing and reducing conditions. Cellular uptake studies in human breast cancer cells (MCF7 cells) were performed using Oregon-green loaded core-crosslinked micelles. The MTX-loaded core-crosslinked micelles were assessed for their cytotoxicity in human breast cancer cells by MTT assays. The apoptosis inducing potential of MTX-loaded core-crosslinked micelles was analysed using Hoechst/PI assays and was further probed by annexin-V/PI assays. The data from these studies indicate that drug release from these crosslinked micelles can be controlled and that redox-responsive micelles are more effective carriers for MTX than non-cross-linked analogues in the cell lines tested. In another strategy, a multifunctional amphiphilic block copolymer based on -amine-PEG-b-poly(CL-co-N3CL) was synthesised and subsequently was used to conjugate methotrexate on the hydrophilic block for receptor mediated targeting of breast cancer cells. Cellular uptake studies revealed 2.3-fold higher uptake of MTX-conjugated micelles as compared with un-conjugated micelles. The blank micelles showed low cytotoxicities in breast cancer cells, however, MTX-conjugated micelles exhibited greater antitumor activity in contrast to the free-MTX. We hypothesise that these functional micelles could be potentially powerful nanocarriers for stimuli-responsive controlled release, active tumour targeting, and cancer therapy.

The aim of this project was to prepare, optimize, characterize and compare a subcutaneous/oral delivery system for insulin. The effect of various low molecular weight chitosans (LMWCs) on the stability of insulin, using USP HPLC methods, was investigated. Insulin was found to be stable in a polyelectrolyte complex (PEC) consisting of insulin and LMWC in the presence of Tris-buffer at pH 6.5. In the presence of LMWC, the stability of insulin increased with decreasing molecular weight of LMWC; 13 kDa LMWC was the most efficient molecular weight for enhancing the physical and chemical stability of insulin. The bioactivity of insulin in the PEC was assessed using enzyme-linked immunosorbent assay (ELISA) testing; results showed that insulin is still functionally active in the presence of chitosan. Solubilization of the PEC in a reverse micelle formulation (RMF) and administration to diabetic rats resulted in an oral delivery system for insulin with acceptable bioactivity. The effect of reduced (GSH) and oxidized (GSSG) glutathione on the bioactivity of insulin was studied. A PEC of insulin with low molecular weight chitosan (13 kDa) was prepared and characterized. The PEC was then solubilized, in the presence and absence of GSH and GSSG, in a reverse micelle consisting of oleic acid and two surfactants (labrasol and plurol). The in vitro and in vivo performances of the reverse micelle formulations (RMFs) were evaluated in rats. At pH 6.5 the association efficiency of the PEC was 76.2%. In vitro insulin release from the RMs was negligible at pH 1.2 and was markedly increased at pH 6.8. The hypoglycemic activity of insulin in the PEC was reduced when administered via the subcutaneous route, regardless of the GSH content. On the other hand, the presence of GSSG significantly enhanced hypoglycaemia. When the RMF was administered via the oral route, the presence of GSH had no effect on the hypoglycemic activity of insulin compared with the GSH free system. However, the presence of GSSG in the oral preparation increased the hypoglycemic activity of insulin; probably by inhibiting insulin degradation, thereby prolonging its effect. Thus, incorporation of GSSG in the RMF reduces blood glucose levels in rats and protects insulin from degradation. The effect of glucosamine HCl (GlcN⋅HCl) on the bioactivity of insulin, administered via subcutaneous (SC) and oral routes, in rats was also investigated. The oral insulin delivery system (IC-RM) was prepared by solubilizing insulin-chitosan (13 kDa) polyelectrolyte complex (IC-PEC) in a RM system consisting of oleic acid, PEG-8 caprylic/capric glycerides and polyglycerol-6-dioleate. The blood glucose levels were measured using a blood glucose meter. The results revealed that the extent of hypoglycemic activity of SC insulin was GlcN⋅HCl dose dependent when they were administered simultaneously. A significant reduction in blood glucose level (p < 0.05) was found for the insulin:GlcN⋅HCl at mass ratios of 1:10 and 1:20, whereas lower ratios (e.g. 1:1 and 1:4) showed no significant reduction. Furthermore, enhancement of the action of SC insulin was achieved by oral administration of GlcN⋅HCl for five consecutive days prior to insulin injection (p < 0.05). For oral insulin administration via the IC-RM system, the presence of GlcN-HCl increased the hypoglycemic activity of insulin (p < 0.05). The relative pharmacological availabilities (PA) were 6.7% and 5.4% in the presence and absence of GlcN⋅HCl (i.e. the increase in the relative PA was about 23% due to the incorporation of GlcN⋅HCl in the IC-RM system), respectively. The aforementioned findings offer an opportunity to incorporate GlcN⋅HCl in oral insulin delivery systems in order to enhance a reduction in blood glucose levels.