Effective treatment of retinal neovascular leakage with fusogenic porous silicon nanoparticles delivering VEGF-siRNA
Abstract
Aim: To evaluate an intravitreally injected nanoparticle platform designed to deliver VEGF-A siRNA to inhibit retinal neovascular leakage as a new treatment for proliferative diabetic retinopathy and diabetic macular edema. Materials & methods: Fusogenic lipid-coated porous silicon nanoparticles loaded with VEGF-A siRNA, and pendant neovascular integrin-homing iRGD, were evaluated for efficacy by intravitreal injection in a rabbit model of retinal neovascularization. Results: For 12 weeks post-treatment, a reduction in vascular leakage was observed for treated diseased eyes versus control eyes (p = 0.0137), with a corresponding reduction in vitreous VEGF-A. Conclusion: Fusogenic lipid-coated porous silicon nanoparticles siRNA delivery provides persistent knockdown of VEGF-A and reduced leakage in a rabbit model of retinal neovascularization as a potential new intraocular therapeutic.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1. . Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis. (Lond.) 2, 17 (2015).
- 2. . The pathogenesis of diabetic retinopathy: old concepts and new questions. Eye (Lond.) 16(3), 242–260 (2002).
- 3. . Ocular neovascularization. J. Mol. Med. (Berl.) 91(3), 311–321 (2013).
- 4. Estimating medicare and patient savings from the use of bevacizumab for the treatment of exudative age-related macular degeneration. Am. J. Ophthalmol. 191, 135–139 (2018).
- 5. Writing Committee for the Diabetic Retinopathy Clinical Research Network, Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA 314(20), 2137–2146 (2015).
- 6. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology 118(4), 615–625 (2011).
- 7. Three-year patient-reported visual function outcomes in diabetic macular edema managed with ranibizumab: the RESTORE extension study. Curr. Med. Res. Opin. 31(11), 1967–1975 (2015).
- 8. Intravitreal aflibercept for diabetic macular edema: 148-week results from the VISTA and VIVID studies. Ophthalmology 123(11), 2376–2385 (2016).
- 9. Diabetic retinopathy: pathogenesis, clinical grading, management and future developments. Diabet. Med. 30(6), 640–650 (2013).
- 10. HORIZON: an open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmology 119(6), 1175–1183 (2012).
- 11. . Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology 120(11), 2292–2299 (2013).
- 12. . Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature. Eye (Lond.) 27(7), 787–794 (2013).
- 13. . Systemic adverse drug reactions secondary to anti-VEGF intravitreal injection in patients with neovascular age-related macular degeneration. Curr. Vasc. Pharmacol. 9(5), 629–646 (2011).
- 14. Early response to anti-vascular endothelial growth factor and two-year outcomes among eyes with diabetic macular edema in Protocol T. Am. J. Ophthalmol. 195, 93–100 (2018).
- 15. . The role of anti-vascular endothelial growth factor (anti-VEGF) in the management of proliferative diabetic retinopathy. Drugs Context 7, 212532 (2018).
- 16. . Preclinical and clinical development of siRNA-based therapeutics. Adv. Drug Deliv. Rev. 87, 108–119 (2015).
- 17. ClinicalTrials.gov. Safety and efficacy study evaluating the combination of Bevasiranib & Lucentis Therapy in Wet AMD (COBALT). Clinical Trial Registration: NCT00499590 (2014).
- 18. Sequence- and target-independent angiogenesis suppression by siRNA via TLR3. Nature 452(7187), 591–597 (2008).
- 19. Short-interfering RNAs induce retinal degeneration via TLR3 and IRF3. Mol. Ther. 20(1), 101–108 (2012).
- 20. Advanced siRNA designs further improve in vivo performance of GalNAc-siRNA conjugates. Mol. Ther. 26(3), 708–717 (2018).
- 21. Therapeutic siRNA: state of the art. Signal Transduct. Target. Ther. 5(1), 101 (2020). • Provides a current overview of siRNA as a therapeutic.
- 22. . Surface engineering of porous silicon microparticles for intravitreal sustained delivery of rapamycin. Invest. Ophthalmol. Vis. Sci. 56(2), 1070–1080 (2015).
- 23. Hydrosilylated porous silicon particles function as an intravitreal drug delivery system for daunorubicin. J. Ocul. Pharmacol. Ther. 29(5), 493–500 (2013).
- 24. Evaluation of mesoporous silicon/polycaprolactone composites as ophthalmic implants. Acta Biomater. 6(9), 3566–3572 (2010).
- 25. . The biocompatibility of porous silicon in tissues of the eye. Biomaterials 30(15), 2873–2880 (2009).
- 26. . Ocular silicon distribution and clearance following intravitreal injection of porous silicon microparticles. Exp. Eye Res. 116, 161–168 (2013).
- 27. Porous silicon–graphene oxide core–shell nanoparticles for targeted delivery of siRNA to the injured brain. Nanoscale Horiz. 1, 407–414 (2016).
- 28. Topical siRNA delivery to the cornea and anterior eye by hybrid silicon-lipid nanoparticles. J. Control. Rel. 326, 192–202 (2020).
- 29. Delivery of siRNA in vitro and in vivo using PEI-capped porous silicon nanoparticles to silence MRP1 and inhibit proliferation in glioblastoma. J. Nanobiotechnol. 16, 38 (2018).
- 30. Small interfering RNA delivery by polyethylenimine-functionalised porous silicon nanoparticles. Biomater. Sci. 3(12), 1555–1565 (2015).
- 31. Polycation-functionalized nanoporous silicon particles for gene silencing on breast cancer cells. Biomaterials 35(1), 423–431 (2014).
- 32. . Cancer-targeting siRNA delivery from porous silicon nanoparticles. Nanomedicine 9(15), 2309–2321 (2014).
- 33. Self-sealing porous silicon–calcium silicate core–shell nanoparticles for targeted siRNA delivery to the injured brain. Adv. Mater. 28(36), 7962–7969 (2016). •• Provides data for the discovery and characterization of calcium silicate siRNA loading into porous silicon nanoparticles and their in vivo application.
- 34. . Immunogene therapy with fusogenic nanoparticles modulates macrophage response to Staphylococcus aureus. Nat. Commun. 9(1), 1969 (2018).
- 35. . Securing the payload, finding the cell, and avoiding the endosome: peptide-targeted, fusogenic porous silicon nanoparticles for delivery of siRNA. Adv. Mater. 31(35), e1902952 (2019). •• Explores the application of peptide targeted fusogenic lipid coatings to porous silicon nanoparticles.
- 36. . Recent advances with liposomes as pharmaceutical carriers. Nat. Rev. Drug Discov. 4(2), 145–160 (2005).
- 37. . Tumor-penetrating peptides. Front. Oncol. 3, 216 (2013).
- 38. . Peptides as targeting elements and tissue penetration devices for nanoparticles. Adv. Mater. 24(28), 3747–3756 (2012). • Ruoslahti is a professor emeritus and leader in the field of targeting peptide discovery. Here Rouslahti provides a review of peptide targeting of nanoparticles.
- 39. . Tumor penetrating peptides for improved drug delivery. Adv. Drug Deliv. Rev. 110–111 (2017).
- 40. Tissue-penetrating delivery of compounds and nanoparticles into tumors. Cancer Cell 16(6), 510–520 (2009).
- 41. Involvement of integrins alpha v beta 3 and alpha v beta 5 in ocular neovascular diseases. Proc. Natl Acad. Sci. USA 93(18), 9764–9769 (1996).
- 42. . Neuropilin 1 involvement in choroidal and retinal neovascularisation. PLOS ONE 12(1), e0169865 (2017).
- 43. Aflibercept action in a rabbit model of chronic retinal neovascularization: reversible inhibition of pathologic leakage with dose-dependent duration. Invest. Ophthalmol. Vis. Sci. 59(2), 1033–1044 (2018). •• Demonstrates the DL-AAA animal model for retinal neovascular leakage used in this work and includes efficacy data using the current gold-standard antibody drug aflibercept.
- 44. A novel model of persistent retinal neovascularization for the development of sustained anti-VEGF therapies. Exp. Eye Res. 174, 98–106 (2018).
- 45. . Retinal vascular changes after glial disruption in rats. J. Neurosci. Res. 88(7), 1485–1499 (2010).
- 46. . Müller glial cells in retinal disease. Ophthalmologica 227(1), 1–19 (2012).
- 47. . Neuronal and glial cell abnormality as predictors of progression of diabetic retinopathy. Curr. Pharm. Design 13(26), 2699–2712 (2007).
- 48. . Inhibited corneal neovascularization in rabbits following corneal alkali burn by double-target interference for VEGF and HIF-1alpha. Biosci. Rep. 39(1), (2019).
- 49. Intravitreal toxicology and duration of efficacy of a novel antiviral lipid prodrug of ganciclovir in liposome formulation. Invest. Ophthamol. Vis. Sci. 41(6), 1523–1532 (2000).
- 50. . NIH Image to ImageJ: 25 years of image analysis. Nat. Methods 9(7), 671–675 (2012).
- 51. . Photoluminescence-based sensing with porous silicon films, microparticles, and nanoparticles. Adv. Funct. Mater. 19(20), 3195–3208 (2009).
- 52. . Size control of porous silicon nanoparticles by electrochemical perforation etching. Part. Part. Syst. Char. 31(2), 252–256 (2014).
- 53. X-ray-absorption spectroscopy of silicon dioxide (SiO2) polymorphs – the structural characterization of opal. Am. Mineral. 79(7-8), 622–632 (1994).
- 54. Determination of a no-observable effect level for endotoxin following a single intravitreal administration to Dutch belted rabbits. Invest. Ophthalmol. Vis. Sci. 58(3), 1545–1552 (2017).
- 55. . Bevasiranib for the treatment of wet, age-related macular degeneration. Ophthalmol. Eye Dis. 2, 75–83 (2010).
- 56. . Investigating impacts of surface charge on intraocular distribution of intravitreal lipid nanoparticles. Exp. Eye Res. 186 (2019).
- 57. . A lipid nanoparticle system improves siRNA efficacy in RPE cells and a laser-induced murine CNV model. Invest. Ophthalmol. Vis. Sci. 52(7), 4789–4794 (2011).
- 58. Anti-VEGF polysiRNA polyplex for the treatment of choroidal neovascularization. Mol. Pharm. 13(6), 1988–1995 (2016).
- 59. Cyclic RGD peptide targeting coated nano drug co-delivery system for therapeutic use in age-related macular degeneration disease. Molecules 25(21), (2020).
- 60. EphA2 targeted doxorubicin stealth liposomes as a therapy system for choroidal neovascularization in rats. Invest. Ophthamol. Vis. Sci. 53(11), 7348–7357 (2012).
- 61. . Conjugation of cell-penetrating peptides with poly(lactic-co-glycolic acid)-polyethylene glycol nanoparticles improves ocular drug delivery. Int. J. Nanomed. 10, 609–631 (2015).
- 62. Topical ocular delivery to laser-induced choroidal neovascularization by dual internalizing RGD and TAT peptide-modified nanoparticles. Int. J. Nanomed. 12, 1353–1368 (2017).
- 63. . siRNA: set for a comeback? Retinal Physician (2010). https://www.retinalphysician.com/issues/2010/september-2010/sirna-set-for-a-comeback
- 64. Evaluation of intravitreal aflibercept for the treatment of severe nonproliferative diabetic retinopathy: results from the PANORAMA randomized clinical trial. JAMA Ophthalmol. 139(9), 946–955 (2021).
- 65. . Ocular silicon distribution and clearance following intravitreal injection of porous silicon microparticles. Exp. Eye Res. 116, 161–168 (2013).