Avoid Ouch. Scientists are working on ways to exchange the needle against a pill



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Many vaccines and some medications, such as insulin, must be given by injection. It's a pain for both patients and health care providers. But two groups of researchers are trying to put some of these drugs in the form of tablets to prevent bites.

A team of scientists, from the MIT's Koch Integrative Cancer Research Institute and Brigham and Women's Harvard Hospital, has developed an insulin delivery system that always uses a needle – but it is so small that you can swallow it and that the injection does not hurt.

They built a pea-sized device containing a source that projects a small, solid insulin spike into the wall of the stomach, said gastroenterologist Carlo Giovanni Traverso, a physician. deputy to the Brigham Men's Hospital.

"We chose the stomach as a birthing site because we recognized that the stomach is a thick and sturdy part of the GI tract," says Traverso.

Once the device has entered the stomach, the moisture allows the spring to launch the insulin dart.

So far, everything is fine, but Traverso says that the team had to overcome a problem: "How can we get these devices to self-orientate so that the end of the injecting part is in direct contact with tissue?"

To put him in the right position, they turned to nature.

"The leopard tortoises have come up with a way to do it," says Traverso. The shape of the turtle shell helps the turtle to turn around if it is on its back.

And there was another source of inspiration: Weebles, these egg-shaped toys that flicker but do not fall.

As the researchers report in the newspaper Science, they tested the device on pigs and it can administer a therapeutic dose of insulin provided that the pork has empty stomach.

Traverso and his colleagues collaborated with the global health care company Novo Nordisk to prepare the device for human testing. He has received consulting fees from the company and is a co-inventor of patent applications describing the issuance of oral biologics. Traverso hopes his device will be ready for human testing in a few years.

On the other side of the United States, the nano-engineer Ronnie Fang of the University of California, San Diego and his colleagues have a different distribution system. It is a kind of unmanageable microrocket, the size of a grain of sand, designed to pbad beyond the stomach and into the small intestine.

"It really propels [itself] using bubbles in a magnesium reaction with biological fluids, "says Fang.

The rocket has a coating that protects its payload from the acidic and enzymatic environment of the stomach. Once the rocket entered the small intestine, the change in acidity caused the dissolution of the coating and allowed the rocket to stick to the intestinal wall to release its payload, in this case a vaccine protein.

Much like Traverso's design was inspired by the shape of a turtle shell, the microrocket propelled by bubbles moves like a bacteria.

"If bacteria invade your gut, they will not stay naked, they will swim and they will reach the intestinal wall," says Fang.

As Fang and his colleagues report in Nano Letters, their system of administration works in the mouse, but the tests on the man probably last for many years.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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