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Review

Nebulization as a delivery method for mAbs in respiratory diseases

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Abstract

Introduction: The pulmonary route is not invasive and can be used to target drugs directly to the lungs, limiting the exposure of secondary organs. It is, thus, an attractive alternative to the intravenous route, for the delivery of mAbs, which display limited transfer from blood into the lungs.

Areas covered: This review provides an overview of the pharmacological properties of antibody-based treatments, describes those for respiratory diseases and discusses preclinical/clinical results of aerosolized antibody-based therapeutics. The advantages and limitations of aerosol devices and the formulation for the administration of aerosolized mAbs are also detailed.

Expert opinion: Overall, the inhalation of mAbs for therapeutic purposes is both appropriate and feasible. The size and structure of the biotherapeutic molecule are important properties to be taken into account when trying to achieve long-term retention. Mesh nebulizers currently appear to be the most appropriate devices for the safe delivery of large amounts of active mAb into the lungs. mAbs should be formulated so as to prevent their degradation and possible immunogenicity. General guidelines can be given for mAb aerosolization, but the formulation and device combination should be adapted for each therapeutic and clinical application.

Acknowledgments

The authors thank J Sappa, of Alex Edelman and Associates, for assistance with the edition of this manuscript.

Declaration of interest

N Heuzé-Vourc’h, R Respaud and L Vecellio received financial support from the French Higher Education and Research Ministry under the program “Investissements d’avenir”, Grant agreement: LabEX MAbImprove ANR-10-LABX-53-01, from ARAIR (Tours, France), from Région Centre (Grant AeroMac and StabioMed) and the European Union (Grant Agreement: Presage 4940 -37478; OutExFon). European FEDER funds have been allocated to Région Centre. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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