Smart design approaches for orally administered lipophilic prodrugs to promote lymphatic transport

Aurelia S Elz; Natalie L Trevaskis; Christopher J H Porter; Joanne M Bowen; Clive A Prestidge

doi:10.1016/j.jconrel.2021.12.003

Smart design approaches for orally administered lipophilic prodrugs to promote lymphatic transport

J Control Release. 2022 Jan:341:676-701. doi: 10.1016/j.jconrel.2021.12.003. Epub 2021 Dec 9.

Authors

Aurelia S Elz¹, Natalie L Trevaskis², Christopher J H Porter³, Joanne M Bowen⁴, Clive A Prestidge⁵

Affiliations

¹ Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia. Electronic address: aurelia_sophia.elz@mymail.unisa.edu.au.
² Department of Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC 3052, Australia. Electronic address: natalie.trevaskis@monash.edu.
³ Department of Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC 3052, Australia. Electronic address: chris.porter@monash.edu.
⁴ School of Biomedicine, The University of Adelaide, Adelaide, SA 5005, Australia. Electronic address: joanne.bowen@adelaide.edu.au.
⁵ Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia. Electronic address: Clive.Prestidge@unisa.edu.au.

PMID: 34896450
DOI: 10.1016/j.jconrel.2021.12.003

Abstract

Challenges to effective delivery of drugs following oral administration has attracted growing interest over recent decades. Small molecule drugs (<1000 Da) are generally absorbed across the gastrointestinal tract into the portal blood and further transported to the systemic circulation via the liver. This can result in a significant reduction to the oral bioavailability of drugs that are metabolically labile and ultimately lead to ineffective exposure and treatment. Targeting drug delivery to the intestinal lymphatics is attracting increased attention as an alternative route of drug transportation providing multiple benefits. These include bypassing hepatic first-pass metabolism and selectively targeting disease reservoirs residing within the lymphatic system. The particular physicochemical requirements for drugs to be able to access the lymphatics after oral delivery include high lipophilicity (logP>5) and high long-chain triglyceride solubility (> 50 mg/g), properties required to enable drug association with the lipoprotein transport pathway. The majority of small molecule drugs, however, are not this lipophilic and therefore not substantially transported via the intestinal lymph. This has contributed to a growing body of investigation into prodrug approaches to deliver drugs to the lymphatic system by chemical manipulation. Optimised lipophilic prodrugs have the potential to increase lymphatic transport thereby improving oral pharmacokinetics via a reduction in first pass metabolism and may also target of disease-specific reservoirs within the lymphatics. This may provide advantages for current pharmacotherapy approaches for a wide array of pathological conditions, e.g. immune disease, cancer and metabolic disease, and also presents a promising approach for advanced vaccination strategies. In this review, specific emphasis is placed on medicinal chemistry strategies that have been successfully employed to design lipophilic prodrugs to deliberately enable lymphatic transport. Recent progress and opportunities in medicinal chemistry and drug delivery that enable new platforms for efficacious and safe delivery of drugs are critically evaluated.

Keywords: First-pass effect; Lipophilicity; Lymphatic transport; Phospholipid; Prodrugs; Triglyceride.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Administration, Oral
Drug Delivery Systems
Lymphatic System / metabolism
Lymphatic Vessels* / metabolism
Prodrugs*

Substances

Prodrugs