Permeability Barriers for Nicotine and Mannitol in Porcine Buccal Mucosa Studied by High-Resolution MALDI Mass Spectrometry Imaging.

Improved nicotine permeability across buccal mucosa may enable more effective oromucosal nicotine replacement therapy products. It is essential to know the location and composition of the main barrier for drug diffusion to enhance the drug permeability. Matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI MSI) is a rapidly evolving technique that can be used to image the spatial distribution of drugs and drug metabolites in tissue cryo-sections, without prior labeling of the drug. In this study, the distribution of nicotine and mannitol in porcine buccal mucosa was imaged with 10 µm spatial resolution after apical as well as submucosal application of the drugs in order to localize the main permeability barrier(s). This was supported by ex vivo permeability studies across separated porcine buccal epithelium and submucosa. Lastly, the metabolism of nicotine in porcine buccal mucosa was evaluated by imaging of the main metabolite, cotinine. The results showed that the main permeability barrier to both nicotine and mannitol was located in the outer fourth of the epithelium. Further, it was shown that cotinine was sparsely distributed in excised porcine buccal mucosa, indicating that nicotine metabolism in excised porcine buccal mucosa was negligible. MALDI MSI was shown to be a useful method for imaging spatial distribution of drugs in buccal mucosa.

Effect of Permeation Enhancers on the Buccal Permeability of Nicotine: Ex vivo Transport Studies Complemented by MALDI MS Imaging.

PURPOSE: The purpose of this study was to assess the effect of several chemical permeation enhancers on the buccal permeability of nicotine and to image the spatial distribution of nicotine in buccal mucosa with and without buccal permeation enhancers. METHODS: The impact of sodium taurodeoxycholate (STDC), sodium dodecyl sulphate (SDS), dimethyl sulfoxide (DMSO) and Azone® on the permeability of [3H]-nicotine and [14C]-mannitol (a paracellular marker) across porcine buccal mucosa was studied ex vivo in modified Ussing chambers. The distribution of nicotine, mannitol and permeation enhancers was imaged using using matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI MSI). RESULTS: Despite STDC significantly increasing permeability of [14C]-mannitol, no enhancing effect was seen on [3H]-nicotine permeability with any of the permeation enhancers. Rather, SDS and DMSO retarded nicotine permeability, likely due to nicotine being retained in the donor compartment. The permeability results were complemented by the spatial distribution of nicotine and mannitol determined with MALDI MSI. CONCLUSIONS: The buccal permeability of nicotine was affected in an enhancer specific manner, suggesting that nicotine primarily diffuses via the transcellular pathway. MALDI MSI was shown to complement ex vivo permeability studies and to be a useful qualitative tool for visualizing drug and penetration enhancer distribution in buccal mucosa.

Visualization of the penetration modifying mechanism of laurocapram by Mass Spectrometry Imaging in buccal drug delivery.

The aim of the study was to visualize the penetration modifying effect of laurocapram on the delivery of diazepam and codeine across buccal mucosa by MALDI Mass Spectrometry Imaging (MALDI-MSI). A qualitative ex vivo study was carried out by mounting porcine buccal mucosa in Ussing chamber sliders and applying a pre-treatment of phosphate buffered saline (PBS) or a 50% (v/v) laurocapram:ethanol solution apically before incubation for 1 or 3 h with a 0.1 M diazepam or 0.1 M codeine solution. MALDI-MSI analysis was performed on vertical cryo-sections of porcine buccal mucosa. The analysis provided detailed images of the localisation of the drugs, laurocapram and endogenous lipids in the epithelium and connective tissue. While diazepam in the absence of laurocapram was distributed with a steady concentration gradient through the connective tissue, indicating passive diffusion, pre-treatment with laurocapram fundamentally altered the penetration of diazepam through the buccal mucosa. In the presence of laurocapram, the distribution of diazepam was restricted to areas where laurocapram itself was present, in particular in the outer epithelial cell layers and in certain islands in the connective tissue. In contrast, the penetration of codeine was unaffected by the presence of laurocapram in similar experiments. The co-localization of laurocapram and diazepam indicates a reservoir effect, which has previously been found in diffusion experiments in Ussing chambers. The major difference in the penetration of codeine and diazepam through the buccal mucosa in presence of laurocapram was explained by the physicochemical properties of the drugs. Codeine is characterized by being more hydrophilic than diazepam and was partly charged under the given experimental conditions.

Buccal delivery of small molecules - Impact of levulinic acid, oleic acid, sodium dodecyl sulfate and hypotonicity on ex vivo permeability and spatial distribution in mucosa.

Studies of drug permeability rate and localization in buccal mucosa are essential to gain new knowledge of means such as chemical enhancers or osmolality to enhance buccal drug transport in the development of new buccal drug products. The transport of caffeine, diazepam and mannitol across porcine buccal mucosa was studied in modified Ussing chambers with a hypotonic donor solution, in the presence of levulinic acid (LA), oleic acid (OA), propylene glycol (PG) as well as sodium dodecyl sulfate (SDS). Subsequently, matrix-assisted laser desorption ionization - mass spectrometry imaging (MALDI-MSI) was applied to image the spatial distribution of caffeine, mannitol and SDS in cross-sections of porcine buccal mucosa. The results revealed that none of the permeation enhancing strategies improved the permeability of caffeine or diazepam, despite impact on the tissue integrity by OA and SDS, as seen by an increased permeability of mannitol. Further studies are needed with OA since PG solvent may have concealed the possible impact of OA. SDS decreased the permeability of caffeine and diazepam, a decrease which can be explained by micellar lipid extraction and encapsulation in micelles. MALDI-MSI showed that SDS permeated into approximately one-third of the epithelium, and it therefore appears that the main permeability barrier for mannitol is located in the outer epithelium. MALDI-MSI was shown to be a useful method for imaging spatial distribution of drugs and permeations enhancers in buccal mucosa.

Alcance de los dispositivos artísticos y poéticos en la investigación en salud y salud mental

Resumen: Introducción: Un tema en común que ha caracterizado la evolución de las metodologías cualitativas en las últimas décadas es un "giro transdisciplinario" en forma de la incorporación de técnicas derivadas de las artes. Objetivo: Realizar un análisis crítico de esta tendencia en el campo de la salud y la salud mental, a través de la descripción y explicación de los alcances de dos dispositivos, el artístico y el poético. Método: El trabajo se desarrolla desde la duo-etnografía, entendida como un proceso dialógico que genera nuevos significados a los fenómenos sociales y constructos epistemológicos. Resultados: Los dispositivos descritos tienen un impacto significativo en la relación de la expresión artística con los fundamentos de la investigación cualitativa. Conclusiones: Las artes han impulsado la investigación cualitativa para ir más allá del logocentrismo en las preocupaciones representacionales. Como consecuencia se ha dejado de pensar el uso del arte como una herramienta, sino como una vivencia de construcción de la subjetividad que permite una auténtica experiencia de construcción de la realidad con la implicación activa y crítica por parte del investigador en sus proyectos.

Resumo: Introdução: Um tema comum que tem caracterizado a evolução das metodologias qualitativas nas últimas décadas é uma "volta transdisciplinar" na forma da incorporação de técnicas derivadas das artes. Objetivo: Realizar uma análise crítica desta tendência no campo da saúde e da saúde mental, através da descrição e explicação do alcance de dois dispositivos, o artístico e o poético. Método: O trabalho é desenvolvido a partir da duo-etnografia, entendida como um processo dialógico que gera novos significados para os fenômenos sociais e construções epistemológicas. Resultados: Os dispositivos descritos têm um impacto significativo sobre a relação da expressão artística com os fundamentos da pesquisa qualitativa. Conclusões: As artes têm impulsionado a pesquisa qualitativa para ir além do logocentrismo nas preocupações de representação. Como consequência, o uso da arte não é mais pensado como uma ferramenta, mas como uma vivência de construção da subjetividade que permite uma experiência autêntica de construção da realidade com o envolvimento ativo e crítico do pesquisador em seus projetos.

Abstract: Introduction: A common theme that has characterized the evolution of qualitative methodologies in recent decades is a "transdisciplinary turn" in the form of the incorporation of techniques derived from the arts. Objective: To carry out a critical analysis of this trend in the field of health and mental health, through the description and explanation of the scope of two dispositifs, the artistic and the poetic. Method: The work is developed from duo-ethnography, understood as a dialogic process that generates new meanings to social phenomena and epistemological constructs. Results: The described dispositifs have a significant impact on the relationship of artistic expression with the foundations of qualitative research. Conclusions: The arts have pushed qualitative research to move beyond logocentrism in representational concerns. As a consequence, the use of art is no longer thought of as a tool, but as an experience of construction of subjectivity that allows an authentic experience of construction of reality with the active and critical involvement of the researcher in their projects.

Mucin dispersions as a model for the oromucosal mucus layer in in vitro and ex vivo buccal permeability studies of small molecules.

The mucus layer is believed to play a part in drug permeation across the oral mucosa. Human freeze-dried saliva (HFDS) and porcine gastric mucin (PGM) was evaluated as model for mucus layer per se or in conjunction with in vitro and ex vivo buccal permeability models. Four small molecules (nicotine, mannitol, propranolol, caffeine) showed decreased permeability across mucin dispersions, compared to controls, and a greater effect was seen with HFDS than with PGM. Permeability of propranolol and caffeine across filter-grown TR146 cells was decreased by the presence of mucin, whereas no effect was found on nicotine and mannitol. Incubation of porcine buccal mucosa with mucin dispersions for 24 h compromised the integrity of the tissue, whereas 30 min incubation did not affect tissue integrity. Tissue incubation with mucin dispersions did not decrease nicotine permeability. For the studied model drugs, it is concluded that mucin dispersions constitute a minor barrier for drug diffusion compared to the epithelium.

Effect of cryoprotectants for maintaining drug permeability barriers in porcine buccal mucosa.

Ex vivo drug permeation studies are useful for early screening of drug candidates for buccal delivery. However, it is not always feasible to obtain fresh tissue for each experiment. Therefore, a method for storing excised tissue for later use is needed. The purpose of this study was to determine if permeability barriers for small molecules (nicotine and diazepam) were maintained after freezing porcine buccal mucosa with cryoprotectants to -80°C. Combinations of dimethyl sulfoxide, bovine serum albumin, glycerol and sucrose were used as cryoprotectants. The permeability of nicotine and diazepam across fresh or frozen/thawed tissue was determined using modified Ussing chambers. Haematoxylin-eosin stained tissue sections for histology were prepared. The permeability of nicotine across tissue frozen without cryoprotectants was significantly higher compared to tissue frozen with cryoprotectants or fresh tissue. Freezing with or without cryoprotectants did not significantly affect the flux of diazepam compared to fresh tissue. Only minor histological changes were seen in frozen/thawed porcine buccal mucosa compared to fresh tissue. In conclusion, permeability barriers for nicotine and diazepam were preserved after freezing with any of the combinations of cryoprotectants; however, the barrier may be damaged when freezing without cryoprotectants.

Ex vivo correlation of the permeability of metoprolol across human and porcine buccal mucosa.

The pH partition theory proposes a correlation between fraction of unionized drug substance and permeability. The aim of this study was to compare the permeability of metoprolol and mannitol in ex vivo human and porcine buccal mucosa models at varying pH to validate whether the porcine permeability model is predictive for human buccal absorption. Human (n = 9-10) and porcine (n = 6-7) buccal mucosa were mounted in a modified Ussing chamber, and the kinetics of metoprolol and mannitol transport was assessed for a period of 5.5 h with the pH values of donor medium set at 7.4, 8.5, and 9.0. In addition, hematoxylin-eosin and Alcian blue-van Gieson were used as tissue stains to evaluate the histology and the presence of acidic polysaccharides (e.g., mucins), respectively. The permeability of metoprolol was decreased in human buccal mucosa by almost twofold when compared with porcine buccal mucosa with a positive correlation (r(2) = 0.96) between the permeability assessed in porcine and human buccal mucosa. There was no change in the degree of either epithelial swelling or desquamation when treating with the pH 9.0 donor medium for 5.5 h. These data suggest that buccal mucosa from pigs can be used to predict human buccal absorption.