Alginate-antacid combinations: raft formation and gastric retention studies.

BACKGROUND: Alginate-based gastroesophageal reflux disease treatments have been used extensively and fall into two main categories. Those containing alginate as the principle active agent and those containing alginate in combination with a significant amount of antacid. METHOD: The effectiveness of the raft formed by a new alginate/antacid suspension (Gaviscon Double Action Liquid, GDAL), in which calcium carbonate was the main antacid ingredient, was compared with those of existing alginate/antacid suspensions. RESULT: GDAL had similar raft strength and improved raft resilience than Gaviscon Liquid (GL), and both were significantly greater than five other products tested. Gastric retention of GDAL was similar to that of GL. CONCLUSION: the in vitro and in vivo performance is maintained in the new GDAL formulation even with higher antacid levels and the product is as good as, or better than, previous formulations.

Oesophageal bioadhesion of sodium alginate suspensions 2. Suspension behaviour on oesophageal mucosa.

Sodium alginate suspensions in a range of water miscible vehicles were investigated as novel bioadhesive liquids for targeting the oesophageal mucosa. Such a dosage form might be utilised to coat the oesophageal surface and provide a protective barrier against gastric reflux, or to deliver therapeutic agents site-specifically. Alginate suspensions swelled and formed an adherent viscous layer on contact with the mucosa. The swelling kinetics of alginate particles on the oesophageal surface was examined with respect to vehicle composition and related to the extent, duration and location of bioadhesion within the oesophagus. Mucosal retention was evaluated in two in vitro models utilising tissue immersion and a peristaltic tube. By varying the vehicle composition it was possible to modulate the rate of swelling of alginate particles on the mucosa and the mucosal retention of suspensions. Suspensions containing predominantly glycerol exhibited superior retention and were preferentially retained within the lower oesophagus. The propensity of these suspensions to rapidly swell on the mucosa and establish adhesive/cohesive bonds may explain their enhanced retention. The potential to control, through vehicle composition, the extent, duration and location of oesophageal retention could provide a useful tool for site targeting of viscous polymers to the oesophagus.

Oesophageal bioadhesion of sodium alginate suspensions: particle swelling and mucosal retention.

This paper describes a prospective bioadhesive liquid dosage form designed to specifically adhere to the oesophageal mucosa. It contains a swelling polymer, sodium alginate, suspended in a water-miscible vehicle and is activated by dilution with saliva to form an adherent layer of polymer on the mucosal surface. The swelling of alginate particles and the bioadhesion of 40% (w/w) sodium alginate suspensions were investigated in a range of vehicles: glycerol, propylene glycol, PEG 200 and PEG 400. Swelling of particles as a function of vehicle dilution with artificial saliva was quantified microscopically using 1,9-dimethyl methylene blue (DMMB) as a visualising agent. The minimum vehicle dilution to initiate swelling varied between vehicles: glycerol required 30% (w/w) dilution whereas PEG 400 required nearly 60% (w/w). Swelling commenced when the Hildebrand solubility parameter of the diluted vehicle was raised to 37 MPa(1/2). The bioadhesive properties of suspensions were examined by quantifying the amount of sodium alginate retained on oesophageal mucosa after washing in artificial saliva. Suspensions exhibited considerable mucoretention and strong correlations were obtained between mucosal retention, the minimum dilution to initiate swelling, and the vehicle Hildebrand solubility parameter. These relationships may allow predictive design of suspensions with specific mucoretentive properties, through judicious choice of vehicle characteristics.

Microscopic techniques as potential tools to quantify the extent of bioadhesion of liquid systems.

This work demonstrates the potential of fluorescence and confocal microscopy as techniques to quantify both the extent and duration of bioadhesion of alginate solutions to porcine oesophageal tissue using an in vitro model. The retention of low (40 kDa), medium (240 kDa) and high (416 kDa) MW alginates was quantified via three methods of analysis. Fluorimetric analysis of the dose removed from the oesophageal surface suggested that the percentage of the original dose retained at 30 min was 7.9 +/- 7.0%, 21.9 +/- 9.5% and 23.7 +/- 5.8% for the alginates in order of increasing MW. Analysis of the dose adhered at 30 min using fluorescence microscopy demonstrated that 5.5 +/- 1.9%, 7.1 +/- 2.7% and 18.2 +/- 1.7% of the original dose of the alginate solutions was retained at 30 min. The results found using confocal microscopy showed that the percentage of the original dose adhered at 30 min of the low, medium and high MW alginates were 4.5 +/- 1.9%, 7.2 +/- 5.3% and 11.8 +/- 4.3%, respectively. All techniques demonstrated significantly greater retention of the high MW solution at 30 min compared to the low MW solution. Both confocal and fluorescence microscopy may be used as techniques to evaluate the bioadhesion of liquid systems.

Localised mapping of water movement and hydration inside a developing bioadhesive bond.

Few studies have investigated the internal processes involved in bioadhesive bond formation, particularly where mucus and hydrated polymer contribute jointly to bond structure. This paper reports the first study to spatially map the internal environment within a developing bioadhesive bond, utilising nuclear magnetic resonance (NMR) microscopy to measure localised water self-diffusion coefficients (SDC) and confocal laser scanning microscopy (CLSM) to estimate mucin concentration. In a model bioadhesive bond formed between an alginate matrix and mucin gel, characteristic profiles were observed in which fluorescence measurements showed a region of increasing mucin concentration in the mucus layer region adjacent to the matrix, corresponding closely with a zone of restricted water SDC in the diffusion profiles. These regions extended 144 microm (a normal human gastric layer thickness [Clin. Sci. 95 (1998) 97]) into the mucin layer after just 30 s, increasing to 800 microm after 30 min. The formation of a hydrated polymer layer at the matrix surface, confirmed visually, was also reflected in corresponding gradient changes. The results suggest a progressive dehydration of the mucus gel during bond formation, and the study demonstrates how together, these microscopies can provide non-invasive, quantitative, spatial and time-resolved evidence of internal hydration behaviour during bioadhesive bond formation.

The retention of 14C-labelled poly(acrylic acids) on gastric and oesophageal mucosa: an in vitro study.

Polymers that bind from solution onto gastric mucosa can be used either as a means of facilitating localised drug delivery, or can act as therapeutic agents in their own right (e.g. by forming a protective layer or by inhibiting enzymes). In our previous study [Int. J. Pharm. 236 (2002) 87], the binding and retention of labelled poly(acrylic acid)s on sections of gastric mucosa from pigs was evaluated using 'dynamic flow' conditions and a high molecular weight poly(acrylic acid) was found to bind most avidly. In the current study, 3% solutions of 'low', 'high' and 'ultra high' molecular weight polymers were evaluated in the 'dynamic flow' model for their ability to bind to tissues from the fundic and pyloric regions of the stomach and the oesophagus of pigs. All the polymers tested were retained on each mucosa for extended periods; the high and ultra high molecular weight polymers showed the greatest retention. Examination of the kinetics of polymer elution suggested that two fractions exist, 'bound' and 'unbound' polymer, showing differing retention profiles. The high molecular weight polymer showed the greatest retention on pyloric tissue, particularly on the upper sections. The retention of the ultra high and high molecular weight polymer was similar on the fundic and oesophageal mucosa, and the distribution was even across the tissue. It was concluded that poly(acrylic acid) binding from solution presents a therapeutic opportunity, and the differences in binding and retention of the polymers on the different mucosae could present an opportunity for targeting.

The effect of chitin and chitosan on fibroblast-populated collagen lattice contraction.

The effects of chitin [(1-->4)-2-acetamido-2-deoxy-beta-D-glucan] and its partially deacetylated derivatives, chitosans, on the human dermal fibroblast-mediated contraction of collagen lattices were examined in vitro as a model for the contraction of cutaneous wounds in vivo. Chitosan CL313A, a short-chain-length 89% deacetylated chitosan chloride, inhibited fibroblast-populated collagen lattice (FPCL) contraction at higher initial concentrations (500 and 1,000 microg/ml) in FPCLs fabricated with responsive dermal fibroblasts, while in FPCLs containing non-responsive fibroblasts inhibition of contraction was reduced. The responsive and non-responsive phenotype of human dermal fibroblasts to treatment with chitosan CL313A has been reported previously by us. The inhibition of fibroblast-mediated collagen lattice contraction by chitosan appeared to be strongly correlated with whether the cells were responsive or non-responsive. The effect of chitin-50A on fibroblast-mediated collagen lattice contraction was also examined to investigate whether the level of deacetylation was important for its inhibitory effect on contraction. However, this had no effect on contraction at the concentrations tested, supporting previous work that only chitosan samples with higher levels of deacetylation showed any biological activity. This work indicates that highly deacetylated chitosan inhibits fibroblast-mediated contraction of collagen lattices and may therefore be useful as a therapeutic agent to reduce contraction and therefore scarring in wound healing in vivo.

An in vitro model for investigating the gastric mucosal retention of 14C-labelled poly(acrylic acid) dispersions.

Polymers that bind from solution onto gastric mucosae can be used as a means of facilitating localised drug delivery, or act as therapeutic agents in their own right (e.g. by forming a protective layer or by inhibiting enzymes). Previous workers have used semi-quantitative methods to identify the ability of commercially available poly(acrylic acid)s to bind to gastric mucosa. In this study, the binding and retention of labelled poly(acrylic acid)s to sections of gastric mucosa from the pyloric region of pigs stomach were evaluated using 'static' and 'dynamic flow' test systems. Dispersions (3%) of 'low', 'high' and 'ultra high' (cross-linked) polymers were seen to adhere to porcine pyloric mucosa after exposure and rinsing in the 'static' system. The high molecular weight polymer showed the greatest retention in the 'dynamic' test system when washing continuously with simulated gastric acid. Changing the pH of the dispersions from 4.3 to 6.2 had little effect on polymer retention. It was concluded that polymers that were sufficiently mobile in solution to spread on, and interact with, the mucosal surface, but had a sufficiently high molecular weight to form viscous solutions and/or bioadhere to the mucosa, may be retained on the mucosal surface for the longest periods.