Katherine Bowman1, Kam W Leong. 1. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Abstract
Chitosan is a widely available, mucoadhesive polymer that is able to increase cellular permeability and improve the bioavailability of orally administered protein drugs. It can also be readily formed into nanoparticles able to entrap drugs or condense plasmid DNA. Studies on the formulation and oral delivery of such chitosan nanoparticles have demonstrated their efficacy in enhancing drug uptake and promoting gene expression. This review summarizes some of these findings and highlights the potential of chitosan as a component of oral delivery systems.
Chitosan is a widely available, mucoadhesive n>an class="Chemical">polymer that is able to increase cellular permeability and improve the bioavailability of orally administered protein drugs. It can also be readily formed into nanoparticles able to entrap drugs or condense plasmid DNA. Studies on the formulation and oral delivery of such chitosan nanoparticles have demonstrated their efficacy in enhancing drug uptake and promoting gene expression. This review summarizes some of these findings and highlights the potential of chitosan as a component of oral delivery systems.
Effective oral drug administration is desirable but challenging owing to the nature of the n>an class="Disease">gastrointestinal tract. The highly acidic pH in the stomach and the presence of enzymes such as pepsin can cause protein degradation (Allemann et al 1998). Secreted pancreatic enzymes in the lumen of the intestine and membrane-bound brush-border enzymes may also cause substantial loss of drug activity (Bernkop-Schnürch and Krajicek 1998). Finally, the physical barrier of the intestinal cells must be crossed before a drug can reach the circulation. This is especially problematic for macromolecular drugs too large to pass between cells through the paracellular pathway and too hydrophilic to be absorbed passively through cell membranes (Goldberg and Gomez-Orellana 2003). These obstacles lead to poor oral bioavailability for many protein and peptide drugs.
Increasingly, nucleic acids are also being applied as drugs, either as components of a vaccine or in gene therapy approaches. Many of the issues facing oral gene delivery are similar to those of oral protein delivery, including protection in the stomach and intestines and transport into or across intestinal epithelial cells. Additional barriers to effective DNA delivery include endosomal escape, nuclear localization, transcription, translation, protein processing, and protein secretion (if necessary) into plasma.One proposed method to overcome these physical and degradative barriers is formulation of the drug or gene into nanoparticles. Such particles may partially protect the entrapped drug or gene from degradation and improve cellular uptake through endocytosis. While a variety of polymers and lipids have been employed to form drug- or gene-loaded nanoparticles, one biodegradable polymer that has received a good deal of recent attention as a component of oral drug and gene delivery systems is chitosan.
Properties of chitosan
Chitosan is a polysaccharide derived from the partial deacetylation of chitin, primarily from crustacean and insect shells. It consists of repeating units of glucosamine and N-acetyl-glucosamine, the proportions of which determine the degree of deacetylation of the polymer. With a pKa of approximately 6.5 on the amine groups, chitosan is insoluble at neutral pH but is soluble and positively charged at acidic pH (Singla and Chawla 2001; Hejazi and Amiji 2003). By affecting the number of protonatable amine groups, the degree of deacetylation fundamentally determines the polymer properties including solubility, hydrophobicity, and the ability to interact electrostatically with polyanions (Kiang, Wen, et al 2004; Huang et al 2005). The solubility of chitosan in neutral and basic pH can be improved by quaternization to form trimethyl chitosan derivatives (van der Merwe et al 2004). The molecular weight of chitosan, which is available over a wide range, is also of fundamental importance. Generally, chitosans having lower molecular weights and lower degrees of deacetylation exhibit greater solubility and faster degradation than their high-molecular-weight counterparts (Zhang and Neau 2001, 2002; Köping-Höggård et al 2004; Mao et al 2004; Ren et al 2005).Positively charged n>an class="Chemical">chitosan will bind to cell membranes and is reported to decrease the trans-epithelial electrical resistance (TEER) of cell monolayers as well as to increase paracellular permeability (Artursson et al 1994; Dodane et al 1999). Chitosan solutions have been shown to increase trans- and para-cellular permeability in a reversible, dose-dependent manner that also depends on the molecular weight and degree of deacetylation of the chitosan (Schipper et al 1996). The mechanism of action, which appears to be mediated by the positive charges on the chitosan, includes interactions with the tight junction proteins occludin and ZO-1, redistribution of F-actin, and slight destabilization of the plasma membrane (Dodane et al 1999; Fang et al 2001; Thanou, Verhoef, Junginger, 2001). Thus, the ability of chitosan to enhance permeation is influenced by the pH of the environment. As mentioned above, trimethyl chitosan derivatives are soluble at higher pH than unmodified chitosan. For example, a trimethyl derivative with 61.2% quaternization was able to decrease TEER of Caco-2 cells and increase mannitol permeability at pH 7.4, unlike unmodified chitosan hydrochloride or 12.3% quaternized trimethyl chitosan (Kotzé et al 1999).
Chitosan is also mucoadhesive (Deacon et al 2000). Mucus is a blend of molecules including salts, lysozyme, and n>an class="Gene">mucins, which are highly hydrated glycoproteins primarily responsible for the viscoelastic properties of mucus. Sialic acid residues on mucin have a pKa of 2.6, making them negatively charged at physiological pH (Deacon et al 2000; Wang et al 2000). Therefore, the presence of mucus affects free drug permeability as well as the uptake of particulates by forming both a physical barrier to diffusion as well as by interacting electrostatically with cationic molecules, such as chitosan. Derivatives of chitosan such as trimethyl chitosan retain their mucoadhesive properties, albeit to a lesser extent than unmodified chitosan (Snyman et al 2003). In addition, formation of chitosan into micro- and nano-particles also preserves mucoadhesion (Behrens et al 2002; Kockisch et al 2003; Dhawan et al 2004).
Chitosan is generally considered nontoxic and biodegradable, with an oral LD50 in n>an class="Species">mice of over 16 g/kg (Hirano 1996). Antimicrobial, antifungal, and wound-healing properties have also been reported (Singla and Chawla 2001). The safety of chitosan, its ability to prolong residence time in the gastrointestinal tract through mucoadhesion, and its ability to enhance absorption by increasing cellular permeability have all been major factors contributing to its widespread evaluation as a component of oral dosage forms.
Chitosan solutions as permeation enhancers
The effects of chitosan solutions on intestinal cells have been extensively investigated (Schipn>per et al 1996, 1997, 1999). Absorpn>tion enhancement was found to depn>end on both molecular weight and degree of deacetylation. n>an class="Chemical">Polymers with low molecular weight and < 65% deacetylation do not increase transport of mannitol across Caco-2 cell layers. On the other hand, polymers with a high degree of deacetylation exhibit greater cellular toxicity. The optimal combination of absorption enhancement and low toxicity was observed for polymers having a moderate degree of deacetylation and a high molecular weight, particularly a chitosan of 170 kDa and 65% deacetylation (Schipper et al 1996) (Figure 1).
The concept that chitosan in formulations such as nanoparticles may be more efficient than chitosan solution at enhancing protein uptake is supported by several recent studies (Fernandez-Urrusuno et al 1999; Pan et al 2002; Ma and Lim 2003; Ma et al 2005). Incubation of Caco-2 cells with chitosan–insulin nanoparticles resulted in greater cell binding and uptake compared with a chitosan–insulin solution (Ma and Lim 2003). While most chitosan in solution remained extracellular, a significant amount of fluorescently labeled nanoparticles was localized inside the cells after a 2-hour incubation, principally near the apical surface. Chitosan nanoparticles could also decrease the TEER of the cell monolayers at both pH 5.3 and 6.1, although to a lesser degree than the chitosan solution. Administration of these chitosan–insulin nanoparticles to diabeticrats led to prolonged reductions in serum glucose levels (Ma et al 2005). Administration of 50 U insulin/kg as nanoparticles (pH 5.3) decreased glucose levels to about 60% of baseline, while administration of a chitosan–insulin solution was ineffective. Delivery of 100 U/kg chitosan–insulin nanoparticles (pH 5.3) decreased glucose levels to about 50% of baseline starting around 12 hours after delivery and maintained this level until at least 24 hours (Figure 2). Delivery of 100 U/kg chitosan–insulin nanoparticles (pH 6.1) resulted in a faster onset of action (2 hours after delivery) but less of a decrease in glucose levels (60%–75% of baseline). Fluorescently labeled nanoparticles were also observed in association with rat intestinal epithelia and some particles had been internalized 3 hours after delivery.
Increasingly, nucleic acids are being applied as drugs, both for vaccination and therapeutic gene expression. Chitosan–DNA nanopn>articles may be readily formed by coacervation between the positively charged amine groups on the chitosan and negatively charged phosphate groups on the DNA (Leong et al 1998; Mao et al 2001). Mao et al (2001) explored the conditions under which chitosan–DNA nanoparticles formed and found that discrete particles formed at chitosan concentrations of 50–400 μg/mL and DNA concentrations of 40–80 μg/mL, where buffer solutions were at pH 5.5 and temperature was 55°C. Sodium sulfate (25 mM) was added as a desolvating agent to enhance the phase separation (Figure 3). Particle formation was dependent on the N/Pratio (amine groups on chitosan/phosphate groups on DNA) and N/Pratios of 3–8 yielded 150–250-nm particles with surface charges of approximately + 15 mV.
One area of oral DNA delivery that has received considerable attention is DNA vaccination. Protein-based subunit vaccines primarily activate humoral immune responses that lead to the production of circulating antibodies against the delivered antigen. However, transfection with antigen-encoding DNA can generate both antibody-based and cell-mediated immune responses (Leitner et al 2000). In addition, unmethylated bacterial CpG motifs in the plasmid DNA act as adjuvants to stimulate the immune response (Krieg 2001). Oral vaccine delivery may be particularly desirable not only for patient preference, but also for the ability to generate immune responses at mucosal surfaces, where many pathogens normally invade (Clark et al 2001).Orally administered particulate vaccines are generally thought to be internalized by antigen-sampling membranous (M) cells in intestinal Peyer’s patches. These M cells have a thinner glycocalyx and less organized microvilli than enterocytes and are known to internalize and transcytose particles to underlying lymphocytes and antigen-presenting cells (Neutra et al 1987; Jepson et al 1996; Clark et al 2001). Particles up to 10 μm in diameter can be internalized into Peyer’s patches and particles less than 5 μm can be transported to draining lymph nodes and the spleen (Eldridge et al 1990).Oral administration to n>an class="Species">mice of chitosan–DNA nano-particles containing the gene for the dominant peanut allergen Arah2 resulted in the production of secretory IgA and serum IgG2a, as well as a reduced increase in IgE (Roy et al 1999). This immune response was not observed for mice given naked plasmid DNA. Delivery of the chitosan-DNA nanoparticles also mitigated the anaphylactic response to peanut challenge, possibly through redirection of the immune response away from an allergic, IgE-based response to a more TH1-dominated response (Figure 4).
Use of chitosan–DNA nanoparticles to deliver therapeutic genes
In addition to oral vaccination, another attractive apn>plication is the oral delivery of DNA for therapn>eutic gene expn>ression as a so-called “gene pill”. The benefits of such a delivery system have been delineated by Sheu et al (2003) and include safety, n>an class="Species">patient compliance, and dose regulation. It is worth noting, however, that one of the arguments proposed for increased safety from an oral nonviral DNA pill is targeting to short-lived gut epithelial cells and lack of systemic cell transfection. However, plasmid DNA can be detected in systemic tissues after oral delivery, albeit at very low copy numbers (Bowman et al 2005) and oral delivery of DNA vaccines can produce detectable systemic immune responses, indicating that the effects of an orally delivered formulation may not be locally confined.
We have also explored this oral gene delivery system for gene therapy of hemophilia, by delivering the Factor IX gene to n>an class="Species">mice through feeding. The DNA nanoparticles were synthesized by complexing chitosan with human factor IX DNA that was driven by a β-actin promoter. The initial dose of 25 μg DNA led to a decline of the hFIX level in plasma of C57bl/6J mice from 37 ng/mL on day 7 to 21 ng/mL on day 28, even with a repeat feeding at day 14 (Okoli et al 2000). The decline appeared to coincide with the rise in anti-hFIX antibody level. At all time points, hFIX levels in control mice, which were fed the same dose of naked DNA, were not significantly different from those of naïve mice.
A therapeutic effect following oral administration was also demonstn>an class="Species">rated for delivery of chitosan nanoparticles containing the gene for murineerythropoietin (mEPO) (Chen et al 2004). Using chitosan with a molecular weight of 300 kDa and the method of particle formulation reported by Mao et al (2001), the authors formed DNA nanoparticles of approximately 100 nm in diameter with a charge of + 10 mV at pH 5.7. Oral delivery of the chitosan–mEPO nanoparticles at a dose of 50 μg DNA led to increased hematocrit. This rise in hematocrit was not detected in naive mice or in mice given naked mEPO plasmid DNA (Figure 5).
Many of the issues facing effective oral protein and gene delivery are similar. As discussed above, these include the need to protect the protein or gene from the damaging environment of the gastrointestinal tract and to facilitate uptake into cells. In particular, the presence of mucus in the GI tract may be a complicating factor for effective particle delivery. Chitosan mucoadhesion can locally increase the concentration of a drug and thus increase the driving force for drug diffusion into cells, which may be advantageous even if the nanoparticles themselves remain trapped extracellularly in mucus. However, it seems likely that gene expression from chitosan–DNA nanoparticles is mediated by cellular uptake of intact particles followed by intracellular DNA release. In this situation, mucoadhesion may be a double-edged sword, prolonging residence time, but possibly entrapping particles, preventing them from reaching cell surfaces, and causing them to be swept from the intestine. The adsorption of gastrointestinal mucins onto the surfaces of orally administered chitosan nanoparticles may also affect surface charges and interfere with cell binding and internalization, particularly at lower pH where the particles are cationic. The interaction with and diffusion through mucus of many chitosan systems have not been reported. More research needs to be conducted on these topics for the rational design of the next generation of oral chitosan drug and gene delivery systems.However, the studies above indicate the feasibility of using chitosan nanopn>articles to deliver poorly bioavailable drugs or to achieve in vivo gene expn>ression. Mechanistic insight and information such as barriers in the macroscopn>ic transport of these nanopn>articles across the mucosal surface, nanopn>article biodistribution in different tissues, types of cells transfected, transgene expn>ression kinetics, and extra- and intracellular release of the drug and DNA from the nanopn>articles are needed to advance the chitosan delivery system. Different groups have focused on different molecular weight chitosans, with different degrees of deacetylation, producing nanoparticles of varying sizes and charge ratios. Some of the differences reported in the levels and time-course of protein release or gene expression from these particles may be due to such formulation differences. Further understanding of the parameters influencing nanoparticle formation and uptake may allow researchers to identify the best combination for a particular application. While much work has been done in the last few years to achieve successful oral drug and gene delivery, the field has yet to progress beyond animal models and demonstrate relevant efficacy in humans. However, the many advantages of chitosan, including safety, biodegradability, ease of modification, ease of DNA or protein complex formation, widespread availability, and low cost justify the continuing development of this promising drug and gene delivery system.