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Medicines delivered in pill form must overcome several hurdles to reach the bloodstream: stomach acid and proteases that degrade proteins, thick layers of mucus, and cellular tight junctions. Small molecules overcome these hurdles successfully. But larger biomacromolecules, such as insulin and monoclonal antibodies used to treat inflammation and malignancy, require parenteral administration.
To overcome this problem of delivering larger molecules orally, bioengineers created tiny (5-mm diameter) devices with flat bottoms. When such a device is swallowed, it rolls on the mucosal surface of the stomach until the flat bottom contacts the mucosa. The device then stays in that position, and gastric fluid triggers a tiny spring that pushes a small…