The influence of positive or negative charges in the passive and iontophoretic skin penetration of porphyrins used in photodynamic therapy

Investigating iontophoresis as a therapeutic approach for Peyronie's disease: a systematic review

INTRODUCTION

Iontophoresis therapy (IPT) is a noninvasive technique that uses electrical impulses to deliver charged molecules into the skin for controlled and targeted drug delivery. IPT has been explored as a noninvasive treatment option for Peyronie's disease (PD), but the current literature in this regard is still scarce.

OBJECTIVE

We aimed to systematically review the current literature on the application of IPT in the management of PD to provide a comprehensive evaluation and holistic outlook on the subject.

METHOD

A comprehensive search strategy was implemented in the following databases to retrieve research articles: PubMed (MEDLINE), Scopus, and Web of Science. Google Scholar was also manually searched. The search results were imported into Rayyan reference management for assessment based on the predefined inclusion criteria. The quality of the articles was evaluated by the proper JBI checklist (ie, per the study design), and the JBI grades of recommendation were used for grading the evidence.

RESULTS

A systematic search yielded 451 publications, 11 of which met the criteria to be included in this systematic review. The results demonstrated that IPT, usually with verapamil and dexamethasone, has shown promising results in treating PD. These methods can reduce pain, plaque size, and penile curvature while improving sexual function and quality of life with no serious adverse events. However, most studies had moderate to low quality, indicating a weak recommendation for a certain health management strategy.

CONCLUSION

Based on the extant literature, there is currently insufficient evidence to support the use of IPT for the management of PD. Placing it in the forefront of research can facilitate the management choices for PD even further, given its therapeutic potential.

Effect of iontophoresis on dacarbazine cutaneous delivery for melanoma topical treatment

Dacarbazine (DTIC) is the drug of choice for melanoma treatment, but its systemic administration is related to several adverse effects. Here, DTIC topical delivery stimulated by iontophoresis is proposed to overcome such drawbacks. Hence, this work analyzed the impact of anodal iontophoresis on DTIC cutaneous delivery to provide an innovative topical alternative for melanoma treatment. The electrical stability of the drug was evaluated prior to the iontophoretic experiments, which demonstrated the need to add an antioxidant to the drug formulation. DTIC cutaneous permeation was evaluated in vitro for 6 h using three current densities (0.10, 0.25, and 0.50 mA/cm2). In addition, the effect of DTIC against skin cancer cells (MeWo and WM164) was investigated for 72 h of exposure to the drug. Iontophoresis stimulated skin drug permeation compared to the passive control. However, the antioxidant presence reduced DTIC permeation under the lower currents of 0.10 and 0.25 mA/cm2, which was compensated by increasing the current density to 0.50 mA/cm2. At 0.50 mA/cm2, iontophoresis enhanced topical cutaneous drug permeation 7-fold (p < 0.05) compared to the passive control. DTIC showed a concentration-dependent antiproliferative effect on melanoma cell lines. Thus, iontophoresis intensifies DTIC skin penetration in concentrations that can reduce cell viability and induce cell death. In conclusion, DTIC cutaneous delivery mediated by iontophoresis is a promising approach for treating melanomas and other skin tumors.

Advancements in transdermal drug delivery: A comprehensive review of physical penetration enhancement techniques

Transdermal drug administration has grown in popularity in the pharmaceutical research community due to its potential to improve drug bioavailability, compliance among patients, and therapeutic effectiveness. To overcome the substantial barrier posed by the stratum corneum (SC) and promote drug absorption within the skin, various physical penetration augmentation approaches have been devised. This review article delves into popular physical penetration augmentation techniques, which include sonophoresis, iontophoresis, magnetophoresis, thermophoresis, needle-free injection, and microneedles (MNs) Sonophoresis is a technique that uses low-frequency ultrasonic waves to break the skin's barrier characteristics, therefore improving drug transport and distribution. In contrast, iontophoresis uses an applied electric current to push charged molecules of drugs inside the skin, effectively enhancing medication absorption. Magnetophoresis uses magnetic fields to drive drug carriers into the dermis, a technology that has shown promise in aiding targeted medication delivery. Thermophoresis is the regulated heating of the skin in order to improve drug absorption, particularly with thermally sensitive drug carriers. Needle-free injection technologies, such as jet injectors (JIs) and microprojection arrays, offer another option by producing temporary small pore sizes in the skin, facilitating painless and effective drug delivery. MNs are a painless, minimally invasive method, easy to self-administration, as well as high drug bioavailability. This study focuses on the underlying processes, current breakthroughs, and limitations connected with all of these approaches, with an emphasis on their applicability in diverse therapeutic areas. Finally, a thorough knowledge of these physical enhancement approaches and their incorporation into pharmaceutical research has the potential to revolutionize drug delivery, providing more efficient and secure treatment choices for a wide range of health-related diseases.

Nanosized ethosomal dispersions for enhanced transdermal delivery of nebivolol using intradermal/transfollicular sustained reservoir: in vitro evaluation, confocal laser scanning microscopy, and in vivo pharmacokinetic studies

Nebivolol (NBV), a BCS class II anti-hypertensive drug, suffers from limited solubility and oral bioavailability. Nanosized ethosomes were adopted as an approach to solubilize and deliver NBV transdermally, as a substitute to oral route. Ethosomal dispersions were prepared employing thin film hydration method. Formulation variables were adjusted to obtain entrapment efficiency; EE > 50%, particle size; PS < 100 nm, zeta potential; ZP > ±25 mV, and polydispersity index; PDI < 0.5. The optimized ethosomal dispersion (OED) showed accepted EE 86.46 ± 0.15%, PS 73.50 ± 0.08 nm, ZP 33.75 ± 1.20 mV, and PDI 0.31 ± 0.07. It also showed enhanced cumulative amount of NBV permeated at 8 h (Q8) 71.26 ± 1.46% and 24 h (Q24) 98.18 ± 1.02%. TEM images denoted spherical vesicles with light colored lipid bi-layer and dark core. Confocal laser scanning microscopy showed deeply localized intradermal and transfollicular permeation of the fluorolabelled OED (FL-OED). Nanosized FL-OED (<100 nm) can permeate through hair follicles creating a drug reservoir for enhanced systemic absorption. OED formulated into transdermal patch (OED-TP1) exhibited accepted physicochemical properties including; thickness 0.14 ± 0.01 mm, folding endurance 151 ± 0.07, surface pH 5.80 ± 0.15, drug content 98.64 ± 2.01%, mucoadhesion 8534 ± 0.03, Q8 87.61 ± 0.11%, and Q24 99.22 ± 0.24%. In vivo pharmacokinetic studies showed significantly enhanced bioavailability of OED-TP1 by 7.9 folds compared to oral Nevilob® tablets (p = 0.0002). It could be concluded that OED-TP1 can be a promising lipid nanocarrier TDDS for NBV and an efficacious alternative route of administration for hypertensive patients suffering from dysphagia.

Liquid crystalline nanogel targets skin cancer via low-frequency ultrasound treatment

The potential of low-frequency ultrasound (LFU) combined with nanotechnology-based formulations in improving skin tumors topical treatment was investigated. The impact of solid lipid nanoparticles (SLN) and hydrophilic nanogels as coupling media on LFU-induced skin localized transport regions (LTR) and the penetration of doxorubicin (DOX) in LFU-pretreated skin was evaluated. SLN were prepared by the microemulsion technique and liquid crystalline nanogels using Poloxamer. In vitro, the skin was pretreated with LFU until skin resistivity of ∼1 KΩ.cm2 using the various coupling media followed by evaluation of DOX penetration from DOX-nanogel and SLN-DOX in skin layers. Squamous cell carcinoma (SCC) induced in mice was LFU-treated using the nanogel with the LFU tip placed 5 mm or 10 mm from the tumor surface, followed by DOX-nanogel application. LFU with nanogel coupling achieved larger LTR areas than LFU with SLN coupling. In LFU-pretreated skin, DOX-nanogel significantly improved drug penetration to the viable epidermis, while SLN-DOX hindered drug transport through LTR. In vivo, LFU-nanogel pretreatment with the 10 mm tip distance induced significant tumor inhibition and reduced tumor cell numbers and necrosis. These findings suggest the importance of optimizing nanoparticle-based formulations and LFU parameters for the clinical application of LFU technology in skin tumor treatment.

Iontophoresis in dermal delivery: A review of applications in dermato-cosmetic and aesthetic sciences

OBJECTIVE

Iontophoresis is defined as the use of electric current to drive molecules across cell membranes through an electrolyte solution. In therapeutic context, it is used to facilitate the administration of bioactive substances, either systemically or locally. The technique presents various advantages and that is why it has been successfully used by a plethora of medical sciences. The constantly developing field of dermato-cosmetic science has also taken advantage of the possibilities offered by iontophoresis, aiming to enhance the delivery of the applied active ingredients and, thus, induce the desired cosmetic effects.

METHODS

The available literature was examined for evidence-based reports of safe and successful iontophoresis of pharmaceutical and cosmetic substances, in order to explore different iontophoretic applications in the field of dermato-cosmetic and dermato-aesthetic sciences.

CONCLUSION

Iontophoresis can be safely and successfully used in the treatment of ageing, photoageing, hyperpigmentation, oxidative stress, hair loss, hair removal, acne, acne sequelae and cellulite, providing many possibilities for enhanced treatment results.

Nonionic omnisoluble photosensitizer reference material for the estimation of singlet oxygen quantum yield

Meso-Tetrakis-(3,4,5-tris{2-[2-(2-methoxyethoxy)ethoxy]ethoxy}phenyl)porphyrin TEG12PH2 is reported as an 'omnisoluble' reference for singlet oxygen (¹O₂) generation quantum yield (Φ_SO) estimation. TEG12PH2 is a highly soluble, nonionic compound possessing excellent ¹O₂ QY in a wide variety of common solvents, including water. TEG12PH2 was prepared on multigram scale by the 12-way O-alkylation of tetrakis(3,4,5-trihydroxyphenyl)porphyrin using 2-(2-(2-methoxyethoxy)ethoxy)ethyl 4-toluenesulfonate as a reaction solvent. The corresponding Zn(II) complex TEG12PZn was also prepared and studied. The ¹O₂ QYs of TEG12PH2 in the different solvents studied were found to be 0.86 (acetone), 0.59 (acetonitrile), 0.66 (chloroform), 0.85 (methanol), 0.45 (toluene) and 0.51 (water). TEG12PH2 can be considered a reliable and easy to implement omnisoluble reference compound for the estimation of the ¹O₂ generating activities of new materials, especially new porphyrinic compounds.

Development and cathodic iontophoretic permeation evaluation of liquid crystalline systems provided of retinoic acid microparticles

BACKGROUND

The intracellular form of action of retinoids requires these agents to reach deeper layers of the skin with viable cells to ensure therapeutic efficiency. However, studies on swine skin models show that some retinoids have low skin permeability. Thus, the association of innovative formulations with technological strategies involving physical permeation promoters can be employed to increase the permeability of this active, ensuring a targeting effect of the active.

AIMS

In this study, it was proposed the development and evaluation of the release and permeation profile of liquid crystalline systems with retinoic acid polymeric microparticles under passive or iontophoretic diffusional conditions.

METHODS

For this study, release, permeation, and diffusional characterization assays were employed using the Franz diffusion cell model, associating or not the cathodic iontophoresis.

RESULTS

Retinoic acid was considered stable in front of the electric current of 0.5mA/cm² , because it did not show significant degradation (with maintenance from 96.03% to 98.57%), indicating the viability of such agents to be applied with iontophoresis. Controlled release profile was evidenced for microencapsulated systems. Comparatively, formulations F1, F3, and F5 presented a significantly higher RA release profile when compared to formulations with retinoic acid microencapsulated. A significant increase was observed in the absolute amount of RA retained in the skin with cathodic iontophoresis in all proposed formulations (P < .01). The increase was up to two times in relation to the passive condition.

CONCLUSIONS

The combination of iontophoresis technique with application of retinoic acid and microencapsulated retinoic acid allows the penetration of the active ingredient to deeper layers of the skin.

Besifloxacin liposomes with positively charged additives for an improved topical ocular delivery

Topical ophthalmic antibiotics show low efficacy due to the well-known physiological defense mechanisms of the eye, which prevents the penetration of exogenous substances. Here, we aimed to incorporate besifloxacin into liposomes containing amines as positively charged additives and to evaluate the influence of this charge on drug delivery in two situations: (i) iontophoretic and (ii) passive treatments. Hypothesis are (i) charge might enhance the electromigration component upon current application improving penetration efficiency for a burst drug delivery, and (ii) positive charge might prolong formulation residence time, hence drug penetration. Liposomes elaborated with phosphatidylcholine (LP PC) or phosphatidylcholine and spermine (LP PC: SPM) were stable under storage at 6 ºC for 30 days, showed mucoadhesive characteristics, and were non-irritant, according to HET-CAM tests. Electron paramagnetic resonance spectroscopy measurements showed that neither the drug nor spermine incorporations produced evident alterations in the fluidity of the liposome's membranes, which retained their structural stability even under iontophoretic conditions. Mean diameter and zeta potential were 177.2 ± 2.7 nm and − 5.7 ± 0.3 mV, respectively, for LP PC; and 175.4 ± 1.9 nm and + 19.5 ± 1.0 mV, respectively, for LP PC:SPM. The minimal inhibitory concentration (MIC) and the minimal bactericide concentration (MBC) of the liposomes for P. aeruginosa showed values lower than the commercial formulation (Besivance). Nevertheless, both formulations presented a similar increase in permeability upon the electric current application. Hence, liposome charge incorporation did not prove to be additionally advantageous for iontophoretic therapy. Passive drug penetration was evaluated through a novel in vitro ocular model that simulates the lacrimal flow and challenges the formulation resistance in the passive delivery situation. As expected, LP PC: SPM showed higher permeation than the control (Besivance). In conclusion, besifloxacin incorporation into positively charged liposomes improved passive topical delivery and can be a good strategy to improve topical ophthalmic treatments.

Modulation of Epidermal Growth Factor Release by Biopolymer-Coated Liposomes

This work describes the development of polysaccharide-coated liposomes to modulate the delivery of epidermal growth factor (EGF), with the aim to produce different EGF release profiles depending on the milieu of infected wounds. For this purpose, cationic liposomes were coated with one layer of sodium alginate (ALG) followed by one layer of chitosan (CHI) using the layer-by-layer (LbL) technique. The coated liposomes exhibited apparent hydrodynamic diameters of 278 ± 36 and 216 ± 96 nm for Lip-ALG and Lip-ALG-CHI, respectively. Thus, it appears that adding the CHI layer compacted the Lip-ALG one. The incorporation efficiency of EGF was a maximum of 55% for liposomes with a polymeric coating. In vitro release experiments showed that Lip-ALG-CHI exhibits a higher release rate constant under acidic pH conditions, resembling those of infected tissue. Using an ex vivo model of EGF release in porcine ear skin, these liposomes were found to accumulate in the epidermis. Thus, coated liposomes could represent a local EGF delivery mechanism to promote healing.

Dutasteride nanocapsules for hair follicle targeting: Effect of chitosan-coating and physical stimulus

In general, nanometer-sized drug delivery systems have a natural tendency for accommodation in the follicular cavities, which makes them advantageous in the treatment of conditions affecting these structures. Still, follicular targeting enhancement can improve therapy outcomes. Here, we compare two strategies to further promote dutasteride follicular-targeted delivery: the chemical modulation of nanosystem surface properties by coating with the natural polymer chitosan, and the application of a massage. For this, poly-(ɛ-caprolactone)-lipid-core nanocapsules (NC) containing dutasteride were developed and had their permeation profile compared to chitosan-coated nanocapsules (NC-CS). Nanocapsules showed high drug encapsulation efficiency (>94%), and stability for up to 90 days of storage. As expected, chitosan coating increased the size and zeta potential, from 199.0 ± 0.5 nm (PdI of 0.12) and - 13.6 ± 0.6 mV to 224.9 ± 3.4 nm (PdI 0.23) and + 40.2 ± 0.8 mV, respectively. Both coated and non-coated nanoparticles targeted the hair follicles compared to a drug solution. Enhanced hair follicles targeting was observed after the massage procedure, with 5 and 2-fold increases relative to NC and NC-CS, respectively. In conclusion, this work demonstrates dutasteride nanocapsules can target the follicular casts, and a simple physical stimulation can enhance 5-times the drug amount accumulated.

Chitosan nanoparticles loading oxaliplatin as a mucoadhesive topical treatment of oral tumors: Iontophoresis further enhances drug delivery ex vivo

Tumors located in the oral mucosa are challenging to treat since surgery can lead to aesthetic, speech, and salivation problems, radiotherapy alone is often ineffective, and systemic chemotherapy brings meaningful side effects to the patient. Here, we proposed to develop mucoadhesive chitosan nanoparticles entrapping the chemotherapeutic oxaliplatin (OXPt) and to evaluate ex vivo its penetration in porcine mucosa under both passive and iontophoretic topical treatments. OXPt-loaded chitosan nanoparticles presented a small hydrodynamic size (188 ± 20 nm), narrow distribution (PDI of 0.28 ± 0.02) and positive zeta potential (+44.8 ± 2.8 mV). These nanoparticles provided a "burst effect" on drug release followed by a longer-term controlled release. When applied to the oral mucosa, the chitosan nanoparticles increased 3-fold drug penetration, and this rate was maintained even when the mucosa was "washed" with a buffer to mimic salivation. Iontophoresis doubled the amount of OXPt transported to the mucosa. These amounts exceeded the dose required to cause cell death of an oral tumor cell line. Besides, chitosan nanoparticles increased the rate of cells that entered into apoptosis. In summary, this study points to the feasibility of topical therapy with chitosan nanoparticles, potentialized by the application of iontophoresis, to treat oral tumors.

Stability-indicating analytical method of quantifying spironolactone and canrenone in dermatological formulations and iontophoretic skin permeation experiments

A simple, stability-indicating, chromatographic method of quantifying spironolactone (SPI) and its metabolite, canrenone (CAN), in the presence of excipients typical in dermatological formulations and skin matrices in studies of passive and iontophoretic permeation was proposed and validated here. SPI and CAN were separated using a reversed-phase column with a mobile phase of methanol-water (60:40, v/v) at a flow rate of 1.0 mL/min. Data were collected with a UV detector at 238 and 280 nm, with retention times of 6.2 and 7.9 min for SPI and CAN, respectively. The method was precise, accurate and linear (r²  > 0.99) in a concentration range of 1-30 μg/mL, and recovery rates of SPI and CAN from the different skin layers exceeded 85%. The method was not only sensitive (LOD of 0.05 and 0.375 μg/mL and LOQ of 0.157 and 1.139 μg/mL for SPI and CAN, respectively) but also selective against skin matrices and highly representative components of topical formulations. The method moreover demonstrated SPI's degradation in iontophoresis by applying Pt-AgCl electrodes and its continued drug stability using Ag-AgCl electrodes. Altogether, the method proved valuable for quantifying SPI and CAN and may be applied in developing and controlling the quality of dermatological products.

Multimodal use of the porphyrin TMPyP: From cancer therapy to antimicrobial applications

The cationic porphyrin meso-tetra(4-[Formula: see text]-methylpyridyl)porphine (TMPyP) has a high yield of singlet oxygen generation upon light activation and a strong affinity for DNA. These advantageous properties have turned it into a promising photosensitizer for use in photodynamic therapy (PDT). In this review, we have summarized the current state-of-the-art applications of TMPyP for the treatment of cancer as well as its implementation in antimicrobial PDT. The most relevant studies reporting its pharmacokinetics, subcellular localization, mechanism of action, tissue biodistribution and dosimetry are discussed. Combination strategies using TMPyP-PDT together with other photosensitizers and chemotherapeutic agents to achieve synergistic anti-tumor effects and reduce resistance to therapy are also explored. Finally, we have addressed emerging applications of this porphyrin, including nanoparticle-mediated delivery, controlled drug release, biosensing and G-quadruplex stabilization for tumor growth inhibition. Altogether, this work highlights the great potential and versatility that TMPyP can offer in different fields of biomedicine such us cancer treatment or antimicrobial therapy.

Nanoemulsion as a Platform for Iontophoretic Delivery of Lipophilic Drugs in Skin Tumors

Lipophilic drugs do not usually benefit from iontophoresis mainly because they do not solubilize in aqueous formulations suitable for the application of electric current. To explore the influence of iontophoresis on penetration of these drugs, a cationic nanoemulsion was developed to solubilize zinc phthalocyanine (ZnPc), a promising drug for the treatment of skin cancer. To verify the influence of particle size on iontophoresis, an emulsion of nanoemulsion-like composition was also developed. The formulations were characterized and cutaneous and tumor penetration studies were performed in vitro and in vivo, respectively. With particles of about 200 nm, the nanoemulsion solubilized 2.5-fold more ZnPc than the 13-µm emulsion. At the same concentration of ZnPc, in vitro passive penetration studies showed that the nanoemulsion increased, after 1 h of treatment, by almost 4 times the penetration of ZnPc into the viable layers of the skin when compared to the emulsion, whereas iontophoresis of nanoemulsion resulted in a 16-fold increase in ZnPc penetration in only 30 min. An in vivo study in a murine model of melanoma showed that ZnPc reached the tumor after iontophoresis of the nanoemulsion. Therefore, iontophoresis of nanoemulsions appears to be a promising strategy for the topical treatment of tumors with lipophilic drugs.

Pharmacotherapeutic approaches for transportation of anticancer agents via skin

Cancer is the largest family of diseases that involve abnormal uncontrolled cell growth which metastasizes to other parts of the body. The most common type of cancers includes lung, liver, colorectal, prostate, stomach, breast and cervical cancer with skin cancer excluding melanoma (contribute up to 40% of the cases). The conventional treatment approaches like surgery, chemotherapy, etc., have several side effects such as severe inflammation and pain. Hence, pharmacotherapeutic approaches of antineoplastic agents can be advantageous for treating various forms of cancer through the skin. Novel transdermal techniques and preparations have been emerged to overcome the limitations of skin and to penetrate inside the cancerous cells by transporting through the deeper tissues of the skin. The transdermal penetration of drugs using different formulations such as nanocarriers, physical penetration enhancement techniques, chemical penetration enhancers and newer technologies such as gels, dendrimers, needle-free injection jet etc., show improved patient compliance, abolition of scars and economic value. The topical delivery of antineoplastic agents is an attractive choice for increasing site-specific delivery, reducing side effects and improving therapeutic effects. The objective of this review is to present insights into pharmacotherapeutic techniques, which can be used for transdermal delivery of anticancer agents through skin due to its potential to create a new frontier in treatment of cancer.

Porphyrin photosensitizers in photodynamic therapy and its applications

In 1841, the extraction of hematoporphyrin from dried blood by removing iron marked the birth of the photosensitizer. The last twenty years has witnessed extensive research in the application of photodynamic therapy (PDT) in tumor-bearing (or other diseases) animal models and patients. The period has seen development of photosensitizers from the first to the third generation, and their evolution from simple to more complex entities. This review focuses on porphyrin photosensitizers and their effect on tumors, mediated via several pathways involved in cell necrosis, apoptosis or autophagic cell death, and the preventive and therapeutic application of PDT against atherosclerosis.

Iontophoresis Improved Growth Reduction of Invasive Squamous Cell Carcinoma in Topical Photodynamic Therapy

This study examined the potential of iontophoresis in topical photodynamic therapy (PDT) of human invasive squamous cells carcinomas (SCC). SCC was induced in nude BALB/c mice by subcutaneous injection of A431 cells. Tumor penetration and distribution of the photosensitizer tetrasulfonated zinc phthalocyanine (ZnPcS4) was investigated after 10 and 30 min of in vivo iontophoresis of a gel containing ZnPcS4. PDT was performed immediately after iontophoresis using laser at 660 nm with a dose of irradiation of 100 J/cm(2) and irradiance of 48 mW/cm(2) while tumor growth was measured for 30 days. Iontophoresis increased ZnPcS4 penetration into tumors by 6-fold after 30 min when compared with passive delivery. Confocal microscopy analysis showed that ZnPcS4 was homogeneous distributed within deep regions of the tumor after iontophoresis. Irradiation of the tumors immediately after iontophoresis showed reduction in tumor size by more than 2-fold when compared to non-treated tumors. Iontophoretic-PDT treated tumors presented large areas of necrosis. The study concluded that iontophoretic delivery of photosensitizers could be a valuable strategy for topical PDT of invasive SCC.