In vivo evaluation of new adjuvant systems based on combination of Salmonella Typhi porins with particulate systems: Liposomes versus polymeric particles.

Subunit vaccines that have weak immunogenic activity require adjuvant systems for enhancedcellular and long-acting humoral immune responses. Both lipid-based and polymeric-based particulate adjuvants have been widely investigated to induce the desired immune responses against the subunit vaccines. The adjuvant efficacy of these particulate adjuvants depends upon their physicochemical properties such as particle size, surface charge, shape and their composition. Previously, we showed in vitro effect of adjuvant systems based on combination of chitosan and Salmonella Typhi porins in microparticle or nanoparticle form, which were spherical with positive surface charge. In the present study, we have further developed an adjuvant system based on combination of porins with liposomes (cationic and neutral) and investigated the adjuvant effect of both the liposomal and polymeric systems in BALB/c mice using a model antigen, ovalbumin. Humoral immune responses were determined following priming and booster dose at 15-day intervals. In overall, IgM and IgG levels were induced in the presence of both the liposomal and polymeric adjuvant systems indicating the positive impact of combination with porins. The highest IgM levels were obtained on Day 8, and liposomal adjuvant systems were found to elicit significantly higher IgM levels compared to polymeric systems. IgG levels were increased significantly after booster, particularly more profound with the micro-sized polymeric system when compared to cationic liposomal system with nano-size. Our results demonstrated that the developed particulate systems are promising both as an adjuvant and delivery system, providing enhanced immune responses against subunit antigens, and have the potential for long-term protection.

Development of multistage recombinant protein vaccine formulations against toxoplasmosis using a new chitosan and porin based adjuvant system.

Toxoplasmosis is a global health problem affecting both human and animal populations. The lack of effective treatment makes the development of a vaccine against toxoplasmosis one of the main goals in the management of this disease. In our study, vaccine formulations containing the multistage recombinant antigens, rBAG1 + rGRA1 were developed with a combined adjuvant system consisting of chitosan and Salmonella Typhi porins in micro (MicroAS) and nanoparticulate (NanoAS) forms. BALB/c mice were immunized intraperitoneally with vaccine formulations two times at three-week intervals. Three weeks after the second vaccination, mice were challenged with 7-8 live tissue cysts of the virulent T. gondii PRU strain by oral gavage. Higher cellular uptake by macrophages and enhanced cellular (IFN-γ and I-4 in stimulated spleen cells) and humoral (IgG, IgG1, IgG2a) responses were obtained with the adjuvanted formulation, higher with microsystem when compared to that of nanosystem. Microsystem was found to stimulate Th1-polarized immune responses, whereasnon-adjuvanted antigens stimulated Th2-polarized immune response. The highest survival rate and reduction in cysts numbers and T. gondii DNA were obtained with the adjuvanted antigens.Our study showed that adjuvanted multistage recombinant vaccine systems increase theimmune response with strong protection againstT. gondii, more profoundly in microparticulate form.

An Overview of Physical, Microbiological and Immune Barriers of Oral Mucosa.

The oral mucosa, which is the lining tissue of the oral cavity, is a gateway to the body and it offers first-line protection against potential pathogens, exogenous chemicals, airborne allergens, etc. by means of its physical and microbiological-immune barrier functions. For this reason, oral mucosa is considered as a mirror to the health of the individual as well as a guard or early warning system. It is organized in two main components: a physical barrier, which consists of stratified epithelial cells and cell-cell junctions, and a microbiological-immune barrier that keeps the internal environment in a condition of homeostasis. Different factors, including microorganism, saliva, proteins and immune components, have been considered to play a critical role in disruption of oral epithelial barrier. Altered mucosal structure and barrier functions results in oral pathologies as well as systemic diseases. About 700 kinds of microorganisms exist in the human mouth, constituting the oral microbiota, which plays a significant role on the induction, training and function of the host immune system. The immune system maintains the symbiotic relationship of the host with this microbiota. Crosstalk between the oral microbiota and immune system includes various interactions in homeostasis and disease. In this review, after reviewing briefly the physical barriers of oral mucosa, the fundamentals of oral microbiome and oral mucosal immunity in regard to their barrier properties will be addressed. Furthermore, their importance in development of new diagnostic, prophylactic and therapeutic strategies for certain diseases as well as in the application for personalized medicine will be discussed.

Current status and future of delivery systems for prevention and treatment of infections in the oral cavity.

Oral health reflects the general health, and it is fundamental to well-being and quality of life. An infection in the oral cavity can be associated with serious complications in human health. Local therapy of these infections offers many advantages over systemic drug administration, targeting directly to the diseased area while minimizing systemic side effects. Specialized drug delivery systems into the oral cavity have to be designed in such a fashion that they resist to the aqueous environment that is constantly bathed in saliva and subject to mechanical forces. Additionally, a prolonged release of drug should also be provided, which would enhance the efficacy and also decrease the repeated dosing. This review is aimed to summarize the current most relevant findings related to local drug delivery of various drug groups for prevention and treatment of infections (viral, bacterial, fungal) and infection-related manifestations in the oral cavity. Current therapeutic challenges in regard to effective local drug delivery systems will be discussed, and the recent approaches to overcome these obstacles will be reviewed. Finally, future prospects will be overviewed to promote novel strategies that can be implemented in clinical management for prevention and treatment of oral infections.

Mucoadhesive bilayered buccal platform for antifungal drug delivery into the oral cavity.

A drug delivery technology comprising a mucoadhesive bilayered buccally anchored tablet containing natamycin was developed. The concept was to anchor the tablet to the buccal tissue and allow controlled release of the drug through the matrix into the mouth. Carbomer (Carbopol ® 974 P NF) was used to formulate the mucoadhesive layer. Hydroxypropyl methylcellulose (HPMC) (Methocel® K4M) at 10, 15, 20, and 40% w/w was used for the drug-containing layer. Natamycin, an amphoteric macrolide antifungal agent, was incorporated into the formulations. In addition, tablets containing erythrosine as a marker were prepared in order to examine the distribution and retention of the dye in the oral cavity. As expected, the in vitro analysis showed that the concentration of natamycin released decreased with the increasing proportion of HPMC in the formulation. A small volunteer study was conducted using the tablets containing 10% and 20% HPMC to quantitate the patterns of distribution of the drug released into the oral cavity (upper right buccal vestibule, lower right and left buccal vestibules, and sublingual region). The mucoadhesive bilayered buccal tablet formulation provided a unidirectional release of the drug from the tablet into the oral cavity in a prolonged release fashion, maintaining drug concentration above the MIC value (2 µg/mL) for Candida albicans. The amount of the drug in the sublingual region was found to be lowest when compared with other regions, which is due to the higher flow of saliva in this region. Graphical abstract.

Nanotechnology and Animal Health.

Nanotechnology has been a rapidly expanding area of research with huge potential in many sectors, including animal healthcare. It promises to revolutionize drug and vaccine delivery, diagnostics, and theranostics, which has become an important tool in personalized medicine by integrating therapeutics and diagnostics. Nanotechnology has also been used successfully in animal nutrition. In this review, the application of nanotechnology in animal health will be reviewed with its pros and cons.

Chitosan-based particulate systems for drug and vaccine delivery in the treatment and prevention of neglected tropical diseases.

Neglected tropical diseases (NTDs) are a diverse group of infections which are difficult to prevent or control, affecting impoverished communities that are unique to tropical or subtropical regions. In spite of the low number of drugs that are currently used for the treatment of these diseases, progress on new drug discovery and development for NTDs is still very limited. Therefore, strategies on the development of new delivery systems for current drugs have been the main focus of formulators to provide improved efficacy and safety. In recent years, particulate delivery systems at micro- and nanosize, including polymeric micro- and nanoparticles, liposomes, solid lipid nanoparticles, metallic nanoparticles, and nanoemulsions, have been widely investigated in the treatment and control of NTDs. Among these polymers used for the preparation of such systems is chitosan, which is a marine biopolymer obtained from the shells of crustaceans. Chitosan has been investigated as a delivery system due to the versatility of its physicochemical properties as well as bioadhesive and penetration-enhancing properties. Furthermore, chitosan can be also used to improve treatment due to its bioactive properties such as antimicrobial, tissue regeneration, etc. In this review, after giving a brief introduction to neglected diseases and particulate systems developed for the treatment and control of NTDs, the chitosan-based systems will be described in more detail and the recent studies on these systems will be reviewed. Graphical abstract.

Development and in vitro evaluation of a new adjuvant system containing Salmonella Typhi porins and chitosan.

In order to improve the immunogenicity of the highly purified vaccine antigens, addition of an adjuvant to formulation, without affecting the safety of the vaccine, has been the key aim of the vaccine formulators. In recent years, adjuvants which are composed of a delivery system and immunopotentiators have been preferred to induce potent immune responses. In this study, we have combined Salmonella Typhi porins and chitosan to develop a new adjuvant system to enhance the immunogenicity of the highly purified antigens. Cationic gels, microparticle (1.69 ± 0.01 µm) and nanoparticles (337.7 ± 1.7 nm) based on chitosan were prepared with high loading efficiency of porins. Cellular uptake was examined by confocal laser scanning microscopy, and the macrophage activation was investigated by measuring the surface marker as well as the cytokine release in vitro in J774A.1 macrophage murine cells. Porins alone were not taken up by the macrophage cells whereas in combination with chitosan a significant uptake was obtained. Porins-chitosan combination systems were found to induce CD80, CD86 and MHC-II expressions at different levels by different formulations depending on the particle size. Similarly, TNF-α and IL-6 levels were found to increase with porins-chitosan combination. Our results demonstrated that combination of porins with chitosan as a particulate system exerts enhanced adjuvant effect, suggesting a promising adjuvant system for subunit vaccines with combined immunostimulating activity.

Localized drug delivery with mono and bilayered mucoadhesive films and wafers for oral mucosal infections.

Local drug delivery into oral cavity offers many advantages over systemic administration in treatment of the oral infections. In this study, monolayer and bilayered mucoadhesive film and wafer formulations were developed as local drug delivery platforms using chitosan and hydroxypropyl methylcellulose (HPMC). Cefuroxime axetil (CA) was used as the model drug. Surface morphology, mechanical strength, water uptake, in vitro adhesion, disintegration and in vitro release properties of the formulations were investigated. Furthermore, antimicrobial activity of the formulations was evaluated against E. coli and S. aureus. HPMC based formulations were found to disintegrate within <30 min whereas chitosan based formulations remained intact up to 6 h. Significantly higher drug release was obtained with wafer formulations. Antimicrobial activity was found to increase in presence of chitosan, and HPMC was also observed to contribute to this action. Bilayered wafer formulation, with adhesive chitosan backing layer and HPMC based drug loaded layer, providing prolonged drug release and suitable adhesive properties, with suitable mechanical strength, would be suggested as a promising local delivery system for treatment of the infections in the oral cavity.

In vivo evaluation of chitosan based local delivery systems for atorvastatin in treatment of periodontitis.

Periodontitis is a local inflammatory disease initiated by bacteria accumulation and results in cytokine mediated alveolar bone resorption and tissue destruction. In this study, the effect of locally delivered atorvastatin (2% w/v) containing chitosan formulations in the treatment of periodontitis was evaluated in rats with ligature induced periodontitis. The levels of interleukin-1beta (IL-1ß), IL-6, IL-8, IL-10, transforming growth factor-ß1 (TGF-ß1), TGF-ß2 and TGF-ß3 were measured after treatment with formulations. Histomorphometric analysis included the measurements of the area of alveolar bone and the distance between cemento-enamel junction (CEJ) and connective tissue attachment to tooth. Inflammatory and osteoclastic activity scores were given semiquantitatively. Following the administration of atorvastatin, release of pro-inflammatory (IL-1ß, IL-6 and IL-8) and anti-inflammatory (TGF-ß1 and TGF-ß2) cytokines was found to decrease, with a significant alveolar bone healing, when compared to that of control. The anti-inflammatory effect was observed to enhance in presence of chitosan. These findings suggest that chitosan based delivery system for a statin group drug, atorvastatin is a promising for the treatment of periodontal disease.

Development and in vitro evaluation of chitosan based system for local delivery of atorvastatin for treatment of periodontitis.

In recent years, statin group drugs have been widely investigated in treatment of periodontal diseases due to their anti-inflammatory effect. The efficacy of statins can be enhanced by local administration into the periodontal pocket by appropriate delivery systems. The aim of our study was to develop a bioadhesive delivery system for local delivery of atorvastatin in treatment of periodontal disease. For this purpose, gel formulations were prepared using different types of chitosan (base and water soluble) and viscosity, bioadhesivity and syringeability of the gels as well as in vitro drug release properties were investigated vitro. Furthermore, anti-inflammatory effect of the formulations was studied in vitro using tumor necrosis factor (TNF)-alfa induced human gingival fibroblast (hGF) cells. Release of proinflammatory (IL-1ß, IL-6, IL-8) and anti-inflammatory (TGF-ß1, TGF-ß2, TGF-ß3, IL-10) cytokines were measured after incubating the hGF cells with the formulations. The viscosity of the formulations was found to be suitable for a local application into periodontal pocket. In presence of drug, bioadhesive property of the formulations was found to increase, and bioadhesion force was within the range, which would retain the delivery system at the application site, subsequently maintain drug levels at desired amount for longer period of time. The release of atorvastatin from the gels was found to be slower than that of the solution. The cytokine levels were found to decrease following application of the formulations, and anti-inflammatory effect was observed to enhance in presence of chitosan. No significant differences were found between base and water-soluble chitosan.

Chitosan-based systems for intranasal immunization against foot-and-mouth disease.

Inactivated conventional vaccines against foot-and-mouth disease (FMD) are used routinely in endemic countries and are effective against clinical disease. Increased systemic IgG levels can be obtained with these vaccines whereas local response at the mucosal sites where the virus primarily enters the organism and replicates remains very limited. The aim of this study was to develop a safe, non-invasive and antigen compatible system for mucosal delivery of the FMD antigen which induces both the systemic and local immunity. Gel formulations were prepared using different types of chitosan at different concentrations and were incorporated with the whole inactivated FMD virion. The immune responses in guinea pigs were determined following intranasal administration. Chitosan-based FMD vaccine formulations have been shown to induce FMD antigen-specific serum IgG and nasal IgA levels, the latter response being significantly stronger as compared to that obtained following subcutaneous administration of the FMD antigen in Freund's incomplete adjuvant. Our results suggest that intranasal immunization with inactivated FMD virion delivered in the presence of chitosan is very promising, inducing both systemic and local immune responses.

Characterization of protein and peptide binding to nanogels formed by differently charged chitosan derivatives.

Chitosan (Chi) is a natural biodegradable cationic polymer with remarkable potency as a vehicle for drug or vaccine delivery. Chi possesses multiple groups, which can be used both for Chi derivatization and for particle formation. The aim of this work was to produce stable nanosized range Chi gels (nanogels, NGs) with different charge and to study the driving forces of complex formation between Chi NGs and proteins or peptides. Positively charged NGs of 150 nm in diameter were prepared from hexanoyl chitosan (HC) by the ionotropic gelation method while negatively charged NGs of 190 nm were obtained from succinoyl Chi (SC) by a Ca²âº coacervation approach. NGs were loaded with a panel of proteins or peptides with different weights and charges. We show that NGs preferentially formed complexes with oppositely charged molecules, especially peptides, as was demonstrated by gel-electrophoresis, confocal microscopy and HPLC. Complex formation was accompanied by a change in zeta-potential and decrease in size. We concluded that complex formation between Chi NGs and peptide/proteins is mediated mostly by electrostatic interactions.

Recent developments in buccal and sublingual delivery systems.

INTRODUCTION: There have been several advances in the delivery of drugs through the buccal mucosa over the last 5 years, which have resulted in a number of new buccal delivery products appearing on the market. AREAS COVERED: This review discusses the most recent developments in the area of buccal and sublingual drug delivery, with a focus on marketed drugs. Likely future directions are also considered and reported. EXPERT OPINION: The future potential of buccal and sublingual delivery systems looks favorable. It is envisaged that in the future, buccal and sublingual delivery technologies will provide a platform for the successful delivery of vaccines and antigens. It is also foreseen that physical means of enhancing drug uptake (e.g., sonophoresis, iontophoresis and electroporation) will be commercialized for buccal delivery, thereby expanding the current drug candidate list for this area. The formulation of delivery systems for photosensitizers in photodynamic therapy is a potential emerging area, while buccal and sublingual delivery, in general, is attractive for the development of intellectual property.

Chitosan based delivery systems for mucosal immunization against bovine herpesvirus 1 (BHV-1).

Bovine herpesvirus 1 (BHV-1), is a major pathogen of cattle which causes serious infections, including infectious bovine rhinotracheitis (IBR)/infectious pustular vulvovaginitis (IPV). At present, BHV-1 is still a serious threat to animal health and productivity in Turkey, hence to develop a more efficient and economical vaccine system against BHV-1 is certainly an important necessity. A mucosal vaccination strategy would provide both mucosal and systemic immune responses to protect disease progression and transmission. However, vaccination through mucosal membranes requires adjuvants/delivery systems in order to enhance the immunogenicity of the antigens. Chitosan, which is a biodegradable, biocompatible and bioadhesive natural polysaccharide, has been shown to be promising both as a delivery system and an adjuvant for mucosal vaccination. In this study, microparticles with appropriate size (<10µm), positive surface charge and high loading efficiency (∼95%) were prepared for mucosal delivery of BHV-1, using various types of chitosan with different molecular weight and solubility. Particles were shown to be taken up by the cells, mostly around the nucleus, whereas with aggregates which were bigger in size were adsorbed at the surface. Furthermore, gel formulations with a suitable viscosity which would provide easy application and remain on the mucosa for extended period of time were also developed with a high zeta potential indicating a stable system. Both the BHV-1 loaded microparticle and gel formulations were shown to maintain cell viability and antigen integrity. Chitosan-based formulations are suggested as promising adjuvant/delivery systems for mucosal immunization against BHV-1.

Effects of platelet-rich plasma and chitosan combination on bone regeneration in experimental rabbit cranial defects.

This study aimed to investigate and compare the effect of chitosan sponge and platelet-rich plasma (PRP) gel alone as well as their combination on bone regeneration in rabbit cranial defects. Four cranial defects with a 4.5-mm diameter were created in rabbit cranium and grafted with PRP, chitosan sponge alone, and chitosan sponge incorporated with PRP. The rabbits were killed by the fourth and eighth weeks, and the defects were analyzed histologically. Higher bone formation was observed in the PRP group when compared with the other groups at weeks 4 and 8. All parts of the defects were filled with thick trabecular new bone in the PRP group. The amount of new bone formation in the control groups was found to be less when compared with the PRP group and the least in the chitosan group. The defects that were filled with chitosan sponge showed a limited amount of new bone formation and an obvious fibrous demarcation line between chitosan particles and bone. Application of PRP showed a histological tendency toward increased bone formation. Other forms or derivatives of chitosan may have beneficial effects to achieve new bone regeneration.

TMC-MCC (N-trimethyl chitosan-mono-N-carboxymethyl chitosan) nanocomplexes for mucosal delivery of vaccines.

In this study, for the first time, TMC/MCC complex nanoparticles as a delivery system and as an adjuvant were developed and evaluated to obtain systemic and mucosal immune responses against nasally administered tetanus toxoid (TT). Nanoparticles were developed by complexation between the oppositely charged chitosan derivatives, N-trimethyl chitosan (TMC, polycationic) and mono-N-carboxymethyl chitosan (MCC, polyampholytic) without using any crosslinker for mucosal vaccination. The cellular viability was found to be higher with TMC/MCC complex compared to that of MCC and TMC alone. Size, zeta potential and morphology of the nanoparticles were investigated as a function of preparation method. Nanoparticles with high loading efficacy (95%) and positively charged surface were obtained with an average particle size of 283+/-2.5 nm. The structural integrity of the TT in the nanoparticles was confirmed by SDS-PAGE electrophoresis analysis. Cellular uptake studies indicated that FITC-BSA loaded nanoparticles were effectively taken up into the mouse Balb/c monocyte macrophages. Mice were nasally immunized with TT loaded TMC/MCC complex nanoparticles and compared to that of TMC and MCC nanoparticles. TMC/MCC complex nanoparticles were shown to induce both the mucosal and systemic immune response indicating that this newly developed system has potential for mucosal administration of vaccines.