Spatially constrained skin electroporation with sodium thiosulfate and urea creates transdermal microconduits

Transdermal Co-Delivery of Urea and Recombinant Human Growth Hormone

BACKGROUND

Urea with super-hydrating and moisturizing properties is mainly used as an adjunctive treatment of diseases associated with dry skin. In this regard, the recombinant human growth hormone (rhGH) with rejuvenating properties is used as a base material in beauty creams. Although urea easily passes through the skin, the epidermal skin barrier restricts the passage of hGH due to its size.

OBJECTIVE

in this research, in order to solve this problem, hydroxy propyl-beta cyclodextrin (HP-β-CD) is used as a soluble chemical enhancer.

MATERIAL AND METHODS

UV and circular dichroism spectroscopy were used for the investigation of structural modification. The permeation process was studied in vitro on rat skin using vertical Franz diffusion cells. Enzyme-linked immunosorbent assay were used for rhGH activity assessment and evaluation of transdermal delivery.

RESULTS

First, due to the denaturing effects of urea on proteins its concentration was optimized to maintain biological structure and protein activity. UV spectroscopy and CD data proved that the secondary structure of rhGH is preserved in the presence of urea (0.5-2 M) and HP-β-CD, which elevates urea and rhGH permeation. Maximum permeability was observed at 120 min after sampling (1424.35 ng.ml.cm^-2), which was much higher than the control. Using a higher concentration of urea in the formulation will significantly decrease the level of rhGH delivery.

CONCLUSION

According to results, this strategy can be considered as a successful method for enhanced Co-delivery of rhGH and urea.

Review of Stratum Corneum Impedance Measurement in Non-Invasive Penetration Application

Due to advances in telemedicine, mobile medical care, wearable health monitoring, and electronic skin, great efforts have been directed to non-invasive monitoring and treatment of disease. These processes generally involve disease detection from interstitial fluid (ISF) instead of blood, and transdermal drug delivery. However, the quantitative extraction of ISF and the level of drug absorption are greatly affected by the individual's skin permeability, which is closely related to the properties of the stratum corneum (SC). Therefore, measurement of SC impedance has been proposed as an appropriate way for assessing individual skin differences. In order to figure out the current status and research direction of human SC impedance detection, investigations regarding skin impedance measurement have been reviewed in this paper. Future directions are concluded after a review of impedance models, electrodes, measurement methods and systems, and their applications in treatment. It is believed that a well-matched skin impedance model and measurement method will be established for clinical and point-of care applications in the near future.

Combination of calcipotriol and methotrexate in nanostructured lipid carriers for topical delivery

The combination of calcipotriol with methotrexate can strengthen the topical therapy for psoriasis. The aim of the present study was to evaluate the potential of nanostructured lipid carriers (NLCs) loaded with lipophilic calcipotriol and hydrophilic methotrexate as topical therapy. NLCs composed of Precirol ATO 5 with various amounts of squalene as the liquid lipid were prepared. The particle size, surface charge, molecular environment, drug permeation, and skin irritation of the carriers were assessed. Hyperproliferative skin was also used as a permeation barrier in this study. It was found that variations in the Precirol/squalene ratio had profound effects on the physicochemical characteristics of the NLCs. The range of particle size of the NLC preparations was 270 to 320 nm, with vehicles containing a higher Precirol amount exhibiting a larger diameter. NLCs with a higher Precirol/squalene ratio also showed greater polarity in their molecular environment. Calcipotriol-loaded NLC systems provided drug fluxes of 0.62 to 1.08 microg/cm(2)/h, which were slightly higher or comparable to the 30% ethanol vehicle (control, 0.72 microg/cm(2)/h). The methotrexate amount permeating the skin was 2.4 to 4.4-times greater using NLCs compared to that with the control. Dual drug-loaded NLCs exhibited reduced skin permeation of calcipotriol but not methotrexate. The in vivo topical delivery examined by confocal laser scanning microscopy (CLSM) showed a good correlation with the in vitro results. These two drugs with extremely different polarities can successfully be combined in NLCs. Results suggest that NLCs may have the potential to serve as delivery carriers for antipsoriatic drugs because of enhanced drug permeation and limited skin irritation.

Transdermal Transport of India Ink by Electromagnetic Electroporation in Guinea Pigs: An Ultrastructural Study

Transdermic administration by electroporation has developed over recent years for applying drugs in a variety of pathological processes. However, mechanisms are still not finally settled. India ink was applied to the backs of guinea pigs and for the transdermic transport short, high-voltage pulses (TDES, Dencort Dell) were administrated. Punch biopsies (4 mm) immediately taken after 24, 48, 72, 96 and at 26 days were studied by light and electronic microscopy. The ultrastructural characteristics and image pigment particles were reported. Particles of India ink were observed in the stratum corneum and in the epidermic keratinocytes of samples studied immediately after treatment. Particles were also seen in the epidermic and folicular keratinocytes, and in the papillary and reticular dermis (among collagen fibers, vessel walls, and macrophages) in all the subsequent biopsies; but not in the controls, which were conducted with electromagnetic waves alone. No tissue alterations were observed. The efficacy and noninvasive nature of electroporation for the transdermic administration of macromolecules is confirmed.

Pilot study of topical delivery of methotrexate by electroporation

BACKGROUND

The topical administration of methotrexate (MTX) for the treatment of psoriasis and neoplastic diseases is restricted by the poor diffusion of MTX across the stratum corneum.

OBJECTIVES

We applied electroporation to increase the transdermal transport of MTX.

METHODS

Electrodes were placed either side-by-side on the surface of excised full thickness pig skin, or on a piece of skin clamped between compartments of a vertical diffusion chamber. Sixty rectangular electric pulses at 120 V, 1 ms and 1 Hz were applied across the skin. MTX was left on the skin surface for an additional 10 min to take advantage of diffusion through electropores. Cumulative drug transport was measured by radioactive tracing, using [3H]-methotrexate, from punch biopsy samples taken from under the cathode. The integrity of the radioisotope was verified by high-performance liquid chromatography.

RESULTS

Using side-by-side electrodes, treatment with the pulses alone resulted in a 2.5-fold increase; adding anionic lipid enhancers to the pulses resulted in a 4.4-fold enhancement compared with passive diffusion. Concurrent iontophoresis for the 11-min time period made a nonsignificant contribution. To reduce tissue resistance we used 40 degrees C hyperthermia in a vertical diffusion chamber; transport was increased 11-fold to 53 microg cm(-2) (flux = 290 microg cm(-2) h(-1)). MTX penetration profiles indicated that more than half of the MTX was confined to the epidermis and papillary dermis. The tissue concentration in this superficial reactive unit was 1.7 mmol L(-1).

CONCLUSIONS

Electroporation of MTX with an anion lipid enhancer under a mild hyperthermic environment provided a significant transdermal delivery within a short application time. The method may be an effective means of drug delivery for treating psoriasis or other MTX-sensitive disorders and avoids the potential systemic toxicity.

Design and feasibility assessment of topically applied drug formulations for electroporation

Few studies have been reported on the design of topical formulations consisting of electrodes and active drugs for electroporation as a means to increase skin permeability of the drugs, although many studies were reported for the effect of this physical means using aqueous drug solutions. We, therefore, designed a prototypic reservoir and matrix topical formulations that are suitable for electroporation in the present study. Plate-plate Ag electrodes and sodium diclofenac were used as model electrodes and the drug, respectively. The in vitro skin permeations of the drug obtained from the reservoir and matrix formulations were slightly higher than that from an aqueous suspension. This may be due to slightly higher electric field in the skin barrier for the presently designed formulations than that for the aqueous suspension. The present feasibility test suggests that these reservoirs and matrix formulations are useful prototypic topical formulations for electroporation application to improve the drug permeability through skin.

Saturated anionic phospholipids enhance transdermal transport by electroporation

Anionic phospholipids, but not cationic or neutral phospholipids, were found to enhance the transdermal transport of molecules by electroporation. When added as liposomes to the milieus of water-soluble molecules to be delivered through the epidermis of porcine skin by electroporation, these phospholipids enhance, by one to two orders of magnitude, the transdermal flux. Encapsulation of molecules in liposomes is not necessary. Dimyristoylphosphatidylserine (DMPS), phosphatidylserine from bovine brain (brain-PS), dioleoylphosphatidylserine (DOPS), and dioleoylphosphatidylglycerol (DOPG) were used to test factors affecting the potency of anionic lipid transport enhancers. DMPS with saturated acyl chains was found to be a much more potent transport enhancer than those with unsaturated acyl chains (DOPS and DOPG). There was no headgroup preference. Saturated DMPS was also more effective in delaying resistance recovery after pulsing, and with a greater affinity in the epidermis after pulsing. Using fluorescent carboxyl fluorescein and fluorescein isothiocyanate (FITC)-labeled Dextrans as test water-soluble molecules for transport, and rhodamine-labeled phospholipids to track anionic phospholipids, we found, by conventional and confocal fluorescence microscopy, that transport of water-soluble molecules was localized in local transport spots or regions (LTRs) created by the electroporation pulses. Anionic phospholipids, especially DMPS, were located at the center of the LTRs and spanned the entire thickness of the stratum corneum (SC). The degree of saturation of anionic phospholipids made no difference in the densities of LTRs created. We deduce that, after being driven into the epidermis by negative electric pulses, saturated anionic phospholipids mix and are retained better by the SC lipids. Anionic lipids prefer loose layers or vesicular rather than multilamellar forms, thereby prolonging the structural recovery of SC lipids to the native multilamellar form. In the presence of 1 mg/ml DMPS in the transport milieu, the flux of FITC-Dextran-4k was enhanced by 80-fold and reached 175 microg/cm(2)/min. Thus, the use of proper lipid enhancers greatly extends the upper size limit of transportable chemicals. Understanding the mechanism of lipid enhancers enables one to rationally design better enhancers for transdermal drug and vaccine delivery by electroporation.

The application of electroporation to transfect hematopoietic cells and to deliver drugs and vaccines transcutaneously for cancer treatment

Electroporation and the associated phenomenon of electrofusion have been widely adapted as tools to a broad range of biomedical research and therapy. In this article, we summarize our adaptation of the electroporation and electrofusion technology in two fronts of cancer research and treatment. The first is genetic manipulation of hematopoietic cells for the purpose of cancer treatment. High efficiency transfection methods have been developed to transfect NK cells, peripheral blood stem cells, and bone marrow derived dendritic cells. Hybrids of tumor cells and bone marrow derived dendritic cells have been formed by electrofusion for the purpose of tumor vaccines. The second front is the use of transcutaneous electroporation to deliver anticancer drugs and vaccines across the skin. Methods to extend the upper molecular weight limit of transcutaneous electroporation have been developed. The pro-photosensitizer drug, delta-amino levulinic acid, the anticancer drug methotrexate, and peptide vaccines designed for cancer prevention and immunotherapy have been delivered transcutaneously by electroporation. These studies hold promise for the treatment of cancers in human.

Enhanced transdermal transport by electroporation using anionic lipids

Transdermal drug delivery is an attractive approach for either local or systemic treatment in medicine. In the last decade, different active transdermal delivery methods have been further investigated such as cationic liposomal delivery and electroporation-enhanced delivery. In light of gaining a synergistic effect of lipid and electroporation, a new method of using anionic lipids to enhance the transdermal transport of molecules under electroporation is reported here. Heat-stripped porcine epidermis was used for measurement of transdermal transport using an in vitro vertical diffusion apparatus. Lipid vesicles were prepared using a 1:1 mole ratio mixture of 1,2-dioleoyl-3-phosphatidylglycerol (DOPG) and 1,2-dioleoyl-3-phosphatidylcholine (DOPC). When the lipids were mixed with (but not encapsulating) the transport target molecule, the electroporation-induced transport through porcine epidermis was increased as compared to that without the lipids. The enhancement in transport was dependent upon the size and the charge of the transported molecule. Methylene blue (MB), protoporphyrin IX (PpIX) and dimethyl-protoporphyrin IX (DM-PpIX) were used as small target molecules, and FITC-dextrans (4 to 155 kDa) were used as large target molecules in our studies. Enhancement of transport, to varying degree, was observed for all three small molecules (molecular weights <1 kDa), in the presence of DOPG:DOPC vesicles. In the case of large molecules, lipid-enhanced transport was only observed for the 4 kDa dextran, and not for the larger ones (M(w)>10 kDa). Neutral or cationic lipids alone did not enhance the transdermal transport under the electroporation conditions we used.

Transdermal insulin delivery using lipid enhanced electroporation

Transdermal insulin transport by electroporation was measured using porcine epidermis and fluorescein-labeled insulin. Previous studies have shown that anionic lipids can enhance the electroporative transport of molecules up to 10 kDa in size. It was also shown that it is the charge and not the type of the phospholipid head group that influences transdermal transport under electroporation. Moreover, phospholipids with saturated acyl chains enhance the transport of larger molecules more as compared to those with unsaturated chains. In the current study, based on those earlier findings, the effect of 1,2-dimyristoyl-3-phosphatidylserine (DMPS) on the transdermal transport of insulin by electroporation was examined. Porcine epidermis was used as a model for skin. Transport was measured using glass vertical diffusion apparatus in which the epidermis separated the donor and receiver compartments. Negative pulses were applied across the epidermis using platinum electrodes. Results show that when electroporation was carried out in the presence of DMPS, there was greater than 20-fold enhancement of insulin transport. Furthermore, while in the presence of the phospholipid, almost all the transported insulin was detected in the receiver compartment; in the absence of added lipids, only about half the insulin transported was in the receiver compartment and an almost equal amount of insulin remained in the epidermis. Fluorescence microscopy revealed that the insulin transport was mainly through the lipid multilayer regions that surround the corneocytes.

Understanding conditions for which biological effects of nonionizing electromagnetic fields can be expected

Scientific interest in the interaction of nonionizing electromagnetic fields with biological systems is longstanding, but often still controversial. Theories, models and computer simulations have usually emphasized physical interactions with subsystems (e.g. cell membranes) of a biological system. By extending this first necessary physical step to a second step of explicitly and quantitatively considering chemical changes, increased understanding appears possible. In the case of "strong fields", the role of field-altered chemistry is important to electrochemotherapy [Biochem. Pharmacol. 42, Suppl. (1991) 567] and creation of transdermal microconduits [Bioelectrochem. Bioenerg. 49 (1999) 11; J. Controlled Release 61 (1999) 185; J. Invest. Dermatol. 116 (2001) 40] For "weak fields" (a topic with much more controversy) consideration of chemical change shows that organized multicellular systems can be understood to respond to extremely small electric [Chaos 8 (1998) 576] or magnetic fields [Nature 405 (2000) 707]. In contrast, isolated individual cells interacting via voltage-gated channels [Proc. Natl. Acad. Sci. 92 (1995) 3740; Biophys. J. 75 (1998) 2251; Bioelectromagnetics 20 (1999) 102], or processes without "temperature compensation" [Biophys. J. 76 (1999) 3026], appear implausible. Satisfactory understanding is likely only if experimental and theoretical work is reconciled, which should therefore be emphasized. The interaction of electromagnetic fields with biological systems is of interest because of fundamental scientific curiosity, potential medical benefits and possible human health hazards.

Novel mechanisms and devices to enable successful transdermal drug delivery

Optimisation of drug delivery through human skin is important in modern therapy. This review considers drug-vehicle interactions (drug or prodrug selection, chemical potential control, ion pairs, coacervates and eutectic systems) and the role of vesicles and particles (liposomes, transfersomes, ethosomes, niosomes). We can modify the stratum corneum by hydration and chemical enhancers, or bypass or remove this tissue via microneedles, ablation and follicular delivery. Electrically assisted methods (ultrasound, iontophoresis, electroporation, magnetophoresis, photomechanical waves) show considerable promise. Of particular interest is the synergy between chemical enhancers, ultrasound, iontophoresis and electroporation.

Microfabrication of individual 200 microm diameter transdermal microconduits using high voltage pulsing in salicylic acid and benzoic acid

We describe an extension of semiconductor fabrication methods that creates individual approximately 200 microm diameter aqueous pathways through human stratum corneum at predetermined sites. Our hypothesis is that spatially localized electroporation of the multilamellar lipid bilayer membranes provides rapid delivery of salicylic acid to the keratin within corneocytes, leading to localized keratin disruption and then to a microconduit. A microconduit penetrating the isolated stratum corneum supports a volumetric flow of order 0.01 ml per s with a pressure difference of only 0.01 atm (about 10(2) Pa). This study provides a method for rapidly microengineering a pathway in the skin to interface future devices for transdermal drug delivery and sampling of biologically relevant fluids.

Synergistic effect of enhancers for transdermal drug delivery

Transdermal drug delivery offers a non-invasive route of drug administration, although its applications are limited by low skin permeability. Various enhancers including iontophoresis, chemicals, ultrasound, and electroporation have been shown to enhance transdermal drug transport. Although all these methods have been individually shown to enhance transdermal drug transport, their combinations have often been found to enhance transdermal transport more effectively than each of them alone. This paper summarizes literature studies on these combinations with respect to their efficacy and mechanisms.