Pulmonary diseases represent a major social and economic problem as many of these are chronic and require multi-drug therapies [1, 2]. Therefore, local pulmonary administration of drugs using innovative formulations with improved bioavailability and easy-to-use devices represents the main objective of many researchers in the field [3,4,5]. Moreover, the development of advanced inhalable formulations has made it possible to harness new drugs whose administration by other routes is accompanied by poor bioavailability and/or serious side effects due to non-specific biodistribution throughout the body [6, 7]. Meanwhile, innovative formulations may provide a new therapeutic opportunity for lung intervention to established drugs currently used in conventional dosage forms for the treatment of other pathologies [8,9,10].
Rapamycin (Rapa) is a macrolide whose major cellular target, mammalian target of rapamycin (mTOR), is one of the central regulators of growth, differentiation, metabolism, and survival in many cell types [11]. It is currently approved as an oral solution and/or film-coated tablets for the prophylaxis of organ rejection after transplant, as well as for the treatment of sporadic lymphangioleiomyomatosis (LAM). Moreover, it has been recently repurposed in the treatment of airway inflammation associated with pulmonary diseases such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary arterial hypertension (PAH), and idiopathic pulmonary fibrosis (IPF) [12,13,14]. Very recently, Rapa is also under evaluation as a drug candidate for optimizing the treatment of coronavirus-induced disease (COVID-19) [15, 16]. Nevertheless, despite the great potential for its use in humans, Rapa applicability is severely limited by formulation problems and poor bioavailability [11].
In literature, there are already numerous attempts to formulate Rapa through innovative formulations such as nanostructured carriers with encouraging results both for the diagnosis and for the treatment of numerous pathologies [17]. Recently, some attempts to realize inhaled formulations of Rapa were reported, with interesting preliminary results [18, 19]. These first results support the concept of local Rapa administration by inhalation to improve drug efficacy in severe lung diseases while minimizing the systemic side effects observed with oral formulations.
Once given the obvious advantage of inhalation to maximize drug bioavailability, formulation/device engineering to ensure correct deposition, drug solubilization in the lung lining fluid, and subsequent absorption is challenging. Particular attention must be given to the materials used for the realization of the aforementioned carriers, by choosing biodegradable and/or biocompatible excipients with tailored properties to control delivery features [20, 21]. Mucus-penetrating nanoparticles can be achieved by decorating the carrier surfaces with suitable materials, such as polyethylene glycols (PEG), able to confer stealth properties and the ability to spread through the mucus present in the airways [22, 23]. Meanwhile, particle engineering at micro-sized level is imperative to meet the requirements allowing their local administration to the lungs as a dry powder by suitable devices, such as with breath-actuated dry powder inhalers (DPIs) [24, 25].
In this work, we develop a dry powder for Rapa inhalation through a nano-into-micro-(NiM) approach [26]. The NiM particles were obtained by spray drying and were constituted of a mannitol (Man) matrix incorporating Rapa-loaded pegylated polymeric nanoparticles. The latter was produced by the nanoprecipitation method starting from a pegylated derivative of the α,β-poly (N-2-hydroxyethyl)-dl-aspartamide (PHEA) grafted with a carboxyl-terminated PCL [27]. The properties of the developed NiM particles, in terms of aerodynamic behavior after aerosolization through a DPI and dissolution profile into a physiological medium, were evaluated. Moreover, the capability of the Rapa-loaded nanoparticles, once released due to NiM dissolution, to diffuse through a mucus layer, to protect the entrapped drug from hydrolysis into simulated lung fluid and cell medium, was also investigated.
Materials and methods
Materials
Anhydrous N,N′-dimethylformamide (a-DMF), anhydrous dimethylacetamide (a-DMA), methanol, diethylether, dichloromethane, poly-ɛ−caprolactone (PCL, \({\overline{M} }_{w}\) = 10–18 kDa), succinic anhydride (SA), dimethylaminopyridine (DMAP), 1,1′-carbonyldiimidazole (CDI), N,N′-disuccinimidyl carbonate (DSC), diethylamine (DEA), triethylamine (TEA), mannitol, mucin from porcine stomach (type III, bound sialic acid 0.5–1.5%), poly(ethylene oxide) standards, O-(2-aminoethyl)-O’-methyl poly(ethylene glycol) 2000 (H2N-PEG) (≤ 0.4 mmol NH2/g, 2 kDa), Dulbecco’s phosphate buffer saline (DPBS), fetal bovine serum (FBS), and mannitol (Man) were of analytic grade and obtained from Sigma-Aldrich (Italy). Rapamycin (Rapa) was purchased from Accel Pharmatech (US).
1H-NMR spectra were registered by a Bruker Avance II-300 spectrometer, working at 300 MHz (Bruker, Milan, Italy).
Size exclusion chromatography (SEC) analysis was performed by a system from Waters (Mildford, MA) equipped with two columns (Phenogel, 5-μm particle size, pore size: 103 Å and 104 Å) from Phenomenex, and a refractometer. Elution parameters: 50 °C, flow of 0.8 mL/min; eluent: DMF solution of 0.01 M LiBr. Standards: PEGs (range 145–1.5 kDa). Sample preparation: dispersion in the eluent (2.5 mg/mL) and filtration (0.2 μm). Each analysis was conducted in triplicate.
α,β-Poly(N-2-hydroxyethyl)-d,l-aspartamide (PHEA) and PHEA-g-RhB were properly synthesized by following procedures already reported in literature [28].
PHEA-g-RhB 1H‐NMR (300 MHz, D2O, 25 °C, TMS): δ 1.15 (12HRhB CH3CH2–); δ 2.71 (2HPHEA –COCHCH2CONH–); δ 3.29 (2HPHEA –NHCH2CH2O–); δ 3.58 (2HPHEA –NHCH2CH2O–); δ 4.65 (1HPHEA –NHCH(CO)CH2–); δ 8.00–8.50 (10HRhB H-Ar). The \({\overline{M} }_{w}\) of PHEA-g-RhB used in this study was 52.5 Da (\({\overline{M} }_{w}/{\overline{M} }_{n}\) = 1.6). The degree of derivatization in RhB (DDRhB), determined from the 1H-NMR spectra, as reported elsewhere, was equal to 0.6 ± 0.05 mol% [29].
Poly-ɛ-caprolactone-succinate (SUCC-PCL) was synthesized and characterized as reported elsewhere [27, 30].
Synthesis and characterization of PHEA-g-RhB-g-SUCC-PCL graft copolymer
A modified synthetic procedure was followed to synthesize PHEA-g-RhB-g-SUCC-PCL graft copolymer with proper derivatization degree (DD%) [30]. Briefly, to an organic PHEA-g-RhB dispersion in a-DMF (33 mg/mL), DEA was added as catalyst according to R2 = 0.3 that is the molar ratio between DEA and those of repeating units (RUs) of PHEA-g-RhB carrying hydroxyl groups. At the same time, on the basis of R1 = 3 (that is the mole ratio between CDI and PCL-SUCC), the calculated amount of CDI was added to the organic PCL-SUCC dispersion (66.5 mg/mL in a-DMF), and the resulting mixture was putted at 40 °C for 5 h. After this time, the PHEA-RhB dispersion was added dropwise to that of CDI-activated PCL-SUCC according to the molar ratio between PCL-SUCC and those of PHEA-g-RhB RUs equal to R3 = 0.12. The resulting mixture was left at 40 °C for 68 h, then the product was recovered by precipitation in diethyl ether, separated from the supernatant by centrifugation (at 4 °C for 15 min, at 9800 rpm), and washed three times with a diethylether:dichloromethane mixture (4:1 v/v). The obtained product was dissolved in DMA, purified by dialysis against water (MWCO 12–14 kDa), and freeze-dried.
1H-NMR (300 MHz, [D7].DMF, 25 °C, TMS): δ 1.13 (m, 12HRhB CH3CH2–); δ 1.5 and 2.1 (m, 6HPCL –[O(O)CCH2(CH2)3CH2]122–);δ 2.5 (2d, 2HPCL –[O(O)CCH2(CH2)3CH2]122–); δ 2.8 (m, 2HPHEA –C(O)CHCH2C(O)NH–); δ 3.2 (t, 2HPHEA –NHCH2CH2O–); δ 3.50 (t, 2HPHEA –NHCH2CH2O–); δ 4.3 (t, 2HPCL –[O(O)CCH2(CH2)3CH2]122–), and δ 5.0 (m, 1HPHEA –NHCH(CO)CH2–); δ 7.00–8.00 (m, 10HRhB H-Ar).
PEGylation of PHEA-g-RhB-g-SUCC-PCL graft copolymer
PEGylation of PHEA-g-RhB-g-SUCC-PCL to obtain PHEA-g-RhB-g-SUCC-PCL-g-PEG graft copolymer was done as already reported for similar copolymers [27, 31]. Briefly, to an organic a-DMA dispersion of PHEA-g-RhB-g-SUCC-PCL (64 mg/mL), TEA as catalyst, and DSC were added according to R4 = 0.1 (the molar ratio between DSC and moles of PHEA RUs carrying hydroxyl groups), and R5 = 1 (the molar ratio between TEA and moles of DSC). The obtained dispersion was placed to reach at 40 °C. After 4 h, the latter was added dropwise to an organic a-DMA dispersion of H2N-PEG (12 mg/mL), according to R6 = 0.075, being R6 the molar ratio between H2N-PEG and moles of PHEA-g-RhB-g-SUCC-PCL RUs carrying hydroxyl groups. After 18 h at 25 °C, the reaction mixture was purified by dialysis (MWCO 12–14 kDa) against distilled water and freeze-dried to recover the obtained copolymer. PHEA-g-RhB-g-SUCC-PCL-g-PEG graft copolymer was obtained with a yield of 240 wt% based on the starting PHEA-g-RhB-g-SUCC-PCL.
1H-NMR (300 MHz, [D7].DMF, 25 °C, TMS): δ 1.13 (m, 12HRhB CH3CH2–); δ 1.5 and 2.1 (m, 6HPCL –[O(O)CCH2(CH2)3CH2]122–); δ 2.5 (2d, 2HPCL –[O(O)CCH2(CH2)3CH2]122–); δ 2.8 (m, 2HPHEA –C(O)CHCH2C(O)NH–); δ 3.2 (t, 2HPHEA –NHCH2CH2O–); δ 3.50 (t, 2HPHEA –NHCH2CH2O–); δ 3.7 (t, 4HPEG –[CH2CH2O]44–); δ 4.3 (t, 2HPCL –[O(O)CCH2(CH2)3CH2]122–); and δ 5.0 (m, 1HPHEA –NHCH(CO)CH2–); δ 7.00–8.00 (m, 10HRhB H-Ar).
Nanoparticle production
Empty or Rapa-loaded pegylated nanoparticles (empty nano-PEG and Rapa-loaded nano-PEG, respectively) were obtained by nano-precipitation. In particular, a PHEA-g-RhB-g-SUCC-PCL-g-PEG graft copolymer dispersion of (1.5% w/v) in DMA (containing or not the drug at a concentration of 0.32% w/v) was placed in a burette and added dropwise to twice-distilled water (1:10 v/v). The mixture was left under stirring for 2 h, dialyzed against twice-distilled water, centrifuged, and filtered, and the obtained nanoparticle dispersion was stored at 5 °C before being used or for further characterization. To obtain empty and drug-loaded non-pegylated nanoparticles (empty and Rapa-loaded Nano), the procedure of nanoprecipitation was followed by using PHEA-g-RhB-g-SUCC-PCL graft copolymer. To obtain PCL-based nanoparticles (PCL nano), the same procedure was followed by using PCL as starting polymeric material.
Nanoparticle characterization
Size and ζ potential measurements
Hydrodynamic diameter (Z-average), polydispersity index (PDI), and ζ potential of each sample were determined by using a Malvern Zetasizer Nano ZSP instrument (Malvern Instrument, Malvern, UK), a He–Ne laser at λ = 632.8 nm, and at a fixed scattering angle of 175°. Each sample, freshly prepared or dispersed in ultrapure water, was analyzed at 25 °C [30]. Each measurement was repeated in triplicate.
XPS analysis
A PHI 5000 VersaProbe II (ULVAC-PHI, Inc.) was used to record XPS spectra of each sample, by using a monochromatic Al-Kα radiation (hν = 1486.6 eV) from an X-ray source operating at a spot size of 200 μm, a power of 50 W and an acceleration voltage of 15 kV.
Determination of drug loading
The drug loading (DL%), that is the Rapa amount loaded into each drug-loaded sample (nano-PEG or nano), and entrapment efficiency (EE%), expressed as the weight percent ratio between the amount of Rapa actually entrapped into the particles and the theoretical one, were assessed by HPLC analyses. In detail, a Waters Breeze System Liquid Chromatograph system was used, which was equipped with a Luna® C18 column (250 × 4.6 mm, 5 μm, from Phenomenex), an autosampler (40 μL as injected volume), and an UV − vis HPLC detector. Other parameters are as follows: a methanol:water 80:20 v/v solution as mobile phase, a flow rate of 1 mL/min, temperature equal to 25 °C, detection wavelength equal to 277 nm. By plotting peak areas (at retention time = 14 min) versus Rapa standard concentration values in methanol (range of 0.02 − 0.001 mg/mL), a calibration curve was built (y = 136,513x, R2 = 0.9994). Each sample was treated as follows: a proper amount was dissolved in DMA, added with methanol (1:9 v/v, 2.5 mg/mL) and the obtained dispersion filtered (with filters at a 0.45-μm pore size). The resulting solution was analyzed by HPLC. Each obtained peak area at 14 min was compared with the calibration curve.
Cell viability assay
Cell viability was assessed by a 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium (MTS) assay on 16HBE cells, using a commercially available kit (Cell Titer 96 Aqueous One Solution Cell Proliferation assay, Promega) containing MTS and phenazine ethosulfate. 16HBE cells were plated on a 96-well plate at a cell density of 15,000 cells/well in DMEM containing 10% FBS. After 24 h of incubation, the medium was removed, and then, the cells were incubated with 200 μL per well with an aqueous dispersion (DMEM containing 10% FBS) of empty nano-PEG or Rapa-loaded nano-PEG (at concentrations ranging between 0.05 and 0.75 mg/mL). Cell viability in the presence of free Rapa, at concentrations corresponding to those loaded into the Rapa-loaded Nano-PEG sample, was also evaluated. All dispersions were sterilized by filtration using 220-nm filter. After 24- and 48-h incubation, supernatant was removed and each plate was washed with sterile DPBS; after this, cells in each well were incubated with 100 μL of fresh DMEM and 20 μL of a MTS solution, and plates were incubated for 2 h at 37 °C. The absorbance at 490 nm was read using a microplate reader (Multiskan Ex, Thermo Labsystems, Finland). Relative cell viability (percentage) was expressed as (Abs490 treated cells/Abs490 control cells) × 100, based on three experiments. Cells incubated with the medium were used as negative control.
Production of NiM particles
NiM formulations were obtained by following a previously reported procedure [26]. In detail, the spray drying process was carried out by using a Buchi Nano Spray Dryer B-90. Liquid feed aqueous dispersions containing Rapa-loaded nano-PEG or Rapa-loaded nano (0.75 mg/mL) and Man (1 g/100 mL) (nanoparticles/Man 1:13 weight ratio) were used to obtain, respectively, NiM(Rapa/PEG) or NiM(Rapa) samples. Before use, each dispersion was sorted through a 1.2-μm filter and then spray-dried with a large spray nebulizer at the inlet temperature of 100 °C. Filtered and dehumidified air was used as the drying gas; the drying gas flow rate was 120 L/min resulting in an inside pressure of 27 mbar with a spray rate of 78% and pump 66%. Each collected NiM sample was appropriately stored at − 20 °C before analysis.
The amount of Rapa loaded into each NiM sample was determined by HPLC. In detail, a known amount of NiM was dissolved in a mixture of DMA and methanol (2.5 mg/mL) for almost 2 h, the obtained dispersion was filtered (0.45 μm), and the supernatant was analyzed by HPLC following the method reported above.
NiM characterization
SEM and OM analyses
NiM(Rapa/PEG) sample was laid on a double-sided adhesive tape, previously applied on a stainless steel stub, which was then sputter-coated with gold prior to microscopy examination, and then observed by using by using a Phenom™ ProX Desktop SEM microscope.
The OM analysis was conducted by recording transmittance images of NiM(Rapa/PEG) dispersed in paraffin oil with a ZEISS optical microscope, using the AxioVision software.
The ImageJ program was used to calculate the average diameter of each sample from either SEM or OM images by analyzing a sufficiently representative number to constitute a certain datum (> 500 particles).
Drug stability
The Rapa stability was evaluated in physiologic conditions mimicking fluid by quantifying the amount of intact drug over time. In particular, a known amount of Rapa (0.09 mg), free or loaded into NiM(Rapa/PEG), was dispersed in 30 mL of simulated lung fluid (SLF4) (MgCl2 (0,2033 g/L), NaCl (6.0193 g/L), KCl (0.2982 g/L), Na2SO4 (0.0710), CaCl2 dihydrate (0,3676 g/L), sodium acetate (0.9526 g/L), NaHCO3 (2.6043), sodium citrate dihydrate (0.0970 g/L), NaH2PO4 monohydrate (0.1420), dipalmitoylphosphatidylcholine (DPPC, 0,02 w/v%)), or cell medium (Dulbecco’s phosphate-buffered saline (DPBS):fetal bovine serum (FBS) (90:10 v/v) mixture) [32]. At fixed times (0, 1, 2, 4, 7, 12, 16, and 24 h), each dispersion was freeze-dried and properly treated in order to recover the intact drug. For free Rapa stability, each freeze-dried sample was treated with 7 mL of methanol, while for Rapa-loaded NiM(Rapa/PEG), the freeze-dried sample was treated with 2 mL of DMA and 5 mL of methanol. Then, the obtained organic dispersions were centrifuged and the supernatants were analyzed by HPLC.
Drug release
The Rapa release profile was evaluated in physiologic conditions mimicking fluid by quantifying the amount of intact drug released from the sample over time. In particular, a known amount of Rapa (0.09 mg) loaded into NiM(Rapa/PEG), was dispersed in 30 mL of simulated lung fluid (SLF4), or cell medium [32]. At fixed times (0, 1, 2, 4, 7, 12, 16, and 24 h), each dispersion was ultra-centrifuged; the supernatant was freeze-dried and properly treated in order to recover the intact drug. In particular, the freeze-dried sample was treated with 1.5 mL of methanol. Then, the obtained organic dispersions were centrifuged, and the supernatants were analyzed by HPLC.
NIM aerodynamic behavior
The aerosolization properties of NiM(Rapa/PEG) were tested after delivery from breath-activated reusable DPIs working with single unit capsule containing the dry powder using a next-generation impactor (NGI) (Copley Scientific, UK) according to Ph. Eur. 10th Ed. Two devices with different resistances to the airflow were tested: the low-resistance DPI RS01 (Plastiape, Italy) and the medium-resistance DPI TurboSpin® (PH&T Pharma, Italy. For each test, a hard gelatin capsule (size 2, Capsugel, USA) was filled with about 20 mg of the powder and placed in the DPI. The NGI was activated at 60 or 90 L/min, respectively, for TurboSpin® and RS01.
The powder deposited on the seven NGI collection cups, in the induction port and in the micro-orifice collector (MOC), was quantitatively recovered by dissolution in an appropriate amount of DMF. The amount of NiM in the samples was determined by spectrofluorimetric analysis at λex = 520 nm. A calibration curve was derived from serial dilutions of a standard solution of fluorescent NiM (2.5 mg/mL) in DMF (0.0125–1.25 mg/mL concentration range, R2 ≥ 0.99).
The experimental mass median aerodynamic diameter (MMADexp) was calculated according to Ph.Eur. deriving a plot of cumulative mass of powder deposited in each collection cup versus cut-off diameter of the respective stage. The fine particle fraction (FPF) was calculated considering the actual amount of NiMs deposited on stages with MMAD < 5 μm as compared to the initial amount loaded into the DPI (nominal dose of NiMs). The respirable fraction (RF) was defined as the percentage of NiMs deposited on stages with MMAD < 5 μm as compared to the total dose of NiMs deposited in the NGI.
Interaction with artificial mucus
Rheological analysis
Measurements of interactions between each chosen sample and mucin were determined by rheological analysis at the temperature of 37 °C by using a rheometer (TA Instruments) equipped with concentric cylinders geometry. A strain sweep (5–30%) was performed on mucin dispersion at 1.0 Hz to determine the linear viscoelastic region, which was found to be in the range of 10–20%. Then, a time sweep (30 min) was performed for all samples at 15% constant strain and 1.0 Hz constant frequency to determine complex viscosity (η*). Chosen samples were as follows: NiM(Rapa/PEG) (corresponding to 14 mg of Rapa-loaded nano-PEG), NiM(Rapa) (corresponding to 14 mg of Rapa-loaded nano), free Rapa (at a concentration corresponding to the drug loaded into the nanoparticles), and chitosan as positive control. For the analyses of mucin-sample mixture, a certain amount of each sample was added to 14 mL of mucin dispersion in PBS (1 mg/mL) and mixed gently with a spatula for 20 s. Obtained dispersion was loaded in the rheometer and then equilibrated to 37 °C for 20 min. To prevent dehydration during rheological measurements, a solvent trap was placed on the top of the geometry.
Turbidimetric analysis
Measurements of interactions between nanoparticles and mucin were determined by turbidimetry. A proper amount of NiM, corresponding to 0.2 mg of Nano-PEG were dispersed in 190 µL of PBS, were mixed with 10 µL of mucin dispersion at the concentration of 20 mg/mL in PBS. Analyzed samples were as follows: NiM(Rapa/PEG), NiM(Rapa), and free Rapa (at the concentration corresponding to the drug loaded into the nanoparticles). After incubation at 37 °C, the turbidity was measured each 50 min until 6 h. The transmittance at the λ of 570 nm was recorded by microplate reader (Multiskan Ex, Thermo Labsystems, Finland). The value obtained from a mucin-free dispersion of each sample was subtracted from each transmittance value. Data were expressed as a percentage ratio between the transmittance of the sample and the transmittance of the 1 mg/mL mucin dispersion.
Muco-diffusion assay
The capability of the Nano-PEG to diffuse through a mucin dispersion was evaluated using a diffusion test, as reported elsewhere [26]. Sixty milligrams of agarose was dispersed in 20 mL of distilled water, and the dispersion was heated until a clear solution was obtained; 1.3 mL of this dispersion was deposited in several 4-mL vials, allowed to harden at room temperature and stored at 4 °C until use. Subsequently, 2 mL of mucin dispersion (1 mg/mL in PBS) was placed on the hardened agarose gel, and 600 μL of a NiM(Rapa/PEG) or NiM(Rapa) aqueous dispersion (5 mg/mL) was placed on the mucin layer and incubated at 37 °C. At regular time intervals (2, 4, 6, 8, and 24 h), the mucin layer containing each sample was removed; the remaining agarose gels were rinsed three times with 2 mL of distilled water, dissolved at 60 °C, and analyzed by UV spectrophotometry, at the λ of 561 nm.
Statistical analysis
All the experiments were repeated at least three times. All data are expressed as means ± standard deviation. All data were analyzed by Student’s t test. A p-value < 0.05 was considered statistically significant, while a p-value < 0.01 was considered highly significant.