Sustained release of steroids from electrospun biodegradable fibers for localized drug delivery

Laryngotracheal damage is a well-described complication of endotracheal intubation leading to local irritation, inflammation, and edema. Such complication is secondary to airway mucosal damage due to the use of an endo-tracheal tube (ETT), which produces local pressure and a pressure-like ulcer [1]. The common clinical approach to manage airway mucosal damage is systemic administration of steroids hours to days prior to extubation, however, such treatment is inadequate, and some patients will need to undergo tracheostomy [2]. Herein, steroid-eluting ETT for localized delivery was developed to improve drug efficiency and circumvent adverse effects. Electrospinning technique was utilized to coat ETTs and produce a microscale layer of poly (lactic-co-glycolic acid) (PLGA) fibers loaded with Mometasone Furoate (MF). The novel delivery system was fully characterized, by means of drug loading, morphology, and mechanical stability of fiber mats. Moreover, in vitro release study demonstrated controlled release of MF over 14 days. The MF-coated ETTs exhibited superior therapeutic response compared to blank ETTs using an in vivo rat model, in terms of reduced laryngeal mucosal thickness and submucosal laryngeal edema [3]. Taken together, steroid-loaded ETT is a novel approach allows for local drug delivery in a controlled manner, for improved treatment of intubation-related morbidity.

References

[1] J.M. Tadie, E. Behm, L. Lecuyer, R. Benhmamed, S. Hans, D. Brasnu, J.L. Diehl, J.Y. Fagon, E. Guerot, Post-intubation laryngeal injuries and extubation failure: a fiberoptic endoscopic study, Intensive Care Med. 36 (2010) 991–998.

[2] R.G. Khemani, A. Randolph, B. Markovitz, Corticosteroids for the prevention and treatment of post-extubation stridor in neonates, children and adults, Cochrane Database Syst. Rev. (2009) CD001000.

[3] A. Abu Ammar, M. Gruber, P. Martin, O. Stern, F. Jahshan, O. Ertracht, E. Sela, S. Srouji, E. Zussman, Local delivery of mometasone furoate from an eluting endotracheal tube, Journal of controlled release, 272 (2018) 54-61.