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Title:
Topical delivery of vaccines
United States Patent: 7,731,968
Issued: June 8, 2010
Inventors: Mikszta; John A.
(Durham, NC), Brittingham; John M. (Wake Forest, NC), Alarcon; Jason
(Raleigh, NC), Pettis; Ronald J. (Durham, NC), Dekker, III; John P. (Cary,
NC)
Assignee: Becton, Dickinson and
Company (Franklin Lakes, NJ)
Appl. No.: 11/851,956
Filed: September 7, 2007
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Executive MBA in Pharmaceutical Management, U. Colorado
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Abstract
The present invention provides improved
methods for delivery of substances into the skin. It has been discovered
that delivery of substances such as nucleic acids, amino acids, amino acid
derivatives, peptides and polypeptides simultaneously with abrasion of the
skin enhances delivery and the biological response as compared to
application of the substance to previously abraded skin.
Description of the
Invention
FIELD OF THE INVENTION
This Invention relates to topical delivery of substances into the skin,
particularly by disruption of the stratum corneum and delivery of the
substance to the epidermal layer beneath.
BACKGROUND OF THE INVENTION
Delivery of substances to the body through the skin has typically been
invasive, involving needles and syringes to facilitate intradermal (ID),
intramuscular (IM) or subcutaneous (SC) injection. These methods are
painful for the subject, require the skills of a trained practitioner and
often produce bleeding. There have more recently been efforts to overcome
these disadvantages by use of devices which disrupt or abrade the stratum
corneum, the thin external layer of keratinized cells about 10-20 .mu.m
thick which serves as the skin's outer barrier, with delivery of the
desired substance to the exposed epidermis. The substance can then diffuse
through the epidermis to the dermis which contains blood vessels and
lymphatics for absorption and delivery of the substance throughout the
body. For topical delivery of vaccines, the epidermis itself is a
particularly desirable target for drug delivery as it is rich in antigen
presenting cells. In comparison, the dermis contains fewer antigen
presenting cells. The stratum corneum and epidermis do not contain nerves
or blood vessels, so this method has the advantage of being essentially
painless and blood-free while giving access to the skin layers capable of
responding to the antigen.
The prior art reports a variety of devices and methods for disrupting the
stratum corneum for the purpose of delivering substances to the body. For
example, breach of the stratum corneum may be achieved by puncturing as
taught in U.S. Pat. No. 5,679,647 to Carson, et al. This patent teaches
that narrow diameter tynes, such as those found on devices used for
tuberculin skin tests and allergy tests, can be coated with
polynucleotides and used for delivery of such materials into the skin. The
method of using such devices involves puncturing the skin with the tynes
resulting in intracutaneous injection of the coated substance. This is in
contrast to the present invention, where it has been unexpectedly
discovered that substances coated onto the surface of narrow diameter
micro-protrusions are delivered more effectively by lateral abrasion
across the skin surface rather than by puncturing. U.S. Pat. No.
5,003,987; U.S. Pat. No. 5,879,326; and U.S. Pat. No. 3,964,482 teach
breaching the stratum corneum by abrasion, however, little is known about
how to optimize topical application methods to achieve efficient and
efficacious delivery by this route. Such optimization is of particular
interest for topical nucleic acid delivery, especially topical delivery of
nucleic acid-based vaccines and gene therapies. In this regard, the most
commonly suggested method for topical administration is to abrade the skin
prior to application of the vaccine. However, it has now been unexpectedly
found that delivery of nucleic acids and peptides or polypeptides such as
allergens is more efficient and more efficacious when the substance is
delivered simultaneously with abrasion.
SUMMARY OF THE INVENTION
The present invention provides optimized methods for topical delivery of
substances, particularly nucleic adds, amino acids, amino acid
derivatives, peptides or polypeptides. It has been discovered that nucleic
adds exhibit enhanced gene expression and produce an enhanced immune
response to the expressed protein when they are delivered simultaneously
with abrasion of the stratum corneum. Similarly, allergens delivered
simultaneously with abrasion produce a more vigorous immune response than
conventional allergen testing methods.
DETAILED DESCRIPTION OF THE INVENTION
The term "abrasion" as used herein refers to disruption of the outer
layers of the skin, for example by scraping or rubbing, resulting in an
area of disrupted stratum corneum. This is in contrast to "puncturing"
which produces discrete holes through the stratum corneum with areas of
undisrupted stratum corneum between the holes. According to the methods of
the invention, substances such as nucleic acid-based vaccines and peptides
or polypeptides are applied to the skin simultaneously with abrasion
rather than being applied to previously abraded skin. That is, the
substance is abraded into the skin rather than being passively applied to
skin which has been previously abraded. This method results in improved
delivery and response as compared to post-abrasion application.
The substance may be delivered into the skin in any pharmaceutically
acceptable form, but a liquid or gel formulation is preferred. In one
embodiment the substance is applied to the skin and an abrading device is
then moved or rubbed reciprocally over the skin and the substance. It is
preferred that the minimum amount of abrasion to produce the desired
result be used. Determination of the appropriate amount of abrasion for a
selected substance is within the ordinary skill in the art. In another
embodiment the substance may be applied in dry form to the abrading
surface of the delivery device prior to application. In this embodiment, a
reconstituting liquid is applied to the skin at the delivery site and the
substance-coated abrading device is applied to the skin at the site of the
reconstituting liquid. It is then moved or rubbed reciprocally over the
skin so that the substance becomes dissolved in the reconstituting liquid
on the surface of the skin and is delivered simultaneously with abrasion.
Alternatively, a reconstituting liquid may be contained in the abrading
device and released to dissolve the substance as the device is applied to
the skin for abrasion. It has been found that nucleic add preparations may
also be coated on the abrading device in the form of a gel, although the
improvement in gene expression is not as significant as in certain other
embodiments of the invention.
Any device known in the art for disruption of the stratum corneum by
abrasion can be used in the methods of the invention. These include, for
example, miroelectromechanical (MEMS) devices with arrays of short
microneedles or microprotrusions, sandpaper-like devices, scrapers and the
like. If the abrading device does not include a reservoir for containment
and discharge of fluids from the device, the substance-containing liquid
or the reconstituting liquid must be separately applied to the skin prior
to abrading, for example from a separate dispenser or pump. However,
reservoirs may be an integral part of the abrading device. Typically the
reservoir is in fluid communication with the abrading surface of the
device, for example via channels through the needles or protrusions, or
via channels which exit the reservoir between such needles or protrusions,
or via porous materials. In this embodiment, the substance or
reconstituting liquid is contained in the reservoir of the abrading device
and is dispensed to the skin surface prior to abrasion or simultaneously
with abrasion. The abrading device may also include means for controlling
the rate of delivery of the substance or reconstituting liquid, or for
controlling the amount of substance or reconstituting liquid delivered.
Nucleic acids for use in the methods of the invention may be RNA or DNA.
They may be in any physical form suitable for topical administration and
for uptake and expression by cells. It may be contained in a viral vector
or liposome, or it may be delivered as a free polynucleotide such as a
plasmid as is known in the art. The nucleic acid will typically be
formulated in a pharmaceutically acceptable formulation such as a fluid or
gel which is compatible with the nucleic acid. Pharmaceutically acceptable
peptide and polypeptide formulations for use in the invention, including
formulations for allergen compositions, are also well known in the art.
It has been found that minimal abrasion (as little as one pass over the
skin) is sufficient to produce an improvement in nucleic acid delivery to
skin cells. The amount of nucleic acid delivery and expression continues
to increase with increasing numbers of abrasive passes over the skin. Six
abrasive passes or more gave the maximum improvement in nucleic acid
delivery in our experimental systems. Although all abrasive passes over
the skin may be in the same direction, it is preferred that the direction
be altered during abrasion. The most commonly used protocol for delivery
of nucleic add vaccines today is IM injection, usually with additional
response enhancers when the dose is low. Determination of the appropriate
dose of nucleic acid vaccine to be delivered using the methods of the
invention is within the ordinary skill in the art. However, it is an
advantage of the inventive methods that delivery of nucleic add vaccines
is more efficient than IM delivery even without response enhancers, as
evidenced by levels of gene expression and stimulation of an immune
response.
Amino adds, amino add derivatives, peptides and polypeptides, particularly
allergens, may also be delivered topically according to the methods of the
invention. Allergens are conventionally delivered into the skin by
intracutaneous puncture using devices similar to the tuberculin tyne test.
However, it has been unexpectedly found that an enhanced allergenic
response can be obtained by simultaneous abrasion and delivery. This
produces a more sensitive test and has the advantage that a minor or
imperceptible response to the conventional allergen test may be more
easily detected using the methods of the invention.
EXAMPLE 1
Delivery of Plasmid DNA Using a Solid Microneedle Array
Plasmid DNA (35 .mu.g) encoding firefly luciferase was administered to
anesthetized BALB/c mice by IM injection or ID injection with a standard
30 g needle and 1 cc syringe, or was administered topically using a 200 .mu.m
silicon microneedle array. Two protocols were used for DNA administration
using the microneedle array: 1) Simultaneous abrasion and delivery (ABRdel):
Mice were shaved on the caudal dorsum using electric clippers, followed by
a No. 10 scalpel blade to remove remaining hair. The DNA solution was then
applied to a 1 cm.sup.2 site on the skin surface and the microneedle array
was placed in contact with this solution and moved laterally in
alternating direction six times across the skin surface (three passes in
each direction). The DNA solution was left to air dry and the skin site
was left uncovered until skin biopsies were recovered. 2) Pre-abrasion (preABR):
After shaving as described above, a 1 cm.sup.2 site was pre-abraded by
lateral movement of the microarray across the skin surface six times with
alternating direction (three passes in each of two directions). The DNA
solution was then spread over the abraded skin surface and left to air dry
as above.
As a control for possible DNA delivery through hair follicles or nicks
resulting from the shaving process, animals were shaved as above but were
not abraded with the microarray (noABR). The DNA solution was applied
topically to the 1 cm.sup.2 shaved skin site and left to air dry.
In all groups, tissue samples were collected 24 hr. after DNA
administration. Tissue homogenates were analyzed for luciferase activity
using a luminescence assay. All samples were normalized for total protein
content, as determined by a standard BCA protein assay. Data were
expressed as Relative Light Units (RLU) per mg of total protein and
results are shown in FIG. 1 (see Original Patent). Each symbol represents
the response of a single mouse. Cumulative data from two separate
experiments are shown (n=6 for each group). The levels of luciferase gene
expression attained following ABRdel were similar in magnitude to
needle-based IM and ID injections and significantly greater (p=0.02) than
for topical delivery onto preabraded or unabraded skin.
EXAMPLE 2
Correlation of Delivery with Number of Abrasive Passes
Luciferase plasmid DNA (35 .mu.g) was administered by ABRdel as described
in Example 1, but the number of lateral passes of the device across the
skin surface was varied (12, 10, 6, 4 and 2 times). In addition, after
placing the DNA solution on the surface of shaved but unabraded skin, the
microneedle array was repetitively pressed against the skin (six times) to
simulate puncture-mediated delivery. Topical application of the DNA
solution in the absence of abrasion (noABR) was included as a control for
possible DNA delivery through hair follicles or nicks. Skin biopsies (1
cm.sup.2) were collected 24 hr. after application and were assayed for
luciferase activity as described in Example 1.
The results are illustrated in FIG. 2 (see Original Patent). Each symbol
represents the response of a single mouse, and n=3 for all groups except
for "x12" and "x6" in which n=5. Increasing levels of gene expression were
attained with increasing numbers of passes of the microneedle array across
the skin surface. Mean levels of expression ranged from greater than
1,000- to 2,800-fold above noABR controls in groups treated by six or more
abrasions. Mean responses following 4, 2, or 1 pass of the device across
the surface of the skin were about 300-, 200- and 30-fold above
background, respectively. Mean levels of expression in the "puncture"
group were only 2-fold above background and were not significantly
different from noABR controls.
These data demonstrate that the abrasion process is a critical component
of topical delivery of DNA into the skin. Increased levels of gene
expression were attained by increasing the number of abrasive passes of
the abrader device, although gene expression was observed after even a
single pass. In addition, laterally rubbing or abrading the skin
significantly increased nucleic acid delivery and gene expression as
compared to repetitively pressing the microneedle array against the skin
without lateral abrasion.
EXAMPLE 3
Formulation of Nucleic Acid Vaccines
Luciferase plasmid (35 .mu.g) was administered as a liquid formulation by
ID injection or by simultaneous abrasion and delivery ("ABRdel liquid")
with six passes of the microneedle device across the skin surface as
described in Example 1. In addition, the DNA was lyophilized to a powder
and coated onto the surface of the microneedle array and administered by
simultaneous abrasion and delivery either directly as a powder ("ABRdel
powder") or upon reconstitution in PBS buffer at the time of application
("ABRdel powder/recon"). Reconstitution was accomplished by placing the
powder-coated array in direct contact with a droplet of PBS on the surface
of the skin, followed by simultaneous abrasion and delivery. Microneedle
arrays were also coated with DNA dissolved in 0.5% agarose gel and
administered by simultaneous abrasion and delivery as described above ("ABRdel
gel"). Topical application of the liquid formulation in the absence of
abrasion (noABR) was included as a control. Skin biopsies (1 cm.sup.2)
were collected 24 hr. after application and were assayed as described in
Example 1.
The results are shown in FIG. 3 (see Original Patent). Each symbol
represents the response of a single mouse. Cumulative data from two
separate experiments are shown, where n=6 for each group. Similar levels
of luciferase expression in the skin (about 20-30 fold above noABR) were
observed for the ID injection, ABRdel liquid and ABRdel powder/recon
groups. Although neither direct delivery of gel or powder-coated DNA
without reconstitution resulted in gene expression statistically above the
noABR control, responses following direct gel-based delivery were about
2-10 fold higher than the mean control response. These results demonstrate
that reconstitution of a dry form of the vaccine at the time of
simultaneous abrasion and delivery produces results comparable to
simultaneous abrasion and delivery of a liquid vaccine formulation. This
has advantages for commercial application of the methods, as an abrader
device with a liquid-filled reservoir could be pre-coated with the vaccine
powder for reconstitution of the vaccine as it is applied by abrasion.
EXAMPLE 4
Antibody Response to Topical Delivery of Plasmid DNA
Plasmid DNA encoding the Hepatitis B surface antigen (HbsAg) was
administered to anaesthetized BALB/c mice by IM or ID injection with a
standard 30 g needle and 1 cc syringe, or was administered topically using
a 200 .mu.m silicon solid microneedle array according to the ABRdel
protocol of Example 1. Mice were given a total of three immunizations of
100 .mu.g per dose. Serum samples were analyzed by ELISA for antibodies to
HbsAg (total Ig) 2-3 weeks following each immunization. DNA was applied
topically to shaven but unabraded (noABR) skin as control for possible
delivery through nicks or hair follicles. Data represent an anti-HbsAg
titer, defined as the highest dilution of a serum sample yielding
absorbance values at least three times above background (serum obtained
from naive, unimmunized mice).
A total of ten mice per group were analyzed. Mean titers are represented
as bars in FIG. 4 (see Original Patent), With the responses of individual
mice indicated as open symbols. The results indicate that the ABRdel
protocol induces strong serum antibody responses in vivo. The magnitude of
such responses were significantly greater (p<0.05 after immunizations 2
and 3) than those induced via either IM (the current standard for
DNA-based vaccine delivery) and ID injections. In addition, the responses
following ABRdel were considerably less variable than those observed
following either standard needle-based injection route. Mean titers after
three immunizations were 12,160 for the ABRdel group, compared to 820
following IM injection and 4800 via ID injection. Notably, the ABRdel
approach was the most effective delivery route following two
Immunizations; 100% (10/10) of animals treated via ABRdel seroconverted
after two immunizations, compared to 40% (4/10) via the IM route and 50%
(5/10) via ID injection. None of the animals administered plasmid DNA
topically in the absence of abrasion mounted a detectable antibody
response. Further characterization of the antibody isotypes revealed that
ABRdel induces a similar mixed response as standard needle-based IM and ID
injections, consisting of both IgG1 and IgG2a. These results are in
contrast to previously described intradermal vaccinations using the gene
gun, in which antibody responses consisted exclusively of IgG1 in the
absence of IgG2a (e.g., see McCluskie, M J et al., Molecular Medicine
5:287, 1999).
EXAMPLE 5
Topical Delivery of Allergens
Histamine dihydrochloride (2.5 mg) was administered to the skin of
anaesthetized swine by simultaneous abrasion and delivery using a 200 .mu.m
silicon solid microneedle array, as described in Example 1 (ABRdel; 4
passes of the device across the skin surface). The histamine was
formulated either as a liquid or as a lyopholized powder which was coated
onto the surface of the microarray and reconstituted in water directly on
the skin at the time of application. For comparison, histamine solution
was placed as a droplet onto the surface of the skin, immediately after
which a tyne-like device was placed in contact with this solution and used
to puncture the skin. This tyne-like device consisted of seven metal 34 g
needles of 1 mm length, similar to commercially available devices used in
allergen testing. Adjacent skin sites were treated with the microarray or
the tyne-like puncturing device in the absence of histamine in order to
monitor skin reactions due to the devices rather than the effects of
histamine. Additional controls included skin sites treated with histamine
topically in the absence of abrasion or puncture. Skin sites were
monitored for immediate inflammatory reactions including redness, swelling
and the appearance of a wheal-and-flare.
Vigorous inflammatory reactions were observed at skin sites treated with
histamine via the solid microneedle array. Severe erythema and swelling
(up to 2 mm of raised tissue) were observed across the entire area of
histamine treated skin, whereas sites treated with the device in the
absence of histamine displayed only mild redness along the path of
abrasion in the complete absence of swelling. Similarly intense reactions
were observed with both liquid and reconstituted powder histamine
formulations. Skin sites treated with the histamine solution using the
tyne-like puncturing device also displayed severe erythema and swelling,
although the response was localized to the points of contact of the tynes
and the immediate surrounding area. Skin sites treated topically with
histamine solution In the absence of abrasion or puncture were not
inflamed and appeared indistinguishable from normal, untreated skin.
Histamine dihydrochloride is used in the art as a model system for
evaluation of peptide and polypeptide allergens. These results indicate
that the described protocol of simultaneous abrasion and delivery can be
effectvely used for the topical administration of allergens which are
amino adds or amino acid derivatives, and predict similar results for
delivery of peptide or polypeptide allergens. Benefits of allergen
delivery by microabrasion compared to skin puncture include distribution
of the substance to a wider surface area of the skin, thus increasing the
reactogenic site compared to the localized distribution accomplished using
puncture with tyne-like devices. The increased area of distribution,
combined with beter targeting of the highly immune-stimulatory epidermal
tissue may increase the sensitivity of allergen testing compared to
current tyne-based skin puncture testing methods. In addition, by
targeting the shallow epidermal tissue above the capillary beds and
peripheral nerve net, delivery according to the current invention is
likely to be less invasive and safer than current testing methods.
Claim 1 of 13 Claims
1. A method for the targeted delivery of
a vaccine to the epidermal tissue of skin to enhance the immune response
comprising simultaneously disrupting only the stratum corneum and
delivering the vaccine wherein the vaccine is a powder on an abrading
surface of an abrading device to the epidermal tissue of the skin, wherein
the disruption of the skin is by abrading the skin with an abrader having
a microneedle array which is in contact with the vaccine wherein a
reconstituting liquid is separately applied to the skin prior to abrading. ____________________________________________
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