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基于壳聚糖和聚乳酸的甲氨蝶呤玻璃体内微植入物治疗原发性眼内淋巴瘤的研发:一项体外研究

Development of chitosan and polylactic acid based methotrexate intravitreal micro-implants to treat primary intraocular lymphoma: an in vitro study.

作者信息

Manna Soumyarwit, Augsburger James J, Correa Zelia M, Landero Julio A, Banerjee Rupak K

出版信息

J Biomech Eng. 2014 Feb;136(2):021018. doi: 10.1115/1.4026176.

Abstract

Primary intraocular lymphoma (PIOL) is an uncommon but clinically and pathologically distinct form of non-Hodgkin's lymphoma. It provides a therapeutic challenge because of its diverse clinical presentations and variable clinical course. Currently available treatments for PIOL include intravenous multiple drug chemotherapy, external beam radiation therapy, and intravitreal methotrexate (MTX) injection. Each intravitreal injection of MTX is associated with potentially toxic peaks and subtherapeutic troughs of intraocular MTX concentration. Repetitive injections are required to maintain therapeutic levels of MTX in the eye. A sustained release drug delivery system is desired for optimized therapeutic release (0.2-2.0 μg/day) of MTX for over a period of 1 month to achieve effective treatment of PIOL. This study reports development of a unique intravitreal micro-implant, which administers therapeutic release of MTX over a period of 1 month. Chitosan (CS) and polylactic acid (PLA) based micro-implants are fabricated for different MTX loadings (10%, 25%, and 40% w/w). First, CS and MTX mixtures are prepared for different drug loadings, and lyophilized in Tygon® tubing to obtain CS-MTX fibers. The fibers are then cut into desired micro-implant lengths and dip coated in PLA for a hydrophobic surface coating. The micro-implant is characterized using optical microscopy, scanning electron microscopy (SEM), time of flight-secondary ion mass spectroscopy (ToF-SIMS), and differential scanning calorimetry (DSC) techniques. The release rate studies are carried out using a UV-visible spectrophotometer. The total release durations for 10%, 25%, and 40% w/w uncoated CS-MTX micro-implants are only 19, 29, and 32 h, respectively. However, the therapeutic release durations for 10%, 25%, and 40% w/w PLA coated CS-MTX micro-implants significantly improved to 58, 74, and 66 days, respectively. Thus, the PLA coated CS-MTX micro-implants are able to administer therapeutic release of MTX for more than 50 days. The release kinetics of MTX from the coated micro-implants is explained by (a) the Korsmeyer-Peppas and zero order model fit (R2 ∼ 0.9) of the first 60% of the drug release, which indicates the swelling of polymer and initial burst release of the drug; and (b) the first order and Higuchi model fit (R2 ∼ 0.9) from the tenth day to the end of drug release, implying MTX release in the therapeutic window depends on its concentration and follows diffusion kinetics. The PLA coated CS-MTX micro-implants are able to administer therapeutic release of MTX for a period of more than 1 month. The proposed methodology could be used for improved treatment of PIOL.

摘要

原发性眼内淋巴瘤(PIOL)是一种罕见但在临床和病理上具有独特特征的非霍奇金淋巴瘤。由于其临床表现多样且临床病程多变,它带来了治疗挑战。目前用于PIOL的治疗方法包括静脉内多药化疗、外照射放疗和玻璃体内甲氨蝶呤(MTX)注射。每次玻璃体内注射MTX都伴随着眼内MTX浓度潜在的毒性峰值和低于治疗水平的谷值。需要重复注射以维持眼内MTX的治疗水平。需要一种持续释放给药系统,以在1个月的时间内实现MTX的优化治疗释放(0.2 - 2.0μg/天),从而有效治疗PIOL。本研究报告了一种独特的玻璃体内微植入物的研发,该微植入物可在1个月的时间内实现MTX的治疗释放。制备了基于壳聚糖(CS)和聚乳酸(PLA)的微植入物,用于不同的MTX负载量(10%、25%和40% w/w)。首先,制备不同药物负载量的CS和MTX混合物,并在泰贡管中冻干以获得CS - MTX纤维。然后将纤维切割成所需的微植入物长度,并浸入PLA中进行疏水表面涂层。使用光学显微镜、扫描电子显微镜(SEM)、飞行时间二次离子质谱(ToF - SIMS)和差示扫描量热法(DSC)技术对微植入物进行表征。使用紫外可见分光光度计进行释放速率研究。10%、25%和40% w/w未涂层的CS - MTX微植入物的总释放持续时间分别仅为19、29和32小时。然而,10%、25%和40% w/w PLA涂层的CS - MTX微植入物的治疗释放持续时间显著提高到分别为58、74和66天。因此,PLA涂层的CS - MTX微植入物能够在50多天内实现MTX的治疗释放。MTX从涂层微植入物中的释放动力学可以通过以下方式解释:(a)药物释放前60%的Korsmeyer - Peppas和零级模型拟合(R2 ∼ 0.9),这表明聚合物的溶胀和药物的初始突释;以及(b)从第10天到药物释放结束的一级和Higuchi模型拟合(R2 ∼ 0.9),这意味着治疗窗口内的MTX释放取决于其浓度并遵循扩散动力学。PLA涂层的CS - MTX微植入物能够在1个月以上的时间内实现MTX的治疗释放。所提出的方法可用于改善PIOL的治疗。

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