Abstract
Purpose. To investigate if pulmonary delivery of low molecular weight heparin (LMWH) formulated with tetradecyl-β-maltoside (TDM) or dimethyl-β-cyclodextrin (DMβCD) could be a feasible alternative to subcutaneous injections for the treatment of pulmonary embolism.
Methods. The pulmonary absorption of two LMWHs and unfractionated heparin formulated with TDM or DMβCD was studied in cell culture and rodent model. The in vitro study was performed by measuring the transport of radiolabeled enoxaparin and mannitol across human bronchial epithelial cells (Calu-3) in the presence or absence of varying concentrations of TDM or DMβCD. The changes in transepithelial electrical resistance (TEER) and enoxaparin metabolic stability were also investigated using Calu-3 cells. In vivo absorption studies were performed by measuring plasma anti-factor Xa activity after pulmonary administration of enoxaparin, dalteparin, or unfractionated heparin to anesthetized rats.
Results. In vitro experiments conducted in Calu-3 cells suggest that the addition of TDM or DMβCD to the apical chamber results in a significant increase in 3H-enoxaparin and 14C-mannitol permeability and a decrease in TEER across the Calu-3 cell monolayer. Enoxaparin incubated in Calu-3 cell extracts was stable for 8 h. In vivo studies indicate that both TDM and DMβCD enhance pulmonary absorption of LMWH. However, TDM was found to be more potent than DMβCD in both in vitro transport and in vivo absorption studies.
Conclusions. TDM and DMβCD enhance pulmonary absorption of LMWH both in vitro and in vivo, with TDM being more efficacious than DMβCD. Both agents increase drug transport by acting mainly on the membrane rather than interacting with the drug.
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REFERENCES
R. D. Hull, G. E. Raskob, R. F. Brant, G. F. Pineo, G. Elliott, P. D. Stein, A. Gottschalk, K. A. Valentine, and A. F. Mah. Low molecular weight heparin vs heparin in the treatment of patients with pulmonary embolism. Arch. Intern. Med. 160:229–236 (2000).
F. A. Anderson, H. B. Wheeler, and R. J. Goldberg. A popula-tion-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. Arch. Intern. Med. 151:933–938 (1991).
P. A. Howard. Dalteparin: a low-molecular-weight heparin. Ann. Pharmacother. 31:192–203 (1997).
R. J. Hughes, R. J. Hopkins, S. Hill, M. Weatherall, N. Van de Water, M. Nowitz, D. Milne, J. Ayling, M. Wilsher, and R. Beas-ley. Frequency of venous thromboembolism in low to moderate risk long distance air travelers: the New Zealand Air Traveller's Thrombosis (NZATT) study. Lancet 362:2039–2044 (2003).
S. M. Erdman, S. K. Chuck, and K. A. Rodvold. Thromboembolic Disorders. In J. T. Dispiro, R. L. Talbert, G. C. Yee, G. R. Matzke, B. G. Wells, and L. M. Posey (eds.), Pharmacotherapy, A Pathophysiogic Approach, 4th Ed, Appleton & Lange, New York, 1999, pp. 295–326.
S. Kaul and P. K. Shah. Low molecular weight heparin in acute coronary syndrome: Evidence for superior or equivalent efficacy compared with unfractionated heparin. J. Am. Coll. Cardiol. 35: 1699–1712 (2000).
R. I. Shulman. Assessment of low-molecular-weight heparin trials in cardiology. Pharm. Ther. 87:1–9 (2000).
D. J. Pillion, F. Ahsan, J. J. Arnold, B. M. Balusubramanian, O. Piraner, and E. Meezan. Synthetic long-chain alkyl maltosides and alkyl sucrose esters as enhancers of nasal insulin absorption. J. Pharm. Sci. 91:1456–1462 (2002).
A. Hussain, T. Yang, A. A. Zaghloul, and F. Ahsan. Pulmonary absorption of insulin mediated by tetradecyl-beta-D-maltoside and dimethyl-beta-cyclodextrin. Pharm. Res. 20:1551–1557 (2003).
E. Marttin, J. C. Verhoef, and F. W. H. M. Merkus. Efficacy, safety and mechanism of cyclodextrins as absorption enhancers in nasal delivery of peptide and protein drugs. J. Drug Target. 6:17–36 (1998).
T. Irie and K. Uekama. Cyclodextrins in peptide and protein delivery. Adv. Drug Del. Rev. 36:101–123 (1999).
F. Mustafa, T. Yang, M. A. Khan, and F. Ahsan. Chain length dependent effects of alkylmaltosides on nasal absorption of enoxaparin. J. Pharm. Sci. 93:675–683 (2004).
T. Yang, A. Hussain, J. Paulson, T. J. Abbruscato, and F. Ahsan. Cyclodextrins in nasal delivery of low molecular weight heparins: in vivo and in vitro Studies. Pharm. Res. 21:1127–1136 (2004).
P. Augustijns, P. Annaert, P. Heylen, G. Van den Mooter, and R. Kinget. Drug absorption studies of prodrug ester using the Caco-2 model: evaluation of ester hydrolysis and transepithelial transport. Int. J. Pharm. 166:45–53 (1998).
K. A. Foster, M. L. Avery, M. Yazdanian, and K. L. Audus. Characterization of the Calu-3 cell line as a tool to screen pul-monary drug delivery. Int. J. Pharm. 208:1–11 (2000).
I. Pezron, R. Mitra, D. Pal, and A. K. Mitra. Insulin aggregation and asymmetric transport across human bronchial epithelial cell monolayers (Calu-3). J. Pharm. Sci. 91:1135–1146 (2002).
F. Ahsan, J. J. Arnold, T. Yang, E. Schiewbert, E. Meezan, and D. J. Pillion. Effects of the permeability enhancers, tetradecyl-maltoside and dimethyl-β-cyclodextrin, on insulin movement across human bronchial epithelial cells (16HBE14o-). Eur. J. Pharm. Sci. 20:27–34 (2003).
F. Delie and W. Rubas. A human colonic cell line sharing simi-larities with enterocytes as a model to examine oral absorption: advantage and limitations of the caco-2 model. Crit. Rev. Ther. Drug Carrier Syst. 14:221–286 (1997).
J. R. Brown, J. H. Collett, D. Attwood, R. W. Ley, and E. E. Sims. Influence of monocaprin on the permeability of a diacidic drug BTA-243 across Caco-2 cell monolayers and everted gut sacs. Int. J. Pharm. 245:133–142 (2002).
P. Bianchini, G. L. Bergonzini, B. Parma, and B. N. Osima. Relationship between plasma anti-factor Xa activity and the anti-throbotic activity of heparins of different molecular mass. Hae-mostasis 25:288–298 (1995).
F. Ahsan, J. J. Arnold, E. Meezan, and D. J. Pillion. Enhanced bioavailability of calcitonin formulated with alkylglycosides fol-lowing nasal and ocular administration in rats. Pharm. Res. 18: 1742–1746 (2001).
J. J. Arnold, F. Ahsan, E. Meezan, and D. J. Pillion. Nasal ad-ministration of low molecular weight heparin. J. Pharm. Sci. 91: 1707–1714 (2002).
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Yang, T., Mustafa, F., Bai, S. et al. Pulmonary Delivery of Low Molecular Weight Heparins. Pharm Res 21, 2009–2016 (2004). https://doi.org/10.1023/B:PHAM.0000048191.69098.d6
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DOI: https://doi.org/10.1023/B:PHAM.0000048191.69098.d6
- dimethyl-β-cyclodextrin
- enoxaparin
- low molecular weight heparins
- permeability
- pulmonary absorption
- tetradecyl-β-maltoside
- transepithelial electrical resistance