(12) Patent Application Publication (10) Pub. No.: US 2005/0112135 A1 Cormier Et Al
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US 2005O112135A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2005/0112135 A1 Cormier et al. (43) Pub. Date: May 26, 2005 (54) ULTRASOUND ASSISTED TRANSIDERMAL Publication Classification WACCINE DELIVERY METHOD AND SYSTEM (51) Int. Cl." .......................... A61K 39/12; A61M 31/00 (52) U.S. Cl. ......................................... 424/185.1; 604/500 (76) Inventors: Michel J.N. Cormier, Mountain View, CA (US); WeiOi Lin, Palo Alto, CA (US); Georg Widera, Palo Alto, CA (57) ABSTRACT (US) An apparatus and method for transdermally delivering a vaccine comprising a delivery System having (i) a micro Correspondence Address: projection member (or System) that includes a plurality of Francis Law Group microprojections (or array thereof) that are adapted to pierce 1942 Embarcadero through the Stratum corneum into the underlying epidermis Oakland, CA 94.606 (US) layer, or epidermis and dermis layers and (ii) an ultrasonic device. In one embodiment, the vaccine is contained in a (21) Appl. No.: 10/971,338 biocompatible coating that is applied to the microprojection Filed: Oct. 21, 2004 member. In a further embodiment, the delivery system (22) includes a gel pack having a vaccine-containing hydrogel Related U.S. Application Data formulation that is disposed on the microprojection member after application to the skin of a patient. In an alternative (60) Provisional application No. 60/524,062, filed on Nov. embodiment, the vaccine is contained in both the coating 21, 2003. and the hydrogel formulation. Patent Application Publication May 26, 2005 Sheet 1 of 5 US 2005/0112135 A1 W EL ( (( Patent Application Publication May 26, 2005 Sheet 2 of 5 US 2005/0112135 A1 Patent Application Publication May 26, 2005 Sheet 3 of 5 US 2005/0112135 A1 40 7777.2/ZZZZZZZZYZZZZZZZYZZZYZZ 22222222222222222 36 34 34- 30 7 Will,% 50 larAn inIL FIG, 5 Patent Application Publication May 26, 2005 Sheet 4 of 5 US 2005/0112135 A1 Patent Application Publication May 26, 2005 Sheet 5 of 5 US 2005/0112135 A1 US 2005/0112135 A1 May 26, 2005 ULTRASOUND ASSISTED TRANSIDERMAL trafficking to regional skin-draining lymph nodes, and pre WACCINE DELIVERY METHOD AND SYSTEM Senting processed antigens to T cells. CROSS-REFERNCE TO RELATED 0008. The effectiveness of the skin immune system is APPLICATIONS responsible for the Success and Safety of vaccination Strat egies that have been targeted to the skin. Vaccination with a 0001) This application claims the benefit of U.S. Provi live-attenuated Smallpox vaccine by Skin Scarification has sional Application No. 60/524,062, filed Nov. 21, 2003. Successfully led to global eradication of the deadly Small poX disease. Intradermal injection using /S to /10 of the FIELD OF THE PRESENT INVENTION standard IM doses of various vaccines has been effective in 0002 The present invention relates generally to transder inducing immune responses with a number of vaccines mal vaccine delivery Systems and methods. More particu while a low-dose rabies vaccine has been commercially larly, the invention relates to an ultrasound assisted vaccine licensed for intradermal application. delivery method and System 0009 Transdermal delivery offers significant advantages for vaccination, given the function of the skin as an immune BACKGROUND OF THE INVENTION organ. Pathogens entering the Skin are confronted with a 0003) Active agents (or drugs) are most conventionally highly organized and diverse population of Specialized cells administered either orally or by injection. Unfortunately, capable of eliminating microorganisms through a variety of many active agents are completely ineffective or have radi mechanisms. Epidermal Langerhans cells are potent anti cally reduced efficacy when orally administered, Since they gen-presenting cells. Lymphocytes and dermal macrophages either are not absorbed or are adversely affected before percolate throughout the dermis. Keratinocytes and Langer entering the bloodstream and thus do not possess the desired hans cells express or can be induced to generate a diverse activity. On the other hand, the direct injection of an agent array of immunologically active compounds. Collectively, into the bloodstream, while assuring no modification of the these cells orchestrate a complex Series of events that agent during administration, is a difficult, inconvenient, ultimately control both innate and Specific immune painful and uncomfortable procedure which Sometimes responses. results in poor patient compliance. 0010. It is further thought that non-replicating antigens 0004 Hence, in principle, transdermal delivery provides (i.e., killed viruses, bacteria, an Subunit vaccines) enter the for a method of administering active agents that would endoSomal pathway of antigen presenting cells. The anti otherwise need to be administered orally, by hypodermic gens are processed and expressed on the cell Surface in injection or by intravenous infusion. Transdermal delivery, association with class II MHC molecules, leading to the when compared to oral delivery, avoids the harsh environ activation of CD4 T cells. Experimental evidence indicates ment of the digestive tract, bypasses gastrointestinal drug that introduction of antigens exogenously induces little or no metabolism, reduces first-pass effects, and avoids the poS cell Surface antigen expression associated with class I MHC, Sible deactivation by digestive and liver enzymes. resulting in ineffective CD8" Tactivation. Replicating vac cines, on the other hand (e.g., live, attenuated viruses, Such 0005 The word “transdermal”, as used herein, is generic as polio and Smallpox vaccines) lead to effective humoral term that refers to delivery of an active agent (e.g., a and cellular immune responses and are considered the "gold therapeutic agent, Such as a drug or an immunologically Standard” among vaccines. A similar broad immune active agent, Such as a vaccine) through the skin to the local response Spectrum can be achieved by DNA vaccines. tissue or Systemic circulatory System without Substantial cutting or penetration of the skin, Such as cutting with a 0011. In contrast, polypeptide based vaccines, like Sub Surgical knife or piercing the skin with a hypodermic needle. unit vaccines, and killed Viral and bacterial vaccines do elicit Transdermal agent delivery includes delivery via passive predominantly a humoral response, as the original antigen diffusion as well as delivery based upon external energy presentation occurs via the class II MHC pathway. A method Sources, Such as electricity (e.g., iontophoresis) and ultra to enable the presentation of these vaccines also via the class Sound (e.g., phonophoresis). I MHC pathway would be of great value, as it would widen the immune response spectrum. 0006 AS is well known in the art, skin is not only a physical barrier that shields the body from external hazards, 0012 Several reports have suggested that soluble protein but is also an integral part of the immune System. The antigens can be formulated with Surfactants, leading to immune function of the skin arises from a collection of antigen presentation via the class I pathway and induce residential cellular and humoral constituents of the viable antigen-specific class I-restricted CTLS (Raychaudhuri, et epidermis and dermis with both innate and acquired immune al., 1992). Introduction of protein antigen by osmotic lysis functions, collectively known as the skin immune System. of pinosomes has also been demonstrated to lead to a class I antigen-processing pathway (Moore, et al.). Ultrasound 0007 One of the most important components of the skin techniques have been used to introduce macromolecules into immune System are the Langerhan's cells (LC), which are cells in vitro and in vivo, and, particularly, DNA-based Specialized antigen presenting cells found in the viable therapeutics. Studies with plasmid DNA have clearly dem epidermis. LCS form a Semi-continuous network in the viable epidermis due to the extensive branching of their onstrated that the delivery efficiency can be significantly dendrites between the Surrounding cells. The normal func enhanced when ultrasound is employed. tion of the LCS is to detect, capture and present antigens to 0013 There is, however, no published literature regard evoke an immune response to invading pathogens. LCS ing in Vivo intracellular ultrasound delivery of protein-based perform his function by internalizing epicutaneous antigens, vaccines into skin antigen-presenting cells (APC) that leads US 2005/0112135 A1 May 26, 2005 to cellular loading of the protein onto class I MHC/HLA outermost layer (i.e., the Stratum corneum) of the skin. The presentation molecules in addition to class II MHC/HLA piercing elements disclosed in these references generally presentation molecules. In particular, there is no mention of extend perpendicularly from a thin, flat member, Such as a the use of a microprojection array in conjunction with pad or sheet. The piercing elements in Some of these devices ultrasound to achieve this means. are extremely Small, Some having a microprojection length 0.014. There is also no published literature mentioning the of only about 25-400 microns and a microprojection thick use of a microprojection array in conjunction with ultra neSS of only about 5-50 microns. These tiny piercing/cutting sound to achieve in vivo delivery of a DNA vaccine intra elements make correspondingly Small microSlits/microcuts cellularly and Subsequent cellular expression and loading of in the Stratum corneum for enhancing transdermal