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<article xml:lang="EN" article-type="research-article" dtd-version="1.4"><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-ta">Mol Pharm</journal-id><journal-id journal-id-type="iso-abbrev">Mol Pharm</journal-id><journal-id journal-id-type="pmc-domain-id">822</journal-id><journal-id journal-id-type="pmc-domain">acssd</journal-id><journal-id journal-id-type="nlm-id">101197791</journal-id><journal-id journal-id-type="publisher-id">mp</journal-id><journal-title-group><journal-title>Molecular Pharmaceutics</journal-title></journal-title-group><issn pub-type="ppub">1543-8384</issn><issn pub-type="epub">1543-8392</issn><?publisher_abbrev acs?><custom-meta-group><custom-meta><meta-name>pmc-is-collection-domain</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-collection-title</meta-name><meta-value>ACS AuthorChoice</meta-value></custom-meta></custom-meta-group></journal-meta><article-meta><article-id pub-id-type="pmcid">PMC10988560</article-id><article-id pub-id-type="pmcid-ver">PMC10988560.1</article-id><article-id pub-id-type="pmcaid">10988560</article-id><article-id pub-id-type="pmcaiid">10988560</article-id><article-id pub-id-type="pmid">38412451</article-id><article-id pub-id-type="doi">10.1021/acs.molpharmaceut.3c00244</article-id><article-version article-version-type="pmc-version">1</article-version><article-categories><subj-group><subject>Article</subject></subj-group></article-categories><title-group><article-title>Therapeutic
Polymer-Based Cannabidiol Formulation:
Tackling Neuroinflammation Associated with Ischemic Events in the
Brain</article-title></title-group><contrib-group><contrib contrib-type="author" id="ath1"><name name-style="western"><surname>Chevalier</surname><given-names initials="MT">Merari
Tumin</given-names></name><xref rid="notes3" ref-type="notes">#</xref></contrib><contrib contrib-type="author" id="ath2"><name name-style="western"><surname>Al-Waeel</surname><given-names initials="M">Mansoor</given-names></name><xref rid="notes3" ref-type="notes">#</xref></contrib><contrib contrib-type="author" id="ath3"><name name-style="western"><surname>Alsharabasy</surname><given-names initials="AM">Amir M.</given-names></name></contrib><contrib contrib-type="author" id="ath4"><name name-style="western"><surname>Rebelo</surname><given-names initials="AL">Ana Lúcia</given-names></name></contrib><contrib contrib-type="author" corresp="yes" id="ath5"><name name-style="western"><surname>Martin-Saldaña</surname><given-names initials="S">Sergio</given-names></name><xref rid="cor1" ref-type="other">*</xref></contrib><contrib contrib-type="author" corresp="yes" id="ath6"><contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0002-6292-4933</contrib-id><name name-style="western"><surname>Pandit</surname><given-names initials="A">Abhay</given-names></name><xref rid="cor2" ref-type="other">*</xref></contrib><aff id="aff1">CÚRAM, SFI Research
Centre for Medical Devices, <institution>University of
Galway</institution>, Galway H92 W2TY, <country>Ireland</country></aff></contrib-group><author-notes><corresp id="cor1"><label>*</label>E-mail: <email>smartinsaldana@gmail.com</email>.</corresp><corresp id="cor2"><label>*</label>E-mail: <email>abhay.pandit@universityofgalway.ie</email>.</corresp></author-notes><pub-date pub-type="epub"><day>27</day><month>02</month><year>2024</year></pub-date><pub-date pub-type="collection"><day>01</day><month>04</month><year>2024</year></pub-date><volume>21</volume><issue>4</issue><issue-id pub-id-type="pmc-issue-id">459183</issue-id><fpage>1609</fpage><lpage>1624</lpage><history><date date-type="received"><day>21</day><month>03</month><year>2023</year></date><date date-type="accepted"><day>13</day><month>02</month><year>2024</year></date><date date-type="rev-recd"><day>11</day><month>02</month><year>2024</year></date></history><pub-history><event event-type="pmc-release"><date><day>03</day><month>04</month><year>2024</year></date></event><event event-type="pmc-live"><date><day>04</day><month>04</month><year>2024</year></date></event><event event-type="pmc-last-change"><date iso-8601-date="2024-04-04 00:25:13.583"><day>04</day><month>04</month><year>2024</year></date></event></pub-history><permissions><copyright-statement>© 2024 The Authors. Published by American Chemical Society</copyright-statement><copyright-year>2024</copyright-year><copyright-holder>The Authors</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/" specific-use="textmining" content-type="ccbylicense">https://creativecommons.org/licenses/by/4.0/</ali:license_ref><license-p>Permits the broadest form of re-use including for commercial purposes, provided that author attribution and integrity are maintained (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>).</license-p></license></permissions><self-uri xmlns:xlink="http://www.w3.org/1999/xlink" content-type="pmc-pdf" xlink:href="mp3c00244.pdf"><?pdf-name mp3c00244.pdf?><?pdf-size 7000103?><?pdf-md5 665b86991ee1415e66308d00e4ec8d9e?><?pdf-image-server-status NEVER_LOAD?><?pdf-cloudpmc-urn urn:app:2d26/10988560/665b86991ee1/mp3c00244.pdf?></self-uri><abstract><p content-type="toc-graphic"><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="ab-tgr1" position="float" orientation="portrait" xlink:href="mp3c00244_0009.jpg"><?image-name mp3c00244_0009.jpg?><?image-size 122983?><?image-md5 5cbfab0c31879876464cccc4386f732a?><?image-image-server-status NEVER_LOAD?><?image-original-height 558?><?image-original-width 673?><?image-scaled-height 558?><?image-scaled-width 673?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/5cbfab0c3187/mp3c00244_0009.jpg?><?thumb-name mp3c00244_0009.gif?><?thumb-size 18056?><?thumb-md5 f600784e8c9f4f09946b0602091d3f10?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 83?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/f600784e8c9f/mp3c00244_0009.gif?></graphic></p><p>Cannabidiol (CBD) is the most relevant nonpsychostimulant
phytocompound
found in <italic toggle="yes">Cannabis sativa</italic>. CBD has been
extensively studied and has been proposed as a therapeutic candidate
for neuroinflammation-related conditions. However, being a highly
lipophilic drug, it has several drawbacks for pharmaceutical use,
including low solubility and high permeability. Synthetic polymers
can be used as drug delivery systems to improve CBD’s stability,
half-life, and biodistribution. Here, we propose using a synthetic
polymer as a nanoparticulate vehicle for CBD (NPCBD) to overcome the
pharmacological drawbacks of free drugs. We tested the NPCBD-engineered
system in the context of ischemic events in a relevant oxygen and
glucose deprivation (OGD) model in primary cortical cells (PCC). Moreover,
we have characterized the inflammatory response of relevant cell types,
such as THP-1 (human monocytes), HMC3 (human microglia), and PCC,
to NPCBD and observed a shift in the inflammatory state of the treated
cells after the ischemic event. In addition, NPCBD exhibited a promising
ability to restore mitochondrial function after OGD insult in both
HMC3 and PCC cells at low doses of 1 and 0.2 μM CBD. Taken together,
these results suggest the potential for preclinical use.</p></abstract><kwd-group><kwd>cannabidiol</kwd><kwd>stroke</kwd><kwd>neuroinflammation</kwd><kwd>oxygen and glucose deprivation</kwd><kwd>poly(lactic-<italic toggle="yes">co</italic>-glycolic acid)</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution>H2020 Marie Sklodowska-Curie Actions</institution><institution-id institution-id-type="doi">10.13039/100010665</institution-id></institution-wrap></funding-source><award-id>713690</award-id></award-group></funding-group><funding-group><award-group><funding-source><institution-wrap><institution>European Regional Development Fund</institution><institution-id institution-id-type="doi">10.13039/501100008530</institution-id></institution-wrap></funding-source><award-id>13/RC/2073_P2</award-id></award-group></funding-group><funding-group><award-group><funding-source><institution-wrap><institution>Science Foundation Ireland</institution><institution-id institution-id-type="doi">10.13039/501100001602</institution-id></institution-wrap></funding-source><award-id>13/RC/2073_P2</award-id></award-group></funding-group><funding-group><award-group><funding-source><institution-wrap><institution>H2020 Marie Sklodowska-Curie Actions</institution><institution-id institution-id-type="doi">10.13039/100010665</institution-id></institution-wrap></funding-source><award-id>813263</award-id></award-group></funding-group><funding-group><award-group><funding-source><institution-wrap><institution>H2020 Marie Sklodowska-Curie Actions</institution><institution-id institution-id-type="doi">10.13039/100010665</institution-id></institution-wrap></funding-source><award-id>797716</award-id></award-group></funding-group><custom-meta-group><custom-meta><meta-name>pmc-status-qastatus</meta-name><meta-value>0</meta-value></custom-meta><custom-meta><meta-name>pmc-status-live</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-status-embargo</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-status-released</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-open-access</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-olf</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-manuscript</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-legally-suppressed</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-has-pdf</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-has-supplement</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-pdf-only</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-suppress-copyright</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-is-real-version</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-is-scanned-article</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-preprint</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>pmc-prop-in-epmc</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>pmc-license-ref</meta-name><meta-value>CC BY</meta-value></custom-meta><custom-meta><meta-name>document-id-old-9</meta-name><meta-value>mp3c00244</meta-value></custom-meta><custom-meta><meta-name>document-id-new-14</meta-name><meta-value>mp3c00244</meta-value></custom-meta><custom-meta><meta-name>ccc-price</meta-name><meta-value/></custom-meta></custom-meta-group></article-meta></front><body><sec id="sec1"><label>1</label><title>Introduction</title><p>Stroke is the leading
cause of long-term disability and the second
leading cause of death worldwide. Of all the stroke cases, 7.6 million
corresponds to ischemic stroke, leading to 3.3 million deaths annually.<sup><xref ref-type="bibr" rid="ref1">1</xref></sup> Ischemic stroke is caused by a blood supply interruption
to a part of the brain.<sup><xref ref-type="bibr" rid="ref1">1</xref></sup> Patients may be
eligible to receive intravenous thrombolysis treatment if they arrive
at the hospital within 4.5 h from witnessed symptom onset; thrombolysis
may be offered alone or in combination with endovascular thrombectomy,
which has a 6 h time window for most patients.<sup><xref ref-type="bibr" rid="ref2">2</xref></sup> Thus, most stroke patients remain without any effective treatment
option besides physical therapy. The human brain is incapable of efficient
self-regeneration, which prevents full long-term functional recovery.
Although insufficient, new therapies addressing brain damage due to
ischemic stroke can boost the endogenous repair mechanisms of our
brain. These approaches can lead to a pivotal step within a clinical
scenario.</p><p>In the last two decades, the endocannabinoid system
(ECS) has become
a subject of great interest in neurobiology and neuropharmacology
as a therapeutic target, mainly due to its wide distribution in the
central nervous system.<sup><xref ref-type="bibr" rid="ref3">3</xref></sup> Indeed, it is
particularly interesting when neuroinflammation plays a vital role
in the onset of the disease component, such as stroke.<sup><xref ref-type="bibr" rid="ref4">4</xref></sup> Cannabidiol (CBD) is one of the hundreds of phytocannabinoids
in the <italic toggle="yes">Cannabis sativa</italic> plant.<sup><xref ref-type="bibr" rid="ref5">5</xref></sup> CBD is a nonpsychostimulant but displays several
beneficial pharmacological effects.<sup><xref ref-type="bibr" rid="ref6">6</xref></sup> Exhibiting
a robust antioxidant and anti-inflammatory activity, glutamate release
reduction, mitochondrial membrane stabilization, adenosine extracellular
concentration increment, and nuclear factor kappa B (NF-κB)
activation prevention, CBD has emerged as a solid neuroprotective
candidate for the multifactorial treatment of ischemic stroke.<sup><xref ref-type="bibr" rid="ref7">7</xref></sup> However, to take advantage of the therapeutic
properties of CBD, it is critical to address the intrinsic limitations
preventing its effective delivery.<sup><xref ref-type="bibr" rid="ref8">8</xref></sup> CBD
is highly lipophilic, which results in the use of high doses to achieve
a therapeutic effect due to its poor biodistribution, also causing
undesired side effects.<sup><xref ref-type="bibr" rid="ref8">8</xref></sup> The most preferred
route for CBD administration is the oral route, but the oral bioavailability
of CBD is estimated at 6% due to gastrointestinal precipitation exhibited
by highly lipophilic drugs.<sup><xref ref-type="bibr" rid="ref9">9</xref></sup> Moreover,
the available CBD preparations include oil- and alcohol-based solutions,
which can easily lead to irritation and local inflammatory responses.<sup><xref ref-type="bibr" rid="ref9">9</xref></sup> CBD is highly sensitive to light and temperature
and easily undergoes oxidation and degradation.<sup><xref ref-type="bibr" rid="ref9">9</xref>,<xref ref-type="bibr" rid="ref10">10</xref></sup> Recent
studies have reported mild to severe side effects related to the need
of increasing CBD doses to achieve therapeutic efficacy both in animals<sup><xref ref-type="bibr" rid="ref11">11</xref></sup> and humans.<sup><xref ref-type="bibr" rid="ref12">12</xref></sup> Therefore,
a simplistic and feasible clinical translation approach is required
to extend CBD’s effective delivery and reduce dosages by increasing
the drug’s bioavailability. The degradation of CBD in gastrointestinal
conditions and the first-pass metabolism of the liver can be avoided
if intravenous administration is considered.<sup><xref ref-type="bibr" rid="ref13">13</xref></sup></p><p>Polymeric systems have been used for drug delivery, and among
them,
biodegradable polymeric nanoparticles (NPs) can efficiently accommodate
hydrophobic drugs and deliver them opportunely. Herein, we have used
poly(lactic-<italic toggle="yes">co</italic>-glycolic acid) (PLGA)-based NPs to
confer efficiency and versatility to CBD delivery. The selected polymer
serves as the NP matrix and overcomes pharmacological drawbacks and
is a well-established, FDA-approved polyester able to be nanostructured
in a reproducible manner with a high CBD loading efficiency. Herein,
we aim to demonstrate that our engineered CBD-loaded PLGA NPs (NPCBD)
are safe to use and that CBD’s availability <italic toggle="yes">in vitro</italic> is as good as CBD in its classic formulations, with improved physiochemical
properties from a pharmacological point of view. We have successfully
fabricated CBD-loaded PLGA NPs (NPCBD) and tested them in relevant <italic toggle="yes">in vitro</italic> models of human monocytes (THP-1) and microglia
(HMC3). Moreover, we have evaluated NPCBD therapeutic performance
in ischemic events exposing a primary cortical cells (PCC) to oxygen
and glucose deprivation (OGD) conditions (<xref rid="sch1" ref-type="scheme">Scheme <xref rid="sch1" ref-type="scheme">1</xref></xref>). NPCBD improved not only in terms of metabolic
activity and dsDNA content but also in the inflammatory state of the
treated cells after OGD to a pro-regenerative one, suggesting a potential
for its preclinical use.</p><fig id="sch1" position="float" orientation="portrait"><label>Scheme 1</label><caption><title>Cannabidiol (CBD)-Loaded Nanoformulation
(NPCBD) Schematic and Overview
of the <italic toggle="yes">In Vitro</italic> Protective Effect Reducing inflammation
After Oxygen and Glucose Deprivation (OGD) Over Primary Cortical Cells
(PCC) Culture</title></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr1" position="float" orientation="portrait" xlink:href="mp3c00244_0008.jpg"><?image-name mp3c00244_0008.jpg?><?image-size 113788?><?image-md5 77608c2186d90eb28d9feb04e7f813d8?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 1024?><?image-original-width 1258?><?image-scaled-height 512?><?image-scaled-width 629?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/77608c2186d9/mp3c00244_0008.jpg?><?thumb-name mp3c00244_0008.gif?><?thumb-size 20905?><?thumb-md5 c82bd690ac1d41194ecba80b1c865a04?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 81?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/c82bd690ac1d/mp3c00244_0008.gif?></graphic></fig></sec><sec id="sec2"><label>2</label><title>Methodology</title><sec id="sec2.1"><label>2.1</label><title>Fabrication of Therapeutic Polymer-Based Cannabidiol
Nanoformulations</title><p>CBD-loaded PLGA NPs (NPCBD) were prepared
by single emulsion method with subsequent solvent evaporation as previously
reported.<sup><xref ref-type="bibr" rid="ref14">14</xref></sup> The NPs were collected by centrifugation
at 11,000<italic toggle="yes">g</italic> after four washes with deionized water
to remove any excess surfactant.<sup><xref ref-type="bibr" rid="ref14">14</xref></sup> Briefly,
50 mg of PLGA and 5 mg of CBD were dissolved in 2.5 mL of dichloromethane
(DCM) by using magnetic agitation. This solution was emulsified with
2% w/v of PVA aqueous solution using a tip sonicator (VIBRA CELL Sonics
mod. VC 750 USA, 39% Amp) for 20 min. The resulting emulsion was transferred
into a 0.2% (w/v) PVA aqueous solution, which was then magnetically
stirred at room temperature to enhance complete solvent evaporation.
Unloaded PLGA NPs (NP-0) were obtained by using the same technique.</p></sec><sec id="sec2.2"><label>2.2</label><title>Characterization of Cannabidiol-Loaded Nanoparticles</title><sec id="sec2.2.1"><label>2.2.1</label><title>Morphology</title><p>The morphology of NPCBD
was analyzed by a field emission scanning electron microscope (FESEM,
Hitachi SU 8000 TED). Samples were prepared by placing freeze-dried
NPs over a carbon tape disk with subsequent coating with a gold–palladium
alloy (80:20).</p></sec><sec id="sec2.2.2"><label>2.2.2</label><title>Particle Size Distribution</title><p>Measurements
of NPCBD dispersions were performed in square polystyrene cuvettes
(SARSTEDT), and the temperature was kept constant at 25 °C. The
particle size distribution of the nanoparticulate dispersions was
determined by dynamic light scattering (DLS) using a Malvern Zetasizer.
The zeta potential (ζ) was determined for NP formulations at
1 mg/mL PBS concentration and pH = 7.4, which is automatically calculated
from the electrophoretic mobility using Smoluchowskí’s
approximation. The evolution of the mean diameter with the temperature
from 24 to 40 °C was also evaluated in the same apparatus. The
statistical average and standard deviation of data were calculated
from 6 different samples (3 measurements of 20 runs each one).</p></sec><sec id="sec2.2.3"><label>2.2.3</label><title>Loading Efficiency</title><p>The loading
efficiency (LE%) of CBD in the PLGA NPs was determined by spectroscopy
using the NanoDrop 2000c spectrophotometer (λ = 207 nm). Briefly,
the amount of entrapped CBD was calculated indirectly by measuring
the difference between the initial amount of CBD (CBDin) and free
CBD (CBDfree) in the supernatant during the washing steps. The LE%
was expressed according to <xref rid="eq1" ref-type="disp-formula">eq <xref rid="eq1" ref-type="disp-formula">1</xref></xref>.</p><p><disp-formula id="eq1"><graphic xmlns:xlink="http://www.w3.org/1999/xlink" position="anchor" orientation="portrait" xlink:href="mp3c00244_m001.jpg"><?image-name mp3c00244_m001.jpg?><?image-size 2826?><?image-md5 0a24efc75009161d02d1980b11d3c1a6?><?image-image-server-status NEVER_LOAD?><?image-original-height 31?><?image-original-width 151?><?image-scaled-height 31?><?image-scaled-width 151?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/0a24efc75009/mp3c00244_m001.jpg?><?thumb-name mp3c00244_m001.gif?><?thumb-size 1020?><?thumb-md5 f86c7c0b11d9b24bdf001e362da79f76?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 31?><?thumb-scaled-width 151?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/f86c7c0b11d9/mp3c00244_m001.gif?></graphic><label>1</label></disp-formula></p></sec><sec id="sec2.2.4"><label>2.2.4</label><title>Fourier-Transform Infrared Spectroscopy
(FTIR)</title><p>FTIR was used to study the characteristic bands of
all of the constituents of the proposed NPCBD. Infrared spectroscopy
was performed in the attenuated total reflection mode on an IR 640
spectrophotometer (Varian). Samples were analyzed at room temperature
by 16 scans using a resolution of 4 cm<sup>–1</sup>.</p></sec><sec id="sec2.2.5"><label>2.2.5</label><title>CBD Stability Over Time</title><p>To determine
the stability over time of CBD and NPCBD, the same amount of CBD in
NPCBD or as a free drug was resuspended or dissolved in ACSF (with
20% DMSO in the case of the free drug) and incubated at 37 °C.
At specific time points (3, 7, and 21 days), the supernatants were
analyzed by HPLC to determine the amount of CBD remaining.</p></sec></sec><sec id="sec2.3"><label>2.3</label><title><italic toggle="yes">In Vitro</italic> Evaluation of Cannabidiol-Loaded
Nanoparticles</title><sec id="sec2.3.1"><label>2.3.1</label><title>Monocytes (THP-1) and Microglia (HMC3)</title><p>THP-1 monocyte cell line, established from peripheral blood acute
monocytic leukemia, was purchased from ATCC. To differentiate THP-1
into macrophages, 100 ng/mL phorbol 12-myristate 13-acetate (PMA)
was used on a monocyte cell suspension. 4 ×10<sup>5</sup> cells
per well were seeded into 24-well plates with PMA-conditioned media
for 24 h. After the differentiation, the media were refreshed with
RPMI medium, and the cells were treated with lipopolysaccharide (LPS)
(100 ng/mL) or different dilutions of NPCBD ranging from 100 to 5
μg/mL. Cells were exposed to the conditioned media for 72 h
to determine the effect, if any. After the stimulation period, the
culture medium was recovered and stored at −20 °C for
further analysis.</p><p>The human microglia HMC3 cell line is a microglial
cell isolated from a patient’s brain and purchased from ATCC.
4 ×10<sup>5</sup> cells per well were seeded into 24-well plates.
Cells were exposed to the conditioned media for 72 h to determine
the effect, if any. After 24 h, cells were treated with LPS (100 ng/mL)
or different dilutions of NPCBD ranging from 100 to 5 μg/mL.
After the stimulation period, the culture medium was recovered and
stored at −20 °C for further analysis.</p></sec><sec id="sec2.3.2"><label>2.3.2</label><title>Primary Cortical Cell (PCC) Culture</title><p>Sprague–Dawley rat pups (P3) were sacrificed with modifications
of the protocol published by Mathew et al.<sup><xref ref-type="bibr" rid="ref15">15</xref></sup> Cortex was harvested from the brain and chopped using a Mc tissue
chopper. The extracted tissue was then incubated in a papain-based
dissociation solution for 1 h to proceed with further trituration,
strain, centrifugation, and cell counting. Research and animal procedures
were performed in accordance with the European (EU) guidelines (2010/63/UE)
and Health Products Regulatory Authority of Ireland. Every effort
was made to minimize animal suffering and to reduce the number of
animals used.</p></sec><sec id="sec2.3.3"><label>2.3.3</label><title>Metabolic Activity and dsDNA Content Evaluation</title><p>The cell metabolic activity was evaluated by using the alamarBlue
protocol (Thermofisher). Briefly, 300 μL of 10% alamarBlue was
added per well and incubated for 3 h at 37 °C (5% CO<sub>2</sub>, humidity), and the solution was measured using a plate reader (Thermofisher,
λex 545 nm, λem 590 nm).</p><p>Cell dsDNA content was
evaluated by using the PicoGreen assay. Briefly, 100 μL of ultrapure
water was added to each well, and after three cycles of freeze–thaw,
the samples were used following the manufacturer’s protocol
(PicoGreen Assay, Protocol ND-3300, Thermo Scientific). The ratio
of metabolic activity per dsDNA content was calculated. Both determinations
were performed eight times on the same cell culture experiment and
were done in three independent experiments (<italic toggle="yes">N</italic> = 3).</p></sec><sec id="sec2.3.4"><label>2.3.4</label><title>Inflammatory Response Induced by NPCBD by
Human Multiplex ELISA</title><p>THP-1 or HMC3 response after NPCBD
exposure was measured by ELISA according to the manufacturer’s
specification (Meso Scale Diagnostics). Briefly, pro-inflammatory
(TNF-α, IL-1β, IFN-γ, IL-6, IL-8 and IL-12) and
anti-inflammatory (IL-10, IL-13 and IL-4) cytokines were quantified
in the recovered culture media after NPCBD treatment for 3 days. Two
technical replicates from 3 independent experiments were assessed.</p></sec></sec><sec id="sec2.4"><label>2.4</label><title>Oxygen and Glucose Deprivation (OGD) Model
Over PCC and HMC3</title><sec id="sec2.4.1"><label>2.4.1</label><title>HMC3 and PCC OGD Induction</title><p>This
procedure was performed after culture of PCCs for 10 days or HMC3
for 1 day. Each well was rinsed twice with prewarmed OGD medium prepared
according to Tasca et al.<sup><xref ref-type="bibr" rid="ref16">16</xref></sup> The medium
in each well was replaced with an OGD medium, and the plate was left
in the hypoxia chamber (N<sub>2</sub> 95%/CO<sub>2</sub> 5%) for 6
h. After OGD exposure, culture plates were removed from the hypoxia
chamber; the wells were withdrawn from the OGD medium, replenished
with a complete culture medium, and incubated for another 24 h. The
control groups were cultured in parallel to those in the OGD group.
Cellular damage was evaluated 24 h posterior to OGD exposure to emulate
reperfusion.</p></sec><sec id="sec2.4.2"><label>2.4.2</label><title>Rat Multiplex ELISA and Proteome Profiling</title><p>PCC and OGD-exposed PCC responses after NPCBD treatment were studied
by multiplex ELISA according to the manufacturer’s specification
(MSD). Briefly, pro-inflammatory (TNF-α, IL-1β, IFN-γ,
IL-6, IL-8, and IL-12) and anti-inflammatory (IL-10, IL-13, and IL-4)
cytokines were quantified in the recovered culture media after 1 day.
Two technical replicates from three independent experiments were assessed.</p><p>The relative expression of chemokines, pro- and anti-inflammatory
cytokines, and growth factors secreted by PCCs and OGD-exposed PCCs
after NPCBD treatment was determined by the Rat XL Cytokine Proteome
Profiler Array kit as per manufacturer’s instructions (ARY030,
R and D SYSTEMS). The signals relative to protein expression were
recorded on X-ray films (CL-XPosure Film, Thermo Scientific, 34090),
which were further analyzed using Image Studio Lite software as pixel
density. Furthermore, each analyte calculated the ‘mean pixel
density,’ and the data were plotted as a heatmap. Hierarchical
clustering of the data was performed using Morpheus (<uri xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="https://software.broadinstitute.org/morpheus">https://software.broadinstitute.org/morpheus</uri>).</p></sec><sec id="sec2.4.3"><label>2.4.3</label><title>Immunocytochemistry</title><p>PCC cultures
intended to be analyzed by image were seeded into poly-<sc>l</sc>-lysine
(PLL)-coated coverslips in 24-well plates, and the coverslips received
the same treatments described before and fixed at the desired time
points (3 and 7 days post-treatment). Briefly, media was removed,
and cells were washed with PBS, exposed for the desired time to 10%
formalin, and washed again after fixation. Fixed cells were permeabilized
by incubating them in 0.2% Triton X-100 in PBS, followed by washing
with PBS. Nonspecific binding was blocked with 1% bovine serum albumin
(BSA) in PBS solution for 1 h at room temperature (RT). Primary antibodies
mouse anti-GFAP (1:500, Sigma-Aldrich), rabbit anti-Iba-1 (1:200,
Dako), mouse anti-Olig-2 (1:200, Sigma-Aldrich), and rabbit anti-β-Tubulin
III (1:500, Abcam) were prepared in blocking buffer and added to the
plates, which were incubated overnight at 4 °C under stirring.
After washing, cells were incubated with secondary antibodies Alexa
Fluor 488 (1:500, Thermo Scientific, A-10667) and Alexa Fluor 546
(1:500, Thermo Scientific, A11035) for 1 h at RT. After washing, cells
were incubated in DAPI (1:2000, Thermo Scientific) for 5 min at RT,
and coverslips were mounted onto glass slides using a fluoromount
and observed under a confocal microscope (Olympus FluoView 3000 system).</p></sec><sec id="sec2.4.4"><label>2.4.4</label><title>Mitochondrial Function</title><p>The mitochondrial
functions of PCC or HMC3 were assessed using the Cell Mito Stress
Test by the measurement of oxygen consumption rate (OCR) and extracellular
acidification rate (ECAR) of cells in real time using an XFp extracellular
flux analyzer (Seahorse Bioscience, Agilent technologies, U.K). 2.5
× 10<sup>4</sup> of PCC or HMC3 wells was seeded into each well
of the 8-well Seahorse XFp cell culture mini plates (Agilent technologies).
After growing in an incubator at 37 °C in 5% CO<sub>2</sub> and
reaching a confluence of 90%, cells were exposed to the OGD, as described
in <xref rid="sec2.4.1" ref-type="other">Section <xref rid="sec2.4.1" ref-type="other">2.4.1</xref></xref> and then treated with NPCBD for 3 days until assessment. On the
selected end points, the media were replaced with unbuffered phenol
red-free Seahorse XF base medium (DMEM) and incubated for 1 h at 37
°C without % CO<sub>2</sub>. The working medium was prepared
freshly by the addition of glucose (25 mM), sodium pyruvate (1.0 mM),
and <sc>l</sc>-glutamine (2.0 mM) to the medium and adjusting the
pH at 7.4. The bioenergetic profiles were generated by sequential
injection of multiple mitochondrial toxins resuspended in Seahorse
assay medium: 1) oligomycin A (an ATP synthase inhibitor that blocks
its proton channel/complex V), 2) carbonyl cyanide-4-(trifluoromethoxy)phenylhydrazone
(FCCP; an uncoupling agent that disrupts the mitochondrial membrane
potential by transporting hydrogen protons through the membrane and
leading the respiration rate to its maximum capacity), and 3) rotenone/antimycin
A (complex I and III inhibitors, respectively, which shut down mitochondrial
respiration). The final concentrations of oligomycin A and rotenone/antimycin
A in each well, after injection, were 1 μM and 0.5 μM,
respectively in both types of cells. However, following FCCP titration,
the optimized final concentration of FCCP was 0.5 and 1.5 μM
in case of HMC3 and PCC cells, respectively. At the end of the assay,
a graph and data sheet were generated in the system, allowing for
the analysis of the effect of the different compounds on mitochondrial
function. Four independent experiments calculated parameters such
as basal, ATP-linked, and reserve capacity OCRs from the Mito Stress
assays.</p></sec></sec><sec id="sec2.5"><label>2.5</label><title>Statistical Analysis</title><p>Graphs and figures
were created by using GraphPad Software. Statistical differences in
histochemical quantification were analyzed by GraphPad Software. One-way
ANOVA was performed, followed by Tukey’s or Dunnet’s
posthoc test where appropriate. Mean and SEM were calculated for all
groups. All error bars indicate SEM.</p></sec></sec><sec id="sec3"><label>3</label><title>Results and Discussion</title><sec id="sec3.1"><label>3.1</label><title>CBD Was Efficiently Accommodated into the
PLGA Matrix, and the Resulting NPCBD Exhibited Suitable Properties
for CBD Delivery</title><p>Among all the new therapeutics proposed
for managing ischemic stroke, CBD arose as a promising pharmacological
ingredient due to its anti-inflammatory, immunosuppressive, and analgesic
properties.<sup><xref ref-type="bibr" rid="ref7">7</xref></sup> However, CBD’s high
hydrophobicity limits its clinical implementation due to the use of
high doses needed to achieve a therapeutic effect.<sup><xref ref-type="bibr" rid="ref17">17</xref></sup> To overcome CBD pharmacological drawbacks, polymer carriers
can be an innovative strategy to improve efficacy and reduce side
effects while maintaining the properties of the entrapped active substances.<sup><xref ref-type="bibr" rid="ref18">18</xref></sup> We deliberately selected a well-studied and
widely used polymer to build our CBD carriers due to the enhanced
feasibility for clinical translation. PLGA has a well-known ability
to efficiently accommodate hydrophobic drugs through the solvent evaporation
method, and it has an appealing history with FDA regulators. PLGA
was nanostructured through a single emulsion/solvent evaporation technique,
yielding NPCBD. FESEM images of the obtained NPs exhibited a quasi-spherical
morphology (<xref rid="fig1" ref-type="fig">Figure <xref rid="fig1" ref-type="fig">1</xref></xref>A,B) associated with effective polymer processing without noticeable
loss of the droplet structure during the first stage of freeze-drying.<sup><xref ref-type="bibr" rid="ref14">14</xref></sup> The fundamental features of the proposed CBD
carriers are summarized in <xref rid="tbl1" ref-type="other">Table <xref rid="tbl1" ref-type="other">1</xref></xref>. DLS measurements of NPCBD evidenced a hydrodynamic
diameter of 240 nm and a zeta potential value of −21.5 ±
0.60 mV due to the intrinsic negative charges in the PLGA chemical
structure. Moreover, the particles exhibited a narrow distribution,
which is confirmed by DLS with a PDI of 0.15 ± 0.030. Differences
among the sizes exhibited in FESEM micrographs and DLS measurements
are typical in this type of system and result from the hydration and
swelling of the NPs in aqueous dispersion (<xref rid="fig1" ref-type="fig">Figure <xref rid="fig1" ref-type="fig">1</xref></xref>B). Furthermore, the ability of PLGA to efficiently
accommodate and trap hydrophobic molecules can be observed again with
the NPCBD, showing a LE of 82% of the initial CBD amount. This high
loading efficiency is directly related to the hydrophobic nature of
both the polymer and drug. Values of hydrodynamic diameter, zeta potential,
and PDI indicate monodispersity, nonaggregation, and colloidal stability
(<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Table S1</ext-link>). In addition, these values show
the feasibility of using NPCBD for intravenous administration, which
is confirmed by the redispersion assay showing that both the Dh and
PDI remain practically unchanged considering possible temperature
ranges according to the physiological medium.</p><table-wrap id="tbl1" position="float" orientation="portrait"><label>Table 1</label><caption><title>NPCBD Physicochemical Properties,
Including Hydrodynamic Diameter (Dh, by Intensity), Polydispersity
Index (PDI); Zeta Potential (δ), Loading Efficiency (LE%), and
Mass of CBD Per mg of NPs Expressed in μg/mg NPs</title></caption><table frame="hsides" rules="groups" border="0"><colgroup span="1"><col align="char" char="±" span="1"/><col align="left" span="1"/><col align="char" char="±" span="1"/><col align="char" char="±" span="1"/><col align="char" char="±" span="1"/><col align="left" span="1"/><col align="left" span="1"/></colgroup><thead><tr><th style="border:none;" align="center" char="±" colspan="1" rowspan="1">ID</th><th style="border:none;" align="center" colspan="1" rowspan="1">CBD % w/w</th><th style="border:none;" align="center" char="±" colspan="1" rowspan="1">Dh (nm)</th><th style="border:none;" align="center" char="±" colspan="1" rowspan="1">PDI</th><th style="border:none;" align="center" char="±" colspan="1" rowspan="1">δ (mV)</th><th style="border:none;" align="center" colspan="1" rowspan="1">LE%</th><th style="border:none;" align="center" colspan="1" rowspan="1">CBD μg/mg NPs</th></tr></thead><tbody><tr><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">CBD-loaded NPs</td><td style="border:none;" align="left" colspan="1" rowspan="1">10</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">240.1 ± 10.1</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">0.15 ± 0.03</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">–21.5 ± 0.60</td><td style="border:none;" align="left" colspan="1" rowspan="1">82</td><td style="border:none;" align="left" colspan="1" rowspan="1">63</td></tr><tr><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">Unloaded NPs</td><td style="border:none;" align="left" colspan="1" rowspan="1">-</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">261.6 ± 10.2</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">0.16 ± 0.02</td><td style="border:none;" align="char" char="±" colspan="1" rowspan="1">–24.1 ± 0.76</td><td style="border:none;" align="left" colspan="1" rowspan="1">-</td><td style="border:none;" align="left" colspan="1" rowspan="1">-</td></tr></tbody></table></table-wrap><fig id="fig1" position="float" orientation="portrait"><label>Figure 1</label><caption><p>NPCBD possesses suitable physicochemical properties for enhancing
CBD pharmacological properties. (A) FESEM micrographs of NPCBD; (B)
extracted histogram of NPCBD distribution; (C) NPCBD stability showed
in terms of the hydrodynamic diameter in nm, and the polydispersity
index (PDI) in a range of temperatures from 20 to 42 °C; (D)
FTIR spectra of the neat PLGA, NP0, NPCBD, and the free drug; (E)
stability of free CBD when compared to NPCBD up to 21 days incubated
in ACSF at 37 °C. Data expressed as % of CBD remaining analyzed
by HPLC (data are represented as mean ± SEM, <italic toggle="yes">N</italic> ≥ 4 experimental replicates. *<italic toggle="yes">p</italic> &lt; 0.05,
one-way ANOVA followed by Tukey’s posthoc test).</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr2" position="float" orientation="portrait" xlink:href="mp3c00244_0001.jpg"><?image-name mp3c00244_0001.jpg?><?image-size 944636?><?image-md5 060185ff44885a5670b1b3ecaa0bc5c5?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 822?><?image-original-width 872?><?image-scaled-height 3421?><?image-scaled-width 3629?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/060185ff4488/mp3c00244_0001.jpg?><?thumb-name mp3c00244_0001.gif?><?thumb-size 3723?><?thumb-md5 fda9cf98790321072132208777b3c138?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 94?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/fda9cf987903/mp3c00244_0001.gif?></graphic></fig><p>To provide information regarding the stability
of NPCBD in the
presence of potential temperature changes, the hydrodynamic diameter
and PDI evolution were evaluated by DLS over a temperature range according
to the human biological milieu (<xref rid="fig1" ref-type="fig">Figure <xref rid="fig1" ref-type="fig">1</xref></xref>C). Both parameters remained constant, indicating that
NPCBD possesses adequate thermal behavior for the proposed application
showing good stability with minor changes at temperatures ranging
from 20 to 42 °C.</p><p>ATR-FTIR was used to determine the chemical
identity and interaction
between CBD and PLGA in the resulting NPCBD (<xref rid="fig1" ref-type="fig">Figure <xref rid="fig1" ref-type="fig">1</xref></xref>D). It was noted that CBD and NPCBD shared
a common spectral doublet feature between 1580 and 1620 cm<sup>–1</sup>, with the peak center and the width of the band being slightly different
among them. The double peak is centered at 1583 and 1627 cm<sup>–1</sup> for free CBD and 1585 and 1622 cm<sup>–1</sup> for NPCBD.
These bands arise from the C=C stretching vibration of the
aromatic ring and the C=C stretches in the cyclohexane ring
of CBD, confirming the presence of the drug in the system.</p><p>Moreover,
a study of the system’s stability in suspension
in ACSF was performed to study how the polymeric particle protects
the integrity of CBD. No differences among free CBD and NPCBD were
observed during the first week (<xref rid="fig1" ref-type="fig">Figure <xref rid="fig1" ref-type="fig">1</xref></xref>E). However, it can be noticed that the amount of CBD
remaining in the formulation after 21 days of incubation was considerably
higher in the NPCBD, with 37% CBD remaining, compared to 18% on the
free CBD. Thus, our engineered system shows enhanced stability provided
by the polymeric particle entrapping the CBD, potentially increasing
its bioavailability in biological fluids.</p></sec><sec id="sec3.2"><label>3.2</label><title>NPCBD Induced an Amenable Inflammatory Profile
Over THP-1 and HMC3</title><p>It is crucial to know the potential toxic
effect of our NPCBD on relevant cell populations such as macrophages
(THP-1) and microglia (HMC3) to ensure a suitable immune response.
To study any potential detrimental immune response, we assessed NPCBD
toxicity on THP-1 cells, a monocyte-like cell line derived from the
blood of a young patient with acute monocytic leukemia, which is a
robust tool for studying monocyte function and response in health
and disease scenarios.<sup><xref ref-type="bibr" rid="ref19">19</xref></sup> The biological
response was compared to that of the well-known pro-inflammatory molecule
LPS, which triggers a robust and reproducible inflammatory response
(<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>). THP-1 cells
were exposed to 100 ng/mL LPS or NPCBD suspension at concentrations
ranging from 0.1 to 0.005 mg/mL. In order to evaluate how cells respond
to NPCBD, cultures were treated with the CBD formulation over 3 days
(<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>A). No statistically
significant differences were appreciated among groups in terms of
metabolic activity and dsDNA content, but in the case of the highest
concentration of NPCBD, a significant decrease from an average value
of 0.33 to 0.13 μg/mL in dsDNA content was shown. Hence, data
showed that 0.1 mg/mL NPCBD (corresponding to 2 μM CBD) exhibited
a cytotoxic effect potentially due to the high concentration of the
formulation for an <italic toggle="yes">in vitro</italic> application (<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>B). However, the
cytotoxic effect can be mild even when NPCBD is used at a 1000×
higher concentration than the LPS..</p><fig id="fig2" position="float" orientation="portrait"><label>Figure 2</label><caption><p>NPCBD treatment for 3 days did not induce
significant changes in
the THP-1 inflammatory state. (A) Experimental workflow of in THP-1 <italic toggle="yes">in vitro</italic> model. (B) dsDNA concentration was determined by
Picogreen analysis, and (C) metabolic activity of the culture was
determined by alamarBlue after 3 days of treatment with NPCBD. Determination
of the release of pro-inflammatory (D–I) and anti-inflammatory
(J–K) cytokines from the THP-1 cells after 3 days of treatment
with NPCBD at four doses (mg/mL). Cytokine concentration released
to the supernatant was analyzed by multiplex ELISA. Data are represented
as mean ± SEM, <italic toggle="yes">N</italic> ≥ 4 experimental replicates.
*<italic toggle="yes">p</italic> &lt; 0.05, **<italic toggle="yes">p</italic> &lt; 0.01, ***<italic toggle="yes">p</italic> &lt; 0.001 vs Healthy cells. One-way ANOVA followed by
Tukey’s posthoc test.</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr3" position="float" orientation="portrait" xlink:href="mp3c00244_0002.jpg"><?image-name mp3c00244_0002.jpg?><?image-size 196823?><?image-md5 ee652e73e5c8bf5890cbfe09926af129?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 3882?><?image-original-width 2400?><?image-scaled-height 1252?><?image-scaled-width 774?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/ee652e73e5c8/mp3c00244_0002.jpg?><?thumb-name mp3c00244_0002.gif?><?thumb-size 5698?><?thumb-md5 88ba04bbb5faf7922f0ef8cd6e787af6?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 162?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/88ba04bbb5fa/mp3c00244_0002.gif?></graphic></fig><p>To study the potential immune and inflammatory
response to NPCBD,
we quantified the secretion of nine cytokines that play a pivotal
role in ameliorating or worsening inflammation.<sup><xref ref-type="bibr" rid="ref20">20</xref></sup> The secreted biomarkers from monocyte-derived macrophages,
such as the pro-inflammatory cytokines, TNF-α, IL-1β,
IL-6, IL-8, IL-12, and IFN-γ (<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>D–I) and anti-inflammatory cytokines,
IL-4, IL-10, and IL-13 (<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>H–L) were studied. The response of THP-1 to inflammatory
insults such as LPS is widely reported, and as was expected, the cell
line exhibited a pro-inflammatory stage similar to the one found in
human monocyte-derived macrophages.<sup><xref ref-type="bibr" rid="ref19">19</xref></sup> When
cells were treated with NPCBD, all of the groups presented a different
cytokine phenotype than the LPS group. Notably, the LPS-treated group
showed a significantly higher release of TNF-α of 11,900% (7
pg/mL compared to 833 pg/mL) and IL-1β of 2,980% (5 to 149 pg/mL)
than NPCBD or Healthy (untreated) cells, suggesting a more amenable
environment for the cells. However, for IL-6, NPCBD-treated groups
secreted a significantly larger amount of 2,980% (5–149 pg/mL)
of the cytokine than the healthy group, showing that the NPCBD might
induce some inflammatory response through IL-6 upregulation. Recently,
CBD’s ability to modulate IL-6 secretion in human monocytes
after LPS-induced inflammation has been reported.<sup><xref ref-type="bibr" rid="ref21">21</xref></sup> In contrast with our findings, a downregulation was reported
independent of the CBD dose (0.5, 1, and 10 μM CBD). However,
the effect on cytokine secretion by CBD alone was not reported. In
contrast, our results showed an apparent dose-dependent influence
on IL-6 release, similar to that of LPS-treated cells when cells were
exposed to 0.1 mg/mL (2 μM CBD) and 0.05 mg/mL (1 μM CBD).
A sex-dependent increase in IL-6 release in healthy animals after
CBD treatment has been reported to be considerably higher in healthy
males.<sup><xref ref-type="bibr" rid="ref22">22</xref></sup> However, further studies are needed
to characterize the effects of CBD on inflammatory cytokines in healthy
donors and sex-related differences on IL-6 expression. A similar effect
has been reported in IL-12 and IFN-γ related to Th1 activation
and proliferation.<sup><xref ref-type="bibr" rid="ref20">20</xref></sup> However, these values
are observed only in the two higher concentrations, while no differences
were seen when cells were treated with lower doses of NPCBD (<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>H–I).</p><p>Regarding the anti-inflammatory cytokines, no significant differences
were seen in any cytokine except IL-4 (<xref rid="fig2" ref-type="fig">Figure <xref rid="fig2" ref-type="fig">2</xref></xref>J–L). A significantly higher release
of the anti-inflammatory IL-4, an increase of 200% (0.2 pg/mL compared
to more than 0.4 pg/mL), was shown in all NPCBD groups. However, as
seen with IL-12 and IFN-γ, the physiological relevance of these
differences may be insignificant due to the detected low concentrations
of the cytokine. Altogether, these results showed the potential safety
of the engineered NPCBD, preventing an unwanted detrimental pro-inflammatory
response. THP-1 cells are widely used as an <italic toggle="yes">in vitro</italic> model to study inflammatory signaling since their behavior resembles
one of freshly isolated primary human peripheral blood monocyte-derived
macrophages. However, it might be noticed that some changes in gene
expression after LPS stimulation are different between them.<sup><xref ref-type="bibr" rid="ref23">23</xref></sup></p><p>Microglia are the first line of defense
of the CNS, and their function
and activation have been extensively studied in experimental models
mainly in rodent ones.<sup><xref ref-type="bibr" rid="ref24">24</xref></sup> However, the characterization
of human cells was limited due to the restricted availability of primary
sources of human microglia. Hence, human immortalized microglial cell
lines were developed being HMC3, previously named CHME3, the most
reliable model nowadays.<sup><xref ref-type="bibr" rid="ref25">25</xref></sup> Hence, HMC3
was used as a model to test the effect of NPCBD in microglia, as was
done in THP-1. Briefly, HMC3 cells were exposed to 100 ng/mL LPS or
NPCBD suspension at concentrations ranging from 0.1 mg/mL to 0.005
mg/mL (<xref rid="fig3" ref-type="fig">Figure <xref rid="fig3" ref-type="fig">3</xref></xref>). Similarly
to what was observed in THP-1, only the highest concentration of NPCBD
showed a significant reduction of 28% (average of 2.21 μg/mL
for the healthy group vs 1.59 μg/mL in the case of 0.1 mg/mL
NPCBD treated group) in dsDNA concentration, while no differences
were observed in terms of metabolic activity. Furthermore, of all
the tested concentrations, NPCBD exhibited a similar cytokine release
profile to untreated healthy cells, with a significantly higher release
of every cytokine from the LPS-treated cells (<xref rid="fig3" ref-type="fig">Figure <xref rid="fig3" ref-type="fig">3</xref></xref>D–L). Microglia are the main immune
cell of the CNS, and they become activated under pathological conditions.<sup><xref ref-type="bibr" rid="ref26">26</xref></sup> The effect of CBD on healthy rodent microglia
(BV-2 cell line) has been recently reported showing no effect on Iba-1
expression when administered in doses of 1 μM, in correlation
with enhanced levels of Mitofusin-2 (Mfn2).<sup><xref ref-type="bibr" rid="ref26">26</xref></sup> Mfn2 is a mitochondrial fusion protein involved in the inflammatory
response mediated by microglia, whose levels were enhanced after CBD
administration. Interestingly, its knockdown abolished CBD’s
anti-inflammatory effect, proving its role in alleviating the inflammatory
response both <italic toggle="yes">in vitro</italic> and in an <italic toggle="yes">in vivo</italic> model of experimental autoimmune encephalomyelitis (EAE).<sup><xref ref-type="bibr" rid="ref26">26</xref></sup> Hence, our NPCBD exhibited a similar safe behavior
in concentrations from 0.1 mg/mL (2 μM CBD), showing a promising
therapeutic potential.</p><fig id="fig3" position="float" orientation="portrait"><label>Figure 3</label><caption><p>HMC3 inflammatory phenotype after NPCBD treatment for
3 days does
not show significant differences with healthy cells. (A) Experimental
workflow of HMC3 <italic toggle="yes">in vitro</italic> model. (B) dsDNA concentration
was determined by Picogreen analysis and (C) metabolic activity of
the culture was determined by alamarBlue after 3 days of treatment
with NPCBD. Determination of the release of pro-inflammatory (D–I)
and anti-inflammatory (J–K) cytokines from the HMC3 cells after
3 days of treatment with NPCBD at four doses. Cytokine concentration
released to the supernatant was analyzed by multiplex ELISA. Data
are represented as mean ± SEM, <italic toggle="yes">N</italic> ≥ 4
experimental replicates. *<italic toggle="yes">p</italic> &lt; 0.05, **<italic toggle="yes">p</italic> &lt; 0.01, ***<italic toggle="yes">p</italic> &lt; 0.001 vs Healthy
cells. One-way ANOVA followed by Tukey’s posthoc test.</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr4" position="float" orientation="portrait" xlink:href="mp3c00244_0003.jpg"><?image-name mp3c00244_0003.jpg?><?image-size 1453242?><?image-md5 fb2702e9d1d0a06320105477a4276cf3?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 1102?><?image-original-width 854?><?image-scaled-height 4583?><?image-scaled-width 3551?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/fb2702e9d1d0/mp3c00244_0003.jpg?><?thumb-name mp3c00244_0003.gif?><?thumb-size 5318?><?thumb-md5 21c6bf206526978ece1ff6fe644520f7?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 129?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/21c6bf206526/mp3c00244_0003.gif?></graphic></fig><p>In conclusion, NPCBD did not seem to induce a detrimental
inflammatory
environment in terms of the cytokine release profile compared with
the one induced by LPS treatment in THP-1 and HMC3. However, these
models present the inherent limitations of any <italic toggle="yes">in vitro</italic> assessment, such as the controlled and isolated environment and
the presence of just one cell population. In addition, the lack of
debris and dead cell removal is a limitation of every <italic toggle="yes">in vitro</italic> model that could conceal a better view of the inflammatory outcome
after treatment. However, taking this in mind, in the dose–response
assessed <italic toggle="yes">in vitro</italic>, NPCBD cytokine release profile
was closer to the healthy control group, especially in HMC3, but also
in the THP-1 model, exhibiting a promising behavior over the two main
immune cell types they will interact with the real <italic toggle="yes">in vivo</italic> scenario.</p></sec><sec id="sec3.3"><label>3.3</label><title>NPCBD Ameliorated OGD-Induced Cytotoxicity</title><p>To overcome some of the limitations described above, NPCBD was
tested in a complex model involving all of the relevant cell populations
found in the <italic toggle="yes">in vivo</italic> scenario. Various <italic toggle="yes">in
vitro</italic> models have been used over the last three decades to
mimic stroke.<sup><xref ref-type="bibr" rid="ref27">27</xref></sup> The OGD model has proved
to be the most reliable and reproducible.<sup><xref ref-type="bibr" rid="ref28">28</xref>,<xref ref-type="bibr" rid="ref29">29</xref></sup> However, it is not possible to fully reproduce <italic toggle="yes">in vitro</italic> the high complexity found in the poststroke brain tissue. To overcome
this limitation, diverse coculture models have been optimized to provide
more complexity to the information provided by the <italic toggle="yes">in vitro</italic> model.<sup><xref ref-type="bibr" rid="ref30">30</xref></sup> Hence, a wide variety of cell
populations, such as neurons, microglia, astrocytes, endothelial cells,
or monocytes, among others, have been cocultured with this purpose.<sup><xref ref-type="bibr" rid="ref30">30</xref>,<xref ref-type="bibr" rid="ref31">31</xref></sup> The primary cortical cells offer a more reliable model involving
an intricately mixed population of cells, including microglia, astrocytes,
neurons, and oligodendrocytes, among others. A PCC model of spinal
cord injury (SCI) was recently described by our group as a platform
to study acute and chronic inflammatory phases of SCI.<sup><xref ref-type="bibr" rid="ref32">32</xref></sup> While immortalized cell lines are more proliferative
and easier to maintain, primary cells are considered more physiologically
relevant.</p><p>Here, PCCs were optimized and implemented to test
the NPCBD therapeutic effect in a relevant OGD model of ischemia (<xref rid="fig4" ref-type="fig">Figure <xref rid="fig4" ref-type="fig">4</xref></xref>A). Afterward, cells
were exposed to OGD over 6 h, followed by 24 h of reperfusion as previously
described.<sup><xref ref-type="bibr" rid="ref28">28</xref></sup> PCCs were analyzed in terms
of dsDNA content and metabolic activity to ensure a balance of having
enough damage to appreciate differences among treatments without compromising
the viability of the whole culture. Metabolic activity and dsDNA content
of PCCs were determined at 3 (<xref rid="fig4" ref-type="fig">Figure <xref rid="fig4" ref-type="fig">4</xref></xref>B–E) and 7 days (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figure S1</ext-link>) after NPCBD treatment. As expected, significant differences
among groups were seen especially in metabolic activity that was considerably
higher (&gt;200%) in all the OGD-exposed groups and their dsDNA content
significantly lower, with a decrease to an average of 33% viability
(average of 0.34 μg/mL for healthy group vs 0.11 μg/mL
in the case of OGD group). However, most NPCBD concentrations tested
exhibited a similar value to the healthy cells. More importantly,
the dsDNA concentration was significantly higher in NPCBD-treated
groups after OGD, a 200% increase compared to that of the OGD groups
(0.11 μg/mL in the OGD group vs 0.2 μg/mL for the NPCBD
treated groups), suggesting a cytoprotective and regenerative effect
3 days after the treatment (<xref rid="fig4" ref-type="fig">Figure <xref rid="fig4" ref-type="fig">4</xref></xref>E). These results align with previous reports using
CBD in similar concentrations (from 1 to 10 μM) <italic toggle="yes">in vitro</italic>(<xref ref-type="bibr" rid="ref33">33</xref>) and <italic toggle="yes">ex vivo</italic>(<xref ref-type="bibr" rid="ref34">34</xref>) OGD models. Moreover, some reports have shown
cellular protection after OGD exposure by pretreating cells with CBD
at even lower doses (from 0.1 to 1 μM).<sup><xref ref-type="bibr" rid="ref35">35</xref>,<xref ref-type="bibr" rid="ref36">36</xref></sup> Interestingly, our results showed a great performance of the NPCBD
in restoring PCC viability after an OGD insult, even at 0.01 mg/mL
doses (corresponding to 0.2 μM), exhibiting great therapeutic
potential.</p><fig id="fig4" position="float" orientation="portrait"><label>Figure 4</label><caption><p>NPCBD restored dsDNA concentration after 6 h OGD and reperfusion
model of rat primary cortical cells. (A) Experimental workflow of
the PCC OGD <italic toggle="yes">in vitro</italic> model, immunocytochemistry after
the reperfusion step, against the glial fibrillary acidic protein
(GFAP) (astrocytes), Iba-1 (microglia), β-III-tubulin (β-Tub
III) (neurons), and Olig-2 (oligodendrocytes) and its relative presence
in the PCC quantified (data extracted from 5 pictures from 4 independent
samples, <italic toggle="yes">N</italic> = 4). Data presented as the mean ±
SD. Scale bar = 100 μm. dsDNA concentration was determined by
Picogreen analysis, and metabolic activity of the culture was determined
by alamarBlue after 3 days of treatment with NPCBD in healthy conditions
(B and D) or after OGD exposure (C and E). Data are represented as
mean ± SEM, <italic toggle="yes">N</italic> ≥ 4 experimental replicates.
*<italic toggle="yes">p</italic> &lt; 0.05, **<italic toggle="yes">p</italic> &lt; 0.01, ***<italic toggle="yes">p</italic> &lt; 0.001 vs Healthy or OGD cells. One-way ANOVA followed
by Dunnet’s posthoc test.</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr5" position="float" orientation="portrait" xlink:href="mp3c00244_0004.jpg"><?image-name mp3c00244_0004.jpg?><?image-size 1502585?><?image-md5 b8a6980a1a455368a3a09e7bbc39b457?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 1138?><?image-original-width 822?><?image-scaled-height 4743?><?image-scaled-width 3425?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/b8a6980a1a45/mp3c00244_0004.jpg?><?thumb-name mp3c00244_0004.gif?><?thumb-size 5246?><?thumb-md5 94378d2dbfc2a86552a7a8b247fc997d?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 138?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/94378d2dbfc2/mp3c00244_0004.gif?></graphic></fig><p>Seven days after the NPCBD treatment, group differences
were notably
reduced (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figure S1</ext-link>). However, differences
among the OGD-exposed and unexposed groups were still appreciable.
Furthermore, the same statistically significant upper trend in dsDNA
concentration was appreciated among OGD-exposed groups that received
NPCBD afterward (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figure S1D</ext-link>). All in all,
these results evidenced the potential of NPCBD to provide a friendly
milieu for CNS cells and exhibit a potential cytoprotective effect
after OGD.</p></sec><sec id="sec3.4"><label>3.4</label><title>NPCBD Treatment Ameliorates OGD/R-Induced
Mitochondrial Impairment Both in HMC3 and PCC</title><p>The brain,
known for its exceptionally high energy consumption, heavily relies
on proper mitochondrial function. During a stroke, the ischemic event
induces mitochondrial dysfunction, impeding the electron transport
chain. Consequently, adenosine triphosphate (ATP) production is hindered,
leading to an overexpression and accumulation of reactive oxygen species
(ROS).<sup><xref ref-type="bibr" rid="ref37">37</xref></sup> Upon reperfusion in stroke, the
restored blood and oxygen supply trigger oxidative damage and cell
death through increased generation of mitochondrial ROS.<sup><xref ref-type="bibr" rid="ref38">38</xref></sup> Thus, it becomes imperative to investigate the
impact of NPCBD on mitochondrial physiology and its potential to alleviate
the effects of OGD-induced damage.</p><p>Mitochondrial performance
was assessed by measuring the oxygen consumption rate (OCR) and extracellular
acidification rate (ECAR) using the Mito Stress test under both healthy
and OGD conditions in the HMC3 cell line (<xref rid="fig5" ref-type="fig">Figure <xref rid="fig5" ref-type="fig">5</xref></xref>) and PCC (<xref rid="fig6" ref-type="fig">Figure <xref rid="fig6" ref-type="fig">6</xref></xref>). The titration of FCCP, an uncoupling agent
used to determine maximal respiration and calculate spare respiratory
capacity, was initially assessed to optimize the dosage for each cell
culture (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figures S2</ext-link> and <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">S3</ext-link>). OCR values directly relate to the mitochondrial electron
transport rate, while ECAR correlates with metabolic activity.<sup><xref ref-type="bibr" rid="ref32">32</xref></sup> Considering previous results suggesting that
lower concentrations of NPCBD exhibit more favorable performance over
PCCs, all subsequent tests were conducted using only 0.05 and 0.01
mg/mL, corresponding to 1.00 μM and 0.20 μM CBD, respectively.
The lowest concentration of 0.005 mg/mL (equivalent to 0.10 μM
CBD) showed no differences from the 0.01 mg/mL concentration and was
thus excluded from further assessments.</p><fig id="fig5" position="float" orientation="portrait"><label>Figure 5</label><caption><p>Mitochondrial dysfunction
in HMC3 after OGD was ameliorated by
NPCBD treatment. Cell Mito Stress analysis of mitochondrial respiratory
capacity in HMC3 cells in the OGD model. Cells were incubated 30 min
before the experiment in an XF assay medium supplemented with 5 mM
glucose and 2 mM glutamine and subsequently injected with oligomycin
(1 μM), FCCP (0.5 μM), antimycin (1 μM), and rotenone
(1 μM). Continuous OCR values (pmol/min/10,000 cells) (A) ECAR
values (mpH/min/10,000 cells) (C) and OCR parameters 3 days after
the treatment are reported (<italic toggle="yes">N</italic> ≥ 3, *<italic toggle="yes">p</italic> &lt; 0.05). One-way ANOVA followed by Dunnet’s
posthoc test</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr6" position="float" orientation="portrait" xlink:href="mp3c00244_0005.jpg"><?image-name mp3c00244_0005.jpg?><?image-size 874209?><?image-md5 7314dc85d5b9e9b7415f9fb4f3b11c9c?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 779?><?image-original-width 854?><?image-scaled-height 3242?><?image-scaled-width 3553?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/7314dc85d5b9/mp3c00244_0005.jpg?><?thumb-name mp3c00244_0005.gif?><?thumb-size 3310?><?thumb-md5 5ab3d5fd3f11073b06a6441e2e30e26d?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 91?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/5ab3d5fd3f11/mp3c00244_0005.gif?></graphic></fig><fig id="fig6" position="float" orientation="portrait"><label>Figure 6</label><caption><p>Mitochondrial dysfunction in PCC after OGD was ameliorated
by NPCBD
treatment. Cell Mito Stress analysis of mitochondrial respiratory
capacity in PCC cells in the OGD model. Cells were incubated 30 min
before the experiment in an XF assay medium supplemented with 5 mM
glucose and 2 mM glutamine and subsequently injected with oligomycin
(1 μM), FCCP (1.5 μM), antimycin (1 μM), and rotenone
(1 μM). Continuous OCR values (pmol/min/10,000 cells) (A), ECAR
values (mpH/min) (B), and OCR parameters (C) 3 days after the treatment
are reported (<italic toggle="yes">N</italic> ≥ 3, *<italic toggle="yes">p</italic> &lt;
0.05). One-way ANOVA followed by Dunnet’s posthoc test</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr7" position="float" orientation="portrait" xlink:href="mp3c00244_0006.jpg"><?image-name mp3c00244_0006.jpg?><?image-size 866165?><?image-md5 198690af7dc2783a55c380c477433bc8?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 790?><?image-original-width 858?><?image-scaled-height 3286?><?image-scaled-width 3568?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/198690af7dc2/mp3c00244_0006.jpg?><?thumb-name mp3c00244_0006.gif?><?thumb-size 3336?><?thumb-md5 d9e7e289c464678744e3f9685ea7f005?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 92?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/d9e7e289c464/mp3c00244_0006.gif?></graphic></fig><p>During an OGD insult, astrocytes and microglia
become reactive
due to massive cell death, leading to impaired mitochondrial function.<sup><xref ref-type="bibr" rid="ref33">33</xref></sup> To discern the effects of NPCBD on mitochondrial
activity, we evaluated mitochondrial respiration in healthy cells,
finding no statistically significant differences compared with the
healthy group (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figure S4</ext-link>) across all measured
parameters. However, the OGD/R insult on HMC3 cells caused a significant
decline in basal respiration compared with the healthy control (<xref rid="fig5" ref-type="fig">Figure <xref rid="fig5" ref-type="fig">5</xref></xref>). Notably, at the
lower NPCBD dose (0.01 mg/mL, corresponding to 0.20 μM of CBD),
OCR values affected by the OGD insult were restored, closely resembling
those of the untreated (HEALTHY) cells. These findings align with
previous studies using CBD at similar doses in cell lines such as
hippocampal neurons (HT22 cells)<sup><xref ref-type="bibr" rid="ref33">33</xref></sup> and
BE(2)-M17 neuroblastoma cells.<sup><xref ref-type="bibr" rid="ref39">39</xref></sup></p><p>Furthermore, our data suggest a dose-dependent effect of NPCBD
on HMC3, with the higher dose not ameliorating OGD-induced mitochondrial
dysfunction. This aligns with previous findings demonstrating the
dose-dependent nature of CBD’s effects.<sup><xref ref-type="bibr" rid="ref39">39</xref></sup> ECAR, an indicator of glycolysis, was also impaired after
the OGD insult, showing some recovery after NPCBD treatment at 0.01
mg/mL, although the differences were not statistically significant
(<xref rid="fig5" ref-type="fig">Figure <xref rid="fig5" ref-type="fig">5</xref></xref>B).</p><p>The ability of NPCBD to counteract mitochondrial damage induced
by the OGD insult was also assessed in PCC (<xref rid="fig6" ref-type="fig">Figure <xref rid="fig6" ref-type="fig">6</xref></xref>). Interestingly, an increase in both OCR
and ECAR values was observed after the OGD insult, potentially resulting
from microglia and astrocyte activation.<sup><xref ref-type="bibr" rid="ref32">32</xref></sup> At the higher dose of 0.05 mg/mL, the values in healthy cells were
similar to those exhibited by the group treated with OGD, suggesting
a potential effect on the activation of neuroglia cells (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">Figure S5</ext-link>), while the lower dose exhibited a
profile similar to untreated cells. NPCBD significantly ameliorates
mitochondrial dysfunction at both doses, as indicated by the reported
OCR values in <xref rid="fig6" ref-type="fig">Figure <xref rid="fig6" ref-type="fig">6</xref></xref>C. Thus, a significant decrease in all tested parameters can be observed
in groups receiving NPCBD after the OGD insult, suggesting the treatment’s
ability to restore mitochondrial activity to levels close to those
of the control group.</p><p>The effects of OGD on HMC3 monoculture
did not mirror the data
obtained from PCC coculture. A potential explanation is the cell communication
within the PCC, which is more representative of cortical response
in vivo, incorporating compensatory mechanisms in the mixed population.
These considerations are crucial given CBD’s promiscuity in
its action on different molecular targets. Similar results have been
reported in other studies employing monocultures and cocultures.<sup><xref ref-type="bibr" rid="ref40">40</xref></sup> Overall, results from Seahorse analysis indicate
a neuroprotective effect provided by NPCBD, reducing OGD-induced oxidative
stress, in line with previous findings.<sup><xref ref-type="bibr" rid="ref33">33</xref>,<xref ref-type="bibr" rid="ref39">39</xref></sup></p></sec><sec id="sec3.5"><label>3.5</label><title>NPCBD Successfully Ameliorated Inflammation
Related to Hypoxic Conditions After OGD Exposure</title><p>Stroke presents
a highly complex pathophysiology.<sup><xref ref-type="bibr" rid="ref27">27</xref></sup> The
innate immune system is activated after ischemic insult due to the
accumulation of cell debris and dying neurons. Hence, the primary
response is led by microglia, the resident immune population of the
CNS, which are the first population to become activated, and monocytes
from the peripheral immune system, differentiated into macrophages
(that migrate into the ischemic site).<sup><xref ref-type="bibr" rid="ref24">24</xref></sup> After their activation, both cell populations can polarize into
phenotypes capable of promoting or ameliorating the inflammatory response.<sup><xref ref-type="bibr" rid="ref24">24</xref></sup> After the ischemic event, microglia and astrocytes
become reactive, producing cytokines, chemokines, and growth factors.<sup><xref ref-type="bibr" rid="ref41">41</xref></sup> Hence, both neuroglial cells lead to secondary
neuroinflammation that promotes further injury, which results in cell
death and promotes recovery. These proinflammatory signals from the
resident immune cells induce the infiltration of a wide range of inflammatory
cells such as monocytes, neutrophils, or T cells. Hence, the secretion
of some of the critical cytokines associated with ischemic stroke
was assessed 24 h after NPCBD treatment (<xref rid="fig7" ref-type="fig">Figure <xref rid="fig7" ref-type="fig">7</xref></xref>A–G). Furthermore, a deeper analysis
of the inflammatory state of the PCCs was assessed 3 and 7 days after
OGD exposure and NPCBD treatment through proteome profiler analysis
(<xref rid="fig7" ref-type="fig">Figure <xref rid="fig7" ref-type="fig">7</xref></xref>H). After
24 h of NPCBD treatment, the level of secreted pro-inflammatory cytokines
was higher in the OGD than in the others, being statistically significant
only in the case of KC/GRO, 90% decrease compared to the OGD group
(2400 pg/mL in the OGD group versus 200 pg/mL in NPCBD treated groups),
a decrease of 75% of IL-5 (11.4 pg/mL on average for the OGD group
versus 3 pg/mL in NPCBD treated groups), and a decrease of 93% of
IL-6 (714 pg/mL in the OGD group versus 55 pg/mL in NPCBD treated
groups). It can be noticed that KC/GRO release (also known as CXCL1)
was ten times higher in OGD-exposed cells than in the groups treated
afterward with NPCBD (<xref rid="fig6" ref-type="fig">Figure <xref rid="fig6" ref-type="fig">6</xref></xref>A). This was also observed in the heatmap representing the
relative expression of cytokines, when an increase in the relative
expression of CXCL1 was seen for the OGD-exposed groups at 3 days,
slightly decreasing at 7 days. It has been previously reported that
neutrophil infiltration occurs as a response to increased levels of
chemokines in the damaged tissue, including CXCL-1 chemokine. Moreover,
inhibiting CXCL-1/CXCR2 (CXC group receptor 2) activation dramatically
reduced the inflammatory response after stroke and the lesion area.<sup><xref ref-type="bibr" rid="ref42">42</xref></sup></p><fig id="fig7" position="float" orientation="portrait"><label>Figure 7</label><caption><p>Inflammatory response of PCC after OGD and NPCBD treatment.
Determination
of the release of pro-inflammatory (A–E), anti-inflammatory
(F), and dual (G) cytokines from the PCC after 24 h of treatment with
NPCBD at two different doses. Cytokine concentration released to the
supernatant was analyzed by multiplex ELISA. Data are represented
as mean ± SEM, <italic toggle="yes">N</italic> ≥ 4 experimental replicates.
*<italic toggle="yes">p</italic> &lt; 0.05, **<italic toggle="yes">p</italic> &lt; 0.01, ***<italic toggle="yes">p</italic> &lt; 0.001 vs Healthy cells. One-way ANOVA followed by
Tukey’s posthoc test. (H) Hierarchical clustering analysis
of 79 analytes. The mean pixel density was analyzed by the proteome
profile array of proteins secreted by PCC in the supernatant. Colors
define activation as highly expressed (red) and no expression (blue).
Treatment was given at two different doses after OGD exposure, and
the supernatant was analyzed at two time points, day 3 and day 7.
The experiment was carried out in three biological replicates, and
supernatants were pooled together to perform the proteome profiler
array. Each analyte on the array was printed in duplicate. The values
shown per time point are an average of both.</p></caption><graphic xmlns:xlink="http://www.w3.org/1999/xlink" id="gr8" position="float" orientation="portrait" xlink:href="mp3c00244_0007.jpg"><?image-name mp3c00244_0007.jpg?><?image-size 238317?><?image-md5 0b35efa369ed08cbc998f4b2f44c7169?><?image-image-server-status LOAD_COMPLETED?><?image-original-height 2729?><?image-original-width 1936?><?image-scaled-height 1091?><?image-scaled-width 774?><?image-cloudpmc-urn urn:cdn:blobs/2d26/10988560/0b35efa369ed/mp3c00244_0007.jpg?><?thumb-name mp3c00244_0007.gif?><?thumb-size 11537?><?thumb-md5 747c302fb1e984822f039b299cd5660f?><?thumb-image-server-status NEVER_LOAD?><?thumb-scaled-height 141?><?thumb-scaled-width 100?><?thumb-cloudpmc-urn urn:cdn:blobs/2d26/10988560/747c302fb1e9/mp3c00244_0007.gif?></graphic></fig><p>On the contrary, it was reported that IL-5, upregulated
here in
the OGD-exposed group, potentially has a protective role on patients
of acute ischemic stroke.<sup><xref ref-type="bibr" rid="ref43">43</xref></sup> Thus, the upregulation
seen here (<xref rid="fig7" ref-type="fig">Figure <xref rid="fig7" ref-type="fig">7</xref></xref>D) is related to the internal mechanism of protection mediated by
microglia and astrocytes to induce a protective effect during the
acute phase after ischemic insult. Furthermore, IL-6 is one of the
critical factors that is upregulated after ischemic stroke.<sup><xref ref-type="bibr" rid="ref44">44</xref></sup> After OGD exposure, a significant increase in
IL-6 secretion was detected with values seven times higher than the
healthy group, and a subsequent reduction after NPCBD treatment was
noticed (<xref rid="fig7" ref-type="fig">Figure <xref rid="fig7" ref-type="fig">7</xref></xref>E).
IL-6 leads to the activation and recruitment of neutrophils and monocytes
and enhances local inflammatory response.<sup><xref ref-type="bibr" rid="ref45">45</xref></sup> The secretion of other crucial markers of ischemic stroke was relatively
reduced after NPCBD treatment, as seen in the heatmap. The tumor necrosis
factor receptor superfamily member 11B (TNFSF11), which is essential
for immune system regulation, showed similar values to the healthy
control after the treatment with 0.05 mg/mL NPCBD (<xref rid="fig7" ref-type="fig">Figure <xref rid="fig7" ref-type="fig">7</xref></xref>H). CCL21, a small cytokine
that belongs to the CC chemokine family, was upregulated 3 days after
OGD, while the values after NPCBD treatment were similar to healthy
cells. CCL21 has been reported to be upregulated after ischemic events,
such as limb ischemia, and regulates migration and homing of T lymphocytes
via CCR7.<sup><xref ref-type="bibr" rid="ref46">46</xref></sup> All of these cytokines are
consistently secreted by reactive microglia and astrocytes in response
to ischemic events and are often used as biomarkers to indicate neuroinflammatory
or neurodegenerative disorders. A hierarchical cluster analysis was
performed on the results obtained for all of the treated groups, showing
two clusters in terms of similarity. One includes Healthy 3D, NPCBD
3D (both concentrations tested), and 0.05 mg/mL NPCBD 7D. Hence, a
similar inflammatory profile to untreated healthy cells, in terms
of secreted cytokines, was noticed by NPCBD-treated cells after OGD
exposure, exhibiting a promising potential to address the inflammatory
response in the subacute phase after the ischemic insult.</p><p>The
effect of NPCBD on OGD-related inflammation is consistent with
many previous studies using CBD in classical formulations.<sup><xref ref-type="bibr" rid="ref13">13</xref>,<xref ref-type="bibr" rid="ref26">26</xref>,<xref ref-type="bibr" rid="ref35">35</xref>,<xref ref-type="bibr" rid="ref36">36</xref></sup> Neuroinflammation is pivotal in secondary injury after cerebral
ischemia-induced brain injury. Thus, a reduction in the main pro-inflammatory
cytokines and chemokines after the treatment with NPCBD proves its
potential as a new CBD formulation to ameliorate ischemic-related
inflammatory processes in the CNS. The mechanism of action of CBD
is still a matter of discussion nowadays. The endocannabinoid receptor
CB<sub>2</sub> is principally expressed in immune cells, including
microglial cells. It can be found in other cell types, such as fibroblasts
and chondrocytes, being a peripheral cannabinoid receptor.</p><p>Moreover,
it was described as present in nervous tissues, such
as dorsal root ganglia or cochlear inner hair cells.<sup><xref ref-type="bibr" rid="ref47">47</xref></sup> We hypothesized that the effect of the NPCBD would be through
CB<sub>2</sub> interaction, and to prove it, we blocked the receptor
with the selective CB<sub>2</sub> inverse agonist SR144528. However,
no significant differences were appreciated in terms of metabolic
activity, dsDNA content, or cytokine release (data not shown). Hence,
we could not confirm whether the NPCBD system acted through this receptor.
Since CBD is a promiscuous drug capable of interacting with different
receptors in the endocannabinoid system, some of which belong to the
family of G-protein-coupled receptors, there are many possible routes
for NPCBD to act. Previous reports showed a partial reduction of CBD
protection after OGD on pericytes by 5HT<sub>1A</sub> antagonism.<sup><xref ref-type="bibr" rid="ref48">48</xref></sup> According to the authors, CBDs can activate
5HT<sub>1A</sub>, the molecular target underpinning CBD’s therapeutic
effect on stroke. The role of 5-HT<sub>1A</sub> and PPARγ was
also reported in the context of the permeability of the BBB, which
was increased by CBD treatment.<sup><xref ref-type="bibr" rid="ref40">40</xref></sup></p><p>Moreover, it has been reported that CB<sub>2</sub> and 5HT1A receptors
may interact to form macromolecular complexes.<sup><xref ref-type="bibr" rid="ref49">49</xref></sup> In a rodent model, a significant reduction in the expression
of CB<sub>2</sub>–5HT<sub>1A</sub>-Hets in CBD-treated rats
has been reported.<sup><xref ref-type="bibr" rid="ref49">49</xref></sup> Altogether, this supports
the hypothesis of the pivotal role of 5HT<sub>1A</sub> in the CBD-mediated
amelioration of the OGD damage. The pathology of ischemic stroke is
multifaceted, which makes a promiscuous drug, CBD, a potential candidate
for success compared with compounds aimed at a single target.<sup><xref ref-type="bibr" rid="ref40">40</xref></sup></p></sec><sec id="sec3.6"><label>4</label><title>Conclusions</title><p>The primary objective of
this investigation is to confirm the safety and efficacy of NPCBD <italic toggle="yes">in vitro</italic> by using two relevant human immune cell lines.
Furthermore, we aim to explore the potential of CBD in treating ischemic
events and compare its effects to those of traditional formulations.
In this study, we present the performance of a well-known polymeric
nanocarrier, PLGA, in delivering the highly hydrophobic drug CBD to
address neuroinflammation associated with ischemic stroke. Given the
favorable regulatory history and excellent properties of PLGA for
hydrophobic drug delivery, our NPCBD demonstrates enhanced potential
for successful translation to preclinical and clinical settings.</p><p>The physicochemical properties of our NPCBD formulation, including
hydrodynamic diameter, zeta potential, polydispersity, and stability
under physiological conditions, make it a potential candidate for
intravenously targeting inflammation. CBD’s high loading efficiency
within the PLGA matrix is also a significant advantage. In addition,
the <italic toggle="yes">in vitro</italic> OGD model used to test the formulation’s
ability to alleviate the inflammatory response was promising, demonstrating
a restorative effect on primary cortical cultures. The Mito Stress
studies also showed the formulation’s ability to restore mitochondrial
function in both HMC3 and PCC cultures at doses of 1 and 0.2 μM
of CBD, which is a critical factor in ameliorating OGD-induced mitochondrial
dysfunction. However, further studies are needed to assess the therapeutic
effects of NPCBD in an appropriate <italic toggle="yes">in vivo</italic> model
of an ischemic stroke.</p><p>The use of an <italic toggle="yes">in vitro</italic> model based on primary
cortical cultures for the purpose of robust stroke emulation presents
both advantages and challenges. On the one hand, the complexity of
multiple coexisting cell populations contributes to the robustness
of the model. However, this same feature also increases the variability,
making it difficult to distinguish statistically significant differences.
In this study, we confirmed that the CBD polymeric nanoformulation
exhibits physicochemical properties that can address the inherent
solubility problems of CBD while maintaining its bioactivity and expanding
its potential for intravenous therapeutic use. Furthermore, the ability
of NPCBD to reduce the inflammatory response induced by ischemic conditions
such as ischemic OGD was demonstrated in an <italic toggle="yes">in vitro</italic> model that incorporates mixed populations from the central nervous
system. In conclusion, we have developed, characterized, and evaluated
a straightforward CBD nanoparticulate polymeric delivery system <italic toggle="yes">in vitro</italic> to address neuroinflammation caused by ischemic
stroke.</p></sec></sec></body><back><notes id="notes1" notes-type="si"><title>Supporting Information Available</title><p>The Supporting Information is
available free of charge at <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/10.1021/acs.molpharmaceut.3c00244?goto=supporting-info">https://pubs.acs.org/doi/10.1021/acs.molpharmaceut.3c00244</ext-link>.<list id="silist1" list-type="simple"><list-item><p>Variability of NPCBD physicochemical properties among
batches (Table S1); effect of 7 day NPCBD treatment after a 6 h OGD
and reperfusion model of rat primary cortical cells (Figure S1); FCCP
optimization with the XF Cell Mito Stress Test on HMC3 (Figure S2);
FCCP optimization with the XF Cell Mito Stress test on PCC (Figure
S3); Cell Mito Stress analysis of mitochondrial respiratory capacity
in HMC3 cells under normoxia (Figure S4); Cell Mito Stress analysis
of mitochondrial respiratory capacity in PCC cells under normoxia
(Figure S5); the cytokine array detects changes in cytokines and chemokines
in the media describing the inflammatory phenotype of PCC after the
treatments (Figure S6); analysis of 79 analytes related to inflammation
(Figure S7) (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://pubs.acs.org/doi/suppl/10.1021/acs.molpharmaceut.3c00244/suppl_file/mp3c00244_si_001.pdf">PDF</ext-link>)</p></list-item></list></p></notes><sec sec-type="supplementary-material"><title>Supplementary Material</title><supplementary-material content-type="local-data" id="sifile1" position="float" orientation="portrait"><media xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="mp3c00244_si_001.pdf" position="float" orientation="portrait"><?suppdata-name mp3c00244_si_001.pdf?><?suppdata-size 553522?><?suppdata-md5 4cfc823e3e0500344850c8d14249f855?><?suppdata-image-server-status NEVER_LOAD?><?suppdata-mime-type application?><?suppdata-mime-sub-type pdf?><?suppdata-cloudpmc-urn urn:app:2d26/10988560/4cfc823e3e05/mp3c00244_si_001.pdf?><caption><p>mp3c00244_si_001.pdf</p></caption></media></supplementary-material></sec><notes notes-type="" id="notes3"><title>Author Contributions</title><p><sup>#</sup> M.T.C. and M.A.-W.
contributed equally to this work.</p></notes><notes notes-type="COI-statement" id="notes2"><p>The authors
declare no competing financial interest.</p></notes><ack><title>Acknowledgments</title><p>This
publication has emanated from research supported
partly by a grant from Science Foundation Ireland and is cofunded
under the European Regional Development Fund under Grant number 13/RC/2073_P2.
This project has received funding from the European Union’s
Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie
grant agreement No. 713690. This work was funded by the European Union
Horizon 2020 Programme (H2020-MSCA-IF-2017) under the Marie Skłodowska-Curie
Individual Fellowship Grant Agreement No. 797716. This project has
received funding from the European Union’s Horizon 2020 research
and innovation programme under the Marie Skłodowska-Curie Grant
agreement No. 813263. The authors acknowledge the facilities and scientific
and technical assistance of the Centre for Microscopy &amp; Imaging
at the University of Galway (<uri xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="https://imaging.universityofgalway.ie/imaging/">https://imaging.universityofgalway.ie/imaging/</uri>).</p></ack><ref-list><title>References</title><ref id="ref1"><mixed-citation publication-type="journal" id="cit1"><name name-style="western"><surname>Feigin</surname><given-names>V. L.</given-names></name>; <name name-style="western"><surname>Brainin</surname><given-names>M.</given-names></name>; <name name-style="western"><surname>Norrving</surname><given-names>B.</given-names></name>; <name name-style="western"><surname>Martins</surname><given-names>S.</given-names></name>; <name name-style="western"><surname>Sacco</surname><given-names>R. L.</given-names></name>; <name name-style="western"><surname>Hacke</surname><given-names>W.</given-names></name>; <name name-style="western"><surname>Fisher</surname><given-names>M.</given-names></name>; <name name-style="western"><surname>Pandian</surname><given-names>J.</given-names></name>; <name name-style="western"><surname>Lindsay</surname><given-names>P.</given-names></name>
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