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Orally Administered Therapeutic Peptide Delivery: Enhanced Absorption Through The Small Intestine Using Permeation Enhancers

V. Pillay, Angus R. Hibbins, Y. Choonara, L. D. Toit, P. Kumar, V. Ndesendo
Published 2012 · Chemistry

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Peptide therapeutics (PTs) is generally regarded as highly effective macromolecule therapeutics at very low concentrations. The main issues surrounding the administration of PTs is guaranteeing that they are bioavailable, reach the desired therapeutic index and distribute throughout the body effectively. The oral administration, a non-invasive route, of PTs is considered a major complication due to inadequate oral absorption through biological membranes such as the small intestine epithelium due to presystemic proteolytic enzymatic activity. PTs bioavailability is further diminished in the systemic circulation due to low stability in the plasma and rapid excretion from the body. Many alternative routes can be considered non-invasive such as transdermal and nasal routes, but this review focuses on the oral route, specifically the small intestine region of the gastrointestinal tract. Although this region has the highest density of proteolytic enzymes, it contains tight junctions which have the lowest trans-epithelial electrical resistance throughout the body; thus paracellular transport of these large PTs can be achieved more readily. The use of a natural polysaccharide polymer, such as trimethyl chitosan (TMC), which enhances the bioavailability of these PTs through the small intestine, will also be discussed in great detail. TMC has been considered because it could potentially solve many of the mechanistic and chemical problems associated with oral therapeutic peptide administration. The safety of orally administered PTs through the small intestinal epithelium employing a polymer such as TMC is also discussed as this is a significant issue for regulatory bodies.
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