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Transport and lymphatic uptake of monoclonal antibodies after subcutaneous injection
The subcutaneous injection has emerged as a common approach for self-administration of biotherapeutics due to the patient comfort and cost-effectiveness. However, the available knowledge about transport and absorption of these agents after subcutaneous injection is limited. Here we aim to find drug distribution in the tissue and lymphatic uptake after subcutaneous (SC) injection. In the first part of the study, a mathematical framework to study the subcutaneous drug delivery from injection to lymphatic uptake is presented. A three-dimensional poroelastic model is exploited to find the biomechanical response of the tissue by taking into account tissue deformation during the injection. The results show that including tissue deformability noticeably changes tissue poromechanical response due to the significant dependence of interstitial pressure on tissue deformation. Moreover, the importance of the amount of lymph fluid at the injection site and injection rate on the drug uptake to lymphatic capillaries is highlighted. Finally, the variability of lymphatic uptake due to uncertainty in parameters, including tissue poromechanical and lymphatic absorption parameters, is evaluated. It is found that interstitial pressure due to injection is the major contributing factor in short-term lymphatic absorption, while the amount of lymph fluid at the site of injection determines the long-term absorption of the drug. Finally, it is shown that the lymphatic uptake results are consistent with experimental data available in the literature.
In the second part, drug transport and distribution in different tissue layers are studied. A single-layer model of the tissue as a base study was first explored. During injection, the difference between the permeability of the solvent and solute results in a higher drug concentration proportional to the inverse of the permeability ratio. Then the effects of layered tissue properties with primary layers, including epidermis, dermis, subcutaneous, and muscle layers, on tissue biomechanical response to injection and drug transport are studied. The drug distributes mainly in the SQ layer due to its lower elastic moduli. Finally, the effect of secondary tissue elements like the deep fascia layer and the network of septa fibers inside the SQ tissue is investigated. The Voronoi algorithm is exploited to create random geometry of the septa network. It is shown how drug molecules accumulate around these tissue components as observed in experimental SC injection. Next, the effect of injection rate on drug concentration is studied. Higher injection rates slightly increase the drug concentration around septa fibers. Finally, it is demonstrated that the concentration-dependent viscosity increases the concentration of biotherapeutics in the direction of septa fibers.
In the third part of this thesis, a poro-hyperelastic model of the tissue is exploited to find the biomechanical response of the tissue together with a transport model based on an advection-diffusion equation in large-deformation poro-hyperelastic Media. The process of mAbs transport to the lymphatic system is explored. This process has two major parts. First, the initial phase, where mAbs are dispersed in the tissue as a result of momentum exerted by injection. This stage last for only a few minutes after the injection. Then there is the second stage, which can take tens of hours, and as a result, monoclonal antibodies (mAbs) molecules are transported from the subcutaneous layer towards initial lymphatics in the dermis to enter the lymphatic system. In third chapter, both stages are studied. The process of plume formation, interstitial pressure, and velocity development is explored. Then the effect of the injection device, injection site, and sensitivity of long-term lymphatic uptake due to variability in permeability, diffusivity, viscosity, and binding of mAbs are investigated. Then the results are used to find an equivalent lymphatic uptake coefficient that is widely used in pharmacokinetic (PK) models to study the absorption of mAbs. We show that the injection rate is the least, and the injection site is the most important parameter in the uptake of mAbs. Injection depth and mAbs dose also significantly alter lymphatic absorption. Finally, the computational model is validated against experimental studies available in the literature.
This work was partially supported by Eli Lilly and Company
- Doctor of Philosophy
- Mechanical Engineering
- West Lafayette