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Electrophoretic Delivery of Clinically Approved Anesthetic Drug for Chronic Pain Therapy
Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
Department of Physiology and Pharmacology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0001-7729-0251
Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0002-3615-1850
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2023 (English)In: Advanced Therapeutics, E-ISSN 2366-3987, Vol. 6, no 7, article id 2300083Article in journal (Refereed) Published
Abstract [en]

Despite a range of available pain therapies, most patients report so-called “breakthrough pain.” Coupled with global issues like opioid abuse, there is a clear need for advanced therapies and technologies for safe and effective pain management. Here the authors demonstrate a candidate for such an advanced therapy: precise and fluid-flow-free electrophoretic delivery via organic electronic ion pumps (OEIPs) of the commonly used anesthetic drug bupivacaine. Bupivacaine is delivered to dorsal root ganglion (DRG) neurons in vitro. DRG neurons are a good proxy for pain studies as they are responsible for relaying ascending sensory signals from nociceptors (pain receptors) in the peripheral nervous system to the central nervous system. Capillary based OEIPs are used due to their probe-like and free-standing form factor, ideal for interfacing with cells. By delivering bupivacaine with the OEIP and recording dose versus response (Ca2+ imaging), it is observed that only cells close to the OEIP outlet (≤75 µm) are affected (“anaesthetized”) and at concentrations up to 10s of thousands of times lower than with bulk/bolus delivery. These results demonstrate the first effective OEIP deliveryof a clinically approved and widely used analgesic pharmaceutical, and thus are a major translational milestone for this technology.

Place, publisher, year, edition, pages
John Wiley & Sons, Ltd , 2023. Vol. 6, no 7, article id 2300083
Keywords [en]
anesthetic, bupivacaine, calcium imaging, drug delivery, electrophoretic, ion exchange membrane
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:liu:diva-193517DOI: 10.1002/adtp.202300083ISI: 000977943800001Scopus ID: 2-s2.0-85154059805OAI: oai:DiVA.org:liu-193517DiVA, id: diva2:1754320
Note

Funding agencies: This work was supported by the Swedish Foundation for Strategic Research, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, the European Research Council (AdG 2018 Magnus Berggren, 834677 and CoG 2019 Camilla Svensson, 866075), and Vinnova. Additional support was provided by the Swedish Government Strategic Research Area in Materials Science on Advanced Functional Materials at Linköping University (Faculty Grant SFO-Mat-LiU no. 2009-00971).

Available from: 2023-05-03 Created: 2023-05-03 Last updated: 2024-03-26Bibliographically approved
In thesis
1. Bioelectronic Devices for Targeted Drug Delivery and Monitoring of Microbial Electrogenesis
Open this publication in new window or tab >>Bioelectronic Devices for Targeted Drug Delivery and Monitoring of Microbial Electrogenesis
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite a range of pain therapies available in the market, 70% of patients report so-called “breakthrough pain”. Coupled with global issues like opioid crisis, there is a clear need for advanced therapies and technologies for pain management. In this thesis we aim to develop a novel pain management therapy based on precise, fluid-flow-free delivery of anesthetic drugs directly to the peripheral nervous system (PNS) using organic electronic ion pumps (OEIPs). OEIPs are devices that can transport charged drug molecules through a permselective ion exchange membrane (IEM) under an applied electric field. In this work we used primary dorsal root ganglion (DRG) neurons as an in vitro PNS model system for neuropathic pain. The IEM was made up of custom synthesized hyberbranched polyglycerols (HPGs), which enabled the delivery of large aromatic anesthetic drug such as bupivacaine for the first time in an OEIP. Bupivacaine is a common local nerve blocker which if delivered to DRGs effectively blocks their neuronal activity which in turn blocks the pain signal to travel to the central nervous system (CNS) thereby blocking the sensation of pain. Two types of OEIP devices were fabricated and characterized in this context: capillary-based OEIPs with a probe-like form factor, and inkjet-printed flexible OEIPs with a potential towards implantable form factor. The results showed that both types of OEIP devices could deliver bupivacaine locally (delivery radius ~ 75 µm) to DRG neurons at concentrations close to 40000 times lower than the bulk/bolus means. The results demonstrated that OEIPs could achieve long-lasting and reversible nerve blockage without causing tissue damage or systemic side effects. These studies lay the foundation for future demonstrations of “iontronic” PNS pain relief in living/awake animals.  

On the other end of the spectrum, most of today’s modern communication is based upon our understanding of how electrons move through semiconductors. This allows one to mediate the flow of electrons by designing complex integrated circuits in the form of microchips which gives rise to smart devices such as mobile phones and computers. Likewise, in many organism’s electron transfer plays a critical role in metabolic processes in eukaryotes, which includes animals all the way down to microbes. In most of these metabolic processes, the role of the final electron acceptor is played by oxygen (aerobic respiration). However, there are few families of bacterial cells that we know today have evolved in special ways allowing them to respire or “breathe” through metals/metal oxides when exposed to anaerobic conditions. In electromicrobiology, this is termed as extracellular electron transfer (EET), wherein the microbes shuttle electrons from inside of their cells to the outside, in presence of favorable extracellular electron acceptors. The EET process has thus been exploited in various microbial electrochemical systems (MESs) such as microbial fuel cells (MFCs), biosensors, and bio-photovoltaic cells to name a few. In this thesis, we have carried out a detailed study examining the EET process in MESs and ways to amplify such signals in broadly two major approaches: Bioelectrochemical and device optimization. Under bioelectrochemical means, we have shown that we can amplify EET signal of exoelectrogens such as Shewanella oneidensis MR-1 in a standard microbial bioreactor set up containing fumarate (a common carbon food source) by up to 50x times without the excess cell growth in the reactor. This study helped to unravel few unknown mysteries of the EET and bust few of its well-studied myths in the process. However, to record EET, traditionally one still requires large area/volume of electrodes with sufficiently high concentration of bacteria to remain well above the threshold signal-to-noise ratio. So under device optimization route, we combined S.oneidensis with an electrochemical transistor termed as Organic Microbial Electrochemical Transistor (OMECT). With OMECT we successfully monitored and amplified EET events from small number of microbial cells on a microscale area (500 µm x 500 µm) in real time without the need big/bulky/expensive signal amplifying instruments. Interestingly, the OMECT platform also revealed an order of magnitude faster EET response of S. oneidensis MR-1 to lactate compared to studies using classical electrochemical approaches thus underlying one of the major advantages of the miniaturized bioelectronic device. 

Abstract [sv]

Trots att det finns många sätt att behandla smärta hos patienter uppger 70 procent att de drabbas av smärta som kommer tillbaka efter att de tagit medicinen. Många smärtmediciner är opioider och beroendeframkallande. Därför finns ett starkt behov att utveckla en ny avancerad lösning på smärtproblemen. Vår lösning är att tillföra anestesimedel i exakt mängd och fri från vätskeflöde direkt till det yttre nervsystemet genom organiska elektroniska jonpumpar (OEIP). Dessa jonpumpar kan transportera laddade läkemedelsmolekyler genom ett permselektivt jonbytarmembran när elektriska fält används.  Vi använde primära dorsalrotganglion (DRG) neuroner som ett in vitro PNS-modellsystem för neuropatisk smärta. För första gången kan vi tillföra stora aromatiska anestesimedelsmolekyler som bupivacaine genom att använda OEIP. Bupivacaine är en vanlig lokal nervblockerare som effektivt blockerar neuronal aktivitet från DRG. Därför når inte smärtsignalerna fram till centrala nervsystemet (CNS). Detta blev möjligt genom specialtillverkade hyperbranched polyglyceroler (HPG). Vi tillverkade och testade två typer av OEIP- enheter: kapillärbaserade och sondliknande samt bläckstråletryckta och flexibla OEIP-er som kan implanteras. Båda typerna kan överföra bupivacaine till DRG neuroner lokalt (leverensradie ~75 µm) och i mycket låg koncentration (40 000 gånger lägre än bulk/ bolus). Resultaten visade att OEIP åstadkom en effektiv och reversibel blockering av nerverna. Nerverna blockerades utan att vävnaden tog skada och utan systematiska biverkningar. Dessa studier är grundläggande för framtida försök att lindra PNS-smärta hos levande/vakna djur genom iontronik.  

I många organismer spelar överföringen av elektroner en betydelsefull roll för metaboliska processer. Syre är den slutliga elektronacceptatorn i många av desa processer (aerob andning). Emellertid finns det få bakterier som kan "andas" genom metaller eller metalloxider när de utsätts för anaeroba förhållanden. Detta kallas extracellulär elektronöverföring (EET) i elektromikrobiologi.  I EET skjuter mikroberna elektroner från insidan av sina celler till utsidan om där finns gynnsamma extracellulära elektronacceptorer. EET-processen har utnyttjats i olika mikrobiella elektrokemiska system ( MES) som mikrobiella bränsleceller (MFC), biosensorer och bio-fotovoltaiska celler. I denna avhandling har vi detaljstuderat EET-processen och studerat två sätt att tillämpa sådana signaler: bioelektrokemisk och enhetsoptimering. Vi kan förstärka EET-signaler från exoelektrogener, som Shewanella oneidensin MR-1, upp till 50 gånger i en standard mikrobiell bioreaktor som innehåller fumarat (en vanlig kolmatkälla) utan överskott av celltillväxt i reaktor. Denna studie hjälpte oss att lösa flera mysterier och avliva några myter kring EET-processen. För att registrera EET med tillräckligt signal-brusförhållande behöver vi elektroder med stor area/volym och hög koncentration av bakterier. Under enhetsomprimeringen kombinerade vi S.oneidensis med en elektrokemisk transistor för att skapa Organic Microbial Electrochemical Transistor (OMECT). Vi använde denna OMECT för att framgångsrikt övervaka och förstärka EET-signaler från ett litet antal mikrobiella celler och på en mikroskala (500 µm x 500 µm) i realtid. Det fanns inget behov av stora, bulkiga och dyra instrument för att förstärka signalerna. Intressant nog fann vi att signalerna från S.oenidensis MR-1 på laktat, som sänds av OMECT-plattformen, var snabbare jämfört med klassiska elektrokemiska metoder. Detta är den stora fördelen med miniatyriserade bioelektroniska enheter.   

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2023. p. 93
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 2312
Keywords
Electrophoresis, Extracellular Electron Transfer (EET), Ion Exchange Membranes (IEM), Drug Delivery, Bupivacaine, Chronic Neuropathic Pain, Microfabrication, Inkjet Printing, Organic Electrochemical Transistor (OECT), Fumarate, Shewanella oneidensis, Dorsal Root Ganglia (DRG), Organic Electronic Ion Pump (OEIP)
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-193523 (URN)10.3384/9789180751551 (DOI)9789180751544 (ISBN)9789180751551 (ISBN)
Public defence
2023-05-24, K1 Kåkenhus, Campus Norrköping, Norrköping, 10:15 (English)
Opponent
Supervisors
Available from: 2023-05-03 Created: 2023-05-03 Last updated: 2023-05-03Bibliographically approved

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Roy, ArghyamalyaArbring Sjöström, TheresiaAbrahamsson, TobiasCherian, DennisTybrandt, KlasBerggren, MagnusPoxson, DavidSimon, Daniel

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