Proliferative vitreoretinopathy (PVR) is the most frequent cause of failure of retinal detachment surgery.
1 PVR could be described as the uncontrolled growth of physiologically altered cells, including transformed retinal pigment epithelium (RPE) cells and glial cells at the vitreoretinal interface, leading to the formation of contractile membranes causing tractional retinal detachment. Inhibition of RPE proliferation by chemotherapeutic agents remains a primary target of PVR prevention.
2–4 Daunorubicin is reported to be a very potent cell growth inhibitory agent in in vitro studies,
4 although it has a short intravitreal half-life (131 minutes) and narrow therapeutic range.
5 Daunorubicin has also been shown to be effective for treatment of experimental PVR.
6,7 However, clinical studies have shown only a moderate effect following an intraoperative infusion or intravitreal injection.
8,9 A large multicenter randomized study showed that the intraoperative application of daunorubicin (7.5 μg/mL infusion for 10 minutes) is safe, helps reduce the number of reoperations, and increases the time until first vitreoretinal reoperation.
8 A single intravitreal injection of daunorubicin (5 μg) before the conclusion of vitrectomy has also been shown to yield higher attachment.
9 These studies support the use of daunorubicin and illustrate the need for a sustainable drug delivery system to overcome the short therapeutic window that results from intraoperative infusion or intravitreal injection.
We previously reported the possibility of using porous silicon photonic crystals as an intraocular drug delivery system.
10 Subsequently we demonstrated a chemical reaction to load daunorubicin covalently via a linker grafted to the inner pore walls of porous silicon particles by a hydrosilylation reaction. Both in vitro and in vivo studies showed successful drug loading
11,12 and no ocular toxicity in vivo after a 6-month safety study. However, the particle formulation was found to induce chemical degradation of the daunorubicin payload, which was attributed to the presence of residual Si-H species and elemental silicon in the particles.
11 We hypothesized that elemental Si in the skeleton of the porous nanostructure and Si-H species on the pore wall surfaces acted as reducing agents for daunorubicin, and this redox reaction led to degradation of the drug either before or after its release from the nanostructure. In a subsequent study,
13 we demonstrated that partial or complete oxidation of the porous silicon nanostructure prior to drug attachment mitigated this deleterious reaction, with no drug degradation observed on material that had been completely oxidized. The high-temperature (800°C) conditions used for complete oxidation of porous silicon (yielding porous silica, SiO
2) are not compatible with the linker chemistry. However, a silanol-based linker (3-aminopropyltrimethoxysilane) can be attached postoxidation, which can then be converted to a carboxylic acid functionality (via treatment with succinic anhydride) that allows covalent attachment of daunorubicin via N-(3-dimethylaminopropyl)-N′-ethylcarbodiimide hydrochloride (EDC) coupling chemistry.
13
In the present study we characterized the ocular properties and safety of the oxidized and silanized porous silicon particles covalently loaded with daunorubicin, as well as those of the oxidized porous silicon microparticles loaded with daunorubicin by physical adsorption following intravitreal injection, in order to identify an optimal formulation for safe and effective long-lasting ocular delivery of this potent antiproliferation agent.