Microneedles
Microneedles are micron-scaled medical devices used to administer vaccines, drugs, and other therapeutic agents. The use of microneedles is known as microneedling. Microneedles are usually applied through even single needle or small arrays, called microneedle patch or microarray patch. The arrays used are a collection of microneedles, ranging from only a few microneedles to several hundred, attached to an applicator, sometimes a patch or other solid stamping device. The height of each needle ranges from 25μm to 2000μm. The arrays are applied to the skin of patients and are given time to allow for the effective administration of drugs.
While microneedles were initially explored for transdermal drug delivery applications, their use has been extended for the intraocular, vaginal, transungual, cardiac, vascular, gastrointestinal, and intracochlear delivery of drugs. Microneedles are also used in disease diagnosis, and collagen induction therapy. Although the concept of microneedling was first introduced in the 1970s, its popularity has surged due to its effectiveness in drug delivery and its cosmetic benefits.
Known for its minimally invasive and precise nature, microneedling is an easier method for physicians as microneedles require less training to apply and because they are not as hazardous as other needles, making the administration of drugs to patients safer and less painful while also avoiding some of the drawbacks of using other forms of drug delivery, such as risk of infection, production of hazardous waste, or cost.
Microneedles are constructed through various methods, usually involving photolithographic processes or micromolding. These methods involve etching microscopic structure into resin or silicon in order to cast microneedles. Microneedles are made from a variety of material ranging from silicon, titanium, stainless steel, and polymers. A variety of MNs types has been developed to possess different functions. Some microneedles are made of a drug to be delivered to the body but are shaped into a needle so they will penetrate the skin. The microneedles range in size, shape, and function but are all used as an alternative to other delivery methods like the conventional hypodermic needle or other injection apparatus. Stimuli-responsive microneedles are advanced devices that respond to environmental triggers such as temperature, pH, or light to release therapeutic agents. The research on MNs has led to improvements in different aspects, including instruments and techniques, yet adverse events are possible in MNs users.
History
The concept of microneedles was first derived from the use of large hypodermic needles in the 1970s, but it only became prominent in the 1990s as microfabrication manufacturing technology developed. Later, the concept of MNs finally came into experimentation in 1994 when Orentreich discovered the insertion of tri-beveled needles to the skin could possibly stimulates the release of fibrous strand. The investigation on MNs' potential to improve transdermal drug delivery gradually raised public awareness of MNs. Since then, there has been massive research conducted on MNs, contributing to the development of different materials, types, and fabrication methods of MNs. Application and adverse events are explored. In the 2000s, clinical trials on MNs' use in drug delivery began.Microneedles were first mentioned in a 1998 paper by the research group headed by Mark Prausnitz at the Georgia Institute of Technology that demonstrated that microneedles could penetrate the uppermost layer of the human skin and were therefore suitable for the transdermal delivery of therapeutic agents. Subsequent research into microneedle drug delivery has explored the medical and cosmetic applications of this technology through its design. This early paper sought to explore the possibility of using microneedles in the future for vaccination. Since then researchers have studied microneedle delivery of insulin, vaccines, anti-inflammatories, and other pharmaceuticals. In dermatology, microneedles are used for scarring treatment with skin rollers. As mentioned before, microneedles have also been explored for local targeted drug delivery at other drug delivery sites, such as the gastrointestinal, ocular, vascular etc., of which, ocular, vaginal and gastrointestinal have shown increasingnly convincing outcomes where they serve as a more efficient, localised drug delivery system, without the drawbacks of systemic exposure/toxicity.
The major goal of any microneedle design is to penetrate the skin's outermost layer, the stratum corneum. Microneedles are long enough to cross the stratum corneum but not so long that they stimulate nerves which are located deeper in the tissues and therefore cause little to no pain.
Research has shown that there is a limit on the type of drugs that can be delivered through intact skin. Only compounds with a relatively low molecular weight, like the common allergen nickel, can penetrate the skin. Compounds that weigh more than 500 Da cannot penetrate the skin.
Materials
Microneedles consist of micro-sized needles arrays that are made of various materials exhibiting different characteristics and are suitable in the synthesis of different types of MNs. The selection of materials for formation of MNs greatly depends on the strength of skin penetration, manufacturing method, and rate of drug release.Silicon is the first material used for the production of MNs. While the flexible nature of silicon allows easy manufacture of different sizes and types of MNs, silicon MNs can easily fracture during insertion in the skin. On the contrary, MNs made of metals like stainless steel, titanium, and aluminum, are non-toxic and possess strong mechanical properties to penetrate the skin without breakage. Nevertheless, metal MNs may cause allergic effects in some patients and it creates non-biodegradable wastes.
Polymer is also regarded as a promising material for MNs due to its good biocompatibility and low toxicity. Water-soluble polymers are more commonly used within the big polymer group and MNs tip breaking is more likely compared to MNs made of silicon and metal. Therefore, polymer is a more suitable material for dissolving MNs or hydrogel-forming MNs.
Types
Since their conceptualization in 1998, several advances have been made in terms of the variety of types of microneedles that can be fabricated. The 5 main types of microneedles are solid, hollow, coated, dissolvable/dissolving, and hydrogel-forming. The distinct characteristic of each type of MNs allow a variety of clinical applications, including diagnosis and treatment.Micro-sized needles in a microneedles device can be as short as 25μm or even 2000μm in length depending on their types.
Solid microneedles
Solid MNs are the first type of MNs fabricated and are the most commonly used. Hard solid MNs have sharp tips that pierce through and form pores on the stratum corneum. A drug patch will then be applied to the skin for drug to be absorbed slowly and passively through numerous micropores.This type of array is designed as a two part system; the microneedle array is first applied to the skin to create microscopic wells just deep enough to penetrate the outermost layer of skin, and then the drug is applied via transdermal patch. Solid microneedles are already used by dermatologists in collagen induction therapy, a method which uses repeated puncturing of the skin with microneedles to induce the expression and deposition of the proteins collagen and elastin in the skin.
Solid MNs help increase the permeability and absorption of drugs.
Hollow microneedles
Hollow MNs are designed with a hole at the tip and a hollow capacity that store drugs. Upon MNs insertion, the stored drug is directly injected into the dermis and this effectively facilitates the absorption of either large-molecular or large-dosage drug. Yet, a portion of the drug can leaked or become clogged, and may hinder the overall drug administration. Since the delivery of the drug depends on the flow rate of the microneedle, this type of array could become clogged by excessive swelling or flawed design. This design also increases the likelihood of buckling under the pressure and therefore failing to deliver any drugs.Coated microneedles
Coated MNs are fabricated by coating drug solution over solid MNs and the thickness of the drug layer can be adjusted depending on the amount of drug to be administered. A benefit of coated MNs is that less of the drug is needed as compared to other drug administration routes. This is because the layer of drug will quickly dissolve and delivered into the systemic circulation directly across the skin. The solid MNs which are removed afterwards may be contaminated by left-over drugs and the reuse of those MNs raise the concern of cross-infection between patients.Coated microneedles are often covered in other surfactants or thickening agents to assure that the drug is delivered properly. Some of the chemicals used on coated microneedles are known irritants. While there is risk of local inflammation to the area where the array was, the array can be removed immediately with no harm to the patient.
Dissolving microneedles
Dissolving MNs are mostly composed of water-soluble drugs that enable the dissolution of MN tips when inserted into skin. This is a one-step approach which does not require the removal of MNs and is convenient for long-term therapy. However, incomplete insertion and delay dissolution is observed with the use of dissolving MNs.This polymer would allow the drug to be delivered into the skin and could be broken down once inside the body. Pharmaceutical companies and researchers have begun to study and implement polymers such as Fibroin, a silk-based protein that can be molded into structures like microneedles and dissolved once in the body.