Tar Getting to Tumour

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    Presented By

    R. VenkateshM. Pharm 1st year 2nd semDepartment : Pharmaceutics

    Guide: Mr. RAGHU KIRANTKR College Of Pharmacy.

    1

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    CONTENTS

    Introduction

    Tumour Microenvironment and stages in tumordevelopment

    Targeted drug delivery systems

    Strategies to Deliver Drugs to Targets within theTumour (Cells) Liposomes Pro drug strategy Nanoparticles Monoclonal antibodies-mediated Therapeutics Dendrimers

    Tumour targeting with folic acid Tumour targeting with peptides

    Conclusion

    References

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    INTRODUCTION Cancer is a leading cause of death around the world.

    Tumour is an abnormal new mass of tissue that serves no

    purpose . The term tumour / tumor is derived from

    the Latin word called "swelling". A tumour is the name for

    a neoplasm or a solid lesion formed by an abnormal growth of

    cells (termed neoplastic) which looks like a swelling. A tumor

    can be benign, pre-malignant or malignant, whereas cancer is

    by definition malignant.

    The best treatment of malignancies such as gastric, colonic, and

    cervical cancers is surgical removal of early-stage tumours that

    are small and confined to a limited area, without metastasis.

    http://en.wikipedia.org/wiki/Latinhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Benign_neoplasmhttp://en.wikipedia.org/wiki/Pre-malignanthttp://en.wikipedia.org/wiki/Malignanthttp://en.wikipedia.org/wiki/Malignanthttp://en.wikipedia.org/wiki/Pre-malignanthttp://en.wikipedia.org/wiki/Pre-malignanthttp://en.wikipedia.org/wiki/Pre-malignanthttp://en.wikipedia.org/wiki/Benign_neoplasmhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Neoplasmhttp://en.wikipedia.org/wiki/Latin
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    Chemotherapy, and to a limited extent radiotherapy, have

    been the last resort to control cancer.

    Conventional chemotherapeutic agents are distributed non-

    specifically in the body affecting both normal and tumoral cells.

    Genes responsible for tumour development

    Oncogene

    Tumour suppressor genes

    Suicide genes

    DNA repair genes

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    TUMOUR MICROENVIRONMENT

    Numerous differences between tumour and normal tissue includingvascular abnormalities, oxygenation, perfusion, pH and metabolic

    states.

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    STAGES OF TUMOUR DEVELOPMENT

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    The three groups of capillaries have been identified(a)continuousthe endothelial cells are connected via tight junctions to form a

    continuous monolayer or an uninterrupted basement membrane.

    (b) fenestratedendothelium is interrupted by fenestrae of diameter 30-80nm they are mainly found in tumours' .

    (c)discontinuous or sinusoidalthey have a discontinuous endothelium and large

    fenestrate with a mean diameter of about 100nm they predominantly found

    in the liver , spleen , and bone marrow.

    http://picasaweb.google.co.in/lh/photo/tbyvjUIUvQMkrr5ODEGBng?feat=embedwebsite
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    Targeted drug delivery is a method of delivering

    medication to a patient in a manner that increases the concentrationof the medication in tissues of interest while reducing the relative

    concentration in other parts of the body. This

    improves efficacy while reducing side effects .Targeted drug

    delivery can be used to treat many diseases but the most important

    application of targeted drug delivery is to treat cancerous tumours.

    TARGETED DRUG DELIVERY SYSTEMS

    SITE SPECIFIC DRUG DELIVERYIt is a part of targeted drug delivery system and includes the localization

    of drug and carrier with in the desired target organ.(a.) Delivery to individual organs or tissues (organ targeting).

    (b.)Targeting to specific cell types with in the tissue (cellular

    targeting).

    (c.)Delivery to different intracellular compartments (intracellular

    targeting).

    http://en.wikipedia.org/wiki/Efficacyhttp://en.wikipedia.org/wiki/Adverse_reactionhttp://en.wikipedia.org/wiki/Drug_deliveryhttp://en.wikipedia.org/wiki/Cancerous_tumorhttp://en.wikipedia.org/wiki/Cancerous_tumorhttp://en.wikipedia.org/wiki/Cancerous_tumorhttp://en.wikipedia.org/wiki/Cancerous_tumorhttp://en.wikipedia.org/wiki/Drug_deliveryhttp://en.wikipedia.org/wiki/Drug_deliveryhttp://en.wikipedia.org/wiki/Drug_deliveryhttp://en.wikipedia.org/wiki/Adverse_reactionhttp://en.wikipedia.org/wiki/Adverse_reactionhttp://en.wikipedia.org/wiki/Adverse_reactionhttp://en.wikipedia.org/wiki/Efficacy
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    Liposomes Structure of phospholipid

    9

    Targeted Drug Delivery To Tumours

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    Liposomes could serve as tumour specific vehicles (even without

    special targeting)

    Liposomes better penetrate into tissueswith disrupted endothelial lining

    Fig 16: Penetration of liposomes into normal and tumour tissue

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    TYPES OF LIPOSOMES

    Multilamellar vesicles (MLVs)- It has a size of 5000nm.

    Multivesicular vesicles (MVVs)- It has a size of several

    microns of more than 1000nm.

    Oligolamellar vesicles (OUVs)-It has a size range of 100-

    1000nm.

    Unilamellar vesicles(ULV)-It has a size range ranging from20-1000nm.

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    Mostly for therapy 50 to 100nm Liposomes are used.

    CLASSES OF LIPOSOMESConventional Liposomes : which can store both water and fat solubledrugs in them with no attachments on its surface. Having a half life of

    two and a half days.

    Stealth Liposomes : These are also called as pegylated Liposomes

    because the surface of this liposome is covered with many PEG (polyethylene glycol )molecules which are attached to the surface

    covalently.

    Immune Liposomes : The surface of these Liposomes is attached with

    specific antibody which attacks the antigen for which it is made anddestroys it.

    Cationic liposomes orDOTAP : when these cationic liposomes bind

    with negatively charged nucleic acids on its surface through

    electrostatic interaction these are called lipoplexes .

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    Because of their reduced recognition anduptake by the phagocytic system, these

    liposomes are referred to as stealth liposomes.

    Stealth Liposomes

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    Pro-drug Strategy

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    NANOPARTICLES

    A nanoparticle is a particle containing adsorbed or entrapped drug ina sterilizable ,nontoxic and biodegradable polymer , e.g.:

    polyalkylcyanoacrylate , poly ( lactide -co - glycolide ) and polyvinyl-

    pyrrolidone . (50-200nm)

    CLASSES OF NANOPARTICLES

    Expansile Nanoparticles : when they are up taken by endosomes they

    swell in response to acidic pH and destabilize endosome which causes

    the release of drug into the cytoplasm and eventually tumor death.Quantum dots Nanoparticles : these are used to identify the bio

    markers in tumor tissue.

    Nanocarriers : these are the Nanoparticles which contain both drug as

    well as nucleic acid.

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    MagneticNanoparticles: They are commonly composed of magnetic

    elements like Fe, nickel, Cobalt and their oxides like magnetite (Fe3O4),

    Magnemite (Y-Fe2O3), cobalt ferrite (Fe2CoO4), chromium dioxide

    (CrO2). Magnetic biocompatible materials provide the ability to bedirected and concentrated with in the target tissue by means of external

    magnetic field and to be removed once therapy was completed.

    C60 are spherical molecules about

    1nm in diameter, comprising 60carbon atoms arranged as 20 hexagons

    and 12 pentagons: the configuration of

    a football.

    On the other hand with development

    of various chemical substitutes for

    C60, it is possible to develop

    functionalized C60 with better drug

    targeting properties

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    MONOCLONAL ANTIBODIES

    The Monoclonal antibodies are very small protein particles

    with size of less than 10 nm. The tissue accessibility depends onthe route of administration

    Intravenous: Direct access to vasculature.

    Subcutaneous: Access to local lymph (indirect access to

    vasculature).

    MAbs are purified antibodies produced by a single source

    or clone of cells.

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    Chemotherapeutic agents when

    attached with antibodies are

    specifically delivered to tumour sites

    thus curtailing the dose and hence

    associated side and toxic effects.

    Radioactive isotopes, such as131I or 99Y, kill tumour cells by

    damaging their DNA.

    Prostascint: monoclonalantibody for imaging prostate

    cancer.

    Zevalin : used for the treatment of

    non Hodgkins lymphoma

    Some of the examples of

    MAbs:

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    CLASSES OF ANTIBODIES

    Figure 8 : Types of antibodies

    F(ab) : Univalent fragments with one

    antigen binding site. Has a half life of

    less than 12 Hrs, with a molecular sizeof 50kD.

    F(ab)2 : Bivalent with covalently

    linked F(ab) fragments. It has a half life

    of 2 days, with a molecular weight of

    100kD.

    Fv : It is same as the ScFv but the

    polypeptide linker is not present which

    prevents the VH and VL domain from

    falling apart.

    Bispecific antibodies : This type of

    antibody is made by joining two halfs of

    two different antibodies. It is also called

    as Trifunctional antibody.

    Chemically linked F(ab)2 : In this Fab

    parts of two antibodies are linked by

    polypeptide linker.

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    DENDRIMERS

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    These are highly branched, monodispersive , polymacro

    molecules. In this the multifunctional core molecule is attached to

    polymer branches. Drug can be inserted b/w the branches and held

    until interactions release it. Many classes of Dendrimers vary by

    functional groups on it. The polymer used in Dendrimers

    preparation is poly( amido-amine) or PAMAM. Dendrimers are 10

    times smaller than the liposomes.

    CLASSES OF DENDRIMERS

    Folate conjugated: Many tumor cells over express folate

    receptors so when a folate conjugated Dendrimers is given it will

    directly go to the tumour site and kill it.

    Glycodendrimer: Increased glycosylation occurs on tumor cells,

    Glyco Dendrimers can be released at the site of tumour to increase

    tumour specific antigens. This increases the number of antibodies

    for tumour cell destruction.

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    pH dependent: Polymers are made so when pH change occurs,

    the polymer branch interactions promote the release of drug.

    Because the pH at tumor site is generally more acidic

    polypropylene imines can be used as polymer branch.

    Tumor-targeting with folic acid

    Folic acid taken from food is delivered to epithelial cells through a

    kind of receptor-mediated endocytosis, potocytosis.(Fr-a and Fr-b),Theexpression of Fr in normal tissues is low and is restricted to various

    epithelial cells .In contrast Fr is over expressed in various tumours

    ,particularly in ovarian and endometrial cancers.

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    Tumor targeting with peptides

    Peptide-based targeting of tumor-associated receptors is an

    attractive approach in tumor-specific drug delivery because high-

    affinity sequences can be discovered through screening of

    combinatorial libraries.

    Gastrointestinal (GI) peptides have many physiological functions

    as hormones, neurotransmitters, and growth factors. Each of these

    peptides usually targets more than one receptor. Thus, these peptides

    and their truncated analogs, possessing appropriate recognition

    properties, could serve as tumor-targeting molecules in combination

    with cytotoxic agents.

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    CONCLUSION AND FUTURE PROSPECTIVES

    The innovation in the field of research on the targeted drug

    delivery in the coming years would be a shift from receptor to

    nucleus reflecting a desire to construct defined pathway linking the

    end points of different regulatory cellular events. In the future,

    targeted drug-delivery systems may also prove particularly valuableto enable the use of drug that seems to be ineffective or toxic, if

    delivered systemically e.g., neural growth factor (which need to

    cross blood brain barrier) or vaccines (which need to be taken up by

    antigen presenting cells). Many of the new drug delivery systemsare going to come based on the concept ofmagicbullet.

    REFERENCES

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    REFERENCES

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    BOOKS

    S.P.Vyas and R.K.Khar- targeted drug delivery to tumours- chapter 14- page

    number 512-561.

    JOURNALS

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