Establishing the effects of mesoporous silica nanoparticle properties on in vivo disposition using imaging-based pharmacokinetics

Nature Communications (2019)

The implementation of nanotechnology in medicine promises to advance drug delivery and diagnostic imaging. Nanoparticle (NP)-based drug delivery and imaging sys- tems, termed nanocarriers, have the potential to package and protect cargos that are too toxic, fragile, insoluble, or unstable to be delivered as free drugs or imaging agents. Nanocarriers can be engineered to package combined therapeutic and diagnostic cargos (the so-called theranostics) and equipped with a variety of triggering mechanisms to release cargo on demand according to intracellular or extracellular environmental stimuli. Further, it is possible to engineer the nanocarrier size, shape, and surface chemistry to enhance circulation times and direct the biodis- tribution of the drug or imaging agent within the organism by passivetargeting, for example, by the enhanced permeability and retention (EPR) effect, wherein NPs passively accumulate in the tumor microenvironment due to its leaky vasculature char- acterized by fenestrations ~2002000 nm in diameter1. Finally, by surface modification of the nanocarrier with targeting ligands that bind to receptors/antigens over-expressed on the cells of interest, it is possible to achieve precise administration of therapeutic cargos to specific cells or tissues via activetargeting, while sparing collateral damage to healthy cells and potentially over- coming multiple drug resistance mechanisms2.

Despite the established preclinical potential of nanocarriers as effective drug delivery vehicles and imaging agents, NP-based delivery has achieved only moderate success in clinical translation, especially for therapeutic nanomedicines. According to a comprehensive review surveying the literature from the past 10 years, the in vivo tumor delivery efficiency of nanocarriers, which has relied primarily upon the EPR effect, has averaged around only 0.7% of the injected dose3. This has been attributed to uncontrolled, non-specific interactions of NPs with the immune and microanatomical components of non-tumor sites, particu- larly the mononuclear phagocytic system (MPS) organs, namely liver, spleen, and bone marrow, that serve as sinksfor preferential NP accumulation4. This is highly problematic as the clinical translation of nanotherapeutics demands a predetermined and reproducible disposition (biodistribution and clearance) profile of NPs needed to achieve the requirements of efficacy and safety. For instance, the US Food and Drug Administration (FDA) guidelines require that diagnostic agents be completely cleared from the body in a reasonable timeframe to avoid interference with other xenobiotics5. In contrast, it is particularly desirable to have prolonged systemic circulation of chemotherapy-loaded NPs for maximal exposure to tumor tissue and accumulation by the EPR effect6. Literature stipulates that a hydrodynamic size of under 5.5 nm and a positive zeta potential promote rapid renal clearance of NPs, which is ideal for diag- nostic applications5,7, but also that solid NPs exceeding 6 nm in diameter cannot be effectively renally cleared5, occasionally shown to be untrue (vide infra). For therapeutic applications, such as cancer nanotherapy, polymeric coatings, such as poly- ethylene glycol (PEG) that serve to reduce serum protein adsorption (opsonization) on the NP surface, are proclaimed to enhance the longevity of NPs in circulation, ideal for increased exposure to the tumor6,8, but so far the tumor-targeting efficiency of largely PEGylated NPs has been modest and highly variable3.

We contend that the deficiencies of NP therapeutics and the confusion in the literature as to their efficiencies and behaviors are largely attributable to insufficient control of NP synthesis and the lack of in vivo colloidal stability, which have led to incon- sistent biodistribution and have therefore prevented the estab- lishment of definitive structureactivity relationships (SAR) necessary for successful preclinical development and clinical translation of nanocarriers. To date, based on the ten-year survey of NP delivery to solid tumors3, several trends have been observed

with respect to NP physicochemical properties: inorganic NPs have higher delivery efficiencies than organic NPs, NPs smaller than 100nm in hydrodynamic diameter have higher delivery efficiencies than larger particles, nearly neutrally charged NPs (defined as having zeta potentials 10 to +10 mV) have higher delivery efficiencies than more positively or negatively charged particles, and rod-shaped particles are more efficient than spherical or plate-like particles. These trends presumably reflect the in vivo stabilities of the NPs, differential uptake by the MPS, and differences in renal clearance; however, this survey did not establish unambiguously the stability or size polydispersity of the NPs nor their biodistribution, and there appeared to be no systematic studies to isolate the effects of size or charge or surface chemistry for NPs of comparable composition and shape. Previous biodistribution studies have shown that NP physicochem- ical properties, primarily size, charge, and surface polymeric coatings912, along with routes of administration1315 are critical in governing the disposition kinetics of NPs, but again systematic comparisons are often lacking. Noteworthy in this regard, we have recently demonstrated for mesoporous silica NPs (MSNs) of identical size and charge that the spatial arrangement and accessibility of charged molecules on the MSN surface (i.e. surface chemistry) is another critical, but to date unrecognized, factor governing biological behavior of NPs16.

Herein to establish quantitative SAR in vivo, we employ single photon emission computed tomography integrated with computed tomography (SPECT/CT) imaging of indium (111In) radiolabeled, colloidally and compositionally stable, monosized, cargoless MSNs to determine biodistribution and clearance in healthy rats. By systematically varying MSN physicochemical variables in the therapeutically relevant size range of ~25150 nm (corresponding to diameters of ~32142 nm in our study), we examine the effect of size, zeta potential, and surface chemistry on in vivo disposition of hydrodynamically stable, non-targeted MSNs administered via intravenous (i.v.) or intraperitoneal (i.p.) injection. We employ SPECT/CT imaging to determine the dis- position kinetics of MSNs within ten regions of interest (ROI) in the rat. We then develop a parsimonious, semi-mechanistic mathematical model to describe the macroscopic concentrationtime behavior of MSNs in individual ROIs and estimate relevant pharmacokinetic (PK) parameters. Our results allow the formulation of significant correlations between MSN size and surface chemistry and PK parameters, thus enabling quantitative comparison of the disposition behavior of MSNs necessary to advance their status toward clinical use. An interplay between physiological and NP physicochemical variables governs the in vivo behavior of NPs, and this study furthers our under- standing of this interaction.

Results

Characterization of MSNs. The establishment of NP SAR in vivo demands consummate control of NP size, shape, surface chemistry, and stability. Here, to avoid confounding effects of particle size polydispersity and hydrodynamic instability (which have obscured the role of particle size in previous studies), we employed well-characterized, monosized (defined as hydro- dynamic diameter polydispersity index (PdI) <0.1), PEGylated MSNs that exhibited long-term stability in physiologically rele- vant media (see Methods for details of MSN synthesis and characterization). 111In-labeled MSNs with three different surface chemistries were synthesized with nominal diameters of 50 nm: (1) PEG-polyethylenimine (PEG-PEI), (2) PEG-quaternary amine (PEG-QA), and (3) PEG-trimethylsilane (PEG-TMS) (see Fig. 1a). Additionally, PEG-TMS MSNs were synthesized with nominal sizes: 25, 90, and 150 nm. The MSN core diameter was

determined by transmission electron microscopy (TEM) and the hydrodynamic diameter and PdI were determined by dynamic light scattering (DLS) (see Table 1 and Supplementary Fig. 1). Hydrodynamic diameters were consistently between 10 and 20 nm larger than core diameters determined by TEM, consistent with previous observations in the literature17. For all three surface chemistries the average pore diameter determined from nitrogen (N2) adsorption isotherms using Non-Local Density Functional Theory assuming a silica surface and cylindrical pores was 3.53.8nm (see Supplementary Fig. 2 and Supplementary Table 2). The uniformity and completeness of the surface

modification was assessed by measurement of the hemolytic activity of the various MSNs towards human red blood cells. It is well documented that amorphous, monosized colloidal silica NPs, for example, the so-called Stöber silica NPs, exhibit a very sig- nificant dose-dependent hemolytic potential18 due to electrostatic and hydrogen bonding interactions of surface silanols (Si-OH and deprotonated silanols (Si-O)) and siloxanes (Si-O-Si) with RBC membrane constituents19. Introduction of meso- porosity reduces necessarily the surface concentrations of silanols and siloxanes and accordingly reduces the hemolytic potential, but there remains significant hemolytic activity18. By comparison, the various PEG-TMS-modified, PEG-QA-modified, and PEG- PEI-modified MSNs studied here have essentially zero hemolytic activity (see Supplementary Fig. 3), meaning that the surface Si- OH groups are completely passivated by the PEG-TMS, PEG-QA, and PEG-PEI surface modifications. All three MSN types showed excellent hydrodynamic stability in 1× phosphate-buffered saline (PBS) over 5 to 7 days (Supplementary Fig. 4) where hydro- dynamic diameter varied by <4.5%. Furthermore, crucial to the establishment of quantitative biodistribution data, we showed the indium-labeled MSNs to have excellent compositional stability. For all three surface chemistries, indium leaching studies con- ducted in simulated body fluid (SBF) showed <0.001% indium loss over 48 h (see Supplementary Fig. 5 and Methods for details). Surface charge of the particles was determined by measurement of zeta potential (ζ). PEG-TMS-modified particles were nearly neutrally charged (ζ = 4 to 7 mV), while PEG-PEI-modified and PEG-QA-modified particles were strongly positively charged with statistically identical zeta potential values (ζ = +37 to +38 mV) (Table 1). In fact, PEI-modified and QA-modified MSNs are essentially indistinguishable according to the standard determi- nants of biodistribution (core size, hydrodynamic size, shape and zeta potential); however, as we will show, they varied greatly in their disposition (vide infra) due to differing distributions and exposures of surface amines (see Fig. 1a), consistent with previous observations of their ex ovo behaviors within a highly vascular- ized chorioallantoic membrane model16.

Generalized biodistribution of MSNs. At the very outset, it is important to understand that the radioactivity observed in SPECT/CT images (see Fig. 2) potentially has two origins: (1) radioactivity from NPs circulating through the vasculature of an ROI, and (2) radioactivity from NPs sequestered in the extra- vascular space of an ROI. The former NPs are still bioavailable for delivery to a potential target site, but the latter are generally not, unless the organ they are sequestered in is the target organ itself. We propose that the extent of NP sequestration in the extra- vascular space of an ROI is dependent on the density of traps in the microvasculature of the ROI. Traps here are referred to as the three recognized microscopic mechanisms that work to remove NPs from circulation: (i) opsonization by plasma proteins20, which label the NPs as foreign invaders for targeted phagocy- tosis21, (ii) binding of NPs to vascular endothelial surfaces, which may lead to cellular internalization22, and (iii) fenestrated capil- laries and sinusoids allowing extravasation1 of NPs into tissue interstitia or directing excretion23. Because these traps are not uniformly distributed across the body, rather are localized in higher densities in the MPS organs, we can classify the organs in the body according to high or low density of the most relevant physiological traps (phagocytes, fenestrae, interendothelial gaps)24,25 as: (1) sink-like and (2) source-like organs, respectively. NPs in the sink-likeorgans can passively accumulate over time in the extravascular space, due to high activity of traps, and eventually metabolized or excreted, leading to a permanent loss of bioavailable NPs. In contrast, NPs in source-like ROIs travel through the vasculature without getting trapped26. Thus, source- like ROIs collectively represent the blood pool through which NPs circulate and remain bioavailable for delivery to the target site or to sink-like organs.

From the representative SPECT/CT images in Fig. 2 and their quantification in Fig. 3, we can understand the generalized biodistribution behavior of MSNs and thus infer similarities and differences between groups. As seen following i.v. injection in Figs. 2ac, gi and 3a and Supplementary Fig. 6, at the 30-min time point, an almost identical concentration is observed across all groups in the thoracic region (heart and lungs). The exception however is PEI50 (Figs. 2i, 3a), where a much weaker signal is observed in the thorax. As seen in the quantified concentrationtime data of heart (Fig. 3a), a significant difference is not observed between groups at 30 min (one-way analysis of variance (ANOVA) and Tukeys test, P > 0.05), except with PEI50. Over time, the concentration in the thorax tends to decline, although at different rates, suggesting that the organs in the thorax tend not to accumulate MSNs into their interstitium, and NPs are cleared from the blood pool of thoracic organs in a particle-type-dependent fashion. This justifies the classification of heart and lungs as source-like organs. In contrast, the concentration in the abdomen (spleen and liver) tends to rise to a maximum followed by a slow or zero decline within 24 h post injection; note that this behavior is also particle-type-dependent (see Figs. 2ac, gi and 3a and Supplementary Fig. 6). The rise of MSN concentration in MPS organs for prolonged periods of time suggests that MSNs tend to accumulate over time in the interstitium of these organs, hence a very small washout is observed within 24 h, justifying these organs to be classified as sink-like organs. The literature shows that over time the spleen and liver gradually clear the NP load through the hepatobiliary route of elimination and not through recirculation into blood12,13,27,28. Further, PEI50 MSNs (Figs. 2i, 3a) that exhibit the lowest concentration in heart and lungs at 30 min among all groups accordingly exhibit the highest accumulation in the liver and spleen at 30min, indicating a rapid hepatic and splenic uptake of PEI50 MSNs from blood. As seen in Figs. 2ac, gi and 3a and Supplementary Fig. 6, the behavior of kidneys and urinary bladder appears to be consistent across groups, except for QA50 (Figs. 2h, 3a), where the bladder shows significantly larger activity over time than other groups. Also, in Fig. 2h QA50 shows radioactivity in the large intestine at the 5 h and 24 h time points, unlike other MSNs. Thus, it can be inferred that because of rapid urinary and fecal excretion, QA50 shows one of the lowest accumulations in the spleen and liver relative to other MSNs (see Fig. 3a). Finally, other ROIs, including abdominal aorta, brain, joints, and muscles exhibit only trivial concentrations (<1.5%ID g 1 (percentage of injected dose per gram of tissue)) across groups. Their behavior, except joints, resembles that of source-like ROIs, that is, a particle-type-dependent decline in concentration over time (see Fig. 3a, Supplementary Figs. 12a, b, 13a, b, 14a, b, and 15a, b).

Next, as seen in Fig. 2df, i.p. injection of PEG-TMS-coated MSNs shows a punctate biodistribution pattern throughout the abdomen at the initial time point of 30 min that seems to map the abdominal lymph circulatory network29, with mediastinal lymph nodes in the thorax (see ROI map Fig. 1c) being an important site of radioactivity (see Figs. 2df, 3b). This initial phase represents the absorption of MSNs from the peritoneal cavity into blood29,30. Over time, however, the distribution pattern starts to resemble that of the corresponding i.v. cases for the three particle types (Fig. 2ac), indicating that the MSNs have entered the systemic circulation. This behavior demonstrates the in vivo stability of the MSNs with respect to non-specific binding in lymph nodes. Having entered the circulatory system, i.p.-injected MSNs ultimately exhibit a mass transfer phenomenon similar to the one following i.v. administration, namely transfer of MSNs over time from source-like organs (e.g., heart and lungs) to sink- like organs (e.g., liver and spleen), and finally excretion (as depicted in Fig. 1d). The kinetics of these processes are, however, particle-type-dependent and in the subsequent sections we will unravel the effects of MSN physicochemical properties on the kinetics of MSN disposition in blood, visceral organs, and excretory organs.

Systemic kinetics. We employed the SPECT-derived radioactivity concentrationtime data of the heart ROI as a substitute for plasma concentrationtime data3133 (assuming that MSNs in the heart ROI were in circulation due to its source-like character, i.e., lack of fenestrations large enough to allow NP escape from circulation34,35) to understand systemic kinetics of MSNs and estimate relevant PK parameters (see Figs. 3, 4a, b). Since the concentrations of different MSNs seem to vary in a mono- exponential or double-exponential fashion, we fit a one- compartment PK model36 (Eq. (6) for i.v. and Eq. (4) for i.p.) to the concentrationtime data and estimate model parameters (see Supplementary Tables 4 and 5). Fitted concentrationtime curves demonstrate the effect of MSN size and route of admin- istration (Fig. 4a) and surface chemistry and zeta potential (Fig. 4b) on systemic kinetics of MSNs. In Supplementary Fig. 7, normalizing the predicted concentration over time (C(t)) of individual MSNs by their own predicted concentration maxima (Cmax) allows a direct comparison of different groups. We then estimated area under the curves (AUC024 h), uptake (kin) and elimination rate constants (kout), and half-lives (t1/2) of individual curves from Fig. 4a, b.

As seen in Fig. 4c, AUC024 h decreases monotonically with an increase in particle size in the studied size range of ~32 to ~142 nm, irrespective of the route of delivery, governed by the mathematical relation: AUC024 h = λ · sizen, where λ and n are fitted coefficients, and size refers to the core diameter of NPs. The value of the power coefficient is ~1 for both i.v. and i.p. cases, suggesting a strongly negative linear dependence (see Supple- mentary Fig. 19e). Further, the elimination rate constant (kout) increases (and thus t1/2 decreases) with an increase in size (see Fig. 4e and Table 2); however, one-way ANOVA reveals no significant difference in the uptake rate constant (kin) values across i.p. administered cases (P > 0.05) (see Fig. 4d). This suggests that absorption of NPs from peritoneal cavity in the studied size range is independent of particle size37 and that the systemic bioavailability through either route of administration is primarily a function of the kout parameter. Published hemody- namic studies3840 show that smaller particles tend to have smaller margination38 probabilities in blood capillaries, in addition to being shielded by erythrocytes, thus escaping near- wall accumulation, resulting in reduced extravasation through fenestrations and reduced internalization by endothelium or near-wall phagocytes41. Thus, greater protection from the traps in microvasculature yields a higher systemic bioavailability for smaller-sized particles.

Given that the i.v. injected MSNs are 100% bioavailable, the bioavailability fraction (calculated as the ratio of dose normalized AUC024 h of i.p. to AUC024 h of i.v.) of i.p. administered TMS25, TMS50, and TMS150 MSNs is 72.8, 66.6, and 79.6%, respectively, thus quantifying the incomplete absorption of MSNs from the peritoneal cavity into blood. It is however important to note that t1/2 is not significantly different (unpaired t test, P > 0.05) between corresponding MSNs injected through the i.v. and i.p. route (see Table 2), indicating that upon entering the blood stream MSN kinetics is independent of their route of administration, which again highlights their in vivo stability required for clinical translation.

Next looking at the effect of surface chemistry in Fig. 4b, c, e and Table 2, PEI50 (which has surface-exposed amines) has a ~9- fold lesser AUC024 h (unpaired t test, P < 0.0001) and half the t1/2 (unpaired t test, P < 0.05) relative to size-matched and zeta potential-matched QA50 (which has obstructed surface amines). These results are consistent with our previously published report16, where we demonstrated the difference in cellular and tissue interactions of PEG-PEI-coated and PEG-QA-coated MSNs in vitro and ex ovo in the highly vascularized chicken chorioallantoic membrane model, which recapitulates the divergingconverging capillary vasculature associated with sink- like organs such as the liver and spleen. It was shown that PEI50 rapidly binds to serum proteins and endothelial cells in comparison to QA50. The subtle difference in surface chemistry arguably alters the vulnerability of PEI50 MSNs to phagocytosis because of increased opsonization and hence reduced systemic residence and is consistent with previous studies of the effects of surface chemistry on protein corona42,43.

Interestingly, we observed no significant effect of zeta potential on the AUC024h of size-matched and surface chemistry- matched, but differently charged TMS50 and QA50 particles (unpaired t test, P > 0.05) (see Fig. 4c), although the positively charged QA50 has a slightly lesser kout (hence slightly greater t1/2) than neutral TMS50 (unpaired t test, P < 0.05) (see Fig. 4e and Table 2). As seen before in Fig. 2b, h, the washout of TMS50 from thorax is accompanied by increased concentration of MSNs in the liver and spleen, but that of QA50 is accompanied primarily by excretion into the large intestine and urinary bladder, indicating that the positively charged particles tend to be excreted out faster than their neutral counterparts, which tend to be sequestered in the liver and spleen longer12. This difference, however, does not cause variation in the systemic bioavailability of the two particles as indicated by similar values of AUC024 h.

Individual-organ kinetics. As described before, we theoretically classify ROIs in the body as source-like and sink-like, which becomes more evident as we consider the kinetic behavior of MSNs in individual ROIs. Because source-like ROIs, namely lungs, abdominal aorta, muscles, and brain, are deficient in traps (e.g., fenestrations are not large enough to allow transvascular escape of NPs34,35), MSNs are not sequestered into the inter- stitium and only traverse through the blood pool of these ROIs. Hence, a mono-exponential decay function (Eq. (6)) explains the concentrationtime course of MSNs through such ROIs (see Fig. 5a, d, Supplementary Figs. 12a, b, 13a, b, and 14a, b, and Supplementary Tables 4 and 5). MSNs demonstrate synchronous behavior across all source-like ROIs, which in turn closely resembles their behavior to systemic kinetics (i.e., heart ROI) (Fig. 4a, b). A change in the heart concentration of MSNs is reflected by a similar change in source-like ROIs, as is also evident from similarity in the kout values of MSNs across ROIs (one-way ANOVA, P>0.05), except PEI50 (one-way ANOVA, P<0.05) (comparing Fig. 4e and Supplementary Figs. 8c, 12f, 13g, and 14g). This is strongly suggestive of coupling between the heart and source-like ROIs; heuristically, the underlying reason lies in the similar microanatomy of these ROIs. As seen in the ROI to heart concentration ratios (Fig. 5g and Supplementary Figs. 12c, 13c, and 14c), source-like ROIs have an almost constant ratio over time, which corroborates the coupling of source-like ROIs to the heart. Also, the mathematical relation AUC024 h = λ · sizen seems to hold true for all source-like ROIs, with values of power coefficient n ranging from 0.5 to 0.9, suggesting a moderate to strongly negative linear dependence (Fig. 5j, Supplementary Figs. 12e, 13e, and 14e, and 19a, b, c, f). All of the above suggest that the effect of MSN physicochemical properties and routes of administration on MSN disposition kinetics in source-like ROIs is similar to that in systemic kinetics. The concentration levels, however, do vary across these ROIs because of differences in organ perfusion (see Fig. 3).

As discussed previously, the sink-like ROIs (i.e., liver, spleen, and thoracic lymph nodes) behave differently than the heart and source-like ROIs (primarily due to porous capillaries with discontinuous endothelium25,34,35,44 and high density of macrophages24,4446), and as a result we observe a varying ROI to heart concentration ratio over time (Fig. 5h, i and Supplementary Fig. 11b). MSN concentrations in these ROIs rise over time initially, followed by slow or no decline in concentra- tion within 24 h, indicating the presence of traps causing MSN accumulation over time into the interstitium (see Fig. 5b, c, e, f and Supplementary Fig. 11a). As a result in sink-like ROIs (Fig. 5b, c, e, f and Supplementary Fig. 11a), Eq. (4) or its adaptation, Eq. (5), is fit to MSN concentrationtime data (see Supplementary Tables 4 and 5).

As to the effect of MSN size, a larger size of TMS-coated MSNs is associated with a greater AUC024 h in sink-like ROIs, irrespective of the route of administration, indicating a greater accumulation of MSNs (see Fig. 5k, l and Supplementary Fig. 11d). The mathematical relation between AUC024 h and particle size, AUC024 h = λ · sizen, is consistent across all sink- like ROIs with values of power coefficient n varying between 0.4 and 1.2, suggesting a moderate to strongly positive linear dependence (see Supplementary Fig. 19d, g, h). Comparing the effect of route of administration, i.v. delivered TMS-coated MSNs are associated with a higher AUC024 h value than their i. p. delivered counterparts in the spleen (unpaired t test, P < 0.05), but with comparable values in the liver (unpaired t test, P > 0.05) (see Fig. 5k, l).

For the PEI50 MSNs with surface-exposed amines, spleen and liver are the prime sites of radioactivity, unlike the size- matched and zeta potential-matched counterpart, QA50, with obstructed amines (see Figs. 3a, 5e, f). QA50, however, shows resemblance in its behavior to TMS50, indicating that surface chemistry plays a more prominent role in affecting the hepatic and splenic accumulation of MSNs compared to zeta potential.

It is worth mentioning that TMS25 (i.v.) and QA50 (i.v.), show a decline in concentration over time in the liver, in contrast to the other MSNs; hence, the mono-exponential Eq. (6) was fit to their concentrationtime course (Fig. 5b, e). The difference is also evident from the almost constant liver-to-heart concentra- tion ratio for these two MSNs, unlike other MSNs which exhibit an increasing ratio over time (Fig. 5h). The small size of TMS25 seems unfavorable for MSN sequestration in the liver9 and the positive zeta potential of QA50 seems favorable for hepatobiliary elimination12, consistent with published litera- ture, hence overall a low sequestration in the liver is observed leading to an almost constant liver to heart concentration ratio. This information is valuable for MSN design optimization.

Excretion kinetics. Urine and feces were not collected during the in vivo study; we thus examine kidneys, urinary bladder, and total excreted activity data (Fig. 6af) to understand the excretion kinetics of MSNs. A mono-exponential decay function (Eq. (6)) was fit to the concentrationtime data in the kidneys following i.v. injection, and Eq. (4) was fit to the data obtained following i.p. injection. As seen in Fig. 6a, d, there is a tight overlap between the kidney concentrationtime profiles of various MSNs injected i.v. or i.p., with a mean radioactivity concentration of <2.5%ID g1 at 30min in all cases, and an overall trend of decline in con- centration over time. Because the radioactivity in kidneys is a combined result of 111In-DTPA (indium-diethylenetriamine pentaacetic acid (DTPA) chelate) present in the glomerulus and collecting duct system, we instead refer to the urinary bladder ROI and the total excreted activity data for an understanding of the excretion behavior of MSNs.

The presence of radioactivity in the urinary bladder ROI indicates that some 111In-DTPA is reaching the bladder (Figs. 2, 3, 6b, e). We note that the bladder signal is unlikely to arise from extravasated NPs in the bladder wall, given the uniformity of radioactivity across the bladder volume evident in thin (0.4mm) sections (Supplementary Fig. 17) and the observation that other smooth muscle structures (such as the trachea, stomach, and intestines) show no significant uptake. Thus, the activity in the bladder arises from one of the following pathways: (a) glomerular filtration of intact NPs through kidneys47, or (b) renal excretion of free 111In-DTPA following degradation of NPs in circulation9. Given the high stability of the 111In-DTPA label on MSNs in physiologically relevant media (Supplementary Fig. 5), possibility bdiminishes. Thus, pathway aseems to be the primary mechanism responsible for visible radioactivity in the bladder. This observation defies the often-quoted renal clearance cutoff of ~5.5 nm5. Although there are published studies13,48,49 that demonstrate excretion of intact NPs as large as 110nm in urine, and an in-house in vivo experiment that shows urinary excretion of intact 50nm PEGylated TMS MSNs in mice (Supplementary Fig. 18), future investigations involving microscopic examination of urine samples will be necessary to validate this hypothesis and to gain an understanding of the mechanism of excretion. Due to loss of activity from the bladder via urination, the activity detected in the bladder at a given time point (Fig. 6b, e) is not equivalent to the cumulative amount of renal excretion. The urinary bladder activity thus gives an incomplete picture of renal excretion. Therefore, we quantify total excretion kinetics instead, which accounts for urinary and fecal excretion combined, to analyze excretion kinetics of MSNs. We fit Eq. (7) to the total excreted activity (%ID) over time, which is obtained by subtracting the measured whole-body activity (%ID) at any time t from the measured activity of the injected dose (100%) (Fig. 6c, f and Supplementary Tables 4, 5).

As can be seen in Fig. 6c, TMS-coated MSNs of different sizes injected i.v. or i.p. are excreted to a comparable amount (except TMS25, which has the least amount excreted). Otherwise, there is no significant correlation between size or route of administration and excretion. Regarding charge, in a previous study, substantial excretion was observed in <30 min with positively charged particles, but was much slower (up to several days) with strongly negatively charged particles12. In our study, QA50, which is strongly positively charged, shows higher excretion than neutral MSNs (Fig. 6f), consistent with the previous study. However, the other highly positively charged MSN used in our study, PEI50, shows lesser excretion than QA50 within 24 h, apparently because sequestration by the liver and spleen delays excretion (see Figs. 2i, 6f). The higher total excretion of QA50 correlates with lower MPS organ accumulation, higher bladder activity, and higher large intestine activity (see Fig. 2h), which suggests that QA50 tends to have higher urinary and fecal excretion, compared to the other MSNs.

Discussion

We have demonstrated the application of a combined mathe- matical modeling and non-invasive SPECT/CT imaging

approach to PK analysis of MSNs. The selection of MSNs as the NP of choice for the current investigation is based on their ability to undergo surface functionalization and precise synthesis control that allows for selection of particle size, shape, and pore size. Furthermore, the safety of MSNs is supported by the fact that amorphous silica is generally recognized as safe as a food additive by the FDA, and recently amorphous silica NP C dots(Cornell dots) were FDA approved for diagnostic applications in a phase I clinical trial50, making MSNs ideal candidates for drug-delivery sys- tems5154. The range of particles used to test the effect of size, charge, and surface chemistry reveals that the in vivo biodis- tribution and clearance of MSNs is significantly affected by their physiochemical properties. We justified the classifi- cation of ROIs into source-like and sink-like organs based on their underlying physiological differences and observed NP kinetics, and applied semi-mechanistic models to the concentrationtime profiles of NPs in these ROIs to determine relevant PK parameters. Our analysis showed that smaller MSN size results in a higher systemic bioavailability, irrespective of the route of administration; positive charge favors greater excretion; and importantly, surface-exposed charged molecules (amines) increase vulnerability to sequestration in the liver and

spleen. Notably, a consistent mathematical relation between one key PK parameter (AUC024 h) and MSN core diameter was identified in the form of AUC024 h = λ · sizen for systemic circulation and all source-like organs in both i.v. and i.p. cases; however, for sink-like organs, the relation identified is AUC024 h = λ · sizen.

Regarding the predictive power of our semi-mechanistic mathematical model, it operates at a macroscopic scale, mean- ing that it is based on the organ-scale or tissue-scale concentrationtime profiles of NPs wherein several microscopic mechanisms are lumped together into the phenomenological macroscopic constants and variables used in the model. The predictive capacity of the model is thus limited in scale. The model can help to reliably predict organ exposure of NPs based on functional relationships (vide supra) between organ exposure (AUC024h) and MSN size through interpolation within the studied size range (~32 to ~142 nm). As for extrapolation beyond the studied size range, we expect its accuracy to worsen for NP size below 5.5 nm. Because of predominance of renal clearance below 5.5 nm, systemic circulation and exposure of source-like and sink-like organs to such particles will be drastically reduced, which means that the correlation function for at least systemic circulation and source-like organs, if not for sink-like organs, will be reversed as per a published report5. Thus, we would like to assume 5.5 nm as the safe lower bound for the functions defined in our study. For sizes above 142 nm, we expect the functional relationship discovered here to generally apply, as larger sizes of NPs should continue to correlate with even greater hepatic and splenic uptakes55. Further, as for the relationship between AUC024 h and zeta potential, we find no significant effect of zeta potential on the systemic circulation and source-like organ exposure of MSNs. However, positive charge with shielded sur- face amines (QA) correlates with greater total excretion, hence lower liver accumulation compared to neutral MSNs (TMS) or cationic MSNs with surface-exposed amines (PEI). The same trend holds true for possible urinary excretion and seems rea- sonable given the presence of anionic charge within the glo- merular capillary wall7, but most importantly it highlights the importance of surface exposure of charged molecules in affecting in vivo interactions. Based on these trends and on previously published studies12,28, we can extrapolate that anionic MSNs will have reduced hepatobiliary and urinary excretion, which needs further investigation for conclusive evidence. Furthermore, based on the scope of our study, we propose 32-nm TMS-alkylated MSNs and 56-nm QA-aminated MSNs for therapeutic applica- tions, primarily due to their low hepatic and splenic accumula- tion. Since 32-nm TMS-alkylated MSNs stay in circulation nearly four times longer than 56-nm QA-aminated MSNs, in applica- tions demanding longer circulation times, for example, tumor delivery, the neutral alkylated MSNs appear to be a better choice over the positive aminated MSNs.

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Expanding its reach

Expanding its reach

The University of New Mexico Health Sciences Center’s Project ECHO (Extension for Community Healthcare Outcomes) has been selected to serve as the central office of the South Central AIDS Education and Training Center (SCAETC).