Titre : Nano-plaquettes à mobilité dirigée et adhésion amplifiée pour l’administration locale: vers un nouveau traitement des maladies vésicalesAbstract : L’administration locale des médicaments, définie comme une voie d’administration où la substance active est directement administrée sur ou proche de la cible ou tissus souhaités, permet d’apporter des grandes quantités des médicaments avec moins d’effets secondaires, et permet une simplification du système nanoparticulaire du fait de la non-extravasation des médicaments. Dans ce contexte, le projet de recherche de cette thèse s’est focalisé sur la voie intra-vésicale comme voie d’administration locale car il existe un besoin clinique de la part des patients, n’étant pas encore résolu. Malgré les hypothétiques avantages fournis par l’administration locale des médicaments, la voie intra-vésicale présente certaines limitations qui diminuent l’efficacité des traitements et l’observance des patients. La plupart des médicaments pour le traitement des maladies vésicales, notamment pour le cancer de la vessie et les cystites interstitielles, sont sous forme de solutions ou suspensions administrées de manière intra-vésicale via un cathéter qui passe à travers l’urètre. Dès leur arrivée à la vessie, les substances actives sont fortement diluées par les urines et éliminées rapidement lors de la miction. Cela conduit à une diminution des concentrations des substances actives au plus proche de l’épithélium, nécessitant plusieurs instillations intra-vésicales, réalisées par des praticiens hospitaliers, pour atteindre des concentrations thérapeutiques. Il y a donc un réel besoin de développer des nouvelles formulations permettant de contrecarrer les phénomènes décrits au préalable.L’objectif de cette thèse de doctorat est de créer un nouveau système nanoparticulaire de morphologie non-sphérique qui serait susceptible d’avoir un mouvement diffèrent et dirigé ainsi qu’une adhésion amplifiée. En conséquence, nous attendons de ces systèmes qu’ils apportent des concentrations en substances actives plus importantes que les systèmes nanoparticulaires sphériques et formulations galéniques traditionnelles.Aux cours de nos travaux expérimentaux, nous avons réussi à développer un système nanoparticulaire de morphologie hexagonale et aplatie. Ces nanoparticules, appellées nano-plaquettes, sont conçues à partir de l’auto-assemblage des molécules d’α-CD et des chaines alkyles greffées sur les squelettes de polysaccharides tels que l’acide hyaluronique, la chondroïtine sulfate ou l’héparine. Ces systèmes présentent l’originalité de ne pas avoir de substance active encapsulé parce que les molécules de polymère elles mêmes agissent à la fois en tant que substance active et de véhicule. Ces nano-plaquettes ont montré un mouvement en milieu isotrope et statique très diffèrent des nano-sphères utilisées comme contrôle. En effet, la majorité d’entre elles diffuse de manière plus importante et dirigée, avec des trajectoires rectilignes. Grâce à leur mouvement et aux propriétés inhérentes liées à leur forme, ces systèmes se sont montrés particulièrement intéressants vis-à-vis des interactions avec des cellules. Ils adhèrent mieux et plus longtemps à la muqueuse vésicale, elles sont mieux internalisées par des cellules et sont éliminées plus lentement une fois adhérées à la surface de l’urothélium.Un modelé in vivo de Syndrome de la Vessie Douloureuse / Cystite Interstitielle développé chez le rat nous a permis de montrer l’efficacité thérapeutique des nano-plaquettes, notamment celle constituées d’acide hyaluronique. En effet, elles présentent une meilleure bioaccumulation dans la vessie et une meilleure activité anti-inflammatoire et de régénération de la muqueuse urothéliale.Ces systèmes nanoparticulaires, conçues lors de nos travaux de thèse, constituent une approche innovante, rationnelle et efficace pouvant ouvrir de nouvelles voies de recherche pour le traitement des maladies vésicales. / Title: Directed-mobility and enhanced-adhesion nano-platelets for local drug delivery: towards a new treatment of bladder diseases.Abstract: Local drug delivery, defined as the administration route where the drug is delivered directly or very close to its target or tissue, allows to bring large amounts of drugs with reduced side effects, in comparison with systemic administration. In this context, our research project has been focused on the intravesical drug delivery as local administration route, because there is a real need to develop new pharmaceutical formulations to thwart several limitations. Despite the advantages provided by the local drug delivery, intravesical drug delivery exhibited some issues which are decreasing the therapeutic efficacy and the patient compliance to the treatment. Most of therapies for the treatment of bladder diseases are simple drug solutions or suspensions administered intravesically by using a catheter through the urethra in order to reach easily the bladder and, consequently, the urothelium. Since the drug is administered into the bladder, drug dilution is occurring because the continuous production of urine. Furthermore, active substances are being eliminated during washout when bladder urine voiding is happening. These two processes lead to the decrease of local drug concentration close to the urothelium. Patients need repeated catheterization, performed by health care practitioners, to reach therapeutic dose of the drug. Therefor, there is a need of new drug formulations to avoid these main limitations.The main goal of this PhD thesis was to create and design a new nanoparticulate system with non-spherical shape susceptible to move in a different manner compared to spherical nanoparticles. These systems may exhibit an amplified mucoadhesion allowing to bring more important amounts of drug than classical and nanoparticle administration.During this thesis, we developed a new nanoparticulate system presenting non-spherical, hexagonal and flattened shape. The driven force for the design of these nanoparticles was the self-assembling of α-cyclodextrin molecules with alkyl chains grafted on the polymer skeleton. Polymers used belong to a polysaccharide family called glycosaminoglycans including hyaluronic acid, chondroitin sulfate or heparin. This original and innovative nanoparticulate system does not encapsulate an active drug. Our polysaccharide will act, at the same time, as the active drug and the carrier. These nanoparticles, called now nano-platelets have shown different movement behavior than the spherical ones. Indeed, they diffuse more rapidly in a straight-line way. Thanks to their oriented and directed motion and to their intrinsic properties, due to the shape, these systems have shown a better mucoadhesion on the bladder tissue, a better uptake in different cell lines and they were far less rapidly eliminated from the urothelium mucosa.An in vivo model of Bladder Painful Syndrome / Interstitial Cystitis in rats demonstrated the therapeutic efficacy of nano-platelets, especially for hyaluronic acid nanoparticles. Indeed, they demonstrated a better bioaccumulation into the bladder and a better therapeutic efficacy as anti-inflammatory and urothelium regenerating agents.These nanoparticulate systems, designed during this work, represent a new innovative, rational and effectiveness approach allowing to open new research pathways for the treatment of bladder diseases.

Le glioblastome (GBM) est une tumeur maligne du cerveau très agressive et actuellement incurable. Après le traitement standard, le GBM récidive toujours à cause de son caractère invasif et de sa résistance aux agents chimiothérapeutiques alkylants. Dans cette thèse, nous avons évalué la faisabilité, l'efficacité et la tolérance de l’hydrogel « nanocapsules lipidiques chargées en Lauroyl-gemcitabine » (GemC12-LNC) pour le traitement local du GBM. GemC12-LNC a été préparé par un procédé d'inversion de phase. Il est injectable, adapté à l'implantation cérébrale et capable de libérer de façon prolongée le médicament in vitro. Chez les souris saines, aucune inflammation, apoptose ou activation de la microglie n’a été observée après exposition à l'hydrogel, ce qui suggère que ce système est bien toléré. L'injection intra-tumorale de GemC12-LNC dans un modèle de GBM U87 sous-cutané et orthotopique a réduit de façon significative la croissance tumorale et a augmenté la survie médiane de l'animal par rapport aux contrôles, respectivement. De plus, en vue d’une meilleure relevance clinique, une technique de résection tumorale reproductible du GBM U87 et du gliosarcome 9L a été mise au point et l'hydrogel GemC12-LNC a réduit les récidives chez les souris et les rats, respectivement. En conclusion, l'efficacité et la tolérance de l’hydrogel GemC12-LNC ont été démontrées in vitro et in vivo. Cette formulation simple peut être injectée directement dans la cavité de résection du GBM, et combine les propriétés avantageuses des nanomédecines et des hydrogels. GemC12-LNC peut donc être considéré comme un système d'administration prometteur et innovant pour le traitement local du GBM. / Glioblastoma (GBM) is an aggressive malignant brain tumor characterized by rapid proliferation and propensity to infiltrate healthy brain tissue. Despite aggressive standard of care therapy GBM always recur, mainly because of its high invasiveness and chemoresistance to alkylating drugs. In this Thesis, we evaluate the feasibility, efficacy and safety of the nanomedicine hydrogel Lauroyl-gemcitabine lipid nanocapsule (GemC12-LNC) for the local treatment of GBM. GemC12-LNC was prepared by a phase-inversion technique process. It is injectable, adapted for brain implantation and able to sustainably release the drug in vitro. In healthy mice brain, no inflammation, apoptosis or microglia activation was observed after exposure to the hydrogel suggesting that this system is well tolerated and suitable for an application in the brain. Intratumoral injection of GemC12-LNC hydrogel in a U87subcutaneous and orthotopic GBM model significantly reduced tumor growth and increased the animal’s median survival compared to the controls, respectively. Moreover, to mimic the clinical setting, a reproducible tumor resection technique of U87 GBM and 9L gliosarcoma was developed and the GemC12-LNC hydrogel slowed down the formation of recurrences in mice and rats brain, respectively. In conclusion, the feasibility efficacy and safety of GemC12-LNC have been shown in vitro and in several preclinical in vivo models showing that this nanomedicine hydrogel is a promising and innovative delivery system for the local treatment of GBM. This gel can be directly injected in the GBM resection cavity, has a very simple formulation and combines the properties of nanomedicines and hydrogels.

Improving the functionality and reducing revision rates are important driving forces in the development of orthopaedic implants. FibMat is a fibrinogen based matrix developed towards commercialisation by the company Optovent AB. This matrix can be coated on implants and act as a local drug delivery system for bisphosphonates (BPs). BPs are drugs inhibiting bone resorption, and applied with FibMat to improve stability of implants in bone, e.g. when fixing bone fractures. In this thesis, FibMat loaded with BP (FibMat/BP) was coated on stainless-steel screws and titanium screws in order to investigate some technology properties relevant to its clinical applicability. Bone-mimicking materials were used to study scrape-off effect upon insertion. The coagulation properties of fibrinogen as well as the structural properties of BPs were studied after exposure to gamma radiation. The screws were coated with FibMat and BP (alendronate and 14C-alendronate) using standard coupling techniques. The total amount and distribution of BP after insertion was measured by liquid scintillation and autoradiography. Coagulation assays were performed in order to determine the coagulation properties of fibrinogen, exposed to doses up to 35 kGy, mixed with thrombin. The structural properties of four different BPs (alendronate, pamidronate, zoledronate and ibandronate), exposed to doses up to 35 kGy were analysed by transmission infrared spectroscopy. The results show that FibMat/BP coating on porous stainless-steel screws is virtually unaffected by insertion into bone materials. The anodised, planar titanium screws are more affected by the insertion process, but an even BP distribution in the cancellous material is indicated. The coagulation assays show that gamma-irradiated fibrinogen has a slower coagulation process compared to non-irradiated fibrinogen and form interrupted network unable to clot. The chemical structures of the BPs seem unaffected by exposure to gamma irradiation. In conclusion, the FibMat/BP is a promising technology for local distribution of BP in conjunction with bone implants.

<p>Improving the functionality and reducing revision rates are important driving forces in the development of orthopaedic implants. FibMat is a fibrinogen based matrix developed towards commercialisation by the company Optovent AB. This matrix can be coated on implants and act as a local drug delivery system for bisphosphonates (BPs). BPs are drugs inhibiting bone resorption, and applied with FibMat to improve stability of implants in bone, e.g. when fixing bone fractures. In this thesis, FibMat loaded with BP (FibMat/BP) was coated on stainless-steel screws and titanium screws in order to investigate some technology properties relevant to its clinical applicability. Bone-mimicking materials were used to study scrape-off effect upon insertion. The coagulation properties of fibrinogen as well as the structural properties of BPs were studied after exposure to gamma radiation.</p><p>The screws were coated with FibMat and BP (alendronate and 14C-alendronate) using standard coupling techniques. The total amount and distribution of BP after insertion was measured by liquid scintillation and autoradiography. Coagulation assays were performed in order to determine the coagulation properties of fibrinogen, exposed to doses up to 35 kGy, mixed with thrombin. The structural properties of four different BPs (alendronate, pamidronate, zoledronate and ibandronate), exposed to doses up to 35 kGy were analysed by transmission infrared spectroscopy.</p><p>The results show that FibMat/BP coating on porous stainless-steel screws is virtually unaffected by insertion into bone materials. The anodised, planar titanium screws are more affected by the insertion process, but an even BP distribution in the cancellous material is indicated. The coagulation assays show that gamma-irradiated fibrinogen has a slower coagulation process compared to non-irradiated fibrinogen and form interrupted network unable to clot. The chemical structures of the BPs seem unaffected by exposure to gamma irradiation. In conclusion, the FibMat/BP is a promising technology for local distribution of BP in conjunction with bone implants.</p>

There are currently two types of intra-arterial drug-delivery system (DDS) in clinical use in the palliative treatment of primary liver cancer. The chemotherapeutic drug doxorubicin (DOX) can be formulated into a drug-in-lipiodol emulsion (LIPDOX) or a microparticulate drug-eluting bead system (DEBDOX). To facilitate development of future DDSs, we need to understand the release and local distribution of drug from these DDSs into the complex, in vivo, pathological environment. The overall aim of this project was to assess and improve understanding of the in vivo release of DOX from LIPDOX and DEBDOX and its local disposition in the liver. These processes were investigated in detail in a multisampling-site, healthy pig model and in human patients with liver cancer. The mechanisms involved in DOX disposition were studied by examining potential interactions between DOX and lipiodol and/or cyclosporine A (CsA) in pigs.   In this project, the main elimination pathway for DOX and its primary metabolite doxorubicinol (DOXol) was via bile; their extensive canalicular carrier-mediated transport (e.g. ATP-binding cassette transporters ABCB1, ABCC1, ABCC2 and ABCG2) was inhibited by CsA. CsA had no effect on the carbonyl and aldo-keto reductases responsible for the metabolism of DOX into DOXol. LIPDOX released DOX more rapidly and to a greater extent into the circulation than DEBDOX, which had only released 15% of the dose in patients after 24 hrs. The systemic exposure to DOX was lower for DEBDOX than for LIPDOX. Greater fractions of DOXol were formed in blood and bile with LIPDOX than with DEBDOX. This may have been because DOX was more widely distributed into regions with increased metabolic capacity or because of increased intracellular uptake when DOX was delivered in LIPDOX. The excipient lipiodol in the LIPDOX formulation did not interact with transporters, enzymes or membranes that would explain the increased cellular uptake of DOX. In conclusion, the release of DOX from DEBDOX is more controlled in vivo than that from LIPDOX, indicating that DEBDOX is a more robust pharmaceutical product. The formulations for future optimized DDSs should therefore be more similar to DEBDOX than to LIPDOX.

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