Self-assembled Oral Nanocarriers Targeting Intestinal Lymphatic System for Treatment of Pancreatic Diseases
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Abstract
Pancreas are most important part of human body carrying out exocrine and
endocrine functions. Exocrine function includes the digestion of food by enzymes,
whereas the endocrine includes the secretion of the insulin which metabolizes the
glucose. The location of the pancreas is visceral and situated beneath the liver in the
arc of the duodenum. While growing in development and influence of the western
diet, we are going to be diabetic capital soon. However, there are other disease
which severely affects the pancreas which are complex and untreatable. The disease
includes Pancreatic ductal adenocarcinoma (PDAC) and Pancreatitis, both disease
carries major burden of pancreas associated disease and due to their complex nature
remains untreated with reports of inconvenient treatment procedure. The current
treatment procedure involves intravenous injections and requires expert to monitor
the dose of the medicament. So, there is burning need for the development of
effective, patient friendly and safe drug or drug delivery system for the treatment of
these disease. Delivering a medicine via oral route is most preferred, convenient and
safer route of drug delivery, however it comes with several challenges including
influence of the gastric enzymes and pH as well as the first pass metabolism. With
the advancement in the development of nanocarrier system we can modify the
carrier and drug bioavailability according to the need of the disease and location of
organ affected. There are several drug carrier systems developed protecting the drug
and nanocarrier in gastric pH and delivering drug to the site affected named as
targeted drug delivery system. In this thesis we have developed such nanocarrier
system preferably suitable for oral route of administration for the treatment of
pancreatic disease.
The pancreas location is complex and the supply or absorption of the nutrients was
carried out by lymphatic system mainly intestinal lymphatic system (ILS) which is
made of enterocytes and Microfold cells (M-Cells), enterocytes carries out the
internalization of lipophilic molecules, whereas M-cells carries out internalization
of antigens and other particles. Intestinal lymphatic absorption after oral drug
delivery is basically governed by either phagocytosis via M-cells of Peyer’s patches
or enterocytes cells. In contrast to other epithelial cells, M-cells does not have
mucus layer covering and direct contact of M-cells to lymphoid follicle, easy to
excess for macrophages, lymphocytes and dendritic cells.
viiiThis thesis comprises of the development patient friendly nanocarrier system for the
site-specific targeting and treatment of pancreas associated diseases. We have
developed two types of drug delivery system with different approach and unique
absorption pathways for oral route of administration. First, we have developed
enteric coated effervescent granules of poorly water-soluble drug for enhancing oral
bioavailability of luteolin, which self-assembled to form drug loaded nanomicelles,
when comes in contact with intestinal aqueous environment after
oral
administration. We utilized Intestinal lymphatic system (ILS) for enhancing oral
absorption of drug. We extensively characterized this system and proved its efficacy
by in-vitro and in-vivo methods, observed potentially suppressing pancreatic cancer.
Further, we have synthesized polymeric nanoparticle decorated with β-glucan over
PLGA nanoparticles for oral drug delivery for treatment of acute and chronic
pancreatitis. We developed β-Glucan conjugated PLGA nanoparticles (GNPs) for
intestinal lymphatic based oral targeted delivery of Amlexanox (AMX) for
pancreatitis treatment. β-glucan is ligand for Dectin-1 receptor which are present on
M-cells which helps in internalization by intestinal lymphatic system (ILS). We
emphasized on active targeting using nano-modification which helps in targeting
drug and nanoparticles in mesenteric lymph node. In-vitro cellular uptake study
shows nanoparticles efficiently uptaken by M-cells and LPS activated (M1
polarized) macrophages. We assessed the in-vitro efficacy of nanoparticles and
observed that the GNPs are effectively inhibiting the inflammation in pro-
inflammatory macrophages by mitigating the inflammatory cytokines. We assessed
the GNPs in in-vivo acute and chronic pancreatitis in L-arginine induced
experimental animal model. We evaluated the GNPs potential as well as the
biodistribution path of absorption and the mechanism of anti-inflammatory activity.
We observed that it was protected in the gastric environment and effectively uptaken
by ILS, subsequently carried by macrophages toward inflammatory site by
Chemotaxis. Further, the trypsin enzyme present in inflamed site breaks the ester
bond and releases the drug in inflamed site only. We observed promising results
which are proven by several molecular techniques.
Overall, this thesis presents several novel approaches for enhancing the oral
delivery of poorly water-soluble drugs, with a focus on targeting pancreatic diseases
through efficient drug carrier systems and exploiting the intestinal lymphatic
pathway for site-specific delivery and improved therapeutic outcomes.