Isolation ofMycobacterium Tuberculosis 31 kDa antigen protein of diagnostic interest from culture filtrate using anti-ES-31 antibody by affinity chromatography

Proteins secreted into the culture medium byMycobacterium tuberculosis (M. tb) are shown to be source of antigens of immunodiagnostic interest. Anin vitro released 31 kDa antigen ESAS-7F isolated fromM.tb H₃₇Ra culture filtrate by salt precipitation, SDS-PAGE and cation exchange fast protein liquid chromatography (FPLC) was shown earlier to be a diagnostically important antigen fraction. In this report, we describe the isolation of ESAS-7F antigen using monospecific antibody coupled to sepharose CL-4B column. The percentage recovery of ESAS-7F antigen using affinity chromatography was approximately 8% of the total ES antigen proteins compared to 0.05% obtained by conventional purification steps using salt precipitation, SDS-PAGE and FPLC. Similar seroreactivity was observed by the antigen isolated by both the methods in indirect ELISA. Affinity chromatography helped in an increased recovery of ESAS-7F antigen and obviates the need for time consuming conventional purification steps.     

Assay of tubercular antibody, circulating free and immune complexed antigen in the diagnosis of pulmonary tuberculosis

Analysis of tubercular antibody, circulating free and immune complexed antigen (CIC-Ag) was done in confimed pulmonary tuberculosis sera by ELISA, using ES-31 antigen and affinity purified anti ES-31 antibody. Twenty three of 25 (92%) tuberculosis sera were positive for IgG antibody to ES-31 antigen. Using anti ES-31 antibody, free tubercular antigen could be detected in 20 of 25 (80%) cases whereas circulating immune complexed antigen (CIC-Ag) in 18 of 25 (72%) cases by sandwich ELISA. Of the two sera showing absence of antibody, one showed presence of free and CIC-Ag whereas the other showed the presence of free antigen. Thus antigen assay may be used as an adjunct tool for confirmation of pulmonary tuberculosis.     

Analysis of SEVA TB ES-31 antigen specific immunoglobulins IgM, IgA and IgG in sera of sputum and culture positive pulmonary tuberculosis

Tuberculosis remains major health problem in India and developing countries Immunodiagnosis has important role in screening, diagnosis and management of tuberculosis. SEVA TB ES-31 antigen has shown potential in detecting tuberculous IgG antibody in earlier studies from our laboratory. In the present study we have analysedSEVA TB ES-31 antigen specific immunoglobulinsIgM, IgA and IgG in clinically and bacteriologically confirmed pulmonary tuberculosis cases to determine the usefulness of specific immunoglobulin class in the diagnosis of patients attending the hospital. Of the 30 cases of pulmonary tuberculosis 25 (83.3%) were positive for IgG, 19 (63.3%) for IgM and 16 (53.3%) for IgA. On combining IgG and IgM positivity, sensitivity was increased to 93.3%. While combining IgG and IgA positivity, sensitivity increased to 90%. However specificity was decreased to 66.6% and 70% for both of these combinations respectively. It could be envisaged from this study that IgG antibody detection against ES-31 antigen showed acceptable sensitivity (83.3%) and specificity (86.6%) compared to IgM or IgA alone or in combination. When immune responses were analysed according to degree of sputum positivity, IgG response was observed to be predominant in all grades, compared to IgM or IgA antibody. The addition of IgM or IgA as an adjunct test increases the sensitivity but at the cost of specificity. Hence the detection of IgG alone is more useful compared to IgM or IgA assay, in detecting tuberculosis disease cases coming to the hospital.     

Serodiagnosis of tuberculosis using two ELISA systems

Serodiagnosis by ELISA has been widely explored over the years, in the diagnosis of tuberculosis. Two ELISA systems were evaluated for detection of mycobacterial antibodies in pulmonary and extra pulmonary tuberculosis. The two test assays explored were ERBA LISA (TB IgG) test (Anda Biologicals) which uses A60 antigen complex found in the cytosol of typical and atypical mycobacteria, and SEVA TB (IgG) ELISA, which uses a 31 kDa, glycoprotein antigen purified fromM. tb H₃₇Ra culture filtrate. Sera from 98 proven tuberculosis [pulmonary TB (48), tuberculous lymphadenopathy (30), tuberculous meningitis (15) & genitourinary TB (5)] were studied along with 32 healthy controls. The overall positivity obtained using ERBA LISA (TB IgG) test and SEVA TB (IgG) ELISA test was 72.9% and 91.6% in pulmonary tuberculosis, 43.3% and 76.6% in tuberculous lymphadenopathy respectively. The sensitivity of ERBA LISA test in tuberculous meningitis and genito-urinary TB was significantly low (26.6% & 40% respectively) compared to sensitivity obtained using SEVA TB ELISA (86.6% & 60% respectively) with overall specificity of 60% and 87.5%. Thus SEVA TB IgG ELISA test was found to be more sensitive than ERBA LISA in detecting IgG antibodies in tuberculous sera, in particular in extra pulmonary tuberculosis cases.     

Detection of tubercular antibody and antigen in sera of bone and joint tuberculosis

Trichloroacetic acid (TCA) solubilized and DEAE fractionatedMycobacterium tuberculosis H₃₇Ra excretory-secretory (ES) antigen viz., Mtb EST DE1 and affinity purified goat antibodies to the TCA solubilized ES antigen (Mtb EST) were explored in detecting tubercular antibody and antigen respectively in sera of bone and joint tuberculosis by indirect and sandwich ELISA. Out of total 36 bone & joint tuberculosis cases, tubercular antibody was detected by indirect ELISA in 30 patients (sensitivity 83%), while circulating tubercular antigen was detected by sandwich ELISA in 27 patients (sensitivity 75%). Out of 34 non tubercular disease control cases, 10 patients showed positive reaction for antibody while only 4 patients showed positive reaction for antigen. In another group of 34 healthy subjects who were screened, 4 individuals showed positive reaction for tubercular antibody and 2 cases for antigen. This study shows that antigen detection assay using affinity purified anti Mtb EST antigen antibody is superior with overall specificity of 91% as compared to antibody detection assay with 75% specificity in bone & joint tuberculosis.     

Diagnostic potential of fractionatedMycobacterium tuberculosis H37Ra excretory-secretory (EST-DE1) antigen in pulmonary tuberculosis

Tuberculosis is emerging as a major public health problem in developing and developed world. Early and precise diagnosis is of prime importance in successful control of infection. Indirect ELISA with penicillinase as marker was developed using purifiedM. tuberculosis excretory-secretory (EST-DE₁) antigen for detecting IgG antibodies in pulmonary tuberculosis. The assay System gave a overall sensitivity of 82% for both smear positive and smear negative pulmonary tuberculosis cases with a specificity of 84%. The positive and negative predictive values were 75% and 88% respectivaly. Further studies with EST-DE₁ antigen revealed that, it contains two of the active antigen fractions of Mtb EST antigen i.e. Mtb EST-4 (56–68 KDa) and Mtb EST-6 (37–45 KDa), as demonstrated by inhibition ELISA. Reactivity with monoclonal antibodies HGT 3a showed the presence of 38 KDa molecule in EST-DE₁ antigen.     

<Emphasis Type="Italic">In vitro</Emphasis> released antigens in diagnosis and immunomonitoring of filaria and tuberculosis

In vitro released antigens by living parasites or bacteria underin vitro maintenance or short term culture showing specific humoral immune response have been explored in development of immunodiagnostics for infectious diseases such as filariasis and tuberculosis in our laboratory. ELISA usingB. malayi mf ES antigen has been explored for detecting IgG antibody by Indirect ELISA and antigen by Inhibition ELISA and in immunomonitoring of carriers as well as clinical filarial cases. A ten year follow up of mf carriers with DEC therapy showed disapperance of antigen and antibody followed by reappearance in few cases in an endemic area. None of the cases followed developed clinical symptoms suggesting the need for long term monitoring and treatment of microfilaraemic carriers. Further immunomonitoring was found to be useful in confirming filaria aetiology in the absence of microfilaremia and determining appropriate period of treatment of acute, early clinical and occult filarial infections for clinical relief and cure.Indirect Stick Penicillinase ELISA system using Mtb EST-6 antigen for detecting tuberculous IgG antibody and a Sandwich Penicillinase ELISA system using affinity purified antibody for detecting circulating antigen were explored in tuberculosis. A combination of both the assay systems with a sensitivity of 70% and specificity of 98% was found to be promising in the precise diagnosis of pulmonary tuberculosis. Further antigen detection was found to be useful in bone and joint tuberculosis.     

Mycobacterium tuberculosis H37Ra ESAS-7—An excretory-secretory antigen fraction of immunodiagnostic potential in pulmonary tuberculosis

A mycobacterial excretory-secretory protein fraction ESAS-7 purified by 50% ammonium sulphate precipitation followed by SDS-PAGE fractionation was evaluated by penicillinase enzyme linked immuno-sorbent assay (ELISA) for its sensitivity and specificity in the diagnosis of pulmonary tuberculosis. At a “cut off” serum dilution of 600, 38 (90%) of 42 sera from bacteriologically confirmed tuberculosis cases, 15 (100%) of 15 sera from bacteriogically negative but anti tubercular therapy (ATT) responded cases, 3 (7%) of 43 sera from normal healthy subjects and 4 (8%) of 48 sera from non tuberculous disease control cases gave positive reaction for tubercular antibody to ESAS-7 antigen fraction containing predominantly 33-kDa protein with a sensitivity of 90% in bacteriologically confirmed cases and specificity of 92%. Further, this diagnostic assay using the ESAS-7 antigen is more sensitive requiring as little as one nanogram antigen per test compared to use of 100 nanogram EST-6 antigen reported earlier. Thus use of ESAS-7 antigen for antibody detection has good diagnostic potential with improved specificity in pulmonary tuberculosis.     

Immunodiagnosis of tuberculosis: An update

Tuberculosis is still a major health problem in most developing countries and its incidence is rising in many developed countries. This resurgence has been attributed to the HIV epidemic and TB has been declared as a global health emergency by WHO in 1993. The diagnosis of tuberculosis mainly depends upon initial clinical suspicion and radiographic findings with subsequent bacteriological confirmation by sputum smear examination and culture. Lack of sensitivity in smear examination, non specificity of radiological findings, extended tum around time ofMycobacterium tuberculosis culture and difficulties in diagnosing paucibacillary, childhood and extrapulmonary tuberculosis has necessitated to explore the utility of immunodiagnosis of tuberculosis as a convenient and cost effective test to supplement clinical information for definite diagnosis. Many commercial tests are available in the market for diagnosis of TB. Most of these tests are based on the detection of IgG, IgA and IgM antibodies to specific mycobacterial antigen or mixture of antigens. Indigenous immunoassay systems have explored excretory-secretory ES-31 mycobacterial antigen for immunodiagnosis of TB. Many a time there is lack of consistent elevation in all the three Ig classes in active infection thus making it more important to determine the ideal antibody isotype assay for reliable diagnosis of tuberculosis and to save the costs of the patient for unnecessary investigations.     

Isolation, PCR based identification, and sensitivity pattern of environmental mycobacteria from leprosy and tuberculosis patients

We have isolated and identified the biotype of environmental mycobacteria from the expectorate of leprosy patients, their contacts, their drinking water supply and also from the sputa samples of tuberculosis patients. 78% of the isolates from lepromatous leprosy patients and their contacts wereMycobacterium fortuitum- chelonae complex (MFC), 9%Mycobacterium avium complex (MAC), 9%Mycobacterium scrofulaceum and 4% wereMycobacterium smegmatis. Among the isolates from tuberculosis patients 63% belonged toM. fortuitum- chelonae complex, 19% toM. avium complex, 12% toMycobacterium Kansasii and 6% toM. smegmatis. All the isolates were multi-drug resistant when tested for sensitivity total of 21 drugs. TheMycobacterium fortuitum-chelonae complex organisms from leprosy contacts were more sensitive to rifampicin than those isolated from lepromatous leprosy and tuberculosis patients. Among 23 isolates from leprosy patients one isolate was resistant to 20 drugs, one isolate to 17 drugs and another isolate was resistant to 13 drugs. Among the 18 isolates from drinking water supply six showed resistance to more than 12 drugs. Polymerase Chain Reaction (PCR) and subsequent hybridisation with specific probes confirmed all the isolated strains as nontuberculous mycobacteria (Using genus primers and probe sensitivity 100%) and none asM. tuberculosis, suggesting that PCR could be used to rapidly identify mycobacteria at the genus level and to rule out tuberculosis in leprosy patients at an early stage to decide on appropriate course of therapy.     

Effect of some antitubercular drugs on the calmodulin content ofMycobacterium tuberculosis

The effect of the antitubercular drugs isoniazid (10 μg/ml), ethambutol (10 μg/ml), rifampicin (0.5 μg/ml) and streptomycin (1 μg/ml) on the calmodulin like protein (CAMLP) content ofMycobacterium tuberculosis H₃₇R_v andM. tuberculosis H₃₇R_a was investigated. The drugs were added to actively growing cells at their mid log phase of growth (14 days) and after 12 more hours of incubation, CAMLP was estimated. In both the mycobacteria, all the four antitubercular drugs CAMLP.     

Diagnostic role of the antibody response to the 38kDa, 16kDa proteins and lipoarabinomannan of mycobacterium tuberculosis

The antibody response to the 38kDa, 16kDa and Lipoarabinomannan (LAM) antigens ofMycobacterium tuberculosis was evaluated using three different ELISAs based on these antigens. The study group included tuberculosis patients (n=52), patients with HIV and TB co-infection (n=10), other chest symptomatics (n=5), HIV infected individuals (n=10), leprosy cases (n=7) and healthy controls (n=75). The results indicate that the 38kDa and LAM based ELISA for IgM/IgG has a low specificity (ranging from 69–85%) and sensitivity (ranging from 55–78%). When three ELISAs are carried out on a single patient the probability of detection of tuberculosis was significantly increased to 95.2% indicating that a single ELISA test is of low sensitivity and that a combination of ELISA’s may be needed to be of any value as a diagnostic test for tuberculosis. Additionally, a western blot assay of the serum antibody response to protein fraction ofM. tuberculosis was analysed in 15 tuberculosis patients and five healthy controls. A multiple antibody response to various M.tuberculosis proteins was observed which varied from patient to patient as compared to controls who showed a single 38–39 kDa protein band positivity. These finding suggest that a western blot assay which determines the antibody response to a set of antigenic components ofM. tuberculosis could be a better serological test for the diagnosis of tuberculosis in our population.     

Preliminary studies on the antitubercular activity and the mechanism of action of the water extract of garlic (Allium sativum) and its two partially purified proteins (Garlic defensins?)

Water extract of garlic (Allium sativum) inhibited the growth ofMycobacterium tuberculosis H₃₇R_v andM. tuberculosis TRC-C1193 susceptible and resistant to isoniazid respectively. The minimum inhibitory concentration (MIC) was slightly above 80 but less than 160 μg/ml and slightly above 100 but less than 200 μg/ml for the susceptible and resistant strains respectively. Gel filtration in Sephadex G-100 columns showed that two protein fractions (43 & 38 kD) possessed antitubercular activity with much lower MICs of 20–40 μg/ml and 30–60 μg/ml for susceptible strain. Water extract, when added to actively growingM. tuberculosis in their mid log phase prevented their further growth. The water extract of garlic inhibited the incorporation of¹⁴C glycine into whole cells by 81% in 6 hrs. indicating that the primary mechanism of action is by inhibition of protein synthesis.     

Inhibitory and bactericidal activity of the calmodulin antagonist,trifluoperazine, againstMycobacterium avium in vitro and within human monocyte-derived macrophages

The activity of a calmodulin antagonist, trifluoperazine (TFP), was testedin vitro againstMycobacterium avium (ATCC 25291). The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of this compound forM. avium were 20 and 30 μg/ml, respectively. TFP was also found to completely inhibit the growth of 10 isolates ofM. avium (5 patient isolates and 5 environmental isolates) at 30 μg/ml. At near neutral pH (6.8), the MIC of TFP was found to be 20 μg/ml. However, at pH 5.5 (intracellular pH of macrophages), there was a decrease in the inhibitory activity of the compound against this organism. Interestingly, 99.6% ofM. avium within human monocyte-derived macrophages were killed at a drug concentration of 30 μg/ml, which correlates well with the MBC of TFP againstM. avium in vitro. Although the MIC for TFP appears to be higher than that forMycobacterium tuberculosis H₃₇R_v, our studies suggest that calmodulin antagonists might be useful as drugs against infection due toM. avium. It is suggested that administration of TFP in combination with other known drugs may enhance the overall bactericidal effect.     

Effects of 5-aminolevulinic acid (ALA)-containing supernatants from selected Rhodopseudomonas palustris strains on rice growth under NaCl stress,with mediating effects on chlorophyll,photosynthetic electron transport and antioxidative enzymes

BackgroundRice is globally one of the most important food crops, and NaCl stress is a key factor reducing rice yield. Amelioration of NaCl stress was assessed by determining the growth of rice seedlings treated with culture supernatants containing 5-aminolevulinic acid (ALA) secreted by strains of Rhodopseudomonas palustris (TN114 and PP803) and compared to the effects of synthetic ALA (positive control) and no ALA content (negative control).ResultsThe relative root growth of rice seedlings was determined under NaCl stress (50 mM NaCl), after 21 d of pretreatment. Pretreatments with 1 μM commercial ALA and 10X diluted culture supernatant of strain TN114 (2.57 μM ALA) gave significantly better growth than 10X diluted PP803 supernatant (2.11 μM ALA). Rice growth measured by dry weight under NaCl stress ordered the pretreatments as: commercial ALA > TN114 > PP803 > negative control. NaCl stress strongly decreased total chlorophyll of the plants that correlated with non-photochemical quenching of fluorescence (NPQ). The salt stress also strongly increased hydrogen peroxide (H₂O₂) concentration in NaCl-stressed plants. The pretreatments were ordered by reduction in H₂O₂ content under NaCl stress as: commercial ALA > TN114 > PP803 > negative control. The ALA pretreatments incurred remarkable increases of total chlorophyll and antioxidative activities of catalase (CAT), ascorbate peroxide (APx), glutathione reductase (GR) and superoxide dismutase (SOD); under NaCl stress commercial ALA and TN114 had generally stronger effects than PP803.ConclusionsThe strain TN114 has potential as a plant growth stimulating bacterium that might enhance rice growth in saline paddy fields at a lower cost than commercial ALA.     

Development of vertical SU-8 microneedles for transdermal drug delivery by double drawing lithography technology

Polymer-based microneedles have drawn much attention in transdermal drug delivery resulting from their flexibility and biocompatibility. Traditional fabrication approaches are usually time-consuming and expensive. In this study, we developed a new double drawing lithography technology to make biocompatible SU-8 microneedles for transdermal drug delivery applications. These microneedles are strong enough to stand force from both vertical direction and planar direction during penetration. They can be used to penetrate into the skin easily and deliver drugs to the tissues under it. By controlling the delivery speed lower than 2 μl/min per single microneedle, the delivery rate can be as high as 71%.Microelectromechanical systems (MEMS) technology has enabled wide range of biomedical devices applications, such as micropatterning of substrates and cells,¹ microfluidics,² molecular biology on chips,³ cells on chips,⁴ tissue microengineering,⁵ and implantable microdevices.⁶ Transdermal drug delivery using MEMS based devices can delivery insoluble, unstable, or unavailable therapeutic compounds to reduce the amount of those compounds used and to localize the delivery of potent compounds.⁷ Microneedles for transdermal drug delivery are increasingly becoming popular due to their minimally invasive procedure,⁸ promising chance for self-administration,⁹ and low injury risks.¹⁰ Moreover, since pharmaceutical and therapeutic agents can be easily transported into the body through the skin by microneedles,^{11, 12} the microneedles are promising to replace traditional hypodermic needles in the future. Previously, various microneedles devices for transdermal drug delivery applications have been reported. They have been successfully fabricated by different materials, including silicon,¹³ stainless steel,¹⁴ titanium,¹⁵ tantalum,¹⁶ and nickel.¹⁷ Although microneedles with these kinds of materials can be easily fabricated into sharp shape and offer the required mechanical strength for penetration purpose, such microneedles are prone to be damaged¹⁸ and may not be biocompatible.¹⁹ As a result, polymer based microneedles, such as SU-8,^{20, 21} polymethyl meth-acrylate (PMMA),^{22, 23} polycarbonates (PCs),^{24, 25} maltose,^{26, 27} and polylactic acid (PLA),^{28, 29} have caught more and more attentions in the past few years. However, in order to obtain ultra-sharp tips for penetrating the barrier layer of stratum corneum,³⁰ conventional fabrication technologies, for instances, PDMS (Polydimethylsiloxane) molding technology,^{31, 32} stainless steel molding technology,³³ reactive ion etching technology,³⁴ inclined UV (Ultraviolet) exposure technology,³⁵ and backside exposure with integrated lens technology³⁶ are time-consuming and expensive. In this paper, we report an innovative double drawing lithography technology for scalable, reproducible, and inexpensive microneedle devices. Drawing lithography technology³⁷ was first developed by Lee et al. They leveraged the polymers'' different viscosities under different temperatures to pattern 3D structures. However, it required that the drawing frames need to be regular cylinders, which is not proper for our devices. To solve the problem, the new double drawing lithography is developed to create sharp SU-8 tips on the top of four SU-8 pillars for penetration purpose. Drugs can flow through the sidewall gaps between the pillars and enter into the tissues under the skin surface. The experiment results indicate that the new device can have larger than 1N planar buckling force and be easily penetrated into skin for drugs delivery purpose. By delivering glucose solution inside the hydrogel, the delivering rate of the microneedles can be as high as 71% when the single microneedle delivery speed is lower than 2 μl/min.An array of 3 × 3 SU-8 supporting structures was patterned on a 140 μm thick, 6 mm × 6 mm SU-8 membrane (Fig. ​(Fig.1a).1a). Each SU-8 supporting structure included four SU-8 pillars and was 350 μm high. The four pillars were patterned into a tubelike shape on the membrane (Fig. ​(Fig.1b).1b). The inner diameter of the tube was 150 μm, while the outer diameter was 300 μm. SU-8 needles of 700 μm height were created on the top of SU-8 supporting structures to ensure the ability of transdermal penetration. Two PDMS layers were bonded with SU-8 membrane to form a sealed chamber for storing drugs from the connection tube. Once the microneedles entered into the tissue, drugs could be delivered into the body through the sidewall gaps between the pillars (Fig. ​(Fig.1c1c).Open in a separate windowFigure 1Schematic illustration of the SU-8 microneedles. (a) Overview of the whole device; (b) SU-8 supporting structures made of 4 SU-8 pillars; and (c) enlarged view of a single SU-8 microneedle.The fabrication process of SU-8 microneedles is shown in Fig. ​Fig.2.2. SU-8 microneedles fabrication started from a layer of Polyethylene Terephthalate (PET, 3M, USA) film pasted on the Si substrate by sticking the edge area with kapton tape (Fig. ​(Fig.2a).2a). The PET film, a kind of transparent film with poor adhesion to SU-8, was used as a sacrificial layer to dry release the final device from Si substrate. A 140 μm thick SU-8 layer was deposited on the top of this PET film. To ensure a uniform surface of this thick SU-8 layer, the SU-8 deposition was conducted in two steps coating. After exposed under 450 mJ/cm² UV, the membrane pattern could be defined (Fig. ​(Fig.2b).2b). In order to ensure an even surface for following spinning process, another 350 μm SU-8 layer was directly deposited on this layer in two steps without development. With careful alignment, an exposure of 650 mJ/cm² UV energy was performed on this 350 μm SU-8 layer to define the SU-8 supporting structures (Fig. ​(Fig.2c).2c). The SU-8 structure could be easily released from the PET substrate by removing the kapton tape and slightly bending the PET film. Two PDMS layers were bonded with this SU-8 structure by a method reported by Zhang et al.³⁸ (Fig. ​(Fig.2d2d).Open in a separate windowFigure 2Fabrication process for SU-8 microtubes. (a) Attaching a PET film on the Si substrate; (b) exposing the first layer of SU-8 membrane without development; (c) depositing and patterning two continuous SU-8 layers as sidewall pillars; (d) releasing the SU-8 structure from the substrate and bonding it with PDMS; (e) drawing hollowed microneedles on the top of supporting structures; (f) baking and melting the hollowed microneedles to allow the SU-8 flow in the gaps between pillars; and (g) drawing second time on the top of the melted SU-8 flat surface to get microneedles.In our previous work,³⁹ we used one time stepwise controlled drawing lithography technology for the sharp tips integration. However, since the frame used to conduct drawing process in present study is a four-pillars structure rather than a microtube, the conventional drawing process can only make a hollowed tip but not a solid tip structure (Fig. ​(Fig.3).3). This kind of tip was fragile and could not penetrate skin in the practical testing process. To solve the problem, we developed an innovative double drawing lithography process. After bonding released SU-8 structure with PDMS layers (Fig. ​(Fig.2d),2d), we used it to conduct first time stepwise controlled drawing lithography³⁷ and got hollowed tips (Fig. ​(Fig.2e).2e). Briefly, the SU-8 was spun on the Si substrate and kept at 95 °C until the water inside completely vaporized. Device of SU-8 supporting structures was fixed on a precision stage. Then, the SU-8 supporting structures were immersed into the SU-8 by adjusting the precision state. The SU-8 were coated on the pillars'' surface. Then, the SU-8 supporting structures were drawn away from the interface of the liquid maltose and air. After that, the temperature and drawing speed were increased. Since the SU-8 was less viscous at higher temperature, the connection between the SU-8 supporting structures and surface of the liquid SU-8 became individual SU-8 bridge, shrank, and then broke. The end of the shrunk SU-8 bridge forms a sharp tip on the top of each SU-8 supporting structure when the connection was separated. After the hollowed tips were formed in the first step drawing process, the whole device was baked on the hotplate to melt the hollowed SU-8 tips. Melted SU-8 reflowed into the gaps between four pillars and the tips became domes (Fig. ​(Fig.2f).2f). Then, a second drawing process was conducted on the top of melted SU-8 to form sharp and solid tips (Fig. ​(Fig.2g).2g). The final fabricated device is shown in Fig. ​Fig.44.Open in a separate windowFigure 3A hollowed SU-8 microneedle fabricated by single drawing lithography technology (scale bar is 100 μm).Open in a separate windowFigure 4Optical images for the finished SU-8 microneedles.During the double drawing process, as long as the heated time and temperature were controlled, the SU-8 flow-in speed of SU-8 inside the gaps could be precisely determined. The relationship between baking temperature and flow-in speed was studied. As shown in Fig. ​Fig.5,5, the flow-in speed is positive related to the baking temperature. The explanation for this phenomena is that the SU-8''s viscosity is different under different baking temperatures.⁴⁰ Generally, baked SU-8 has 3 status when temperature increases, solid, glass, and liquid. The corresponding viscosity will decrease and the SU-8 can also have higher fluidity. When the baking temperature is larger than 120 °C, the flow-in speed will increase sharply. But, if the baking temperature is higher, the SU-8 will reflow in the gaps too fast, which makes the flow-in depth hard to be controlled. There is a high chance that the whole gaps will be blocked, and no drugs can flow through these gaps any more. Considering that the total SU-8 supporting structure is only 350 μm high, we choose 125 °C as baking temperature for proper SU-8 flow-in speed and easier SU-8 flow-in depth control.Open in a separate windowFigure 5The relationship between flow-in speed and baking temperature.To ensure the adequate stiffness of the SU-8 microneedles in vertical direction, Instron Microtester 5848 (Instron, USA) was deployed to press the microneedles with the similar method reported by Khoo et al.⁴¹ As shown in Fig. ​Fig.6a,6a, the vertical buckling force was as much as 8.1N, which was much larger than the reported minimal required penetration force.⁴² However, in the previous practical testing experiments, even though the microneedles were strong enough in vertical direction, the planar shear force induced by skin deformation might also break the interface between SU-8 pillars and top tips. In our new device with four pillars supporting structure, the SU-8 could flow inside the sidewall gaps between the pillars to form anchors. These anchors could enhance microneedles'' mechanical strength and overcome the planar shear force problems. Moreover, the anchors strength could be improved by controlling the SU-8 flow-in depth. Fig. ​Fig.77 shows that the flow-in depth increases when the baking time increases as the baking time increases at 125 °C. Fig. ​Fig.6b6b shows that the corresponding planar buckling force can be improved to be larger than 1 N by increasing flow-in depth. Some sidewall gaps at bottom are kept on purpose for drugs delivery; hence, the flow-in depth is chosen as 200 μm.Open in a separate windowFigure 6(a) Measurement of the vertical buckling force. (b) The planar buckling force varies under different flow-in depth (I, II, III, and IV corresponding to the certain images in Fig. ​Fig.77).Open in a separate windowFigure 7Different flow-in depth inside the gaps between SU-8 pillars. (a) 0 μm; (b) 100 μm; (c) 200 μm; and (d) 350 μm (scale bar is 100 μm).The penetration capability of the 3 × 3 SU-8 microneedles array is characterized by conducting the insertion experiment on the porcine cadaver skin. 10 microneedles devices were tested and all of them were strong enough to be inserted into the tissue without any breakage. Histology images of the skin at the site of one microneedle penetration were derived to prove that the sharp conical tip was not broken during the insertion process (Fig. ​(Fig.8).8). It also shows penetrated evidence because the hole shape is the same as the sharp conical tip.Open in a separate windowFigure 8Histology image of individual microneedle penetration (scale bar is 100 μm).In order to verify that the drug solution can be delivered into tissue from the sidewall gaps of the microneedles, FITC (Fluorescein isothiocyanate) (Sigma Aldrich, Singapore) solution was delivered through the SU-8 microneedles after they were penetrated into the mouse cadaver skin. The representative results were then investigated via a confocal microscope (Fig. ​(Fig.9).9). The permeation pattern of the solution along the microchannel created by microneedles confirmed the solution delivery results. The black area was a control area without any diffused florescent solution. In contrast, the illuminated area in Fig. ​Fig.99 indicates the area where the solution has diffused to it. These images were taken consecutively from the skin surface down to 180 μm with 30 μm intervals. The diffusion area had a similar dimension with the inserted microneedles. It has proved that the device can be used to deliver drugs into the body.Open in a separate windowFigure 9Images of confocal microscopy to show the florescent solution is successfully delivered into the tissue underneath the skin surface. (a) 30 μm; (b) 60 μm; (c) 90 μm; (d) 120 μm; (e) 150 μm; and (f) 180 μm (scale bar is 100 μm).Due to the uneven surface of deformed skin, there is always tiny gap happened between tips of some microneedles and local surface skin. The microneedles could not be entirely inserted into the tissue. Drugs might leak to the skin surface through the sidewall gaps under certain driven pressure. Hydrogel absorption experiment was conducted to quantify the delivery rate (i.e., the ratio of solution delivered into tissues in the total delivered volume) and to optimize the delivery speed. Using hydrogel as the tissue model for quantitative analysis of microneedle releasing process was reported by Tsioris et al.⁴³ The details are shown here. Gelatin hydrogel was prepared by boiling 70 ml DI (Deionized) water and mixing it with 7 g of Knox^TM original unflavored gelatin powder. The solution was poured into petri dish to 1 cm high. Then, the petri dish was put into a fridge for half an hour. Gelatin solution became collagen slabs. The collagen slabs were cut into 6 mm × 6 mm sections. A piece of fully stretched parafilm (Parafilm M, USA) was tightly mounted on the surface of the collagen slabs. This parafilm was used here to block the leaked solution further diffusing into the collagen slab in the delivery process. Then, the microneedles penetrated the parafilm and went into the collagen slab. Controlled by a syringe pump, 0.1 ml–0.5 mg/ml glucose solution was delivered into the collagen slab under different speeds. Methylene Blue (Sigma Aldrich, Singapore) was mixed into the solution for better inspection purpose (Fig. 10a). Then, the collagen slabs was digested in 1 mg/ml collagenase (Sigma Aldrich, Singapore) at room temperature (Fig. 10b). It took around 1 h that all the collagen slabs could be fully digested (Fig. 10d). The solution was collected to measure the glucose concentration with glucose detection kit (Abcam, Singapore). Briefly, both diluted glucose standard solution and the collected glucose solution were added into a series of wells in a well plate. Glucose assay buffer, glucose enzyme, and glucose substrate were mixed with these samples in the wells. After incubation for 30 min, their absorbance were examined by using a microplate reader at a wavelength of 450 nm. By comparing the readings with the measured concentration standard curve (Fig. 11a), the glucose concentration in the hydrogel, the glucose absorption rate in the hydrogel, and the solution delivery rate by microneedles could be measured and calculated. As shown in Fig. 11b, when the delivering speed of a single microneedle increased from 0.1 μl/min to 2 μl/min, the glucose absorption rate also increased. Most of the glucose solution from microneedles could go into the hydrogel. The delivered rate could be as high as 71%. The rest solution leaked from sidewall gaps and blocked by parafilm. However, when the delivered speed for a single microneedle was larger than 2 μl/min, the hydrogel absorption rate was saturated. More and more solution could not go into the hydrogel but leak from the sidewall gaps. Then, the delivered rate decreased. Therefore, 2 μl/min was chosen as the optimized delivery speed for the microneedle.Open in a separate windowFigure 10Glucose solution could be delivered into the hydrogel, and the collagen stabs were dissolved by collagenase.Open in a separate windowFigure 11(a) Standard curve for glucose detection; (b) glucose absorption rate and solution delivery rate in a single needle corresponding to different delivery speed.In conclusion, a drug delivery device of integrated vertical SU-8 microneedles array is fabricated based on a new double drawing lithography technology in this study. Compared with the previous biocompatible polymer-based microneedles fabrication technology, the proposed fabrication process is scalable, reproducible, and inexpensive. The fabricated microneedles are rather strong along both vertical and planar directions. It is proved that the microneedles were penetrated into the pig skin easily. The feasibility of drug delivery using SU-8 microneedles is confirmed by FITC fluorescent delivery experiment. In the hydrogel absorption experiment, by controlling the delivery speed under 2 μl/min per microneedle, the delivery rate provided the microneedle is as high as 71%. In the next step, the microneedles will be further integrated with microfluidics on a flexible substrate, forming a skin-patch like drug delivery device, which may potentially demonstrate a self-administration function. When patients need an injection treatment at home, they can easily use such a device just like using an adhesive bandage strip.