Nordic Life Science 1
76 “For decades, intranasal vaccination has been
considered a “holy grail” because the nasal mucosa is both the entry point for most pathogens and a difficult environment for traditional vaccine technologies.” MARIA ALRIKSSON N ASAL DRUG DELIVERY is rapidly becoming an attractive option for emergency medicines and vaccines, and promises easier administration that can be carried out by anyone. The scientific rationale is simple: drugs absorbed through the nasal mucosa bypass the gastrointestinal tract and liver, enabling faster and more efficient uptake. “Nasal delivery is one of the big focus areas in drug delivery right now,” says Nikolaj Sørensen, CEO of Orexo, an Uppsala-based drug delivery formulation company. Nasal delivery allows for a higher drug load and higher and faster bioavailability, making it both quicker and more precise than other delivery methods, which is crucial especially in emergency situations. In the case of Orexo, three of the four candidates in its pipeline are emergency medications for opioid overdose. 85% of all severe diseases come through the mucosa Another advantage is the ability to stop infections at the point where many pathogens enter the body – through the nose. This is central to why nasal vaccines may outperform injections, for example against respiratory diseases. Maria Alriksson, CEO of Abera Bioscience, another company in Uppsala, which develops nasal vaccines – distinguishes between mucosal immunity, which acts directly in the nasal passages, and systemic immunity, which activates only after a pathogen enters the bloodstream. “With mucosal immunity, the immune system reacts already at that physical place,” she explains, without the body having to wait for the virus to enter the blood stream before an immune response is activated. For decades, intranasal vaccination has been considered a “holy grail” because the nasal mucosa is both the entry point for most pathogens and a difficult environment for traditional vaccine technologies, according to Alriksson. “If you eliminate the virus in the mucosa, you don’t spread it when you sneeze or cough. You can stop transmission, which could make a huge difference in a pandemic,” she says, and adds that 85% of all severe diseases come through the mucosa. G iven that the nose is designed to flush out irritants rather than absorb them in the mucus, it’s proven difficult to develop a technology that can elicit a strong immune response. Abera’s platform is looking to overcome this by generating strong mucosal and systemic immunity simultaneously. The company develops its own vaccine candidates using a vesicle-based platform that can be decorated with different antigens “in a plug-and-play manner,” as Alriksson puts it. The same vesicle is used across all their candidates, enabling rapid development of vaccines for influenza, pneumococcal disease, and other pathogens. Powder vs. liquid nose sprays While Abera’s candidates – four of which are in preclinical stage and another three in the discovery phase – are all liquid formulations, their platform also works for powder formulations, and nasal drugs in powder form offers additional benefits. THE NOSE // NASAL DRUG DELIVERY