Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the...

Full description

Saved in:
Bibliographic Details
Main Authors: Justin T Clark, Meredith R Clark, Namdev B Shelke, Todd J Johnson, Eric M Smith, Andrew K Andreasen, Joel S Nebeker, Judit Fabian, David R Friend, Patrick F Kiser
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0088509&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849720463644688384
author Justin T Clark
Meredith R Clark
Namdev B Shelke
Todd J Johnson
Eric M Smith
Andrew K Andreasen
Joel S Nebeker
Judit Fabian
David R Friend
Patrick F Kiser
author_facet Justin T Clark
Meredith R Clark
Namdev B Shelke
Todd J Johnson
Eric M Smith
Andrew K Andreasen
Joel S Nebeker
Judit Fabian
David R Friend
Patrick F Kiser
author_sort Justin T Clark
collection DOAJ
description The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.
format Article
id doaj-art-3f02cff4b85c4444ad40be1a69cc36d8
institution DOAJ
issn 1932-6203
language English
publishDate 2014-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-3f02cff4b85c4444ad40be1a69cc36d82025-08-20T03:11:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0193e8850910.1371/journal.pone.0088509Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.Justin T ClarkMeredith R ClarkNamdev B ShelkeTodd J JohnsonEric M SmithAndrew K AndreasenJoel S NebekerJudit FabianDavid R FriendPatrick F KiserThe HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0088509&type=printable
spellingShingle Justin T Clark
Meredith R Clark
Namdev B Shelke
Todd J Johnson
Eric M Smith
Andrew K Andreasen
Joel S Nebeker
Judit Fabian
David R Friend
Patrick F Kiser
Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
PLoS ONE
title Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
title_full Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
title_fullStr Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
title_full_unstemmed Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
title_short Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.
title_sort engineering a segmented dual reservoir polyurethane intravaginal ring for simultaneous prevention of hiv transmission and unwanted pregnancy
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0088509&type=printable
work_keys_str_mv AT justintclark engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT meredithrclark engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT namdevbshelke engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT toddjjohnson engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT ericmsmith engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT andrewkandreasen engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT joelsnebeker engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT juditfabian engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT davidrfriend engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy
AT patrickfkiser engineeringasegmenteddualreservoirpolyurethaneintravaginalringforsimultaneouspreventionofhivtransmissionandunwantedpregnancy