Cyclosporine coated microneedle for transcutaneous delivery: Characterization, in vitro evaluation, and in vivo anti-psoriatic efficacy against IMQ-induced psoriasis

Development and comparative analysis of clobetasol-loaded microneedle patches versus clobetasol propionate ointment in experimental induced-psoriasis model

The utilization of dissolvable microneedles (MNs) is a promising and cutting-edge approach to drug delivery for the treatment of psoriasis, an autoimmune skin disorder characterized by the appearance of red, scaly patches on the skin. This study presents the development of a dissolving MN patch made of polyvinylpyrrolidone for the purpose of delivering Clobetasol 17-Propionate through the skin. The MN patches were evaluated for their physical characteristics, including morphology, solubility, strength, and ability to penetrate the skin. This evaluation was conducted on both unloaded and drug-loaded MN patches to determine their suitability for future applications. The manufacturing of 484 pyramidal-shaped tips, each measuring roughly 400 µm in height, was demonstrated by microscopy photographs. Compression tests revealed that the MN patch could endure a force greater than 1 N/needle while displacing around 300 µm, confirming the needle's ability to penetrate the stratum corneum. Following H&E staining, the penetration depth in mice skin was determined to be around 200 µm. The MN tips exhibited rapid drug release within a 10-minute timeframe, while the MN patch dissolved in the mice skin in roughly 20 min. An animal model was utilized to examine the effects of the produced patches on the treatment of psoriasis. Psoriasis was artificially induced in three groups of mice using imiquimod cream, applied for eight consecutive days to evaluate the inhibitory effect of clobetasol on exacerbating the disease. This assessment was accomplished using two methods: applying clobetasol ointment and using CP-loaded MNs. This innovative drug delivery system demonstrated encouraging results in terms of quick and effective administration, highlighting the potential of dissolvable MNs for psoriasis treatment.

Novel Small-Molecule Treatment and Emerging Biological Therapy for Psoriasis

Psoriasis is an immune-related disorder that is marked by abnormal thickening of the skin, the rapid multiplication of keratinocytes, and complex interactions between immune cells and the affected areas. Although psoriasis cannot currently be cured, drugs can alleviate symptoms by regulating immune homeostasis and preventing comorbidities. There are many types of drugs to treat psoriasis: small-molecule drugs, including corticosteroids; retinoids; vitamin D analogs; and immunosuppressants, such as glucocorticoid ointment, tretinoin cream, methotrexate tablets, etc. Macromolecular biological drugs, such as Certolizumab, Secukinumab, Guselkumab, etc., include monoclonal antibodies that target various inflammatory signaling pathways. Compared with traditional small-molecule drugs, biological therapies offer better targeting and lower systemic side effects, but their high costs and invasive administration modes constrict their widespread use. Spesolimab is the latest biological agent used to target the interleukin-36 receptor (IL-36R) to be approved for market use, which significantly reduces the risk of general pustular psoriasis (GPP) flare by 84%. Additionally, there are several biological agents used to target the interleukin-23/T helper 17 cell pathway that have already entered Phase II and III clinical trials. At present, the first-line therapeutic strategy for mild psoriasis is topical administration. Systemic therapy and phototherapy are preferred for treating moderate to severe types. However, the current therapeutic drugs for psoriasis cannot completely meet the clinical needs. More advanced drug delivery systems with optimized target effects and better bioavailability are required. Nanocarriers are emerging for the delivery of proteins, nucleic acids, and cell-based therapies. In this review, we analyze the current status of psoriasis therapeutics and discuss novel delivery systems for diverse psoriasis drugs, as well as emerging cell-based therapies. We also summarize the therapeutic effectiveness of different delivery strategies.

Ionic Liquid-Mediated Transdermal Delivery of Organogel Containing Cyclosporine A for the Effective Treatment of Psoriasis

The dermal delivery of peptide therapeutics that are of high molecular weight is a challenge. Cyclosporine A (CsA) is a cyclic undecapeptide with poor aqueous solubility and high molecular weight (1202 Da) indicated for psoriasis. The objective of the study was to evaluate the effect of ionic liquids mixed with the Pluronic F127 matrix in skin permeation of CsA and its efficacy in psoriasis treatment. Choline and geranic acid (CAGE) ionic liquids in a 1:2 molar ratio were mixed with Pluronic F127 (22.7%) and PEG 400 (45%) to prepare an organogel formulation. The CsA-loaded CAGE (CsA-CAGE) and CAGE-Pluronic F127 gels (CsA-CAGE-P gel) were characterized for physical and rheological characteristics. The skin transport studies showed that free CsA did not permeate across the excised porcine skin after 48 h. The amount of CsA permeated across the oleic acid (0.25% v/v) and palmitic acid (0.25% w/v) cotreated skin was found to be 244 ± 4 and 1236 ± 17 μg/cm2, respectively. The application of CsA-CAGE and CsA-CAGE-P gel enhanced CsA flux by 110- and 135-fold, respectively, compared with the control. The thermal analysis and biophysical studies changed the barrier property of the skin significantly (p < 0.05) after incubation with CAGE and CAGE-P gel. The pharmacokinetic studies in the rat model showed that topical application of CsA-CAGE-P gel provided 2.6- and 1.9-fold greater C max and AUC0-t, respectively, compared to the control group. In vitro-in vivo level A correlations were established with R 2 values of 0.991 and 0.992 for both linear and polynomial equations for the CsA-CAGE-P gel formulation using the Wagner-Nelson method. The topical application of CsA-CAGE-P gel (10 mg/kg) on an imiquimod-induced plaque psoriatic model reduced the area of the psoriasis and severity index (PASI) score significantly for erythema and scaling, reversing the changes to skin thickness, blood flow rate, and transepidermal water loss. Together, CAGE-Pluronic F127 organogel was developed as an effective topical formulation for the local and systemic delivery of CsA for the treatment of psoriasis.

Fabrication of Hybrid Coated Microneedles with Donepezil Utilizing Digital Light Processing and Semisolid Extrusion Printing for the Management of Alzheimer's Disease

Microneedle (MN) patches are gaining increasing attention as a cost-effective technology for delivering drugs directly into the skin. In the present study, two different 3D printing processes were utilized to produce coated MNs, namely, digital light processing (DLP) and semisolid extrusion (SSE). Donepezil (DN), a cholinesterase inhibitor administered for the treatment of Alzheimer's disease, was incorporated into the coating material. Physiochemical characterization of the coated MNs confirmed the successful incorporation of donepezil as well as the stability and suitability of the materials for transdermal delivery. Optical microscopy and SEM studies validated the uniform weight distribution and precise dimensions of the MN arrays, while mechanical testing ensured the MNs' robustness, ensuring efficient skin penetration. In vitro studies were conducted to evaluate the produced transdermal patches, indicating their potential use in clinical treatment. Permeation studies revealed a significant increase in DN permeation compared to plain coating material, affirming the effectiveness of the MNs in enhancing transdermal drug delivery. Confocal laser scanning microscopy (CLSM) elucidated the distribution of the API, within skin layers, demonstrating sustained drug release and transcellular transport pathways. Finally, cell studies were also conducted on NIH3T3 fibroblasts to evaluate the biocompatibility and safety of the printed objects for transdermal applications.

Microneedle system for tissue engineering and regenerative medicines: a smart and efficient therapeutic approach

The global demand for an enhanced quality of life and extended lifespan has driven significant advancements in tissue engineering and regenerative medicine. These fields utilize a range of interdisciplinary theories and techniques to repair structurally impaired or damaged tissues and organs, as well as restore their normal functions. Nevertheless, the clinical efficacy of medications, materials, and potent cells used at the laboratory level is always constrained by technological limitations. A novel platform known as adaptable microneedles has been developed to address the abovementioned issues. These microneedles offer a solution for the localized distribution of various cargos while minimizing invasiveness. Microneedles provide favorable patient compliance in clinical settings due to their effective administration and ability to provide a painless and convenient process. In this review article, we summarized the most recent development of microneedles, and we started by classifying various microneedle systems, advantages, and fundamental properties. Subsequently, it provides a comprehensive overview of different types of microneedles, the material used to fabricate microneedles, the fundamental properties of ideal microneedles, and their applications in tissue engineering and regenerative medicine, primarily focusing on preserving and restoring impaired tissues and organs. The limitations and perspectives have been discussed by concluding their future therapeutic applications in tissue engineering and regenerative medicines.

Transdermal microneedle patches as a promising drug delivery system for anti-obesogenic molecules

Obesity, characterized by excessive storage of lipids, has become a global pandemic with high incidence levels, and its forecast is not encouraging. Currently, there are different strategies to treat obesity; however, these conventional methods have various limitations. Lifestyle changes may result in poor outcomes due to the complexity of obesity causes, pharmaceutic treatments produce severe side effects, and bariatric surgery is highly invasive. In the search for alternative treatments to fight obesity, transdermal drug delivery systems of anti-obesogenic molecules have gained particular attention. However, the diffusion of molecules through the skin is the main drawback due to the characteristics of different layers of the skin, principally the stratum corneum and its barrier-like behavior. In this sense, microneedles patches (MP) have emerged to overcome this limitation by piercing the skin and allowing drug delivery inside the body. Although MP have been studied for some years, it was not until about 2017 that their potential as anti-obesogenic treatment was reported. This article aims to summarize and analyze the strategies employed to produce MP and to embed the active molecules against obesity. Special attention is focused on the microneedle's material, geometry, array, and additional delivery strategies, like nanoencapsulation. MP are a promising tool to develop an easy-access treatment, avoiding the digestive tract and with the capacity to enhance the anti-obesogenic activity by delivering one or more active molecules.

Encapsulation of Cyclosporine A-Loaded PLGA Nanospheres in Alginate Microbeads for Anti-Inflammatory Application

The controlled release of cyclosporine A (CsA) microencapsulated in alginate microbeads is a novel drug delivery system for the treatment of inflammatory diseases. In this study, CsA-loaded nanospheres encapsulated in alginate microbeads were applied to evaluate their controlled release profile and anti-inflammatory activity. Initially, a controlled-release drug delivery system was created by encapsulating CsA-loaded PLGA nanospheres within alginate microbeads. CsA-loaded PLGA nanospheres had a diameter of 418.70 ± 59.08 nm, a zeta potential of -22 ± 0.57 mV, and a polydispersity index of 0.517 ± 0.010. CsA-loaded nanosphere-encapsulated alginate microbeads were stable for 37 days. After encapsulating CsA-loaded PLGA nanospheres in the alginate microbeads, 5.60% of CsA was released after 24 h, and approximately 85.90% of the drugs were diffused until day 64. The cytotoxic and anti-inflammatory properties of the CsA released from the microbeads were evaluated in vitro using a murine macrophage cell line (RAW 264.7 cells). CsA-loaded nanosphere-encapsulated alginate microbeads inhibited 39.47 ± 1.71% of nitric oxide production from the RAW 264.7 cells on day 3, whereas nanosphere-encapsulated alginate microbeads inhibited 18.45 ± 1.56% only. CsA released from CsA-loaded nanosphere-encapsulated alginate microbeads had a RAW cell viability of 82.73 ± 5.58% on day 3 compared to 87.59 ± 0.69% of nanosphere-encapsulated alginate microbeads. The efficacy of the CsA-loaded nanosphere-encapsulated alginate microbeads in protecting the immune system via a controlled drug delivery system was established through anti-inflammatory and cell viability evaluation. Based on this research, the controlled release of CsA-loaded nanosphere-encapsulated alginate microbeads provides an innovative treatment for inflammatory diseases.

Nanofibers of Glycyrrhizin/Hydroxypropyl-β-Cyclodextrin Inclusion Complex: Enhanced Solubility Profile and Anti-inflammatory Effect of Glycyrrhizin

Despite having a wide range of therapeutic advantages, glycyrrhizin (GL) has few commercial applications due to its poor aqueous solubility. In this study, we combined the benefits of hydroxypropyl β-cyclodextrin (HP-βCD) supramolecular inclusion complexes and electrospun nanofibers to improve the solubility and therapeutic potential of GL. A molecular inclusion complex containing GL and HP-βCD was prepared by lyophilization at a 1:2 molar ratio. GL and hydroxypropyl β-cyclodextrin inclusion complexes were also incorporated into hyaluronic acid (HA) nanofibers. Prepared NF was analyzed for physical, chemical, thermal, and pharmaceutical properties. Additionally, a rat model of carrageenan-induced hind paw edema and macrophage cell lines was used to evaluate the anti-inflammatory activity of GL-HP-βCD NF. The DSC and XRD analyses clearly showed the amorphous state of GL in nanofibers. In comparison to pure GL, GL-HP-βCD NF displayed improved release (46.6 ± 2.16% in 5 min) and dissolution profiles (water dissolvability ≤ 6 s). Phase solubility results showed a four-fold increase in GL solubility in GL-HP-βCD NF. In vitro experiments on cell lines showed that inflammatory markers like IL-1β, TNF-α, and IL-6 were significantly lower in GL-HP-βCD NF compared to pure GL (p < 0.01 and p < 0.05). According to in vivo results, the prepared nanofiber exhibits a better anti-inflammatory effect than pure GL (63.4% inhibition vs 53.7% inhibition). The findings presented here suggested that GL-HP-βCD NF could serve as a useful strategy for improving the therapeutic effects of GL.

Cyclosporine and Pentoxifylline laden Tailored Niosomes for the effective management of Psoriasis: In-vitro Optimization, Ex-vivo and Animal Study

Psoriasis is a chronic skin inflammatory auto-immune disorder. Cyclosporine is the drug of choice in severe cases of psoriasis for systemic administration. But its systemic administration leads to some serious side effects like nephrotoxicity and cardiovascular disorders. Pentoxifylline is reported to reduce such side effects of cyclosporine and also it is found useful in the management of psoriasis. In this study, Box-Behnken design was used to prepare and optimize Cyclosporine and Pentoxifylline loaded niosomes. The optimized niosomes were prepared using cholesterol and surfactant (7:3), a total of 500µmol. Ratio of Tween 80 to span 80 for the preparation of optimized niosome was 0.503 (tween80:span80), and hydration and sonication time were kept at 60 minutes and 10 minutes, respectively. Size, Poly Dispersity Index, zeta potential, and % entrapment efficiency of Pentoxifylline and cyclosporine, for optimized niosomes were found to be 179nm, 0.285, -37.5mV, 84.6%, and 75.3%, respectively. The optimized niosomes were further studied for in-vitro skin permeation and skin deposition. Though niosomes significantly influenced the permeation of both drugs, only a small amount of drug (both cyclosporine and Pentoxifylline) was permeated through the skin. In comparison with the permeation, the quantity of drug retained in the stratum corneum and viable epidermis (SC and VED) was very high. In the in-vivo studies conducted on mice induced with psoriasis using imiquimod, both the histopathology and psoriasis area severity index has shown marked improvement in the skin condition of mice treated with niosomes loaded with Pentoxifylline and cyclosporine, in comparison with the solution/suspension of individual drugs. The study shows that niosomes could be effectively used for the simultaneous delivery of cyclosporine and Pentoxifylline for the better management of psoriasis.