The objective of this study was to investigate the role of organic cation transporters (OCTs) in the uptake of hydrophilic drugs into the olfactory bulb and subsequently to the brain. Two OCT2 substrates, amantadine and cimetidine were used as model drugs for this purpose. Bovine nasal explants (olfactory and respiratory tissue) were used as an in vitro model for preliminary screening to identify the role of transporters involved in the uptake of drug across these tissues. It was observed from both PCR and immunohistochemistry that OCTs, OCT2, OCTN1 and OCTN2 were present in the bovine respiratory and olfactory mucosa. Transport studies of amantadine in the presence and absence of OCT2 and OCTN2 inhibitors indicated that both these transporters play a role in the transport of amantadine across the bovine respiratory mucosa, whereas transport across the olfactory mucosa was predominantly via OCT2. This was followed by in vivo studies in rats where the blood, striatum and olfactory bulb concentrations of amantadine were determined following intranasal and intra-arterial administration. Shortly after nasal administration, the olfactory bulb concentrations exceeded the concentrations in the striatum suggesting the olfactory pathway to be the major route of uptake. Co-administration of the drug with an OCT2 inhibitor intranasally showed statistically significant reductions in the brain uptake of amantadine. A synergistic inhibitory effect on amantadine uptake was observed with the combined inhibition OCT2 and OCTN2. Additionally, the CNS exposure of these drugs following intranasal administration in the presence and absence of the OCT inhibitors was evaluated using the ratio of the free drug concentrations in the brain compared to plasma. While the plasma concentration profiles were similar both in the presence and absence of inhibition, the free drug ratios were highest when no inhibitor was included. Additionally similiar in vivo studies were also carried out for a second model drug, cimetidine, where cimetidine uptake into the rat brain was found to be significantly reduced in the presence of the OCT2 inhibitor, pentamidine. This demonstrates that there was a greater CNS exposure to each drug when OCT transporters were active, confirming their role in their direct CNS distribution from the nasal cavity to the brain. The results of this study suggest that OCT substrates might be good candidates for the delivery to the brain via the olfactory route.

High grade gliomas remain a devastating disease, for which a curative therapy is virtually absent. The high medical need is unmet by novel treatment strategies and advances in chemo-and radiotherapy. Patients diagnosed for GBM face a median survival of 15 months after maximal standard-of-care therapy, and relapse is often observed due to micro-metastasis in the direct environment of resection. In part, current treatment modalities such as chemo-and immunotherapy are hampered in their efficacy due to the specialized TME. This area is adequately equipped to withstand the cytotoxic attack of chemo- and immunotherapy. Therefore, we hypothesized that modulation of the TME could decrease these defense mechanisms, and increase susceptibility to tumor lysis.In this respect, we focused on Gal-1 as an ideal target to modulate the TME in the context of GBM. Gal-1 exerts multiple tumor promoting functions. From pre-clinical research, we have learned that Gal-1 is an important mediator for the proliferation and migration of tumor cells, moreover Gal-1 could also promote angiogenesis in the TME, providing nutrients and oxygen for GBM to grow. Gal-1 also maintains the inherent defense mechanisms to chemo and immunotherapy. Gal-1 is crucial for the resistance mechanisms to TMZ by altering the EPR stress response. Moreover, and most important for our purposes, Gal-1 is also a crucial immune suppressor in the TME, which can induce apoptosis in activated T cells, and recruit Tregs. To target Gal-1 in the TME would be clinically most relevant if this could be performed via a non-invasive treatment modality. Therefore, we developed a nanoparticle complex that could deliver siGal-1 from the nasal cavity directly to the CNS, and even the TME. This nose-to-brain delivery bypasses systemic routes, with a higher (and more selective) local bioavailability in the CNS. The major pharmaceutical excipient in this nanoparticle complex consists of chitosan polymers. These polymers are highly interesting agents to promote nose-to-brain delivery due their muco-adhesive and epithelial barrier modulation properties. When applying these particles in vitro on GBM cells, a solid decrease of Gal-1 was noted, and the epithelial modulatory properties were confirmed. Furthermore, we observed a rapid transport from the nasal cavity to the brain upon intranasal administration of a highly-concentrated chitosan nanoparticle siGal-1 suspension and we could even observe the sequence-specific cleavage of Gal-1 mRNA, and a decrease of Gal-1 in the TME. This Gal-1 reduction could modulate the TME from immune suppression to immune activation, as demonstrated by decrease in suppressor cells, and increased stage of activation in rejective immune cells. Moreover, due to decreased Gal-1, also angiogenesis was alleviated, and a reduced size in vasculature was observed, mimicking a morphological vessel normalisation. Reversing the immune and vascular contexture of the TME by Gal-1 reduction seemed a prerequisite to increase the efficacy of TMZ, DC vaccination and PD-1 blocking. In combination experiments, we noticed that siGal-1 on top of these treatments, could further increase the efficiency of chemo and immunotherapy. The findings presented in this thesis can serve as a proof of concept for the feasibility to modulate and re-orchestrate the TME of GBM via intranasal administration. The intranasal administration of siGal-1 could represent a valuable clinically translational treatment to increase the efficiency of chemo- and immunotherapy for GBM patients. In our research facilities, a phase 0 as a first-in-human trial is actively pursued. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

For many years, the nasal route of administration as part of a therapeutic treatment has been used. This route of administration is easy to implement, especially due to its non-invasiveness the ease of administration that it affords for the patient. In addition, it is suitable for chronic treatment as well as for an emergency situation when the patient is unconscious. For instance, the administration of benzodiazepines, such as midazolam, may be done to stop convulsions in a patient.Traditionally, intranasal administration was mainly borrowed to target a local effect (e.g. treatment of a cold with a decongestant agent). Subsequently, its application for systemic delivery (e.g. treatment of migraine with triptans) was more and more frequently considered. However, the administration of a drug in the nasal cavities for systemic delivery still remains limited. Indeed, even if the intravenous route has several major limitations such as its invasiveness or the pain generated during administration, it remains more widely used than the intranasal route. This can be explained, on the one hand, by the knowledge that was relatively limited regarding the nasal delivery but also because of the unavailability of nasal devices allowing precise control of the nasal administration (i.e. accurate dose delivery, strong deposition in the nasal cavity, etc).Subsequently, the intranasal route has led to a third therapeutic targeting, namely, the “nose-to-brain pathway”. In that case, the nasal cavity was considered as an opportunity to access the central nervous system (CNS). Indeed, the nose-to-brain delivery allows reaching the brain while bypassing the blood-brain barrier which is known to be a major obstacle to the diffusion of drugs in the CNS. Moreover, the passage through the nasal cavity would allow the administration of sensitive molecules (e.g. biopharmaceuticals) while avoiding excessive enzymatic degradation.Therefore, the nose-to-brain pathway appears to be an attractive route for the delivery of unstable molecules, requiring an access to the brain to reach their site of action. In this context, the therapeutic target that has been selected was "cachexia". It is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. It usually results in particular from undernutrition and a generalized inflammatory state in the patient. In order to treat this syndrome and to restore the appetite in these patients, the goal was to use ghrelin (GHRL) as a model drug. GHRL is a peptide hormone that exhibits, among other effects, an orexigenic action. This biopharmaceutical needs to reach its receptors, located in the hypothalamus, to exert its therapeutic effect.In this study, the goal was to develop a formulation that was able to protect GHRL during its nasal administration, while increasing its residence time to promote its diffusion through the nasal olfactory epithelium.In the first part of the project, GHRL was mainly characterized in terms of stability (e.g. temperature and pH), but also in terms of surface charge. These results allowed selecting the most suitable strategy of formulation as well as the optimal storage conditions. After these preformulation evaluations, it was decided to work on the development of a liquid formulation. The first formulation was based on micelles composed of lipids with polyethylene glycol "DSPE-PEG (1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N- [amino (polyethylene glycol) -2000] (ammonium salt)" as hydrophilic group. This type of pegylated lipids have already shown, in many scientific studies, interesting properties in the context of intranasal administration, especially in terms of mucopenetration. With a slight adaptation of the protocol found in the literature, it was possible to obtain micelles of an adequate size (~15 nm). The micelles produced also showed good ability to encapsulate GHRL with an encapsulation rate of 98%, but micelles of DSPE-PEG failed to increase the GHRL diffusion through epithelial layer. This step is essential in order to obtain high GHRL levels in the brain. The formulation containing DSPE-PEG micelles has thus been abandoned.Still in the goal of combining lipid excipients with hydrophilic polymer, another formulation strategy based on liposomes coated with chitosan has been considered. Since GHRL has a positive charge at physiological pH, anionic liposomes have been developed to get a high loading. Three types of liposomes have been produced: anionic, neutral and cationic. The objective was to evaluate the influence of the liposomes charge on GHRL encapsulation. By working with anionic liposomes, the loading could be 46% higher than that obtained from the cationic liposomes. In order to evaluate a potential relation between the amount of GHRL that was encapsulated in the liposomes and the amount of GHRL that could potentially be degraded in the presence of enzyme, the three types of liposomes were exposed to trypsin. Following enzyme exposure, anionic liposomes showed enzymatic protection 4 times higher than cationic liposomes. These anionic liposomes have also shown high GHRL protection in the presence of another enzyme with another mechanism of digestion, namely, carboxylesterase-1. Subsequently, isothermal titration calorimetry tests were performed to better understand the interaction mechanisms between GHRL and anionic liposomes. This technique showed that hydrophobic interactions between both compounds were predominant. The coating of anionic liposomes by chitosans was performed and confirmed by an increase of the mean diameter (+48 nm) and charge (+6 mV) as well as by the modification of the morphology of the liposomes. This coating of liposomes with chitosans was supposed to confer additional properties to the formulation such as mucoadhesion and permeation enhancement. These both effects can be obtained thanks to the positive charge of chitosans which allows adhering to the mucins of the mucus, on the one hand, and thanks to the opening of the epithelial tight junctions that enhances drug permeation, on the other hand. The chitosan coating allowed increasing the fixation of the liposomes to mucins by about twenty percent compared to uncoated liposomes. In addition, the "absorption promoter" effect of chitosans was confirmed on cells culture. Then, the formulation was introduced into two distinct nasal devices intended for the administration of liquid nasal sprays, namely, the VP3 device from Aptar Pharma and the SP270 device from Nemera. The aerosols produced by each device allowed generating droplets characterized by a mean diameter higher than 10µm, leading to potential satisfactory impaction onto the olfactory region instead of diffusion throughout posterior region of the nasal cavities. In the second part of the work, a dry formulation was produced by spray-drying from the liquid dispersion of coated liposomes. The objective was to increase the stability of GHRL during storage as well as to enhance its remanence and diffusion through the olfactory epithelium. The optimized parameters allowed producing a powder characterized by a mean diameter higher than 10 μm with an acceptable yield. The powder produced exhibited a low residual moisture and showed good homogeneity in terms of GHRL content. Then, a comparative study was carried out between the powder and the liquid formulation to compare the GHRL stability over time during storage at different temperatures (4°C and 25°C) but also their ability to fix mucins. In both cases, the dry powder showed better results The powder was also re-dispersed in aqueous phase to evaluate the ability of the liposomes to be reconstituted without modifying their physicochemical properties (e.g. size distribution, charges, stability). It was demonstrated that the majority of the initial properties could be preserved after reconstitution (i.e. rate of encapsulation). Similarly to the liquid formulation, the powder was loaded into a specific device developed for the nasal administration of powders that allows targeting the olfactory region to optimize the nose-to-brain transfer. The device, "UDS - Unit Dose System " from Aptar Pharma, has shown excellent properties in terms of particle size distribution in the aerosol but also in terms of targeting the olfactory zone. The latest was studied by means of "nasal cast" that is a 3-printed model of artificial nasal cavities. After impaction in the different cavities of the cast, it was possible to quantify the amount of GHRL that was deposited in the olfactory zone. Using our optimized formulation in combination with the device developed by Aptar, it was shown that 52% of the powder was impacted onto the area corresponding to the olfactory region. Such data demonstrated the relative difficulty to target this section of the nasal cavities.Finally, the formulation loaded with fluorescent GHRL was intranasally administered in mice. It was demonstrated that GHRL could reach the brain after intranasal administration of the formulation and that the formulation was essential to allow this transfer to the brain.The administration of such biopharmaceutical by nose-to-brain with this formulation seems to be an interesting alternative to exploit. However, additional studies to quantify this transfer more precisely, to better define its kinetics and also to evaluate the efficacy of the treatment should be carried out. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

Orientador: Maria Palmira Daflon Gremião / Resumo: Glioblastomas (GBM) representam 77% dos tumores malignos do sistema nervoso central (SNC) e ainda hoje, apesar de todos os avanços na terapia, continua com prognóstico limitado. A existência de barreiras fisiológicas como a barreira hematoencefálica (BHE) representa o principal obstáculo que impede que concentrações adequadas do fármaco atinjam o local de ação. Por suas vantagens anatômicas, uma estratégia proposta para a administração de fármacos destinados ao SNC consiste no uso da via nasal. Além disso, o uso de terapias combinadas utilizando fármacos capazes de agir em diferentes alvos moleculares deve ser considerada para o tratamento de doenças complexas como GBM. O candidato a fármaco ácido alfa-ciano-4-hidroxicinâmico (CHC) e o anticorpo monoclonal cetuximab (CTX) já são explorados devido à capacidade de agir em diferentes alvos moleculares nas células tumorais e aplicados em conjunto, como uma nova abordagem combinada, podem melhorar os resultados terapêuticos. De forma complementar, a utilização de sistemas de liberação baseados em nanotecnologia trará inevitavelmente ganhos terapêuticos à combinação proposta, permitindo que atributos específicos sejam agregados ao sistema e possibilite não somente a administração nasal, como também a associação de diferentes fármacos em um único carreador. Assim, o presente estudo propõe o desenvolvimento de diferentes plataformas poliméricas baseadas em poli(ácido láctico-co-glicólico) (PLGA) e quitosana trimetilada (TMC) ou quito... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Glioblastomas (GBM) account for 77% of malignant tumors in the central nervous system (SNC), and today, despite all advances in therapy, remains with a limited prognosis. The existence of physiological barriers as the blood brain barrier (BBB) represents the main obstacle that limits appropriate concentrations of drugs designed to therapy. Due to their anatomical advantages, a strategy proposed for direct delivery to SNC involves the use of the nose-to-brain route. Besides, combination therapy that uses multiple drugs against different molecular targets should be considered for complex diseases such as GBM. Drugs like alpha-cyano-4-hydroxycinnamic acid (CHC) and the monoclonal antibody cetuximab (CTX) are already explored for their capacity to act against different hallmarks of cancer and applied together, as a novel combining approach, might improve therapeutic outcomes. Therefore, advances in nanotechnology-based delivery systems will inevitably bring therapeutic gains to the proposed combination since they enable acquisition of important characteristics desired and also the association of different drugs into a single carrier. Thus, the current study proposes the development of different polymeric platforms based on poly(lactic-co-glycolic acid) (PLGA) and trimethyl chitosan (TMC) /chitosan oligosaccharide (OCS) for CHC encapsulation. Both CHC-loaded developed systems (PLGA/TMC and PLGA/OCS) exhibited nanostructure organization of about 300 to 400 nm, containing chitosan o... (Complete abstract click electronic access below) / Doutor