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Champeau M, Vignoud S, Mortier L, Mordon S. Photodynamic therapy for skin cancer: How to enhance drug penetration? JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 197:111544. [PMID: 31295716 DOI: 10.1016/j.jphotobiol.2019.111544] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 12/27/2022]
Abstract
Photodynamic therapy (PDT) induced by protoporphyrin IX (PpIX) has been widely used in dermatological practices such as treatment of skin cancers. Clearance rate depends on different factors such as light irradiation, skin oxygenation and drug penetration. The poor penetration of 5-aminolevulinic acid (5-ALA) with topical application is limited and restrains the production of PpIX which could restrict PDT outcomes. This review will focus on techniques already used to enhance drug penetration in human skin, and will present their results, advantages, and drawbacks. Chemical and physical pretreatments will be discussed. Chemical pre-treatments comprise of drug formulation modification, use of agents that modify the heme cycle, enhance PpIX formation, and the combination of differentiation-promoting agent prior to PDT. On the other hand, physical pretreatments affect the skin barrier by creating holes in the skin or by removing stratum corneum. To promote drug penetration, iontophoresis and temperature modulation are interesting alternative methods. Cellular mechanisms enrolled during chemical or physical pretreatments have been investigated in order to understand how 5-ALA penetrates the skin, why it is preferentially metabolized in PpIX in tumour cells, and how it could be accumulated in deeper skin layers. The objective of this review is to compare clinical trials that use innovative technology to conventional PDT treatment. Most of these pretreatments present good or even better clinical outcomes than usual PDT.
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Affiliation(s)
- Mathilde Champeau
- LETI-DTBS, CEA, 17 rue des Martyrs, Grenoble Cedex, France; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France.
| | | | - Laurent Mortier
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France
| | - Serge Mordon
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, CHU Lille, Univ. Lille, Inserm, F-59000 Lille, France
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Tasić‐Kostov M, Lukić M, Savić S. A 10% Lactobionic acid‐containing moisturizer reduces skin surface pH without irritation—An in vivo/in vitro study. J Cosmet Dermatol 2019; 18:1705-1710. [DOI: 10.1111/jocd.12908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/07/2019] [Indexed: 12/18/2022]
Affiliation(s)
| | - Milica Lukić
- Department of Pharmaceutical Technology and Cosmetology University of Belgrade ‐ Faculty of Pharmacy Belgrade Serbia
| | - Snežana Savić
- Department of Pharmaceutical Technology and Cosmetology University of Belgrade ‐ Faculty of Pharmacy Belgrade Serbia
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Pantelic I, Lukic M, Markovic B, Lusiana, Hoffmann C, Müller-Goymann C, Milic J, Daniels R, Savic S. Development of a prospective isopropyl alcohol-loaded pharmaceutical base using simultaneousin vitro/in vivocharacterization methods of skin performance. Drug Dev Ind Pharm 2013; 40:960-71. [DOI: 10.3109/03639045.2013.794827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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4
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Lapteva M, Kalia YN. Microstructured bicontinuous phase formulations: their characterization and application in dermal and transdermal drug delivery. Expert Opin Drug Deliv 2013; 10:1043-59. [DOI: 10.1517/17425247.2013.783008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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5
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Benton CM, Lim CK. Liquid chromatography and mass spectrometry of haem biosynthetic intermediates: a review. Biomed Chromatogr 2012; 26:1009-23. [DOI: 10.1002/bmc.2772] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Chang Kee Lim
- Clinical Biochemistry; King's College Hospital; Denmark Hill; London; SE5 9RS; UK
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Pappinen S, Pryazhnikov E, Khiroug L, Ericson MB, Yliperttula M, Urtti A. Organotypic cell cultures and two-photon imaging: Tools for in vitro and in vivo assessment of percutaneous drug delivery and skin toxicity. J Control Release 2012; 161:656-67. [DOI: 10.1016/j.jconrel.2012.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 12/14/2022]
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7
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Jaksic I, Lukic M, Malenovic A, Reichl S, Hoffmann C, Müller-Goymann C, Daniels R, Savic S. Compounding of a topical drug with prospective natural surfactant-stabilized pharmaceutical bases: Physicochemical and in vitro/in vivo characterization – A ketoprofen case study. Eur J Pharm Biopharm 2012; 80:164-75. [DOI: 10.1016/j.ejpb.2011.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 09/04/2011] [Accepted: 09/05/2011] [Indexed: 10/17/2022]
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Morrow DI, McCarron PA, Woolfson AD, Juzenas P, Juzeniene A, Iani V, Moan J, Donnelly RF. Hexyl Aminolaevulinate Is a More Effective Topical Photosensitiser Precursor than Methyl Aminolaevulinate and 5-Aminolaevulinic Acids When Applied in Equimolar Doses. J Pharm Sci 2010; 99:3486-98. [DOI: 10.1002/jps.22116] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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9
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Morrow DIJ, McCarron PA, Woolfson AD, Juzenas P, Juzeniene A, Iani V, Moan J, Donnelly RF. Novel patch-based systems for the localised delivery of ALA-esters. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 101:59-69. [PMID: 20634088 DOI: 10.1016/j.jphotobiol.2010.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 06/06/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
In photodynamic therapy (PDT) a combination of visible light and a sensitising drug causes the destruction of selected cells. Aminolaevulinic acid (ALA) has been widely used in topical PDT for over 15 years. However, ALA does not possess favourable physicochemical properties for skin penetration. Consequently, the clearance rates for difficult to treat lesions, such as nodular basal cell carcinomas are relatively low. For the first time, equimolar concentrations of ALA, methyl-ALA (m-ALA) and hexyl-ALA (h-ALA) have been incorporated into a bioadhesive patch-based system. In vitro penetration studies into excised porcine skin revealed that ALA patches containing relatively high loadings (226.7 micromol cm(-2)) were associated with significantly greater tissue concentrations (70.7 micromol cm(-3)) than patches containing m-ALA (16.3 micromol cm(-3)) or h-ALA (17.4 micromol cm(-3)). ALA was also found to be the most efficient inducer of protoporphyrin (PpIX) fluorescence in mice, in vivo (maximum mean fluorescence: ALA=236.2 a.u., m-ALA=175.1 a.u., h-ALA=193.5 a.u.). However, when the lipophilic hexylester was formulated in a pressure sensitive adhesive (PSA) patch, significantly higher PpIX levels were achieved compared to all bioadhesive systems tested. Of major importance, PSA patches containing relatively low h-ALA loadings induced high PpIX levels, which were localised to the application area. This study has highlighted the importance of rational selection of both the active agent and the delivery system. Bioadhesive preparations containing ALA are ideal for delivery to moist environments; whereas h-ALA-loaded PSA systems may facilitate enhanced delivery to dry areas of skin. In addition, owing to the relatively low loadings of h-ALA required in PSA patches, the costs of clinical PDT may potentially be reduced.
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Affiliation(s)
- Desmond I J Morrow
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
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Al-Kassas R, Donnelly RF, McCarron PA. Aminolevulinic acid-loaded Witepsol microparticles manufactured using a spray congealing procedure: implications for topical photodynamic therapy. J Pharm Pharmacol 2010. [DOI: 10.1211/jpp.61.09.0001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objectives
The aim was to enhance aminolevulinic acid (ALA) stability by incorporation into low-melting microparticles prepared using a spray congealing procedure and to evaluate temperature-triggered release, allowing topical bioavailability following melting at skin temperature.
Methods
ALA-loaded Witepsol microparticles were prepared using a novel spray congealing technique. Entrapment efficiency was compared with conventional emulsion-based methods and modelled drug release profiles determined using a membrane separation technique. Raised receiver medium temperature was used to determine triggered release. Bioavailability and lipid-mediated enhancement of ALA penetration were determined in excised murine skin.
Key findings
ALA-loaded Witepsol microparticles were spherical, with a mean diameter of 20 μm. Loading and stability studies demonstrated effective encapsulation, ranging from 91% to 100%, with no evidence of degradation to pyrazine derivatives. ALA release correlated with dissolution medium temperature, triggered at temperatures close to that of skin. Results suggested that molten Witepsol enhanced cutaneous permeation, whereas incorporation of microparticles in a semi-solid vehicle attenuated ALA penetration. Optimal use was direct application under occlusion.
Conclusions
Spray congealing is superior to the emulsion-based procedures with respect to encapsulation efficiency of ALA in Witepsol matrices, providing temperature-triggered release, enhanced stability and improved penetration of ALA through keratinised skin. These features could improve ALA delivery to superficial lesions as part of photodynamic therapy.
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Affiliation(s)
- Rasil Al-Kassas
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| | - Paul A McCarron
- Department of Pharmacy and Pharmaceutical Sciences, University of Ulster, Coleraine, Co. Londonderry, UK
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Natural surfactant-based topical vehicles for two model drugs: Influence of different lipophilic excipients on in vitro/in vivo skin performance. Int J Pharm 2009; 381:220-30. [DOI: 10.1016/j.ijpharm.2009.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Revised: 05/19/2009] [Accepted: 07/09/2009] [Indexed: 11/19/2022]
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12
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Savic S, Weber C, Tamburic S, Savic M, Müller-Goymann C. Topical vehicles based on natural surfactant/fatty alcohols mixed emulsifier: The influence of two polyols on the colloidal structure and in vitro/in vivo skin performance. J Pharm Sci 2009; 98:2073-90. [DOI: 10.1002/jps.21591] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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13
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Weber C, Muller-Goymann C. Usefulness of a 3D skin construct in the detection of regenerative effects after previous SDS damage. J Drug Deliv Sci Technol 2009. [DOI: 10.1016/s1773-2247(09)50070-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Donnelly RF, McCarron PA, Morrow DIJ, Sibani SA, Woolfson AD. Photosensitiser delivery for photodynamic therapy. Part 1: Topical carrier platforms. Expert Opin Drug Deliv 2008; 5:757-66. [PMID: 18590460 DOI: 10.1517/17425247.5.7.757] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a medical treatment in which a combination of a photosensitising drug and visible light causes destruction of selected cells. Due to the lack of true selectivity of preformed photosensitisers for neoplastic tissue and their high molecular weights, PDT of superficial skin lesions has traditionally been mediated by topical application of the porphyrin precursor 5-aminolevulinic acid (ALA). OBJECTIVE This article aims to review the traditional formulation-based approaches taken to topical delivery of ALA and discusses the more innovative strategies investigated for enhancement of PDT mediated by topical application of ALA and preformed photosensitisers. METHODS All of the available published print and online literature in this area was reviewed. As drug delivery of agents used in PDT is still something of an emerging field, it was not necessary to go beyond literature from the last 30 years. RESULTS/CONCLUSION PDT of neoplastic skin lesions is currently based almost exclusively on topical application of simple semisolid dosage forms containing ALA or its methyl ester. Until expiry of patents on the current market-leading products, there is unlikely to be a great incentive to engage in design and evaluation of innovative formulations for topical PDT, especially those containing the more difficult-to-deliver preformed photosensitisers.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, UK.
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Grüning N, Müller-Goymann CC. Physicochemical Characterisation of a Novel Thermogelling Formulation for Percutaneous Penetration of 5-Aminolevulinic Acid. J Pharm Sci 2008; 97:2311-23. [PMID: 17828744 DOI: 10.1002/jps.21157] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The present contribution was dedicated to the development and characterisation of a semisolid formulation of 5-aminolevulinic acid (5-ALA), appropriate for the diagnosis and treatment of actinic keratosis in photodynamic therapy. To achieve sufficiently high concentrations of the polar substance within the living epithelium after topical application, the semisolid base was enriched with penetration enhancers. A semisolid liquid crystalline system for drug delivering was the formulation of choice. It was composed of isopropyl alcohol, dimethyl isosorbide, medium chain triglycerides, water, and Pluronic F 127 as a polyoxyethylene-polyoxypropylene surface-active block copolymer. Rheometrical investigations were performed in the oscillatory mode and showed a thermo reversible gelification behaviour of the formulation, which therefore was denoted Thermogel. Permeation studies through human stratum corneum revealed higher permeation coefficients for 5-ALA from the Thermogel than from different German Pharmacopoeia creams. For example a 7.5-fold increase in comparison with Basiscreme DAC, and a 19.5-fold increase compared to water containing hydrophilic ointment. With respect to Dolgit(R) Mikrogel, the permeation coefficient from the Thermogel was 6.4-fold higher. These results were in accordance with those of differential scanning calorimetry measurements. Thermogel disclosed the strongest interactions with stratum corneum lipids.
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Affiliation(s)
- Nadja Grüning
- Technical University of Braunschweig, Institute of Pharmaceutical Technology, Mendelssohnstrasse 1, 38106 Braunschweig, Germany
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Donnelly RF, McCarron PA, Woolfson DA. Derivatives of 5-Aminolevulinic Acid for Photodynamic Therapy. PERSPECTIVES IN MEDICINAL CHEMISTRY 2007. [DOI: 10.1177/1177391x0700100005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Photodynamic therapy (PDT) is a clinical treatment that combines the effects of visible light irradiation with subsequent biochemical events that arise from the presence of a photosensitising drug (possessing no dark toxicity) to cause destruction of selected cells. Today, the most common agent used in dermatological PDT is 5-aminolevulinic acid (ALA). As a result of its hydrophilic character, ALA penetrates skin lesions poorly when applied topically. Its systemic bioavailability is limited and it is known to cause significant side effects when given orally or intravenously. Numerous chemical derivatives of ALA have been synthesised with the aims of either improving topical penetration or enhancing systemic bioavailability, while reducing side effects. In vitro cell culture experiments with ALA derivatives have yielded promising results. However, if ALA derivatives are to demonstrate meaningful clinical benefits, a rational approach to topical formulation design is required, along with a systematic study aimed at uncovering the true potential of ALA derivatives in photodynamic therapy. With respect to systemic ALA delivery, more study is required in the developing area of ALA-containing dendrons and dendrimers.
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Affiliation(s)
- Ryan F. Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - Paul A. McCarron
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
| | - David A. Woolfson
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, U.K
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Donnelly RF, McCarron PA, Woolfson AD. Drug Delivery of Aminolevulinic Acid from Topical Formulations Intended for Photodynamic Therapy¶. Photochem Photobiol 2007. [DOI: 10.1111/j.1751-1097.2005.tb01439.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Savić S, Savić M, Tamburić S, Vuleta G, Vesić S, Müller-Goymann CC. An alkylpolyglucoside surfactant as a prospective pharmaceutical excipient for topical formulations: The influence of oil polarity on the colloidal structure and hydrocortisone in vitro/in vivo permeation. Eur J Pharm Sci 2007; 30:441-50. [PMID: 17331708 DOI: 10.1016/j.ejps.2007.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Revised: 01/17/2007] [Accepted: 01/22/2007] [Indexed: 10/23/2022]
Abstract
There is a growing need for research into new skin- and environment-friendly surfactants. This paper focuses on a natural surfactant of an alkylpolyglucoside type, which can form both thermotropic and lyotropic liquid-crystalline phases. The aim of this study was to relate some physicochemical properties (characterised by polarisation and transmission electron microscopy, thermal analysis and rheology) of the three formulations based on cetearyl glucoside and cetearyl alcohol, to the results of in vitro and in vivo bioavailability of hydrocortisone (HC). The three formulations contained oils of different polarity (medium chain triglycerides: MG, isopropyl myristate: IPM and light liquid paraffin: LP), respectively. In vitro permeation was followed through the artificial skin constructs (ASC), while the parameters measured in vivo were erythema index: EI (using instrumental human skin blanching assay), transepidermal water loss (TEWL) and stratum corneum hydration (SCH). The vehicles based on cetearyl glucoside and cetearyl alcohol showed a complex colloidal structure of lamellar liquid-crystalline and lamellar gel-crystalline type, depending on oil polarity. Rheological profile of the vehicle was directly related to the in vitro profile of the HC permeation. In vivo results suggested that the vehicle with MG retarded the HC permeation, whereas less polar IPM and non-polar LP enhanced it. It is suggested that the enhancement is achieved either by a direct interaction with lipid lamellae of the SC or indirectly by improving skin hydration. There were no adverse effects during in vivo study, which indicates a good safety profile of this alkylpolyglucoside surfactant.
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Affiliation(s)
- S Savić
- Institute of Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia and Montenegro.
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Donnelly RF, Ma LW, Juzenas P, Iani V, McCarron PA, Woolfson AD, Moan J. Topical bioadhesive patch systems enhance selectivity of protoporphyrin IX accumulation. Photochem Photobiol 2006; 82:670-5. [PMID: 16475870 DOI: 10.1562/2005-08-08-ra-641] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In clinical 5-aminolevulinic acid (ALA)-based photodynamic therapy (PDT) of skin tumors it is desirable to develop vehicles that minimize the penetration of ALA through normal stratum corneum and maximize it through the compromised stratum corneum of the tumors to improve tumor selectivity. We have designed a bioadhesive patch, which may be able to achieve this aim. It induces levels of protoporphyrin IX (PpIX) in skin overlying tumors similar to those induced by the proprietary cream (Porphin) but at the same time induces less PpIX to form in normal skin and at distant sites. The mechanisms of action of the patch, as compared with that of the cream, were studied by means of Cuprophan barriers that mimic compromised tumor stratum corneum and in a mouse model with transplanted tumors.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, UK.
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Gilmore BF, McCarron PA, Morrow DIJ, Murphy DJ, Woolfson AD, Donnelly RF. In vitro phototoxicity of 5-aminolevulinic acid and its methyl ester and the influence of barrier properties on their release from a bioadhesive patch. Eur J Pharm Biopharm 2006; 63:295-309. [PMID: 16682177 DOI: 10.1016/j.ejpb.2006.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Accepted: 03/10/2006] [Indexed: 11/15/2022]
Abstract
Topical administration of excess exogenous 5-aminolevulinic acid (ALA) leads to selective accumulation of the potent photosensitiser protoporphyrin IX (PpIX) in neoplastic cells, which can then be destroyed by irradiation with visible light. Due to its hydrophilicity, ALA penetrates deep lesions, such as nodular basal cell carcinomas (BCCs) poorly. As a result, more lipophilic esters of ALA have been employed to improve tissue penetration. In this study, the in vitro release of ALA and M-ALA from proprietary creams and novel patch-based systems across normal stratum corneum and a model membrane designed to mimic the abnormal stratum corneum overlying neoplastic skin lesions were investigated. Receiver compartment drug concentrations were compared with the concentrations of each drug producing high levels of PpIX production and subsequent light-induced kill in a model neoplastic cell line (LOX). LOX cells were found to be quite resistant to ALA- and M-ALA-induced phototoxicity. However, drug concentrations achieved in receiver compartments were comparable to those required to induce high levels of cell death upon irradiation in cell lines reported in the literature. Patches released significantly less drug across normal stratum corneum and significantly more across the model membrane. This is of major significance since the selectivity of PDT for neoplastic lesions will be further enhanced by the delivery system. ALA/M-ALA will only be delivered in significant amounts to the abnormal tissue. PpIX will only then accumulate in the neoplastic cells and the normal surrounding tissue will be unharmed upon irradiation.
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Affiliation(s)
- Brendan F Gilmore
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, Belfast, UK
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Pierre MBR, Ricci E, Tedesco AC, Bentley MVLB. Oleic acid as optimizer of the skin delivery of 5-aminolevulinic acid in photodynamic therapy. Pharm Res 2006; 23:360-6. [PMID: 16341572 DOI: 10.1007/s11095-005-9261-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Accepted: 10/26/2005] [Indexed: 01/23/2023]
Abstract
PURPOSE In photodynamic therapy (PDT), topically applied aminolevulinic acid (5-ALA) is converted to protoporphyrin IX (PpIX), which upon light excitation induces tumor destruction. To optimize 5-ALA-PDT via improving the highly hydrophilic 5-ALA limited penetration into the skin, we propose the use of the known skin penetration enhancer, oleic acid (OA). METHODS In vitro skin penetration and retention of 5-ALA (1% w/w) were measured in the presence or absence of OA (2.5, 5.0, and 10.0% w/w) in propylene glycol (PG) using porcine ear skin as the membrane. In vivo accumulation of PpIX, 4 h after application, was determined fluorometrically in healthy mice skin by chemical extraction of skin samples. In vivo PpIX fluorescence kinetics was also investigated by noninvasive techniques using an optical fiber probe, for 30 min up to 24 h after topical application of 1.0% 5-ALA + 10.0% OA in PG on hairless mice skins. RESULTS The flux and in vitro retention of 5-ALA in viable epidermis increased in the presence of 10.0% (w/w) OA. The amounts of PpIX, evaluated both by chemical tissue extractions and in vivo measurements by an optical fiber probe, increased after applying 5-ALA formulations containing 5.0 or 10.0% OA. Moreover, in vivo kinetic studies showed an increase in skin PpIX accumulation when formulations containing 10% OA were used; PpIX accumulation was also maintained longer compared to controls. CONCLUSIONS Both in vitro and in vivo results show the OA potential as an optimizer of 5-ALA skin delivery.
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Affiliation(s)
- Maria Bernadete Riemma Pierre
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Av. do Café s/n, 14040-903, Ribeirão Preto, São Paulo, San Paul, Brazil
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Donnelly RF, Morrow DIJ, McCarron PA, Juzenas P, Woolfson AD. Pharmaceutical analysis of 5-aminolevulinic acid in solution and in tissues. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2006; 82:59-71. [PMID: 16242952 DOI: 10.1016/j.jphotobiol.2005.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2005] [Revised: 08/10/2005] [Accepted: 08/26/2005] [Indexed: 11/28/2022]
Abstract
Quantification of 5-aminolevulinic acid (ALA) in solution, and methods used to achieve this, have been extensively reported in the literature. However, validated methods have only rarely been presented and never have methods been compared. Due to a necessity in drug delivery research for optimised and validated methods for determination of ALA in solution, this paper compares, for the first time, two such methods validated to International Conference on Harmonisation (ICH) standards. Of major importance, derivatisation of ALA with acetyl acetone and formaldehyde was found to be more suitable for routine fluorimetric HPLC analysis of ALA than derivatisation with o-phthaldialdehyde and 2-mercaptoethanol. This former method was successfully utilised in the comparison of in vitro drug release from a proprietary ALA cream and a novel bioadhesive patch-based system. In addition, determination of ALA in tissue is necessary to compare different topical formulations, in terms of their ability to deliver the drug successfully, and different tissue types, to assess their barrier properties to penetration of the drug. Consequently, this paper also describes the use of liquid scintillation spectroscopy as an analytical tool for rapid, convenient and routine quantification of ALA in tissue and determination of penetration depth following topical application of creams and patches.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK.
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Fotinos N, Campo MA, Popowycz F, Gurny R, Lange N. 5-Aminolevulinic Acid Derivatives in Photomedicine: Characteristics, Application and Perspectives. Photochem Photobiol 2006; 82:994-1015. [PMID: 16542112 DOI: 10.1562/2006-02-03-ir-794] [Citation(s) in RCA: 149] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The introduction of lipophilic derivatives of the naturally occurring heme precursor 5-aminolevulinic acid (5-ALA) into photomedicine has led to a true revival of this research area. 5-ALA-mediated photodynamic therapy (PDT) and fluorescence photodetection (FD) of neoplastic disease is probably one of the most selective cancer treatments currently known in oncology. To date, this method has been assessed experimentally for the treatment of various medical indications. However, the limited local bioavailability of 5-ALA has widely prevented its use in daily clinical practice. Although researchers were already aware of this drawback early during the development of 5-ALA-mediated PDT, only recently have well-established concepts in pharmaceutical science been adapted to investigate ways to overcome this drawback. Recently, two derivatives of 5-ALA, methylaminolevulinate (MAL) and hexylaminolevulinate (HAL), gained marketing authorization from the regulatory offices in Europe and Australia. MAL is marketed under the trade name Metvix for the treatment of actinic keratosis and difficult-to-treat basal cell carcinoma. HAL has recently been launched under the trade name Hexvix to improve the detection of superficial bladder cancer in Europe. This review will first present the fundamental concepts underlying the use of 5-ALA derivatives in PDT and FD from a chemical, biochemical and pharmaceutical point of view. Experimental evidences from preclinical data on the improvements and limits observed with 5-ALA derivatives will then be introduced. The state-of-the-art from clinical studies with 5-ALA esters will be discussed, with special emphasis placed on the process that led to the development of MAL in dermatology and to HAL in urology. Finally, we will discuss promising medical fields in which use of 5-ALA derivatives might potentially lead to further use of this methodology in photomedicine.
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Affiliation(s)
- Nicolas Fotinos
- Laboratory of Pharmaceutical Technology and Biopharmaceutics, Ecole de Pharmacie Genève-Lausanne, University of Geneva, Switzerland
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Donnelly RF, McCarron PA, Woolfson AD. Drug Delivery of Aminolevulinic Acid from Topical Formulations Intended for Photodynamic Therapy¶. Photochem Photobiol 2005. [DOI: 10.1562/2004-08-23-ir-283r1.1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Merclin N, Bramer T, Edsman K. Iontophoretic delivery of 5-aminolevulinic acid and its methyl ester using a carbopol gel as vehicle. J Control Release 2004; 98:57-65. [PMID: 15245889 DOI: 10.1016/j.jconrel.2004.04.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2003] [Accepted: 04/22/2004] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate a Carbopol gel as a vehicle for iontophoretic delivery of 5-aminolevulinic acid (ALA) and its methyl ester (m-ALA). The formulation was characterized rheologically and the passive diffusion of ALA and m-ALA in the gels was measured. Addition of ALA and m-ALA did not change the rheological behavior of the gel and the diffusion coefficients of ALA and m-ALA were 4.4 +/- 1.2 x 10(-6) and 3.08 +/- 0.7 x 10(-7) cm2 s(-1), respectively. The anodal iontophoretic transport of ALA and m-ALA through porcine skin in vitro was followed for 15 h at a constant current of 0.4 mA. When incorporating ALA in the gel, the steady-state was reached in 10-12 h at a flux level of approx. 65 nmol cm(-2) h(-1) compared to 2.5-4 h and a level of approximately 145 nmol cm(-2) h(-1) for m-ALA. The total amount of m-ALA delivered after 15 h of iontophoresis resulted in a six-fold enhancement over ALA delivery. Iontophoretic delivery from the gel formulation seems to be better than, or comparable to, the passive delivery from formulations commonly used clinically, in spite of the 10-20 times lower concentration of the drug in the gel formulation. The skin uptake after iontophoresis for m-ALA showed a nine-fold increase over that of ALA in the stratum corneum (SC).
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Affiliation(s)
- Nadia Merclin
- Department of Pharmacy, Uppsala Biomedical Centre, Uppsala University, P.O. Box 580, SE-751 23, Sweden.
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Jaeckle E, Schaefer UF, Loth H. Comparison of effects of different ointment bases on the penetration of ketoprofen through heat-separated human epidermis and artificial lipid barriers. J Pharm Sci 2003; 92:1396-406. [PMID: 12820144 DOI: 10.1002/jps.10398] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In vitro tests were performed to understand the effects of topical vehicles on the permeability of ketoprofen through artificial lipid barriers and heat-separated human epidermis consisting of stratum corneum and viable epidermis. Ketoprofen was selected as the model penetrant. Human epidermis and artificial membranes made from several mixtures of free fatty acids, cholesterol, cholesteryl ester, ceramides, and triglycerides were used as permeation matrices in untreated conditions and after pretreatment with petrolatum, wool alcohols ointment, or triglycerides. Apparent permeability and diffusion coefficients as well as the solubility of the drug in the artificial lipid matrices were ascertained. The solubilities of drugs and vehicle components that depend on the composition of the lipid matrix predominantly control the permeability of the barrier. Ceramides and cholesterol reduce the permeability and solubility, whereas triglycerides have the opposite effect. The vehicle effects in artificial membranes correspond to those in epidermis observed with samples pretreated with the aforementioned bases. The logarithms of the permeabilities of untreated and pretreated lipid mixtures 3, 4, and 5 are very well correlated with those of the permeabilities of heat-separated epidermis (r > = 0.9868). The artificial mixture containing all five lipids mentioned gives the best approximation to human epidermis. This result indicates comparable vehicle effects although the composition of the artificial mixture was adapted only in a simplified manner to the horny layer lipid phase. This lipid matrix or similar mixtures, therefore, are convenient tools for investigation into the effects of dermatological vehicles.
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Affiliation(s)
- Elke Jaeckle
- Institute of Biopharmaceutics and Pharmaceutical Technology, Saarland University, D-66041 Saarbruecken, Germany
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