Qin Zeng1, Joshua M Gammon1, Lisa H Tostanoski1, Yu-Chieh Chiu1, Christopher M Jewell2. 1. Fischell Department of Bioengineering, University of Maryland, College Park , 8228 Paint Branch Drive, 2212 Jeong H. Kim Building, College Park, Maryland 20742, United States. 2. Fischell Department of Bioengineering, University of Maryland, College Park, 8228 Paint Branch Drive, 2212 Jeong H. Kim Building, College Park, Maryland 20742, United States; Department of Microbiology and Immunology, University of Maryland Medical School, 685 West Baltimore Street, HSF-I Suite 380, Baltimore, Maryland 21201, United States; Marlene and Stewart Greenebaum Cancer Center, 22 S. Greene Street, Suite N9E17, Baltimore, Maryland 21201, United States.
Abstract
Microneedles (MNs) are micron-scale polymeric or metallic structures that offer distinct advantages for vaccines by efficiently targeting skin-resident immune cells, eliminating injection-associated pain, and improving patient compliance. These advantages, along with recent studies showing therapeutic benefits achieved using traditional intradermal injections in human cancer patients, suggest MN delivery might enhance cancer vaccines and immunotherapies. We recently developed a new class of polyelectrolyte multilayers based on the self-assembly of model peptide antigens and molecular toll-like receptor agonists (TLRa) into ultrathin, conformal coatings. Here, we reasoned that these immune polyelectrolyte multilayers (iPEMs) might be a useful platform for assembling cancer vaccine components on MN arrays for intradermal delivery from these substrates. Using conserved human melanoma antigens and a potent TLRa vaccine adjuvant, CpG, we show that iPEMs can be assembled on MNs in an automated fashion. These films, prepared with up to 128 layers, are approximately 200 nm thick but provide cancer vaccine cargo loading >225 μg/cm2. In cell culture, iPEM cargo released from MNs is internalized by primary dendritic cells, promotes activation of these cells, and expands T cells during coculture. In mice, application of iPEM-coated MNs results in the codelivery of tumor antigen and CpG through the skin, expanding tumor-specific T cells during initial MN applications and resulting in larger memory recall responses during a subsequent booster MN application. This study support MNs coated with PEMs built from tumor vaccine components as a well-defined, modular system for generating tumor-specific immune responses, enabling new approaches that can be explored in combination with checkpoint blockade or other combination cancer therapies.
Microneedles (MNs) are micron-scale polymeric or metallic structures that offer distinct advantages for vaccines by efficiently targeting skin-resident immune cells, eliminating injection-associated pain, and improving patient compliance. These advantages, along with recent studies showing therapeutic benefits achieved using traditional intradermal injections in humancancerpatients, suggest MN delivery might enhance cancer vaccines and immunotherapies. We recently developed a new class of polyelectrolyte multilayers based on the self-assembly of model peptide antigens and molecular toll-like receptor agonists (TLRa) into ultrathin, conformal coatings. Here, we reasoned that these immune polyelectrolyte multilayers (iPEMs) might be a useful platform for assembling cancer vaccine components on MN arrays for intradermal delivery from these substrates. Using conserved humanmelanoma antigens and a potent TLRa vaccine adjuvant, CpG, we show that iPEMs can be assembled on MNs in an automated fashion. These films, prepared with up to 128 layers, are approximately 200 nm thick but provide cancer vaccine cargo loading >225 μg/cm2. In cell culture, iPEM cargo released from MNs is internalized by primary dendritic cells, promotes activation of these cells, and expands T cells during coculture. In mice, application of iPEM-coated MNs results in the codelivery of tumor antigen and CpG through the skin, expanding tumor-specific T cells during initial MN applications and resulting in larger memory recall responses during a subsequent booster MN application. This study support MNs coated with PEMs built from tumor vaccine components as a well-defined, modular system for generating tumor-specific immune responses, enabling new approaches that can be explored in combination with checkpoint blockade or other combination cancer therapies.
The skin is an important
component of the immune system as a barrier
but also as a network that is rich in antigen presenting cells (APCs)
able to survey the periphery for foreign molecules.[1] These cells are immunologically important in infectious
disease, in tolerance, and in cancer. Dendritic cells (DCs), Langerhans
cells, and other APCs traffic these antigens to lymph nodes (LNs),
presenting peptide fragments to lymphocytes that drive adaptive immunity
after activation and migration from LNs or other immunological tissues.
This high concentration of APCs, along with ease-of-access, has made
the skin one of the most effective vaccination routes, intradermal-injection
(i.d.), in particular.[2−5] As with all traditional needle-based injections,
intradermal injections create medical sharps, require training for
effective administration, and cause pain, of particular relevance
since a high percentage of vaccine recipients are children. Further,
the vaccines themselves often require refrigeration, a cold chain
that is problematic for developing countries. Not surprisingly, immense
interest has thus developed in microneedles (MNs), polymeric or metallic
structures that offer features to overcome all of the challenges above.[6−8] MNs improve patient compliance by eliminating medical sharps and
injection-associated pain, while also often providing thermal stability
and dose-sparing for vaccines or drugs loaded on or within MNs.[9,10] These devices also allow consistent delivery to specific target
tissues, such as within the skin (i.e., intradermally), or as another
example, the suprachoroidal space at the back of the eye.[11]Most MN approaches fall into one of four
modalities: solid microneedles
for prepenetration of the skin, coated microneedles, hollow microneedles,
and dissolvable microneedles.[6−8] The design constraints (e.g.,
dosing needs, kinetics, and cargo stability) for a specific application
drive the choice of these strategies, but all of these options are
attractive because they offer rapid vaccine administration through
the stratum corneum, an important immunological barrier in the skin.
Thus, nearly all MN vaccines strategies have been aimed at prophylactic
vaccination against infection, influenza,[12−14] HIV,[15−17] and hepatitis,[18,19] to name a few. However, there
are tremendous opportunities to apply these technologies to therapeutic
vaccines and immunotherapies in the context of cancer, in part for
the reasons above, such as APC targeting, but also owing to some unique
considerations. For example, several recent studies in humanpatients
and animal models suggest that intradermal injection improves antitumor
responses during melanoma and prostate cancer vaccination.[20−22]Recently, a few studies have begun demonstrating the unique
potential
of MNs for cancer vaccination. Some of these approaches have generated
antitumor immunity in preclinical models using microneedles to penetrate
the skin prior to topical administration of tumor antigens encoded
in plasmids or isolated from tumor cell cultures.[23,24] Thus far, none of these strategies has incorporated tumor antigens
on or within MNs for cancer vaccination. However, some recent work
has utilized dissolvable polymeric microneedles loaded with polymeric
nanoparticles encapsulating model antigens (ovalbumin, OVA) to target
Langerhans cells and provide protection during challenge with melanoma
cells expressing OVA.[25,26] Several other recent reports
have used MNs to support the delivery of cancer immunotherapies including
cytokines,[27] chemotherapeutics,[28] and cutting-edge checkpoint inhibitors.[29]One important coating technology that
has been applied to microneedles
for prophylactic vaccination but not yet for cancer vaccination is
polyelectrolyte multilayers (PEMs).[17,30−34] PEMs are assembled by electrostatic interactions and offer unique
features such as the ability to juxtapose multiple cargos with tunable
control over the relative loading and ultrathin coatings that allow
conformal films to be assembled on the fine geometries of MN arrays.[35] We recently reported a new type of PEM assembled
entirely from immune signals, immune PEMs (iPEMs).[36−38] These films
are composed of antigens modified with cationic amino acid residues
and nucleic acid–based toll-like receptor (TLR) agonists that
serve both as adjuvants and as negatively charged structural components
of the films. In contrast to other PEMs used in drug and vaccine delivery,
iPEMs eliminate all other polymers or film components. This feature
simplifies vaccine design through modular assembly of immune signals
while preserving attractive features such as codelivery and tunable
control over the absolute and relative loading of film components.
In particular for cancer vaccination, our studies reveal that iPEMs
codeliver the vaccine components used to build the films, enhancing
APC costimulation and the function of T cells expanded by these populations.
Thus, we hypothesized iPEMs would be an attractive platform to coat
microneedles to create the first tumor-antigen specific vaccine delivered
using microneedles.Here, we show that iPEMs can be assembled
on poly(l-lactide)
(PLLA) MNs using a conserved humanmelanoma antigen, tyrosinase-related
protein 2 (Trp2),[39] and CpG oligonucleotide,
a potent TLR9 agonist that has been intensely studied as a vaccine
adjuvant (Scheme ).[40] Trp2 peptide modified with a cationic nona-arginine
(R9) domain (Trp2*) supports stable assembly with CpG using
an automated LbL process to deposit up to 128 layers on PLLA MN arrays
with linear control over the loading of both tumor antigen and the
CpG adjuvant. Cargo released from MNs in situ and
incubated with primary immune cells promotes uptake and activation
of APCs, triggering functional responses in Trp2-specific T cells
during coculture. In mice, MNs coated with Trp2*/CpG iPEMs deliver
both signals to ear immunization sites, resulting in expansion of
tumor-specific T cells during priming MN immunizations and more potent
memory recall responses during booster MN applications. This work
could enable a new approach to cancer vaccination based on combining
MNs to deliver tumor vaccine components self-assembled at high density
into PEMs.
Scheme 1
Approach for Assembling Immune Polyelectrolyte Multilayers
on Microneedle
Arrays to Enhance Cancer Vaccination
Materials and Methods
Materials
Trp2180–188 (SVYDFFVWL),
Trp2* (SVYDFFVWLRRRRRRRRR), and SIIN257–264 (SIINFEKL) peptide from OVA protein were synthesized by Genscript
with >98% purity, with or without a FITC label on the N-terminus.
TLR9 agonist CpG oligonucleotide (5′T*C*C*A*T*G*A*C*G*T*T*C*C*T*G*A*C*G*T*T
3′) and a nonimmunostimulatory control oligonucleotide (CTRL,
5-T*C*C*T*G*A*G*C*T*T*G*A*A*G*T-3) were synthesized by IDT with
a phosphorothioate backbone. Label-IT nucleic acid labeling kits (Cy5)
were purchased from Mirus Bio LLC. Poly(l-lactide) (PLLA)
and poly(sodium 4-styrenesulfonate) (SPS) were purchased from Sigma-Aldrich.
Poly(ethylenimine) (PEI, MW 25 k) was purchased from Polysciences,
Inc. A Sylgard silicone-elastomer kit was obtained from Dow Corning.
Animals and Care
C57BL/6J mice (female, 6–8
weeks) were obtained from The Jackson Laboratory. Breeding pairs of
transgenic mice displaying T cell receptors specific for Trp2 were
a gift from Dr. Giorgio Trinchieri (National Cancer Institute, National
Institutes of Health). All animal care and experiments were carried
out using protocols approved and overseen by the University of Maryland
IACUC committee in compliance with local, state, and federal guidelines.
Assembly and Characterization of iPEMs on Planar Substrates
All bilayers were assembled using a DR3 dipping robot (Riegler
& Kirstein GmbH). First, PEI/SPS baselayers were built on a planar
substrate for 10 bilayers to provide a uniform charged surface. Silicon
wafers (Silicon Inc.) and quartz slides (VWR) were cut into 5 mm ×
25 mm substrates using a diamond dicing saw (model 1006, Micro Automation).
Substrates were cleaned via sequential rinsing in acetone, ethanol,
methanol, and water, dried under filtered air, and charged with an
oxygen plasma deposition system (Jupiter III, March). The prepared
substrates were then coated with the PEI/SPS precursor layers by alternative
dipping into a filtered PEI solution (20 mM polymer; 50 mM NaCl; 5
mM HCl in water) for 5 min and SPS (20 mM polymer; 50 mM NaCl in water)
for 5 min, separated by two sequential 1 min rinsing steps in deionized
water. Following a total of 10 cycles, the precursor-coated substrates
were coated with iPEMs using the same dipping and wash times but using
Trp2* as the polycation (0.5 mg/mL, 0.2 M sodium acetate) and CpG
as the polyanion (0.5 mg/mL, 0.2 M sodium acetate). In some studies,
fluorescently labeled peptide (FITC-Trp2*) and CpG (Cy5-CpG) were
used to facilitate tracking during experiments. After depositing the
desired number of layers, 2, 4, 8, 16, or 32 bilayers, chips were
dried under filtered air. Film thickness was measured during deposition
at defined intervals using a Stokes Ellipsometer (Gaertner Scientific)
to allow monitoring of film growth. For each reading, the thickness
at five locations on at least three separate substrates was recorded
and averaged. In studies designed to quantify relative cargo loading
as a function of the number of layers, iPEMs were assembled on quartz
chips, and UV–visible spectrophotometry was used to record
the absorbance values from 200 to 600 nm. Wavelengths of 260 and 488
nm were used to identify the loading of CpG and FITC-Trp2*, respectively.
For release assays, planar substrates coated with FITC-Trp2*/CpG bilayers
were incubated in PBS buffer adjusted with 2 M NaCl and to different
pH values: 4, 6, 8, 10, and 12. After 24 h, the substrates were removed,
and the remaining film thickness was measured by ellipsometery (silicon
substrates), while the amount of cargo released into solution was
determined using a microBCA assay (Thermo Scientific) for FITC-Trp2*
and by UV–visible spectrophotometry for CpG. The pH of each
solution was adjusted back to 7.4 using HCl or NaOH solution prior
to all measurements.
MN Fabrication
MNs arrays were prepared
as previously
described.[16] Briefly, poly(dimethylsiloxane)
(PDMS) molds using a Sylgard 184 silicon elastomer kit (Dow-Corning)
were prepared using a Clark-MXR-CPA-2010 (VaxDesign). PLLA was melted
through a phase transition in the molds under vacuum (−25 in.
Hg, 200 °C, 40 min), then cooled to −20 °C for least
30 min before separating the cast PLLA microneedles from the PDMS
mold. MN morphology was characterized by scanning electron microscopy
(SEM) using a JEOL 6700F FEG-SEM and confocal laser scanning microscope
(CLSM) using a Leica SP5X instrument.
Assembly and Characterization
of iPEMs on MNs
Trp2*/CpG
bilayers were coated onto MN arrays using a protocol similar to the
procedure described above, but PEI/SPS precursor layers were not used.
To assemble iPEMs on MNs, the MN arrays were sequentially exposed
for 5 min each to Trp2* (1 mg/mL, 0.2 M sodium acetate buffer), with
or without a FITC label, and CpG (1 mg/mL, 0.2 M sodium acetate),
with or without a Cy5 label. These deposition steps were separated
by two sequential 1 min rinsing steps in deionized water, with fresh
rinse solutions used for each cycle. Assembly on MNs was automated
using a DR3 dipping robot programmed to repeat the bilayer deposition
a desired number of times, up to 64 bilayers (128 layers). For quantification,
the needles on MN arrays were removed and then incubated in DMSO at
room temperature (RT) for 24 h. The loading amounts of CpG and Trp2
were calculated by UV–visible spectrophotometry and microBCA
assay, respectively, then reported on an area basis. Release products
were characterized using a similar approach described above for planar
substrates. Coated MN arrays were incubated in the indicated solutions,
then the components released into the solutions were characterized
using dynamic light scatting (DLS) for size and electrophoretic mobility
for surface charge using a Zetasizer Nano ZS90 (Marvern). The concentrations
of each component in similarly prepared solutions were determined
by fluorescence and absorbance as described above.
Cell Internalization
Studies
Uptake of iPEM cargo released
from MNs by DCs was characterized by flow cytometry (FACS CantoII,
BD Bioscience) and confocal microscopy (Leica SP5X). Cargo was released
from MNs by incubation of iPEM-coated MN arrays in PBS solutions adjusted
to pH 10 for 24 h. After release, the incubation solutions were collected
and adjusted to pH 7.4. DCs were isolated from the spleens of naïve
C57BL/6J mice (The Jackson Laboratory) using a CD11c+ magnetic
isolation system (Miltenyi Biotec). For flow cytometry studies, CD11+ splenic DCs were seeded in 96-well plates at a concentration
of 1.0 × 105 cells per well in RPMI 1640 media (Lonza),
supplemented with 10% fetal bovine serum (FBS, Corning), 2 mM l-glutamine (Gibco), 55 μM β-mercaptoethanol (Sigma-Aldrich)
1× nonessential amino acids (Fisher Scientific), 10 mM HEPES
(Fisher Scientific), 100 units/mL of penicillin, and 100 μg/mL
of streptomycin (Gibco). 2-Fold serial dilutions were then prepared
from the MN cargo release solutions beginning with the undiluted solution,
which contained 5 μg/mL Trp2* and 4.1 μg/mL CpG. Twenty
microliters of PBS (control) or of each cargo release solution was
then added to the wells, in triplicate, containing the DCs in 180 μL
of media. Cells were then cultured for 20 h. After incubation, cells
were washed twice by centrifugation and resuspended in FACS buffer
(PBS in 1% BSA). The washed cells were finally resuspended in 4′,6-diamidino-2-phenylindole
(DAPI, 0.1% in PBS with 1% BSA) to measure viability (i.e., DAPI– cells) by flow cytometry. Cells positive for FITC
and the Cy5 signal were gated among live cells compared with negative
controls and single color staining controls.Cell internalization
was confirmed directly using confocal microscopy by incubating 5 ×
106 DCs (prepared as described above in 1 mL media) with
20 μL of MN cargo release solution. The final concentration
of released cargo in the medium was 10.0 μg/mL Trp2* and 8.2
μg/mL CpG. Four hours later, the cells were gently washed three
times with PBS, then fixed with 4% paraformaldehyde for 15 min at
37 °C, and washed twice with PBS. Cell membranes were stained
with tetramethyl rhodamine labeled wheat germ agglutinin conjugate
(5 μg/mL in PBS; Invitrogen) at RT for 10 min protected from
light. After three additional washes in PBS, cells were resuspended
in Hoescht stain (4 μg/mL) to visualize nuclei, and the signals
of Hoescht (nuclei), FITC (peptide), rhodamine (cell membrane), and
Cy5 (CpG) were imaged by confocal microscopy.
Dendritic Cell Activation
Studies
CD11c+ DCs were obtained as described
above and plated (1 × 105 cells/well) in complete
RPMI 1640 media (Lonza). Samples,
added to wells in triplicate, included PBS, lipopolysaccharide (LPS,
1 μg/mL), CpG (5 μg/mL), CTRLoligonucleotide (5 μg/mL),
SIIN peptide (5 μg/mL), or iPEM cargo released from MNs coated
with (Trp2*/CpG, 5 μg/mL for Trp2* and 4.1 μg/mL CpG,
repectively). The release solutions from these MNs corresponded to
final doses in the medium of 5.0 μg/mL Trp2* and 4.1 μg/mL
CpG. Cultures were incubated for 24 h, then collected by centrifugation
(800 g, 5 min), washed twice in FACS buffer, and blocked with anti-CD16/CD32
(BD Biosciences). The cells were finally stained for 20 min at RT
using monoclonal antibody against the surface activation markers CD40,
CD80, and CD86 (BD Bioscience). After staining, cells were washed
twice and resuspended in FACS buffer containing DAPI for analysis
by flow cytometry.
T Cell Proliferation Studies
CD11c+ DCs
from naïve C57BL/6J mice were isolated and treated as
described above for DC activation studies. After 48 h of culture,
naïve CD8+ T cells were isolated by magnetic
separation (StemCell Technologies) from the spleens of Trp2transgenicmice. T cells from these mice display T cell receptors specific for
Trp2. Isolated CD8+ T cells were stained with carboxyfluorescein
succinimidyl ester (CSFE, 5 μM) and washed 3 times, then 2.5
× 105 labeled T cells were added to the DC cultures.
After another 60 h of coculture, cells were washed and blocked, as
described above. Cells were then stained with anti-CD8 (BD Biosciences)
for 20 min at RT, washed, and resuspended in DAPI for analysis by
flow cytometry.
ELISA Assays
Supernatants from cocultures
of splenic
DCs and transgenic CD8+ T cells were quantified by sandwich
ELISA according to the manufacturer’s protocols for the secretion
of IFN-γ, IL-6, and IL-1β (BD Biosciences).
Application
of MNs for in Vivo Histology and
Dosing Studies
To administer MN arrays to mice, animals were
anesthetized under isoflurane. The ear was then rinsed in sterile
PBS and gently flattened against clean glass slides. MN arrays were
then applied to one ear for 15 min under a constant mass of 0.45 kg.
For trypan blue studies, uncoated MN arrays were applied, mice were
sacrificed, the ears were removed, and then 4% trypan blue dye was
applied by incubation with the applied ear for 5 min. To confirm iPEM
cargo delivery into skin, MNs coated with (FITC-Trp2*/Cy5-CpG)X iPEMs were applied to naïve mice for 15 min,
then the arrays were removed and the mice were sacrificed. The treated
portion of the skin was isolated and fixed in 4% paraformaldehyde
for 10 min at RT protected from light. After three washes in PBS,
the skin was observed using confocal microscopy to visualize each
cargo signal. To quantify how much of the iPEM cargo was delivered
to the ear from the MN array, the MNs used for treatment were dissolved
in DMSO for 24 h after the treatment, then the amount of FITC-Trp2*
and CpG in the DMSO solution were quantified as described above. The
amount delivered to the ear was calculated by subtracting the value
measured after treatment from measurements of the amount of cargo
on identical MNs not applied to animals.
In Vivo Vaccination Studies Using iPEM-Coated
MN Arrays
C57Bl/6 mice (N = 6/group) were
immunized with PBS or coated MNs on day 0 in the right ear and boosted
on day 15 by application of a second MN array to the left ear. Blood
was then collected by the submandibular route on days 0, 7, 14, 21,
and 28. Blood samples were treated with 1 mL of ACK lysing buffer
(Life Technologies) to remove red blood cells, collected by centrifugation
(800 g, 5 min.), washed in FACS buffer, and collected. Each cell sample
were then blocked with anti-CD16/32 for 10 min at RT, followed by
staining with the MHC I Trp2 tetramer (APC-conjugated, MBL International
Corp.) for 30 min at RT. Cells were subsequently surface-stained by
incubation with anti-CD8a (FITC, BD bioscience) for 20 min at RT,
washed twice, and suspended in FACS buffer containing DAPI for analysis
by flow cytometry.
Statistical Analysis
Student’s t tests were used in the comparison of two groups. One-way
ANOVA with
a Dunnet post-test was used to compare three or more groups. In all
cases, analyses were carried out with Graphpad Prism (version 6.02).
Error bars in all panels represent the mean ± SEM, and p values ≤0.05 were considered significant. Levels
of significance were defined as * p < 0.05; ** p < 0.01; *** p < 0.001; and **** p < 0.0001.
Results
iPEMs Allow Tunable Assembly
of Cancer Vaccine Components on
Planar Substrates
We first used planar substrates to evaluate
the formation, loading, and stability of iPEMs built from Trp2* and
CpG on the precursor layers (PL). Ellipsometry performed on silicon
substrates during assembly revealed increasing thickness that grew
linearly (R2 = 0.99) at a rate of 4.6
nm per bilayer, reaching a thickness of 193.0 nm after depositing
32 bilayers of iPEMs (Figure A). Similarly, loading on quartz substrates revealed linear
control over cargo loading for both Trp2* (Figure B and Figure S1; R2 = 0.99) and CpG (Figure B and Figure S1; R2 = 0.97). Next, we assessed
the release behavior of iPEMs by incubating coated substrates in buffer
solution at the indicated pH values (Figure C,D). After 24 h, release from iPEMs was
pH-dependent, as indicated by both the extent of decrease in film
thickness (Figure C) and the amount of cargo released into solution (Figure D). These studies revealed
release of up to 23.2 ± 1.87 μg/cm2 for Trp2*
and 21.9 ± 0.32 μg/cm2 of CpG for substrates
coated with (Trp2*/CpG)32 iPEMs. This general approach
was then adapted to deposit Trp2*/CpG iPEMs on MNs for subsequent
use in cell and animal studies.
Figure 1
PEM films assembled from Trp2* and CpG
can be deposited on planar
substrates. (A) Thickness of iPEM films exhibiting linear growth on
silicon substrates as a function of the number of layers deposited.
(B) Relative loading of Trp2* peptide antigen and CpG adjuvant on
quartz substrates using FITC-labeled Trp2* and CpG. (C) Decrease in
film thickness on coated silicon substrates after incubation in buffer
at the indicated pH conditions. (D) Quantification of cargo release
from iPEMs using absorbance (CpG, 260 nm) and protein determination
(Trp2*).
PEM films assembled from Trp2* and CpG
can be deposited on planar
substrates. (A) Thickness of iPEM films exhibiting linear growth on
silicon substrates as a function of the number of layers deposited.
(B) Relative loading of Trp2* peptide antigen and CpG adjuvant on
quartz substrates using FITC-labeled Trp2* and CpG. (C) Decrease in
film thickness on coated silicon substrates after incubation in buffer
at the indicated pH conditions. (D) Quantification of cargo release
from iPEMs using absorbance (CpG, 260 nm) and protein determination
(Trp2*).
iPEMs Allow Automated and
Tunable Assembly of Trp2* and CpG
on MN Arrays
MN arrays were fabricated from PLLA using PDMS
molds to form arrays displaying a total of 77 needles, each with a
diameter of 250 μm at the base and a height of 650 μm
(Figure A–C).
Next, fluorescently labeled Trp2* (FITC) and CpG (Cy5) were deposited
on the MN arrays using a programmable robotic dipping system to automate
the LbL process. This LbL approach led to uniform, conformal coating
on MNs even after the deposition of 64 bilayers (128 layers) (Figure D–F). Fluorescence
microscopy of the fluorescent iPEM components assembled on the MNs
revealed clear colocalization of the Trp2* and CpG signals on the
surface of the individual MNs (Figure A). To assess film growth on MN arrays, arrays were
dried after deposition of 4, 16, 32, and 64 bilayers (128 layers),
then the spatial distribution of the fluorescent signal was visualized
using confocal microscopy. These measurements revealed Trp2* and CpG
signal intensities that were a function of the number of layers deposited
(Figure B), colocalized,
and well-defined in a given z-plane (Figure C), and localized to the changing circumference
of MNs along the entire height (Figure D). Signal intensity analysis from data analogous to
the representative samples shown in Figure B,C indicated a near-linear relationship
between the number of layers deposited and fluorescent signal for
Trp2* (R2 = 0.99) and CpG (R2 = 0.93) (Figure E). This was reflected by the continuous coating shown in
a 3D projection from image stacks collected along the height of MNs
coated with (Trp2*/CpG)64 iPEMs (Figure F). Direct measurements of the loading of
each signal on MNs indicated 120.0 ± 12.7 μg/cm2 for Trp2* and 107.8 ± 18.9 μg/cm2 of CpG for
MNs coated with 64 bilayers of Trp2*/CpG iPEMs (Figure G). Together, these data indicate that clinically
relevant cancer vaccine components can be self-assembled into PEMs
on MNs with tunable control over the loading of both Trp2* and CpG.
Figure 2
iPEMs
composed of 64 bilayers (128 layers) of Trp2* and CpG assembled
on MN arrays by robotic deposition exhibit a uniform, conformal morphology.
(A–C) SEM images of uncoated MN arrays and (D–F) images
of iPEM coated MNs arrays. Scale bars for A and D = 200 μm;
scale bars for B, C, E, and F = 1 mm.
Figure 3
iPEM layers are deposited with tunable
control over dose during
the LbL assembly of (Trp2*/CpG)64. (A) Image of individual
MNs visualized by florescence microscopy (Scale bar = 100 μm).
(B) Confocal microscopy images demonstrating increasing signal intensity
from Trp2* and CpG after 4, 16, 32, and 64 bilayers (Scale bar = 500
μm). (C) Pixel intensity traces across the corresponding dashed
line in each panel in B. (D) Confocal microscopy z-stack images of
MNs coated with (Trp2*/CpG)64 at different z positions
(Scale bar = 100 μm). (E) quantification of MFI of iPEM signals
from individual MNs in panel B. (F) 3D projection of MN tips from
Z-stack demonstrating colocalization (yellow) of Trp2* (green) and
CpG (red) along the length of the MNs (Scale bar = 50 μm). (G)
Loading levels of Trp2* and CpG on MNs on a per area basis.
iPEMs
composed of 64 bilayers (128 layers) of Trp2* and CpG assembled
on MN arrays by robotic deposition exhibit a uniform, conformal morphology.
(A–C) SEM images of uncoated MN arrays and (D–F) images
of iPEM coated MNs arrays. Scale bars for A and D = 200 μm;
scale bars for B, C, E, and F = 1 mm.iPEM layers are deposited with tunable
control over dose during
the LbL assembly of (Trp2*/CpG)64. (A) Image of individual
MNs visualized by florescence microscopy (Scale bar = 100 μm).
(B) Confocal microscopy images demonstrating increasing signal intensity
from Trp2* and CpG after 4, 16, 32, and 64 bilayers (Scale bar = 500
μm). (C) Pixel intensity traces across the corresponding dashed
line in each panel in B. (D) Confocal microscopy z-stack images of
MNs coated with (Trp2*/CpG)64 at different z positions
(Scale bar = 100 μm). (E) quantification of MFI of iPEM signals
from individual MNs in panel B. (F) 3D projection of MN tips from
Z-stack demonstrating colocalization (yellow) of Trp2* (green) and
CpG (red) along the length of the MNs (Scale bar = 50 μm). (G)
Loading levels of Trp2* and CpG on MNs on a per area basis.
iPEM Cargo Released from
MNs Is Internalized by DCs and Drives
DC Activation
We next examined the interactions of cancer
vaccine cargo released from MNs with splenic DCs. In these studies,
FITC-Trp2* Cy5-CpG coated on MNs were released from the arrays in
an analogous manner to Figure , then the size and surface charge of the released components
were measured by DLS and zeta potential analysis, respectively. These
studies revealed that the released cargos assembled into nanosized
complexes exhibiting near-neutral charge (Figure S2). Next, the amount of cargo in each released solution was
quantified (Figure A) and used to treat DCs isolated from spleens of mice. Following
incubation, confocal microscopy confirmed the signal for both Trp2*
(green signal) and CpG (red signal) in DCs (Figure B), while flow cytometry revealed that a
significant fraction of DCs took up Trp2 and CpG in a dose dependent
manner (Figure C).
A significant fraction of these cells were also positive for both
signals, indicating codelivery. To gain insight into the components
released into solution during these studies, we incubated iPEM-coated
MNs in PBS or PBS with 10% FBS (v/v) for 36 h. The released components
exhibited sizes of approximately 50 nm in both buffers, while the
addition of serum shifted the surface charge toward neutral values
(Figure S3). With respect to cargo release,
24.2% of Trp2* and 16.4% of CpG were released in PBS, while 26.9%
of Trp2* and 84.8% of CpG were released in serum containing media
over this interval (Figure S3). Together,
these data demonstrate that iPEMs assembled from tumor antigens and
TLR agonists on MNs are released in a manner that can be efficiently
internalized by primary DCs.
Figure 4
iPEM cancer vaccine components released from
MNs coated with (Trp2*/CpG)64 are cointernalized by primary
DCs. (A) Quantification of
the release levels of each iPEM component as a function of pH used
to disrupt the films. (B) Confocal microscopy images of DCs incubated
for 4 h with iPEM components released from MNs demonstrate colocalization
of both components in the cells (white, cell membrane; blue, nuclei;
green, Trp2*; red, CpG; scale bar = 10 μm). (C) Frequency of
primary DCs internalizing each iPEM component after incubation for
20 h with the cargo released from the MNs.
iPEMcancer vaccine components released from
MNs coated with (Trp2*/CpG)64 are cointernalized by primary
DCs. (A) Quantification of
the release levels of each iPEM component as a function of pH used
to disrupt the films. (B) Confocal microscopy images of DCs incubated
for 4 h with iPEM components released from MNs demonstrate colocalization
of both components in the cells (white, cell membrane; blue, nuclei;
green, Trp2*; red, CpG; scale bar = 10 μm). (C) Frequency of
primary DCs internalizing each iPEM component after incubation for
20 h with the cargo released from the MNs.Next, we incubated DCs with iPEM release solutions as described
above and used flow cytometry to test if uptake of iPEM components
drives DC surface activation and costimulatory markers. In these experiments,
DCs treated with cargo released from MN arrays exhibited high levels
of CD80 (Figure A,D),
CD86 (Figure B,E),
and CD40 (Figure C,F)
expression, readings that were comparable to those measured in cells
treated with free LPS, a potent TLR4 agonist (Figure ). These values were also similar to those
of free CpG, which was at a similar dose to the amount of CpG in the
MN release solutions (Figure ). As expected, treatment of cells with a nonimmunostimulatory
oligonucleotide (CTRL), SIIN control peptide, or Trp2* alone did not
result in any significant activation relative to DCs treated with
PBS (Figure ). Analysis
of mean fluorescent intensity values indicated similar results (Figure S4). Thus, assembly of iPEMs on MNs does
not impact the ability of adjuvants (i.e., CpG) to activate DCs.
Figure 5
iPEM components
released from MNs activate primary DCs. Frequency
of DCs expressing costimulatory markers: (A) CD80, (B) CD86, and (C)
CD40 after incubation with cargo release solutions for 24 h. Representative
flow cytometry histograms showing traces for (D) CD80, (E) CD86, and
(F) CD40, corresponding to panels A, B, and C, respectively.
iPEM components
released from MNs activate primary DCs. Frequency
of DCs expressing costimulatory markers: (A) CD80, (B) CD86, and (C)
CD40 after incubation with cargo release solutions for 24 h. Representative
flow cytometry histograms showing traces for (D) CD80, (E) CD86, and
(F) CD40, corresponding to panels A, B, and C, respectively.
DCs Treated with Cargo
Released from MNs Activate Trp2-Specific
T Cells in Coculture
To investigate if DCs process and present
Trp2 with the appropriate costimulatory ligands needed to activate
Trp2-reactive T cells, we set up a coculture system in which DCs were
first cultured with MN release solutions for 48 h. These cells were
then cocultured with CD8+ T cells isolated from transgenicmice. In these mice, T cells display T cell receptors that recognize
Trp2 peptide when displayed by APCs in the MHC I antigen presentation
complex. Consequently, Trp2-reactive T cells encountering the display
of this peptide–MHC complex, along with the correct costimulatory
ligands on APCs, proliferate and secrete inflammatory signaling molecules
(e.g., cytokines). Our studies with this coculture system revealed
strong and selective proliferation in cultures treated with the MN
release solutions, as indicated by the greatly reduced signal of a
fluorescent tracer (CSFE) as dye is diluted during successive generations
of cell proliferation. In contrast, DCs treated with adjuvant alone
(LPS, CpG), nonimmunostimulatory oligonucleotide (CTRL), irrelevant
peptide antigen (SIIN), or PBS did not cause T cell proliferation
(Figure A). These
control results were indicated by the high CSFE intensity measured
in these samples since the cells did not divide to dilute the dye
(Figure A). Similar
findings were also reflected in the analysis of frequency data (Figure B) evaluated using
the gates shown in Figure C. The results of this study demonstrate that the selectivity
of Trp2 incorporated in iPEMs and released from MNs is not altered
by these processes.
Figure 6
Increased DCs activation after incubation with released
MN cargo
drives proliferation of Trp2-specific transgenic CD8+ T
cells and effector cytokine secretion during coculture. (A) MFI of
CFSE and (B) frequency of the CD8+ T cells as measured
by flow cytometry. (C) Representative flow cytometry histograms showing
the gating scheme and frequency of T cell proliferation. (D) IFN-γ,
(E) IL-6, and (F) IL-1β concentrations in supernatants from
the cocultures in A, B, and C measured by ELISA. Controls are vehicle
(PBS), positive control (Trp2), negative controls (CpG, LPS), and
irrelevant antigen control (SIIN).
Increased DCs activation after incubation with released
MN cargo
drives proliferation of Trp2-specific transgenic CD8+ T
cells and effector cytokine secretion during coculture. (A) MFI of
CFSE and (B) frequency of the CD8+ T cells as measured
by flow cytometry. (C) Representative flow cytometry histograms showing
the gating scheme and frequency of T cell proliferation. (D) IFN-γ,
(E) IL-6, and (F) IL-1β concentrations in supernatants from
the cocultures in A, B, and C measured by ELISA. Controls are vehicle
(PBS), positive control (Trp2), negative controls (CpG, LPS), and
irrelevant antigen control (SIIN).We next measured inflammatory and effector cytokine levels
in the
supernatants of coculture samples to investigate whether the cargo
from MNs expand T cells that then exhibit functional characteristics
(i.e., cytokine secretion). LPS-treatment resulted in high levels
of pro-immune cytokines secreted by DCs (i.e., IL-6 and IL-1β),
while only a modest level of a key T cell effector cytokine, IFN-γ,
was observed (Figure D–F). In contrast, cultures treated with MN release solutions
induced high levels of IFN-γ that were comparable to the levels
observed in positive control cultures treated with free Trp2, the
peptide recognized by the transgenic T cells (Figure E). The levels of IL-6 associated with MN
cargo treatment were modest, while IL-1β secretion was not observed.
The latter is a key component in the NALP3 inflammasome innate signaling
cascade.[41] Thus, cargo released from MNs
expands T cells that generate high levels of effector cytokines associated
with antigen-specific immune response, rather than less-specific inflammatory
reactions (e.g., inflammasome activation).
MNs Codeliver iPEMs to
Skin in Vivo
Building on our in
vitro results, we next applied
uncoated or iPEM-coated MN arrays to the ears of mice for a period
of 5 min. Staining ears with trypan blue after application of uncoated
MN arrays revealed a clear penetration into the epidermis and a pattern
characteristic of the MN arrangement on the arrays used in the study
(Figure A). Similarly,
confocal microscopy revealed colocalization of both iPEM components
(i.e., FITC-Trp2*, green; Cy5-CpG, red) following application of MN
arrays coated with (Trp2*/CpG)64 iPEMs (Figure B). Quantification of the delivered
dose showed the delivery of 28.9 ± 6.4 μg/cm2 for Trp2* (dose = 5.77 μg) and 23.6 ± 6.5 μg/cm2 for CpG (dose = 4.84 μg) using a single array coated
with (Trp2*/CpG)64 iPEMs (Figure C). These result indicate the successful
codelivery of iPEM components from MNs to the skin without need for
other PEM components.
Figure 7
iPEM-coated MNs penetrate the skin and codeliver Trp2*
and CpG
into the skin. (A) True color image of a representative mouse ear
after the application of MNs and staining with trypan blue. The arrow
indicates a single penetration point. (B) Confocal microscopy images
of treated skin showing the codelivery of each iPEM component (green,
Trp2*; red, CpG) to an individual penetration site (arrows) after
the application of MNs coated with (Trp2*/CpG)64 (Scale
bar = 200 μm). (C) Doses of Trp2* and CpG administered to mouse
skin after the application of coated MNs.
iPEM-coated MNs penetrate the skin and codeliver Trp2*
and CpG
into the skin. (A) True color image of a representative mouse ear
after the application of MNs and staining with trypan blue. The arrow
indicates a single penetration point. (B) Confocal microscopy images
of treated skin showing the codelivery of each iPEM component (green,
Trp2*; red, CpG) to an individual penetration site (arrows) after
the application of MNs coated with (Trp2*/CpG)64 (Scale
bar = 200 μm). (C) Doses of Trp2* and CpG administered to mouse
skin after the application of coated MNs.
Immunization with (Trp2*/CpG)64 iPEMs on MNs Expands
Tumor-Specific T Cells
We last investigated the ability of
iPEM-coated MNs to expand tumor-specific CD8+ T cells in
naïve mice. In these studies, mice were primed with iPEM-coated
MN arrays on day 0 by application to the right ear for 15 min, then
boosted on day 15 using a second iPEM-coated array applied to the
left ear for 15 min. Staining of peripheral blood with the MHC I Trp2
tetramer was performed weekly. After 7 days, mice immunized with MNs
exhibited a slight, but statistically significant increase in the
frequency of Trp2-specific CD8+ T cell relative to mice
treated with PBS (Figure A). These populations were still evident at week 2, though
the statistical significance was not observed relative to the control
group at this point (Figure A). One week after the booster injection on day 15 (i.e.,
day 21), a significantly higher frequency and more tightly distributed
group of values were observed, while by week 4, the frequency of Trp2-specific
CD8+ T cell reached the highest value of the experiment
(Figure B), with frequencies
greater than 2.0% (Figure C). These results demonstrate that MNs coated with iPEMs generate
tumor-specific T cell response and further that boosting leads to
recall responses with a greater magnitude of response compared with
that of the priming MN application.
Figure 8
Cancer vaccination of mice with iPEM coated
MNs promotes melanoma-specific
CD8+ T cells. Mice were primed at day 0 and boosted at
day 15 with MNs coated with (Trp2*/CpG)64. (A) Frequency
of Trp2 specific CD8+ T cells in peripheral blood was quantified
by tetramer staining weekly during priming and boosting with MNs.
(B) Development of Trp2-specific CD8+ T cell response over
28 days. Arrows indicated prime and booster MN applications. (C) Representative
flow cytometry scatter plots demonstrating the development of a clear
population of CD8+ T cells specific for the Trp2 epitope
as measured by the MHC I Trp2 tetramer on day 28 post prime.
Cancer vaccination of mice with iPEM coated
MNs promotes melanoma-specific
CD8+ T cells. Mice were primed at day 0 and boosted at
day 15 with MNs coated with (Trp2*/CpG)64. (A) Frequency
of Trp2 specific CD8+ T cells in peripheral blood was quantified
by tetramer staining weekly during priming and boosting with MNs.
(B) Development of Trp2-specific CD8+ T cell response over
28 days. Arrows indicated prime and booster MN applications. (C) Representative
flow cytometry scatter plots demonstrating the development of a clear
population of CD8+ T cells specific for the Trp2 epitope
as measured by the MHC I Trp2 tetramer on day 28 post prime.
Discussion
Microneedles
offer many advantages for prophylactic vaccination,
including elimination of medical sharps and injection-associated pain,
improved patient compliance, and better cargo stability. Importantly,
the immunological features of skin, a high concentration of APCs,
for example, and recent studies in humanmelanoma and prostate cancerpatients highlight the potential of leveraging intradermal delivery
for improving cancer immunotherapy.[20−22] Some of the unique ways
intradermal delivery might be harnessed include local delivery to
common skin cancers such as melanoma, as well as more-broadly applicable
concepts such as using intradermal delivery to strongly activate large
subsets of skin-resident immune cells already sampling but perhaps
not activated against existing and neo-tumor antigens that often develop
during cancer.[42] MNs, as demonstrated by
the first few examples recently reported using these technologies
in the context of cancer,[23−29] clearly have great potential. As discussed in the Introduction, some studies have focused on the delivery of
chemotherapeutics,[28] pro-immune cytokines,[27] or signals to unleash immune functions that
tumors often suppress.[29] Within the sphere
of cancer vaccines, several studies have explored coating MNs with
model antigens (e.g., OVA),[25,26] while a few examples
have used uncoated MNs to prepenetrate the skin, then topically applied
cancer vaccine components to the skin.[23,24] Our approach
is distinguished from past studies because this is the first time
tumor antigens have been incorporated on or within MNs. The molecules
we chose are significant because Trp2 is a conserved antigen in many
humancancers,[39,43,44] while CpG is a potent TLR9 agonist already being studied in human
therapies.[40] Thus, we reasoned that juxtaposing
Trp2 and CpG at high concentrations in iPEMs would create a simple,
modular approach for MN-based cancer vaccination. This approach is
also unique because of the simple set of vaccine components, eliminating
synthetic polymers and polyelectrolytes, carrier components, or excipients
used in all previously reported MN delivery examples.From a
materials perspective, we made several interesting discoveries
in building and assessing iPEMs. First, coating of MNs with iPEMs,
like traditional PEMs, allowed tunable and linear control over the
loading of both the tumor antigen and the TLR agonist. One of the
unique features of PEM is the stepwise and conformal nature of assembly.
We exploited this idea to automate the assembly of iPEMs and observed
that MNs coated in this manner were conformal even after the deposition
of 128 layers (Figure ). Positive trypan-blue signal, a dye that stains permeable cells,
confirmed penetration of the skin following MN application (Figure ). Excitingly, iPEM
coated MNs were effective in expanding tumor-specific T cells in mice
(Figure ), effects
that were concurrent with our observation of the colocalization of
both Trp2* and CpG within the skin at the MN administration sites
(Figure ). The delivered
dose in these studies was 5.77 μg for Trp2* and 4.84 μg
for CpG, approximately 24% and 22% of total amount of each component
loaded on the MN arrays. This is not surprising, as we did not integrate
an explicit release mechanism into our assemblies in this proof-of-concept
work. However, many possibilities exist for incorporating releasable
technology into MNs. For PEMs in particular, strategies for releasable
multilayers or incorporated cargos have included ultrasound,[45] magnetic fields,[46] laser irradiation,[47] chemical cues,[48] and integration of enzyme-sensitive polymers.[46,49] Much work has also been carried out on degradable polymers as components
of PEMs to control release and delivery kinetics;[50,51] this is another promising strategy to further enhance our approach.
However, the strong in vivo T cell responses associated
with delivering only 20–25% of the iPEM dose demonstrate the
potential of this strategy, along with the possibility of simply adding
more layers, for tumor vaccination.In our cell culture studies,
we confirmed that iPEMs maintain the
function and selectivity of the components used to build these assemblies.
DCs treated with iPEMs built from CpG and Trp2*, for example, expanded
transgenic T cells specific for Trp2. In our past studies with model
antigens coated on colloidal templates,[36] appending cationic R9 to these antigens was required
to support PEM growth. However, R9 is also a cell-penetrating
peptide (CPP).[52,53] This and similar molecules have
been used for a range of applications, such as improving cellular
transport of proteins conjugated to nanoparticles.[53−55] Thus, R9 might also contribute to the uptake or colocalization features
we observed during cell cultures studies (Figure ) or to improve interactions with skin-resident
immune cells during in vivo immunization using iPEM-coated
MN arrays. Future intracellular trafficking studies to assess the
mechanisms of uptake and sequestration of these signals in immune
cells will provide insight into if and how this component impacts
immunogenicity.Our cell culture studies also provided some
insight into some of
the immunological populations that iPEMs target. We observed that
all iPEM and control samples containing Trp2 peptide caused significant
proliferation, whereas the cytokine profiles between groups differed
significantly (Figure ). IFN-γ secretion was most dependent on the presence of Trp2
since this cytokine is produced by T cells upon activation (i.e.,
proliferation), which only occurred in Trp2-containing samples. Modest
levels were observed in the LPS, one of the strongest TLR agonists.
In contrast, IL-6 was observed to varying degrees whenever a TLR agonist
was present, even when the antigen was absent. This is also consistent,
as IL-6 plays an important role in innate immunity and is secreted
by APCs.[56] Perhaps most interestingly,
IL-1β, a key component of the inflammasome,[57] was not observed with iPEMs released from MNs. This is
in contrast to several recent papers demonstrating that poly(lactide-co-glyoclide), polystyrene, and other common biomaterial
carriers activate nonspecific inflammatory pathways (e.g., inflammasomes)
as a result of intrinsic immunogenic features.[58−61] Thus, iPEMs improve vaccine definition
by simplifying the number of vaccine and carrier components.Microneedles themselves also offer a number of useful features,
including the elimination of biomedical sharps and improved cargo
stability that can facilitate scale-up. For traditional prophylactic
vaccination, improved compliance owing to reduced pain and ease of
application are also important benefits. However, these latter points
may be less important in the context of immunotherapy and therapeutic
vaccination where recipients are patients already dealing with significant
illness and more invasive treatments such as surgical resection and
chemotherapy.With respect to adaptive responses, our in vivo studies demonstrate strong expansion of tumor specific
CD8+ T cells. These cytotoxic T lymphocytes are an important
component
of effective antitumor responses able to target and destroy cancer
cells. We also showed that boosting of mice results in a significantly
larger recall response that suggests the generation of immunological
memory. However, an important next step will be to test the functional
capacity of these cells during tumor challenge. In particular, these
studies will assess if the expanded T cells confer anti-tumor immunity
and if these enhancements are efficacious during early or late-stage
treatments of mice challenged with melanoma or other preclinical models.
Current clinical strategies being explored for cancer vaccination
focused on combination therapies, such as those employing cancer vaccination
to provide tumor-specific immune responses while also administering
checkpoint inhibitors that release pro-immune inflammatory processes
that tumorsco-opt and suppress.[62] Thus,
conducting challenge studies in isolation during cancer vaccination
as a monotherapy is less attractive since even candidate vaccines
that potently expand tumor-specific cells often fail to be curative
because these cells are suppressed by the tumors.[63,64] Recent studies with MNs for delivering immunotherapies, including
checkpoint inhibitors, thus set the stage for combining vaccination
and cotherapies in a way that mimics some of the most-promising approaches
being explored in human trials.[27,29]
Conclusions
In
this study, we demonstrate the potential of using MN arrays
to codeliver clinically relevant tumor peptides with human vaccine
adjuvants. This system simplifies vaccine design by eliminating polymeric
and excipient components, while maintaining useful features of biomaterials
such as codelivery. Further, iPEMs can be assembled in a stepwise,
automated manner to control cargo loading while maintaining the immunological
specificity of the vaccine components. In mice, these assemblies expand
tumor-specific CD8+ T cells during priming injections and
promote memory recall responses during boosting. The findings reported
here could contribute to a new, more rational design of MN-enabled
cancer vaccine platforms.
Authors: Richard T Kenney; Sarah A Frech; Larry R Muenz; Christina P Villar; Gregory M Glenn Journal: N Engl J Med Date: 2004-11-03 Impact factor: 91.245
Authors: Helen L Quinn; Mary-Carmel Kearney; Aaron J Courtenay; Maelíosa T C McCrudden; Ryan F Donnelly Journal: Expert Opin Drug Deliv Date: 2014-07-14 Impact factor: 6.648
Authors: Sunaina Indermun; Regina Luttge; Yahya E Choonara; Pradeep Kumar; Lisa C du Toit; Girish Modi; Viness Pillay Journal: J Control Release Date: 2014-05-05 Impact factor: 9.776
Authors: Alfons J M van den Eertwegh; Jurjen Versluis; H Pieter van den Berg; Saskia J A M Santegoets; R Jeroen A van Moorselaar; Tim M van der Sluis; Helen E Gall; Thomas C Harding; Karin Jooss; Israel Lowy; Herbert M Pinedo; Rik J Scheper; Anita G M Stam; B Mary E von Blomberg; Tanja D de Gruijl; Kristen Hege; Natalie Sacks; Winald R Gerritsen Journal: Lancet Oncol Date: 2012-02-10 Impact factor: 41.316
Authors: Lisa H Tostanoski; Haleigh B Eppler; Boyan Xia; Xiangbin Zeng; Christopher M Jewell Journal: Biomater Sci Date: 2019-02-26 Impact factor: 6.843
Authors: Alison J Scott; Robert K Ernst; Courtney E Chandler; Erin M Harberts; Tim Laemmermann; Qin Zeng; Belita N Opene; Ronald N Germain; Christopher M Jewell Journal: Infect Immun Date: 2018-08-22 Impact factor: 3.441
Authors: Yanpu He; Celestine Hong; Jiahe Li; MayLin T Howard; Yingzhong Li; Michelle E Turvey; Divakara S S M Uppu; John R Martin; Ketian Zhang; Darrell J Irvine; Paula T Hammond Journal: ACS Nano Date: 2018-10-04 Impact factor: 15.881