Controlled Release of Insulin Based on Temperature and Glucose Dual Responsive Biomicrocapsules

The treatment of diabetes lies in developing novel functional carriers, which are expected to have the unique capability of monitoring blood glucose levels continuously and dispensing insulin correctly and timely. Hence, this study is proposing to create a smart self-regulated insulin delivery system according to changes in glucose concentration. Temperature and glucose dual responsive copolymer microcapsules bearing N-isopropylacrylamide and 3-acrylamidophenylboronic acid as main components were developed by bottom-spray coating technology and template method. The insulinoma β-TC6 cells were trapped in the copolymer microcapsules by use of temperature sensitivity, and then growth, proliferation, and glucose-responsive insulin secretion of microencapsulated cells were successively monitored. The copolymer microcapsules showed favorable structural stability and good biocompatibility against β-TC6 cells. Compared with free cells, the biomicrocapsules presented a more effective and safer glucose-dependent insulin release behavior. The bioactivity of secreted and released insulin did not differ between free and encapsulated β-TC6 cells. The results demonstrated that the copolymer microcapsules had a positive effect on real-time sensing of glucose and precise controlled release of insulin. The intelligent drug delivery system is supposed to mimic insulin secretion in a physiological manner, and further provide new perspectives and technical support for the development of artificial pancreas.     

In vitro and in vivo testing of glucose-responsive insulin-delivery microdevices in diabetic rats

We have developed glucose-responsive implantable microdevices for closed-loop delivery of insulin and conducted in vivo testing of these devices in diabetic rats. The microdevices consist of an albumin-based bioinorganic membrane that utilizes glucose oxidase (GOx), catalase (CAT) and manganese dioxide (MnO(2)) nanoparticles to convert a change in the environmental glucose level to a pH stimulus, which regulates the volume of pH-sensitive hydrogel nanoparticles and thereby the permeability of the membrane. The membrane is integrated with microfabricated PDMS (polydimethylsiloxane) structures to form compact, stand-alone microdevices, which do not require tethering wires or tubes. During in vitro testing, the microdevices showed glucose-responsive insulin release over multiple cycles at clinically relevant glucose concentrations. In vivo, the microdevices were able to counter hyperglycemia in diabetic rats over a one-week period. The in vitro and in vivo testing results demonstrated the efficacy of closed-loop biosensing and rapid response of the 'smart' insulin delivery devices.     

Glucose-Responsive Charge-Switchable Lipid Nanoparticles for Insulin Delivery

Lipid nanoparticle-based drug delivery systems have a profound clinical impact on nucleic acid-based therapy and vaccination. Recombinant human insulin, a negatively-charged biomolecule like mRNA, may also be delivered by rationally-designed positively-charged lipid nanoparticles with glucose-sensing elements and be released in a glucose-responsive manner. Herein, we have designed phenylboronic acid-based quaternary amine-type cationic lipids that can self-assemble into spherical lipid nanoparticles in an aqueous solution. Upon mixing insulin and the lipid nanoparticles, a heterostructured insulin complex is formed immediately arising from the electrostatic attraction. In a hyperglycemia-relevant glucose solution, lipid nanoparticles become less positively charged over time, leading to reduced attraction and subsequent insulin release. Compared with native insulin, this lipid nanoparticle-based glucose-responsive insulin shows prolonged blood glucose regulation ability and blood glucose-triggered insulin release in a type 1 diabetic mouse model.     

Thermodynamic Studies of Insulin Loading into a Glucose Responsive Hydrogel Based on Chitosan‐polyacrylamide‐polyethylene Glycol

The insulin therapy constitutes the preferred treatment for Diabetes Mellitus (DM). The traditional insulin therapy, which consists of daily subcutaneous insulin injections to control blood glucose level, is not able to regulate the blood glucose level precisely. In this research, to facilitate the diabetic patient life, an intelligent drug delivery system based on a biodegrable biopolymer to control the insulin release, was designed. In this system, chitosan‐polyethylene glycol hydrogel and glucose oxidize play the role of drug carrier and glucose biosensor, respectively. To increase the hydrogel drug loading capacity, hydrogels with different PEG content were synthesized and insulin was loaded by swelling‐diffusion method into them. The loaded hydrogels were characterized by Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM), High performance liquid chromatography (HPLC), and Thermogravimetric analysis (TGA). Finally, the thermodynamic study for insulin loading process was performed to investigate the stability of the drug in the system.     

格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性分析

目的 研究格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性。方法 以天津市武清区河西务医院2015年1月—2016年11月初诊2型糖尿病患者106例随机分两组。A组采用常规饮食、运动等干预,并口服格列美脲治疗,B组在A组基础上联合二甲双胍治疗,共治疗12周。比较两组患者低血糖、肝肾和胃肠不良反应发生率;血糖达标时间;施行治疗前和施行治疗后患者血糖水平、胰岛素分泌指数、胰岛素抵抗指数的差异。结果 两组患者低血糖、肝肾和胃肠不良反应发生率无显著差异,P0.05;B组血糖达标时间短于A组,P0.05;施行治疗前两组血糖水平、胰岛素分泌指数、胰岛素抵抗指数比较无显著差异,P0.05;施行治疗后B组血糖水平、胰岛素分泌指数、胰岛素抵抗指数改善幅度更大,P0.05。结论格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性高,可有效改善患者血糖水平和胰岛素分泌情况,低血糖风险低,安全可靠,值得推广。     

A glucose-responsive controlled release of insulin system based on enzyme multilayers-coated mesoporous silica particles

A novel glucose-responsive controlled release of insulin system is constructed through coating enzyme multilayers on mesoporous silica particles (MSPs). The MSPs serve as the drug reservoir, and the enzyme multilayers cross-linked with glutaraldehyde act as a valve to control the release of insulin in response to the external glucose level.     

pH-temperature Responsive Hydrogel-Mediated Delivery of Exendin-4 Encapsulated Chitosan Nanospheres for Sustained Therapeutic Efficacy in Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus (T2D) is a chronic, obesity-related, and inflammatory disorder characterize by insulin resistance, inadequate insulin secretion, hyperglycemia, and excessive glucagon secretion. Exendin-4 (EX), a clinically established antidiabetic medication that acts as a glucagon-like peptide-1 receptor agonist, is effective in lowering glucose levels and stimulating insulin secretion while significantly reducing hunger. However, the requirement for multiple daily injections due to EX's short half-life is a significant limitation in its clinical application, leading to high treatment costs and patient inconvenience. To address this issue, an injectable hydrogel system is developed that can provide sustained EX release at the injection site, reducing the need for daily injections. In this study, the electrospray technique is examine to form EX@CS nanospheres by electrostatic interaction between cationic chitosan (CS) and negatively charged EX. These nanospheres are uniformly dispersed in a pH-temperature responsive pentablock copolymer, which forms micelles and undergoes sol-to-gel transition at physiological conditions. Following injection, the hydrogel gradually degraded, exhibiting excellent biocompatibility. The EX@CS nanospheres are subsequently released, maintaining therapeutic levels for over 72 h compared to free EX solution. The findings demonstrate that the pH-temperature responsive hydrogel system containing EX@CS nanospheres can be a promising platform for the treatment of T2D.     

Insulin Delivery from Glucose-Responsive,Self-Assembled,Polyamine Nanoparticles: Smart “Sense-and-Treat” Nanocarriers Made Easy

Polyamine–salt aggregates (PSA) are biomimetic soft materials that have attracted great attention due to their straightforward fabrication methods, high drug-loading efficiencies, and attractive properties for pH-triggered release. Herein, a simple and fast multicomponent self-assembly process was used to construct cross-linked poly(allylamine hydrochloride)/phosphate PSAs (hydrodynamic diameter of 360 nm) containing glucose oxidase enzyme, as a glucose-responsive element, and human recombinant insulin, as a therapeutic agent for the treatment of diabetes mellitus (GI-PSA). The addition of increasing glucose concentrations promotes the release of insulin due to the disassembly of the GI-PSAs triggered by the catalytic in situ formation of gluconic acid. Under normoglycemia, the GI-PSA integrity remained intact for at least 24 h, whereas hyperglycemic conditions resulted in 100 % cargo release after 4 h of glucose addition. This entirely supramolecular strategy presents great potential for the construction of smart glucose-responsive delivery nanocarriers.     

Thermosensitive Microneedles Capable of On Demand Insulin Release for Precise Diabetes Treatment

As a novel painless and minimally invasive transdermal drug delivery method, microneedles have solved the challenges of microbial infection and tissue necrosis associated with multiple subcutaneous injections in patients with diabetes. However, traditional soluble microneedles cannot switch drug release on and off according to the patient's needs during long-term use, which is one of the most critical elements of diabetes treatment. Herein, an insoluble thermosensitive microneedle (ITMN) that can control the release of insulin by adjusting the temperature, enabling the precise treatment of diabetes is designed. Thermosensitive microneedles are produced by in situ photopolymerization of the temperature-sensitive compound N-isopropylacrylamide with the hydrophilic monomer N-vinylpyrrolidone, which is encapsulated with insulin and bound to a mini-heating membrane. ITMN are demonstrated to have good mechanical strength and temperature sensitivity, can release significantly different insulin doses at different temperatures, and effectively regulate blood glucose in type I diabetic mice. Therefore, the ITMN provides a possibility for intelligent and convenient on-demand drug delivery for patients with diabetes, and when combined with blood glucose testing devices, it has the potential to form an integrated and precise closed-loop treatment for diabetes, which is of great importance in diabetes management.     

两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率比较

目的研究两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率。方法选取孝感市中心医院2013年3月—2014年8月84例门诊初诊2型糖尿病患者,抽签随机分为两组,其中42例采用餐前皮下注射门冬胰岛素治疗记为对照组,剩下42例采用餐前注射门冬胰岛素联合晚间注射甘精胰岛素强化治疗记为观察组。结果两组治疗后血糖相关指标比较无明显差异,不具有统计学意义(P0.05);观察组低血糖率11.90%较对照组30.95%显著较低,具有统计学意义(P0.05)。结论两种胰岛素方案治疗初诊2型糖尿病均较为有效,但早期采用强化治疗方案能有效稳定平衡血糖代谢、预防低血糖发生,可作为临床治疗初诊2型糖尿病的首选参考方法。     

A glucose-responsive controlled release system using glucose oxidase-gated mesoporous silica nanocontainers

A glucose-responsive controlled-release system based on the competitive combination between glucose oxidase, glucosamine and glucose has been described, which exhibits perfect controlled release properties and high selectivity for glucose over other monosaccharides. This paved the way for a new generation of stimuli-responsive delivery systems.     

Formulation and Evaluation of Self‐Regulated Insulin Delivery System Based on poly(HEMA‐co‐DMAEMA) Hydrogels

In the present work a self‐regulated insulin delivery system based on the hydrogel poly(2‐hydroxyethyl methacrylate‐co‐N,N‐dimethylaminoethyl methacrylate) with entrapped glucose oxidase, catalase and insulin was developed and evaluated both by in vitro and in vivo studies. The hydrogels were characterized by FTIR, DSC, SEM and elemental analysis. The swelling studies were carried out in different pH and glucose solutions. The mesh size of the hydrogels and diffusion coefficient of water and insulin in different glucose solution was calculated. The effect of the crosslinking agent (ethylene glycol dimethacrylate) concentration (0–2% w/w) on swelling and insulin release was studied. The equilibrium swelling and insulin release was found to depend on the external glucose concentration and dimethylaminoethyl methacrylate content of the hydrogels. The in vivo studies indicated that the entrapped insulin was stable and was effective in reducing the blood glucose of streptozotocin induced diabetic rats. The histopathological studies revealed that there was no fibrous tissue encapsulation after 56 days of implantation.     

In vivo oral insulin delivery via covalent organic frameworks

With diabetes being the 7th leading cause of death worldwide, overcoming issues limiting the oral administration of insulin is of global significance. The development of imine-linked-covalent organic framework (nCOF) nanoparticles for oral insulin delivery to overcome these delivery barriers is herein reported. A gastro-resistant nCOF was prepared from layered nanosheets with insulin loaded between the nanosheet layers. The insulin-loaded nCOF exhibited insulin protection in digestive fluids in vitro as well as glucose-responsive release, and this hyperglycemia-induced release was confirmed in vivo in diabetic rats without noticeable toxic effects. This is strong evidence that nCOF-based oral insulin delivery systems could replace traditional subcutaneous injections easing insulin therapy.

We report the successful use of a gastro-resistant covalent organic framework for in vivo oral delivery of insulin.     

Glucose‐Responsive Trehalose Hydrogel for Insulin Stabilization and Delivery

Effective delivery of therapeutic proteins is important for many biomedical applications. Yet, the stabilization of proteins during delivery and long‐term storage remains a significant challenge. Herein, a trehalose‐based hydrogel is reported that stabilizes insulin to elevated temperatures prior to glucose‐triggered release. The hydrogel is synthesized using a polymer with trehalose side chains and a phenylboronic acid end‐functionalized 8‐arm poly(ethylene glycol) (PEG). The hydroxyls of the trehalose side chains form boronate ester linkages with the PEG boronic acid cross‐linker to yield hydrogels without any further modification of the original trehalose polymer. Dissolution of the hydrogel is triggered upon addition of glucose as a stronger binder to boronic acid (K_b = 2.57 vs 0.48 m ⁻¹ for trehalose), allowing the insulin that is entrapped during gelation to be released in a glucose‐responsive manner. Moreover, the trehalose hydrogel stabilizes the insulin as determined by immunobinding after heating up to 90 °C. After 30 min heating, 74% of insulin is detected by enzyme‐linked immunosorbent assay in the presence of the trehalose hydrogel, whereas only 2% is detected without any additives.     

Biodegradable in situ gel-forming controlled vancomycin delivery system based on a thermosensitive mPEG-PLCPPA hydrogel

In this study, a biodegradable in situ gel-forming controlled drug delivery system based on a thermosensitive methoxy polyethylene glycol-co-poly (lactic acid-co-aromatic anhydride) (mPEG-PLCPPA) hydrogel was studied. The hydrogels were formed by micelle aggregation with rising temperature. The hydrogels underwent a temperature-dependent sol–gel–sol transition, which was a flowing sol at ambient temperature and a non-flowing gel at the physiological body temperature. The residual weight and pH value changes after degradation and the viscosity properties of the hydrogel were investigated. The in vitro release behavior of vancomycin from the mPEG-PLCPPA hydrogels at different concentrations was also investigated. The results showed that the mPEG-PLCPPA amphiphilic copolymer could self-assemble to form micelles at low concentrations, and that the particle sizes gradually increased with increasing temperature. The hydrogel maintained a stable degradation rate and provided a moderate pH microenvironment after degradation for 30 days. Vancomycin sustained a stable release profile from the hydrogel over a 10-day period. Furthermore, good biocompatibility was proven by MTT assay and live and dead test. Therefore, the mPEG-PLCPPA hydrogel shows promise as an injectable local antibiotic delivery system.     

Preparation and characterization of insulin-loaded acrylic hydrogels containing absorption enhancers

The objectives of this study were to prepare insulin-loaded acrylic hydrogel formulations containing various absorption enhancers, to perform in vitro and in vivo characterization of these formulations, and to evaluate the factors which affecting insulin availability on rectal delivery of insulin using this hydrogel system. The acrylic block copolymer of methacrylic acid and methacrylate, Eudispert, was used to make the hydrogel formulations. As absorption enhancers, 2,6-di-O-methyl-beta-cyclodextrin (DM-beta-CyD), lauric acid (C12), or the sodium salt of C12 (C12Na), were incorporated into the hydrogels. In an in vitro release test, the release rate of insulin from the hydrogels decreased as the polymer concentration of the hydrogel increased. The addition of C12Na to the hydrogel further increased the insulin release rate, which was greater at higher concentrations of the enhancer. A portion of the C12Na was found to remain bound to the acrylic polymer in dissolution medium. Serum insulin levels were determined at various time points after the administration of insulin solution or insulin-loaded (50 units/kg body weight) Eudispert hydrogels containing 5% (w/w) of C12, C12Na, or DM-beta-CyD to in situ loops in various regions of the rat intestine. The most effective enhancement of insulin release was observed with formulations containing C12Na. The bioavailability of insulin from the hydrogels was lower than that from the insulin solutions. Hydrogel formulations containing 7% or 10% Eudispert remained in the rectum for 5 h after rectal administration. However, the 5% (w/w) C12Na solution stained with Evan's-blue had diffused out and the dye had reached the upper intestinal tract within 2 h. Finally, the rectal administration of insulin-loaded hydrogels, containing 4%, 7%, or 10% (w/w) Eudispert and 5% (w/w) of enhancer (C12, C12Na, or DM-beta-CyD) to normal rats was shown to decrease serum glucose concentrations. The greatest effect was found with insulin-loaded 7% (Eudispert) hydrogel containing C12Na which having cosiderable large insulin release rate and bioadhesive characteristics.     

Effect of the incorporation of amino groups in a glucose-responsive polymer complex having phenylboronic acid moieties

A novel polymer complex system sensitive to glucose was studied as a candidate material for formulating a chemically regulated insulin release system. A ternary copolymer of N-vinyl-2-pyrrolidone (NVP), 3-acrylamidophenylboronic acid (AAm-PBA) and N,N-dimethylaminopropylacrylamide (DMAPAA) (poly(NVP-co-PBA-co-DMAPAA)) was synthesized by radical copolymerization. The phenylboronic acid group in this copolymer serves as a glucose sensor moiety. Poly(NVP-co-PBA-co-DMAPAA) was soluble in water in the pH range of 3–12, in sharp contrast to a binary copolymer of NVP and AAm-PBA (poly(NVP-co-PBA)) which showed solubility only under alkaline aqueous conditions, where the boronic acid group is in a tetrahedral ionized form. The protonated amino group in poly(NVP-co-PBA-DMAPAA) contributed to increase the solubility of the polymer under physiological and acidic aqueous conditions. Furthermore, poly(NVP-co-PBA-co-DMAPAA) formed a stable polymer complex gel with poly(vinyl alcohol) (PVA) in pH 7.4 phosphate buffered solution due to the formation of a covalent linkage between the boronic acid groups in ternary copolymer and diol units in PVA. The release of myoglobin as model protein from the complex gel was increased immediately after the addition of glucose, due to the transition of gel into sol state, indicating the feasibility of this complex gel as a candidate material for a glucose-responsive delivery system for insulin.     

Antihyperglycemic effect of insulin from self-dissolving micropiles in dogs

As a percutaneous delivery device, self-dissolving micropiles (SDMPs) composed of chondroitin sulfate and insulin were prepared under room temperature from highly concentrated solution, glue. The mean weight of SDMP was 1.03+/-0.04 mg. One insulin SDMP was percutaneously administered to the shaved abdominal skin of four beagle dogs at insulin dose level of 1.0 and 2.0 IU/dog. After administration, blood samples were collected for 6 h and plasma glucose levels were measured. The time when minimum plasma glucose level appeared, T(min), was 1.38+/-0.2 h for 1.0 IU study and 1.38+/-0.1 h for 2.0 IU study and clear dose-dependent hypoglycemic effect of insulin was observed in the dose range. By comparing the area above the plasma glucose level vs. time curve (AAC) between insulin SDMP and subcutaneous (s.c.) injection solution, the relative pharmacological availabilities were 99% (1.0 IU) and 90% (2.0 IU), respectively. To ascertain the usefulness of insulin SDMP, oral glucose tolerance test (OGTT) was performed. When dogs were treated with insulin SDMPs, 2.0 IU, followed by an OGTT 30 min, glycemia did not appear for 5 h. On the other hand, when OGTT was performed at 1 h after insulin SDMP administration, hypoglycemia appeared as in the case of s.c. injection of insulin solution, 2.0 IU. Insulin SDMP improved the oral glucose challenge for 3 h, with a maximum effect at 30 min before the administration of glucose. Those results suggest the usefulness of a SDMP for the percutaneous delivery of peptide/protein drugs like insulin.     

Magnetic Resonance Methods as a Prognostic Tool for the Biorelevant Behavior of Xanthan Tablets

Hydrophilic matrix tablets with controlled drug release have been used extensively as one of the most successful oral drug delivery systems for optimizing therapeutic efficacy. In this work, magnetic resonance imaging (MRI) is used to study the influence of various pHs and mechanical stresses caused by medium flow (at rest, 80, or 150 mL/min) on swelling and on pentoxifylline release from xanthan (Xan) tablets. Moreover, a bimodal MRI system with simultaneous release testing enables measurements of hydrogel thickness and drug release, both under the same experimental conditions and at the same time. The results show that in water, the hydrogel structure is weaker and less resistant to erosion than the Xan structure in the acid medium. Different hydrogel structures affect drug release with erosion controlled release in water and diffusion controlled release in the acid medium. Mechanical stress simulating gastrointestinal contraction has no effect on the hard hydrogel in the acid medium where the release is independent of the tested stress, while it affects the release from the weak hydrogel in water with faster release under high stress. Our findings suggest that simultaneous MR imaging and drug release from matrix tablets together provide a valuable prognostic tool for prolonged drug delivery design.     

Designed glucose-responsive microgels with selective shrinking behavior

We report on the synthesis of various glucose-responsive microgels based on N-alkylacrylamide derivatives and phenylboronic acid (PBA) as a glucose sensing moiety. Depending on their chemical composition, the microgels exhibit opposite behaviors in response to glucose concentration increase: they can either swell or shrink, using two different mechanisms for glucose recognition. Both behaviors may be suitable for glucose sensing and insulin delivery. When glucose binds a single boronate receptor, the microgel swells as glucose concentration increases. This mechanism can be used to deliver a drug by diffusion through the network. In other cases, glucose binds specifically to two boronates, which creates additional cross-links within the network and provokes shrinkage. Such systems are promising for the development of sensors with improved selectivity and also as potential "intelligent" valves in microfabricated delivery systems. By a rational choice of the constituting units of the network structure, we show how to favor one or the other type of response to glucose variation. Therefore, glucose-swelling microgels operating under physiological conditions have been obtained by copolymerization with an appropriate choice of alkylacrylamide monomer and boronate derivative. At a pH above the pK(a) of the boronic acid derivative, the same structures shrink in response to glucose concentration. The nature of the cross-linker is a key parameter to enable this dual behavior. In other microgels, an amine group is introduced in the vicinity of the boronic acid, which lowers its pK(a) and favors microgel contraction at physiological pH. This work has allowed us to give some general rules to control the swelling/shrinking behavior of glucose-responsive microgels.