Rapid development in molecular biology and recent advancement in recombinant technology increase identification and commercialization of potential protein drugs. Traditional forms of administrations for the peptide and protein drugs often rely on their parenteral injection, since the bioavailability of these therapeutic agents is poor when administered nonparenterally. Tremendous efforts by numerous investigators in the world have been put to improve protein formulations and as a result, a few successful formulations have been developed including sustained-release human growth hormone. For a promising protein delivery technology, efficacy and safety are the first requirement to meet. However, these systems still require periodic injection and increase the incidence of patient compliance. The development of an oral dosage form that improves the absorption of peptide and especially protein drugs is the most desirable formulation but one of the greatest challenges in the pharmaceutical field. The major barriers to developing oral formulations for peptides and proteins are metabolic enzymes and impermeable mucosal tissues in the intestine. Furthermore, chemical and conformational instability of protein drugs is not a small issue in protein pharmaceuticals. Conventional pharmaceutical approaches to address these barriers, which have been successful with traditional organic drug molecules, have not been effective for peptide and protein formulations. It is likely that effective oral formulations for peptides and proteins will remain highly compound specific. A number of innovative oral drug delivery approaches have been recently developed, including the drug entrapment within small vesicles or their passage through the intestinal paracellular pathway. This review provides a summary of the novel approaches currently in progress in the protein oral delivery followed by factors affecting protein oral absorption.

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Hydrophilic drugs are often poorly absorbed when administered orally. There has been considerable interest in the possibility of using absorption enhancers to promote absorption of polar molecules across membrane surfaces. The bile acids are one of the most widely investigated classes of absorption enhancers, but there is disagreement about what features of bile acid enhancers are responsible for their efficacy. We have designed a class of glycosylated bile acid derivatives to evaluate how increasing the hydrophilicity of the steroid nucleus affects the ability to transport polar molecules across membranes. Some of the glycosylated molecules are significantly more effective than taurocholate in promoting the intestinal absorption of a range of drugs, showing that hydrophobicity is not a critical parameter in transport efficacy, as previously suggested. Furthermore, the most effective glycosylated compound is also far less damaging to membranes than the best bile acid absorption promoters, presumably because it is more hydrophilic. The results reported here show that it is possible to decouple absorption-promoting activity from membrane damage, a finding that should spark interest in the design of new compounds to facilitate the delivery of polar drugs.

The effects of enzyme inhibitor, amastatin, and absorption site following intravenous (i.v.) oral (p.o.), jejunal and ileal administration of [D-ala(2), D-leu(5)]enkephalin (YdAGFdL) were investigated in rats. Model dependent and independent pharmacokinetic parameters were obtained and compared. Linear pharmacokinetics of YdAGFdL were evaluated at 0.28 and 500 microg doses for i.v. and at 1, 500, and 1000 microg for p.o. and ileal routes. Plasma samples were collected and assayed for intact YdAGFdL using a radiometric thin layer chromatography. The clearance (CL) and half lives of the distribution and elimination phases following the 0.28 microg (n=6) i.v. dose were 42.7+/-26.2 (S.D.) ml/min, 0.48+/-0.17 min, and 3.98+/-0.92 min, while those of the 500 microg dose (n=6) were 48.0+/-23.3 ml/min, 0.59+/-0.25, and 6.81+/-3.12 min, respectively, suggesting apparent linear kinetics. The CL values were close to the cardiac output of rats (50 ml/min) indicating very rapid elimination from the body. Mean bioavailability (F) values following p.o. (n=15), jejunal (n=4), and ileal (n=16) administration were 0.40+/-0.24% (S.E.), 1.25+/-0.39, and 1.78+/-0.40, respectively, and were not significantly different (p<0.05) among three doses (1, 1000, 5000 microg). The F value of YdAGFdL following ileal administration in the presence of amastatin was 8.76+/-4.47% (n=6), a 22 fold increase over po administration and a five fold increase over ileal administration without an inhibitor. These results indicate that 'effective' oral delivery of small peptides may be achievable.

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