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Yin XJ, Hewitt NJ, Erler S, Bryson P, Blömeke B, Gaspari AA, Goebel C. Safety assessment for nail cosmetics: Framework for the estimation of systemic exposure through the nail plate. Regul Toxicol Pharmacol 2024; 148:105588. [PMID: 38423269 DOI: 10.1016/j.yrtph.2024.105588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/19/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
All cosmetics products, including nail care products, must be evaluated for their safety. The assessment of systemic exposure is a key component of the safety assessment. However, data on the exposure, especially via ungual route (nail plate) are limited. Based on the physicochemical properties of human nails and permeability data of topical onychomycosis drugs, the nail plate is considered a good barrier to chemicals. We examine factors impacting penetration of nail care ingredients through the nail plate, including properties of the nails of the ingredients and formulations. The molecular weight, vapor pressure, logP, water solubility, and keratin binding, as well as formulations properties e.g., polymerization of acrylate monomers are considered important factors affecting penetration. To estimate systemic exposure of nail care ingredients through the nail plate, a standardized framework is applied that quantifies the impacts of these properties on penetration with an adjustment factor for each of these influencing properties. All the adjustment factors are then consolidated to derive an integrated adjustment factor which can be used for calculation of the systemic exposure dose for the ingredient. Several case studies are presented to reflect how this framework can be used in the exposure assessment for nail cosmetic products.
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Affiliation(s)
- Xuejun J Yin
- OPI, Wella Company, 4500 Park Granada, Calabasas, CA, USA
| | | | - Steffen Erler
- Beiersdorf AG, Beiersdorfstraβe 1-9, 22529, Hamburg, Germany
| | - Paul Bryson
- OPI, Wella Company, 4500 Park Granada, Calabasas, CA, USA
| | | | - Anthony A Gaspari
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Carsten Goebel
- Wella Company, Berliner Allee 65, 64295, Darmstadt, Germany.
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2
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Malallah OS, Coleman L, Nasereddin SM, Lockhat M, Chen T, Jones SA. Systematic review and QSPR analysis of chemical penetration through the nail to inform onychomycosis candidate selection. Drug Discov Today 2024; 29:103844. [PMID: 38000719 DOI: 10.1016/j.drudis.2023.103844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Recalcitrant nail plate infections can be life-long problems because localizing antifungal agents into infected tissues is problematic. In this systematic review, guided by the SPIDER method, we extracted chemical nail permeation data for 38 compounds from 16 articles, and analyzed the data using quantitative structure-property relationships (QSPRs). Our analysis demonstrated that low-molecular weight was essential for effective nail penetration, with <120 g/mol being preferred. Interestingly, chemical polarity had little effect on nail penetration; therefore, small polar molecules, which effectively penetrate the nail, but not the skin, should be set as the most desirable target chemical property in new post-screen onychomycosis candidate selections.
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Affiliation(s)
- Osamah S Malallah
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, Franklin-Wilkins Building, King's College London, 150 Stamford Street, London SE1 9NH, UK
| | - Lucy Coleman
- School of Chemistry and Chemical Engineering, University of Surrey, Guildford GU2 7XH, UK
| | - Sara M Nasereddin
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, Franklin-Wilkins Building, King's College London, 150 Stamford Street, London SE1 9NH, UK; College of Pharmacy, Amman Arab University, Mubis, Amman 11953, Jordan
| | - Mohammad Lockhat
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, Franklin-Wilkins Building, King's College London, 150 Stamford Street, London SE1 9NH, UK
| | - Tao Chen
- School of Chemistry and Chemical Engineering, University of Surrey, Guildford GU2 7XH, UK
| | - Stuart A Jones
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, Franklin-Wilkins Building, King's College London, 150 Stamford Street, London SE1 9NH, UK; Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College, SE1 9NH, UK.
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3
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Chakraborty S, Sanshita, Singh I. Therapeutic treatment strategies for the management of onychomycosis: a patent perspective. Expert Opin Ther Pat 2023; 33:613-630. [PMID: 37800854 DOI: 10.1080/13543776.2023.2268278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/04/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Onychomycosis, a multifactorial fungal infection of the nails, shows a global prevalence of about 5.5% and is responsible for 50% of all nail infections. To develop effective management strategies, it is necessary to understand the etiology, pathophysiology, and risk factors of onychomycosis. Oral route of drug delivery is one of the routes utilized to deliver anti-fungal agents, but, has its own limitations like longer duration of treatment, increased adverse effects, and potential for drug interaction. The ungual route has received greater attention due to its localized, non- invasive action and improved patient compliance. AREAS COVERED This review comprehensively discusses conventional onychomycosis therapies and patented novel drug delivery systems for the management of onychomycosis including chemical permeation enhancers, non-particulate drug delivery systems, penetration enhancing devices etc., Databases such as PubMed, ResearchGate, and Google Patents were searched by using the keywords onychomycosis and trans-ungual drug delivery. EXPERT OPINION Enormous research has been conducted and is still ongoing to find the best possible novel drug delivery system for onychomycosis management. Approaches like incorporation of herbal constituents in nano-formulations, inkjet printing, laser devices, iontophoretic techniques, etc. can be employed to make safe and effective drug delivery systems which are regulatory compliant.
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Affiliation(s)
| | - Sanshita
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Inderbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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4
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Khan N, Ahmed S, Sheraz MA, Anwar Z, Ahmad I. Pharmaceutical based cosmetic serums. PROFILES OF DRUG SUBSTANCES, EXCIPIENTS AND RELATED METHODOLOGY 2023; 48:167-210. [PMID: 37061274 DOI: 10.1016/bs.podrm.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The growth and demand for cosmeceuticals (cosmetic products that have medicinal or drug-like benefits) have been enhanced for the last few decades. Lately, the newly invented dosage form, i.e., the pharmaceutical-based cosmetic serum has been developed and widely employed in various non-invasive cosmetic procedures. Many pharmaceutical-based cosmetic serums contain natural active components that claim to have a medical or drug-like effect on the skin, hair, and nails, including anti-aging, anti-wrinkle, anti-acne, hydrating, moisturizing, repairing, brightening and lightening skin, anti-hair fall, anti-fungal, and nail growth effect, etc. In comparison with other pharmaceutical-related cosmetic products (creams, gels, foams, and lotions, etc.), pharmaceutical-based cosmetic serums produce more rapid and incredible effects on the skin. This chapter provides detailed knowledge about the different marketed pharmaceutical-based cosmetic serums and their several types such as facial serums, hair serums, nail serums, under the eye serum, lip serum, hand, and foot serum, respectively. Moreover, some valuable procedures have also been discussed which provide prolong effects with desired results in the minimum duration of time after the few sessions of the serum treatment.
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Affiliation(s)
- Nimra Khan
- Department of Pharmacy Practice, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan
| | - Sofia Ahmed
- Department of Pharmaceutics, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan
| | - Muhammad Ali Sheraz
- Department of Pharmacy Practice, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan; Department of Pharmaceutics, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan
| | - Zubair Anwar
- Department of Pharmaceutical Chemistry, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan
| | - Iqbal Ahmad
- Department of Pharmaceutical Chemistry, Baqai Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi, Pakistan
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5
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Antifungal Nail Lacquer for Enhanced Transungual Delivery of Econazole Nitrate. Pharmaceutics 2022; 14:pharmaceutics14102204. [PMID: 36297639 PMCID: PMC9607990 DOI: 10.3390/pharmaceutics14102204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
The fungal disease of the nail, onychomycosis, which is also the most prevalent nail disturbance, demands effective topical treatment options considering the possible adverse effects of systemic antifungal therapy. The current work is focused on development of an adhesive and resistant, drug-delivering and permeation-enhancing polymeric film containing econazole nitrate (ECN) for topical antifungal treatment. The development of the lacquer formulation was guided by the Quality by Design approach to achieve the critical quality attributes needed to obtain the product of desired quality. Eudragit RSPO at 10% w/w was found to be the ideal adhesive polymer for the application and an optimal permeation-enhancing lacquer formulation was achieved by the optimization of other formulation excipients, such as plasticizer and the solvent system. Additionally, novel experimental enhancements introduced to the research included refined D50 drying time and drying rate tests for lacquer characterization as well as a multi-mechanism permeation-enhancing pre-treatment. Moreover, a practical implication was provided by a handwashing simulation designed to test the performance of the lacquer during actual use. In vitro drug release testing and ex vivo nail permeation testing demonstrated that the optimized nail lacquer performed better than control lacquer lacking the permeation enhancer by achieving a faster and sustained delivery of ECN. It can be concluded that this is a promising drug delivery system for topical antifungal treatment of onychomycotic nails, and the novel characterization techniques may be adapted for similar formulations in the future.
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Puri V, Froelich A, Shah P, Pringle S, Chen K, Michniak-Kohn B. Quality by Design Guided Development of Polymeric Nanospheres of Terbinafine Hydrochloride for Topical Treatment of Onychomycosis Using a Nano-Gel Formulation. Pharmaceutics 2022; 14:pharmaceutics14102170. [PMID: 36297605 PMCID: PMC9611585 DOI: 10.3390/pharmaceutics14102170] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 11/28/2022] Open
Abstract
Superficial fungal diseases of the skin and nails are an increasingly common occurrence globally, requiring effective topical treatment to avoid systemic adverse effects. Polymeric nanoparticles have demonstrated sustained and effective drug delivery in a variety of topical formulations. The aim of this project was to develop polymeric antifungal nanospheres containing terbinafine hydrochloride (TBH) to be loaded into a hydrogel formulation for topical nail drug delivery. A quality by design (QbD) approach was used to achieve optimized particles with the desired quality target product profile (QTPP). Polyvinyl alcohol (PVA) at 2% w/v and a drug to polymer ratio of 1:4, together with a robust set of processes and material attributes, resulted in nanoparticles of 108.7 nm with a polydispersity index (PDI) of 0.63, 57.43% recovery, and other desirable characteristics such as zeta potential (ZP), particle shape, aggregation, etc. The nanospheres were incorporated into a carbomer-based gel, and the delivery of TBH through this formulation was evaluated by means of in vitro drug release testing (IVRT) and ex vivo nail permeation study. The gel containing the TBH nanospheres demonstrated a slower and controlled drug release profile compared with the control gel, in addition to a more efficient delivery into the nail. These antifungal nanospheres can be utilized for topical therapy of a multitude of superficial fungal infections.
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Affiliation(s)
- Vinam Puri
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08855, USA
- Center for Dermal Research, Life Science Building, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Anna Froelich
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland
| | - Parinbhai Shah
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08855, USA
- Center for Dermal Research, Life Science Building, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Shernelle Pringle
- Department of Biomedical Sciences, School of Graduate Studies, Rutgers, The State University of New Jersey, Piscataway, NJ 08855, USA
| | - Kevin Chen
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08855, USA
- Center for Dermal Research, Life Science Building, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Bozena Michniak-Kohn
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08855, USA
- Center for Dermal Research, Life Science Building, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
- Correspondence: ; Tel.: +1-(848)-445-3589
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7
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Structural and Functional Analysis of Excised Skins and Human Reconstructed Epidermis with Confocal Raman Spectroscopy and in Microfluidic Diffusion Chambers. Pharmaceutics 2022; 14:pharmaceutics14081689. [PMID: 36015315 PMCID: PMC9415586 DOI: 10.3390/pharmaceutics14081689] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 12/02/2022] Open
Abstract
Several ex vivo and in vitro skin models are available in the toolbox of dermatological and cosmetic research. Some of them are widely used in drug penetration testing. The excised skins show higher variability, while the in vitro skins provide more reproducible data. The aim of the current study was to compare the chemical composition of different skin models (excised rat skin, excised human skin and human-reconstructed epidermis) by measurement of ceramides, cholesterol, lactate, urea, protein and water at different depths of the tissues. The second goal was to compile a testing system, which includes a skin-on-a-chip diffusion setup and a confocal Raman spectroscopy for testing drug diffusion across the skin barrier and accumulation in the tissue models. A hydrophilic drug caffeine and the P-glycoprotein substrate quinidine were used in the study as topical cream formulations. The results indicate that although the transdermal diffusion of quinidine is lower, the skin accumulation was comparable for the two drugs. The various skin models showed different chemical compositions. The human skin was abundant in ceramides and cholesterol, while the reconstructed skin contained less water and more urea and protein. Based on these results, it can be concluded that skin-on-a-chip and confocal Raman microspectroscopy are suitable for testing drug penetration and distribution at different skin layers within an exposition window. Furthermore, obese human skin should be treated with caution for skin absorption testing due to its unbalanced composition.
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8
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Krawczyk-Santos AP, da Rocha PBR, Kloppel LL, Souza BDS, Anjos JLV, Alonso A, de Faria DLA, Gil OM, Gratieri T, Marreto RN, Taveira SF. Enhanced nail delivery of voriconazole-loaded nanomicelles by thioglycolic acid pretreatment: A study of protein dynamics and disulfide bond rupture. Int J Pharm 2021; 602:120597. [PMID: 33862134 DOI: 10.1016/j.ijpharm.2021.120597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
This work aimed to select an effective penetration enhancer (PE) for nail pretreatment, develop voriconazole (VOR)-loaded nanomicelles, and evaluate their ability to deliver VOR to the nail. A complete analysis of nail protein dynamics, bond rupture, and microstructure was performed. Alternative methods as electron paramagnetic resonance (EPR) and the Ellman's reagent (DTNB) assay were also evaluated. Nanomicelles were produced and characterized. The PE hydrated the hooves, following the order: urea ≈ cysteine ≈ glycolic acid < thioglycolic acid (TGA) < NaOH. SEM images and methylene blue assay showed enlarged pores and roughness of porcine hooves after incubation with NaOH and TGA. EPR was demonstrated to be the most sensitive technique. DTNB assay quantified higher thiol groups for samples treated with TGA (p < 0.05). A stratigraphic analysis with Raman spectroscopy demonstrated that hooves treated with TGA presented a higher SH/SS ratio at the edges, affecting protein secondary structure. In vitro permeation studies demonstrated significant VOR permeation (29.44 ± 6.13 µg/cm2), 10-fold higher than previous studies with lipid nanoparticles. After TGA pretreatment, VOR permeation was further enhanced (3-fold). TGA pretreatment followed by VOR-loaded nanomicelles demonstrates a promising approach for onychomycosis treatment. The novel methods for protein analysis were straightforward and helpful.
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Affiliation(s)
- Anna Paula Krawczyk-Santos
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil
| | - Priscila B R da Rocha
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil
| | - Leandro L Kloppel
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil
| | - Bruno Dos S Souza
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil
| | - Jorge Luiz V Anjos
- Physics Department, Universidade Federal de Catalão (UFCAT), Catalão, GO, Brazil
| | - Antonio Alonso
- Biophysics Department, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | - Dalva Lúcia A de Faria
- Laboratory of Molecular Spectroscopy, Institute of Chemistry, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes 748, Butantã, 05508-000 São Paulo, SP, Brazil
| | - Otávio M Gil
- Laboratory of Molecular Spectroscopy, Institute of Chemistry, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes 748, Butantã, 05508-000 São Paulo, SP, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs and Cosmetics (LTMAC), School of Health Sciences, Universidade de Brasilia (UnB), Campus Universitário Darcy Ribeiro, Asa Norte, 70, 910-900 Brasília - DF, Brazil
| | - Ricardo N Marreto
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil
| | - Stephania Fleury Taveira
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Universidade Federal de Goiás (UFG), Rua 240, esq. com 5ª Avenida, Setor Leste Universitário, 74605-170 Goiânia, GO, Brazil.
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9
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Aslam R, Hussain T, Yousaf AM, Ghori MU, Khan IU, Rizvi SAA, Shahzad Y. Onychomycosis: Current Understanding and Strategies for Enhancing Drug Delivery into Human Nail Tissue. Curr Drug Res Rev 2021; 13:25-35. [PMID: 32735534 DOI: 10.2174/2589977512666200731171505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Onychomycosis is by far the most common finger or toe nail fungal infectious disease caused by dermatophytes, non-dermatophytic molds or yeast. It accounts for 50% of the total nail disorders, and affects patients physically, socially, and psychologically and can seriously influence their quality of life. OBJECTIVES Oral antifungals are routinely used to treat the nail fungal disease; however oral therapy is associated with severe side effects and longer treatment times. In recent years, drug delivery directly into the nail or nail bed has gained attention and various topical products have been tested that can cure the disease when applied topically or transungually. Nevertheless, drug penetration into and through the nail is not straightforward and requires chemicals to improve its permeability or by applying physical stress to promote drug penetration into and through the nail. This lucid review presents an overview of various causes of onychomycosis, current therapeutic approaches, and efforts aimed at increasing the permeability of nails through various strategies such as chemical, physical and mechanical methods for permeation enhancement. CONCLUSION Various strategies have been proposed for the treatment of onychomycosis, however, much research into a more precise and effective therapy is still required.
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Affiliation(s)
- Rabia Aslam
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan
| | - Talib Hussain
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Abid Mehmood Yousaf
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
| | - Muhammad U Ghori
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Ikram U Khan
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Syed A A Rizvi
- Department of Pharmaceutical Sciences, Hampton University School of Pharmacy, Hampton University, VA, United States
| | - Yasser Shahzad
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan
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10
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Effect of Penetration Enhancers on Toenail Delivery of Efinaconazole from Hydroalcoholic Preparations. Molecules 2021; 26:molecules26061650. [PMID: 33809569 PMCID: PMC8000921 DOI: 10.3390/molecules26061650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022] Open
Abstract
The incorporation of permeation enhancers in topical preparations has been recognized as a simple and valuable approach to improve the penetration of antifungal agents into toenails. In this study, to improve the toenail delivery of efinaconazole (EFN), a triazole derivative for onychomycosis treatment, topical solutions containing different penetration enhancers were designed, and the permeation profiles were evaluated using bovine hoof models. In an in vitro permeation study in a Franz diffusion cell, hydroalcoholic solutions (HSs) containing lipophilic enhancers, particularly prepared with propylene glycol dicaprylocaprate (Labrafac PG), had 41% higher penetration than the HS base. Moreover, the combination of hydroxypropyl-β-cyclodextrin with Labrafac PG further facilitated the penetration of EFN across the hoof membrane. In addition, this novel topical solution prepared with both lipophilic and hydrophilic enhancers was physicochemically stable, with no drug degradation under ambient conditions (25 °C, for 10 months). Therefore, this HS system can be a promising tool for enhancing the toenail permeability and therapeutic efficacy of EFN.
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11
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Aggarwal R, Targhotra M, Kumar B, Sahoo PK, Chauhan MK. Treatment and management strategies of onychomycosis. J Mycol Med 2020; 30:100949. [PMID: 32234349 DOI: 10.1016/j.mycmed.2020.100949] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/15/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022]
Abstract
Onychomycosis is one of the most prevalent and severe nail fungal infections, which is affecting a wide population across the globe. It leads to variations like nail thickening, disintegration and hardening. Oral and topical drug delivery systems are the most desirable in treating onychomycosis, but the efficacy of the results is low, resulting in a relapse rate of 25-30%. Due to systemic toxicity and various other disadvantages associated with oral therapy like gastrointestinal, hepatotoxicity, topical therapy is commonly used. Topical therapy improves patient compliance and reduces the cost of treatment. However, due to poor penetration of topical therapy across the nail plate, research is focused on different chemical, mechanical and physical methods to improve drug delivery. Penetration enhancers like Thioglycolic acid, Hydroxypropyl-β-cyclodextrin (HP-β-CD), Sodium lauryl sulfate (SLS), carbocysteine, N-acetylcysteine etc. have shown results enhancing the drug penetration across the nail plate. Results with physical techniques such as iontophoresis, laser and Photodynamic therapy are quite promising, but the long-term suitability of these devices is in need to be determined. In this article, a brief analysis of the treatment procedures, factors affecting drug permeation across nail plate, chemical, mechanical and physical devices used to increase the drug delivery through nails for the onychomycosis management has been achieved.
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Affiliation(s)
- R Aggarwal
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Mehrauli - Badarpur Rd, Sector 3, Pushp Vihar, New Delhi 110017, India.
| | - M Targhotra
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Mehrauli - Badarpur Rd, Sector 3, Pushp Vihar, New Delhi 110017, India
| | - B Kumar
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Mehrauli - Badarpur Rd, Sector 3, Pushp Vihar, New Delhi 110017, India
| | - P K Sahoo
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Mehrauli - Badarpur Rd, Sector 3, Pushp Vihar, New Delhi 110017, India
| | - M K Chauhan
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Mehrauli - Badarpur Rd, Sector 3, Pushp Vihar, New Delhi 110017, India
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12
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Lee BC, Pangeni R, Na J, Koo KT, Park JW. Preparation and in vivo evaluation of a highly skin- and nail-permeable efinaconazole topical formulation for enhanced treatment of onychomycosis. Drug Deliv 2019; 26:1167-1177. [PMID: 31738083 PMCID: PMC6882438 DOI: 10.1080/10717544.2019.1687612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/31/2022] Open
Abstract
Onychomycosis is a progressive fungal infection of the nails that involves the deeper nail layer and nail bed. It is important to maintain sufficient drug concentration in the diseased tissues after topical application. In this study, a stable topical delivery system for efinaconazole (EFN) was designed to enhance absorption potential through the skin and nail plate by incorporating ethanol, diethylene glycol monoethyl ether (Transcutol P) and isopropyl myristate, and cyclomethicone into the topical solution as a delivery vehicle, permeation enhancers, and a wetting agent, respectively. In addition, the stability of EFN in the formulation was significantly improved by adding butylated hydroxytoluene, diethylenetriamine pentaacetic acid, and citric acid as an antioxidant, chelating agent, and pH-adjusting agent, respectively, without discoloration. The optimum EFN formulation (EFN-K) showed 1.46-fold greater human skin permeation than that of the reference control (commercial 10% EFN topical solution). Furthermore, after a 24-hour incubation, the amount of infiltrated EFN from EFN-K in the human nail plate was 4.11-fold greater than that of the reference control, resulting in an 89.7% increase in nail flux at 7 days after treatment. EFN-K significantly accelerated structural recovery of the keratin layer in a Trichophyton mentagrophytes-infected guinea pig onychomycosis model, decreasing the mean viable fungal cell count by 54.3% compared to the vehicle-treated group after once-daily treatment for 4 weeks. Thus, the accelerated skin and nail penetration effect of EFN-K is expected to achieve good patient compliance, and improve the complete cure rate of onychomycosis.
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Affiliation(s)
- Byung Chul Lee
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Republic of Korea
| | - Rudra Pangeni
- College of Pharmacy and Natural Medicine Research Institute, Mokpo National University, Jeonnam, Republic of Korea
| | - Jungtae Na
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Republic of Korea
| | - Kyo-Tan Koo
- BioBelief Co., Ltd., Seoul, Republic of Korea
| | - Jin Woo Park
- College of Pharmacy and Natural Medicine Research Institute, Mokpo National University, Jeonnam, Republic of Korea
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13
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Dhamoon RK, Goyal RK, Popli H, Gupta M. Luliconazole-Loaded Thermosensitive Hydrogel as Aqueous based Nail Lacquer for the Treatment of Onychomycosis. ACTA ACUST UNITED AC 2019. [DOI: 10.2174/2210303109666190520081552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Onychomycosis is a nail fungal infection which accounts for 50% of the nail
diseases and is characterized by disfigurement and discoloration of nails. The current therapy includes
oral and topical formulations both of which come with their own drawbacks. This has left a room for
developing patient- compliant novel strategies which can facilitate drug delivery deeper into the nails
effectively.
Objective:
The main objective of the present work was to develop and evaluate in situ gelling thermosensitive
hydrogel as an aqueous nail lacquer for the treatment of onychomycosis. The idea was to
enhance permeation of Luliconazole into the nail while simultaneously solubilizing it in a hydrophilic
formulation.
Methods:
The sample of Luliconazole was authenticated using modern analytical techniques. The hydrogel-
nail lacquer was prepared using poloxamer Pluronic F127. The formulation was evaluated in
terms of drying time, viscosity, non- volatile content, pH, transition temperature, etc. In vitro study was
done to check the drug release while determining release kinetics. In vitro transungual permeation study
was done to check drug permeation through porcine hoof membrane. Stability studies were conducted
to ensure formulation stability.
Results:
The results confirmed a stable formulation with enhanced permeation through porcine hoof
membrane.
Conclusion:
The results support the potential use of in situ gelling thermo-sensitive hydrogels as a
novel transungual formulation in the treatment of onychomycosis with a slight improvement in water
resistance.
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Affiliation(s)
- Rupinder K. Dhamoon
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp vihar, Sector-3, M.B Road, New Delhi -110017, India
| | - Ramesh K. Goyal
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp vihar, Sector-3, M.B Road, New Delhi -110017, India
| | - Harvinder Popli
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp vihar, Sector-3, M.B Road, New Delhi -110017, India
| | - Madhu Gupta
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp vihar, Sector-3, M.B Road, New Delhi -110017, India
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14
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Albarahmieh E, AbuAmmouneh L, Kaddoura Z, AbuHantash F, Alkhalidi BA, Al-Halhouli A. Fabrication of Dissolvable Microneedle Patches Using an Innovative Laser-Cut Mould Design to Shortlist Potentially Transungual Delivery Systems: In Vitro Evaluation. AAPS PharmSciTech 2019; 20:215. [PMID: 31172376 DOI: 10.1208/s12249-019-1429-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/21/2019] [Indexed: 12/31/2022] Open
Abstract
There has been a great interest towards transungual delivery systems due to limited drug penetration for the treatment of nail diseases. More important, antifungal oral medicaments used may cause serious side effects including liver damage. Therefore, we propose non-oral dissolvable microneedle (MN) patch to strike the poor permeability of the nail. We report the design of MN patch mould using a laser-cutting machine and solvent casting of several hydrophilic polymers to fabricate these MN patches. Formulations were evaluated for their in vitro release and penetration properties and selected based on physical characterization for compatibility (differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD)), dimension repeatability and drug content uniformity. A 72-array of cone-shaped MN patch mould was successfully constructed on polymethylmethacrylate sheets. Interval and frequency of laser exposure were pivotal to determine the needle sharpness, attained unexpectedly at a low level of circa 30 μm. F1 platform of polyvinyl alcohol, kollicoat IR®, ethylene glycol and gelatin showed circa 74% penetration of methylhydroxy-4-benzoate (F1(A)) over 24 h, whereas F2 (same as F1-A with the addition of poloxamer 338) resulted in an almost 42% of this drug retention in the bovine hoof (24 h). Both formulations are likely to be useful for onychomycosis treatment. F1 polymers also afford enhanced permeability (almost 73.5% after 24 h) of terbinafine hydrochloride into the hoof (F1(B)). However, F3 (chitosan, gelatin and ethylene glycol) presents the prospect of developing MN patch for this drug with almost complete hoof penetration (circa 96.3% after 24 h). All medicated formulations have shown similar mechanical properties after ageing for 1 year under dry conditions.
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Potential of Chemical and Physical Enhancers for Transungual Delivery of Amorolfine Hydrochloride. MATERIALS 2019; 12:ma12071028. [PMID: 30925734 PMCID: PMC6480142 DOI: 10.3390/ma12071028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/12/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023]
Abstract
Topical monotherapy of nail infection is limited by poor drug permeability into the human nail plate. Numerous substances and methods are applied to improve the antifungal agent delivery across the nail plate. This work aimed to evaluate the effect of chemical and physical enhancers on the accumulation and permeation of amorolfine hydrochloride through human nail clippings. Polymeric nail lacquers with Eudragit E100 were developed as a potentially suitable delivery system for amorolfine hydrochloride. Incorporating thioglycolic acid and urea into formulations provided increased accumulation of antifungal agent in nail layers of up to 100% and 57%, respectively. Structural changes of nail barrier, induced by fractional CO2 laser, were visualized by microscopy. The permeation of amorolfine hydrochloride through the nail increased twofold when thioglycolic acid-containing formulation was applied and the nail was pretreated with a fractional CO2 laser. The results suggest that this novel combination of enhancers has the potential to be an effective option for topical drug delivery through the nail, and increased the efficacy of treatment.
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16
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Kreutz T, de Matos SP, Koester LS. Recent Patents on Permeation Enhancers for Drug Delivery Through Nails. RECENT PATENTS ON DRUG DELIVERY & FORMULATION 2019; 13:203-218. [PMID: 31663846 PMCID: PMC7011684 DOI: 10.2174/1872211313666191030155837] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/21/2019] [Accepted: 10/24/2019] [Indexed: 12/29/2022]
Abstract
The human nail is a unique barrier with a keratinized constitution that favors protection and fine touch. However, many disorders can affect the nail, among them, are the onychomycosis and psoriasis. Systemic oral therapy has been applied to treat these diseases, even presenting disadvantages, including side effects, drug interactions, contraindications, toxicity, high cost and low patient compliance. A great option to succeed in dealing with the problems associated with oral therapy is the topical administration of drugs. However, nail composition, low diffusion through ungual route and reduced tissue bioavailability for topical treatments are limiting factors. These drawbacks can be overcome by promoting penetration through the nails by employing penetration enhancers. The review focuses on patents that highlight permeation enhancers applied to nail drug delivery for the treatment of onychomycosis and psoriasis. Literature and patent searches were conduced regarding the topic of interest. The substantial literature and patent search revealed that permeation enhancers, especially chemicals, are great strategies for promoting the ungual delivery of drugs. Nail topical therapy containing permeation enhancers is an attractive option for delivering localized treatments.
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Affiliation(s)
- Tainá Kreutz
- Graduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio Grande do Sul, Av. Ipiranga, Santana, 2752, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sheila Porto de Matos
- Graduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio Grande do Sul, Av. Ipiranga, Santana, 2752, Porto Alegre, Rio Grande do Sul, Brazil
| | - Letícia Scherer Koester
- Graduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio Grande do Sul, Av. Ipiranga, Santana, 2752, Porto Alegre, Rio Grande do Sul, Brazil
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17
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Angelo T, Borgheti-Cardoso LN, Gelfuso GM, Taveira SF, Gratieri T. Chemical and physical strategies in onychomycosis topical treatment: A review. Med Mycol 2018; 55:461-475. [PMID: 27703019 DOI: 10.1093/mmy/myw084] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/30/2016] [Indexed: 12/13/2022] Open
Abstract
Onychomycosis is a fungal infection of the fingernails or toenails caused by dermatophytes, nondermatophytes, moulds, and yeasts. This condition affects around 10-30% people worldwide, negatively influencing patients' quality of life, with severe outcomes in some cases. Since the nail unit acts as a barrier to exogenous substances, its physiological features hampers drug penetration, turning the onychomycosis treatment a challenge. Currently, there are several oral and topical therapies available; nevertheless, cure rates are still low and relapse rates achieves 10-53%. Also, serious side effects may be developed due to long-term treatment. In light of these facts, researchers have focused on improving topical treatments, either by modifying the vehicle or by using some physical technique to improve drug delivery trough the nail plate, hence increasing therapy effectiveness. Therefore, the aim of this paper is to explain these novel alternative approaches. First, the challenges for drug ungual penetration are presented. Then, the chemical and physical strategies developed for overcoming the barriers for drug penetration are discussed. We hope that the information gathered may be useful for the development of safer and more effective treatments for onychomycosis.
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Affiliation(s)
- Tamara Angelo
- Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil
| | - Lívia Neves Borgheti-Cardoso
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo. Avenida do Café, s/n, 14040903, Ribeirão Preto, SP, Brazil
| | - Guilherme Martins Gelfuso
- Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil
| | - Stephânia Fleury Taveira
- School of Pharmacy, Federal University of Goiás. Rua 240 c/5ª. Avenida, s/n, Setor Leste Universitário, 74.605-170, Goiânia, GO, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil
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18
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Voriconazole-loaded nanostructured lipid carriers (NLC) for drug delivery in deeper regions of the nail plate. Int J Pharm 2017; 531:292-298. [PMID: 28859937 DOI: 10.1016/j.ijpharm.2017.08.115] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/23/2017] [Accepted: 08/27/2017] [Indexed: 12/31/2022]
Abstract
Voriconazole-loaded nanostructured lipid carriers (VOR-NLC) were developed and drug penetration evaluated in porcine hooves in vitro. Synergistic effect of urea (Ur), selected among other known chemical enhancers according to hoof hydration potential, was also evaluated. VOR-NLC presented a high encapsulation efficiency (74.52±2.13%), approximate mean diameter of 230nm and were positively charged (+27.32±2.74mV). Stability studies indicated they were stable under refrigeration (4±2°C) for up to 150days. SEM images revealed hooves treated with VOR-NLC and VOR-NLC-Ur suffered a disturbance on the surface depicting high roughness and porosity. Permeation data showed a substantial VOR amount retained in superficial hooves sections independent of the formulation used (2.42±0.26; 2.52±0.36 and 2.41±0.60μg/cm2 for unloaded VOR, VOR-NLC and VOR-NLC-Ur, respectively, p>0.05). Still, successive extractions, revealed the amount of VOR retained in deeper regions was significantly higher when VOR-NLC or VOR-NLC-Ur was used (0.17±0.04, 0.47±0.14 and 0.36±0.07μg/cm2 for unloaded VOR, VOR-NLC and VOR-NLC-Ur, respectively, p<0.05). Such results indicate NLC are promising formulations for the management of onychomycosis. Further studies in diseased nail plates are necessary.
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19
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Evaluation of the Ability of a Novel Miconazole Formulation To Penetrate Nail by Using Three In Vitro Nail Models. Antimicrob Agents Chemother 2017; 61:AAC.02554-16. [PMID: 28438926 DOI: 10.1128/aac.02554-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/14/2017] [Indexed: 11/20/2022] Open
Abstract
In an effort to increase the efficacy of topical medications for treating onychomycosis, several new nail penetration enhancers were recently developed. In this study, the ability of 10% (wt/wt) miconazole nitrate combined with a penetration enhancer formulation to permeate the nail is demonstrated by the use of a selection of in vitro nail penetration assays. These assays included the bovine hoof, TurChub zone of inhibition, and infected-nail models.
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20
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Elsherif NI, Shamma RN, Abdelbary G. Terbinafine Hydrochloride Trans-ungual Delivery via Nanovesicular Systems: In Vitro Characterization and Ex Vivo Evaluation. AAPS PharmSciTech 2017; 18:551-562. [PMID: 27138036 DOI: 10.1208/s12249-016-0528-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/03/2016] [Indexed: 11/30/2022] Open
Abstract
Treating a nail infection like onychomycosis is challenging as the human nail plate acts as a formidable barrier against all drug permeation. Available oral and topical treatments have several setbacks. Terbinafine hydrochloride (TBH), belonging to the allylamine class, is mainly used for treatment of onychomycosis. This study aims to formulate TBH in a nanobased spanlastic vesicular carrier that enables and enhances the drug delivery through the nail. The nanovesicles were formulated by ethanol injection method, using either Span® 60 or Span® 65, together with Tween 80 or sodium deoxycholate as an edge activator. A full factorial design was implemented to study the effect of different formulation and process variables on the prepared TBH-loaded spanlastic nanovesicles. TBH entrapment efficiency percentages, particle size diameter, percentage drug released after 2 h and 8 h were selected as dependent variables. Optimization was performed using Design-Expert® software to obtain an optimized formulation with high entrapment efficiency (62.35 ± 8.91%), average particle size of 438.45 ± 70.5 nm, and 29.57 ± 0.93 and 59.53 ± 1.73% TBH released after 2 and 8 h, respectively. The optimized formula was evaluated using differential scanning calorimetry and X-ray diffraction and was also morphologically examined using transmission electron microscopy. An ex vivo study was conducted to determine the permeation and retainment of the optimized formulation in a human cadaver nail plate, and confocal laser scanning microscope was used to show the extent of formulation permeation. In conclusion, the results confirmed that spanlastics exhibit promising results for the trans-ungual delivery of TBH.
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21
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Baswan S, Kasting GB, Li SK, Wickett R, Adams B, Eurich S, Schamper R. Understanding the formidable nail barrier: A review of the nail microstructure, composition and diseases. Mycoses 2017; 60:284-295. [PMID: 28098391 DOI: 10.1111/myc.12592] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 11/25/2016] [Indexed: 01/27/2023]
Abstract
The topical treatment of nail fungal infections has been a focal point of nail research in the past few decades as it offers a much safer and focused alternative to conventional oral therapy. Although the current focus remains on exploring the ways of enhancing permeation through the formidable nail barrier, the understanding of the nail microstructure and composition is far from complete. This article reviews our current understanding of the nail microstructure, composition and diseases. A few of the parameters affecting the nail permeability and potential causes of the recurrence of fungal nail infection are also discussed.
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Affiliation(s)
- Sudhir Baswan
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, OH, USA.,Amway Corporation, Ada, MI, USA
| | - Gerald B Kasting
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - S Kevin Li
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Randy Wickett
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Brian Adams
- Department of Dermatology, College of Medicine, The University of Cincinnati Academic Health Center, Cincinnati, OH, USA
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22
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Matsuda Y, Sugiura K, Hashimoto T, Ueda A, Konno Y, Tatsumi Y. Efficacy Coefficients Determined Using Nail Permeability and Antifungal Activity in Keratin-Containing Media Are Useful for Predicting Clinical Efficacies of Topical Drugs for Onychomycosis. PLoS One 2016; 11:e0159661. [PMID: 27441843 PMCID: PMC4956321 DOI: 10.1371/journal.pone.0159661] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 07/05/2016] [Indexed: 11/18/2022] Open
Abstract
Onychomycosis is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. In order to obtain an in vitro index that is relevant to the clinical efficacy of topical anti-onychomycosis drugs, we profiled five topical drugs: amorolfine, ciclopirox, efinaconazole, luliconazole, and terbinafine, for their nail permeabilities, keratin affinities, and anti-dermatophytic activities in the presence of keratin. Efinaconazole and ciclopirox permeated full-thickness human nails more deeply than luliconazole. Amorolfine and terbinafine did not show any detectable permeation. The free-drug concentration of efinaconazole in a 5% human nail keratin suspension was 24.9%, which was significantly higher than those of the other drugs (1.1-3.9%). Additionally, efinaconazole was released from human nail keratin at a greater proportion than the other drugs. The MICs of the five drugs for Trichophyton rubrum were determined at various concentrations of keratin (0-20%) in RPMI 1640 medium. The MICs of ciclopirox were not affected by keratin, whereas those of efinaconazole were slightly increased and those of luliconazole and terbinafine were markedly increased in the presence of 20% keratin. Efficacy coefficients were calculated using the nail permeation flux and MIC in media without or with keratin. Efinaconazole showed the highest efficacy coefficient, which was determined using MIC in media with keratin. The order of efficacy coefficients determined using MIC in keratin-containing media rather than keratin-free media was consistent with that of complete cure rates in previously reported clinical trials. The present study revealed that efficacy coefficients determined using MIC in keratin-containing media are useful for predicting the clinical efficacies of topical drugs. In order to be more effective, topical drugs have to possess higher efficacy coefficients.
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Affiliation(s)
- Yoshiki Matsuda
- Drug Research Center, Kaken Pharmaceutical Co., Ltd., Kyoto, Japan
| | - Keita Sugiura
- Drug Research Center, Kaken Pharmaceutical Co., Ltd., Kyoto, Japan
| | | | - Akane Ueda
- Drug Research Center, Kaken Pharmaceutical Co., Ltd., Kyoto, Japan
| | - Yoshihiro Konno
- Drug Research Center, Kaken Pharmaceutical Co., Ltd., Kyoto, Japan
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23
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Thapa RK, Choi JY, Go TG, Kang MH, Han SD, Jun JH, Son MW, Yong CS, Kim JO. Development of ciclopirox nail lacquer with enhanced permeation and retention. Arch Pharm Res 2016; 39:953-9. [PMID: 27306785 DOI: 10.1007/s12272-016-0774-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/08/2016] [Indexed: 11/30/2022]
Abstract
Onychomycosis is a prevailing disease caused by fungal infection of nails that mostly affects athletes and the elderly. Ciclopirox is approved by the US Food and Drug Administration for the topical treatment of onychomycosis. However, the desired penetration of ciclopirox into the nail bed has not been achieved via topical application for efficient treatment. Therefore, the main aim of this study was to enhance ciclopirox permeation and retention in nail by the development of a new nail lacquer formulation. We screened the effects of different solvents, alkalizing agents, and permeation enhancers on the permeation of bovine hooves by ciclopirox and its retention in human nail clippings. The results suggest that isopropyl alcohol, potassium hydroxide, and urea as the solvent, alkalizing agent, and permeation enhancer, respectively, improved the permeation of the ciclopirox nail lacquer formulation the most with high flux rates. Comparison of the final formulation and marketed product revealed enhanced retention of ciclopirox from our developed formulation in human nail clippings. Therefore, our newly developed nail lacquer may be a potentially effective formulation for the treatment of onychomycosis in humans.
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Affiliation(s)
- Raj Kumar Thapa
- College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyeongsan, 712-749, South Korea
| | - Ju Yeon Choi
- College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyeongsan, 712-749, South Korea
| | - Toe Gyung Go
- College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyeongsan, 712-749, South Korea
| | - Min Hyung Kang
- Dong-A ST Research Institute, Pharmaceutical Product Research Laboratories, Yongin, 449-905, South Korea
| | - Sang Duk Han
- Dong-A ST Research Institute, Pharmaceutical Product Research Laboratories, Yongin, 449-905, South Korea
| | - Joon-Ho Jun
- Dong-A ST Research Institute, Pharmaceutical Product Research Laboratories, Yongin, 449-905, South Korea
| | - Mi Won Son
- Dong-A ST Research Institute, Pharmaceutical Product Research Laboratories, Yongin, 449-905, South Korea
| | - Chul Soon Yong
- College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyeongsan, 712-749, South Korea
| | - Jong Oh Kim
- College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyeongsan, 712-749, South Korea.
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McAuley WJ, Jones SA, Traynor MJ, Guesné S, Murdan S, Brown MB. An investigation of how fungal infection influences drug penetration through onychomycosis patient's nail plates. Eur J Pharm Biopharm 2016; 102:178-84. [PMID: 26969264 PMCID: PMC4827374 DOI: 10.1016/j.ejpb.2016.03.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/24/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022]
Abstract
The treatment of onychomycosis remains problematic even though there are several potent antifungal agents available for patient use. The aim of this investigation was to understand whether the structural modifications that arise when a patient’s nail become infected plates influences the permeation of drugs into the nail following topical application. It was hoped that through improving understanding of the nail barrier in the diseased state, the development of more effective topical treatments for onychomycosis could be facilitated. The permeation of three compounds with differing hydrophobicities, caffeine, terbinafine and amorolfine (clog D at pH 7.4 of −0.55, 3.72 and 4.49 respectively), was assessed across both healthy and onychomycosis infected, full thickness, human nail plate sections. Transonychial water loss (TOWL) measurements performed on the healthy and diseased nails supported previous observations that the nail behaves like a porous barrier given the lack of correlation between TOWL values with the thicker, diseased nails. The flux of the more hydrophilic caffeine was twofold greater across diseased in comparison with the healthy nails, whilst the hydrophobic molecules terbinafine and amorolfine showed no statistically significant change in their nail penetration rates. Caffeine flux across the nail was found to correlate with the TOWL measurements, though no correlation existed for the more hydrophobic drugs. These data supported the notion that the nail pores, opened up by the infection, facilitated the passage of hydrophilic molecules, whilst the keratin binding of hydrophobic molecules meant that their transport through the nail plate was unchanged. Therefore, in order to exploit the structural changes induced by nail fungal infection it would be beneficial to develop a small molecular weight, hydrophilic antifungal agent, which exhibits low levels of keratin binding.
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Affiliation(s)
- W J McAuley
- Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK.
| | - S A Jones
- Pharmaceutical Science Division, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - M J Traynor
- Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK
| | - S Guesné
- Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK
| | - S Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - M B Brown
- Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK; MedPharm Ltd, Unit 3 Chancellor Court, 50 Occam Road, Surrey Research Park, Guildford GU2 7AB, UK
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25
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Baswan SM, Li SK, LaCount TD, Kasting GB. Size and Charge Dependence of Ion Transport in Human Nail Plate. J Pharm Sci 2016; 105:1201-8. [PMID: 26886342 DOI: 10.1016/j.xphs.2015.12.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 12/26/2022]
Abstract
The electrical properties of human nail plate are poorly characterized yet are a key determinate of the potential to treat nail diseases, such as onychomycosis, using iontophoresis. To address this deficiency, molar conductivities of 17 electrolytes comprising 12 ionic species were determined in hydrated human nail plate in vitro. Cation transport numbers across the nail for 11 of these electrolytes were determined by the electromotive force method. Effective ionic mobilities and diffusivities at infinite dilution for all ionic species were determined by regression analysis. The ratios of diffusivities in nail to those in solution were found to correlate inversely with the hydrodynamic radii of the ions according to a power law relationship having an exponent of -1.75 ± 0.27, a substantially steeper size dependence than observed for similar experiments in skin. Effective diffusivities of cations in nail were 3-fold higher than those of comparably sized anions. These results reflect the strong size and charge selectivity of the nail plate for ionic conduction and diffusion. The analysis implies that efficient transungual iontophoretic delivery of ionized drugs having radii upward of 5 Å (molecular weight, ca. ≥ 340 Da) will require chemical or mechanical alteration of the nail plate.
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Affiliation(s)
- Sudhir M Baswan
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0004
| | - S Kevin Li
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0004
| | - Terri D LaCount
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0004
| | - Gerald B Kasting
- James L. Winkle College of Pharmacy, The University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0004.
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Bseiso EA, Nasr M, Sammour OA, Abd El Gawad NA. Novel nail penetration enhancer containing vesicles "nPEVs" for treatment of onychomycosis. Drug Deliv 2015; 23:2813-2819. [PMID: 26447337 DOI: 10.3109/10717544.2015.1099059] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
CONTEXT The systemic treatment of onychomycosis has been hampered by the reported side effects of antifungals in addition to the limited blood circulation to the affected nails. Topical ungual treatment would circumvent the limitations of systemic onychomycosis treatment. OBJECTIVE Preparation and characterization of nail penetration enhancer containing nanovesicles (nPEVs) loaded with sertaconazole for topical treatment of onychomycosis. MATERIALS AND METHODS nPEVs were prepared using different nail penetration enhancers (N-acetyl-L-cysteine, thioglycolic acid, thiourea and ethanol) by the thin film hydration method, and characterized for their particle size, zeta potential, entrapment efficiency (EE%), elasticity, viscosity, physical stability and morphology. The selected nPEVs formula and the marketed Dermofix® cream were compared in terms of nail hydration, transungual drug uptake and antifungal activity against Trichophyton rubrum. RESULTS N-acetyl-l-cysteine was the optimum nail penetration enhancer for incorporation within vesicles. nPEVs showed high EE% of sertaconazole ranging from 77 to 95%, a size ranging from 38-538 nm and a zeta potential ranging from +48 to +72 mV. The selected nPEVs formula displayed spherical morphology and good storage stability. Compared to the conventional marketed cream, the selected nPEVs formula showed 1.4-folds higher hydration and drug uptake enhancement into nail clippings. Furthermore, it showed significantly higher zone of inhibition for Trichophyton rubrum (20.9 ± 0.25 mm) than the marketed cream (11.6 ± 0.44 mm). CONCLUSION Nail penetration enhancer containing nanovesicles (nPEVs) present a very promising option, worthy of clinical experimentation on onychomycotic patients.
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Affiliation(s)
- Eman A Bseiso
- a Department of Pharmaceutics , Faculty of Pharmacy, October 6 University , Cairo , Egypt
| | - Maha Nasr
- b Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Ain Shams University , Cairo , Egypt , and
| | - Omaima A Sammour
- b Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Ain Shams University , Cairo , Egypt , and
| | - Nabaweya A Abd El Gawad
- a Department of Pharmaceutics , Faculty of Pharmacy, October 6 University , Cairo , Egypt.,c Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Cairo University , Cairo , Egypt
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Abstract
Nail disorders are beyond cosmetic concern; besides discomfort in the performance of daily chores, they disturb patients psychologically and affect their quality of life. Fungal nail infection (onychomycosis) is the most prevalent nail-related disorder affecting a major population worldwide. Overcoming the impenetrable nail barrier is the toughest challenge for the development of efficacious topical ungual formulation. Sophisticated techniques such as iontophoresis and photodynamic therapy have been proven to improve transungual permeation. This article provides an updated and concise discussion regarding the conventional approach and upcoming novel approaches focused to alter the nail barrier. A comprehensive description regarding preformulation screening techniques for the identification of potential ungual enhancers is also described in this review while highlighting the current pitfalls for the development of ungual delivery.
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Tuncay Tanrıverdi S, Hilmioğlu Polat S, Yeşim Metin D, Kandiloğlu G, Özer Ö. Terbinafine hydrochloride loaded liposome film formulation for treatment of onychomycosis:in vitroandin vivoevaluation. J Liposome Res 2015; 26:163-73. [DOI: 10.3109/08982104.2015.1067892] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Täuber A, Müller-Goymann CC. In vitro permeation and penetration of ciclopirox olamine from poloxamer 407-based formulations – comparison of isolated human stratum corneum, bovine hoof plates and keratin films. Int J Pharm 2015; 489:73-82. [DOI: 10.1016/j.ijpharm.2015.04.043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 12/21/2022]
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Elsayed MMA. Development of topical therapeutics for management of onychomycosis and other nail disorders: a pharmaceutical perspective. J Control Release 2014; 199:132-44. [PMID: 25481439 DOI: 10.1016/j.jconrel.2014.11.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/14/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
The human nail plate is a formidable barrier to drug permeation. Development of therapeutics for management of nail diseases thus remains a challenge. This article reviews the current knowledge and recent advances in the field of transungual drug delivery and provides guidance on development of topical/ungual therapeutics for management of nail diseases, with special emphasis on management of onychomycosis, the most common nail disease. Selection of drug candidates, drug delivery approaches, and evaluation of formulations are among the topics discussed. A comprehensive mathematical description for transungual permeation is also introduced.
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Affiliation(s)
- Mustafa M A Elsayed
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, El-Khartoum Square, El-Azarita, Alexandria 21521, Egypt.
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Hydroxypropyl- β -cyclodextrin: A Novel Transungual Permeation Enhancer for Development of Topical Drug Delivery System for Onychomycosis. JOURNAL OF DRUG DELIVERY 2014; 2014:950358. [PMID: 25177500 PMCID: PMC4142161 DOI: 10.1155/2014/950358] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/18/2014] [Accepted: 07/21/2014] [Indexed: 11/24/2022]
Abstract
The treatment of onychomycosis is a challenging task because of unique barrier properties of the nail plate which hampers the passage of antifungal drugs in a concentration required to eradicate the deeply seated causative fungi in the nail bed. In present investigation, application of hydroxypropyl-β-cyclodextrin (HP-β-CD) was established as an effective and nail friendly transungual drug permeation enhancer especially for poorly water soluble drugs using terbinafine hydrochloride as a poorly soluble drug. HP-β-CD significantly improves hydration of nail plates and increases solubility of terbinafine hydrochloride in the aqueous environment available therein, which leads to uninterrupted drug permeation through water filled pores of hydrogel-like structure of hydrated nail plates. A nail lacquer formulation was designed with an objective to deliver the drug in an effective concentration across nail plates, using HP-β-CD as a permeation enhancer. The formulations containing HP-β-CD showed higher flux than the control formulation in in vitro drug permeation study. The formulation containing 10% w/v of HP-β-CD showed maximum flux of 4.586 ± 0.08 μg/mL/cm2 as compared to the control flux of 0.868 ± 0.06 μg/mL/cm2. This finding supports application of HP-β-CD as an effective permeation enhancer for transungual delivery of terbinafine hydrochloride and possibly other poorly water soluble drugs where HP-β-CD can act as a solubilizer.
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Abstract
Topical therapy is at the forefront in treating nail ailments (especially onychomycosis and nail psoriasis) due to its local effects, which circumvents systemic adverse events, improves patient compliance and reduces treatment cost. However, the success of topical therapy has been hindered due to poor penetration of topical therapeutics across densely keratinized nail plate barrier. For effective topical therapy across nail plate, ungual drug permeation must be enhanced. Present review is designed to provide an insight into prime aspects of transungual drug delivery viz. nail structure and physiology, various onychopathies, techniques of nail permeation enhancement and in vitro models for trans-nail drug permeation studies. Updated list of drug molecules studied across the nail plate and key commercial products have been furnished with sufficient depth. Patents pertinent to, and current clinical status of transungual drug delivery have also been comprehensively reviewed. This is the first systematic critique encompassing the detailed aspects of transungual drug delivery. In our opinion, transungual drug delivery is a promising avenue for researchers to develop novel formulations, augmenting pharmaceutical industries to commercialize the products for nail disorders.
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Affiliation(s)
- Manish V Saner
- Department of Pharmaceutics, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, North Maharshtra University , Maharashtra , India
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Naumann S, Meyer JP, Kiesow A, Mrestani Y, Wohlrab J, Neubert RH. Controlled nail delivery of a novel lipophilic antifungal agent using various modern drug carrier systems as well as in vitro and ex vivo model systems. J Control Release 2014; 180:60-70. [DOI: 10.1016/j.jconrel.2014.02.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 12/28/2022]
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Probabilistic assessment of exposure to nail cosmetics in French consumers. Food Chem Toxicol 2014; 66:36-43. [PMID: 24447976 DOI: 10.1016/j.fct.2014.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/10/2014] [Accepted: 01/13/2014] [Indexed: 12/27/2022]
Abstract
The aim of this study was to assess probabilistic exposure to nail cosmetics in French consumers. The exposure assessment was performed with base coat, polish, top coat and remover. This work was done for adult and child consumers. Dermal, inhalation and oral routes were taken into account for varnishes. Exposure evaluation was performed for the inhalation route with polish remover. The main route of exposure to varnishes was the ungual route. Inhalation was the secondary route of exposure, followed by dermal and oral routes. Polish contributed most to exposure, regardless of the route of exposure. For this nail product, P50 and P95 values by ungual route were respectively equal to 1.74 mg(kg bw week)(-1) and 8.55 mg(kg bw week)(-1) for women aged 18-34 years. Exposure to polish by inhalation route was equal to 0.70 mg(kg bw week)(-1) (P50) and 5.27 mg(kg bw week)(-1) (P95). P50 and P95 values by inhalation route were respectively equal to 0.08 mg(kg bw week)(-1) and 1.14 mg(kg bw week)(-1) for consumers aged 18-34 years exposed to polish remover. This work provided current exposure data for nail cosmetics, and a basis for future toxicological studies of the uptake of substances contained in nail cosmetics in order to assess systemic exposure.
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Smijs TG, Jachtenberg JW, Pavel S, Bakker-Schut TC, Willemse-Erix D, de Haas ERM, Sterenborg H. Detection and differentiation of causative organisms of onychomycosis in an ex vivo
nail model by means of Raman spectroscopy. J Eur Acad Dermatol Venereol 2013; 28:1492-9. [DOI: 10.1111/jdv.12324] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- T. G. Smijs
- Centre for Optical Diagnostics and Therapy; Department of Radiotherapy; Erasmus Medical Centre; Rotterdam The Netherlands
| | - J. W. Jachtenberg
- Department of Neurosurgery; Erasmus Medical Centre; Rotterdam The Netherlands
| | - S. Pavel
- Department of Dermatology; Charles University; Pilsen Czech Republic
| | - T. C. Bakker-Schut
- Department of Dermatology and Venereology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - D. Willemse-Erix
- Department of Medical Microbiology and Infectious Diseases; Erasmus Medical Centre; Rotterdam The Netherlands
| | - E. R. M. de Haas
- Department of Dermatology and Venereology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - H. Sterenborg
- Centre for Optical Diagnostics and Therapy; Department of Radiotherapy; Erasmus Medical Centre; Rotterdam The Netherlands
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37
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Smijs T, Dame Z, de Haas E, Aans JB, Pavel S, Sterenborg H. Photodynamic and Nail Penetration Enhancing Effects of Novel Multifunctional Photosensitizers Designed for The Treatment of Onychomycosis. Photochem Photobiol 2013; 90:189-200. [DOI: 10.1111/php.12196] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/20/2013] [Indexed: 01/20/2023]
Affiliation(s)
- Threes Smijs
- Department of Radiaotherapy; Center for Optical Diagnostics and Therapy; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Zoë Dame
- Department of Radiaotherapy; Center for Optical Diagnostics and Therapy; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Ellen de Haas
- Department of Dermatology and Venereology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Jan-Bonne Aans
- Department of Radiaotherapy; Center for Optical Diagnostics and Therapy; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Stan Pavel
- Department of dermatology; Faculty of Medicine; Charles University; Pilsen Czech Republic
| | - Henricus Sterenborg
- Department of Radiaotherapy; Center for Optical Diagnostics and Therapy; Erasmus Medical Centre; Rotterdam The Netherlands
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38
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39
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Ahn TS, Lee JP, Kim J, Oh SY, Chun MK, Choi HK. Effect of pressure sensitive adhesive and vehicles on permeation of terbinafine across porcine hoof membrane. Arch Pharm Res 2013; 36:1403-9. [DOI: 10.1007/s12272-013-0191-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
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41
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Hafeez F, Hui X, Selner M, Rosenthal B, Maibach H. Ciclopirox delivery into the human nail plate using novel lipid diffusion enhancers. Drug Dev Ind Pharm 2013; 40:838-44. [PMID: 23600655 DOI: 10.3109/03639045.2013.788016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
CONTEXT Onychomycosis is a common fungal infection of the nail plate and bed that affects up to 14% of the population and can have a substantial impact on the quality of life of those affected. OBJECTIVE This study compared the onychopharmacokinetics, nail absorption, nail distribution, and nail penetration of [(14)C]-ciclopirox dissolved in novel lipid diffusion enhancers with that of a commercial ciclopirox nail lacquer using the in vitro finite dose model. MATERIALS AND METHODS The penetration rate of ciclopirox was determined by applying doses of topical formulation twice daily to human nail plates for 11 d. Drug absorption was then measured by monitoring its rate of appearance in each nail layer and in the cotton pad/nail supporting bed. RESULTS After a multiple day treatment, cumulative concentrations of ciclopirox formulated with lipid enhancers in the deep nail layer and the nail bed were significantly greater than cumulative concentrations of the commercial ciclopirox lacquer (p < 0.001) as well as several orders of magnitude greater than the minimal inhibitory concentration (MIC) deemed necessary to inhibit the growth of the causative dermatophyte species. CONCLUSION When formulated with lipid enhancers, the amount of ciclopirox in the ventral/intermediate layer and supporting bed dramatically exceed the inhibitory concentration of ciclopirox for the most common onychomycosis organisms. These results suggest that topical ciclopirox with lipid enhancers has the potential to be an effective topical treatment for onychomycosis, and the lipidic pathway of the nail can be utilized as a means of effective transungual delivery.
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Affiliation(s)
- Farhaan Hafeez
- Dermatology Department, University of California , San Francisco, CA , USA and
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42
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Tanrıverdi ST, Özer Ö. Novel topical formulations of Terbinafine-HCl for treatment of onychomycosis. Eur J Pharm Sci 2013; 48:628-36. [PMID: 23295582 DOI: 10.1016/j.ejps.2012.12.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 12/12/2012] [Accepted: 12/20/2012] [Indexed: 10/27/2022]
Abstract
Terbinafine hydrochloride (TBF-HCl) is an active substance that is using for treatment of onychomycosis. Onychomycosis is a fungal infection which is the most common disease of nail plate. The nail plate is a barrier which prevents effective topical treatment of ungual disorders. In this study, TBF-HCl loaded liposome and ethosome formulations and also gel form of these formulations were prepared. The formulations were characterized and in vitro and ex vivo release studies were performed. Nail characterization studies were also performed to examine the effect of formulations and experimental conditions on nail surface. As a result, all formulations can serve as efficient formulations for ungual application of TBF-HCl. By the way, the results of the accumulation studies suggested that liposome poloxamer gel formulation could be promising system for ungual drug delivery due to the better accumulation and easier application of the formulation.
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Affiliation(s)
- Sakine Tuncay Tanrıverdi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Ege University, 35100 Bornova, Izmir, Turkey.
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43
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Pereiro Ferreirós M, García-Martínez F, Alonso-González J. Update on the Treatment of Superficial Mycoses. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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44
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Pereiro Ferreirós M, García-Martínez F, Alonso-González J. Actualización en el tratamiento de las micosis cutáneas. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:778-83. [DOI: 10.1016/j.ad.2012.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 01/11/2012] [Accepted: 01/15/2012] [Indexed: 10/28/2022] Open
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45
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De Simone C, Maiorino A, Tassone F, D’Agostino M, Caldarola G. Tacrolimus 0.1% ointment in nail psoriasis: a randomized controlled open-label study. J Eur Acad Dermatol Venereol 2012; 27:1003-6. [DOI: 10.1111/j.1468-3083.2012.04642.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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46
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Abstract
Topical therapy is desirable in treatment of nail diseases like onychomycosis (fungal infection of nail) and psoriasis. The topical treatment avoids the adverse effects associated with systemic therapy, thereby enhancing the patient compliance and reducing the treatment cost. However the effectiveness of the topical therapies has been limited due to the poor permeability of the nail plate to topically applied therapeutic agents. Research over the past one decade has been focused on improving the transungual permeability by means of chemical treatment, penetration enhancers, mechanical and physical methods. The present review is an attempt to discuss the different physical and chemical methods employed to increase the permeability of the nail plate. Minimally invasive electrically mediated techniques such as iontophoresis have gained success in facilitating the transungual delivery of actives. In addition drug transport across the nail plate has been improved by filing the dorsal surface of the nail plate prior to application of topical formulation. But attempts to improve the trans-nail permeation using transdermal chemical enhancers have failed so far. Attempts are on to search suitable physical enhancement techniques and chemical transungual enhancers in view to maximize the drug delivery across the nail plate.
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47
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Lusiana, Reichl S, Müller-Goymann CC. Keratin film made of human hair as a nail plate model for studying drug permeation. Eur J Pharm Biopharm 2011; 78:432-40. [DOI: 10.1016/j.ejpb.2011.01.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 01/19/2011] [Accepted: 01/31/2011] [Indexed: 10/18/2022]
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Lusiana, Müller-Goymann CC. Preparation, characterization, and in vitro permeation study of terbinafine HCl in poloxamer 407-based thermogelling formulation for topical application. AAPS PharmSciTech 2011; 12:496-506. [PMID: 21479748 DOI: 10.1208/s12249-011-9611-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 03/20/2011] [Indexed: 11/30/2022] Open
Abstract
Upon topical administration, a high penetration rate of antifungal drug into the infected site is desirable to reduce treatment length and systemic side effects which occur especially after a prolonged peroral administration. Thermogelling formulations composed of poloxamer 407, medium chain triglycerides, isopropyl alcohol, dimethyl isosorbide, and water for topical application were developed, and a lipophilic drug terbinafine HCl (TBF) was incorporated. Previously, a remarkable high permeation rate of a hydrophilic drug 5-aminolevulinic acid from this vehicle was evident compared to different creams from German Pharmacopoeia. By varying the composition of vehicle constituents, a broad range of consistencies and appearances was obtained. Up to 4% TBF could be solubilized in the vehicle. TBF fluxes at steady state across human stratum corneum from these formulations were higher than those from the German Pharmacopoeia Basiscreme Deutscher Arzneimittel Codex and a marketed product at similar concentration of 1%. TBF fluxes increased along with a higher content of TBF in the formulation. The amount of TBF retained in stratum corneum was higher compared to those from both standards of comparison (p < 0.01). The thermodynamic activity of TBF in the thermogelling formulation was lower compared to those in other formulations. Therefore, the nature of the vehicle and its interaction with TBF are suggested to play a significant role in explaining higher fluxes along with higher TBF content. Differential scanning calorimetry measurements revealed comparable T2 and T3 endothermic shifts from all examined formulations suggesting equal influences to the skin lipids.
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49
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Shivakumar HN, Vaka SRK, Madhav NVS, Chandra H, Murthy SN. Bilayered nail lacquer of terbinafine hydrochloride for treatment of onychomycosis. J Pharm Sci 2010; 99:4267-76. [PMID: 20737634 DOI: 10.1002/jps.22150] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The present study aimed to develop bilayered nail lacquer of terbinafine hydrochloride (TH) for treatment of onychomycosis. The composite nail lacquer formed an underlying drug-loaded hydrophilic layer and overlying hydrophobic vinyl layer. The hydrophilic lacquer made of hydroxylpropyl methylcellulose E-15 contained polyethylene glycol 400 (PEG 400) as a drug permeation enhancer. The vinyl lacquer was composed of poly (4-vinyl phenol) as a water-resistant film former. In vitro permeation studies in Franz diffusion cells indicated that the amount of TH permeated across the human cadaver nail in 6 days was 0.32 +/- 0.14, 1.12 +/- 0.42, and 1.42 +/- 0.53 microg/cm(2) from control (hydrophilic lacquer devoid of PEG 400), monolayer (hydrophilic lacquer alone), and bilayered nail lacquers, respectively. A higher nail drug load was seen in vitro with the bilayered lacquer (0.59 +/- 0.13 microg/mg) as compared to monolayer (0.36 +/- 0.09 microg/mg) and control (0.28 +/- 0.07 microg/mg) lacquers. The drug loss despite multiple washing was significantly low (p < 0.001) for the bilayered lacquer owing to the protective vinyl coating. Clinical studies demonstrated the efficacy of bilayered lacquer to achieve better drug load in the nail plate (1.27 +/- 0.184 microg/mg) compared to monolayer (0.67 +/- 0.18 microg/mg) and control (0.21 +/- 0.04 microg/mg) lacquers.
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Affiliation(s)
- H N Shivakumar
- Department of Pharmaceutics, The University of Mississippi, University, Mississippi 38677, USA
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50
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Traynor MJ, Turner RB, Evans CRG, Khengar RH, Jones SA, Brown MB. Effect of a novel penetration enhancer on the ungual permeation of two antifungal agents. J Pharm Pharmacol 2010; 62:730-7. [PMID: 20636860 DOI: 10.1211/jpp.62.06.0009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of this study was to demonstrate the effect of a novel permeation enhancer system using two existing marketed nail lacquers and the delivery of terbinafine through human nail samples in vitro. METHODS Initially a modified Franz cell was used, where sections of human nail serve as the barrier through which drug penetrates into an agar-filled chamber infected with dermatophytes. A second study was performed using a novel infected nail model where dermatophytes are incubated with and grow into human nail and ATP levels are used as biological marker for antimicrobial activity. KEY FINDINGS The novel permeation enhancing system increased the permeation of both existing drugs formulated in nail lacquers and terbinafine through human nail sections mounted in a modified Franz cell. Furthermore the ATP assay confirmed that the system also enhanced the permeation of terbinafine through infected cadaver nail resulting in a decrease in ATP levels equivalent to those of uninfected negative control samples. CONCLUSIONS This study has clearly demonstrated that the use of a novel permeation enhancing system, which fundamentally alters the chemical structure of the nail, not only enhances the efficacy of the existing topical formulations but also enables the delivery and efficacy of terbinafine when applied ungually. Such a topically applied system has the possibility of overcoming the systemic side effects when terbinafine is delivered orally.
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Affiliation(s)
- M J Traynor
- School of Pharmacy, University of Hertfordshire, Hatfield, UK.
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