Kinetics of finite dose absorption through skin 1. Vanillylnonanamide

Dose-dependent effect on skin permeation of polar and non-polar compounds

The study of the relationship between the amount of drug applied to the skin and fraction of drug absorbed can improve our understanding of finite-dose percutaneous absorption in the development of topical products and risk assessment of hazardous chemical exposure. It has been previously shown that an increase in the dose applied to the skin leads to a decrease in the fraction of drug permeated the skin (dose-dependent effect). The objective of this research was to examine the dose-dependent effect using permeants of varying physiochemical properties. The dose-dependent effect was studied using human epidermal membrane under finite dose conditions in Franz diffusion cell with model permeants at doses ranging from 0.1 to 200 μg. The dose-dependent effect was evident with model permeants caffeine, corticosterone, dexamethasone, and estradiol, consistent with the relationship of decreasing fraction of dose permeated the skin at increasing the applied dose. However, no significant dose-dependent effect was observed for the polar model permeants urea, mannitol, tetraethyl ammonium, and ethylene glycol, suggesting different transport mechanisms for these permeants. It was also found that, at relatively high doses, estradiol, dexamethasone, and corticosterone could increase the permeation of polar and lipophilic permeants, which could counter the dose-dependent effect under the conditions studied.

Modeling the percutaneous absorption of solvent-deposited solids over a wide dose range: II. Weak electrolytes

Dermal absorption of weak electrolytes applied to skin from pharmaceutical and cosmetic compositions is an important consideration for both their efficacy and skin safety. We developed a mechanistic, physics-based framework that simulates this process for leave on applications following solvent deposition. We incorporated this framework into our finite dose computational skin permeation model previously tested with nonelectrolytes to generate quantitative predictions for weak electrolytes. To test the model, we analyzed experimental data from an in vitro human skin permeation study of a weak acid (benzoic acid) and a weak base (propranolol) and their sodium and hydrochloride salts from simple, ethanol/water vehicles as a function of dose and ionization state. Key factors controlling absorption are the pH and buffer capacity of the dose solution, the dissolution rate of precipitated solids into a lipid boundary layer and the rate of conversion of the deposited solid to its conjugate form as the nonionized component permeates and (sometimes) evaporates from the skin surface. The resulting framework not only describes the current test data but has the potential to predict the absorption of other weak electrolytes following topical application.

Percutaneous absorption of steroids from finite doses: Predicting urinary excretion from in vitro skin permeation testing

Pharmacokinetic (PK) models are widely used to describe drug permeation across the epidermal membrane barrier, the stratum corneum (SC). Here, we extend our previously reported diffusion and compartment-in-series models to describe plasma concentrations, urinary excretion-time profiles and exposure estimates after topically applied finite doses of solvent deposited solids. In vivo models were derived by convolution of a skin absorption input function for finite dosing with that for in vivo disposition PK. In vitro skin permeation test (IVPT) and in vivo urinary excretion data for cortisone, desoxycorticosterone, and testosterone were extracted from literature for model validation and establishment of in vitro - in vivo relationships (IVIVR). Both SC diffusion and SC 3-compartment-in-series PK models adequately described experimental in vitro and in vivo permeation data, with similar model parameter estimates for SC diffusion time and bioavailability. A satisfactory IVIVR was generated for cortisone, whereas testosterone and desoxycorticosterone showed higher bioavailability in vitro compared to in vivo. In recognising that future prospective studies need to both have an adequate sampling schedule and be harmonized for robust IVIVRs, we developed expressions for predicting extent of absorption and time for peak absorption for both in vitro and in vivo studies. Other study parameters, such as application site, applied dose, and application techniques, can also affect drug permeability through skin during dosage form metamorphosis after finite dose application, and a lack of correlation may result if these are poorly matched.

A Mechanistic Bayesian Inferential Workflow for Estimation of In Vivo Skin Permeation from In Vitro Measurements

Computational models can play an integral role in the chemical risk assessment of dermatological products. However, a limitation on the ability of mathematical models to extrapolate from in vitro measurements to in human predictions arises from context-dependence: modeling assumptions made in one setting may not carry over to another scenario. Mechanistic models of dermal absorption relate the skin penetration kinetics of permeants to their partitioning and diffusion across elementary sub-compartments of the skin. This endows them with a flexibility through which specific model components can be adjusted to better reflect dermal absorption in contexts that differ from the in vitro setting, while keeping fixed any context-invariant parameters that remain unchanged in the two scenarios. This paper presents a workflow for predicting in vivo dermal absorption by integrating a mechanistic model of skin penetration with in vitro permeation test (IVPT) measurements. A Bayesian approach is adopted to infer a joint posterior distribution of context-invariant model parameters. By populating the model with samples of context-invariant parameters from this distribution and adjusting context-dependent parameters to suit the in vivo setting, simulations of the model yield estimates of the likely range of in vivo dermal absorption given the IVPT data. This workflow is applied to five compounds previously tested in vivo. In each case, the range of in vivo predictions encompassed the range observed experimentally. These studies demonstrate that the proposed workflow enables the derivation of mechanistically derived upper bounds on dermal absorption for the purposes of chemical risk assessment.

In Vitro Human Skin Absorption of Solvent-deposited Solids: Niacinamide and Methyl Nicotinate

A quantitative understanding of the dose dependence of topical delivery is important to cosmetic and dermatological product development and to risk assessment for hazardous chemicals contacting the skin. Despite considerable research, predictive capability in this area remains limited. To this end we conducted an experimental skin absorption study of two closely related skin care agents, niacinamide (nicotinamide, NA) and methyl nicotinate (MN), and analyzed the results quantitatively using a transient diffusion model described separately (Yu et al. submitted for publication). Radiolabeled test compounds were solvent-deposited onto ex vivo human skin mounted in Franz diffusion cells over a dose range exceeding 4.5 orders of magnitude, and permeation was measured over a 1-4 day period. At low doses, the permeation rate of NA was approximately 60-fold lower than that of its lower melting, more lipophilic analog, MN; at high doses an even greater difference was observed. The difference can be qualitatively explained based on higher lipid solubility and lower crystallinity of MN relative to NA. Dissolution-limited mass transfer through a lipid layer at the SC surface is suggested. Relevance of the results to practical skin care formulations was confirmed by a parallel study of NA in an o/w emulsion.

Assessment of Vehicle Volatility and Deposition Layer Thickness in Skin Penetration Models

Systemic disposition of dermally applied chemicals is often formulation-dependent. Rapid evaporation of the vehicle can result in crystallization of active compounds, limiting their degree of skin penetration. In addition, the choice of vehicle can affect the permeant’s degree of penetration into the stratum corneum. The aim of this study is to build a predictive, mechanistic, dermal absorption model that accounts for vehicle-specific effects on the kinetics of permeant transport into skin. An existing skin penetration model is extended to explicitly include the effect of vehicle volatility over time. Using in vitro measurements of skin penetration by chemicals applied in both a saline and an ethanol solvent, the model is optimized to learn two vehicle-specific quantities: the solvent evaporation rate and the extent of permeant deposition into the upper stratum corneum immediately following application. The dermal disposition estimates of the trained model are subsequently compared against those of the original model using further in vitro measurements. The trained model showed a 1.5-fold improvement and a 19-fold improvement in overall goodness of fit among compounds tested in saline and ethanol solvents, respectively. The proposed model structure can thus form a basis for in vitro to in vivo extrapolations of dermal disposition for skin formulations containing volatile components.

Influence of experimental parameters on in vitro human skin permeation of Bisphenol A

Bisphenol A (BPA) in vitro skin permeation studies have shown inconsistent results, which could be due to experimental conditions. We studied the impact of in vitro parameters on BPA skin permeation using flow-through diffusion cells with ex-vivo human skin (12 donors, 3-12 replicates). We varied skin status (viable or frozen skin) and thickness (200, 400, 800 μm), BPA concentrations (18, 250 mg/l) and vehicle volumes (10, 100 and 1000 μl/cm²). These conditions led to a wide range of BPA absorption (2%-24% after 24 h exposure), peak permeation rates (J = 0.02-1.31 μg/cm²/h), and permeability coefficients (K_p = 1.6-5.2 × 10^-3 cm/h). This is the first time steady state conditions were reached for BPA aqueous solutions in vitro (1000 μl/cm² applied at concentration 250 mg/l). A reduction of the skin thickness from 800 and 400 μm to 200 μm led to a 3-fold increase of J (P < 0.05). A reduction of the vehicle volume from 1000 to 100 led to a 2-fold decrease in J (P > 0.05). Previously frozen skin led to a 3-fold increase in J compared to viable skin (P < 0.001). We found that results from published studies were consistent when adjusting J according to experimental parameters. We propose appropriate J values for different exposure scenarios to calculate BPA internal exposures for use in risk assessment.

Predicting Transdermal Uptake of Phthalates and a Paraben from Cosmetic Cream Using the Measured Fugacity

Transdermal uptake models compliment in vitro and in vivo experiments in assessing risk of environmental exposures to semivolatile organic compounds (SVOCs). A key parameter for mechanistic models is the chemical driving force for mass transfer from environmental media to human skin. In this research, we measure this driving force in the form of fugacity for chemicals in cosmetic cream and use it to model uptake from cosmetics as a surrogate for condensed environmental media. A simple cosmetic cream, containing no target analytes, was mixed with diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), and butyl paraben (BP) and diluted to make creams with concentrations ranging from 0.025% to 6%. The fugacity, relative to the pure compound, was measured using solid-phase micro extraction (SPME). We found that the relationship between the concentration and fugacity is highly nonlinear. The relative fugacity of the chemicals for a 2% w/w formulation was used in a diffusion-based model to predict transdermal uptake of each chemical and was compared with excretion data from a prior human subject study with the same formulation. Dynamic simulations of excretion are generally consistent with the results of the human subject experiment but sensitive to the input parameters, especially the time between cream application and showering.

Modeling of Drug Diffusion Based on Concentration Profiles in Healthy and Damaged Human Skin

Based on experimental drug concentration profiles in healthy as well as tape-stripped ex vivo human skin, we model the penetration of the antiinflammatory drug dexamethasone into the skin layers by the one-dimensional generalized diffusion equation. We estimate the position-dependent free-energy and diffusivity profiles by solving the conjugated minimization problem, in which the only inputs are concentration profiles of dexamethasone in skin at three consecutive penetration times. The resulting free-energy profiles for damaged and healthy skin show only minor differences. In contrast, the drug diffusivity in the first 10 μm of the upper skin layer of damaged skin is 200-fold increased compared to healthy skin, which reflects the corrupted barrier function of tape-stripped skin. For the case of healthy skin, we examine the robustness of our method by analyzing the behavior of the extracted skin parameters when the number of input and output parameters are reduced. We also discuss techniques for the regularization of our parameter extraction method.

Development of a Two-Dimensional Model for Predicting Transdermal Permeation with the Follicular Pathway: Demonstration with a Caffeine Study

Purpose

The development of a new two-dimensional (2D) model to predict follicular permeation, with integration into a recently reported multi-scale model of transdermal permeation is presented.

Methods

The follicular pathway is modelled by diffusion in sebum. The mass transfer and partition properties of solutes in lipid, corneocytes, viable dermis, dermis and systemic circulation are calculated as reported previously [Pharm Res 33 (2016) 1602]. The mass transfer and partition properties in sebum are collected from existing literature. None of the model input parameters was fit to the clinical data with which the model prediction is compared.

Results

The integrated model has been applied to predict the published clinical data of transdermal permeation of caffeine. The relative importance of the follicular pathway is analysed. Good agreement of the model prediction with the clinical data has been obtained. The simulation confirms that for caffeine the follicular route is important; the maximum bioavailable concentration of caffeine in systemic circulation with open hair follicles is predicted to be 20% higher than that when hair follicles are blocked.

Conclusions

The follicular pathway contributes to not only short time fast penetration, but also the overall systemic bioavailability. With such in silico model, useful information can be obtained for caffeine disposition and localised delivery in lipid, corneocytes, viable dermis, dermis and the hair follicle. Such detailed information is difficult to obtain experimentally.

Data-based modeling of drug penetration relates human skin barrier function to the interplay of diffusivity and free-energy profiles

Based on experimental concentration depth profiles of the antiinflammatory drug dexamethasone in human skin, we model the time-dependent drug penetration by the 1D general diffusion equation that accounts for spatial variations in the diffusivity and free energy. For this, we numerically invert the diffusion equation and thereby obtain the diffusivity and the free-energy profiles of the drug as a function of skin depth without further model assumptions. As the only input, drug concentration profiles derived from X-ray microscopy at three consecutive times are used. For dexamethasone, skin barrier function is shown to rely on the combination of a substantially reduced drug diffusivity in the stratum corneum (the outermost epidermal layer), dominant at short times, and a pronounced free-energy barrier at the transition from the epidermis to the dermis underneath, which determines the drug distribution in the long-time limit. Our modeling approach, which is generally applicable to all kinds of barriers and diffusors, allows us to disentangle diffusivity from free-energetic effects. Thereby we can predict short-time drug penetration, where experimental measurements are not feasible, as well as long-time permeation, where ex vivo samples deteriorate, and thus span the entire timescales of biological barrier functioning.

Separation of capsaicin from capsaicinoids by macroporous resin adsorption chromatography

The aim of present study is to develop an efficient and low-cost method for capsaicin production isolated from capsaicinoids by macroporous resin adsorption chromatography. HZ816 resin has shown the best adsorption and desorption capacities for capsaicin among other resins. To optimize the operating parameters for separation, initial concentration, diameter-to-height ratio, mobile phase ratio, and crystallization method were investigated. When capsaicinoids solution (5 g/L) was loaded onto the column (diameter-to-height ratio = 1:12) with ethanol/1% w/w NaOH (4:6, v/v) as the mobile phase, capsaicin was purified most effectively. By using acid neutralization as the crystallization method, the purity of capsaicin improved from 90.3 to 99.5% with 82.3% yield. In conclusion, this study provides a simple and low-cost method for the industrial-scale production of high-purity capsaicin.

Mathematical models for dermal drug absorption

INTRODUCTION

Mathematical models of dermal transport offer the advantages of being much faster and less expensive than in vitro or in vivo studies. The number of methods used to create such models has been increasing rapidly, probably due to the steady rise in computational power. Although each of the various approaches has its own virtues and limitations, it may be difficult to decide which approach is best suited to address a given problem.

AREAS COVERED

Here we outline the basic ideas, drawbacks and advantages of compartmental and quantitative structure-activity relationship models, as well as of analytical and numerical approaches for solving the diffusion equation. Examples of special applications of the different approaches are given.

EXPERT OPINION

Although some models are sophisticated and might be used in future to predict transport through damaged or diseased skin, the comparatively low availability of suitable and accurate experimental data limits extensive usage of these models and their predictive accuracy. Due to the lack of experimental data, the possibility of validating mathematical models is limited.

The transient dermal exposure II: post-exposure absorption and evaporation of volatile compounds

The transient dermal exposure is one where the skin is exposed to chemical for a finite duration, after which the chemical is removed and no residue remains on the skin's surface. Chemical within the skin at the end of the exposure period can still enter the systemic circulation. If it has some volatility, a portion of it will evaporate from the surface before it has a chance to be absorbed by the body. The fate of this post-exposure "skin depot" is the focus of this theoretical study. Laplace domain solutions for concentration distribution, flux, and cumulative mass absorption and evaporation are presented, and time domain results are obtained through numerical inversion. The Final Value Theorem is applied to obtain the analytical solutions for the total fractional absorption by the body and evaporation from skin at infinite time following a transient exposure. The solutions depend on two dimensionless variables: χ, the ratio of evaporation rate to steady-state dermal permeation rate; and the ratio of exposure time to membrane lag time. Simple closed form algebraic equations are presented that closely approximate the complete analytical solutions. Applications of the theory to the dermal risk assessment of pharmaceutical, occupational, and environmental exposures are presented for four example chemicals.

A simplified approach for estimating skin permeation parameters from in vitro finite dose absorption studies

Historically, percutaneous absorption permeation parameters have been derived from in vitro infinite dose studies, yet there is uncertainty in their accuracy if the applied vehicle saturates or damages the stratum corneum, or when the permeation parameters are inappropriately derived from cumulative absorption data. An approach is provided for determining penetration parameters from in vitro finite dose data. Key variables, and equations for their derivation, are identified from the literature and provide permeation parameters that use only Tmax , AUC, and AUMC from finite dose data. The equations are tested with computer-generated model data and to actual study data. Derived permeation parameters obtained from the computer model data match those used in generating the simulated finite dose data. Parameters obtained from actual study data reasonably and acceptably model the penetration profile kinetics of the study data. From in vitro finite dose absorption data, three parameters can be obtained: the diffusion transit time (td ), which characterizes the diffusion coefficient, the partition volume (Vm P), which characterizes the partition coefficient, and the permeation coefficient (Kp ). These parameters can be obtained from finite dose data without having to know the length of the diffusion pathway through the membrane.

Spray-on transdermal drug delivery systems

INTRODUCTION

Transdermal drug delivery possesses superior advantages over other routes of administration, particularly minimizing first-pass metabolism. Transdermal drug delivery is challenged by the barrier nature of skin. Numerous technologies have been developed to overcome the relatively low skin permeability, including spray-on transdermal systems.

AREAS COVERED

A transdermal spray-on system (TSS) usually consists of a solution containing the drug, a volatile solvent and in many cases a chemical penetration enhancer. TSS promotes drug delivery via the complex interplay between solvent evaporation and drug-solvent drag into skin. The volatile solvent carries the drug into the upper layers of the stratum corneum, and as the volatile solvent evaporates, an increase in the thermodynamic activity of the drug occurs resulting in an increased drug loading in skin.

EXPERT OPINION

TSS is easily applied, delivering flexible drug dosage and associated with lower incidence of skin irritation. TSS provides a fast-drying product where the volatile solvent enables uniform drug distribution with minimal vehicle deposition on skin. TSS ensures precise dose administration that is aesthetically appealing and eliminates concerns of residual drug associated with transdermal patches. Furthermore, it provides a better alternative to traditional transdermal products due to ease of product development and manufacturing.

Oil-in-oil-emulsions with enhanced substantivity for the treatment of chronic skin diseases

The therapy of chronic skin diseases often requires several applications of creams or ointments per day. This is inconvenient to the patients and frequently leads to poor acceptance and compliance. We therefore developed oil-in-oil-emulsions that deliver the active pharmaceutical ingredient (API) to the skin over a prolonged period of time. In this study, we compare the permeation of the API from a conventional formulation to its permeation from an oil-in-oil-emulsion under infinite and finite dosing. Furthermore, we evaluate the substantivity of the formulations. Our results show that the permeation from oil-in-oil-emulsions is constant over a prolonged time and that the emulsions show significantly higher substantivity than conventional formulations. Because of that, the treatment intervals can be extended substantially and compliance can be increased.

Mathematical models for skin toxicology

INTRODUCTION

Our skin is exposed daily to substances; many of these are neutral and safe but others are potentially harmful. In order to estimate the degree of toxicity and damage to skin tissues when exposed to harmful substances, skin toxicology studies are required. If these studies are coupled with suitably designed mathematical models, they can provide a powerful tool that allows appropriate interpretation of data. This work reviews mathematical models that can be employed in skin toxicology studies.

AREAS COVERED

Two types of mathematical models and their suitability for assessing skin toxicology are covered in this review. The first is focused on predicting penetration rate through the skin from a solute's physicochemical properties, while the second type of models transport processes in skin layers using appropriate equations with the specific aim of predicting the concentration of a given solute in viable skin tissues.

EXPERT OPINION

Mathematical models are an important tool for accurate valuation of skin toxicity experiments, estimation of skin toxicity and for developing new formulations for skin disease therapy. Comprehensive mathematical models of drug transport in skin, especially those based on more physiologically detailed mechanistic considerations of transport processes, are required to further enhance their role in assessing skin toxicology.

Analysis of finite dose dermal absorption data: implications for dermal exposure assessment

A common dermal exposure assessment strategy estimates the systemic uptake of chemical in contact with skin using the fixed fractional absorption approach: the dermal absorbed dose is estimated as the product of exposure and the fraction of applied chemical that is absorbed, assumed constant for a given chemical. Despite the prominence of this approach there is little guidance regarding the evaluation of experiments from which fractional absorption data are measured. An analysis of these experiments is presented herein, and limitations to the fixed fractional absorption approach are discussed. The analysis provides a set of simple algebraic expressions that may be used in the evaluation of finite dose dermal absorption experiments, affording a more data-driven approach to dermal exposure assessment. Case studies are presented that demonstrate the application of these tools to the assessment of dermal absorption data.

A preliminary comparison of three dermal exposure sampling methods: rinses, wipes and cotton gloves

Several methods exist to estimate dermal exposure and it is unclear how comparable they are. These methods fall into three main categories: (i) removal techniques (such as wiping or rinsing); (ii) interception techniques (such as gloves, patches, or coveralls); and (iii) fluorescent tracer techniques. Controlled experiments were conducted to compare two removal methods for exposure to particulate, and a removal method with an interception method for exposure to liquids. Volunteers' hands were exposed to three liquid solutions (glycerol-water solutions of different concentrations) and three particulates (Epsom salts, calcium acetate and zinc oxide) in simulated exposure scenarios. Both hands were exposed and a different sampling method was used on each to allow comparison of methods. Cotton glove samplers and a cotton wipe sampling method were compared for exposure to liquids. For exposure to powders a cotton wipe sampling method was compared to rinsing the hands in deionised water. Wipe and rinse methods generally yielded similar results for Epsom salts and zinc oxide (geometric mean [GM] ratios of wipe-to-rinse measurements of 0.6 and 1.4, respectively) but they did not for calcium acetate (GM wipe-to-rinse ratio of 4.6). For glycerol solutions measurements from the glove samplers were consistently higher than wipe samples. At lower levels of exposure the relative difference between the two methods was greater than at higher levels. At a hand loading level of 24,000 μg cm(-2) (as measured by wiping) the glove-to-wipe ratio was 1.4 and at a hand loading of 0.09 μg cm(-2) the ratio was 42.0. Wipe and rinse methods may be directly comparable but the relationship between glove and wipe sampling methods appears to be complex. Further research is necessary to enable conversion of exposure measurements from one metric to another, so as to facilitate more reliable risk assessment.

Prospective, non-interventional study on the tolerability and analgesic effectiveness over 12 weeks after a single application of capsaicin 8% cutaneous patch in 1044 patients with peripheral neuropathic pain: first results of the QUEPP study

BACKGROUND

Reversible defunctionalisation of nociceptors by the TRPV1 agonist capsaicin in high concentration is an emerging new concept for the treatment of peripheral neuropathic pain.

OBJECTIVES

The capsaicin 8% cutaneous patch with a long-lasting effect for up to 3 months after a single application is available in Germany by prescription since October 2010. The aim of this study was to monitor its usage and therapeutic performance in clinical practice.

METHODS

Patients had a single patch application with up to 4 patches and were followed up after 7-14 days, 4, 8, and 12 weeks. Average pain intensity (NPRS-11), pain attacks, neuropathy symptoms, sleep parameters, quality of life, working capacity and concomitant neuropathic pain medication were assessed during at least two visits.

RESULTS

A total of 509 females (48.8%; effectiveness population N = 1044) and 531 males (50.9%) were included; the mean age was 61.2 ± 14.4 (SD) years. Postherpetic neuralgia was the most frequent diagnosis (31.9%), followed by postsurgical neuralgia (22.8%), post-traumatic neuropathy (12.4%), polyneuropathy (14.3%), and mixed pain syndromes (16.6%). Thirty and 50% responder rates were 42.7% and 23.7%, respectively, with a mean relative reduction of pain intensity during weeks 1-12 of 24.7% (1.1 SEM) and significant improvements in pain attacks, sleep duration and sleep quality, while the consumption of opioids and antiepileptics decreased significantly. In 106 patients (10.0%; safety population n = 1063) 146 adverse drug reactions (ADRs) were reported, mainly application site reactions (erythema, pain). A total of 27 serious ADRs were documented in 17 patients (1.6%).

CONCLUSIONS

Analgesic treatment of peripheral neuropathic pain with the capsaicin 8% cutaneous patch is safe and effective.

LIMITATIONS

The study did not include a control group; therefore, a comparison of the results with that of therapeutic alternatives is not justified.

Mechanism- and experience-based strategies to optimize treatment response to the capsaicin 8% cutaneous patch in patients with localized neuropathic pain

The capsaicin 8% cutaneous patch is an emergent new treatment option for patients with peripheral neuropathic pain. In randomized controlled clinical studies relevant pain relief for 12 weeks was achieved in about one third of patients following a single application. The first part of this paper is a review of the pathophysiology, pharmacology, and published clinical trials with the capsaicin 8% cutaneous patch. The second part reports on outcomes of an interdisciplinary expert workshop, where new treatment results of three major German pain centers were presented and reviewed with the objectives of obtaining responder rates for different pain syndromes, assessing maintenance of effect under real-life conditions, and giving recommendations for practical care. The 12 week responder rates with pain relief of ≥ 30% were comparable in patients with mononeuropathies (37.9%) and postherpetic neuralgia (38.8%). Similar responder rates were seen in a subgroup of patients with cervical spine radiculopathy and back pain (46.7%). In HIV-associated neuropathy the responder rates were high (47.8%) but lower in patients with other polyneuropathies (17.6%). Response rates were nearly identical after 1 week (46.6%) and 4 weeks (43.3) and dropped only slightly at 12 weeks (37.4%). In a subgroup of 54 patients who underwent a second treatment, efficacy was maintained. Response rates in patients with or without lidocaine pretreatment were comparable. Treatment with the capsaicin 8% cutaneous patch was generally safe and well tolerated. The workshop panel recommended further investigation of opportunities to improve the application procedure and to perform studies on the skin penetration and distribution of capsaicin. A modified quantitative sensory testing (QST) should be developed for clinical practice in order to better understand the correlation of sensory profiles and response to capsaicin treatment.

In vitro skin permeation and penetration of nonivamide from novel film-forming emulsions

The purpose of this study was to develop film-forming emulsions (FFE) facilitating long-term treatment of chronic pruritus with capsaicinoids. To this end, oil-in-water emulsions, which comprise dispersions of sustained-release polymers, were examined. Such emulsions form a film when applied to the skin and encapsulate the oily drug solution in a dry polymeric matrix. Permeation of the antipruritic drug nonivamide (NVA) is controlled by the matrix. Permeation rates of NVA from FFE and its concentration in the skin are equivalent to those achieved with a conventional semisolid formulation, but can be maintained for a longer period of time. FFE may therefore improve the treatment of chronic pruritus with capsaicinoids by enhancing patient compliance by means of a sustained-release regimen.

Finite and infinite dosing: difficulties in measurements, evaluations and predictions

Due to the increased demand for reliable data regarding penetration into and permeation across human skin, assessment of the absorption of xenobiotics has been gaining in importance steadily. In vitro experiments allow for determining these data faster and more easily than in vivo experiments. However, the experiments described in literature and the subsequent evaluation procedures differ considerably. Here we will give an overview on typical finite and infinite dose experiments performed in fundamental research and on the evaluation of the data. We will point out possible difficulties that may arise and give a short overview on attempts at predicting skin absorption in vitro and in vivo.

Improved input parameters for diffusion models of skin absorption

To use a diffusion model for predicting skin absorption requires accurate estimates of input parameters on model geometry, affinity and transport characteristics. This review summarizes methods to obtain input parameters for diffusion models of skin absorption focusing on partition and diffusion coefficients. These include experimental methods, extrapolation approaches, and correlations that relate partition and diffusion coefficients to tabulated physico-chemical solute properties. Exhaustive databases on lipid-water and corneocyte protein-water partition coefficients are presented and analyzed to provide improved approximations to estimate lipid-water and corneocyte protein-water partition coefficients. The most commonly used estimates of lipid and corneocyte diffusion coefficients are also reviewed. In order to improve modeling of skin absorption in the future diffusion models should include the vertical stratum corneum heterogeneity, slow equilibration processes, the absorption from complex non-aqueous formulations, and an improved representation of dermal absorption processes. This will require input parameters for which no suitable estimates are yet available.

Mathematical and pharmacokinetic modelling of epidermal and dermal transport processes

Topical delivery to the various regions of the skin and underlying tissues, transdermal drug delivery and dermal exposure to environmental chemicals are important areas of research. Mathematical models of epidermal and dermal transport, involving penetration of a solute through various layers of the skin, metabolism in the skin and its subsequent distribution and clearance into systemic circulation from underlying tissues, play an essential role in this research area and are reviewed in this work.

Finite dose skin mass balance including the lateral part: comparison between experiment, pharmacokinetic modeling and diffusion models

This work investigates in vitro finite dose skin absorption of the model compounds flufenamic acid and caffeine experimentally and mathematically. The mass balance in different skin compartments (donor, stratum corneum (SC), deeper skin layers (DSL), lateral skin parts and acceptor) is analyzed as a function of time. For both substances high amounts were found in the lateral skin compartment after 6h of incubation, which emphasizes not to elide these parts in the modeling. Here, three different mathematical models were investigated and tested with the experimental data: a pharmacokinetic model (PK), a detailed microscopic two-dimensional diffusion model (MICRO) and a macroscopic homogenized diffusion model (MACRO). While the PK model was fitted to the experimental data, the MICRO and the MACRO models employed input parameters derived from infinite dose studies to predict the underlying diffusion process. All models could satisfyingly predict or describe the experimental data. The PK model and MACRO model also feature the lateral parts.

Measuring the stratum corneum reservoir: desorption kinetics from keratin

High keratin binding and slow desorption kinetics are assumed to be responsible for the formation of the stratum corneum (SC) reservoir. We measured equilibrium binding coefficients (K(b)) and desorption rate constants (k(off)) with bovine hoof/horn keratin and six solutes with similar molecular weight (180-288 Da) and varying lipophilicities [expressed as octanol-water distribution coefficient, i.e., a partition coefficient corrected for pH (log K(pH))-0.13 to 3.8]. Two ionizable solutes within this set were tested at different pH values as degree of ionization and lipophilicity were expected to influence equilibrium binding and desorption kinetics. The unbound fraction at equilibrium varied between 18% and 93%. All solutes exhibited linear binding isotherms within the investigated concentration range. Equilibrium binding and the rate of desorption are both functions of solute lipophilicity [log K(b) = 1.23 + 0.32 log K(pH); log k(off) = 1/(25.75 + 8.35 K(pH) (0.34))]. Our results prove that slow desorption from keratin may be a major contributor to the SC reservoir. Also, they prove that reservoir formation is relevant for lipophilic solutes independent of drug class, thus allowing new options for topical pharmacotherapy.

Review: Takagi–Sugeno Fuzzy Modeling of Skin Permeability

The skin is a major exposure route for many potentially toxic chemicals. It is, therefore, important to be able to predict the permeability of compounds through skin under a variety of conditions. Available skin permeability databases are often limited in scope and not conducive to developing effective models. This sparseness and ambiguity of available data prompted the use of fuzzy set theory to model and predict skin permeability. Using a previously published database containing 140 compounds, a rule-based Takagi-Sugeno fuzzy model is shown to predict skin permeability of compounds using octanol-water partition coefficient, molecular weight, and temperature as inputs. Model performance was estimated using a cross-validation approach. In addition, 10 data points were removed prior to model development for additional testing with new data. The fuzzy model is compared to a regression model for the same inputs using both R2 and root mean square error measures. The quality of the fuzzy model is also compared with previously published models. The statistical analysis demonstrates that the fuzzy model performs better than the regression model with identical data and validation protocols. The prediction quality for this model is similar to others that were published. The fuzzy model provides insights on the relationships between lipophilicity, molecular weight, and temperature on percutaneous penetration. This model can be used as a tool for rapid determination of initial estimates of skin permeability.

A spreadsheet-based method for estimating the skin disposition of volatile compounds: application to N,N-diethyl-m-toluamide (DEET)

The disposition of N,N-diethyl-3-methylbenzamide (DEET) applied to split-thickness human cadaver skin was measured in modified Franz cells maintained at 32 degrees C and fitted with a vapor trap. Ethanolic solutions of DEET (1% w/w) spiked with (14)C radiolabel were applied to skin at a dose of 10 microL per cell, corresponding to a DEET dose of 127 microg/cm(2). Room air was drawn over the skin at velocities ranging from 10-100 mL/min. Evaporation of radiolabel from the skin surface and absorption into the receptor solution were monitored for 24 hr post-dose. The percentage of radioactivity collected in the vapor trap after 24 hr increased with airflow, ranging from 16 +/- 4% at 10 mL/min to 59 +/- 7% at 70 mL/min. The percentage of radioactivity absorbed through the skin after 24 hours decreased with increasing airflow, ranging from 69 +/- 7% at 10 mL/min to 20 +/- 1% at 80 mL/min. Tissue retention after 24 hr was 6-14% of the radioactive dose with no clear correlation to airflow. This data as well as DEET absorption data from two previous in vitro studies in which dose and location (fume hood or bench top) was varied were analyzed in terms of a recently developed diffusion/evaporation model for skin implemented on an Excel spreadsheet. A priori model calculations based on independently estimated transport parameters (Model 1) were compared with calculations based on fitted parameters (Models 2 and 3). The analysis of the combined dataset (n = 272 observations) showed that the Model 1 estimates matched the cumulative disposition profiles to within a root mean square error of 12.4% of the applied dose (r(2) = 0.65), whereas the Model 2 and Model 3 fits matched to within 9.4% (r(2) = 0.80) and 6.5% (r(2) = 0.91), respectively. The Model 3 fits were obtained using a concentration-dependent diffusivity of DEET in the stratum corneum, the value of which increased 3.4-fold between low concentrations and saturation. This result was consistent with the mild skin penetration enhancement effect for DEET reported elsewhere. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a word document containing tables and figures including more information on the spreadsheet skin absorption model.]

The transient dermal exposure: theory and experimental examples using skin and silicone membranes

A diffusion model is presented to account for the disposition of chemicals applied to skin as transient exposures. Two conditions are considered that apply to the skin surface following the exposure period, which are applicable to chemicals exhibiting two extremes of chemical volatility. For one case, representing highly volatile compounds, the solution is generalized to apply to multiple transient exposures. For both cases, algebraic expressions are derived to calculate the total amount of chemical that penetrates the skin. The theory is applied to experimental measurements of the in vitro penetration of diethyl phthalate applied to hairless guinea pig (HGP) skin and silicone rubber membranes (SRMs) as transient exposures. The transient exposure theory ably models the experimental data, with coefficients of determination greater than 0.97 (HGP) and greater than 0.99 (SRM). The ability of parameters derived from concurrent infinite dose experiments to predict the time course of absorption from transient exposures is explored. Discrepancies were found between measured cumulative penetration of chemical from transient exposure experiments and penetration predicted from parameters derived from infinite dose experiments, particularly for HGP. Possible reasons are explored. The current model may provide a realistic framework for estimating absorption from occupational, environmental and pharmaceutical dermal exposures.

Analysis of in vitro skin permeation of 22-oxacalcitriol from ointments based on a two- or three-layer diffusion model considering diffusivity in a vehicle

In the present study, in vitro rat skin permeation of 22-oxacalcitriol (OCT) from ointments having differing compositions was determined and discussed based on a diffusion model. Diffusion coefficients of OCT in two ointments, one containing 3% (w/w) medium chain triglyceride (MCT) (3MO) and the other 30% (w/w) MCT (30MO), were determined using a modified membraneless method resulting in values of 0.89x10(-4) and 1.87x10(-4) cm2/h, respectively. At 24 h after application with 3MO, 7% of the applied OCT dose permeated through full-thickness skin and 22% remained in the ointment, whereas with 30MO, 2% of the applied dose permeated through full-thickness skin and 65% remained in the ointment. The diffusion coefficient of OCT in 3MO was lower than 30MO but the cumulative amount of OCT permeated was higher. From analysis of skin permeation of OCT based on a diffusion model considering diffusivity in an ointment, the partition coefficient of OCT from the ointment to stratum corneum (K(SC/V)) was calculated to be five-fold higher with 3MO than with 30MO. Our simulation study based on a diffusion model suggests that the diffusion coefficients of OCT in both ointments were high enough to have no affect on the skin permeation of OCT in the present case and that the difference in the skin permeations of the ointments was mainly caused by a difference in K(SC/V).

Kinetics of finite dose absorption through skin 2: Volatile compounds

A diffusion model to account for the disposition of an arbitrary dose of a (potentially) volatile compound applied to skin from a volatile vehicle is presented. In its most general form, the model allows for variable diffusivity of the permeant in the stratum corneum (SC) and must be solved numerically. However, for permeants having a constant diffusivity, absorption, and evaporation is characterized in terms of four dimensionless parameters-a reduced time tau, a fractional deposition depth in the SC f, a ratio of membrane capacity for the permeant to the applied dose beta, and a ratio of evaporative mass transfer coefficient to diffusive permeability chi. An important combination of these parameters arises as the reduced dose M(r) = (fbeta)(-1). Two cases are distinguished. In Case 1, corresponding to M(r) < or = 1, the dose is less than that required to saturate the upper layers of the SC, and the shape of the absorption and evaporation profiles is independent of the dose. Analytical solutions to Case 1 may be derived for arbitrary initial distributions of the permeant; the solution for a square wave is presented. In Case 2, corresponding to M(r) > 1, absorption and evaporation approach steady-state values as the dose is increased. Numerical evaluations of this behavior are shown. Limiting behavior for the case of a highly volatile solvent applied to skin is discussed. A companion paper discusses the application of the model to the absorption and evaporation of benzyl alcohol from human skin in vitro.

Absorption and evaporation of N,N-diethyl-m-toluamide from human skin in vitro

The penetration of DEET through split-thickness cadaver skin was measured in non-occluded Franz cells placed either in a fume hood or on a laboratory workbench. DEET, dissolved in a small volume of ethanol and spiked with (14)C radiolabel was applied to skin at doses from 0.02 to 11000 microg/cm(2). DEET penetration was greater for cells placed on the workbench, and the percentage of radioactivity penetrated after 72 h increased gradually with dose, for doses up to 680 microg/cm(2). At higher doses, it declined. Percent penetration ranged from 11.5 +/- 3.2% for a dose of 0.021 microg/cm(2) in the fume hood to 71.9 +/- 5.5% for a dose of 260 microg/cm(2) on the workbench. Results were interpreted in terms of a diffusion/evaporation model having three parameters-a solubility value for the chemical in the upper stratum corneum, M(sat); a mass transfer coefficient for evaporation, k(evap); and a characteristic time for diffusion, h(2)/D. The parameters obtained from fitting the model to the data (normalized to the fume hood environment) were M(sat) = 18 microg/cm(2) and k(evap) = 2.6 x 10(-5) cm/h. The value of h(2)/D decreased from 16 h at a DEET dose of 25 microg/cm(2) to 10 h at 1480 microg/cm(2), consistent with an increase in skin permeability of about 1.5-fold over this dose range. This effect was confirmed by means of an additional study in which skin samples pretreated with increasing amounts of unlabeled DEET were washed and redosed with (14)C-benzyl alcohol. A small (1.7-fold), but significant, increase in benzyl alcohol penetration with increasing amount of DEET was obtained. Thus, DEET enhanced its own skin permeation rate as well as that of another compound, but the effect was modest and not likely to be a major concern for compounds coadministered with DEET.

Effects of vehicle on the uptake and elimination kinetics of capsaicinoids in human skin in vivo

While the physiologic and molecular effects of capsaicinoids have been extensively studied in various model systems by a variety of administration routes, little is known about the uptake and elimination kinetic profiles in human skin following topical exposure. The present study evaluated the uptake and elimination kinetics of capsaicinoids in human stratum corneum following a single topical exposure to 3% solutions containing 55% capsaicin, 35% dihydrocapsaicin, and 10% other analogues prepared in three vehicles: mineral oil (MO), propylene glycol (PG), and isopropyl alcohol (IPA). Capsaicinoid solutions were evaluated simultaneously in a random application pattern on the volar forearms of 12 subjects using a small, single 150-microg dose. Capsaicin and dihydrocapsaicin were recovered from human skin using commercial adhesive discs to harvest stratum corneum from treated sites. Capsaicinoids were extracted from the stratum corneum-adhesive discs and quantified by liquid chromatography/mass spectroscopy (LC/MS). Both capsaicinoids were detected in stratum corneum 1 min after application with all vehicles and achieved a pseudo-steady state shortly thereafter. IPA delivered three times greater capsaicin and dihydrocapsaicin into the human stratum corneum than PG or MO at all time points investigated. The Cmax of capsaicin in IPA, PG, and MO was 16.1, 6.2, and 6.5 microg, respectively. The dihydrocapsaicin content was 60% of capsaicin with all vehicles. The estimated T(half) of capsaicin and dihydrocapsaicin in the three vehicles was similar (24 h). Thus, maximal cutaneous capsaicinoid concentrations were achieved quickly in the human stratum corneum and were concentration and vehicle dependent. In contrast, capsaicinoid half-life was long and vehicle independent.

Steady-state flux and lag time in the stratum corneum lipid pathway: results from finite element models

Finite element model (FEM) solutions of the diffusion through two-dimensional representations of the stratum corneum (SC) lipid pathway are presented. Both simplified, regular "brick and mortar" models and a more complex, irregular model are analyzed. It is assumed that diffusion occurs only within the SC lipids and the lipids are isotropic. The steady-state flux and lag time are solved and compared with the corresponding values for a homogeneous membrane of the same thickness consisting of lipid material. Results confirm that the heterogeneous SC model behaves like a homogeneous membrane, meaning that FEM diffusion simulations are well approximated by an appropriate solution of the diffusion equation for a homogeneous membrane. Additionally, both steady-state flux and lag time (relative to these values in a homogeneous membrane) can be predicted from algebraic equations based on simple dimensionless descriptors of SC geometry. However, values for diffusivity derived from homogeneous membrane approximations to the FEM solutions (effective diffusivity, D*) are not equal to the intrinsic diffusivity of the chemical in lipid. Furthermore, the pathlength derived from homogeneous membrane approximations to FEM solutions (effective pathlength, l*) is not equal to the lipid pathlength and is not dependent on SC tortuosity. Whereas l* is not a function of corneocyte overlap, D* is. These model results suggest that diffusion properties of the SC lipid pathway can be correlated to SC geometry, but intrinsic diffusion coefficients and SC tortuosity cannot be derived from common diffusion cell experiments. Use of the model equations to predict permeability and lag time of lipophilic solutes is described.

Disposition of Benzyl Alcohol After Topical Application to Human Skin in vitro

Dissipation of a volatile compound or mixture from the skin surface after topical application involves both diffusion and evaporation. This report presents a detailed test of a previously described first-order kinetic approach to modeling this problem. Modified Franz diffusion cells fitted with a vapor trap were used to obtain absorption and evaporation data for benzyl alcohol (1% solution in ethanol) after application to human skin in vitro. Airflow over the skin surface (upsilon) was controlled in the experiment and accounted for in the model by allowing the evaporation rate constant(s) to vary as a function of upsilon. A linear dependence was found over the working range of the system, 10-100 mL/min. Three kinetic models were developed, all of which satisfactorily correlated cumulative absorption and evaporation results over the full range of upsilon (n = 120, s = 4-5%, r2 = 0.98-0.99). One of these was the model presented previously, in which all dissipation occurs from a single skin compartment. However, more details of the evaporation and absorption profiles could be accounted for by means of two-compartment models that explicitly consider the surface film present in the early stages post-application. The latter models seem to be better candidates for describing the time evolution of the volatile mixture evolving from the skin surface after topical application of, e.g., a complex fragrance or perfume.