Stimuli-sensitive cross-linked hydrogels as drug delivery systems: Impact of the drug on the responsiveness

Responsiveness of drug delivery systems (DDS) against internal and external stimuli attracts wide interest as a mechanism that can provide both site-specific release at the target place and feedback regulated release rate. Biological environment is quite complex and the effects that the intricate medium may have on the effectiveness of the stimulus have received certain attention. Differently, the impact that the drug loaded may have itself on the responsiveness of the DDS has been underestimated. Most drugs are not merely trapped in the polymer network, but they effectively interact with some polymer moieties. Nearly all drugs, including therapeutic proteins, are ionizable amphiphilic molecules, and thus ionic, hydrogen bonding and hydrophobic interactions are commonly exploited to increase the loading yield. If the moiety involved in drug binding is also responsible for (or at least partially involved in) the stimuli responsiveness, a strong impact of the drug on the behavior of the DDS can be expected. This review gathers relevant examples of how the drug may modify the sensitiveness (stimulus threshold) and the responsiveness (actuation) of the DDS to therapeutically relevant stimulus, and aims to shed light on the different drug binding modes of the swollen and collapsed states, which in turn modify drug release patterns. The information evidences that drug loading and release may trigger phase transitions in hydrogels non-intended to be drug-responsive (i.e., a priori not analyte-responsive networks). A better knowledge about the effect of the drug on the responsiveness is a required step forward for the clinical application of smart hydrogels and may also unveil novel uses of the stimuli-responsive DDS.