Biodegradable microfuses to enable the safe and compliant long-term interval dosing of 5HT2A agonists

可生物降解的微熔丝可实现 5HT2A 激动剂安全、合规的长期间隔给药

• 批准号: 10372879
• 负责人: Glenn Madison Walker
• 金额: $ 18.25万
• 依托单位: UNIVERSITY OF MISSISSIPPI
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10372879
• 关键词: Acetates; Acids; Address; Affect; Agonist; Autopsy; Cellulose; Centers of Research Excellence; Characteristics; Clinical; Clinical Research; Clinical Trials; Creativeness; Devices; Dose; Drug Delivery Systems; Drug Kinetics; Effectiveness; Electrons; Ensure; Exposure to; Film; Goals; Grant; Growth; Hallucinogens; Histopathology; Immune response; Immunocompetent; Implant; In Vitro; Ingestion; Investigation; Ketamine; Kinetics; Letters; Liquid substance; Lysergic Acid Diethylamide; Major Depressive Disorder; Medical; Medical Care Costs; Mental Depression; Mental disorders; Microfluidics; Microscopy; Mississippi; Modality; Moods; Mus; Natural Products; Needles; Neurosciences; Occupational; Organ; Patients; Pharmaceutical Preparations; Pharmacotherapy; Physiologic pulse; Pluronics; Polymers; Population; Positioning Attribute; Psychiatry; Psychotherapy; Regimen; Reporting; Research; Research Personnel; Resistance; Scanning; Schedule; Series; Serum; Site; Structure; Suicide attempt; Surface; Symptoms; System; Technology; Therapeutic; Time; Toxicology; Translating; Treatment Protocols; Trocars; Universities; Walkers; Work; alternative treatment; base; biomaterial compatibility; caprolactone; clinical investigation; clinical translation; commercialization; compliance behavior; cost; craving; depressive symptoms; disabling symptom; effective therapy; experience; follow-up; high reward; high risk; implantation; improved; in vitro Assay; in vivo; innovation; microdevice; phthalates; polycaprolactone; preclinical study; prevent; prototype; psychologic; reduce symptoms; social; subcutaneous; suicide rate; technology development; treatment-resistant depression

Abstract There is an urgent unmet medical need to develop therapeutic options for the ~50% of depression patients suffering from treatment-resistant depression, a form of depression resistant to treatment by existing psycho- and pharmaco-therapies. Classical psychedelics, such as the 5HT2A agonists lysergic acid diethylamide (LSD) and psilocybin, have re-emerged as a treatment option for patients with depression that is treatment-resistant. Recent clinical trials highlight the potential effectiveness of 5HT2A agonists to improve mood and psychotherapeutic growth in treatment-resistant depression patients, even in those who have failed a median of 4 previous medications in their lifetime. Accordingly, the FDA recently granted “Breakthrough Therapy” designation to psilocybin for treatment-resistant depression. The improvements associated with 5HT2A agonist pharmacotherapy last for weeks to months, a marked increase relative to ketamine, but administration requires a 6-8-hr psychological support session, an approach which is unlikely to scale. Moreover, many patients find their symptoms recur and need repeat administration. ‘Microdosing’ – ingesting subperceptual doses of psychedelics every 3-7 days to improve mood and/or creativity – represents an alternative, potentially long-term treatment option. Microdosing has become prominent in the lay public, with recent scientific studies corroborating anecdotal claims that it improves mood, energy levels, social connectedness, and decreases craving for addictive substances. However, there are a gamut of practical barriers that stymie further investigation of 5HT2A agonists microdosing in the clinical setting, including: low compliance with the complicated dosing regimen, high risk of diversion of controlled substances, and difficulty and cost administering the long-term treatment regimens in controlled settings. Here, we propose to overcome the above limitations by developing a bioresorbable microdosing implant (MDI) composed of “microfluidic fuses”, or µfuses, that enables long-term, intermittent delivery of sub-perceptual microdoses of 5HT2A agonists. The µfuses are composed of a 70:30 mixture of Cellulose Acetate Phthalate (CAP) and Pluronic® F-127 (P) polymers which form a surface-eroding film. CAPP µfuses will be embedded in a slowly biodegrading polycaprolactone (PCL) body and sit atop 5HT2A agonist- containing drug reservoirs in series. As the CAPP µfuse erodes, the reservoirs will be exposed to the surrounding fluid and release pulses of 5HT2A agonist, where the timing between pulses is controlled by the distance between reservoirs beneath the µfuse. We will develop the CAPP µfuse technology in two aims. 1) Microfabricate and validate the function of µfuse devices in vitro. 2) Characterize the in vivo pharmacokinetics and biocompatibility of prototype µfuse devices in immune-competent, healthy mice. Successful development of this technology will enable unprecedented studies into the merits of 5HT2A microdosing as a therapeutic strategy to overcome treatment-resistant depression.

抽象的 紧急未满足的医疗需要为约50％的抑郁症患者开发治疗选择 患有抗治疗抑郁症，一种抗抑郁症的形式 和药房治疗。古典迷幻药，例如5HT2A激动剂脂肪酸二乙酰胺（LSD） psylocybin已重新出现，作为耐药性抑郁症患者的治疗选择。 最近的临床试验凸显了5HT2A激动剂改善情绪和 即使在那些失败的中位数的患者的心理治疗患者中， 4个以前的药物一生。根据FDA最近授予的“突破疗法” 为psilocybin设计，以抗治疗抑郁症。与5HT2A激动剂相关的改进 药物疗法持续数周到几个月，相对于氯胺酮有明显增加，但是给药需要 一个6-8小时的心理支持会议，这种方法不太可能扩展。而且，许多患者发现 他们的症状复发，需要重复给药。 “微剂量” - 摄取亚感知剂量 每3-7天的迷幻药来改善情绪和/或创造力 - 代表一种替代的，潜在的长期 治疗选项。微化在外行公众中变得很突出，最近的科学研究证实了 轶事声称它改善了情绪，能量水平，社会联系，并减少了对 加性物质。但是，有一系列实用障碍阻碍了5HT2A的进一步调查 激动剂在临床环境中的微剂量，包括：低符合复杂的剂量方案，高 受控物质转移的风险，以及为长期治疗方案的困难和成本 在受控设置中。在这里，我们建议通过开发可生物吸收来克服上述限制 由“微流体融合”或µFUSS组成的微剂量植入物（MDI），可实现长期，间歇性 5HT2A激动剂的亚感知微剂量的递送。 µFUS由70:30的混合物组成 乙酸纤维素邻苯二甲酸酯（CAP）和Pluronic®F-127（P）聚合物，它们形成表面磨损膜。卡普 µFUSS将嵌入缓慢的生物降解多丙酮酸（PCL）体中，并位于5HT2A激动剂上 串联含有药物库。随着CAPP µFUSE的侵蚀，储层将暴露于周围 5HT2A激动剂的流体和释放脉冲，其中脉冲之间的时间由 µFUSE下方的储层。我们将以两个目标开发CAPP µFUSE技术。 1）微型制剂和 在体外验证µFUSE设备的功能。 2）表征体内药代动力学和生物相容性 免疫能力，健康小鼠中的原型µFUSE设备。该技术的成功开发将 将5HT2A微剂量的优点作为一种治疗策略，使其具有前所未有的研究 耐治疗抑郁症。