Topical Drug Delivery for Treating Macular Degeneration

NIH RePORTER · VA · I21 · · view on reporter.nih.gov ↗

Abstract

Many blinding eye diseases, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR), are commonly seen in veterans. If left untreated, both AMD and DR can result in irreversible blindness. Both diseases exhibit increased permeability of blood vessels in the macula (central) portion below the retina, the choroid, leading to abnormal fluid accumulation and vision loss. The dry form of AMD does not cause much vision reduction; however, the wet form (10-15% of AMD) is associated with leaky new blood vessels (angiogenesis) and can destroy the central vision. The wet form of AMD is treated with an intravitreal injection of antibodies, a therapy that has transformed eye care. However, intravitreal injections are associated with complications, and patient compliance is poor. Ideally, topical delivery of large molecules to the retina would be preferable, because patients could administer the drug in the comfort of their home. The over-expression of cluster of differentiation 44 (CD44) cell surface receptors is a common feature of many blinding diseases, which offers a fortunate opportunity for research. Overexpression is frequently observed during disease proliferation and inflammation, as well as in cancer growth and metastasis. Retinal pigment epithelial (RPE) cells, as well as the Müller cells and the ganglion cells in the retina, express CD44 receptors in their normal state and overexpress them in disease states. CD44 receptors have an affinity for hyaluronic acid (HA) that enables cells to internalize large molecules that have HA attached to them. Thus, coating drug nanoparticles (NPs) with HA can deliver more drugs to cells that overexpress CD44 receptors and also enable receptor-mediated endocytosis, providing a transcytosis pathway to bypass the ocular barriers. Although any drug-NP can be coated with HA, in this proposal, we will use gold nanoparticles (AuNPs) because their size, shape, and surface properties can be precisely altered. Further, their unique surface plasmon resonance effect can be used for imaging and photothermal therapy, while their anti-angiogenic properties are useful for therapeutic applications. Au-nanorods, in particular, possesses superior photothermal conversion properties. During choroidal neovascularization (CNV), endothelial cells over-express CD44 and release vascular endothelial growth factors, so the innate antiangiogenic activity of AuNPs can be tested. Our strategically designed nanoplatform will enable us to carry various payloads across the barriers and to effectively treat potentially blinding diseases. The proposed research is expected to assess the two routes of administration (for greater specificity, better efficiency, and higher biocompatibility) of our targeted nanoplatform to the retina. This contribution will be significant, because it will both provide a formula for creating a smart biocompatible nano-core-shell carrier and identify a method for effective delivery of drugs to the ey...

Key facts

NIH application ID
10058218
Project number
5I21RX003313-02
Recipient
ST. LOUIS VA MEDICAL CENTER
Principal Investigator
Nathan RAVI
Activity code
I21
Funding institute
VA
Fiscal year
2021
Award amount
Award type
5
Project period
2020-01-01 → 2022-09-30