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      Current status and future prospects of needle-free liquid jet injectors.

      Nature reviews. Drug discovery
      Drug Delivery Systems, Growth Hormone, administration & dosage, Humans, Immunization, Injections, Jet, Insulin, Needles, Vaccines

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          Abstract

          Needle-free liquid jet injectors have been used for more than 50 years for parenteral delivery of vaccines and drugs. Although excellent bioavailability has been reported for a number of drugs, occasional pain and bruising have limited wide acceptance of jet injectors. This article reviews jet injectors with respect to their current clinical applications, emerging applications, mechanistic understanding and future prospects.

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          Most cited references55

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          Immune surveillance in the skin: mechanisms and clinical consequences

          Key Points The skin, together with other epithelial-cell interfaces with a hostile environment, supports a range of passive and active immune defence mechanisms. Cutaneous immune responses serve as a model for the study of interactions between innate and acquired immune mechanisms. Adaptive immune surveillance addresses the logistical challenge of targeting naive, effector and memory T cells to their respective sites of function by using distinct homing mechanisms at different stages of the immune response, termed primary, secondary and tertiary immune surveillance. Primary immune surveillance involves the process by which tissue dendritic cells are induced to engulf foreign particles, undergo maturation and emigrate through the afferent lymphatics to the local draining lymph node, where they encounter naive T cells recruited from the peripheral circulation. This greatly increases the efficiency with which naive T cells are exposed to antigens presented by professional antigen-presenting cells. Secondary immune surveillance involves the production and distribution of antigen-specific effector memory T cells that express homing receptors that direct their migration back to the tissue draining the lymph node where activation occurred and their participation in tissue-based immune responses. The persistence of memory T cells with both antigen and tissue specificity also protects against possible future encounters with the same pathogen, by providing a population of antigen-specific effector cells pre-targeted to the site where exposure to that pathogen might most probably recur. Tertiary immune surveillance involves the production of central memory and effector cells potentially directed to lymph nodes and tissues other than the site of primary exposure, providing broad coverage in the event that the pathogen is encountered through a different route. These concepts have implications for the understanding of both inflammatory skin disorders and the development of antitumour and antipathogen vaccine strategies.
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            Microfabricated needles for transdermal delivery of macromolecules and nanoparticles: fabrication methods and transport studies.

            Arrays of micrometer-scale needles could be used to deliver drugs, proteins, and particles across skin in a minimally invasive manner. We therefore developed microfabrication techniques for silicon, metal, and biodegradable polymer microneedle arrays having solid and hollow bores with tapered and beveled tips and feature sizes from 1 to 1,000 microm. When solid microneedles were used, skin permeability was increased in vitro by orders of magnitude for macromolecules and particles up to 50 nm in radius. Intracellular delivery of molecules into viable cells was also achieved with high efficiency. Hollow microneedles permitted flow of microliter quantities into skin in vivo, including microinjection of insulin to reduce blood glucose levels in diabetic rats.
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              Immunization without needles.

              Most current immunization procedures make use of needles and syringes for vaccine administration. With the increase in the number of immunizations that children around the world routinely receive, health organizations are beginning to look for safer alternatives that reduce the risk of cross-contamination that arises from needle reuse. This article focuses on contemporary developments in needle-free methods of immunization, such as liquid-jet injectors, topical application to the skin, oral pills and nasal sprays.
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                Author and article information

                Journal
                16816837
                10.1038/nrd2076

                Chemistry
                Drug Delivery Systems,Growth Hormone,administration & dosage,Humans,Immunization,Injections, Jet,Insulin,Needles,Vaccines

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