Therapeutic Deep Eutectic Systems
Therapeutic Deep Eutectic Systems
Therapeutic Deep Eutectic Systems
Contents
3.1 I ntroduction 105
3.2 H istory of Green Solvents and Evolution Until Therapeutic Deep Eutectic Systems 106
3.2.1 Eutectics in Pharmacy 108
3.2.2 Advantages of Using Eutectics in Pharmacy 110
3.2.3 Different Methods for Preparation of Therapeutic Deep Eutectic Systems 112
3.2.4 Characterization of Therapeutic Deep Eutectic Systems 113
3.3 Applications of Therapeutic Deep Eutectic Systems in Research and Industry 117
3.3.1 Therapeutic Deep Eutectic Systems for Improvement of the Bioavailability
of Drugs 117
3.3.2 Biomedical Formulation with Therapeutic Deep Eutectic Systems 120
3.3.3 Future Perspectives 122
3.4 Conclusion 124
References 124
Abstract Nowadays, green and sustainable approaches are one of the principles
that companies have presented in their products and processes, and the pharmaceu-
tical industry is not an exception. A constant search for new developments that
allow the use of methods with minor risks to the environment is a transversal con-
cern throughout the industry. For pharmaceutical and biomedical companies, green
chemistry is a principle to have in mind, particularly in their search for new sub-
stances or matrices to deliver drugs or solve problems of solubility, polymorphism,
toxicity, bioavailability, and pharmacokinetic. Currently, despite the investment on
research and development, it is increasingly difficult to find new molecules to sub-
stitute the “old” ones with enhanced therapeutic efficacy. Because of that, the
© The Editor(s) (if applicable) and The Author(s), under exclusive license to 103
Springer Nature Switzerland AG 2021
S. Fourmentin et al. (eds.), Deep Eutectic Solvents for Medicine, Gas
Solubilization and Extraction of Natural Substances, Environmental Chemistry
for a Sustainable World 56, https://doi.org/10.1007/978-3-030-53069-3_3
104 F. Santos and A. R. C. Duarte
Abbreviations
3.1 Introduction
The development of green chemistry methods was initially reported in the 1990s
and has a major importance in the development of more sustainable processes and
less hazardous substances (Anastas and Eghbali 2010; Dunn 2012; Anastas and
Kirchhoff 2002). The green chemistry concept was defined by the Environmental
Protection Agency as the “design of chemical products and processes to reduce or
eliminate the use and generation of hazardous substances” (Anastas and Eghbali
2010; Anastas and Warner 1998). This concept is diffused throughout chemical
industry and academia in a search for the development of sustainable processes and
new substances to be applied in different fields, such as healthcare and pharmaceu-
ticals, cosmetics, agriculture, energy, advanced materials, and many other areas of
research (Dunn 2012; Warner et al. 2004).
The green chemistry approaches in pharmaceutical field are frequently applied to
solve problems concerning toxicity and bioavailability of the active pharmaceutical
ingredients (APIs). Nonetheless, it is also crucial to design new sustainable pro-
cesses for the synthesis of APIs. The sustainability in pharmaceutical industry is
nowadays an essential point to take into consideration, due to the possibility of
reducing costs of production and produce safer products that contribute to decrease
their toxicity in human health, but that also reduce the risk of contamination of the
environment (Kümmerer 2007, 2010; Cizmas et al. 2015; Ali and Khan 2017;
Blasco and DelValls 2008). It was reported early in the 1990s that the amount of
waste produced for the synthesis of 1 kg of an API was around 50–100 kg. These
findings triggered pharmaceutical industries to find alternatives for the reduction
and/or elimination of the waste generated, implement the use of green solvents, and
develop new synthesis processes (Kümmerer 2007, 2010).
The investigation and application of green solvents has been one of the most
active areas in the research of green chemistry, because solvents currently used
contribute with a mass waste in synthesis processes and usually present high toxic-
ity and flammability and could be corrosive (Anastas and Eghbali 2010). In this
sense, the implementation of processes that avoid the use of solvents or use alterna-
tive solvents such as water, supercritical fluids, ionic liquids, and more recently
deep eutectic systems is taken into consideration for improvement of industrial
106 F. Santos and A. R. C. Duarte
processes and research methods (Anastas and Eghbali 2010; Welton 2015). In this
chapter, the focus will be on the application and development of deep eutectic sys-
tems in pharmaceutical field and their importance for the improvement of the API
properties, namely, the increase of their bioavailability.
The concept of green solvents was introduced by John Warner and Paul Anastas, in
1998, when they listed the 12 principles of green chemistry. One of the green chem-
istry principles assumes that the use of solvents should be as an auxiliary substances,
in the synthesis and preparation processes, and emphases that they should be made
unnecessary whenever possible, and if used they should be innocuous (Anastas and
Warner 1998; Warner et al. 2004). The sustainability of a process or a product is,
hence, a result of the complex interaction between the product or process imple-
mented and environment, technology, and economic factors (Welton 2015).
In the last decades, the research on green or safer solvents, recognized as envi-
ronmentally benign, has been growing exponentially. However, it is necessary to
consider the source and synthesis of the solvent, its properties, and the disposal. A
variety of compounds have been considered as green solvents such as water, super-
critical and subcritical fluids, ionic liquids, solvents derived from biomass, and
more recently deep eutectic systems (Bubalo et al. 2015; Francisco et al. 2013;
Hayyan et al. 2015; Welton 2015). Strategies for the development of green solvents
that lead to the substitution of petroleum-based solvents by solvents from renewable
resources have been explored. Furthermore, the substitution of hazardous solvents
by solvents that present better environmental, health, and safety properties is also a
topic of intense research (Bubalo et al. 2015; Welton 2015).
Ionic liquids (ILs) appeared for the first time in 1914, described by Paul Walden
in the synthesis of ethylammonium nitrate in a reaction that involves nitric acid
(Domínguez de María and Maugeri 2011; Kudlak et al. 2015). An IL is defined as
an organic salt composed by ions that result in a single salt with a melting point
below 100 °C; some examples of cations and anions that are commonly used for the
synthesis of ionic liquids are presented in Fig. 3.1. In the last years, they have been
frequently used and investigated as green solvents (Ferraz et al. 2011; Hough et al.
2007; Liu et al. 2018a, b; Pena-Pereira and Namieśnik 2014). One of the applica-
tions of ionic liquids which was foreseen as a major breakthrough in industry was
to replace volatile organic compounds (VOCs), presenting a safer alternative and
exhibiting high solvency and a negligible vapor pressure (Brennecke and Maginn
2001; Heckenbach et al. 2016; Hough and Rogers 2007).
Ionic liquids have been developed in sequent generations. The first generation of
ILs appeared in the 1960s and describes compounds that are designed in accordance
with desired physical properties, such as hydrophobicity, viscosity, density, thermal
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 107
Fig. 3.1 Examples of some cations and anions that are commonly used in the synthesis of ionic
liquids for different applications (Sivapragasam et al. 2016; Kudlak et al. 2015)
stability, conductivity, and melting point. However, these generation has the disad-
vantage to be sensitive to the presence of water and air (Domínguez de María and
Maugeri 2011). In the early 1990s, the second generation of ILs emerged, which are
considered advanced materials, in which the design of compounds combines both
physical and chemical properties, such as chemical reactivity, energy density, oxy-
gen balance, flammability, and others (Kudlak et al. 2015). The third generation of
ILs appeared in the 2000s and consists in the synthesis of ionic liquids that have
biological properties combined with physicochemical properties. In this group, the
ILs that are used in pharmaceutical and biomedicine applications are included. In
this case, a combination of cations and anions could lead to specific biological activ-
ity, for example, in drug delivery and production processes (Dias et al. 2017;
Domínguez de María and Maugeri 2011; Ferraz et al. 2011; Kudlak et al. 2015).
Although ionic liquids are considered green solvents and have demonstrated
good results for some applications, they are expensive and sometimes difficult to
prepare and some of them have high toxicity (Kudlak et al. 2015; Paiva et al. 2014).
In 2003, Abbott and coworkers reported a new type of green solvents that could act
as an alternative to ionic liquids (Abbott et al. 2003, 2004, 2006; Francisco et al.
2013; Kudlak et al. 2015; Ruß and König 2012). When they experimented mixing
urea and choline chloride, in which the initial components are in solid state, they
verified that they formed a eutectic mixture, liquid at room temperature and present-
ing interesting properties to be used as a solvent (Abbott et al. 2004; Francisco et al.
2013; Kudlak et al. 2015; Ruß and König 2012). Despite eutectic mixtures have
been described decades ago for many applications, it was only a few years ago that
they started to be studied as solvents, as illustrated in Fig. 3.3. Abbott and coworkers
introduced the term “deep eutectic solvent” (DES) to refer to a mixture of two or
more starting materials with high melting points that often form a liquid at room
temperature with lower melting temperature than the initial compounds (Abbott
108 F. Santos and A. R. C. Duarte
et al. 2017; Aroso et al. 2016; Dai et al. 2013; Francisco et al. 2013). Different theo-
ries were reported to explain the formation of eutectic mixtures as stable liquids,
namely, the idea of a cluster formation or a mechanical mixture of the components.
Abbott and coworkers suggested hydrogen bond interactions, in which the mixture
results from the interactions between a hydrogen bond donor and a hydrogen bond
acceptor, which leads to lowering the entropic differences of the phase transitions
and allows decreasing the melting point (Francisco et al. 2013; Pedro et al. 2019).
The nature of the interactions between the components could affect the capacity of
the initial compounds to interact, and the charge delocalization could modulate the
different physicochemical properties of DES, when compared to initial compo-
nents, since the interactions could be hydrogen bonds, van der Waals, and/or elec-
trostatic forces (Francisco et al. 2013; Santana et al. 2019). The van der Waals
interactions in liquids could be observed by molecular dynamics using the empirical
Lennard-Jones (LJ) equation that includes repulsive and attractive forces
(Wojnarowska et al. 2018). The higher capacity of the components to establish
hydrogen bonds is related with the phase-transition temperature and stability of the
components (Francisco et al. 2013).
DES represent a group of systems that can be prepared from a variety of com-
pounds, which may lead to thousands of different combinations (up to 106) (Barros
et al. 2017; Francisco et al. 2013). These systems emerged as alternative candidates
to ionic liquids and have also been described as low transition temperature mixtures
(LTTM) (Durand et al. 2016). In 2011, Choi and coworkers reported 30 different
combinations with choline chloride, natural carboxylic acids, sugars, and water that
form viscous liquids and were named as natural deep eutectic solvents (NADES).
NADES could be eutectic mixtures that we observe in our daily life; as an example,
honey and syrup are eutectic mixtures of sugars at room temperature, and they could
be used in food, as dietary supplement, and for medical formulations, because they
are easily biodegradable and often have low toxicity (Fig. 3.2) (Choi et al. 2011; Dai
et al. 2015; Liu et al. 2018a, b; Kudlak et al. 2015).
The use of eutectic mixtures for therapeutic applications was reported decades
ago for transdermal delivery of anesthetic and anti-inflammatory drugs (Evers et al.
1985). Later, Stott and coworkers observed that ibuprofen could form eutectic mix-
tures with different terpenes and enhance skin permeation, dissolving API and
increasing its solubility, permeability, and absorption (Aroso et al. 2015; Stott et al.
1998). In 2015, Aroso and coworkers named these solvents as therapeutic deep
eutectic systems (THEDES), and they include deep eutectic systems that have an
API incorporated in the mixture or a DES that can dissolve an API and improve
their characteristics in terms of bioavailability and toxicity (Aroso et al. 2015; Gala
et al. 2014; Wojnarowska et al. 2018) (Fig. 3.3).
The term eutectic is derived from the Greek word eutectos, which means easily
fused, and it was used for the first time by Frederik Guthrie, in 1884, to describe
“bodies made up of two or more constituents, which constituents are in such
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 109
Fig. 3.2 Structures of molecules that could be used to prepare deep eutectic systems as sugars,
organic acids, salts, amino acids, and polyols (Yang 2018)
Fig. 3.3 Main developments on eutectic mixtures since they were referred for the first time until
they started to be used as therapeutic deep eutectic systems. Deep eutectic solvents (DES) have
been considered green and alternative solvents since they comply the principles of green chemis-
try, allow to reduce waste, develop safer products, minimize the energy used, develop degradable
products, and reduce the use of hazardous substances
reported the use of eutectic mixtures in pharmacy; however, the aim of this study
was to prevent the liquefaction and incompatibilities between the components of the
eutectic mixtures (camphor and salol), incorporating powders with absorbent char-
acteristics as magnesium carbonate, kaolin, and magnesium oxide (Bellafiore 1953;
Prista et al. 2008). Another study performed with camphor and salol showed that
these components form a eutectic mixture with a decrease in the melting point from
43 °C of salol and 179 °C of camphor to 6 °C of the mixture salol-camphor (Prista
et al. 2008). Sekiguchi and coworkers studied eutectic mixtures and admitted that
eutectic compounds are composed by two components. Being one of them water
soluble and when exposed to gastrointestinal environment, this soluble compound
dissolves fast, keeping the insoluble part with a large superficial area and more sus-
ceptible to absorption. It was reported that for binary combinations, the eutectic
mixtures usually present a characteristic “V” type phase diagram, while the cocrys-
tals exhibit a characteristic “W” type phase diagram (Prista et al. 2008;
Cherukuvada 2016).
Eutectic mixtures sometimes present high viscosity or cannot be formed without
the presence of water, and it was reported that adding water to a eutectic mixture in
a certain molar ratio, being water part of the mixture, could help in the preparation
of eutectic mixtures and decreases their viscosity, without compromising the system
(Dai et al. 2015). Dai and coworkers studied the effects of water incorporated in
natural deep eutectic solvents and observed that small amounts of water resulted in
mixtures with low viscosity and reduced preparation time and in general the stabil-
ity and solubility are increased. Nevertheless, adding up to 50% of water to the
system could lead to the break of hydrogen bonds and dilution of the components,
making a solution and not a DES (Craveiro et al. 2016; Dai et al. 2015).
The use of eutectic mixtures for therapeutic applications could represent an advan-
tage to improve formulations and avoid the drawbacks of polymorphic drugs, since
the mixtures, frequently, are in liquid form at room temperature, and could therefore
provide a better solvent for several low soluble or insoluble drugs. The intrinsic
characteristics of eutectic mixtures such as low melting point, liquid form, 100%
yield, high solvent stability, and low toxicity confer to these systems an opportunity
for the search of mixtures that could improve the drug bioavailability and pharma-
cokinetics, by adding characteristics to the API that lead to an efficient absorption,
high biocompatibility, high solubility and permeability, and low toxicity. These
parameters are essential for determining the bioavailability of an API, and the use of
eutectic mixtures could enable to have new formulations or improved formulations
without modifying the API (Álvarez and Zhang 2019).
The pharmaceutical industry has designed mostly crystalline APIs for formula-
tion; however, many of these drugs fail in testing, due to issues with delivery mecha-
nisms, like dissolution, transport, bioavailability, and polymorphism that could
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 111
Table 3.1 Biopharmaceutics classification system (BCS) based on problems and solutions
presented by the pharmaceutical industry in the last years
Biopharmaceutics classification system (BCS)
CLASS I CLASS II CLASS III CLASS IV
Improved ↑ Solubility ↓ Permeability Combine
bioavailability permeability enhancement permeability enhancement approaches
↑ permeability ↓ solubility -Particle size ↑ solubility -Use for enhancing
↓ solubility reduction absorption solubility and
-Solid dispersions enhancers permeability
-Nanoparticles -Efflux ↓
-Soluble salts inhibitors permeability
-Cosolvents -Motility ↓ solubility
-Surfactants modifiers
-pH adjustment -Prodrugs
-SMEDDS/ -DES
SEDDS
-DES
112 F. Santos and A. R. C. Duarte
API, since their features could offer solubility and dissolution enhancement of
poorly soluble drugs (Aroso et al. 2016; Cherukuvada and Nangia 2014).
Goldberg and coworkers studied eutectic mixtures with urea and paracetamol,
concluding that the mixture leads to a significant increase in the solubility and gas-
trointestinal absorption of paracetamol (Prista et al. 2008; Goldberg et al. 1966).
Later on, Dichi and coworkers reinvestigate eutectic mixtures formed with
paracetamol, acetylsalicylic acid, and caffeine and observed eutectic and metatectic
points close to each other in the mixture paracetamol-caffeine (138.6 and 139.5 °C),
and then they determined the eutectic composition of the mixture by Tamman’s tri-
angle for each phase diagram (Dichi et al. 2018).
In another study, Stott and coworkers observed that deep eutectic systems could
be formed with the incorporation of an API in the DES, creating, hence, the possi-
bility of develop controlled drug delivery devices, and improving the characteristics
of the APIs themselves (Aroso et al. 2016; Stott et al. 1998), also showed an
enhancement of solubility of drugs in different eutectic mixtures with choline chlo-
ride (Morrison et al. 2009).
Goud and colleagues investigated the formation of eutectic mixtures with cur-
cumin that is an active compound and a hydrophobic polyphenol that could present
diverse therapeutic activities like anti-inflammatory, antioxidant, anticancer and
potentially used for Alzheimer’s disease (Goud et al. 2012). Curcumin has problems
of solubility and, consequently, bioavailability, and because of that, many strategies
have been used for enhancing the stability and bioavailability of curcumin, such as
use of nanoparticles and micelles, polymorphs, cocrystals, and then eutectic compo-
sitions with nicotinamide, ferulic acid, hydroquinone, p-hydroxybenzoic acid, and
L-tartaric acid. These eutectic compositions with therapeutic components have
shown an enhancement of the solubility and were prepared by mechanochemical
grinding to provide stabilized mixtures by weak and short-range interactions (Goud
et al. 2012).
Fig. 3.4 Different methods described for the preparation of therapeutic deep eutectic systems
(THEDES). In the mix and heating method, it is described that a mortar and a pestle could be used
or otherwise it is possible to mix the compounds and by heating and stirring form a deep eutectic
system. Other methods that have been reported are the preparation of solutions of different compo-
nents and then evaporating the solvent or freeze-dried and a deep eutectic solvent (DES) is obtained
Table 3.2 Summary of potential methods of characterization of therapeutic deep eutectic systems (THEDES)
Hydrogen Melting point,
Identification Molecular bonding Thermal Phase glass In vitro
Characterization method and morphology structure interactions stability transitions transition Bioavailability cytotoxicity
Polarized optical microscopy √
1
H nuclear magnetic resonance √ √ √
(2D techniques)
Differential scanning √ √ √ √
calorimetry
Thermogravimetric analysis √ √ √
Fourier-transform infrared √ √ √
spectroscopy/attenuated total
reflection
Water content √
Solubility √
Permeability √
Viscosity √
Density √
Polarity √
MTS/MTT/Alamar Blue (cell √
viability assays)
F. Santos and A. R. C. Duarte
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 115
Physicochemical Characterization
Biological Characterization
The therapeutic deep eutectic systems represent an attractive and sustainable method
to explore an infinite number of possible combinations with different components
that incorporate or dissolve a drug. For industry and research, it is a very interesting
area that provides the possibility of improving the characteristics of the APIs (solu-
bility and permeability, for example). However, other properties could be enhanced
depending on the compounds that are part of the mixture. Incorporating natural
compounds with very low toxicity can, for instance, reduce the toxicity of a drug,
while the incorporation of an antioxidant can tune the antioxidant properties of the
API (Zainal-Abidin et al. 2019; Álvarez and Zhang 2019).
In the last decade, the interest and knowledge for providing solutions for old
biomedical and pharmaceutical problems has increased. The objective remains to
find alternative and safe biomaterials, active compounds, and routes of administra-
tion of “old” drugs that improve their characteristics, turn them less toxic, and facil-
itate the therapeutics (Aroso et al. 2016).
The most common approach to form eutectic mixtures and use them in pharmacy is
trying to incorporate one or more APIs as components of the eutectic mixture.
Bonain discovered a eutectic mixture for topical anesthesia that includes cocaine
hydrochloride, phenol, or menthol to form a homogeneous liquid at room tempera-
ture. Nevertheless, it was observed that cocaine has toxic effects and phenol has
caustic properties (Gala et al. 2014). Evers and coworkers, in 1981, reported the use
of a eutectic mixture of lidocaine and prilocaine (1:1) in an oil-in-water emulsion to
increase the analgesic effect through the skin. With this mixture, they described an
increase of the concentration of local anesthetic in the emulsion of approximately
20% to 80% of lidocaine-prilocaine, maintaining the total concentration of the local
anesthetic low (5%) (Buckley and Benfield (1993); Evers et al. (1985); Lowrie et al.
1989). The transdermal permeation enhancement of this cream (trade name EMLA)
is possible through the combination of the components that decreases the melting
point of the mixture to approximately 22 °C, while the compounds individually
have low permeation through the skin, due to their melting points higher than the
body temperature (37 °C) (Cherukuvada and Nangia (2014); Yin and Jiang (2018);
Woolfson et al. 2000). It was though observed that prilocaine has high tendency to
cause methemoglobinemia, and this discovery led Gala and coworkers to study
other eutectic mixtures for lidocaine, such as lidocaine-tetracaine and lidocaine-
camphor (Gala et al. 2014).
118 F. Santos and A. R. C. Duarte
Solubility Enhancement
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Fig. 3.5 Representative results presented in the literature with enhancement of solubility of APIs
when present in the eutectic mixture as part of therapeutic deep eutectic systems (THEDES)
(Aroso et al. (2016); Duarte et al. (2017); Aroso et al. (2015); Barros et al. (2017); Santos
et al. 2019)
These studies that include the formation of eutectic mixtures with therapeutic
agents demonstrated an improvement of the characteristics of the therapeutic agent.
These promising results lead to investigation and development of studies of solubil-
ity with therapeutic eutectic mixtures and using the eutectic mixtures as a vehicle to
solubilize poorly soluble drugs, to improve their solubility, as we can observe in
Fig. 3.5.
Shen and coworkers have studied the intestinal absorption of daidzein in the
presence of a eutectic mixture of borneol:menthol and with a microemulsion to
improve the bioavailability of daidzein. The results indicate that the eutectic mix-
ture increased the solubility of daidzein, increasing the membrane fluidity and per-
meability through the intestinal mucosa. The use of daidzein borneol:menthol
microemulsion with a surfactant to improve the intestinal absorption could result in
a synergistic effect between the eutectic mixture and microemulsion with surfactant
(Shen et al. 2011).
Morrison et al. tested potential solubilization of drugs such as benzoic acid, gris-
eofulvin, danazol, itraconazole, and AMG517 in NADES. In this study, was mea-
sured the solubility with pure NADES and mixtures of NADES and water in
different proportions, the results showed an increase of 5- to 22,000-fold in the solu-
bility of the drugs comparing with water. In addition, NADES could represent a
promising vehicle for oral drug delivery, since their components are, in general,
pharmaceutically tolerable (Morrison et al. (2009); Vanda et al. 2018); Álvarez and
Zhang 2019).
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 119
antitumor activity itself but present some cytotoxicity. The systems prepared were
myristic acid:limonene (1:1, 1:2, and 2:1), menthol:limonene (1:1, 1:2, and 2:1),
capric acid:limonene (1:1, 1:2, and 2:1), and ibuprofen:limonene (1:1, 1:2, 2:1, 1:4,
and 1:8); all of them present antitumor activity; however, only ibuprofen:limonene
(1:4) was able to inhibit HT29 without compromising cell viability and also improve
the anti-inflammatory activity of ibuprofen (Pereira et al. 2019). The studies of
these therapeutic mixtures in vitro and in vivo are essential for understanding the
mechanisms that govern the therapeutic effect and the possible interactions that
these mixtures have with different cells and tissues. The implementation of these
biological studies accompanied with modeling of the interaction and permeation
through cellular membranes could be very promising and help formulate mixtures
with specific targets and low toxicity.
The design and formulation of suitable drug delivery carriers is another major con-
cern of the pharmaceutical industry, and different examples of formulations are
reported in the literature. Tuntarawongsa and Phaechamud have previously prepared
eutectic mixtures with menthol and camphor, borneol, and WS-3 and observe an
increase of drug bioavailability. Later, they incorporate a polymer in the eutectic
mixture menthol and camphor to prolong the drug release and have a slow drug dif-
fusion. The polymeric eutectic system with Eudragit® was used as a vehicle for
ibuprofen, due to its higher solubility in the system menthol:camphor, and the
hydrophobic part turns this mixture suitable for controlled release of ibuprofen, for
example, in periodontitis (Tuntarawongsa and Phaechamud (2012); Mbous et al.
2017a, b). Mano et al. prepared THEDES with choline chloride and mandelic acid
(1:2) which were encapsulated in gelatin fibers by electrospinning, producing fibers
with a smooth surface and that can adopt many conformations. These fibers were
designed to obtain fast-dissolving delivery systems (FDDS) with simple techniques
(Mano et al. 2016; Roda et al. 2019).
Zainal-Abidin et al. explored the use of DES to functionalize the surface of nano-
drug carriers of graphene. In spite of these, nanodrug carriers of graphene per se
represent an alternative way for increasing the efficiency of drug delivery, due to
their high surface area, intrinsic mobility, thermal stability, and high loading capac-
ity. But these nanocarriers of graphene could present some toxicity for humans and
for the environment, and the functionalization of these carriers with DES allows
surface modifications and introduction of functional groups that increase the bio-
compatibility of graphene (Zainal-Abidin et al. 2019).
In order to observe an improvement of the characteristics of a drug in an eutectic
mixture, Patel et al. studied the eutectic mixture nimesulide:nicotinamide (1:2) and
produce a powder through spray dried and verify that the solubility of this mixture
was enhanced 14-fold and the dissolution in water enhanced 2-fold, when compared
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 121
with pure drug. In spite of eutectic mixtures are most of the times in a liquid form,
they can be used directly for processing and manufacturing of solid forms and at the
same time improve the characteristics of the drugs (Patel et al. 2019; Álvarez and
Zhang 2019).
Several papers in the literature report the use of supercritical fluid technology as
a versatile technology for the preparation of different formulations. Using different
particle formation techniques such as rapid expansion of supercritical solutions
(RESS), particle from gas saturated solution (PGSS), supercritical antisolvent
(SAS), or GAS for coprecipitation of the drug and the polymer, it is possible to
produce particles, for example, encapsulating drug in a polymer matrix (Guney and
Akgerman 2002; Reverchon et al. 2009). Silva et al. explored the loading of gauzes
with a eutectic blend of lauric acid:myristic acid by supercritical CO2. With these
novel approaches, it was possible to obtain homogeneous eutectic blends and
improve their antibacterial properties, which could be explained by the increase of
the hydrophobicity of the blend formulated that may improve their ability to interact
with the membrane of the bacteria (Silva et al. 2019a, b, c). In an attempt to find and
effective therapy for tuberculosis treatment, Roda and coworkers investigated for
the first time the encapsulation of THEDES with anti-tuberculosis drugs, as a com-
ponent of the mixture, through PGSS and evaluate the influence of different water
ratios present on the mixtures on the PGSS process (Roda et al. 2020).
Supercritical carbon dioxide technology can be used for the incorporation of a
drug in a polymeric matrix rendering a controlled release systems basis on a slight
plasticization of the polymeric particles that fused together and produce a 3D struc-
ture. Silva et al. reported the possibility of using the THEDES choline
chloride:ascorbic acid and solubilized dexamethasone in the eutectic mixture, which
was then impregnated in a polymeric matrix by supercritical CO2. This system
could be important in studies of bone tissue engineering, because its components
could assist osteogenic differentiation from stem cells (Barros et al. 2017; Silva
et al. 2018).
Aroso and coworkers studied the development of controlled drug delivery sys-
tems of anti-inflammatory drugs, namely, using the THEDES menthol:ibuprofen
and a biodegradable polymer, composed by a blend of starch, and obtained three-
dimensional porous materials with supercritical fluid sintering (Aroso et al. 2015;
Roda et al. 2019). In this work, the release of ibuprofen from THEDES form has
shown significant differences, being the ibuprofen dissolved in THEDES released
much faster than API itself.
The impregnation of THEDES with supercritical CO2 is still a research area that
remains relatively unexplored, particularly due to the lack of measurements on the
binary systems of THEDES and CO2. The vapor liquid equilibria (VLE) experi-
ments are relevant to optimize the operating conditions for impregnation, such that
the amount of THEDES impregnated is within its therapeutic window. However,
Barros et al. explore the impregnation of a THEDES system (menthol:ibuprofen) in
alginate sponges that were prepared by freeze-drying, supercritical CO2 was used
for the impregnation of THEDES, and the solubility of these binary systems
(THEDES + CO2) was studied (Barros et al. 2017).
122 F. Santos and A. R. C. Duarte
The THEDES could be used as a single mixture, providing higher dissolution rates
of the API and enhancement of solubility, permeability, and absorption through tis-
sues, or they can be incorporated in suitable polymer to potentiate the efficiency of
biomedical devices (Aroso et al. 2016, 2015; Roda et al. 2019). The different appli-
cations that THEDES have been used and reported are represented in Table 3.3.
The use of DES as therapeutic agents reveals to be very promising to enhance the
characteristics of existing drugs and optimize or develop new formulations that
could be easily administrated and more effective. However, the formulation of
eutectic mixtures is still based on trial and error experiments to obtain a liquid and
stable mixture at room temperature that can be used in different applications, includ-
ing pharmaceutical research. To facilitate these studies, it is important to understand
how molecular interactions are established between the components of the mixture
and what molecules could be mixed, leading to enhanced properties, avoiding trial
and error experiments. To better understand this type of mixtures and their charac-
teristics, how they can be modulated for different applications will represent a huge
step on the research of these mixtures and in their development. The computational
modeling and molecular dynamics studies could represent one part of the investiga-
tion of these mixtures and could help researchers understand better their advantages
as well as provide tools for a more systematic preparation of these formulations.
Table 3.3 Different systems reported in the literature for different applications of therapeutic deep
eutectic systems (THEDES)
THEDES Application References
Ibuprofen:terpenes (menthol, Preparation and characterization of Stott et al. (1998)
thymol, menthone, 1,8-cineole, eutectic mixtures with ibuprofen and
d-limonene, p-cymene) several terpenes. Evaluate them as
transdermal permeation enhancers
Lidocaine:prilocaine (3:7); (4:6); Evaluation of the enhancement of Fiala et al. (2010)
(5:5); (6:4); (7:3) transmembrane drug transport
Borneol:menthol (25:75) Enhance the intestinal absorption of Shen et al. (2011)
daidzein
Lidocaine:tetracaine (1:1) Preparation of eutectic mixtures for Gala et al. (2014)
Lidocaine:camphor (1:1) anesthetic applications
Choline chloride:glycolic acid (1:2) Enhance the solubility of poorly Li and Lee (2016)
Choline chloride:glycolic soluble drugs
acid:oxalic acid (1:1.6:0.4)
Choline chloride:acetylsalicylic Preparation of THEDES with API Aroso et al. (2016),
acid (1:1) incorporated in the system, without and Duarte et al.
Choline chloride:phenylacetic acid solvent addition (2017)
(1:1)
Menthol:benzoic acid (1:1); (2:1);
(3:1)
Menthol:acetylsalicylic acid (1:1);
(2:1); (3:1)
Menthol:phenylacetic acid (1:1);
(2:1); (3:1)
(continued)
3 Therapeutic Deep Eutectic Systems for the Enhancement of Drug Bioavailability 123
3.4 Conclusion
The present review emphasizes the importance and evolution of therapeutic deep
eutectic solvents. THEDES are systems that have an infinite number of possible
combinations of its components, which allows the modulation of their features and
the application in different pharmaceutical formulations. For pharmaceutical
research, it is important to have this possibility that involves less toxicity, improves
the properties of the drugs, is cost-effective, and is an ecological alternative to the
preparation of enhanced biopharmaceuticals.
Acknowledgments The research leading to these results has received funding from the European
Union Horizon 2020 Programme under the agreement number ERC-2016-CoG 725034 (ERC
Consolidator Grant Des.solve). This work was supported also by the Associate Laboratory for
Green Chemistry-LAQV which is financed by the ERDF under the PT2020 Partnership Agreement
(POCI-01-0145-FEDER-007265).
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