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      Is Open Access

      Oral delivery of proteins and peptides: Challenges, status quo and future perspectives

      review-article
      a , , a , , a , c , , a , b , a , b , , a , b ,
      Acta Pharmaceutica Sinica. B
      Elsevier
      Proteins, Peptides, Oral delivery, Permeation enhancer, Enzyme inhibitor, Stability, Clinical, ASBT, apical sodium-dependent bile acid transporter, BSA, bovine serum albumin, CAGR, compound annual growth, CaP, calcium phosphate, CD, Crohn's disease, COPD, chronic obstructive pulmonary disease, CPP, cell penetrating peptide, DCs, dendritic cells, DDVAP, desmopressin acetate, DTPA, diethylene triamine pentaacetic acid, EDTA, ethylene diamine tetraacetic acid, EPD, empirical phase diagrams, EPR, electron paramagnetic resonance, FA, folic acid, FcRn, Fc receptor, FDA, U.S. Food and Drug Administration, GALT, gut-associated lymphoid tissue, GI, gastrointestinal, GIPET, gastrointestinal permeation enhancement technology, GLP-1, glucagon-like peptide 1, GRAS, generally recognized as safe, HBsAg, hepatitis B surface antigen, HPMCP, hydroxypropyl methylcellulose phthalate, IBD, inflammatory bowel disease, ILs, ionic liquids, LBNs, lipid-based nanoparticles, LMWP, low molecular weight protamine, MCT-1, monocarborxylate transporter 1, MSNs, mesoporous silica nanoparticles, NAC, N-acetyl-l-cysteine, NLCs, nanostructured lipid carriers, PAA, polyacrylic acid, PBPK, physiologically based pharmacokinetics, PCA, principal component analysis, PCL, polycarprolacton, PGA, poly-γ-glutamic acid, pHPMA, N-(2-hydroxypropyl)methacrylamide, pI, isoelectric point, PLA, poly(latic acid), PLGA, poly(lactic-co-glycolic acid), PPs, proteins and peptides, PVA, poly vinyl alcohol, RGD, Arg-Gly-Asp, RTILs, room temperature ionic liquids, SAR, structure–activity relationship, sc, subcutaneous, sCT, salmon calcitonin, SDC, sodium deoxycholate, SGF, simulated gastric fluids, SGC, sodium glycocholate, STC, sodium taurocholate, SIF, simulated intestinal fluids, SLNs, solid lipid nanoparticles, SNAC, sodium N-[8-(2-hydroxybenzoyl)amino]caprylate, SNEDDS, self-nanoemulsifying drug delivery systems, TAT, trans-activating transcriptional peptide, Tf, transferrin, TfR, transferrin receptors, TMC, N-trimethyl chitosan, UC, ulcerative colitis, UEA1, ulex europaeus agglutinin 1, VB12, vitamin B12, WGA, wheat germ agglutinin

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          Abstract

          Proteins and peptides (PPs) have gradually become more attractive therapeutic molecules than small molecular drugs due to their high selectivity and efficacy, but fewer side effects. Owing to the poor stability and limited permeability through gastrointestinal (GI) tract and epithelia, the therapeutic PPs are usually administered by parenteral route. Given the big demand for oral administration in clinical use, a variety of researches focused on developing new technologies to overcome GI barriers of PPs, such as enteric coating, enzyme inhibitors, permeation enhancers, nanoparticles, as well as intestinal microdevices. Some new technologies have been developed under clinical trials and even on the market. This review summarizes the history, the physiological barriers and the overcoming approaches, current clinical and preclinical technologies, and future prospects of oral delivery of PPs.

          Graphical abstract

          The current strategies for improving oral absorption of proteins and peptides (PPs) include stabilization, absorption enhancement and mucus-related technologies. Most of marketed oral PP products employ two or more strategies.

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          Most cited references371

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          Experimental and computational approaches to estimate solubility and permeability in drug discovery and development settings.

          Experimental and computational approaches to estimate solubility and permeability in discovery and development settings are described. In the discovery setting 'the rule of 5' predicts that poor absorption or permeation is more likely when there are more than 5 H-bond donors, 10 H-bond acceptors, the molecular weight (MWT) is greater than 500 and the calculated Log P (CLogP) is greater than 5 (or MlogP > 4.15). Computational methodology for the rule-based Moriguchi Log P (MLogP) calculation is described. Turbidimetric solubility measurement is described and applied to known drugs. High throughput screening (HTS) leads tend to have higher MWT and Log P and lower turbidimetric solubility than leads in the pre-HTS era. In the development setting, solubility calculations focus on exact value prediction and are difficult because of polymorphism. Recent work on linear free energy relationships and Log P approaches are critically reviewed. Useful predictions are possible in closely related analog series when coupled with experimental thermodynamic solubility measurements.
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            Mucus-penetrating nanoparticles for drug and gene delivery to mucosal tissues.

            Mucus is a viscoelastic and adhesive gel that protects the lung airways, gastrointestinal (GI) tract, vagina, eye and other mucosal surfaces. Most foreign particulates, including conventional particle-based drug delivery systems, are efficiently trapped in human mucus layers by steric obstruction and/or adhesion. Trapped particles are typically removed from the mucosal tissue within seconds to a few hours depending on anatomical location, thereby strongly limiting the duration of sustained drug delivery locally. A number of debilitating diseases could be treated more effectively and with fewer side effects if drugs and genes could be more efficiently delivered to the underlying mucosal tissues in a controlled manner. This review first describes the tenacious mucus barrier properties that have precluded the efficient penetration of therapeutic particles. It then reviews the design and development of new mucus-penetrating particles that may avoid rapid mucus clearance mechanisms, and thereby provide targeted or sustained drug delivery for localized therapies in mucosal tissues.
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              Oral drug delivery with polymeric nanoparticles: the gastrointestinal mucus barriers.

              Oral delivery is the most common method for drug administration. However, poor solubility, stability, and bioavailability of many drugs make achieving therapeutic levels via the gastrointestinal (GI) tract challenging. Drug delivery must overcome numerous hurdles, including the acidic gastric environment and the continuous secretion of mucus that protects the GI tract. Nanoparticle drug carriers that can shield drugs from degradation and deliver them to intended sites within the GI tract may enable more efficient and sustained drug delivery. However, the rapid secretion and shedding of GI tract mucus can significantly limit the effectiveness of nanoparticle drug delivery systems. Many types of nanoparticles are efficiently trapped in and rapidly removed by mucus, making controlled release in the GI tract difficult. This review addresses the protective barrier properties of mucus secretions, how mucus affects the fate of orally administered nanoparticles, and recent developments in nanoparticles engineered to penetrate the mucus barrier. Copyright © 2011 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Acta Pharm Sin B
                Acta Pharm Sin B
                Acta Pharmaceutica Sinica. B
                Elsevier
                2211-3835
                2211-3843
                29 April 2021
                August 2021
                29 April 2021
                : 11
                : 8
                : 2416-2448
                Affiliations
                [a ]Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
                [b ]Key Laboratory of Smart Drug Delivery of MOE, School of Pharmacy, Fudan University, Shanghai 201203, China
                [c ]Department of Pharmacy, Gono Bishwabidyalay (University), Mirzanagar Savar, Dhaka 1344, Bangladesh
                Author notes
                [†]

                These authors made equal contributions to this work.

                Article
                S2211-3835(21)00116-7
                10.1016/j.apsb.2021.04.001
                8424290
                34522593
                ff946e97-08f6-4e5f-aa2c-70c0db058a71
                © 2021 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 28 November 2020
                : 29 January 2021
                : 12 February 2021
                Categories
                Review

                proteins,peptides,oral delivery,permeation enhancer,enzyme inhibitor,stability,clinical,asbt, apical sodium-dependent bile acid transporter,bsa, bovine serum albumin,cagr, compound annual growth,cap, calcium phosphate,cd, crohn's disease,copd, chronic obstructive pulmonary disease,cpp, cell penetrating peptide,dcs, dendritic cells,ddvap, desmopressin acetate,dtpa, diethylene triamine pentaacetic acid,edta, ethylene diamine tetraacetic acid,epd, empirical phase diagrams,epr, electron paramagnetic resonance,fa, folic acid,fcrn, fc receptor,fda, u.s. food and drug administration,galt, gut-associated lymphoid tissue,gi, gastrointestinal,gipet, gastrointestinal permeation enhancement technology,glp-1, glucagon-like peptide 1,gras, generally recognized as safe,hbsag, hepatitis b surface antigen,hpmcp, hydroxypropyl methylcellulose phthalate,ibd, inflammatory bowel disease,ils, ionic liquids,lbns, lipid-based nanoparticles,lmwp, low molecular weight protamine,mct-1, monocarborxylate transporter 1,msns, mesoporous silica nanoparticles,nac, n-acetyl-l-cysteine,nlcs, nanostructured lipid carriers,paa, polyacrylic acid,pbpk, physiologically based pharmacokinetics,pca, principal component analysis,pcl, polycarprolacton,pga, poly-γ-glutamic acid,phpma, n-(2-hydroxypropyl)methacrylamide,pi, isoelectric point,pla, poly(latic acid),plga, poly(lactic-co-glycolic acid),pps, proteins and peptides,pva, poly vinyl alcohol,rgd, arg-gly-asp,rtils, room temperature ionic liquids,sar, structure–activity relationship,sc, subcutaneous,sct, salmon calcitonin,sdc, sodium deoxycholate,sgf, simulated gastric fluids,sgc, sodium glycocholate,stc, sodium taurocholate,sif, simulated intestinal fluids,slns, solid lipid nanoparticles,snac, sodium n-[8-(2-hydroxybenzoyl)amino]caprylate,snedds, self-nanoemulsifying drug delivery systems,tat, trans-activating transcriptional peptide,tf, transferrin,tfr, transferrin receptors,tmc, n-trimethyl chitosan,uc, ulcerative colitis,uea1, ulex europaeus agglutinin 1,vb12, vitamin b12,wga, wheat germ agglutinin
                proteins, peptides, oral delivery, permeation enhancer, enzyme inhibitor, stability, clinical, asbt, apical sodium-dependent bile acid transporter, bsa, bovine serum albumin, cagr, compound annual growth, cap, calcium phosphate, cd, crohn's disease, copd, chronic obstructive pulmonary disease, cpp, cell penetrating peptide, dcs, dendritic cells, ddvap, desmopressin acetate, dtpa, diethylene triamine pentaacetic acid, edta, ethylene diamine tetraacetic acid, epd, empirical phase diagrams, epr, electron paramagnetic resonance, fa, folic acid, fcrn, fc receptor, fda, u.s. food and drug administration, galt, gut-associated lymphoid tissue, gi, gastrointestinal, gipet, gastrointestinal permeation enhancement technology, glp-1, glucagon-like peptide 1, gras, generally recognized as safe, hbsag, hepatitis b surface antigen, hpmcp, hydroxypropyl methylcellulose phthalate, ibd, inflammatory bowel disease, ils, ionic liquids, lbns, lipid-based nanoparticles, lmwp, low molecular weight protamine, mct-1, monocarborxylate transporter 1, msns, mesoporous silica nanoparticles, nac, n-acetyl-l-cysteine, nlcs, nanostructured lipid carriers, paa, polyacrylic acid, pbpk, physiologically based pharmacokinetics, pca, principal component analysis, pcl, polycarprolacton, pga, poly-γ-glutamic acid, phpma, n-(2-hydroxypropyl)methacrylamide, pi, isoelectric point, pla, poly(latic acid), plga, poly(lactic-co-glycolic acid), pps, proteins and peptides, pva, poly vinyl alcohol, rgd, arg-gly-asp, rtils, room temperature ionic liquids, sar, structure–activity relationship, sc, subcutaneous, sct, salmon calcitonin, sdc, sodium deoxycholate, sgf, simulated gastric fluids, sgc, sodium glycocholate, stc, sodium taurocholate, sif, simulated intestinal fluids, slns, solid lipid nanoparticles, snac, sodium n-[8-(2-hydroxybenzoyl)amino]caprylate, snedds, self-nanoemulsifying drug delivery systems, tat, trans-activating transcriptional peptide, tf, transferrin, tfr, transferrin receptors, tmc, n-trimethyl chitosan, uc, ulcerative colitis, uea1, ulex europaeus agglutinin 1, vb12, vitamin b12, wga, wheat germ agglutinin

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