A Novel Needle-Free Micromist Delivery Platform for Deep Tissue Transdermal Delivery of Genes and Peptides to Modulate Gene Expression and Expedite Chronic Ulcer Healing
Chronic ulcers that damage muscle and bone and result in limb amputations are a major disease burden that costs over $25 billion/year. Despite major advances in understanding the factors that cause non-healing ulcers, currently there are no effective treatments that can heal such ulcers and mitigate associated morbidity and mortality. Changing the gene expression in all affected tissues (skin, vasculature, muscle and bone) via gene or protein therapy to attenuate the inflammatory microenvironment in the non-healing ulcer and activate new cell growth is critical for effective wound healing. Current approaches to deliver gene and protein therapy to deep tissues that are damaged via local transdermal delivery depends on medicated topical creams that contain these large molecular weight therapeutics and/or microneedle arrays or various skin substitutes that carry stem cells or growth factors and placed on top of wound. However, microneedle arrays can deliver molecules only few millimeters below wound surface and transdermal injection is painful. Moreover, degradation by wound enzymes, washout by wound exudates, and inability to enter cells in deep tissues that are located a few centimeters below wound surface substantially reduce the efficacy of these approaches. Therefore, there is an urgent, unmet, medical need to develop a new treatment based on delivery for growth factors, cytokines and reparative gene or protein therapy to the deep wound beds of chronic ulcers that can reach not only deep skin, but also the damaged muscle and bone tissues, to repair deep tissue damage and expedite healing of chronic ulcers. The goal of this study was to test new prototypes of Droplette Micromist Technology Device (DMTD) to enable needle-free localized transdermal delivery of DNA, siRNA and protein to regulate gene expression in deep tissues. Two new DMTD prototypes were used to test our hypothesis that DMTD-delivered plasmid DNA and siRNA would change gene expression in deep tissues, and Insulin like Growth Factor 1 (IGF-1) would promote wound healing. Both ex vivo (pig skin and human skin from amputated limbs of consented and deidentified patients at Tufts Medical Center) and in vivo (Zucker diabetic fatty (ZDF) rat wound model, Wistar rat, and FVB-Tg(CAG-luc,-GFP)L2G85Chco/J strain #:008450 transgenic mice that expresses green fluorescent protein (GFP)) preclinical models were used (n=5; p<0.001-0.05). Animals studies were approved by IACUCs of Tufts and University of Missouri and handled as per the US National Institutes of Health standards. Human studies were performed after Tufts IRB approval. Robust expression of de novo Red Fluorescent Protein (RFP) was achieved by delivery of 300µL of DMTD micromist containing 10µg and 2.5µg pCMV-AC-RFP plasmid DNA using 15volt and 18volt DMTD prototypes in human and pig skin and live Wistar rat. The 18-volt DMTD micromist with 10µg DNA expressed RFP in muscle layer and in an area 7.5cm wide and 4cm deep. The 18-volt DMTD micromist containing anti-GFP siRNA (1µMolar) significantly suppressed GFP expression in ear, shoulder and paw of GFP transgenic mice compared to scrambled siRNA micromist. Finally, DMTD-micromist with IGF-1 (200ng) delivered daily reduced re-epithelialization times of 4mm full thickness wounds on ZDF rats faster (40%) than topical application (20%). In conclusion, DMTD micromist is a novel, needle-free and painless transdermal delivery stem that can successfully deliver plasmids and siRNA to change gene expression in deep tissues and expedite diabetic wound healing. We propose that DMTD micromist containing gene and peptide therapeutics offer a much needed treatment for chronic ulcer healing. This work is supported by DoD grant PR220947 to LP This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
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