Development and clinical translation of microneedles for insulin delivery and self-vaccination
Norman, James Jefferis
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Type-1 diabetes and influenza cause significant illness and unnecessary medical costs despite the existence of insulin for maintenance of diabetes and a vaccine for prevention of influenza. This dissertation describes three studies on the development and clinical translation of microneedles to improve the administration of these biopharmaceuticals. The first study reports on a sharp-tipped hollow metal microneedle designed to reduce manufacturing costs, improve insertion into skin, and improve fluid flow compared to other hollow microneedles used for drug delivery. The results showed sharp-tipped metal microneedles could be fabricated using an inexpensive electroplating and sacrificial micromolding process. Single-microneedle devices made by this method achieved high flow rates and delivered model drugs into tissue. The second study reports on insulin delivery using microneedles in children with type-1 diabetes. The results showed microneedle insertion was less painful, which is a promising result for improving injection compliance in children. Additionally, microneedle delivery showed rapid onset of insulin action compared to subcutaneous catheter delivery, which may enable automatic closed-loop insulin therapy. This was the first study of drug delivery to children using microneedles. The last study reports on microneedle patches for self-vaccination against influenza. Human subjects were recruited from greater Atlanta, were asked to self-administer placebo microneedle patches, and were then given a dynamic questionnaire to determine their views and preferences regarding influenza vaccination using microneedles compared to conventional intramuscular injection. The results showed that microneedles were usable by the participants, the introduction of microneedles may improve vaccination coverage by approximately 20%, and self-administration of vaccines may significantly reduce vaccination costs for a healthcare payer. This was the first study to assess the ability of human subjects to self- administer a microneedle patch and the first study to determine the potential impact of self-vaccination against influenza using a microneedle patch on vaccination coverage and vaccination cost. Overall, the fabrication advances and positive findings from human subjects research support additional translation of microneedles for insulin delivery and self-vaccination toward clinical use.