00:08Welcome back at Yagahima TV, today we're going to talk about personalized medicine.
00:13As you know, when you take a tablet, then the tablet is being produced on large scale
00:20and is not, let's say, personalized to your personal situation.
00:25And today I'm going to talk with Beatrice Pereira, she did a PhD research project at the University of Central
00:32Lancashire in the UK
00:34about 3D printing of modular polypills for personalized therapy.
00:38So welcome, Beatrice.
00:41Let's start with what you have been doing on your research project and then we go from there.
00:47Okay, so I'm going to share my screen.
00:51First of all, I would like to thank you for inviting me for this interview.
00:59So I'm going to talk about 3D printing of modular polypills for personalized medicine.
01:03So just a quick overview of my background.
01:08As Peter said, I did my PhD in the University of Central Lancashire, which is in Preston, UK.
01:15And I was part of a research team led by Dr. Mohamed Alnan, who is a pioneer in this field.
01:21So initially I was an Erasmus student when I first came to the UK.
01:25And I worked also in the same uni with 3D printing of medicines in general.
01:30And then during my PhD, I focused more in polypills, which are tablets or capsules with multiple drugs.
01:36So just a quick overview, introduction.
01:41So the current healthcare is based on a one size fits all approach.
01:46And this is associated with variations in health outcomes.
01:50And this is due to the individual variations.
01:53So with the introduction of genetic diagnosis, this approach has been replaced by a patient-centered approach.
02:03So it is believed that in the future, the healthcare system will have a database with information about the patients.
02:12For example, in terms of their genetics, other conditions they may have, their weight, age.
02:18And then this will simulate the target pharmacokinetic profile of the drugs.
02:24And then they will generate an individualized therapy for this patient.
02:29And then this will be, we will have an e-prescription and healthcare professionals will be able to 3D print
02:38these medicines on demand.
02:40So one of the applications of 3D printing more specifically is in the production of polypills, like I said.
02:49And the advantages of this is that, for example, with traditional tableting, we need to produce in large scale.
02:57And there have been many studies studying, comparing the polypills with usual care, which is the administration of several drugs
03:06at the same time.
03:07And actually, they have shown that there's improved patient adherence.
03:10And this is a problem with when people need to take several medicines.
03:14Sometimes they don't take it for one day or two.
03:16And this is associated with disease progression, for example, and increased hospitalizations.
03:22So one of the issues with the traditional tableting methods is the rigid nature.
03:27So, for example, if we have one tablet with three or four drugs that are specific and they have a
03:33specific dose, not everyone can take this specific tablet.
03:38And with the traditional manufacturing methods, it's hard to change just one of the drugs.
03:43For example, the dose of one of the drugs or the number of drugs.
03:46So 3D printing offers much more flexibility in terms of the number of drugs we can add, the dose of
03:53each drug, and we can individualize also the release profile, also improving patient's adherence.
04:01So one of the projects I worked with during my PhD was in the production of multi-compartment capsules.
04:08The reason why I chose capsules was because the technique I used was fused deposition modeling, 3D printing, and this
04:15is associated.
04:17So for this, you need heat to 3D print.
04:21And this can be associated with drug degradation if you melt filaments that contain drugs, and this can degrade some
04:29drugs.
04:30So when using capsules, this capsule will have a shell that will be blank.
04:35So this will be just polymer.
04:38And then the drugs are manually dispensed in these compartments.
04:43So in this case, my goal was to develop two different systems.
04:48And these systems will differ in the design.
04:51So here you can see they have different design.
04:53Here is parallel, here is concentric.
04:55And they will also differ in terms of the polymer that we use.
04:59So on the left, we use PLA, which is not soluble in water.
05:03So the goal here is that the shell will remain intact.
05:08And then the drugs will dissolve through these free pass corridors and through these pores here.
05:15So to show that this is a modular system, I tried different, for example, pore sizes to see how this
05:22was going to affect the release profile.
05:24So I'm going to show you these results later.
05:26Then here on the right, I used PVA, which is water soluble.
05:31So the goal here is that the shell will dissolve with time.
05:35And then I change the thickness of this wall here, the internal wall.
05:42So by changing the thickness, increasing the thickness, I will delay the release profile, the release of these two drugs
05:49that are here in the internal compartments.
05:53So here is a quick summary of how I produce these.
05:59So as I said, I just use 3D printing to produce the shells.
06:04So initially I 3D print the bottom shells.
06:07Then I fill this paste with the drugs.
06:11So this was something also that we optimize this kind of paste.
06:15So we made this hot paste that is easy to dispense with the syringe.
06:20And then at room temperature, it will solidify and it will produce a stable structure and there's no leakage.
06:28Then after this, we just bring the top shell and seal the capsule.
06:35So just really quickly, I will show you more or less how it worked.
06:40So here, as I said, I changed the size of these pores.
06:43So this is the size of the pores here.
06:46So you can see that by increasing the size of the pores, the release profile is faster.
06:54Then with this system, as I said, we increased the wall thickness and this delayed the release profile of the
07:04drugs.
07:05So we achieved what we wanted to achieve.
07:08So we can change the release profile of drugs.
07:11So even these drugs, not all have the same release profile.
07:14We can individualize them just by a digital approach.
07:18So if something is it can be used for a complex therapy, but we use a few starting materials and
07:26we use a easy approach, easy way to do this.
07:29So it's easy for the health care professionals to do it in the future.
07:34And here in this case, I used for specific drugs, but the number of drugs that can be used here
07:39is unlimited.
07:43So I would just like to highlight some of the challenge and future work that needs to be done here
07:48just to apply this in a clinical setting.
07:50So we need to ensure the quality and safety of the drug product.
07:54This is by controlling the formulation we are going to use.
07:57We need to make sure that the components are compatible between themselves and then also between the formulation and then
08:05the equipment with, for example, with the 3D printers.
08:08We also need to control the process. We need to make sure that these 3D printers are GMP qualified.
08:14Also in terms of validation of the control, sorry, validation of the cleaning process to make sure there's no contamination,
08:20cross contamination.
08:21Then there's also the need of more preclinical and clinical studies, clinical studies, especially in populations that may benefit the
08:29most of this, which are, which are pediatric and geriatric populations and see how really they can, how we can
08:38improve their therapy.
08:39And then there's also the need of better regulatory guidance. And so for this is needed that academia, industry and
08:47regulatory bodies collaborate with each other to give us a more specific regulatory guidance in terms of 3D printed drug
08:57products.
08:59So this is it really.
09:01Okay. Well, thank you very much for your, for your, in a very short time to explain your approach.
09:08I have one question, because if you have multiple drugs in one pill, is there no, let's say, how do
09:15you say, interaction between those drugs possible or when people are so have swallowed it that something happens?
09:23It can be. So this is, for example, another advantage of capsules that we use different compartments.
09:28So we physically separate them. So there's no physical interaction between them.
09:33And then, for example, if the interaction between the drugs is, for example, after they are taken, for example, in
09:39terms of pharmacokinetics of the absorption of these drugs,
09:43we can change the release profile of these two drugs.
09:47So we can choose one to release immediately and one to release later to avoid any interaction.
09:52Okay. Okay. Okay. Well, well, thank you very much for this concise explanation about 3D Prima printing and your, your
10:01research project.
10:03As you know, I always ask at the end of the presentation, a personal question and about your favorite music
10:11or art or food or city.
10:13So please go ahead. What's your favorite thing?
10:17I'm going to talk about foods.
10:19I'm Portuguese and I was recently in Portugal.
10:21So I had the chance to eat some of my favorite foods.
10:24I'm going to talk about a specific dish.
10:27I will even share a picture of this, this dish.
10:33So you can have a better idea how it looks like.
10:38Yeah, you make the, what you are hungry then in that case.
10:42Yeah.
10:45So this dish is called francisinha.
10:48And the literal translation is little Frenchy.
10:51This is because the person that invented this dish was Portuguese and used to live in France.
10:56And when he came back to Portugal, he wanted to adapt a French toast that they had there.
11:02It was with ham and cheese.
11:04And when he came to Portugal, they increased the amount of cheese they use.
11:08So they changed a little bit.
11:09And that's why the name is little Frenchy.
11:11Okay.
11:12So this is, I don't, I don't, don't suggest this to vegan, vegan or vegetarians because it contains a lot
11:22of meat.
11:23So it contains Parma ham, steak, sausage, any type of meat you can think about.
11:30And then it has, on top it has a melted cheese.
11:34And then one of the most special things about this is the sauce.
11:39So each restaurant has their own recipe.
11:42In general, the ingredients are the same.
11:44It contains beer, tomato sauce, stock.
11:48But then every restaurant has their special touch.
11:54And it's really, really good, but very caloric.
11:57And it's traditional from Porto, the city of Porto in Portugal.
12:01Okay.
12:02Well, that sounds, it looks very tasty.
12:05So I want to eat.
12:09So, so thank you very much for, for sharing your, your work, your research project and your favorite food in
12:15this case.
12:16And I look forward to listen to your presentation at our conference.
12:22Beginning of next year.
12:23So thank you very much.
Comments