Delivery systems of therapeutic nucleic acids for the treatment of acute lung injury/acute respiratory distress syndrome.

Acute lung injury (ALI)/ acute respiratory distress syndrome (ARDS) is a devastating inflammatory lung disease with a high mortality rate. ALI/ARDS is induced by various causes, including sepsis, infections, thoracic trauma, and inhalation of toxic reagents. Corona virus infection disease-19 (COVID-19) is also a major cause of ALI/ARDS. ALI/ARDS is characterized by inflammatory injury and increased vascular permeability, resulting in lung edema and hypoxemia. Currently available treatments for ALI/ARDS are limited, but do include mechanical ventilation for gas exchange and treatments supportive of reduction of severe symptoms. Anti-inflammatory drugs such as corticosteroids have been suggested, but their clinical effects are controversial with possible side-effects. Therefore, novel treatment modalities have been developed for ALI/ARDS, including therapeutic nucleic acids. Two classes of therapeutic nucleic acids are in use. The first constitutes knock-in genes for encoding therapeutic proteins such as heme oxygenase-1 (HO-1) and adiponectin (APN) at the site of disease. The other is oligonucleotides such as small interfering RNAs and antisense oligonucleotides for knock-down expression of target genes. Carriers have been developed for efficient delivery for therapeutic nucleic acids into the lungs based on the characteristics of the nucleic acids, administration routes, and targeting cells. In this review, ALI/ARDS gene therapy is discussed mainly in terms of delivery systems. The pathophysiology of ALI/ARDS, therapeutic genes, and their delivery strategies are presented for development of ALI/ARDS gene therapy. The current progress suggests that selected and appropriate delivery systems of therapeutic nucleic acids into the lungs may be useful for the treatment of ALI/ARDS.

Hybrid nanoparticles with cell membrane and dexamethasone-conjugated polymer for gene delivery into the lungs as therapy for acute lung injury.

Gene therapy has been suggested as a new treatment for acute lung injury (ALI), which is a severe inflammatory disease. Previously, amphiphilic polymeric carriers such as dexamethasone-conjugated polyethylenimine (PEI) (DP) have been used to transport plasmid DNA (pDNA) into the lungs. In the current study, hybrid nanoparticles comprising DP and cell membrane (CM) from LA-4 lung epithelial cells were developed for enhanced delivery of pDNA into the lungs. The CM components of the hybrid nanoparticles may interact with plasma membranes of target cells and facilitate intracellular uptake of pDNA. DP/CM/pDNA nanoparticles had the highest transfection efficiency into LA-4 cells at a weight ratio of 8 : 3 : 1. In vitro transfection assays showed that DP/CM/pDNA nanoparticles improved the cellular uptake and transfection efficiency of pDNA compared with PEI (25 kDa, PEI25k)/pDNA and DP/pDNA nanoparticles. The DP/CM/pDNA nanoparticles were approximately 80 nm in diameter with a zeta potential of +25 mV. To evaluate the therapeutic effects, heme oxygenase-1 pDNA (pHO-1) was administered to ALI animal models by intratracheal instillation. DP/CM/pHO-1 nanoparticles improved gene delivery efficiency compared with PEI25k/pHO-1 and DP/pHO-1 nanoparticles. As a result, inflammation in the lungs was alleviated by DP/CM/pHO-1 nanoparticles more effectively than by other nanoparticles. The results suggest that DP/CM/pDNA hybrid nanoparticles may be useful gene carriers for the treatment of ALI.

Pulmonary delivery of curcumin-loaded glycyrrhizic acid nanoparticles for anti-inflammatory therapy.

Acute lung injury (ALI) is an inflammatory disease of the lungs. Curcumin (Cur) shows protective effects in ALI animal models. However, Cur is a hydrophobic drug and its administration into the lungs is inefficient due to its low bioavailability. In this study, glycyrrhizic acid (GA) micelles were produced and evaluated as a carrier of Cur for treatment of ALI. Cur-loaded GA (GA-Cur) nanoparticles were produced using an oil-in-water emulsion/solvent evaporation method. The size and surface charge of the GA-Cur nanoparticles were 159 nm and -23 mV, respectively. In lipopolysaccharide-activated RAW264.7 cells, the GA-Cur nanoparticles decreased the pro-inflammatory cytokine levels more efficiently than GA, Cur, or a simple mixture of GA and Cur (GA + Cur). This suggests that the GA-Cur nanoparticles improved the therapeutic efficiency by enhanced delivery of GA and Cur. GA-Cur inhibited the nuclear translocation of nuclear factor-κb and induced endogenous heme oxygenase-1 more efficiently than the other treatments. Furthermore, an in vitro toxicity test showed that GA-Cur had little cytotoxicity. In vivo therapeutic effects of GA-Cur were evaluated in ALI mouse models. GA-Cur was administered into the animals by intratracheal instillation. The results showed that GA-Cur reduced pro-inflammatory cytokines in a dose-dependent manner and did so more efficiently than GA, Cur, or GA + Cur. Furthermore, the hemolysis and infiltration of monocytes into the lungs were more effectively inhibited by GA-Cur than the other treatments. The data indicate that GA is an efficient carrier of Cur and an anti-inflammatory drug. Owing to their delivery efficiency and safety, GA-Cur nanoparticles will be useful for treatment of ALI.

Pulmonary delivery of a recombinant RAGE antagonist peptide derived from high-mobility group box-1 in a bleomycin-induced pulmonary fibrosis animal model.

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterised by irreversible fibrosis and destruction of the alveolar structure. Receptor for advanced glycation end products (RAGE) has been identified as one of the key molecules involved in IPF pathogenesis. A RAGE-antagonist peptide (RAP) was developed based on the RAGE-binding domain of high mobility group box-1 (HMGB-1). Anti-IPF effects of RAP were evaluated in a bleomycin-induced mouse model of IPF. Bleomycin was administered intratracheally, and then RAP was administrated twice by intratracheal instillation, 1 and 3 d after bleomycin challenge. Seven days after the bleomycin challenge, the mice were sacrificed and the lungs were harvested. The results showed that pulmonary hydroxyproline was reduced in mice administered RAP compared with the control group. Tumour growth factor-ß (TGF-ß), α-smooth muscle actin (α-SMA) and collagen were also reduced by RAP administration in a dose-dependent manner. Longer-term effects of RAP were investigated in mice challenged with bleomycin. RAP was administered intratracheally every 7 d for 28 d, after which lung samples were harvested and analysed. The results showed that hydroxyproline, TGF-ß, α-SMA and collagen were reduced by repeated RAP administration. Taken together, the results suggest that RAP is useful for treatment of IPF.

Delivery of MiRNA-92a Inhibitor Using RP1-Linked Peptide Elicits Anti-Inflammatory Effects in an Acute Lung Injury Model.

Acute lung injury (ALI) is an inflammatory lung disease. miRNA-92a (miR92a) is induced in the lungs of ALI patients and mediates inflammatory reactions. In this study, a RP1-linked R3V6 (RP1R3V6) peptide was synthesized and evaluated as a carrier of anti-microRNA-92a oligonucleotide (AMO92a) into the lungs of an ALI animal model. In addition to the carrier function, the RP1-linked peptide can have anti-inflammatory effects in the lungs, since RP1 is an antagonist of the receptors for advanced glycation end-products (RAGEs). In a gel retardation assay, the RP1R3V6 peptide formed a spherical complex with AMO92a. In an in vitro delivery assay to L2 rat lung epithelial cells, RP1R3V6 had a lower AMO92a delivery efficiency than R3V6 and polyethyleneimine (PEI25k; 25 kDa). However, RP1R3V6 had an additional anti-inflammatory effect, reducing tumor necrosis factor-α (TNF-α) in lipopolysaccharide-activatedmacrophage cells. With the combined effects of AMO92a and RP1, the RP1R3V6/AMO92a complex reduced the miR92a level more efficiently than did the R3V6/AMO92a and PEI25k/AMO92a complexes. The RP1R3V6/AMO92a complex was administered into the lungs of ALI animals by intratracheal instillation. As a result, the expression of phosphatase and tensin homolog, a target of miR92a, was increased in the lungs. Furthermore, the RP1R3V6/AMO92a complex decreased the TNF-α and interleukin-1ß (IL-1ß) levels more efficiently than did the PEI25k/AMO92a and R3V6/AMO92a complexes, decreasing the damage in the lungs. These results suggest that RP1R3V6 is a useful carrier of AMO92a and has anti-inflammatory effects in an ALI animal model.

A RAGE-antagonist peptide potentiates polymeric micelle-mediated intracellular delivery of plasmid DNA for acute lung injury gene therapy.

Acute lung injury (ALI) is a severe inflammatory lung disease. A high mobility group box-1 (HMGB-1) derived RAGE-antagonist peptide (RAP) was previously developed for anti-inflammatory therapy for ALI. Due to its specific binding to RAGE on the surface of inflammatory cells, the RAP may facilitate polymer-mediated intracellular delivery of plasmid DNA (pDNA) into the inflammatory cells. To evaluate this hypothesis, a pDNA/polymer/RAP ternary-complex was produced and applied for ALI gene therapy. Dexamethasone-conjugated polyamidoamine G2 (PAM-D) was used as a gene carrier, and the adiponectin (APN) gene was employed as a therapeutic gene. First, the ratio of pDNA to PAM-D was optimized in terms of anti-inflammation and low toxicity. Then, the RAP was added to the pDNA/PAM-D complex, producing the pDNA/PAM-D/RAP complex. The transfection efficiency of the luciferase plasmid (pLuc)/PAM-D/RAP reached its maximum at a weight ratio of 1 : 2 : 9. At this weight ratio, pLuc/PAM-D/RAP had a higher transfection efficiency than pLuc/PAM-D or pLuc/RAP. The transfection efficiency of pLuc/PAM-D/RAP decreased due to competition with free RAPs, suggesting the RAGE-mediated endocytosis of the complex. In the LPS-activated ALI mouse models, intratracheal administration of APN plasmid (pAPN)/PAM-D/RAP induced higher APN expression and less pro-inflammatory cytokines in the lungs of ALI animal models than pAPN/PEI25k, pAPN/RAP, and pAPN/PAM-D. Hematoxylin and eosin staining confirmed the higher anti-inflammatory effect of pAPN/PAM-D/RAP than the other complexes in the ALI models. Therefore, RAP-mediated enhanced delivery of pAPN/PAM-D may be useful for the development of a treatment for ALI.