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vii
viii Contributors
The book series titled Expectations and 4. establish collaborations between academic
Realities of Multifunctional Drug Delivery scientists, and industrial and clinical
Systems covers several important topics on researchers.
drug-delivery systems, regulatory requirements,
Innovative cutting-edge developments in
clinical studies, intellectual properties trends,
micro-nanotechnology offer new ways of
new advances, manufacturing challenges, etc.
preventing and treating diseases like cancer,
written by leading industry and academic
malaria, HIV/AIDS, tuberculosis, and many
experts. Overall, the chapters published in this
more. The applications of micro-nanoparticles
series reflect the broadness of nanopharma-
in drug delivery, diagnostics, and imaging are
ceuticals, microparticles, other drug carriers, and
vast. Hence, Volume 3: Drug Delivery Trends
the importance of respective quality, regulatory,
in the book series mainly reviews advances in
clinical, GMP scale-up, and regulatory
drug delivery areas via targeted therapy with
registration aspects.
improved drug efficiency at a lower dose, trans-
This series is destined to fill the knowledge
portation of the drug across physiological
gap through information sharing and with orga-
barriers, as well as reduced drug-related toxicity.
nized research compilation between diverse
The contribution by Fernandes et al.
areas of pharma, medicine, clinical, regulatory
(Chapter 1) discusses new trends in drug
practices, and academics.
delivery areas via bioactive hybrid nanowires.
Expectations and Realities of Multifunctional
Nanowires offer multifunctionality and the pros-
Drug Delivery Systems is divided into four
pect of biofunctionalization, thereby reducing
volumes:
toxicity and side effects. This synergistic approach
Volume 1: Nanopharmaceuticals
overcomes the challenges associated with conven-
Volume 2: Delivery of Drugs
tional nanomedicines and exhibits better perfor-
Volume 3: Drug Delivery Trends
mance. The authors review the potential of
Volume 4: Drug Delivery Aspects
nanowires in this chapter.
The specific objectives of this book series The chapter by Procopio and Tewari (Chapter
are to: 2) highlights another industry trenddi.e., 3D
1. provide a platform to discuss opportunities printing. This is a fascinating topic recently
and challenges in development of nano adopted by industry. The Food and Drug
medicine and other drug-delivery systems; Administration has already approved the first
2. discuss current and future market trends; product: Spritam (levetiracetam), a 3D printed
3. facilitate insight sharing within various areas tablet (Aprecia Pharmaceuticals). A thorough
of expertise; and overview of material requirements, types of
ix
x Preface
polymer, available 3D printing techniques, and discusses in detail the mechanism of formation
regulatory aspects is provided. Finally, the au- of liquid crystalline systems, types of structure
thors present case studies from industry on formed, factors affecting formation of liquid crys-
tunable release technology and paste gel talline systems, compositions, advantages, and
extrusion in tableting. limitations of these forms of drug delivery
The contribution by Al-Hindawi (Chapter 3) systems.
describes marketing authorization and licensing The chapter by Veloso et al. (Chapter 8)
of medicinal products in the European Union. reviews opportunities and challenges in amor-
The main aim of this chapter is to provide phous drug stabilization using mesoporous
readers with a generalized overview of the steps materials. The team of authors highlights key
and criteria while applying licenses in the points like the role of mesoporous materials,
European Union. The author also highlights structural characterizations of such systems,
various directives, extension requests, protection physical forms of drug loading, and physical
periods, and legal requirements guidance to performance of mesoporous particles. Mesopo-
industry and researchers. On the other hand, rous particles have huge potential in pharmaceu-
preclinical understanding is key to proposing ticals as a drug delivery system, in cosmetics, in
products for particular indications. nutraceuticals, and in fast-moving consumer
The chapter by Tiwari et al. (Chapter 4) goods (detergent, oral care), and is a highly
reviews preclinical considerations on micro- explored trend in the market.
and nanodrug delivery, which will lead to the Quality is an important aspect in regulatory
proper positioning of products for market which makes sure patients receive “quality”
authorization. products. Newer trends in pharmaceuticals like
The work by Ghan (Chapter 5) is aimed at dis- nanomedicines, drug device combinations,
cussing synergistic delivery of nanoparticles nanoparticulate-based tablets, etc. require
using traditional approaches like tableting or special techniques and an understanding of
other forms. The author reviews various nano- quality. The chapter by Qureshi (Chapter 9)
particulate treatments for oral delivery to asks questions like “what is quality?”, “do we
improve bioavailability, target specific regions evaluate quality as per a regulatory definition?”,
in the gastrointestinal tract, improve physiolog- and “is there a need to change the definition of
ical stability in the gut environment, and quality when a product is altered?” The main
modulate release when needed. Drug delivery theme of this chapter is to underline basic
systems like solid lipid nanoparticles, polymeric concepts of “quality” and discuss them with
nanoparticles, nanomicelles, and nanosus- regard to current practices. The author provides
pension are also reviewed. his views on further modifications of current
The chapter by Tumuluri (Chapter 6) testing methodologies to assure “real quality.”
highlights opportunities and challenges in The work by Reymond and K€ onigsrainer
formulating minitablets. This is another trend (Chapter 10) is aimed at discussing the potential
in oral drug delivery systems besides nano-oral of pressurized intraperitoneal aerosol chemo-
and 3D printed dosage forms. The author therapy (PIPAC). The authors review various
describes in detail technological potential, indus- chemotherapeutic systems currently used
trial advantages, technological availability, and in vitro/ex vivo models and the success of
the limitations of minitablets. clinical trials to date. This generalized overview
The topic presented by Nalone et al. of PIPAC technology provides readers with
(Chapter 7) describes the potential of liquid crys- updates from another innovative trend in
talline systems in drug delivery. This chapter medical practice.
Preface xi
The last contribution by T€ ureli and T€ ureli insights in areas of micro-nanomedicines, drug
(Chapter 11) describes industrial challenges of delivery sciences, new trends, and regulatory
upscaling and good manufacturing practice in aspects.
the production of pharmaceutical drug delivery All the efforts of experts, scientists, and au-
systems. The authors highlight the current regu- thors are highly acknowledged for sharing their
latory status of approved nanomedicines and knowledge, ideas, and insights about the topic.
manufacturing limitations and initiatives.
In summary, I am sure this book volume and Ranjita Shegokar, PhD
the complete book series will provide you great Editor
C H A P T E R
1
Bioactive hybrid nanowires: a new in
trend for site-specific drug delivery and
targeting
A.R. Fernandes1, J. Dias-Ferreira1, M.C. Teixeira1,
A.A.M. Shimojo2, Patrícia Severino3,4, A.M. Silva5,6,
Ranjita Shegokar7, Eliana B. Souto1,8
1
Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Polo
ude, Azinhaga de Santa Comba, Coimbra, Portugal; 2Department of Materials
das Ci^encias da Sa
Engineering and Bioprocesses, School of Chemical Engineering, State University of Campinas
(UNICAMP), Cidade Universitaria Zeferino Vaz e Bar~ao Geraldo, Campinas, S~ao Paulo, Brazil;
3
Universidade Tiradentes (UNIT), Aracaju, Sergipe, Brazil; 4Instituto de Tecnologia e Pesquisa (ITP),
Aracaju, Sergipe, Brazil; 5Department of Biology and Environment, School of Life and Environmental
Sciences, University of Tras-os-Montes and Alto Douro, Vila Real, Portugal; 6Centre for the Research
and Technology of Agro-Environmental and Biological Sciences, University of Tras-os-Montes and Alto
Douro, Vila Real, Portugal; 7Capnomed GmbH, Zimmern, Germany; 8CEB e Centre of Biological
Engineering, University of Minho, Campus de Gualtar, Braga, Portugal
The special features of these particles are related the presence of AMF, with the consequent release
to their capacity to efficiently accumulate at the of the drug. In the second approach, the release of
tumor cells through the increased permeability drugs takes place from a polymeric matrix with
of the tumor vessels and by cancer-specific bind- magnetic material [5,13]. The heat created by
ing agents, making the treatment more selective the magnetic field produces crevices or cracks in-
and effective [5]. The application of an alter- side the polymeric matrix, which releases the
nating magnetic field (AMF) with the introduc- encapsulated drugs [5].
tion of magnetic nanoparticles generates local Nanowires, nanowhiskers, nanofibers, nano-
heat in the tissues that contain these nanopar- tubes, and other one-dimensional nanostructures
ticles due to magnetic relaxation and hysteresis have demonstrated huge abilities for improving
loss [6]. Particle characteristics such as size distri- the electrical, optical, thermal, and mechanical
bution, shape, crystal structure, particle mag- properties of a broad range of functional mate-
netic anisotropy and its temperature rials and composites [14]. These enhancements
dependence on magnetization, fluid viscosity, substantially exceed those offered by micro- or
amplitude and frequency of the AMF directly nanosized particles. Most of the methods used
affect the generation of heat, which in turn de- for their synthesis are relatively expensive and
pends on the absorption efficiency of the mag- difficult to scale up [15]. The underlying princi-
netic particles [1,7]. ples for the synthesis of one-dimensional mate-
A significant number of magnetic nanopar- rials offer significant challenges in the control of
ticles have been studied over the last few de- diameter, structure, and composition in the axial
cades. Examples of well-known hyperthermic and radial coordinates, which are essential for
agents include iron oxide-based nanomaterials the synthesis of materials with designed and
such as magnetite (Fe3O4) and maghemite (g- tunable functionality [16].
Fe2O), which continue attracting attention due Nanowires, besides their magnetic perfor-
to their lack of toxicity and excellent biocompat- mance, also have aso an interest in developing
ibility [8]. Ferrite nanoparticles (XFe2O4, where intrinsic mobility triggered by a photochemical
X can be Co, Mn, Ni, Li, or mixes of these reaction. Examples of applications of magnetic
metals), metallic nanoparticles, such as Mn, Co, segmented nanowires are:
Ni, Zn, Gd, Mg, and their oxides, or metal alloys
1. Magnetic alignment and wireless manipula-
(FeCo, CoPd, FePt, NiPd, NiPt, NiCu) have also
tion (Au/polypyrrole/Ni) [17]
been studied as possible candidates for hyper-
2. Magnetic field sensors and spintronic nano-
thermia treatments [9e11].
devices (Co/Cu and FeCoNi/Cu) [18]
There are new designs of magnetic nanomate-
3. Photochemical conversion and hydrogen
rials based on a core/shell approach that have
generation (Ag/ZnO) [19]
started to gain prominence due to their versatility
4. Detection of DNA molecules (CdTe/Au/
to tailor properties of both core and shell and to
CdTe) [20]
offer multifunctionality, such as core protection,
5. Magnetic control of biomolecule desorption
biofunctionalization platform, toxicity reduction,
(FeCo/Cu) [21]
and increase in biocompatibility. Examples of
6. Exchange-coupled patterned media (Ni/
these particles are gold- or silica-coated ferromag-
CoPt) [22]
netic particles [12]. Magnetic nanoparticles also
7. Nanosensors (Au/Co) [23]
hold great promise for drug delivery by heating
8. Catalytic activities (Pt/Ni) [24]
the tissues. The drug can be released using two
9. Higher oxygen reduction reaction activity
strategies. In the first approach, the drug mole-
(Co/Pt) [25,26]
cules are attached to the particles through a
10. Drug delivery
linker, which breaks with the heat generated by
3. Production methods 3
Magnetic nanoparticles (including nanowires) composed of alternating structures of ferromag-
are recognized as nanoparticles with unique netic/ferromagnetic or ferromagnetic/nonmag-
physicochemical properties and are mostly netic materials, such as Ni/Cu [33], Ni/Au [34],
different from those of conventional materials, Co/Cu [35], NiFe/Cu [36], CoNi/Cu [37],
specifically the electromagnetic properties. Mag- FeCoNi/Cu [38], FeGa/Cu [39], Co/Pt [40],
netic nanoparticles show good magnetic orienta- NiFe/Pt [41], and NiCoCu/Cu [42], among
tion, small size, biodegradability, and reactive others.
functional groups [27]. The biocompatibility of
magnetic nanoparticles can be improved by
combining them with a variety of functional 3. Production methods
molecules such as enzymes, antibodies, cells,
DNA, or RNA. The coating of other materials The properties of many systems are basically
such as polyethylene glycol (PEG), chitosan, dependent of the material type used in produc-
lipids, and proteins with good biocompatibility tion; however, in the case of nanowires the
can stabilize magnetic nanoparticles in physio- material geometry is also important. Thus to
logical fluids and provide chemical functionality produce and maximize all the properties of
for additional modifications [28]. nanowires requires reliable and controlled syn-
theses. The synthesis methods can be grouped
into two categories: (1) top-down and (2)
bottom-up synthesis.
2. Types of nanowires
In the last few years, magnetic hybrid nano-
3.1 Top-down method
wires have been intensively studied for many The most conventional top-down method in
applications, such as optics and medicine. There the fabrication of nanowires is lithography.
are two types of morphologies in hybrid Lithography is based on the deposition of a resis-
nanowires: tant material, for example, poly(methylmetha-
crylate), that has the function to act as a
1. Radial structures (core/shell type); and
photographic film for the production of a pattern
2. Axial structures (segmented or layered type).
after exposure and development using a
The nanowires that present a core/shell struc- patterned mask. The resolution of this technique
ture explain many physical characteristics in the is dependent on the wavelength of light used in
magnetism of the nanoparticles. The hard/soft photolithography and sometimes is not suitable
core/shell nanoparticles have been studied and for small nanowires [43]. To obtain patterns
reveal interesting magnetic properties, i.e., with a higher resolution, normally electron-
reversible tuning of the blocking temperature beam lithography is the method used, which
[29], improved microwave absorption [30], opti- does not use a mask and has direct-write expo-
mized hyperthermia [31], and enhanced coer- sure [44]. Thus nanowires can be obtained by
civity [32]. The magnetic segmented nanowires etching the extraneous material from the wafer.
have multifunctional and structural advantages Resistance can be applied directly because the
compared to their counterparts, single- etch mask can serve as the template for the depo-
component nanowires. The literature reports sition of a much more stable mask material, for
that magnetic segmented nanowires are example, gold. Material that can be used to
4 1. Bioactive hybrid nanowires: a new in trend for site-specific drug delivery and targeting
etch a pattern is, for example, potassium hydrox- the vapor/liquid/solid method; however, in
ide (a wet chemical etchant) or another electro- this case nanowire precursors are dissolved in
chemical etchant. With these materials it is a high-boiling liquid and the catalysts are sus-
possible to produce tapered cylindrical wires pended in this liquid [53]. Substrates, such as
once the etching is underneath the mask [45]. anodic aluminum oxide, can be used as template
One way to obtain cylindrical vertical wires is solution for nanowire growth, using electro-
to change the wet chemical etch with a highly chemical deposition and after filling the channels
anisotropic deep reactive ion etch [46]. Nano- in the template [54]. Control of growth along the
sphere lithography is another approach that axes of nanowires is necessary for the introduc-
promises higher resolution by combining the tion of surfactants capable of changing the sur-
self-assembly of a monolayer of nanospheres of face energy of crystal facets, for example,
polystyrene, for example, onto a substrate in a hexadecyltrimethylammonium bromide.
close-packed lattice [47]. The nanospheres serve Anisotropy of nanowires is easy to achieve by
as a model for the deposition of a metal or the control of surface chemistry [55] (Tables 1.1
another material and are removed after deposi- and 1.2 and Fig. 1.1).
tion. Nanoscale patterns can be produced by me-
4. Applications of nanowires
chanical transfer using nanoimprint lithography
[48,49].
Nanowire biosensors consist of typical field-
effect transistor-based devices, made up of three
electrodes that are very sensitive to the variation
3.2 Bottom-up method
in the charge density that promotes changes in
In contrast to top-down techniques, bottom- the electric field at the external surface of the
up synthesis offers the opportunity to control nanowires [64].
nanowire composition during growth. Nanowires have a high surface-to-volume ra-
In this technique of the production of nano- tio and well-defined geometry; they have high
wires, the anisotropic growth of nanowires is sensitivity and short response time. These char-
normally done using nanoparticle catalysts and acteristics offer applications in biology and
gas-phase precursors. The most used method of chemistry. Applications of nanowires can be
production is vapor/liquid/solid growth. In categorized into two methodologies: electrical
this method, gaseous precursors are used to detection and optical detection [49].
obtain the desired nanowires and these precur-
sors are dissolved into a liquid-metal catalyst,
4.1 Nanowires in bioanalytical chemistry
for example, in the case of silicon nanowires
the precursor used is SiCl4. After the catalyst is One of the bioapplications of nanowires is
supersaturated, solid nanowire crystallization biomolecule analysis. This application includes
from the liquid catalyst begins [50,51]. In this the study of mechanical cell lysis. Cellular lysis
process, the metal should form a droplet in the is a fundamental process in the study of intracel-
liquid state that will serve as the catalyst. This lular components. There are a number of well-
droplet, in some cases, will melt at a lower tem- established methods that can analyze the cell
perature when compared to pure metal, due to components, such as chemical, electrical, and
its eutectic composition. In the case of the syn- mechanical methods. In the case of chemical
thesis of binary or ternary compounds, which cell lysis many steps are necessary and it is an
are metals with low melting points, the vapor/ expensive process, consuming many reagents
liquid/solid system can be self-catalyzed [52]. aimed at the purification of biomolecule sam-
The solution/liquid/solid method is another ples. Another disadvantage is the high probabil-
technique of nanowire production similar to ity of the occurrence of harmful effects on
4. Applications of nanowires 5
FIGURE 1.1 Scanning electron microscopy images of CuS nanowires: (A) array; (B) copper oxide (CuO) nanotubes;
(C) array; (D) fabrication using anodic aluminum oxide template. Image copied from Mu C, He J, Confined conversion of CuS nano-
wires to CuO nanotubes by annealing-induced diffusion in nanochannels. vol. 6. 2011. p. 150. Available via license: CC BY 2.0 (https://
creativecommons.org/licenses/by/2.0/).
TABLE 1.1 Advantages and disadvantages of top-down and bottom-up methods [56e58].
Top-down Easy to construct order arrays of nanowires. The applicability of the photolithography method decreases as
This order facilitates electrical contact with the the desired length scale diminishes, which requires the use of
nanowires and their integration into large-scale more advanced methods, for example, extreme ultraviolet
devices lithography, electron-beam and scanning probe lithographies
Compatibility of production methods with Nanowires formed by top-down methods frequently lack
standard microelectronics industry processes. complex electronic characteristics. All the codifications after
Easy scale-up growth greatly increase the material cost of nanowire
Bottom-up Provides the opportunity for the control of the The major challenge of these methods is their integration into
composition of nanowires during growth, which large-scale devices
permits the production of complex superlattice
structures
microorganisms [65,66]. The solution to this low throughput [67]. The ultimate discovery
problems is the use of electrical cell lysis, which was the use of nanowires because of their small
is less harmful than the aforementioned method; size (smaller than the cells) and the critical advan-
however, it still an expensive method and has a tage is that the nanowire tip can penetrate and
6 1. Bioactive hybrid nanowires: a new in trend for site-specific drug delivery and targeting
disrupt the function of cellular membranes [68]. used for biomedical applications. Major chal-
Nanowires eliminate microorganisms in cells lenges include
much faster than the previously described
1. advanced techniques and easy methods
methods.
(needed to increase the sensitivity of nanowire-
In analytical and biological processes, the
based electrochemical cytosensors in signal
development of biomolecule separation and
amplification),
analysis is essential. In the separation of long
2. further research into nanowires to promote
DNA molecules, conventional gel electropho-
cell adhesion, sensitivity, and selectivity,
resis has a disadvantage: it is necessary to
3. more specialized coatings to decrease non-
analyze biomolecules for several hours. The
specific bonding,
combination of nanostructures produced by
4. protocols and further experiments to deter-
top-down approaches and microfluidic systems
mine the exact nature of the nanotoxicity of
is usually proposed to overcome the problem.
nanowires and their constituents,
However, difficulty in their production using
5. innovative solutions to reduce fabrication and
an electron-beam lithography process makes it
running costs of nanowire-based micro/nano-
a very expensive and sophisticated system
fluidic devices to make them economically
[69,70]. On the other hand, nanostructures pro-
viable,
duced by bottom-up approaches offer easy fabri-
6. with every emerging technology, standards to
cation and separation of biomolecules; however,
avoid doubts about the lack of reproducibility,
size limitation causes difficulty in their develop-
repeatability, and compatibility across plat-
ment. To overcome all these problems, self-
forms and laboratories, and
assembled nanowire structures of metal oxides
7. an opportunity for further advances and de-
have been investigated due to their rigidity and
velopments of cytosensing devices based on
the possibility of reusability [49] (Table 1.3).
electrochemical methods [73].
Circulating tumor cells play an essential role
4.2 Nanowires as biosensors in medical in cancer metastasis, and knowledge of their
diagnosis presence in blood samples of cancer patients is
There are many challenges ahead that must be needed to understand more about the type of
addressed before nanowires can be successfully cancer. Hosokawa et al. have shown an array
4. Applications of nanowires 7
TABLE 1.3 Nanowires in bioanalytical analyses.
Mechanical ZnO nanowires Method of low- Higher extraction efficiency for nucleic acids [71]
cell lysis (diameter: 100 nm) temperature and proteins than using chemical cell lysis
on the surface of a hydrothermal methods
pillar array in a reaction
microchannel
ZnO nanowires were Method of low- Easy and rapid mechanical cell lysis [72]
synthesized on the Si temperature Higher extraction efficiency for proteins and
membrane (average hydrothermal reaction nucleic acids than that obtained for
pore diameter: 75 nm) commercially available kits
Biomolecule SnO2 nanowires Photolithography Nanowire structure controlled the pore [49]
separation produced into process and vapor/ size (20e400 nm) by varying the number of
and filtration fused silica liquid/solid technique nanowire growth times
microchannels Highly dense nanowires, used as a
molecular filter, could provide high-throughput
filtration of DNA molecules
of microcavities to perform size-selective capture diagnosis, because they capture and purify circu-
of circulating tumor cells [74]. Another study re- lating tumor cells rapidly prior to circulating tu-
ported that a herringbone chip captured and iso- mor cell molecular analysis [49,76].
lated clusters of circulating tumor cells from the A silicon nanowire-based electrical cell
patient’s blood, which had a capture efficiency of impedance sensor has been developed for the
more than 80% [75]. Tseng et al. developed sili- detection of cancerous cultured living lung cells
con nanowires, which they called a NanoVelcro by monitoring their spreading state at which
chip, to capture and release circulating tumor the cells stretched and became extended on
cells from blood samples with high selectivity nanowires [80]. The diagnosis was carried out
[76,77]. Si nanowires were produced based on by penetration into the extended membrane of
substrates by a standard photolithography and malignant cells with respect to healthy cells.
chemical wet etching process, and they were Silicon nanowire biosensors have advantages
then bonded to a chaotic mixture of microfluidic in molecular detection because of their high
channels to fabricate the NanoVelcro chip. This sensitivity and fast response. A polycrystalline
procedure of surface modification with cell sur- silicon nanowire field-effect transistor device
face markers of anti-EpCAM increased the was developed to achieve specific and ultrasen-
capturing efficiency of circulating tumor cells sitive detection of microRNAs without labeling
or of anti-CD45-depleted white blood cells on and amplification, showing that the diagnostic
the nanowires [78,79]. The NanoVelcro chip and prognostic value of microRNAs in a variety
with nanowires has been developed for single- of diseases is promising. Thus the polysilicon
circulating tumor cell isolation by depositing nanowire biosensor device is promising for
thermoresponsive polymer brushes, poly(N-iso- microRNA detection [81].
propylacrylamide), on silicon nanowires [78]. In short, semiconductor nanowires are
NanoVelcro chips are promising tools in emerging as promising biosensors enabling
8 1. Bioactive hybrid nanowires: a new in trend for site-specific drug delivery and targeting
Silicon nanowire field-effect transistors Detection of proteins, DNA sequences, small molecules, [83]
cancer biomarkers, and viruses
NanoVelcro chip with nanowires Developed for single-circulating tumor cell isolation [78]
Silicon nanowire-based electrical cell impedance Detection of cancerous cultured living lung cells [80]
sensor
Nanowire-based field-effect sensor devices (which Used as a powerful detection device for a broad range of [84]
can be modified with specific surface receptors) biological and chemical species in solution
particles is the strong photothermal effect as a that W18O49-based synergistic trimodal therapy
result of the near-infrared absorbing ability of eradicated xenograft tumors, and no recurrence
polypyrrole synergistically that, as a conse- was observed. In conclusion, these nanowires
quence, maximizes chemotherapeutic efficacy, have shown significant potential for cancer ther-
which is very promising for many therapeutic apy with inherent image guidance and synergis-
applications, including cancer [91]. tic effects from phototherapy and radiation
To detect specific mRNA sequences, essential therapy, which warrants further investigation
in the treatment of cancer, molecular beacons [94].
have been widely employed as sensing probes.
Kim et al. developed a nanowire-incorporated
and pneumatic pressure-driven microdevice for
rapid, high-throughput, and direct molecular 5. Conclusions
beacon delivery to human breast cancer MCF-7
cells to monitor survivin mRNA expression This chapter summarizes the critical results ob-
[92]. This microdevice is composed of three tained using nanowire structures as a platform
layers: (1) a pump-associated glass manifold useful in bioanalytical chemistry and medical di-
layer, (2) a monolithic polydimethylsiloxane agnostics. Nowadays, there are various technical
membrane, and (3) a ZnO nanowire-patterned approaches to develop nanowires for bio-
microchannel layer. The molecular beacons are applications in molecular to cellular levels. Nano-
immobilized using the ZnO nanowires by disul- wires have been integrated with microchannels,
fide bonding, and the glass manifold and mono- providing a novel pathway from the macroscale
lithic polydimethylsiloxane membrane serve as a to the nanoscale that will allow researchers to
microvalve. The cellular attachment and detach- observe and analyze target molecules such as
ment on the molecular beacon-coated nanowire DNA, RNA, proteins, and circulating tumor cells.
array can be easily manipulated. All these pro- Another benefit of nanowires is their very small
cedures enable the transfer of molecular beacons diameter size with high aspect ratio; this can
into the cells in a controllable way with high cell allow researchers to use nanowires as a probe
viability and are useful to detect survivin mRNA tip to stimulate and record changes in electrical
expression quantitatively after docetaxel treat- signals in living cells. Nanowires were also used
ment [92]. as biological optical sensors. These improvements
Combination therapy is a promising cancer in nanowire structures will allow the develop-
treatment strategy that is usually based on the ment of new bioanalytical chemistry and medical
utilization of complex nanostructures with mul- diagnostics tools that will open a new age of
tiple components. Ultrathin tungsten oxide nanotechnology with the widespread use of
nanowires (W18O49) were synthesized using a nanowires for bioapplications.
solvothermal approach and were examined as
a multifunctional theragnostic nanoplatform
[93]. In vitro and in vivo analyses demonstrated
Acknowledgments
that these nanowires could induce extensive The authors acknowledge the financial support received from
heat- and singlet oxygen-mediated damage to the Portuguese Science and Technology Foundation (FCT/
MCT) and from European Funds (PRODER/COMPETE) un-
cancer cells under 980 nm near-infrared laser der the project reference M-ERA-NET/0004/2015-PAIRED,
excitation. The comparison of near infrared- cofinanced by FEDER, under the Partnership Agreement
induced photothermal therapy/photodynamic PT2020.
therapy and radiation therapy alone showed
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C H A P T E R
2
Opportunities and challenges of
3D-printed pharmaceutical dosage forms
Adam Procopio1, Divya Tewari2
1
Merck & Co., Inc., Kenilworth, NJ, United States; 2Noramco Inc., Wilmington, DE, United States
shown to modify the release rate [4e7]. the chosen material. Material properties have
Manufacturing of drug product dosage forms wide-ranging impact, from influencing the
that combine a shell-based approach to be preferred route of manufacturing to the phys-
described in detail in a later section have ical properties of the dosage form to its pharma-
demonstrated a unique ability to generate codynamic fate in the body. A wide range of
distinct release rates. Such core/shell tablets materials are used as substrates in 3DP; howev-
have been manufactured by using a second er, because of their origin in industrial prototyp-
API-containing material [8] or a placebo mate- ing, most 3DP techniques lack availability of
rial with the intent to mimic enteric-coated tab- suitable developed materials [15].
lets [9,10] and have demonstrated the agility of The successful design and printability of the
3DP to change the onset of the release of the core 3D-printed dosage forms is dictated by the phys-
of the dosage form. ical, chemical, thermal, and mechanical proper-
While these approaches have demonstrated ties of the chosen material. Additional
an ability to use software for tuning drug considerations should be given to ease of avail-
release rate while maintaining a constant mate- ability and the regulatory status of the materials.
rial feedstock, they are reliant on a successful In the absence of the standard test methods a
hot melt extrusion (HME) formulation of a specifically designed method to characterize
printable filament for each API. Developing the material properties of the additives can be
process conditions to incorporate API into an used, and we have compiled current test proced-
excipient-based solid filament is not trivial ures employed by various researchers and high-
[11e14], and these filament processing develop- lighted some of the standard utilized ASTM
ments add to the product development burden, methods.
reducing the rapid prototyping advantage 3DP The range of polymers used in 3DP include
brings to the table for early drug screenings. A thermoplastics, thermosets, elastomers, hydro-
major hurdle the pharmaceutical 3DP field has gels, functional polymers, polymer blends, com-
yet to overcome is providing a wide, distinct posites, and biomaterials [16]. Polymeric
range of dosage forms using a universal set of materialsdpolymersdconstitute the majority
starting print-ready materials to accommodate of materials used in 3DP due to several
any API without filament formulation burden, advantages such as low cost, biocompatibility,
and has even a greater hurdle on aligning availability, ease of processing, and physico-
manufacturing partners to generate good chemical properties. Material selection is
manufacturing-processed pharmaceutical ma- dictated by the choice of the 3DP technology,
terials that are printer ready. e.g., polymeric filaments used by FDM must
have a constant diameter of 1.75 mm, an ideal
melt viscosity to facilitate viscous melt forma-
tion preextrusion and solidification postextru-
2. Materials
sion, and a sufficient elastic modulus-to-melt
viscosity ratio to prevent filament buckling and
Pharmaceutical dosage form design begins
shear thinning tendencies in liquid form [17].
with material selection. Because the materials
Commonly used polymers include aliphatic
are altered during the 3DP process, it is
polyesters (poly(lactide) [PLA], poly(glycolide),
imperative to understand the source, purity
poly(caprolactone) [PCL]), cellulosic derivatives
and associated material chemistry changes of
2. Materials 17
(hydroxypropylcellulose [HPC], hypromellose 2.1 Aliphatic polyesters
[HPMC], HPMC acetate succinate [HPMCAS],
cellulose acetate, and cellulose acetate phthalate), Aliphatic polyesters are synthetic homopoly-
vinyl polymers (polyvinylpyrrolidone [PVP] and mers or copolymers of lactic acid, glycolic acid,
copovidone), polyethylene oxide, polyethylene lactide, glycolide, and 6-hydroxycaproic acid.
glycol (PEG), and acrylic polymers (Eudragit). Typically, the molecular weights of homopoly-
Table 2.1 provides an overview of 3DP tech- mers and copolymers range from 2000 to
nologies and desired material properties >100,000 Da. The representative chemical struc-
required for successful development of 3D- tures are provided in Fig. 2.1 and a brief sum-
printed dosage forms. mary of their physical, chemical, and
mechanical properties is outlined in Tables 2.1
and 2.2.
TABLE 2.1 Summary of material properties and test methods commonly employed.
Powder physical properties Particle shape, particle size distribution, Laser light diffraction, densitometry,
bulk and tap densities, crystallinity, powder X-ray diffraction, differential
moisture content scanning
calorimetry, Karl Fischer, flow index
Mechanical properties Yield strength, elasticity, modulus, ASTM D638, D3039, D882, ISO 527-2,
elongation at break three-point bend test
Thermal properties Melting point, glass transition temperature, Thermogravimetric analysis
degradation temperature
Optical properties Ultraviolet absorption, laser power
Rheological properties Viscosity of the solution, binderepowder AERS-G2 rheometers, viscometers (USP
interaction, melt viscosity, melt index, 911), ASTM D1238
surface tension
TABLE 2.2 Typical chemical names and trade names of the representative aliphatic polyesters.
Composition
Aliphatic polyesters are United States Food and a wider processability window but lower
and Drug Administration (FDA) and European mechanical properties [19] (Table 2.2).
Medicine Agency approved, versatile thermo- PCL is a hydrophobic polymer with excellent
plastic polymers that are used in a number of blend compatibility with many other polymers
3DP technologies such as FDM, selective laser such as polyvinyl(acetate), poly(vinylchloride),
sintering (SLS), pressure-assisted microsyringes poly(styrene-acrylonitrile), and poly(acryloni-
(PAMs), etc. due to their biocompatibility, trile butadiene styrene). Its blend compatibility,
biodegradability, high mechanical strength biodegradability, low melting point, and solubi-
and modulus, and processability [18]. Ease of lity make this polymer suitable for precise
availability and cost effectiveness make extrusion deposition and FDM techniques. The
aliphatic polyesters highly desirable polymers only disadvantage of PCL is its hydrophobicity,
for 3DP, whereas the main disadvantages are which might adversely impact drug dissolution
the appearance of rough surfaces and low characteristics.
resolution.
PLA is by far the most widely used material
for FDM printing. PLA and its derivatives are
poorly water soluble but have good solubility
2.2 Cellulose ethers and esters
in dioxane, acetonitrile, chloroform, methylene Cellulose is the most abundant naturally
chloride, 1,1,2-trichloroethane, and dichloroace- occurring polysaccharide. Each polysaccharide
tic acid. The thermal and mechanical properties unit is linked by b-1,4-glycosidic bonds. Each
of PLA are influenced by small amounts of glucose unit has three hydroxyl groups that
enantiomeric impurities. Amorphous grades can be derivatized and the average substitution
were reported to have better processability grade cannot exceed three. Alkalization of
2. Materials 19
cellulose, followed by etherification reaction at Thermoplastic polymers are typically mate-
elevated temperatures and pressures, is used to rials of choice in 3DP coupled with extrusion
convert cellulose molecules into their corre- because they can be processed at suitable tem-
sponding ether, such as HPC, HPMC, and peratures without affecting the stability of the
many other semisynthetic cellulosics. Esterifica- APIs [21]. Cellulose esters and ethers have been
tion of the cellulose ethers could be used to tested as carriers or matrices for drugs in FDM
derive molecules such as HPMCAS. At the basic technology with HME [22]. HPMC in either solu-
level, cellulose derivatives are characterized by tion, dispersion, or paste forms has also been
their average molecular weight distribution used in PAMs printing technology [23].
and average composition. Compositionally,
these polymers are defined by the percent
weight of the functional group attached to the 2.3 Acrylic polymers
backbone, the degree of substitution per anhy- Polymethacrylates are synthetic cationic and
droglucose, or the total molar substitution per anionic polymers of dimethylaminoethyl meth-
anhydroglucose residue [20]. The representative acrylates, methacrylic acid, and methacrylic
chemical structures are provided in Fig. 2.2 and a acid esters in varying ratios [24]. Eudragit poly-
summary of their physical, chemical, and mers are copolymers derived from esters of
mechanical properties is provided in Table 2.3. acrylic and methacrylic acid whose
TABLE 2.3 Typical physical and mechanical properties of the aliphatic polyesters.
8515
Properties L-PLAa DL-PLAa PGAa PCLa 85/15 DL-PLGa L/PCLb
reaction in an organic solvent such as ethanol or FDM, polymers used in HME are frequently
2-propanol [29]. adapted for use in 3DP. Additives, such as plas-
The representative chemical structures, com- ticizers and fillers, are usually employed to
mercial supplier information, and polymer prop- reduce the Tg of PVP polymers and render
erties are given in Fig. 2.4 and Tables 2.7 and 2.8, them suitable for FDM printing coupled with
respectively. HME. Major et al. examined the material proper-
PVA is a thermoplastic, water-soluble excip- ties of PVP/VA copovidone copolymers in hot
ient that is commonly employed as polymeric melt extrusion-based 3DP and encountered diffi-
support material for FDM-based 3DP culties in printing due to brittleness and high
[5,6,8,30,43,44]. The degree of hydrolysis impacts stiffness of the copolymer. Melt blending with
the physicochemical, thermal, and mechanical a carrier polymer such as PCL improved flexi-
properties of the resultant PVA grade. Besides bility and ductility thereby resolving the print-
FDM printing, PVA has also been used in inkjet ability issue. Polyethylene oxide was also
printing [31]. added to the formulation to reduce the negative
PVP and PVP/VA polymers are known for impact of PCL on drug release profiles [32]. Melt
their application in the solubility enhancement blending PVP/VA with hydrophilic polymers
of poorly water-soluble drugs via HME. Due to such as HPMC and HPMCAS resulted in imme-
the complementarity of HME technology with diate release formulations [33].
22 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
TABLE 2.5 Typical physical, mechanical, and thermal properties of the cellulose polymers.
Aqualon
Properties Klucel HPCa Benecel HPMC AquaSolve HPMCAS ethylcellulose
2.4.1 Novel polymers in the market (polyether or polyester based) and hard seg-
Melfil is a water-soluble filament of butane- ments (aliphatic or aromatic based) of the
diol vinyl alcohol copolymer specifically TPUs [34].
designed for FDM 3DP. It offers superior water Polyether ether ketone (PEEK) and polyether
solubility and printability along with the flexi- imide (PEI, brand name ULTEM) are newer ther-
bility to use as a support material or a water- moplastic semicrystalline materials from the pol-
soluble model (see the Nippon GohseidMelfil yaryletherketone (PAEK) family of polymers
Product Brochure [53]). currently used in FDM printers [35]. PAEK poly-
Thermoplastic polyurethanes (TPUs) are mers can withstand high temperatures while
elastic and melt processable linear-segmented maintaining mechanical strength [36]. PEEK is
block copolymers. TPUs offer a unique advan- a superhigh-performance, biocompatible, chemi-
tage over other thermoplastic polymers because cally stable, semicrystalline plastic that offers the
of their extreme material adaptability. This is advantages of high-temperature resistance
due to the flexibility in modifying the molecular (melting point of 334 C, Tg of 143 C) and excel-
weight, ratio, and chemical composition of soft lent mechanical properties, including high
2. Materials 23
TABLE 2.6 Typical chemical names and trade names of the representative acrylic polymers.
Polymer dry
Generic name weight content (%) Trade name (supply form) Manufacturer
TABLE 2.7 Typical chemical names and trade names of the representative vinyl polymers.
TABLE 2.8 Typical physical, mechanical, and thermal properties of the vinyl polymers.
PVA, Polyvinyl alcohol. a Specifications from the Ashland brochure, b Handbook of Pharmaceutical Excipients, Sixth Edition, 564e565, c Handbook of
Pharmaceutical Excipients, Sixth Edition, 581e585, d Ashland Literature PTR-092 Plasticizer compatibility and thermal and theological properties of
Plasdone povidone and copovidone polymers for hot-melt extrusion applications, e Hamied, S.F.A; Abd El-Kader, K.A.M. Preparation of poly (vinyl alcohol)
films with promising physical properties in comparison with commercial polyethylene film.
Laser
Vat
SLA Photo 3D Printed Y plaorm
resin Object
which are electromechanical instruments used to surfaces. Unlike SLA where the photochemical
precisely control the position of the mirror and reaction is near the liquid/air interface and sub-
hence the position of the laser spot location. ject to oxygen inhibition less direct control of the
This process is conducted layer by layer whereby photochemical cross-linking reaction, DLP 3D
the slicing software converts the 3D image to be printers are controlled in the reverse direction
printed into a series of control statements that where the reaction layer occurs at a plane
ascribe not only the position of the platform po- immersed well below the liquid/air interface.
sition, but also the laser energy pulse and well as An example of the application of DLP in 3DP is
the tilt angle of the mirrors used to position the the work by Kim et al. with precision bioprinting
xey position of the spot. A unique feature of of silk fibroin bioink for applications in building
photopolymerization 3D printers is the ability complex organ structures [38].
to resolve fine details by the application of galva-
nometer dithering (or high-frequency move- 3.1.3 Continuous liquid interface production
ments) to effectively process grayscale images The latest variety of vat photopolymerization
that prescribe laser energy states between full is CLIP [39,40]. This technology addresses the
on or full off. This technique allows for the crea- major time-limiting step of both SLA and DLP,
tion of highly resolved surfaces. In general, pho- which is the required mechanical separation of
topolymerization techniques allow for highly the just-cured material from the vat of unpoly-
resolved features and surfaces on the order of merized material. This 3DP technique uses an
1 mm. Their main disadvantages are extremely oxygen permeable membrane to inhibit poly-
limited for use as a biopharmaceutically accept- merization at the interface nearest to the ultravi-
able process in that they are using both toxic olet (UV) light source. This region creates a
monomer and oligomer materials and usually 10e100 mm “dead zone” where free radical
have lengthy postprocessing steps to remove polymerization does not occur. Just above this
any unreacted monomer and oligomer as well zone, light-catalyzed free radical polymeriza-
as completely consume any unreacted free radi- tion occurs on the focal plane of the projected
cals as a result of photochemistry. The materials light. This innovation is key to facilitate a faster
available for creating 3DP drug products from 3DP process because the need to refresh or
photochemical reactions are limited but research recoat the region between the printed part and
in this area is evolving. the light source using a mechanically activated
platform is not needed. Using CLIP, this region
3.1.2 Digital light processing is continuously present with uncured formula-
DLP is analogous to SLA because both pro- tion and the 3D-printed part appears to
cesses use a controlled wavelength light source “grow” out of the resin. Resolution of the part
to selectively drive a photochemical reaction of in the vertical direction is improved by
a resin formulation. The main difference be- increasing the concentration of the passive light
tween SLA and DLP is that the light source in absorber. This slows down the production
SLA acts as an XeY rastering, whereas in DLP speed because light penetration is in a smaller
the entire layer to be cured is projected onto volume of the resin. By lowering the concentra-
the focal plane at one time. The technology tion of this additive, deeper penetration of light
used with DLP is the same technology used in can be realized and hence faster production
overhead projectors, which allows for dithering speeds. Part quality is also improved by
as described in the SLA section earlier and for removing the need to mechanically separate
grayscale image processing and hence higher the part from the resin bath. This mechanical
resolution features and smoother printed separation that is typical in most SLA 3D
3. Technology details 27
printers causes undue stress on the part and can also implies that a lengthy and “dirty” postpro-
lead to feature distortion or even failure. CLIP cessing is required to remove the bulk powder
allows for both high print quality and speeds from the build chamber as well as the powder
and can produce parts with features below that is loosely adhered to the final printed part.
100 mm at growth rates in the range of a vertical Because of the impact of the heat-affected zone
support plate speed of 1000e3000 mm/h. powder, not all of this unprinted powder can
be reused, and it is good practice to blend virgin
powder with this recycled material.
3.2 Powder bed fusion processes One key to this technique is for the process to
proceed so that enough thermal mass is present,
3.2.1 Selective laser sintering process/laser such that not only are the particles bonded
sintering process within the as-printed 2D layer, but this layer
Generally, laser sintering 3DP allows for also softens/melts and binds through the same
many more materials over other 3DP techniques diffusional process to the layer(s) just below to
from high-performance thermoplastic polymers form our 3D-printed part. For thermoplastic ma-
to even metal powders. terials, liquid-phase sintering drives capillary in-
The operating principle behind powder-based teractions between neighboring particles
SLS consists of powder deposition from the feed resulting in bonds due to the diffusion of poly-
chamber to the build chamber by powder trans- mer chains or chemical cross-linking.
fer and consists of build surface preparation by One method that ensures a well-formed 3D-
rolling and leveling with a scraper, laser raster- printed part is to keep the entire 3DP chamber
ing and particle melting and sintering, cooling at a temperature just below the softening or
and solidification, followed by the build cham- melting point of the material to decrease the pro-
ber being lowered by one-layer thickness to cessing time and reduce thermal gradients
repeat with a recoating of fresh material from within the part, which can lead to part distor-
the feed chamber. During the printing process, tions caused by the relatively large volume
the laser, in most applications a 2 W blue diode changes in semicrystalline or amorphous poly-
laser (445 nm) light source, is rastered mers. In this method, maintaining an elevated
(w100 mm/s) to match the geometry of the layer environment is a key consideration in the pro-
[27]. The light energy from the laser source is cessing of thermally sensitive materials (e.g.,
absorbed by the particles at the site of the laser oxidation) and would need careful evaluation
focal spot, which in turn heats the material depending on the material that is used for print-
beyond the thermal transition (Tg or Tm) allow- ing. To provide the best part quality and mini-
ing for interparticle contact diffusion and bind- mal part warpage, the build volume is left to
ing. After removal of the light source the cool gradually over 24e48 h for both safety in
energy dissipates, and the newly formed handling and to avoid distortion caused by pre-
coherent body solidifies. The unprinted material mature handling while the parts are in a softened
surrounding the printed material serves as an condition.
intrinsic support material. The fact that the 3D- One of the more critical criteria for this pro-
printed parts are constantly surrounded by cess to be effective is the flow and particle pack-
unprinted support material means that parts ing properties of the starting material. Because
can be effectively stacked and printed together the powder deposition process between adja-
to make efficient use of the build volume but it cent layers is done by depositing material
28 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
through a blade and roller recoating process, cell growth in tissue engineering. SLS is appli-
the distribution of the particles across the 2D cable to materials with vastly different bulk
plane to be printed directly impacts part qual- properties. Moreover, SLS powders for the
ity. If the particles do not flow and fill in the re- same bulk material can also vary in their
gion in a uniform manner there will be voids in morphology, sintering, and melting behavior.
the final printed part. The size and sphericity of
the particle properties also directly influence the 3.2.2 Powder binding technology
surface roughness and spatial print resolution Like the SLS processes, in the first step of
of the manufactured parts. Part resolution on powder binding 3DP a powder layer is depos-
the order of 100 mm is typical for a printed ited using a roller/scraper assembly from a
part. Compressibility, or volume reduction, un- feeder chamber to the build chamber. Unlike
der the roller assembly can aid in powder bed SLS, which used a thermal method of binding
uniformity and this predensification can enable powder, in liquid-phase powder binding 3DP,
the printing of higher-density final parts. the powder is bound together with the use of a
Many SLS 3D-printed parts undergo a series liquid that is dispensed using an inkjet printing
of postprocess finishing operations to provide head. The inkjet head will either contain a sol-
more elegant surface properties. In addition, vent (e.g., water) or a solventebinder solution.
intrinsic to the type of 3DP, because of the use In the former, the binder is contained within
of powder as the starting material, final parts the powder formulation whereas if the inject
will be porous in nature, which may be consid- print head has a solventebinder solution the
ered as defects from a mechanical strength point binder is dispensed from the print head. The
of view or could aid in the disintegration of oral finished 3D-printed part is then cleaned of any
dosage forms as in traditional compressed tab- residual powder using a combination of a vibra-
lets. For biomedical applications the porosity tory plate and airflow. Much like SLS, the parti-
present in these 3D-printed parts could also cle properties drive product quality and final
serve as a scaffold for cell growth. part resolution, but unlike SLS the inkjet print
Regardless of the material used, the parts head spatial resolution is lower than that of a
obtained by the powder bed fusion processes laser spot size. This technology offers the ability
will typically exhibit a certain level of porosity. to print several materials because of two reasons:
The amount of free volume is dependent on par- either the powder loaded into the feed chamber
ticle size distribution, material choice, and pro- is a blend of multiple materials or the inkjet print
cess parameters. The pores remaining within a head could also contain a different material such
green part after the additive manufacturing as an active ingredient or a colorant. This tech-
process represent potential weak points in nology is likely the closest analogy to a tradi-
models subjected to mechanical load. If high tional wet granulation process because of the
mechanical strength is required for a given similarities in materials that are used. In fact,
application, it is therefore common practice to the powder binding technology is the same
improve mechanical properties by means of core process that is used by Aprecia Pharmaceu-
isostatic pressing, infiltration with suitable ticals to manufacture the Spritam tablet. The
resins, or sintering. On the positive side, SLS- porous nature of the powder bed process creates
fabricated parts are light and porosity can be a dosage form that instantaneously dissolves
advantageous in other applications that require because of the formulation and the intrinsic
large surface areas, for example, scaffolds for capillary wicking action of the dosage form.
3. Technology details 29
Connuous elevaon
Build Support Plate
Imaging Unit
O2 permeable
window
Mirror
Mirror Laser
Build plaorm
Material
Spool
Filament
3D printed object
Nozzle
Molten Bead
Build plaorm
nozzle assembly. Process temperature is is often the limiting factor for this 3DP tech-
defined by the thermal properties of the poly- nique. Processing not only needs to consider
mer filament, which for amorphous polymers the speed for appropriate bead deposition but
is above the glass transition temperature and also the temperature and time required for
for semicrystalline polymers is above the fusion of the deposited beads onto the adjacent
melting point. The melted filament forms a layers that were previously printed.
molten bead upon exit from the small nozzle Often in 3DP for a new polymer the impact of
orifice (0.1e1 mm diameter) and begins solidifi- several parameters is often experimentally
cation at the location from which it was derived such as filament extrusion feed rate,
extruded. The resolution of an FFF-printed temperature and thermal gradients, nozzle
part is often defined by the diameter of the design, die swelling, polymer melt rheology,
nozzle. Generally, a smaller nozzle results in a quench rate using convective air cooling, nozzle
surface that more closely follows the profile of path direction, and part orientation. These
the 3D geometry; however, this results in an in- parameters are optimized to improve 3DP
crease in print time because of the requirements efficiency, surface roughness, dimensional
of more nozzle traces to completely define the accuracy, mechanical properties, and isotropy.
geometry as well as often slowing the print Many common thermoplastic materials (e.g.,
speed because of the increase in nozzle melt PLA, acrylonitrile-butadiene-styrene copoly-
pressure as a result of the smaller diameter. mers, polycarbonate, and polyamides), have
The rheology of viscous thermoplastic polymer been optimized for fused filament fabrication
4. Regulatory and quality considerations 31
3DP, while other more nascent thermoplastic the reader to key recommendations that are
polymers relevant for the pharmaceutical common for drug products. Generally, regu-
industry are still being experimented. lated products must fulfill standard Quality
System requirements. Specific to 3DP of drug
3.3.1 Postprocessing products, manufacturers must validate their
Across most all 3DP technologies, the final process and establish and maintain procedures
part requires additional processing steps after for monitoring and controlling processing
completion of 3DP. Depending on the printing parameters to ensure that the specifications of
process these steps involve either mechanical the drug product can be met with a high degree
removal of material used to improve adhesion of confidence and the product performs as
to the printing plates, removal of support intended. There are numerous 3DP technologies
material used in the printing process, chemical described that can be used to manufacture drug
and/or thermal treatment of unreacted surface products and hence there are different process-
material, removal of unbound surface powder, ing steps that are implemented to manufacture
or heat treatment to reduce unwanted part a quality drug product. Because of the relative
residual stresses. Careful consideration and novelty of 3DP, a higher level of scrutiny should
execution of the postprocessing steps is crucial be expected due to the integration of a novel
to ensure that the part does not suffer undue manufacturing technique with traditional or
damage. novel materials that have been reprocessed or
adapted to be enabled by 3DP. One unique reg-
ulatory consideration that is atypical from tradi-
tional pharmaceutical manufacturing is the
4. Regulatory and quality considerations utilization of software in both the design of
the final product and in the control of the pro-
The FDA recently issued a guidance for
cess to manufacture the final drug product.
industry entitled “Technical Considerations for
3DP involves a multistep software process that
Additive Manufactured Medical Devices.”
is used to design and convert 3D dosage form
Even though medical device and combination
shapes ranging from simple/traditional to com-
products are regulated by the Center for
plex (more on these designs will be highlighted
Devices and Radiological Health, many ele-
in the sections that follow), into sliced 2D layers
ments discussed in this document highlight
(using “slicer” software). This geometrical 2D
key considerations for additive manufactured
information is then used as input into control
drug products that are regulated by the Center
software that then translates this information
for Drug Evaluation and Research. This guid-
into print commands. To enable consistency
ance like most offers supplementary regulatory
across the industry, the FDA guidance proposes
guidance that covers 3DP-specific recommen-
the utilization of a specific file format for addi-
dations. The device-specific 3DP guidance
tive manufacturing (ISO/ASTM 52915 “Stan-
document covers (1) design for 3DP, (2)
dard specification for additive manufacturing
patient-matched device design, (3) software
file format”). The intention of this standard is
workflows, (4) controls over materials used for
to create a well-controlled and integrated file
3DP, (5) postprocessing considerations, (6) pro-
that describes the printed volume, material
cess validation and product acceptance testing,
information, and the print controls and print
(7) quality, and (8) device testing consider-
location within the print volume. As will be
ations. It is not the intention of this section to
highlighted later, and perhaps more unlike
recount this guidance document but to direct
32 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
other traditional pharmaceutical applications, Table 2.9 highlights some of the critical 3DP
software processes are as critical as and, in processing variables and failure modes that
some instances, more critical of final product need to be considered when establishing the
quality compared to traditional pharmaceutical quality system for a drug product.
process hardware/critical process parameters.
Quality that is governed by software is not
only process control over material being 5. Pharmaceutical applications for drug
handled by the printer in terms of temperature delivery
and time as was pointed out earlier, but just as
important is the structure and path for the print- The current advantages of using 3DP for
ing tool that drives the printing of the drug pharmaceutical dosage forms are targeted at
product. dosage form design and patient customization.
Just like other pharmaceutical processes, 3DP Here we detail several published accounts of
often uses environmentally sensitive material as applying 3DP in the production of more tradi-
a matrix and therefore needs to be handled and tional oral dosage forms, customized oral
evaluated similarly. In addition, many physical dosage forms that highlight the ability to tailor
and chemical attributes that govern product doses and release rates to meet patient needs,
quality in traditional processes are just as impor- as well as nonoral dosage forms that aim to pro-
tant in 3DP. For example, particle size for SLS is a vide more patient complaint dosage forms
critical material attribute that defines not only through longer acting drug delivery. Another
final dosage form elegance but also mechanical advantage of 3DP in drug product development
strength and dissolution variability due to defect is the ability to circumvent the long and com-
populations because of broad particle size distri- plex clinical R&D process. This is especially
bution and insufficient sintering at specified true when the work requires: increasing drug
locations because of voids. solubility by converting the active ingredient
from crystalline to amorphous using processes
such as spray drying or HME, protecting the
TABLE 2.9 Examples of fused filament fabrication active ingredient from a specific region of the
process critical process variables and gut, or altering the drug release profile to over-
failure modes. come pharmacokinetic-related adverse events.
3DP can allow for production of dosage forms
Process variables Failure modes
that overcome these common R&D challenges
Hardware/software Voids between layers in a cost-effective and rapid approach in a
input/output Incomplete layer print single-step process.
Extrusion rate Interlayer adhesion
Retraction settings Plateepill adhesion
Nozzle temperature Stringing
Nozzle size Temperature excursions 5.1 Tunable release technologies
Nozzleeplatform gap Thermal degradation
Platform surface type
Currently, there are limited pharmaceutically
Platform surface roughness acceptable materials available in filament form,
Platform temperature which is the raw material feedstock for FDM
Flow rate printers. Many traditional polymer excipients
Print Speed do not have the appropriate thermal and
5. Pharmaceutical applications for drug delivery 33
mechanical properties for filament processing surface roughness of the printed capsule walls
or the physical properties are altered when were investigated. Typically, however, the fila-
drug is incorporated in the filaments. To have ment that is loaded into the FDM 3D printer is
a robust filament the polymer must be suffi- preprocessed using extrusion to incorporate
ciently rigid to maintain its form as it is pushed active ingredients, which are then used to print
from the compression gear through the hot end the final dosage form. PVP [10,41a,41b] mixed
nozzle orifice of the printer. The polymer with drug in an HME process has been used
should be sufficiently tough so the extruder with FDM to construct oral dosage forms.
gear of the FDM printer can gently depress PVA has been most commonly used due to its
and grip the filament to generate an extrusion beneficial mechanical and thermal properties
force greater than the resistance from the aiding the FDM process [6,8,30,40b,42e44].
molten polymer flow out of the nozzle. In addi- Recent work on manufacturing filaments for
tion, the melting temperature or glass transition 3DP examined the use of Eudragit EPO, a
temperature must be significantly higher than cationic acrylic polymer with dimethylamine-
the temperature inside the printing enclosure containing side chains, which is a polymer typi-
to allow forced air cooling to rapidly quench cally unsuitable for FDM due to its brittle prop-
the extrudate. The melting temperature should erties [14]. This study showed that Eudragit
also be below 250 C, which is the maximum EPO could be compounded with a plasticizer,
temperature allowed in most commercially triethyl citrate, and a nonmelting filler, trical-
available FDM printers. Finally, to maintain cium phosphate, to optimize the hardness and
proper molten flow, the thermoplastic material flexibility properties to enable printing of the
must not degrade while it is held at elevated filament. The same research group
temperatures during the printing process for demonstrated the feasibility of printing an
extended periods of time, usually on the order enteric-coated 3D-printed caplet using the
of minutes. Once a filament is extruded, X-ray same plasticizer and filler approach with PVP
computed tomography can be used as a quality and drug-free Eudragit EPO [10]. Other
check for surface or volumetric defects extruded materials, where quinine was mixed
[40a,40b]. Diameter variations in the filament individually with Eudragit RS, PCL, PLA, and
tend to strongly correlate with the quality of ethyl cellulose at a 5 wt% drug loading, demon-
the final print as most commercial printers do strated viability for use as FDM filaments for
not dynamically change the extrusion rate preparing 3D-printed implants [44a]. It has
based on the filament’s instantaneous diameter. also been demonstrated that soaking filaments
Typically, pharmaceutically acceptable poly- in a poor or nonsolvent solution containing
mers have been experimented with varying suc- drug can result in diffusion of drug into the
cess. HPC has been used to print drug-free filament, although drug loading is intrinsically
capsules that are manually filled and assembled lower than extrusion methods [42]. To date,
postprinting [41]. Additional work has high- there are limited successful piloting examples
lighted the difficulties and limitations of using of pharmaceutically acceptable filaments, and
FDM for printing PVA capsules where the the surface quality of these printed dosage
dosage forms were printed for hand filling forms indicates more optimization is required
with placebo liquids, followed by manual as- before widespread adoption can be realized.
sembly and sealing, and external and internal
34 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
As of 2019, there are numerous examples of the final dosage form play are key role. An advan-
applying 3DP to produce dosage forms in a rapid tage of this approach of manufacturing dosage
prototyping method with variable and tunable forms directly from drug-loaded filament is that
release rates within the same manufacturing the final dosage forms are generally robust
step. Several examples rely on incorporating an enough to be used immediately after printing.
API into the filament used in extrusion-based Figs. 2.9 and 2.10 highlights a well-known study
3DP using a typical HME process by Ref. [5,8,43,44] where the dosage form surface
[1,2,5,9,10,41,43,45e48] or solvent-based diffu- area, surface area/volume, or mass were
sional processes [26,42]. The primary limitation discretely controlled and thereby directly
with these approaches is the limited amount of impacted the dissolution rate without changes
drug that can be incorporated into the filament to the formulation.
and hence the final 3D-printed dosage form Another degree of freedom in 3DP is the
with typical drug loadings in the 1e30 wt% modification of the infill parameters of the
range. The release rates of dosage forms made printed tablet, which can manipulate diffu-
by this approach are governed by either diffusion sional length scales as well as the dosage form
or erosion for which the volume and geometry of buoyancy and hence the release rates [1e3].
FIGURE 2.9 3D-printed dosage forms of various geometries using poly(lactide) as the primary matrix for tunable release
rates at constant (A) surface area, (B) surface area/volume ratio, and (C) mass (scale bar in cm). Adapted from Goyanes A, Chang
H, Sedoug HD, Hatton GB, Wang J, Buanz A, Gaisford S, Basit AW. Fabrication of controlled-release budesonide tablets via desktop
(FDM) 3D printing. Int J Pharm 2015b;496:414e420; Goyanes A, Martinez PR, Buanz A, Basit AW, Gaisford S. Effect of geometry
on drug release from 3D printed tablets. Int J Pharm 2015c;494:657e663; Goyanes A, Buanz AB, Hatton GB, Gaisford S, Basit AW.
3D printing of modified-release aminosalicylate (4-ASA and 5-ASA) tablets. Eur J Pharm Biopharm 2015a;89:157e162; Goyanes A,
Wang J, Buanz A, Martínez-Pacheco R, Telford R, Gaisford S, Basit AW. 3D printing of medicines: engineering novel oral devices
with unique design and drug release characteristics. Mol Pharm 2015d;12:4077e4084.
5. Pharmaceutical applications for drug delivery 35
FIGURE 2.10 Paracetamol dissolution profiles from 3DP solid dosage with surface area/volume ratio 1 in phosphate
buffer (pH 6.8). Adapted from Goyanes A, Chang H, Sedoug HD, Hatton GB, Wang J, Buanz A, Gaisford S, Basit AW. Fabrication
of controlled-release budesonide tablets via desktop (FDM) 3D printing. Int J Pharm 2015b;496:414e420; Goyanes A, Martinez PR,
Buanz A, Basit AW, Gaisford S. Effect of geometry on drug release from 3D printed tablets. Int J Pharm 2015c;494:657e663; Goyanes
A, Buanz AB, Hatton GB, Gaisford S, Basit AW. 3D printing of modified-release aminosalicylate (4-ASA and 5-ASA) tablets. Eur J Pharm
Biopharm 2015a;89:157e162; Goyanes A, Wang J, Buanz A, Martínez-Pacheco R, Telford R, Gaisford S, Basit AW. 3D printing of
medicines: engineering novel oral devices with unique design and drug release characteristics. Mol Pharm 2015d;12:4077e4084.
Infill is the process by which the print head will require postprocessing, such as drying or active
print an outer shell of the shape of the part and thermal curing, and the mechanical properties
the inside of this shell is filled in with a partic- for the resulting dosage product have not been
ular pattern to accommodate a predefined vol- investigated thoroughly. With both of these ap-
ume percentage. The material that is printing proaches, API chemical and/or physical stability
between the outer shell is termed “infill” and may be compromised. These paste formulations
can be controlled through software to define have been printed using similar equipment to an
both the geometry of the infill material as well FDM printer, except the hot end is replaced with
as the amount of infill. a closed shot canister. Using this approach,
In addition to their use in solid filament as the HPMC and polyacrylic acid (Carbopol 974P)
starting material for extrusion-based 3DP, [46], HPMC and lactose [47], and HPMC hydro-
viscous pastes and UV curable polymers have alcoholic gels [49] have been printed. Notably,
been shown to be viable feedstocks for this approach has been used for polypills
extrusion-based 3DP of active dosage forms [47,49], which are single oral dosage forms that
[46,47,49]. Preparing these starting materials as contain three or more isolated volumes each con-
shown in Fig. 2.11 requires less process develop- taining a different active ingredient. While paste
ment as compared to an extrusion-based formulations open doors to more material
approach; however, these dosage forms typically choices, this approach typically requires
36 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
FIGURE 2.11 (i) Schematic diagrams of (A) the dispersion technique of hypromellose (HPMC) 2910 powder and
(B) formulation of HPMC hydroalcoholic gel [46]. (ii) Photograph of a RegenHU 3D printer (left) RegenHU Switzerland
(regnhu,com), and image of a multiactive tablet (right) (10.45 mm [height], 6 mm [radius]) composed of a captopril osmotic
pump compartment (bottom), and nifedipine (hole I) and glipizide (hole II) sustained release compartments (top) and joining
layer (middle).
subsequent steps such as overnight drying of the rates using different strategies, largely focused
print to remove any solvent or water from the on maintaining a similar material feedstock
dosage form for long-term physical stability, and using creative printing parameters to
and it is unclear at this time how the mechanical generate various releases. With all the following
robustness of paste-printed dosage forms will examples, at least one solid filament material is
endure secondary packaging and user handling. preprocessed to contain API. The extrusion of
These are existing examples of implementing filaments or pastes has been used to manufac-
3DP technology into rapid prototype release ture what are termed core/shell tablets, where
5. Pharmaceutical applications for drug delivery 37
the outer shell’s thickness is varied, and has 5.2 Paste/gel extrusion-based
demonstrated the generation of distinct release technologies
rates. Core/shell tablets have been manufac-
tured by using a second API-containing mate- A unique approach that attempts to incorpo-
rial [8] or a placebo material with the intent to rate both filament-based and paste/gel
mimic enteric-coated tablets [9,10], and have extrusion-based technologies has been devel-
demonstrated the agility of 3DP to change the oped by Smith et al. [50,51]. The aim of their
onset of the release of the core of the dosage work was to take advantage of the printability
form by as much as 2 h in vitro using the same of pharmaceutically acceptable polymers like
material feedstock. While these strategies have PLA and PVA while limiting the processing of
been demonstrated to provide a software tun- API to similar approaches shown earlier for
ing knob for release rate manipulation while paste, liquids, and gel-based formulations.
maintaining a constant material feedstock, all They developed a single-step FDM 3DP process
of these strategies rely on HME formulation of to manufacture thin-walled drug-free capsules,
a printable filament for each API. Developing which can be filled with dry or liquid drug prod-
process conditions to incorporate API into an uct formulations. Drug release from these sys-
excipient-based solid filament is usually not tems is governed by the combined dissolution
trivial [11e14], and these filament processing of the FDM capsule “shell” and the dosage
developments add to the product development form encapsulated in these shells. To prepare
burden, reducing the rapid prototyping advan- the shells, the 3D printer files (extension
tage 3DP brings to the table for early drug “.gcode”) were modified by creating discrete
screenings. zones, so-called “zoning process,” with individ-
Fina et al. [52] presented the first published ual print parameters. Their work clearly shows
work to utilize SLS for the production of oral several unique aspects of the difficulty in 3DP
dosage forms using two thermoplastic quality dosage forms that are elegant and water
pharmaceutical-grade polymers, Kollicoat IR tight. The geometry of the dosage form requires
(75% polyvinyl alcohol and 25% PEG a design that is specific to the 3DP process,
copolymer) and Eudragit L100-55 (50% metha- breaking from the more traditional shapes to
crylic acid and 50% ethyl acrylate copolymer), account for the physics of 3DP. In their work
with immediate and modified release char- they highlight the need to redesign the shape
acteristics. For this process to achieve print- with different angles (so-called zoning) using
ability and aid in the sintering process, software that is commonly available to the pub-
pharmaceutical-grade silicate and oxide-based lic. Fig. 2.13 shows different colors within the
pigments are added to improve laser energy dosage form to show where FDM thermal and
absorption and dissipation. In general, SLS- mechanical process conditions are purposely
printed dosage forms have poorer surface qual- changed to improve the quality of the final
ity and higher porosity as shown in the example printed dosage form.
from [52] (Fig. 2.12A). Control of the release rate It is well known that the speed of FDM 3D
of the SLS dosage forms based on the research printers is not particularly fast as compared to
thus far is governed more by the thermoplastic traditional dosage form manufacturing where a
material than by the printing conditions as rotary tablet press can accommodate on the
seen in Fig. 2.12B. order of 1,000,000 tablets per hour. A 3D printer
38 2. Opportunities and challenges of 3D-printed pharmaceutical dosage forms
FIGURE 2.12 (A): Scanning electron microscopy images of the selective laser sintering of printlet vertical sections. On the
top from left to right, Kollicoat IR K5, K20, and K35. On the bottom from left to right, Eudragit L100-55 E5, E20, and E35, where
5, 20, and 35 represent the wt% of paracetamol used as a model active pharmaceutical ingredient. (B) Drug dissolution from
Eudragit SLS printlets. Adapted from Fina F, Goyanes A, Gaisford S, Basit AW. Selective laser sintering (SLS) 3D printing of medicines.
Int J Pharm 2017;529:285e293.
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CHAPTER I.
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Lophius.
Acipenser.
Cyclopterus.
Balistes.
Ostracion.
Tetrodon.
Diodon.
Centriscus.
Syngnathus.
Pegasus.
Pisces Apodes.
Muræna.
Gymnotus.
Trichiurus.
Anarhichas.
Ammodytes.
Ophidium.
Stromateus.
Xiphias.
Pisces Jugulares.
Callionymus.
Uranoscopus.
Trachinus.
Gadus.
Blennius.
Pisces Thoracici.
Cepola.
Echeneis.
Coryphæna.
Gobius.
Cottus.
Scorpæna.
Zeus.
Pleuronectes.
Chæetodon.
Sparus.
Labrus.
Sciæna.
Perca.
Gasterosteus.
Scomber.
Mullus.
Trigla.
Pisces Abdominales.
Cobitis.
Amia.
Silurus.
Teuthis.
Loricaria.
Salmo.
Fistularia.
Esox.
Elops.
Argentina.
Atherina.
Mugil.
Mormyrus.
Exocœtus.
Polynemus.
Clupea.
Cyprinus.
b. Malacoptérygiens.
Abdominaux.
Cyprinoïdes.
Siluroïdes.
Salmonoïdes.
Clupeoïdes.
Lucioïdes.
Subbrachiens.
Sparoïdes.
Pleuronectes.
Discoboles.
Apodes.
Murenoïdes.
B. Cartilagineux ou Chondroptérygiens.
Sturioniens.
Plagiostomes.
Cyclostomes.