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      Is Open Access

      An update on oral drug delivery via intestinal lymphatic transport

      review-article
      a , a , a , a , b ,
      Acta Pharmaceutica Sinica. B
      Elsevier
      Drug delivery, Oral, Lymphatic transport, Drug absorption, Chylomicron, Microfold cell, Drug carriers, Nanoparticles, ACQ, aggregation-caused quenching, ASRT, apical sodium-dependent bile acid transporter, AUC, area under curve, BCS, biopharmaceutics classification system, CM, chylomicron, DC, dendritic cell, DDT, dichlorodiphenyltrichloroethane, DTX, docetaxel, FA, fatty acid, FAE, follicle-associated epithelia, FRET, Föster resonance energy transfer, GIT, gastrointestinal tract, HBsAg, hepatitis B surface antigen, HIV, human immunodeficiency virus, LDL, low-density lipoprotein, LDV, Leu-Asp-Val, LDVp, LDV peptidomimetic, M cell, microfold cells, MG, monoglyceride, MPA, mycophenolic acid, MPS, mononuclear phagocyte system, OA, oleate, PCL, polycaprolactone, PEG-PLA, polyethylene glycol-poly(lactic acid), PEI, polyethyleneimine, PLGA, poly(lactic-co-glycolic acid), PVA, poly(vinyl alcohol), RGD, Arg-Gly-Asp, RGDp, RGD peptidomimetic, SNEDDS, self-nanoemulsifying drug delivery system, SEDDS, self-emulsifying drug delivery system, SLN, solid lipid nanoparticles, TEM, transmission electron microscopy, TG, triglyceride, TPGS, D-α-tocopherol polyethylene glycol 1000 succinate, TU, testosterone undecanoate, WGA, wheat germ agglutinin, YCW, yeast cell wall

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          Abstract

          Orally administered drug entities have to survive the harsh gastrointestinal environment, penetrate the enteric epithelia and circumvent hepatic metabolism before reaching the systemic circulation. Whereas the gastrointestinal stability can be well maintained by taking proper measures, hepatic metabolism presents as a formidable barrier to drugs suffering from first-pass metabolism. The pharmaceutical academia and industries are seeking alternative pathways for drug transport to circumvent problems associated with the portal pathway. Intestinal lymphatic transport is emerging as a promising pathway to this end. In this review, we intend to provide an updated overview on the rationale, strategies, factors and applications involved in intestinal lymphatic transport. There are mainly two pathways for peroral lymphatic transport—the chylomicron and the microfold cell pathways. The underlying mechanisms are being unraveled gradually and nowadays witness increasing research input and applications.

          Graphical abstract

          Orally administered molecular drugs and particulates could be absorbed alternatively via lymphatic transport. There are two main pathways—the chylomicron and M cell pathway—for efficient lymphatic transport.

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          Most cited references274

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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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              Nanoparticles as potential oral delivery systems of proteins and vaccines: a mechanistic approach.

              Peptides and proteins remain poorly bioavailable upon oral administration. One of the most promising strategies to improve their oral delivery relies on their association with colloidal carriers, e.g. polymeric nanoparticles, stable in gastrointestinal tract, protective for encapsulated substances and able to modulate physicochemical characteristics, drug release and biological behavior. The mechanisms of transport of these nanoparticles across intestinal mucosa are reviewed. In particular, the influence of size and surface properties on their non-specific uptake or their targeted uptake by enterocytes and/or M cells is discussed. Enhancement of their uptake by appropriate cells, i.e. M cells by (i) modeling surface properties to optimize access to and transport by M cells (ii) identifying surface markers specific to human M cell allowing targeting to M cells and nanoparticles transcytosis is illustrated. Encouraging results upon in vivo testing are reported but low bioavailability and lack of control on absorbed dose slow down products development. Vaccines are certainly the most promising applications for orally delivered nanoparticles.
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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
                09 April 2021
                August 2021
                09 April 2021
                : 11
                : 8
                : 2449-2468
                Affiliations
                [a ]Key Laboratory of Smart Drug Delivery of MOE, School of Pharmacy, Fudan University, Shanghai 201203, China
                [b ]Center for Medical Research and Innovation, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
                Author notes
                []Corresponding author. Tel./fax: +86 21 51980084. wuwei@ 123456shmu.edu.cn
                Article
                S2211-3835(21)00034-4
                10.1016/j.apsb.2020.12.022
                8424224
                34522594
                2a8e5ea9-3a88-4856-8817-8363192fb875
                © 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
                : 18 October 2020
                : 14 November 2020
                : 7 December 2020
                Categories
                Review

                drug delivery,oral,lymphatic transport,drug absorption,chylomicron,microfold cell,drug carriers,nanoparticles,acq, aggregation-caused quenching,asrt, apical sodium-dependent bile acid transporter,auc, area under curve,bcs, biopharmaceutics classification system,cm, chylomicron,dc, dendritic cell,ddt, dichlorodiphenyltrichloroethane,dtx, docetaxel,fa, fatty acid,fae, follicle-associated epithelia,fret, föster resonance energy transfer,git, gastrointestinal tract,hbsag, hepatitis b surface antigen,hiv, human immunodeficiency virus,ldl, low-density lipoprotein,ldv, leu-asp-val,ldvp, ldv peptidomimetic,m cell, microfold cells,mg, monoglyceride,mpa, mycophenolic acid,mps, mononuclear phagocyte system,oa, oleate,pcl, polycaprolactone,peg-pla, polyethylene glycol-poly(lactic acid),pei, polyethyleneimine,plga, poly(lactic-co-glycolic acid),pva, poly(vinyl alcohol),rgd, arg-gly-asp,rgdp, rgd peptidomimetic,snedds, self-nanoemulsifying drug delivery system,sedds, self-emulsifying drug delivery system,sln, solid lipid nanoparticles,tem, transmission electron microscopy,tg, triglyceride,tpgs, d-α-tocopherol polyethylene glycol 1000 succinate,tu, testosterone undecanoate,wga, wheat germ agglutinin,ycw, yeast cell wall

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