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Review ArticleReview Article

Exploring Intestinal Surface Receptors in Oral Nanoinsulin Delivery

Carlynne Choy, Lee Yong Lim, Lai Wah Chan, Zhixiang Cui, Shirui Mao and Tin Wui Wong
Clive Page, ASSOCIATE EDITOR
Pharmacological Reviews October 2022, 74 (4) 962-983; DOI: https://doi.org/10.1124/pharmrev.122.000631
Carlynne Choy
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Lee Yong Lim
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Lai Wah Chan
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Zhixiang Cui
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Shirui Mao
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Tin Wui Wong
Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore (C.C., L.W.C., T.W.W.); Pharmacy, School of Allied Health, The University of Western Australia, 35 Stirling Highway, Crawley WA, Australia (L.Y.L.); School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China (Z.C., S.M.); Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.); and Particle Design Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam, Selangor, Malaysia (T.W.W.)
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Clive Page
Roles: ASSOCIATE EDITOR
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Abstract

Subcutaneous and inhaled insulins are associated with needle phobia, lipohypertrophy, lipodystrophy, and cough in diabetes treatment. Oral nanoinsulin has been developed, reaping the physiologic benefits of peroral administration. This review profiles intestinal receptors exploitable in targeted delivery of oral nanoinsulin. Intestinal receptor targeting improves oral insulin bioavailability and sustains blood glucose–lowering response. Nonetheless, these studies are conducted in small animal models with no optimization of insulin dose, targeting ligand type and content, and physicochemical and molecular biologic characteristics of nanoparticles against the in vivo/clinical diabetes responses as a function of the intestinal receptor population characteristics with diabetes progression. The interactive effects between nanoinsulin and antidiabetic drugs on intestinal receptors, including their up-/downregulation, are uncertain. Sweet taste receptors upregulate SGLT-1, and both have an undefined role as new intestinal targets of nanoinsulin. Receptor targeting of oral nanoinsulin represents a viable approach that is relatively green, requiring an in-depth development of the relationship between receptors and their pathophysiological profiles with physicochemical attributes of the oral nanoinsulin.

Significance Statement Intestinal receptor targeting of oral nanoinsulin improves its bioavailability with sustained blood glucose–lowering response. Exploring new intestinal receptor and tailoring the design of oral nanoinsulin to the pathophysiological state of diabetic patients is imperative to raise the insulin performance to a comparable level as the injection products.

Footnotes

    • Received April 13, 2022.
    • Revision received June 1, 2022.
    • Accepted June 24, 2022.
  • No author has an actual or perceived conflict of interest with the contents of this article.

  • dx.doi.org/10.1124/pharmrev.122.000631.

  • Copyright © 2022 by The American Society for Pharmacology and Experimental Therapeutics
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Pharmacological Reviews: 74 (4)
Pharmacological Reviews
Vol. 74, Issue 4
1 Oct 2022
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Review ArticleReview Article

Intestinal Receptor-Mediated Oral Nanoinsulin Delivery

Carlynne Choy, Lee Yong Lim, Lai Wah Chan, Zhixiang Cui, Shirui Mao and Tin Wui Wong
Pharmacological Reviews October 1, 2022, 74 (4) 962-983; DOI: https://doi.org/10.1124/pharmrev.122.000631

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Review ArticleReview Article

Intestinal Receptor-Mediated Oral Nanoinsulin Delivery

Carlynne Choy, Lee Yong Lim, Lai Wah Chan, Zhixiang Cui, Shirui Mao and Tin Wui Wong
Pharmacological Reviews October 1, 2022, 74 (4) 962-983; DOI: https://doi.org/10.1124/pharmrev.122.000631
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    • I. Diabetes Mellitus and Therapy
    • II. Intestinal Receptors Targeted for Nanoinsulin Delivery
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