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Futaki M, Inamura K, Nishimura T, Niitsu T, Tojo T, Sugibayashi K, Todo H. A Hollow Microneedle Equipped with a Micropillar for Improved Needle Insertion and Injection of Drug Solution. Pharm Res 2024; 41:819-831. [PMID: 38443630 DOI: 10.1007/s11095-024-03681-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Hollow-type microneedles (hMNs) are a promising device for the effective administration of drugs into intradermal sites. Complete insertion of the needle into the skin and administration of the drug solution without leakage must be achieved to obtain bioavailability or a constant effect. In the present study, several types of hMN with or without a rounded blunt tip micropillar, which suppresses skin deformation, around a hollow needle, and the effect on successful needle insertion and administration of a drug solution was investigated. Six different types of hMNs with needle lengths of 1000, 1300, and 1500 µm with or without a micropillar were used. METHODS Needle insertion and the disposition of a drug in rat skin were investigated. In addition, the displacement-force profile during application of hMNs was also investigated using a texture analyzer with an artificial membrane to examine needle factors affecting successful insertion and administration of a drug solution by comparing with in vivo results. RESULTS According to the results with the drug distribution of iodine, hMN1300 with a micropillar was able to successfully inject drug solution into an intradermal site with a high success rate. In addition, the results of displacement-force profiles with an artificial membrane showed that a micropillar can be effective for depth control of the injected solution as well as the prevention of contact between the hMN pedestal and the deformed membrane. CONCLUSION In the present study, hMN1300S showed effective solution delivery into an intradermal site. In particular, a micropillar can be effective for depth control of the injected solution as well as preventing contact between the hMN pedestal and the deformed membrane. The obtained results will help in the design and development of hMNs that ensure successful injection of an administered drug.
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Affiliation(s)
- Mika Futaki
- Graduate School of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Kazuya Inamura
- Graduate School of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Tomoya Nishimura
- Processing Development Research Lab., Kao Corp., 2606 Akabane, Ichikai-cho, Haga-gun, Tochigi, 321-3426, Japan
| | - Takatoshi Niitsu
- Processing Development Research Lab., Kao Corp., 2606 Akabane, Ichikai-cho, Haga-gun, Tochigi, 321-3426, Japan
| | - Takehiko Tojo
- Processing Development Research Lab., Kao Corp., 2606 Akabane, Ichikai-cho, Haga-gun, Tochigi, 321-3426, Japan
| | - Kenji Sugibayashi
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
- Faculty of Pharmaceutical Sciences, Josai International University, 1 Gumyo, Togane, Chiba-ken, 283-8555, Japan
| | - Hiroaki Todo
- Graduate School of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan.
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Lim SY, Jung YM, Kim Y, Kim G, Jeon J, Chin B, Kim MK. Adverse Reactions After Intradermal Vaccination With JYNNEOS for Mpox in Korea. J Korean Med Sci 2024; 39:e100. [PMID: 38442725 PMCID: PMC10911936 DOI: 10.3346/jkms.2024.39.e100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/18/2024] [Indexed: 03/07/2024] Open
Abstract
In response to the Mpox domestic epidemic, South Korea initiated a nationwide vaccination program in May 2023, administering a 0.1 mL intradermal dose of JYNNEOS (Modified Vaccinia Ankara vaccine, Bavarian Nordic) to a high-risk group. To investigate the adverse reactions after intradermal JYNNEOS vaccination, an anonymous online survey was conducted at the National Medical Center from May 22 to July 31, 2023. Overall, 142 individuals responded. Over 80% of the respondents reported local reactions of predominantly mild severity. The predominant local reactions were pruritus, redness, and swelling; their incidence rates after the first dose were 66.2%, 48.1%, and 49.4%, respectively; the corresponding rates after the second dose were 69.2%, 60.6%, and 53.8%. Fewer respondents reported systemic symptoms. The most common systemic symptom was fatigue, the incidence rates of which after the first and second doses were 37.7% and 24.6%, respectively. Overall, the intradermally administered JYNNEOS vaccine appeared well tolerated.
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Affiliation(s)
- So Yun Lim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Yu Mi Jung
- Infectious Diseases Response Team, National Medical Center, Seoul, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Gayeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Jaehyun Jeon
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - BumSik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Min-Kyung Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.
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Schuelke F, Brendt P. Simple Yet Effective-Sterile Water Injections to Treat Labor Pain in the Transport Environment. Air Med J 2024; 43:174-176. [PMID: 38490784 DOI: 10.1016/j.amj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 03/17/2024]
Abstract
Sterile water injections (SWI) is a nonpharmacologic pain relief option to treat back pain in labor. This case report describes and discusses the use of SWI in the context of an obstetric retrieval of a 29-year-old woman who was transferred by the Royal Flying Doctor Service South Eastern Section. It provides an overview of SWI, discusses the relevance for medical transport, and offers suggestions for medical transport professionals.
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Affiliation(s)
- Fabian Schuelke
- Royal Flying Doctor Service South Eastern Section, Dubbo, New South Wales, Australia.
| | - Peter Brendt
- Royal Flying Doctor Service South Eastern Section, Dubbo, New South Wales, Australia
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Kang G, Kim M, Lee Y, Yang H, Seong BL, Jung H. Egg microneedles for transdermal vaccination of inactivated influenza virus. Biomater Sci 2024; 12:907-918. [PMID: 38174731 DOI: 10.1039/d3bm01635h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The use of dissolving microneedles (DMNs) is a drug delivery technique in which drug dissolution occurs once it is administered into the skin. The skin is a remarkable site for vaccination due to its significant immunologic properties. Compared to the traditional hypodermic intramuscular (IM) injection, vaccination via DMN does not require cold chains and allows for minimal invasive drug delivery. On account of the significance of skin vaccination, preceding studies have been conducted to elucidate the importance of the DMN technology in vaccination. Most of these studies focused on formulations that maintain the activity of the vaccine, so formulations designed to be specific to the mechanical properties of the microneedle could not be used together independently. In this study, we have developed influenza vaccine loaded egg microneedles (EMN) and characterized the specificity of layer-specific functions of EMN by distinguishing between formulations that can maintain the activity of the vaccine and have the mechanical strength. By the use of in vitro tests such as ELISA and SRID assays, we quantitively evaluated the antigen activity of the formulation candidates to be 87% and 91%, respectively. In vivo tests were also conducted as mouse groups were inoculated with the formulation constructed into egg microneedles (FLU-EMN) to determine the protective efficacy against infection. The results demonstrated that FLU-EMN with functionalized formulations successfully enabled protective immune response even with a fractional dose compared to IM injection.
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Affiliation(s)
- Geonwoo Kang
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Juvic Inc., 272 Digital-ro, Guro-gu, Seoul 08389, Republic of Korea
| | - Minkyung Kim
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Youjin Lee
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Huisuk Yang
- Juvic Inc., 272 Digital-ro, Guro-gu, Seoul 08389, Republic of Korea
| | - Baik-Lin Seong
- Department of Microbiology, College of Medicine, Yonsei University, Seoul, 03721, Republic of Korea
- Vaccine Innovative Technology Alliance (VITAL)-Korea, Yonsei University, Seoul 03721, Republic of Korea
| | - Hyungil Jung
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Juvic Inc., 272 Digital-ro, Guro-gu, Seoul 08389, Republic of Korea
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Tsiogka A, Agiasofitou E, Tsimpidakis A, Kontochristopoulos G, Stratigos A, Gregoriou S. Management of primary plantar hyperhidrosis with botulinum toxin type A: A retrospective case series of 129 patients. Australas J Dermatol 2024; 65:49-54. [PMID: 37964488 DOI: 10.1111/ajd.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/29/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND/OBJECTIVES To date, scientific data on the efficacy of botulinum toxin type A (BoNT-A) for primary plantar hyperhidrosis (PPH) are mainly derived from case reports and small case series. Herein, we sought to assess the efficacy and safety of BoNT-A for PPH on a large series of patients. METHODS Medical records of patients who were referred to the outpatient department for hyperhidrosis of a tertiary care hospital and received BoNT-A for PPH from March 2003 until December 2022 were reviewed. RESULTS A total of 129 patients [12 males, 117 females; median age 32 years (range, 16-72)] were included in the study, after excluding 24 patients with insufficient documented follow-up data. Most patients [115 (89.1%)] received onabotulinumtoxin-A, nine (7.0%) abobotulinumtoxin-A and five (3.9%) both in subsequent sessions. The mean number of sessions was 2.02 [standard deviation (SD), 2.29] and the mean duration of response 6.16 months (SD, 4.01). The percentage of response, as evaluated by Minor's test, was 71.67%, 63.44%, 47.78% and 34.13% after 1, 3, 6 and 9 months, respectively. Most patients were satisfied (21.7%) or very satisfied (58.9%) with the treatment. No serious side effects were reported. CONCLUSIONS The results of this retrospective study suggest that BoNT-A is an effective and safe treatment option for PPH.
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Affiliation(s)
- Aikaterini Tsiogka
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Efthymia Agiasofitou
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Antonios Tsimpidakis
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - George Kontochristopoulos
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Alexander Stratigos
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Stamatios Gregoriou
- Faculty of Medicine, 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
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Overduin LA, Koopman JPR, Prins C, Verbeek-Menken PH, De Pijper CA, Eblé PL, Heerink F, van Genderen PJJ, Grobusch MP, Visser LG. Boostability after single-visit pre-exposure prophylaxis with rabies vaccine: a randomised controlled non-inferiority trial. Lancet Infect Dis 2024; 24:206-216. [PMID: 37802090 DOI: 10.1016/s1473-3099(23)00452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/20/2023] [Accepted: 07/12/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND After rabies pre-exposure prophylaxis (PrEP) vaccination, scarcely available rabies immunoglobulins are not required for post-exposure prophylaxis (PEP). However, PrEP is not sufficiently accessible as it is cost-intensive and time-intensive. This study investigates whether rabies PrEP schedules can be shortened to one visit, removing some of these barriers. METHODS In a block-randomised (2:2:2:1) controlled, multicentre non-inferiority trial, healthy adult travellers (aged 18-50 years and >50 years) were randomly assigned to (A) single-visit intramuscular (1·0 mL); (B) single-visit intradermal (0·2 mL); (C) standard two-visit intramuscular (1·0 mL; day 0 and 7) PrEP; or (D) no rabies vaccination. 6 months later, participants received simulated intramuscular rabies PEP (1·0 mL; day 0 and 3). Rabies virus neutralising antibody (RVNA) concentrations were measured repeatedly. The primary outcome was the fold increase in geometric mean RVNA concentrations between day 0 and 7 after simulated PEP for all participants. The two main comparisons of this primary outcome are between the standard two-visit schedule and the one-visit intramuscular schedule, and between the standard two-visit schedule and the one-visit intradermal schedule. The non-inferiority margin was 0·67. This study is registered with EudraCT, 2017-000089-31. FINDINGS Between May 16, 2018, and March 26, 2020, 288 healthy adult travellers were randomly assigned and 214 participants were evaluated for the primary outcome. Single-visit intramuscular rabies PrEP induced an anamnestic antibody response non-inferior compared with the two-visit intramuscular schedule; single-visit intradermal PrEP did not. The fold increases in the single-visit intramuscular and the single-visit intradermal schedule were 2·32 (95% CI [1·43-3·77]) and 1·11 (0·66-1·87) times as high as the fold increase in the standard schedule, respectively. No vaccine-related serious adverse events were observed. Adverse events related to vaccination were mostly mild. INTERPRETATION Single intramuscular rabies vaccination can effectively prime travellers (aged 18-50 years), and potentially other populations, and could replace current standard two-visit rabies vaccination as PrEP. FUNDING ZonMW. TRANSLATION For the Dutch translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Lisanne A Overduin
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Jan Pieter R Koopman
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Corine Prins
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Petra H Verbeek-Menken
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Cornelis A De Pijper
- Centre for Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Phaedra L Eblé
- Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Fiona Heerink
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Martin P Grobusch
- Centre for Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands.
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Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, Namazi MR. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles. J Cosmet Dermatol 2024; 23:600-606. [PMID: 37822183 DOI: 10.1111/jocd.16004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles. AIMS In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up. METHODS In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection. RESULTS Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients. CONCLUSION Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required.
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Affiliation(s)
- Farzaneh Akbari
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student research committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Sara Dehghani
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Prodan-Barbulescu C, Castiglione L, Burtic SR, Murariu M, Reddy S, Rosca O, Bratosin F, Melania Fizedean C, Krupyshev P, Enatescu I. Longitudinal Assessment of Facial Hyperhidrosis Management: Evaluating the Utility and Quality of Life Improvements following Botulinum Toxin Injection. Toxins (Basel) 2024; 16:59. [PMID: 38276535 PMCID: PMC10820190 DOI: 10.3390/toxins16010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/15/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024] Open
Abstract
Facial hyperhidrosis is a debilitating condition that can severely impact the quality of life. This study aimed to assess the long-term utility of Botulinum toxin type A therapy (BTA) for facial hyperhidrosis and its impact on quality of life over a one-year period. Conducted at the Pius Brinzeu Clinical Emergency Hospital in Timisoara, Romania, this longitudinal observational study involved 77 adult patients with primary facial hyperhidrosis. Participants received two sessions of Botulinum toxin injections (50 U IncoBTX-A each) and were evaluated at baseline, 6 months, and 12 months using the Hyperhidrosis Disease Severity Scale (HDSS), WHOQOL-BREF, Dermatology Life Quality Index (DLQI), and a bespoke survey. The study demonstrated significant reductions in HDSS scores from 3.6 ± 0.5 to 1.2 ± 0.8 post-treatment, sustained at 1.3 ± 0.6 at 12 months (p-value < 0.001). DLQI scores markedly decreased from 24.8 ± 4.2 to 6.2 ± 2.1 post-treatment, stabilizing at 6.5 ± 2.5 at 12 months (p-value < 0.001). Sweat production significantly dropped from 0.75 g ± 0.15 to 0.18 g ± 0.07 per 15 min (p-value < 0.001). WHOQOL-BREF scores improved notably in the mental domain from 66.7 ± 6.1 to 70.8 ± 5.2 at 12 months (p-value < 0.001), with physical and social domains also showing significant improvements. Correlation analysis revealed strong negative correlations between DLQI total score and HDSS (rho = -0.72, p-value < 0.001) and sweat production (rho = -0.68, p-value < 0.001). Regression analysis indicated significant predictors for DLQI total score, including HDSS (B Coefficient = -3.8, p-value < 0.001) and sweat production (B Coefficient = -2.2, p-value < 0.001). BTA therapy significantly improved the quality of life in facial hyperhidrosis patients, with lasting effects on symptom severity, sweat production, and quality of life domains. The correlation and regression analyses further substantiated the treatment's impact on both physical and psychological aspects. These findings advocate Botulinum toxin as a viable long-term treatment for facial hyperhidrosis.
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Affiliation(s)
- Catalin Prodan-Barbulescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.P.-B.); (S.R.B.)
- IInd Surgery Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department I-Discipline of Anatomy and Embryology, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Luca Castiglione
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.P.-B.); (S.R.B.)
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Sonia Roxana Burtic
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.P.-B.); (S.R.B.)
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Murariu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Shruta Reddy
- Department of General Medicine, SVS Medical College, Yenugonda, Mahbubnagar 509001, Telangana, India;
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.R.); (F.B.)
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.R.); (F.B.)
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Camelia Melania Fizedean
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Pavel Krupyshev
- Faculty of General Medicine, I.M. Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Ulitsa 2, 119435 Moscow, Russia;
| | - Ileana Enatescu
- Department of Obstetrics and Gynecology, Discipline of Childcare and Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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Gupta AK, Polla Ravi S, Wang T, Talukder M, Starace M, Piraccini BM. Systematic review of mesotherapy: a novel avenue for the treatment of hair loss. J DERMATOL TREAT 2023; 34:2245084. [PMID: 37558233 DOI: 10.1080/09546634.2023.2245084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance. This systematic review aims to summarize the current literature that evaluates the efficacy of this technique for the treatment of hair loss and provides an overview of the results observed. Of the 416 records identified, 27 articles met the inclusion criteria. To date, mesotherapy using 6 classes of agents and their combinations have been studied; this includes dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins. While several studies report statistically significant improvements in hair growth after treatment, there is currently a lack of standardized regimens. The emergence of adverse effects after mesotherapy has been reported. Further large-scale and controlled clinical trials are warranted to evaluate the utility of mesotherapy for hair loss disorders.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Canada
- Mediprobe Research Inc, London, Canada
| | | | - Tong Wang
- Mediprobe Research Inc, London, Canada
| | - Mesbah Talukder
- Mediprobe Research Inc, London, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy
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Tao F, Ye Q, Chen Y, Luo L, Xu H, Xu J, Feng Z, Wang C, Li T, Wen Y, Hu Y, Dong H, Zhao X, Wu J. Antigen-loaded flagellate bacteria for enhanced adaptive immune response by intradermal injection. J Control Release 2023; 364:562-575. [PMID: 37926245 DOI: 10.1016/j.jconrel.2023.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Since the skin limits the distribution of intradermal vaccines, a large number of dendritic cells in the skin cannot be fully utilized to elicit a more effective immune response. Here, we loaded the antigen to the surface of the flagellate bacteria that was modified by cationic polymer, thus creating antigen-loaded flagellate bacteria (denoted as 'FB-Ag') to overcome the skin barrier and perform the active delivery of antigen in the skin. The FB-Ag showed fast speed (∼0.2 μm s-1) and strong dendritic cell activation capabilities in the skin model in vitro. In vivo, the FB-Ag promoted the spread of antigen in the skin through active movement, increased the contact between Intradermal dendritic cells and antigen, and effectively activated the internal dendritic cells in the skin. In a mouse of pulmonary metastatic melanoma and in mice bearing subcutaneous melanoma tumor, the FB-Ag effectively increased antigen-specific therapeutic efficacy and produced long-lasting immune memory. More importantly, the FB-Ag also enhanced the level of COVID-19 specific antibodies in the serum and the number of memory B cells in the spleen of mice. The movement of antigen-loaded flagellate bacteria to overcome intradermal constraints may enhance the activation of intradermal dendritic cells, providing new ideas for developing intradermal vaccines.
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Affiliation(s)
- Feng Tao
- Department of Andrology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China; State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Qingsong Ye
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Yimiao Chen
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Lifeng Luo
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Haiheng Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Jialong Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Zhuo Feng
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Chao Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Tao Li
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Yuxuan Wen
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China
| | - Yiqiao Hu
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China; Jiangsu Provincial Key Laboratory for Nano Technology, Nanjing University, Nanjing 210093, China
| | - Hong Dong
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China.
| | - Xiaozhi Zhao
- Department of Andrology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China.
| | - Jinhui Wu
- Department of Andrology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210093, China; State Key Laboratory of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing University, Nanjing 210093, China; Chemistry and Biomedicine Innovation Center, Nanjing University, Nanjing 210023, China; Jiangsu Provincial Key Laboratory for Nano Technology, Nanjing University, Nanjing 210093, China.
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11
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Yi K, Lee B, Kim MJ, Lee S, Hidajat IJ, Lim TS, Kim HM, Kim J. Observation on cadavers and through ultrasonography using a 2 mm needle length for intradermal injections. Skin Res Technol 2023; 29:e13529. [PMID: 38009043 PMCID: PMC10661215 DOI: 10.1111/srt.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND An intradermal injection is a medical procedure that involves administering a small amount of medication or substance into the dermal layer of the skin. This research focused on identifying the most suitable injection needle for precise intradermal administration of skin boosters. METHODS The study involved conducting intradermal injections on four cadavers and participants using a 2 mm length, 34-gauge needle (N-Finders, Inc., South Korea). During the cadaveric study, the polynucleotide prefilled syringe was dyed green, and an anatomist performed dissections, removing only the skin layer. Ultrasonographic observations were carried out to ensure accurate intradermal injection placement. RESULTS In all four cadavers, the facial injections at the anterior cheek region were precisely administered intradermally at a 30-degree injection angle. However, the 90-degree injection was found just below the dermal layer upon skin layer removal. DISCUSSION The findings suggest that using a 2 mm needle length allows for easy and convenient intradermal injections.
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Affiliation(s)
- Kyu‐Ho Yi
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of Dentistry50–1 Yonsei‐ro, Seodaemun‐guSeoulSouth Korea
- Maylin Clinic (Apgujeong)SeoulSouth Korea
| | - Brian Lee
- Department of Internal MedicineNewYork‐Presbyterian Brooklyn Methodist HospitalBrooklynNew YorkUSA
| | | | | | - Inneke Jane Hidajat
- Department of DermatologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaJakartaIndonesia
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Ullas PT, Balachandran C, Pathak N, Manikrao YP, Rathod S, Pavitrakar DV, Bondre VP, Abraham P. Case Report: Survival from Clinical Rabies in a Young Child from Maharashtra, India, 2022. Am J Trop Med Hyg 2023; 109:1157-1160. [PMID: 37783454 PMCID: PMC10622477 DOI: 10.4269/ajtmh.22-0683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 08/07/2023] [Indexed: 10/04/2023] Open
Abstract
A 3.5-year-old male child from Maharashtra, India, presented with features of meningoencephalitis approximately 1 month after sustaining severe bite injuries on the right hand from a stray dog. He had received four doses of post-exposure intradermal rabies vaccination (on days 0, 3, and 7 of the bite and erroneously on day 20, instead of day 28 as recommended in the updated Thai Red Cross regimen) as well as local and systemic injections of equine rabies immune globulin. The child was initially diagnosed with and treated for acute encephalitis syndrome before rabies encephalitis was confirmed by detection of rabies virus neutralizing antibodies in the cerebrospinal fluid. During the emergent period, he also received the antimalarial drug artesunate, recently reported to have antiviral effects against rabies virus. With intensive and supportive care, the child showed substantial clinical improvement over the next few weeks. He has now survived for more than 10 months after disease onset, albeit with severe neurological sequelae including diffuse cerebral and cerebellar atrophy.
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Affiliation(s)
| | - Chandhu Balachandran
- Rabies Laboratory, Encephalitis Group, Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, India
| | | | | | | | - Daya Vishal Pavitrakar
- Rabies Laboratory, Encephalitis Group, Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, India
| | - Vijay Parashramji Bondre
- Rabies Laboratory, Encephalitis Group, Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, India
| | - Priya Abraham
- Director, Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, India
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13
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Hanna SJ, Thayer TC, Robinson EJS, Vinh NN, Williams N, Landry LG, Andrews R, Siah QZ, Leete P, Wyatt R, McAteer MA, Nakayama M, Wong FS, Yang JHM, Tree TIM, Ludvigsson J, Dayan CM, Tatovic D. Single-cell RNAseq identifies clonally expanded antigen-specific T-cells following intradermal injection of gold nanoparticles loaded with diabetes autoantigen in humans. Front Immunol 2023; 14:1276255. [PMID: 37908349 PMCID: PMC10613693 DOI: 10.3389/fimmu.2023.1276255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023] Open
Abstract
Gold nanoparticles (GNPs) have been used in the development of novel therapies as a way of delivery of both stimulatory and tolerogenic peptide cargoes. Here we report that intradermal injection of GNPs loaded with the proinsulin peptide C19-A3, in patients with type 1 diabetes, results in recruitment and retention of immune cells in the skin. These include large numbers of clonally expanded T-cells sharing the same paired T-cell receptors (TCRs) with activated phenotypes, half of which, when the TCRs were re-expressed in a cell-based system, were confirmed to be specific for either GNP or proinsulin. All the identified gold-specific clones were CD8+, whilst proinsulin-specific clones were both CD8+ and CD4+. Proinsulin-specific CD8+ clones had a distinctive cytotoxic phenotype with overexpression of granulysin (GNLY) and KIR receptors. Clonally expanded antigen-specific T cells remained in situ for months to years, with a spectrum of tissue resident memory and effector memory phenotypes. As the T-cell response is divided between targeting the gold core and the antigenic cargo, this offers a route to improving resident memory T-cells formation in response to vaccines. In addition, our scRNAseq data indicate that focusing on clonally expanded skin infiltrating T-cells recruited to intradermally injected antigen is a highly efficient method to enrich and identify antigen-specific cells. This approach has the potential to be used to monitor the intradermal delivery of antigens and nanoparticles for immune modulation in humans.
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Affiliation(s)
- Stephanie J. Hanna
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Terri C. Thayer
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
- Department of Biological and Chemical Sciences, Roberts Wesleyan University, Rochester, NY, United States
| | - Emma J. S. Robinson
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Ngoc-Nga Vinh
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Nigel Williams
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Laurie G. Landry
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, CO, United States
| | - Robert Andrews
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Qi Zhuang Siah
- John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Pia Leete
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, United Kingdom
| | - Rebecca Wyatt
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, United Kingdom
| | | | - Maki Nakayama
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, CO, United States
| | - F. Susan Wong
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Jennie H. M. Yang
- Department of Immunobiology, School of Immunology & Microbial Sciences, King’s College London, Guy’s Hospital, London, United Kingdom
| | - Timothy I. M. Tree
- Department of Immunobiology, School of Immunology & Microbial Sciences, King’s College London, Guy’s Hospital, London, United Kingdom
| | - Johnny Ludvigsson
- Division of Pediatrics, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences and Crown Princess Victoria Children´s Hospital, Linköping University, Linköping, Sweden
| | - Colin M. Dayan
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Danijela Tatovic
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
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14
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Jia W, Li Q, Ni J, Zhang Y, Wu L, Xu L. Efficacy and safety of methylene blue injection for intractable idiopathic pruritus ani: a single-arm metaanalysis and systematic review. Tech Coloproctol 2023; 27:813-825. [PMID: 37306793 DOI: 10.1007/s10151-023-02825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/15/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE To evaluate how effective methylene blue injection was at treating intractable idiopathic pruritus ani. METHODS A comprehensive literature search of the PubMed, Embase, Cochrane library, and Web of Science databases was conducted. All clinical studies (prospective and retrospective) that evaluated the efficacy of methylene blue in treating intractable idiopathic pruritus ani were included. Studies that reported the resolution rate, after a single injection and after a second injection, the recurrence rate, symptom scores, and transient complications of methylene blue injections in treating intractable idiopathic pruritus ani were included. RESULTS The seven selected studies included 225 patients with idiopathic pruritus ani. The resolution rates after a single injection and after a second injection was 0.761 (0.649-0.873, P < 0.01, I2 = 69.06%) and 0.854 (0.752-0.955, P < 0.01, I2 = 77.391%), respectively, the remission rates at 1, 3, and 5 years were 0.753 (0.612-0.893, P < 0.001), 0.773 (0.675-0.871, P < 0.001) and 0.240 (0.033-0.447, P < 0.001), respectively, the effect value of the merger was 0.569 (0.367-0.772, P < 0.001, I2 = 79.199%), and the recurrence rates at 1, 2, 3, and < 1 year were 0.202 (0.083-0.322, P < 0.001), 0.533 (0.285-0.781, P < 0.001), 0.437 (-0.044, 0.917, P < 0.001) and 0.067 (0.023-0.111, P < 0.001), respectively. The effect value of the merger was 0.223 (0.126-0.319, P < 0.001, I2 = 75.840). CONCLUSION Using methylene blue injections to treat intractable idiopathic pruritus ani is relatively efficacious, resulting in a relatively low recurrence rate and no severe complications. However, the available literature was of poor quality. Therefore, higher quality studies are necessary to confirm that methylene blue injection is efficacious for pruritus ani, such as a randomized prospective multicenter studies.
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Affiliation(s)
- W Jia
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, Zhejiang Province, China
| | - Q Li
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, 310053, Zhejiang Province, China
| | - J Ni
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, Zhejiang Province, China
| | - Y Zhang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, Zhejiang Province, China
| | - L Wu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, Zhejiang Province, China
| | - L Xu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), 54 Youdian Road, Hangzhou, 310006, Zhejiang Province, China.
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15
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Auerswald H, Maestri A, Touch S, In S, Ya N, Heng B, Bosch-Castells V, Augard C, Petit C, Dussart P, Peng Y, Cantaert T, Ly S. Side-by-side Comparative Study of the Immunogenicity of the Intramuscular and Intradermal Rabies Post-exposure Prophylaxis Regimens in a Cohort of Suspected Rabies Virus Exposed Individuals. Clin Infect Dis 2023; 77:910-916. [PMID: 37337899 PMCID: PMC10506778 DOI: 10.1093/cid/ciad304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
All World Health Organization (WHO) pre-qualified rabies vaccines for humans are inactivated tissue culture rabies virus formulations produced for intramuscular (IM) administration. Due to costs and vaccine shortage, dose-saving intradermal (ID) administration of rabies post-exposure prophylaxis (PEP) is encouraged by WHO. This study compared the immunogenicity of the ID 2-site, 3-visit Institut Pasteur Cambodge (IPC) PEP regimen to the IM 1-site, 4-visit 4-dose Essen regimen using Verorab vaccine (Sanofi). The development of neutralizing antibodies (nAbs) and T cell response was assessed in 210 patients with a category II or III animal exposure in a rabies-endemic country. At day 28, all participants developed nAbs (≥0.5 IU/mL), irrespective of PEP scheme, age, or administration of rabies immunoglobulin. T cell response and nAb titers were similar for both PEP schemes. This study demonstrated that the 1-week ID IPC regimen is as effective as the 2-week IM 4-dose Essen regimen in inducing an anti-rabies immune response under real-life PEP.
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Affiliation(s)
- Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Alvino Maestri
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sothy Touch
- Rabies Prevention Center, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Saraden In
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Nisa Ya
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Borita Heng
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | | | | | | | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Yiksing Peng
- Rabies Prevention Center, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
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16
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Fabi SG, Park JY, Goldie K, Wu W. Microtoxin for Improving Pore Size, Skin Laxity, Sebum Control, and Scars: A Roundtable on Integrating Intradermal Botulinum Toxin Type A Microdoses Into Clinical Practice. Aesthet Surg J 2023; 43:1015-1024. [PMID: 36857534 PMCID: PMC10481112 DOI: 10.1093/asj/sjad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND In aesthetic clinical practice, botulinum toxin type A (BoNT-A) is best known for its use as a neuromodulator for the treatment of dynamic facial lines; however, when injected intradermally as microdroplets, BoNT-A can improve skin quality and overall skin appearance. OBJECTIVES To discuss key aspects of microtoxin use in clinical practice and provide expert guidance on utilization. METHODS As part of a continuing medical education lecture series and roundtable, the authors discussed key aspects of microtoxin patient selection, injection technique, and safety. RESULTS The experiences of expert faculty are shared here. Clinical experience is consistent with reported data. Microtoxin can be used to reduce pore size, sebum production, rosacea, acne, and fine lines, and to improve jawline and neck definition. Intradermal injection can also be employed for the improvement of transverse neck lines as well as for the safe prevention and management of scars and keloids. CONCLUSIONS Expanding the use of BoNT-A, a predictable, minimally invasive, and affordable treatment to address commonly encountered complaints is appealing. The authors have found that making patients aware of microtoxin as a treatment option results in an increased interest in and utilization of BoNT-A, and high satisfaction among appropriately selected patients.
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Affiliation(s)
- Sabrina Guillen Fabi
- Corresponding Author: Dr Sabrina Guillen Fabi, 9339 Genesee Ave Unit 300, San Diego, CA 92121, USA. E-mail:
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17
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Abd Elraouf IG, Obaid ZM, Fouda I. Intradermal injection of tranexamic acid versus platelet-rich plasma in the treatment of melasma: a split-face comparative study. Arch Dermatol Res 2023; 315:1763-1770. [PMID: 36856856 PMCID: PMC10338558 DOI: 10.1007/s00403-023-02580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023]
Abstract
Millions of people throughout the world suffer from the acquired condition of hyperpigmentation known as melasma. Melasma is characterized by symmetrically oriented hyperpigmented macules and patches. Many treatment options are available with variable degrees of efficacy and tolerability. The aim of the work was to evaluate and compare the effectiveness and safety of intradermal tranexamic acid (TXA) versus intradermal platelet-rich plasma (PRP) in the treatment of various types of melasma. The current split-face prospective study included 40 cases with melasma. Tranexamic acid (TXA) was injected intradermally into the right side of the face by using a concentration of 4 mg/ml, while platelet-rich plasma (PRP) was injected intradermally into the left side. In both sides, a total of three sessions of treatment were provided, once every 4 weeks. Digital photographs were taken before each treatment session and 3 months after the last session. The modified melasma area severity index (mMASI) grading system and dermoscopy were used to assess the improvement in the condition. The disease severity and percentage of improvement were assessed by mMASI score before and after therapy across both sides of the face. along with determining the degree of satisfaction and side effects among the included cases. The mean mMASI score before therapy in the TXA side was 4.59 ± 2.87, while in the PRP side, the mean mMASI score before therapy was 4.72 ± 2.72 with no statistically significant difference between the two sides (p = 0.841). After 3 months of treatment, the mean mMASI score in the TXA-treated side was 2.49 ± 1.58 with a mean percentage of decrease of 45.67 ± 8.10%, while in the PRP side, the mean mMASI score after treatment was 2.17 ± 1.41 with a mean percentage of decrease of 53.66 ± 11.27%. There was a high statistically significant decrease in the mMASI score after treatment on both sides (p < 0.001); however, the percentage of score reduction in the PRP side compared to the TXA side was statistically higher. Intradermal injection with PRP revealed higher efficacy in the treatment of melasma as compared to TXA injection with no significant difference regarding the associated side effects.
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Affiliation(s)
- Israa Gomaa Abd Elraouf
- Dermatology, Venereology and Andrology Department, Itay Elbaroud General Hospital, Albehira, Egypt
| | - Zakaria Mahran Obaid
- Dermatology, Venereology and Andrology Department, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Ibrahim Fouda
- Dermatology, Venereology and Andrology Department, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
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18
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Futaki M, Inamura K, Hashimoto M, Motegi S, Itakura S, Sugibayashi K, Todo H. Effects of Intradermal Administration Volume Using a Hollow Microneedle on the Pharmacokinetics of Fluorescein Isothiocyanate Dextran (M.W. 4,000). Pharm Res 2023; 40:1953-1963. [PMID: 37165148 DOI: 10.1007/s11095-023-03529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/21/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Hollow microneedles (hMNs) have been gaining attention as a tool to enable the intradermal (i.d.) administration of pharmaceutical products. However, few reports have examined the effect of administration volume on distribution in the skin and pharmacokinetics parameters after i.d. injection. In the present study, a model middle molecular weight compound, fluorescein isothiocyanate dextran (M.W. 4,000, FD-4), was selected, and blood concentration-time profiles after i.d. and subcutaneous (s.c.) injections with different administration volumes were compared. METHODS FD-4 solution was injected i.d. using a hMN or injected s.c. with a 27 G needle. Pharmacokinetics and dermatokinetics of FD-4 were analyzed using a compartment model. The skin distribution of iodine, as an X ray tracer, was used to evaluate drug disposition. RESULTS With the administered drug assumed to be absorbed from the broad injection site into blood vessels in the upper and lower dermis by rapid (krapid) and slow (kslow) first-order absorption rate constants, respectively, better agreement of observed and theoretical values was obtained. Furthermore, the fraction, F, of the administered dose absorbed with krapid decreased with the increase in injection volume after i.d. injection, although the pharmacokinetics parameters were almost the same regardless of administration volume after s.c. injection. CONCLUSION The drug distribution in the skin may be related to the obtained pharmacokinetics parameters suggested that the number of needles in the MN system and the total administration volume should be considered in designing hMN systems. The present results provide useful information that may support effective drug delivery with hMNs.
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Affiliation(s)
- Mika Futaki
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Kazuya Inamura
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Miyu Hashimoto
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Shunsaku Motegi
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Shoko Itakura
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
| | - Kenji Sugibayashi
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan
- Faculty of Pharmaceutical Sciences, Josai International University, 1 Gumyo, Togane, Chiba-Ken, 283-8555, Japan
| | - Hiroaki Todo
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan.
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Oh S, Jang MS, Jung KJ, Han JS, Lee H, Gil A, Jeon B, Roberts CC, Maslow JN, Kim YB, Han KH. Preclinical safety assessment of the suction-assisted intradermal injection of the SARS-CoV-2 DNA vaccine candidate pGO-1002 in white rabbit. Arch Toxicol 2023; 97:1177-1189. [PMID: 36683063 PMCID: PMC9868498 DOI: 10.1007/s00204-023-03446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
pGO-1002, a non-viral DNA vaccine that expresses both spike and ORF3a antigens of SARS-CoV-2, is undergoing phase 1 and phase 2a clinical trials in Korea and the US. A preclinical repeated-dose toxicity study in New Zealand white rabbits in compliance with Good Laboratory Practice (GLP) was conducted to assess the potential toxicity, local tolerance, and immunogenicity of the vaccine and GeneDerm suction device. The dose rate was 1.2 mg/head pGO-1002, and this was administered intradermally to a group of animals (eight animals/sex/group) three times at 2-week intervals, followed by a 4-week recovery period. After each administration, suction was applied to the injection site using the GeneDerm device. Mortality, clinical signs, body weight, food consumption, skin irritation, ophthalmology, body temperature, urinalysis, and clinical pathology were also monitored. Gross observations and histopathological evaluation were performed. Overall, pGO-1002 administration-related changes were confined to minor damage or changes at the injection site, increased spleen weight and minimal increased cellularity in white pulp. All changes of injection site were considered local inflammatory changes or pharmacological actions due to the vaccine with the changes in spleen considered consistent with vaccine-induced immune activation. All findings showed reversibility during the 4-week recovery period. Animals vaccinated with pGO-1002, administered by intradermal injection and followed by application of suction with GeneDerm, developed humoral and cellular responses against the SARS-CoV-2 antigens consistent with prior studies in rats. Collectively, it was concluded that the pGO-1002 vaccine was safe and effective under these experimental conditions and these data supported future human study of the vaccine, now known as GLS-5310, for clinical trial use.
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Affiliation(s)
- Seunghee Oh
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea
| | - Min Seong Jang
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea
| | - Kyung Jin Jung
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea
| | - Ji-Seok Han
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea
| | - Hyojin Lee
- GeneOne Life Science, Inc., Yeongdeungpo Gu, Seoul, 07335, Korea
| | - Areum Gil
- GeneOne Life Science, Inc., Yeongdeungpo Gu, Seoul, 07335, Korea
| | - Bohyun Jeon
- GeneOne Life Science, Inc., Yeongdeungpo Gu, Seoul, 07335, Korea
| | | | - Joel N Maslow
- GeneOne Life Science, Inc., Yeongdeungpo Gu, Seoul, 07335, Korea
| | - Yong-Bum Kim
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea
| | - Kang-Hyun Han
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, 141 Gajeong-Ro, Yuseong-Gu, Daejeon, 34114, Republic of Korea.
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Abstract
The majority of vaccines have been delivered into the muscular tissue. Skin contains large amounts of antigen-presenting cells and has been recognized as a more immunogenic site for vaccine delivery. Intradermal delivery has been approved to improve influenza vaccine efficacy and spare influenza vaccine doses. In response to the recent monkeypox outbreak, intradermal delivery has been also approved to stretch the limited monkeypox vaccine doses to immunize more people at risk. Incorporation of vaccine adjuvants is promising to further increase intradermal vaccine efficacy and spare more vaccine doses. Yet, intradermal vaccination is associated with more significant local reactions than intramuscular vaccination. Thus, adjuvants suitable to boost intradermal vaccination need to have a good local safety without inducing overt local reactions. This review introduces currently approved adjuvants in licensed human vaccines and their relative reactogenicity for intradermal delivery and then introduces emerging chemical and physical adjuvants with a good local safety to boost intradermal vaccination. The rational to develop physical adjuvants, the types of physical adjuvants, and the unique advantages of physical adjuvants to boost intradermal vaccination are also introduced in this review.
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Affiliation(s)
- Xinyuan Chen
- Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Avedisian Hall, Room 480, Kingston, RI 02881, United States.
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Quach HQ, Kennedy RB. Enhancing Immunogenicity of Influenza Vaccine in the Elderly through Intradermal Vaccination: A Literature Analysis. Viruses 2022; 14:v14112438. [PMID: 36366536 PMCID: PMC9698533 DOI: 10.3390/v14112438] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/25/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Aging and immunosenescence lead to a gradual decline in immune responses in the elderly and the immunogenicity of influenza vaccines in this age group is sub-optimal. Several approaches have been explored to enhance the immunogenicity of influenza vaccines in the elderly, including incorporating vaccine adjuvant, increasing antigen dosage, and changing the route of vaccine administration. METHOD We systematically compared the immunogenicity and safety of influenza vaccines administered by intradermal (ID) route and either intramuscular (IM) or subcutaneous (SC) routes in older adults aged ≥ 65. RESULTS Of 17 studies included in this analysis, 3 studies compared the immunogenicity of ID vaccination to that of SC vaccination and 14 studies compared ID and IM vaccinations. ID vaccination was typically more immunogenic than both IM and SC routes at the same dosage. Importantly, a minimum of 3 µg of hemagglutinin antigen could be formulated in an ID influenza vaccine without a significant loss of immunogenicity. ID administration of standard-dose, unadjuvanted influenza vaccine was as immunogenic as IM injection of adjuvanted influenza vaccine. Waning of influenza-specific immunity was significant after 6 months, but there was no difference in waning immunity between vaccinations in ID, IM, or SC routes. While ID vaccination elicited local adverse reactions more frequently than other routes, these reactions were mild and lasted for no more than 3 days. CONCLUSIONS We conclude that ID vaccination is superior to IM or SC routes and may be a suitable approach to compensate for the reduced immunogenicity observed in elderly adults. We also conclude that the main benefit of ID influenza vaccine lies in its dose-sparing effect. Additional research is still needed to further develop a more immunogenic ID influenza vaccine.
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Affiliation(s)
- John T Brooks
- From the Multinational Monkeypox Outbreak Response (J.T.B.) and the Office of the Director (R.H.G., R.P.W.), Centers for Disease Control and Prevention, Atlanta; and the Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD (P.M.)
| | - Peter Marks
- From the Multinational Monkeypox Outbreak Response (J.T.B.) and the Office of the Director (R.H.G., R.P.W.), Centers for Disease Control and Prevention, Atlanta; and the Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD (P.M.)
| | - Robert H Goldstein
- From the Multinational Monkeypox Outbreak Response (J.T.B.) and the Office of the Director (R.H.G., R.P.W.), Centers for Disease Control and Prevention, Atlanta; and the Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD (P.M.)
| | - Rochelle P Walensky
- From the Multinational Monkeypox Outbreak Response (J.T.B.) and the Office of the Director (R.H.G., R.P.W.), Centers for Disease Control and Prevention, Atlanta; and the Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD (P.M.)
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Larkin HD. FDA Authorizes Intradermal Vaccine, Streamlines Rules to Increase Monkeypox Treatment Access. JAMA 2022; 328:819. [PMID: 36066536 DOI: 10.1001/jama.2022.14692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Bifarini B, Gori F, Russo D, Mammucari M, Maggiori E, Di Marzo R, Migliore A, Massafra U, Ronconi G, Ferrara PE, Paolucci T, Vellucci R, Mediati D, Violo B, Natoli S, Brauneis S. Intradermal therapy (mesotherapy): the lower the better. Clin Ter 2022; 173:79-83. [PMID: 35147651 DOI: 10.7417/ct.2022.2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Intradermal therapy (mesotherapy) is a technique used to inject drugs into the surface layer of the skin. The intradermal micro deposit allows to modulate the kinetics of drugs, slowing down its absorption and prolonging the local mechanism of action. This technique is applied in the treatment of some forms of localized pain when a systemic drug-saving effect is useful, when it is necessary to synergize with other pharmacological or non-pharmacological thera-pies, when other therapies have failed or cannot be used. AIM The purpose of our study was to evaluate the effect of a mixture with respect to its lower concentration. We also wanted to evaluate the number of sessions needed to reach the therapeutic goal (50% reduction in pain from baseline) in patients with acute or chronic neck pain. METHOD We analyzed retrospectively data from 62 patients with cervicobrachial pain treated with intradermal drugs. Group A received a mixture of drugs; group B received half the dose of drugs. RESULTS Patients who received a lower concentration of drugs achieved similar results to those who received a higher dose. The therapeutic goal was achieved on average with 3.5 + 1.7 sessions on a weekly basis (min 1; max 9). Subjects in group A required 4+1.7 treatments (min 1; max 9), while subjects in group B required 3+1.5 treatments (min 1; max 7). CONCLUSIONS Our study confirms that even a lower dose of drugs can induce a clinically useful result. This study confirms that the useful effect of mesotherapy is only partly due to the pharmacological action. Further randomized prospective studies are needed to standardize the technique in the various pain syndromes, but it is recommended to follow the guidelines of the Italian Society of Mesotherapy to ensure patients receive appropriate treatment.
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Affiliation(s)
- B Bifarini
- Section of Anesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - F Gori
- Section of Anesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - D Russo
- "San Marco" Hospice and Palliative Care, Latina, Italy
| | | | | | - R Di Marzo
- Member of the Italian So-ciety of Mesotherapy, Rome, Italy
| | - A Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - U Massafra
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - G Ronconi
- University Policlinic Foundation A. Gemelli IRCCS, Rome, Italy
| | - P E Ferrara
- University Policlinic Foundation A. Gemelli IRCCS, Rome, Italy
| | - T Paolucci
- Unit of Physical Medicine and Rehabilitation, G. D'Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Italy
| | - R Vellucci
- Anesthesiology department, University hospital Careggi, Florence, Italy
| | - D Mediati
- Anesthesiology department, University hospital Careggi, Florence, Italy
| | - B Violo
- Pain Therapy Unit, S. Spirito Nuovo Regina Margherita Hospital, Rome, Italy
| | - S Natoli
- Department of Clinical Science and Translational Medicine, Tor Vergata University, Rome, Italy
| | - S Brauneis
- Pain Center "Enzo Borzomati", University Hospital of Rome "Policlinico Umberto I", Rome, Italy
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Waeckerle-Men Y, Kotkowska ZK, Bono G, Duda A, Kolm I, Varypataki EM, Amstutz B, Meuli M, Høgset A, Kündig TM, Halin C, Sander P, Johansen P. Photochemically-Mediated Inflammation and Cross-Presentation of Mycobacterium bovis BCG Proteins Stimulates Strong CD4 and CD8 T-Cell Responses in Mice. Front Immunol 2022; 13:815609. [PMID: 35173729 PMCID: PMC8841863 DOI: 10.3389/fimmu.2022.815609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Conventional vaccines are very efficient in the prevention of bacterial infections caused by extracellular pathogens due to effective stimulation of pathogen-specific antibodies. In contrast, considering that intracellular surveillance by antibodies is not possible, they are typically less effective in preventing or treating infections caused by intracellular pathogens such as Mycobacterium tuberculosis. The objective of the current study was to use so-called photochemical internalization (PCI) to deliver a live bacterial vaccine to the cytosol of antigen-presenting cells (APCs) for the purpose of stimulating major histocompatibility complex (MHC) I-restricted CD8 T-cell responses. For this purpose, Mycobacterium bovis BCG (BCG) was combined with the photosensitiser tetraphenyl chlorine disulfonate (TPCS2a) and injected intradermally into mice. TPCS2a was then activated by illumination of the injection site with light of defined energy. Antigen-specific CD4 and CD8 T-cell responses were monitored in blood, spleen, and lymph nodes at different time points thereafter using flow cytometry, ELISA and ELISPOT. Finally, APCs were infected and PCI-treated in vitro for analysis of their activation of T cells in vitro or in vivo after autologous vaccination of mice. Combination of BCG with PCI induced stronger BCG-specific CD4 and CD8 T-cell responses than treatment with BCG only or with BCG and TPCS2a without light. The overall T-cell responses were multifunctional as characterized by the production of IFN-γ, TNF-α, IL-2 and IL-17. Importantly, PCI induced cross-presentation of BCG proteins for stimulation of antigen-specific CD8 T-cells that were particularly producing IFN-γ and TNF-α. PCI further facilitated antigen presentation by causing up-regulation of MHC and co-stimulatory proteins on the surface of APCs as well as their production of TNF-α and IL-1β in vivo. Furthermore, PCI-based vaccination also caused local inflammation at the site of vaccination, showing strong infiltration of immune cells, which could contribute to the stimulation of antigen-specific immune responses. This study is the first to demonstrate that a live microbial vaccine can be combined with a photochemical compound and light for cross presentation of antigens to CD8 T cells. Moreover, the results revealed that PCI treatment strongly improved the immunogenicity of M. bovis BCG.
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Affiliation(s)
- Ying Waeckerle-Men
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Zuzanna K. Kotkowska
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Géraldine Bono
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Agathe Duda
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Isabel Kolm
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Eleni M. Varypataki
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Beat Amstutz
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Michael Meuli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | | | - Thomas M. Kündig
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Cornelia Halin
- Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - Peter Sander
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- National Center for Mycobacteria, University of Zurich, Zurich, Switzerland
| | - Pål Johansen
- Department of Dermatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- *Correspondence: Pål Johansen,
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26
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Rzhevskiy A, Popov A, Pavlov C, Anissimov Y, Zvyagin A, Levin Y, Kochba E. Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial. PLoS One 2022; 17:e0261641. [PMID: 35100279 PMCID: PMC8803196 DOI: 10.1371/journal.pone.0261641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Peripheral venous cannulation is one of the most common procedures in medicine. It is associated with noticeable pain and apprehension, although in most cases it is performed without any anesthesia due to lack of a painless, cost-effective option, which would provide rapid local anesthesia with subsequent significant reduction in the experienced pain. We conducted an open-label placebo-controlled clinical trial to evaluate the efficacy and safety of a 2% lidocaine injection using the commercially available microneedle device MinronJet600 (NanoPass Technologies Ltd, Israel) to achieve rapid local anesthesia prior to peripheral venous cannulation. Methods One hundred and two subjects were randomly allocated into two groups. In the first group, 100μL of lidocaine hydrochloride (2%) was injected intradermally to subjects using the MicronJet600 device in the left arm (MJ-Lido) and 100μL of saline was injected intradermally using the device in the right arm (MJ-Saline). In the second group, 100μL of lidocaine hydrochloride (2%) was injected using the MicronJet600 device into the left arm (MJ-Lido), with no injection into the right arm of subjects (No pretreatment). In both groups the intradermal injection was performed at the cannulation site prior to insertion of a 18G cannula into a median cubital vein in both arms. As a primary variable, a score of cannulation-induced pain was indicated by subjects using a 100-point visual analog scale immediately after cannulation. As a secondary variable, subjects in Group 2 also indicated their preference to receive the anaesthetic injection with MicronJet600 in the future by using the 5-point Likert scale. Also, as a secondary variable, the duration of skin numbness after lidocaine injection was indicated by performing a superficial pin-prick with a 27G needle at 15, 30 and 45 minutes, at distances of 1, 2 and 3 centimeters from the injection site. Results A significant pain reduction (11.0-fold) was achieved due to the lidocaine injection compared to the cannulation without any pretreatment (p< 0.005). After the lidocaine injection the anesthesia was effective up to 2 centimeters from the injection site and remained for up to 30 minutes. Eighty percent of subjects from the second group preferred cannulation after the lidocaine injection over cannulation without any pretreatment. No significant side effects were identified. Conclusion Intradermal injection of anaesthetic with Micronjet600 was found to be a safe and effective option for providing rapid local anesthesia for peripheral intravenous cannulation. Trial regiatration The clinical trial was registered, before the patient enrollment began, in the Research Registry publicly accessible database (registration identifier: researchregistry4662). Also, the trial was registered in ClinicalTrials.gov (registration identifier: NCT05108714) after its completion.
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Affiliation(s)
- Alexey Rzhevskiy
- Center of Biomedical Engineering, Sechenov First Moscow State Medical University, Moscow, Russia
- * E-mail:
| | - Andrei Popov
- Center of Biomedical Engineering, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Chavdar Pavlov
- Clinic of Internal Diseases Propedeutics, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Yuri Anissimov
- School of Natural Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Andrei Zvyagin
- Center of Biomedical Engineering, Sechenov First Moscow State Medical University, Moscow, Russia
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Hsu CC, Hsu I, Chang HH, Hsu R, Dorjee S. Extended Injection Intervals of Gonadotropins by Intradermal Administration in IVF Treatment. J Clin Endocrinol Metab 2022; 107:e716-e733. [PMID: 34601606 DOI: 10.1210/clinem/dgab709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Indexed: 01/08/2023]
Abstract
CONTEXT Gonadotropins can be administered every 5 days under intradermal injection in in vitro fertilization (IVF) treatment. OBJECTIVE To explore the effectiveness of intradermal injection of recombinant human FSH (rhFSH) for women undergoing IVF. METHODS Women who received their first IVF treatment enrolled in this prospective intervention in 2018. All women received a bolus of 900 IU rhFSH intradermally at day 2 of the treatment cycle followed by additional dosage of rhFSH at day 7 and/or day 10. The main outcome measures included the total dose of rhFSH and number of injections required, sequential serum FSH level detected, and number of mature oocytes retrieved. RESULTS Seventy women completed the study. On average, 2.31 ± 0.73 injections and 1662 ± 397 IU of rhFSH were administered. While the baseline FSH level was 5.6 ± 2.2 IU/L, the serum concentrations of FSH after rhFSH administration were 35.3 ± 7.0 on the first day (24 hours) and 10.7 ± 3.7 IU/L on the fifth day (120 hours). A total of 10.5 ± 6.6 mature oocytes were retrieved, resulting in 7.3 ± 5.1 pronuclear embryos; 1.8 ± 0.6 embryos were transferred to the uterus. Our findings resulted in 72% fertilization, 91% cleavage, 31% implantation, and 36% live birth rates. Although fewer larger follicles were found, noninferiority results were noted in the mature oocytes retrieved, good embryos available, and clinical pregnancy rate compared with those received conventional daily subcutaneous rhFSH administration. CONCLUSION Intradermal administration of rhFSH, with a smaller dose of rhFSH and fewer injections, may achieve the goal of a cost-effective and more patient-friendly regimen.
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Affiliation(s)
- Chao Chin Hsu
- Taiwan United Birth-promoting Experts Fertility Clinic, Tainan, Taiwan
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Isabel Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui Hua Chang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin,Taiwan
| | - Rosie Hsu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Sonam Dorjee
- Taiwan United Birth-promoting Experts Fertility Clinic, Tainan, Taiwan
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Choi BC, Zhou C, Ye H, Sun Y, Zhong Y, Gong F, Sini I, Abramova N, Longobardi S, Hickey M, D'Hooghe T. A comparative, observational study evaluating dosing characteristics and ovarian response using the recombinant human follicle-stimulating hormone pen injector with small-dose dial in assisted reproductive technologies treatment in Asia: IMPROVE study. Reprod Biol Endocrinol 2022; 20:15. [PMID: 35039049 PMCID: PMC8762890 DOI: 10.1186/s12958-021-00882-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian stimulation during medically assisted reproduction treatment should be individualized to optimize outcomes and reduce complications. This study assessed whether use of the recombinant human follicle-stimulating hormone (r-hFSH) pen injector allowing small 12.5 IU dose increments resulted in lower r-hFSH dose per oocyte retrieved in a subgroup of patients at risk of OHSS, compared with r-hFSH injection devices allowing only 37.5 IU increments. METHODS This multicenter, comparative, observational study evaluated patients from a prospective (study group) and historical (control group) cohort. The study group enrolled 1783 patients using the redesigned r-hFSH pen injector (GONAL-f®, Merck Healthcare KGaA, Darmstadt, Germany) from a prospective phase IV, non-interventional, open-label study, conducted in Korea, Vietnam, Indonesia, and China. The control group consisted of 1419 patients from a historical study using r-hFSH devices allowing 37.5 IU increments. In the study group, 397 patients were considered at risk of OHSS; this information was unavailable for the control group, so biomarkers and patient characteristics were used to match 123 patients from the study group and control group. Each center adhered to standard practice; starting dose and intra-cycle dose adjustments were allowed at any point. The primary endpoint, amount of r-hFSH (IU) administered per oocyte retrieved, was assessed in matched patients only. Additional outcomes and safety were assessed in the overall populations. RESULTS Baseline characteristics were comparable between groups. Mean (SD) total dose of r-hFSH administered per oocyte retrieved in patients at risk of OHSS, was significantly lower in the study group compared with the control group (132.5 [85.2] vs. 332.7 [371.6] IU, P < 0.0001, n = 123). Implantation rate, clinical pregnancy rate, and live birth rates in the overall study and control groups were 30.0 vs. 20.6%, 50.3 vs. 40.7%, and 43.8 vs. 34.0%, respectively. OHSS incidence was significantly lower in the study group compared with the control group (27/1783 [1.5%] vs. 57/1419 [4.0%] patients, P < 0.0001). AEs were reported by 5.0% of patients in the study group. CONCLUSIONS A significantly lower r-hFSH dose per oocyte retrieved and lower OHSS incidence were observed in patients using the redesigned injector compared with patients using other injection devices.
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Affiliation(s)
| | - Canquan Zhou
- First Affiliated Hospital, SunYat-sen University, GuangZhou, Guangdong, China
| | - Hong Ye
- Chongqing Maternity and Child Healthcare Hospital, Chongqing, China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zhong
- Chengdu Jinjiang District Maternal and Child Health Hospital, Chengdu Shi, China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Ivan Sini
- Indonesian Reproductive Science Institute (IRSI), Morula IVF, Jakarta, Indonesia
| | | | | | - Miranda Hickey
- Merck Healthcare Pty. Ltd (an affiliate of Merck KGaA), NSW, Macquarie Park, Australia
| | - Thomas D'Hooghe
- Merck Healthcare KGaA, Darmstadt, Germany.
- Research Group Reproductive Medicine, Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Leuven, Belgium.
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA.
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Sawutdeechaikul P, Kanokrungsee S, Sahaspot T, Thadvibun K, Banlunara W, Limcharoen B, Sansureerungsikul T, Rutwaree T, Oungeun M, Wanichwecharungruang S. Detachable dissolvable microneedles: intra-epidermal and intradermal diffusion, effect on skin surface, and application in hyperpigmentation treatment. Sci Rep 2021; 11:24114. [PMID: 34916571 PMCID: PMC8677736 DOI: 10.1038/s41598-021-03503-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/10/2021] [Indexed: 01/04/2023] Open
Abstract
Delivering bioactive compounds into skin tissue has long been a challenge. Using ex vivo porcine and rat skins, here we demonstrate that a detachable dissolvable microneedle (DDMN) array, a special dissolvable microneedle that allows needle detachment from the base within 2 min post administration, can effectively embed a model compound into epidermis and dermis. Diffusion of the compound from the needle embedding sites to the nearby skin tissue is demonstrated at various post administration periods. The relationship between the time that a conventional dissolvable microneedle array is left on skin without needle detachment from the base and the degree of skin surface abrasion at each microneedle penetration spot is also demonstrated on skin of human volunteers. Co-loading glutathione with vitamin C (vitC) can stabilize vitC in the DDMN. DDMN loaded with vitC and glutathione can help erasing post-acne-hyperpigmentation spots.
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Affiliation(s)
| | - Silada Kanokrungsee
- Faculty of Medicine, Skin Center, Srinakharinwirot University, Bangkok, Thailand
| | - Thanyapat Sahaspot
- Faculty of Medicine, Skin Center, Srinakharinwirot University, Bangkok, Thailand
| | - Kamonwan Thadvibun
- Faculty of Medicine, Skin Center, Srinakharinwirot University, Bangkok, Thailand
| | - Wijit Banlunara
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Materials and Bio-Interfaces, Chulalongkorn University, Bangkok, Thailand
| | - Benchaphorn Limcharoen
- Department of Anatomy, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Materials and Bio-Interfaces, Chulalongkorn University, Bangkok, Thailand
| | | | - Teeranut Rutwaree
- Mineed Technology, 142 Innovation Cluster 2, Thailand Science Park, Pathum Thani, Thailand
| | - Miranda Oungeun
- Department of Petrochemistry and Polymer Science, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Supason Wanichwecharungruang
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand.
- Center of Excellence in Materials and Bio-Interfaces, Chulalongkorn University, Bangkok, Thailand.
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Sun S, Zhang L, Liu J, Li H. Insulin Topical Application for Wound Healing in Nondiabetic Patients. Comput Math Methods Med 2021; 2021:9785466. [PMID: 34840600 PMCID: PMC8616663 DOI: 10.1155/2021/9785466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low-cost and safe strategies to improve wound healing will be of great social and economic value. The goal of this pilot clinical trial is aimed at analyzing how effective insulin therapy is at healing wounds in nondiabetic people. METHODS In this protocol research, 346 individuals were included. Patients were divided as 2 groups at random: experimental patients were given a ten-unit answer. For each 10 cm2 of wound, insulin was injected in solution with 1 mL 0.9 percent saline, whereas the control group got a standard dressing with normal saline. RESULTS During the therapy period, no adverse effects were reported. After insulin therapy, no substantial insulin-related side effects were reduced. After 10 days of therapy, the experimental group's granulation tissue coverage rate and thickness were considerably improved as compared to control. Furthermore, a momentous difference in the occurrence of wound bleeding and suppurative wounds between the two groups (P = 0.05). CONCLUSION The results of this pilot research suggest that insulin injections could harmless and effective alternative therapy for wound healing in nondiabetic individuals and that larger, placebo-controlled trials are needed to evaluate effectiveness and safety of insulin treatment in wound healing patients.
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Affiliation(s)
- Shudong Sun
- Department of Burn and Wound Repair, Weifang People's Hospital, Weifang, Shandong, China
| | - Lei Zhang
- Department of Burns and Plastic Surgery, Binzhou People's Hospital Binzhou, Shandong, China
| | - Jun Liu
- Department of Dermatology, Sunshine Union Hospital, Weifang, Shandong, China
| | - Huiling Li
- Department of Burn and Wound Repair Weifang People's Hospital, Weifang, Shandong, China
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Rentzsch M, Wawrzinek R, Zelle-Rieser C, Strandt H, Bellmann L, Fuchsberger FF, Schulze J, Busmann J, Rademacher J, Sigl S, Del Frari B, Stoitzner P, Rademacher C. Specific Protein Antigen Delivery to Human Langerhans Cells in Intact Skin. Front Immunol 2021; 12:732298. [PMID: 34745102 PMCID: PMC8566742 DOI: 10.3389/fimmu.2021.732298] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Immune modulating therapies and vaccines are in high demand, not least to the recent global spread of SARS-CoV2. To achieve efficient activation of the immune system, professional antigen presenting cells have proven to be key coordinators of such responses. Especially targeted approaches, actively directing antigens to specialized dendritic cells, promise to be more effective and accompanied by reduced payload due to less off-target effects. Although antibody and glycan-based targeting of receptors on dendritic cells have been employed, these are often expensive and time-consuming to manufacture or lack sufficient specificity. Thus, we applied a small-molecule ligand that specifically binds Langerin, a hallmark receptor on Langerhans cells, conjugated to a model protein antigen. Via microneedle injection, this construct was intradermally administered into intact human skin explants, selectively loading Langerhans cells in the epidermis. The ligand-mediated cellular uptake outpaces protein degradation resulting in intact antigen delivery. Due to the pivotal role of Langerhans cells in induction of immune responses, this approach of antigen-targeting of tissue-resident immune cells offers a novel way to deliver highly effective vaccines with minimally invasive administration.
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Affiliation(s)
- Mareike Rentzsch
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
- Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Robert Wawrzinek
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
- Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Claudia Zelle-Rieser
- Langerhans Cell Research Lab, Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helen Strandt
- Langerhans Cell Research Lab, Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lydia Bellmann
- Langerhans Cell Research Lab, Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Felix F. Fuchsberger
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
| | - Jessica Schulze
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
| | - Jil Busmann
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
| | - Juliane Rademacher
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
| | - Stephan Sigl
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Del Frari
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Patrizia Stoitzner
- Langerhans Cell Research Lab, Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Rademacher
- Department of Biomolecular Systems, Max-Planck-Institute of Colloids and Interfaces, Potsdam, Germany
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Decates TS, Velthuis P, Zarringam D, Bruin L, Schepers RH, van der Lei B. Upward trend in number of injectable treatments in the Netherlands 2016-2019. J Cosmet Dermatol 2021; 20:3049-3051. [PMID: 34403196 PMCID: PMC8457223 DOI: 10.1111/jocd.14339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/15/2021] [Accepted: 07/06/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Tom S. Decates
- Department of DermatologyErasmus Medical CenterRotterdamthe Netherlands
| | - Peter Velthuis
- Department of DermatologyErasmus Medical CenterRotterdamthe Netherlands
| | - Danial Zarringam
- Department of DermatologyErasmus Medical CenterRotterdamthe Netherlands
| | - Luca Bruin
- Department of DermatologyErasmus Medical CenterRotterdamthe Netherlands
| | - Rutger H. Schepers
- Department of Oral and Maxillofacial SurgeryUniversity of Groningen and University Medical Center Groningen (UMCGGroningenthe Netherlands
| | - Berend van der Lei
- Deparment of Plastic SurgeryUniversity of Groningen and University Medical Center Groningen (UMCGGroningenthe Netherlands
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Jacobse J, ten Voorde W, Tandon A, Romeijn SG, Grievink HW, van der Maaden K, van Esdonk MJ, Moes DJA, Loeff F, Bloem K, de Vries A, Rispens T, Wolbink G, de Kam M, Ziagkos D, Moerland M, Jiskoot W, Bouwstra J, Burggraaf J, Schrier L, Rissmann R, ten Cate R. Comprehensive evaluation of microneedle-based intradermal adalimumab delivery vs. subcutaneous administration: results of a randomized controlled clinical trial. Br J Clin Pharmacol 2021; 87:3162-3176. [PMID: 33403697 PMCID: PMC8359405 DOI: 10.1111/bcp.14729] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/09/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022] Open
Abstract
AIMS To evaluate feasibility of intradermal (i.d.) adalimumab administration using hollow microneedles, and to compare a single i.d. dose of adalimumab using a hollow microneedle with a single subcutaneous (s.c.) dose using a conventional needle. METHODS In this single-centre double-blind, placebo-controlled, double-dummy clinical trial in 24 healthy adults we compared 40 mg adalimumab (0.4 mL) administered i.d. using a hollow microneedle with a s.c. dose using a conventional needle. Primary parameters were pain, acceptability and local tolerability; secondary parameters safety, pharmacokinetics and immunogenicity. We explored usability of optical coherence tomography, clinical photography, thermal imaging, and laser speckle contrast imaging to evaluate skin reaction after i.d. injections. In vitro protein analysis was performed to assess compatibility of adalimumab with the hollow microneedle device. RESULTS While feasible and safe, injection pain of i.d. adalimumab was higher compared to s.c. adalimumab (35.4 vs. 7.9 on a 100-point visual analogue scale). Initial absorption rate and relative bioavailability were higher after i.d. adalimumab (time to maximum plasma concentration = 95 h [47-120]; Frel = 129% [6.46%]) compared to s.c. adalimumab (time to maximum plasma concentration = 120 h [96-221]). Anti-adalimumab antibodies were detected in 50% and 83% of the subjects after i.d. and s.c. adalimumab, respectively. We observed statistically significantly more erythema and skin perfusion after i.d. adalimumab, compared to s.c. adalimumab and placebo injections (P < .0001). Cytokine secretion after whole blood lipopolysaccharide challenge was comparable between administration routes. CONCLUSIONS Intradermal injection of adalimumab using hollowing microneedles was perceived as more painful and less accepted than s.c. administration, but yields a higher relative bioavailability with similar safety and pharmacodynamic effects.
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Affiliation(s)
- Justin Jacobse
- Department of Pediatric Rheumatology Willem‐Alexander Children's HospitalLeiden University Medical CenterLeidenthe Netherlands
- Centre for Human Drug ResearchLeidenthe Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
- Currently also affiliated with department of PathologyMicrobiology and Immunology at Vanderbilt UniversityNashvilleTennesseeUSA
| | - Wouter ten Voorde
- Centre for Human Drug ResearchLeidenthe Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | | | - Stefan G. Romeijn
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | | | - Koen van der Maaden
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | | | - Dirk Jan A.R. Moes
- Department of Clinical Pharmacy & ToxicologyLeiden University Medical CenterLeidenthe Netherlands
| | - Floris Loeff
- Biologics Lab, Sanquin Diagnostic ServicesAmsterdamthe Netherlands
| | - Karien Bloem
- Biologics Lab, Sanquin Diagnostic ServicesAmsterdamthe Netherlands
| | - Annick de Vries
- Biologics Lab, Sanquin Diagnostic ServicesAmsterdamthe Netherlands
| | - Theo Rispens
- Biologics Lab, Sanquin Diagnostic ServicesAmsterdamthe Netherlands
| | - Gertjan Wolbink
- Biologics Lab, Sanquin Diagnostic ServicesAmsterdamthe Netherlands
| | | | | | | | - Wim Jiskoot
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | - Joke Bouwstra
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | - Jacobus Burggraaf
- Centre for Human Drug ResearchLeidenthe Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
| | - Lenneke Schrier
- Department of Pediatric Rheumatology Willem‐Alexander Children's HospitalLeiden University Medical CenterLeidenthe Netherlands
- Currently at Princess Maxima Centre for Pediatric OncologyUtrechtthe Netherlands
| | - Robert Rissmann
- Centre for Human Drug ResearchLeidenthe Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug ResearchLeiden UniversityLeidenthe Netherlands
- Department of Clinical Pharmacy & ToxicologyLeiden University Medical CenterLeidenthe Netherlands
| | - Rebecca ten Cate
- Department of Pediatric Rheumatology Willem‐Alexander Children's HospitalLeiden University Medical CenterLeidenthe Netherlands
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Fabi SG, Alhaddad M, Boen M, Goldman M. Prospective Clinical Trial Evaluating the Long-Term Safety and Efficacy of Calcium Hydroxylapatite for Chest Rejuvenation. J Drugs Dermatol 2021; 20:534-537. [PMID: 33938688 DOI: 10.36849/jdd.5680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Calcium hydroxylapatite (CaHA) is indicated for correcting moderate-to-severe facial wrinkles and folds. Hyperdilute CaHA is increasingly being used for stimulating neocollagenesis to improve skin quality and firmness. OBJECTIVE This study assessed long-term effects of hyperdilute CaHA for improving chest wrinkle appearance. METHODS AND MATERIALS Adult female subjects (N=20) were treated with a 1:2 dilution of CaHA and evaluated at week 6, week 12, day 180, and day 360 using validated Merz Décolletage Scales. A Subject Satisfaction Questionnaire was used to assess overall satisfaction on a scale from 0 (Completely Dissatisfied) to 6 (Completely Satisfied). RESULTS Subjects achieved significant improvements in baseline Merz Décolletage Scale–Dynamic scores at week 6, after a single treatment (P=0.02), at week 12 (two treatments) (P=0.01), day 180 (P=0.01), and day 360 (P<0.01). Subjects also demonstrated significant improvement in baseline Merz Décolletage Scale–At Rest scores at week 6 (P<0.01), remaining significant at week 12 (P<0.01), day 180 (P<0.01), and day 360 (P<0.01). Subject Satisfaction scores increased from 3.25 at day 180 to 3.59 at day 360 using a 7-point scale. CONCLUSION Hyperdilute CaHA significantly improves the dynamic and resting appearance of wrinkles of the décolleté. These durable improvements persist for at least 1 year. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5680.
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Mammucari M, Paolucci T, Russo D, Maggiori E, Di Marzo R, Migliore A, Massafra U, Ronconi G, Ferrara PE, Gori F, Bifarini B, Brauneis S, Vellucci R, Mediati RD, Violo B, Natoli S, Pediliggieri C, Di Campli C, Collina MC. A Call to Action by the Italian Mesotherapy Society on Scientific Research. Drug Des Devel Ther 2021; 15:3041-3047. [PMID: 34285471 PMCID: PMC8285234 DOI: 10.2147/dddt.s321215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/22/2021] [Indexed: 01/22/2023] Open
Abstract
Mesotherapy (local intradermal therapy, LIT) is a technique used to slowly spread drugs in tissues underlying the site of injection to prolong the pharmacological effect with respect to intramuscular injection. Recommendations for proper medical use of this technique have been made for pain medicine and rehabilitation, chronic venous disease, sport medicine, musculoskeletal disorders, several dermatological conditions, skin ageing, and immune-prophylaxis. Although mesotherapy is considered a valid technique, unresolved questions remain, which should be answered to standardize methodology and dosing regimen as well as to define the right indications in clinical practice. New randomized controlled trials are needed to test single products (dose, frequency of administration, efficacy and safety). Even infiltration of substances for dermo-cosmetic purposes must be guided by safety and efficacy tests before being proposed by mesotherapy. In this article, we put forth a preclinical and clinical research plan and a health technology assessment as a call to action by doctors, researchers and scientific societies to aid national health authorities in considering mesotherapy for prevention, treatment and rehabilitation paths.
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Affiliation(s)
| | - Teresa Paolucci
- Unit of Physical Medicine and Rehabilitation, G. D’ Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Chieti, Italy
| | | | | | | | - Alberto Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Umberto Massafra
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Gianpaolo Ronconi
- Physical Medicine and Rehabilitation Unit, IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Paola Emilia Ferrara
- Physical Medicine and Rehabilitation Unit, IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Fabio Gori
- Section of Anaesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - Barbara Bifarini
- Section of Anaesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - Stefano Brauneis
- Pain Centre “Enzo BorzomatI”, University Hospital of Rome “Policlinico Umberto I”, Rome, Italy
| | - Renato Vellucci
- Anaesthesiology Department, University Hospital Careggi, Florence, Italy
| | | | - Bartolomeo Violo
- Pain Therapy Unit, S. Spirito Nuovo Regina Margherita Hospital, Rome, Italy
| | - Silvia Natoli
- Department of Clinical Science and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Carmen Pediliggieri
- Department of Vascular Surgery, Limb Salvage and Diabetic Foot, IDI-IRCCS, Rome, Italy
| | - Cristiana Di Campli
- Department of Vascular Surgery, Limb Salvage and Diabetic Foot, IDI-IRCCS, Rome, Italy
| | - Maria Chiara Collina
- Department of Vascular Surgery, Limb Salvage and Diabetic Foot, IDI-IRCCS, Rome, Italy
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Gentile S, Satta E, Strollo F, Guarino G, Romano C, Della Corte T, Alfarone C. Insulin-induced skin lipohypertrophies: A neglected cause of hypoglycemia in dialysed individuals with diabetes. Diabetes Metab Syndr 2021; 15:102145. [PMID: 34186346 DOI: 10.1016/j.dsx.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is the leading cause of end-stage renal disease and 50% of dialysis patients are insulin-treated. AIM to search for unexplained hypoglycemia (HYPO). METHODS identify a possible cause of HYPO due to altered insulin absorption. RESULTS insulin injected into subcutaneous lipo-hypertrophy (LH) nodules leads to unpredictable HYPOS. CONCLUSION looking for LH systematically and training patients to the best injection technique are new challenges for nephrologists to reduce HYPO and emergency hospitalization rates, thus sparing healthcare resources and improving the quality of life of insulin-treated dialysis patients.
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Affiliation(s)
- Sandro Gentile
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy; Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Ersilia Satta
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy; Multi-specialty Nephrology Center (CNP) SrL, Frattamaggiore, Italy
| | - Felice Strollo
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy; Endocrinology and Diabetes, San Raffaele Termini Institute, Rome, Italy
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Carmine Romano
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy
| | - Teresa Della Corte
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy; Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy.
| | - Carmelo Alfarone
- Nefrocenter Research Network & Nyx Innovative Research Start-Up, Naples, Italy
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Briggs DJ, Moore SM. The Route of Administration of Rabies Vaccines: Comparing the Data. Viruses 2021; 13:v13071252. [PMID: 34199111 PMCID: PMC8310204 DOI: 10.3390/v13071252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
Cell culture rabies vaccines were initially licensed in the 1980s and are essential in the prevention of human rabies. The first post-exposure prophylaxis (PEP) vaccination regimen recommended by the World Health Organization (WHO) was administered intramuscularly over a lengthy three-month period. In efforts to reduce the cost of PEP without impinging on safety, additional research on two strategies was encouraged by the WHO including the development of less expensive production methods for CCVs and the administration of reduced volumes of CCVs via the intradermal (ID) route. Numerous clinical trials have provided sufficient data to support a reduction in the number of doses, a shorter timeline required for PEP, and the approval of the intradermal route of administration for PEP and pre-exposure prophylaxis (PreP). However, the plethora of data that have been published since the development of CCVs can be overwhelming for public health officials wishing to review and make a decision as to the most appropriate PEP and PreP regimen for their region. In this review, we examine three critical benchmarks that can serve as guidance for health officials when reviewing data to implement new PEP and PreP regimens for their region including: evidence of immunogenicity after vaccination; proof of efficacy against development of disease; and confirmation that the regimen being considered elicits a rapid anamnestic response after booster vaccination.
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Cheng WJ, Lin SY, Chen M, Chen LC, Ho HO, Chuang KH, Sheu MT. Active Tumoral/Tumor Environmental Dual-Targeting by Non-Covalently Arming with Trispecific Antibodies or Dual-Bispecific Antibodies on Docetaxel-Loaded mPEGylated Nanocarriers to Enhance Chemotherapeutic Efficacy and Minimize Systemic Toxicity. Int J Nanomedicine 2021; 16:4017-4030. [PMID: 34140769 PMCID: PMC8203191 DOI: 10.2147/ijn.s301237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/07/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study was aimed at developing the trispecific antibodies (anti-EGFR/anti-FAP/anti-mPEG, TsAb) or dual bispecific antibodies (anti-EGFR/anti-mPEG and anti-FAP/anti-mPEG) docetaxel (DTX)-loaded mPEGylated lecithin-stabilized micelles (mPEG-lsbPMs) for improving the targeting efficiency and therapeutic efficacy. METHODS mPEG-lsbPMs were simply prepared via thin film method. The trispecific antibodies or bispecific antibodies bound the mPEG-lsbPMs by anti-mPEG Fab fragment. The formulations were characterized by DLS and TEM; in vitro and in vivo studies were also conducted to evaluate the cellular uptake, cell cytotoxicity and therapeutic efficacy. RESULTS The particle sizes of mPEG-lsbPMs with or without the antibodies were around 100 nm; the formulations showed high encapsulation efficiencies of 97.12%. The TsAb and dual bispecific antibodies were fabricated and demonstrated their targeting ability. Two EGFR-overexpressed cell lines (HT-29 and MIA PaCa-2) were co-cultured with FAP-overexpressed WS1 cells (HT-29/WS1; MIA PaCa-2/WS1) to mimic a tumor coexisting in the tumor microenvironment. Cellular binding study revealed that the binding of anti-FAP micelles to three co-culture ratios (4:1, 1:1, and 1:4) of HT-29/EGFR to WS1/FAP was significantly higher than that for TsAb micelles and dual (1:1) micelles, and the binding of those targeting antibodies to WS1/FAP and MIA PaCa-2/EGFR was equally efficacious resulting in a similar binding amount of the TsAb and dual BsAbs (1:1) with the co-culture of MIA PaCa-2/EGFR and WS1/FAP at a 1:1 ratio. Antitumor efficacy study showed that treatment with DTX-loaded mPEG-lsbPMs modified with or without BsAbs, dual BsAbs (1:1), and TsAbs was enhanced in inhibiting tumor growth compared with that for Tynen® while showing fewer signs of adverse effects. CONCLUSION Active targeting of both tumors and TAF-specific antigens was able to increase the affinity of DTX-loaded mPEG-lsbPMs toward tumor cells and TAFs leading to successive uptake by tumor cells or TAFs which enhanced their chemotherapeutic efficacy against antigen-positive cancer cells.
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MESH Headings
- Animals
- Antibodies, Bispecific/administration & dosage
- Antibodies, Bispecific/chemistry
- Antibodies, Bispecific/pharmacology
- Antineoplastic Agents, Immunological/administration & dosage
- Antineoplastic Agents, Immunological/pharmacokinetics
- Antineoplastic Agents, Immunological/pharmacology
- Cancer-Associated Fibroblasts/drug effects
- Cell Line, Tumor
- Coculture Techniques
- Docetaxel/administration & dosage
- Docetaxel/pharmacokinetics
- Drug Carriers/administration & dosage
- Drug Carriers/chemistry
- Drug Delivery Systems/methods
- ErbB Receptors/antagonists & inhibitors
- ErbB Receptors/immunology
- Humans
- Injections, Intradermal
- Lecithins/chemistry
- Male
- Mice, Nude
- Micelles
- Particle Size
- Polyethylene Glycols/chemistry
- Rats, Sprague-Dawley
- Tumor Microenvironment/drug effects
- Xenograft Model Antitumor Assays
- Mice
- Rats
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Affiliation(s)
- Wei-Jie Cheng
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Shyr-Yi Lin
- Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Michael Chen
- PhD Program in Clinical Drug Development of Chinese Herbal Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chun Chen
- Department of Biotechnology and Pharmaceutical Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Hsiu-O Ho
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Hsiang Chuang
- PhD Program in Clinical Drug Development of Chinese Herbal Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Pharmacognosy, Taipei Medical University, Taipei, Taiwan
| | - Ming-Thau Sheu
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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40
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Szőke D, Kovács G, Kemecsei É, Bálint L, Szoták-Ajtay K, Aradi P, Styevkóné Dinnyés A, Mui BL, Tam YK, Madden TD, Karikó K, Kataru RP, Hope MJ, Weissman D, Mehrara BJ, Pardi N, Jakus Z. Nucleoside-modified VEGFC mRNA induces organ-specific lymphatic growth and reverses experimental lymphedema. Nat Commun 2021; 12:3460. [PMID: 34103491 PMCID: PMC8187400 DOI: 10.1038/s41467-021-23546-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/30/2021] [Indexed: 12/01/2022] Open
Abstract
Lack or dysfunction of the lymphatics leads to secondary lymphedema formation that seriously reduces the function of the affected organs and results in degradation of quality of life. Currently, there is no definitive treatment option for lymphedema. Here, we utilized nucleoside-modified mRNA encapsulated in lipid nanoparticles (LNPs) encoding murine Vascular Endothelial Growth Factor C (VEGFC) to stimulate lymphatic growth and function and reduce experimental lymphedema in mouse models. We demonstrated that administration of a single low-dose of VEGFC mRNA-LNPs induced durable, organ-specific lymphatic growth and formation of a functional lymphatic network. Importantly, VEGFC mRNA-LNP treatment reversed experimental lymphedema by restoring lymphatic function without inducing any obvious adverse events. Collectively, we present a novel application of the nucleoside-modified mRNA-LNP platform, describe a model for identifying the organ-specific physiological and pathophysiological roles of the lymphatics, and propose an efficient and safe treatment option that may serve as a novel therapeutic tool to reduce lymphedema.
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Affiliation(s)
- Dániel Szőke
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Gábor Kovács
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Éva Kemecsei
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - László Bálint
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Kitti Szoták-Ajtay
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Petra Aradi
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | - Andrea Styevkóné Dinnyés
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary
| | | | - Ying K Tam
- Acuitas Therapeutics, Vancouver, BC, Canada
| | | | | | - Raghu P Kataru
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Drew Weissman
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Babak J Mehrara
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Norbert Pardi
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Zoltán Jakus
- Department of Physiology, Semmelweis University School of Medicine, Budapest, Hungary.
- MTA-SE "Lendület" Lymphatic Physiology Research Group of the Hungarian Academy of Sciences and the Semmelweis University, Budapest, Hungary.
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41
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Mitzmacher MG, Mithieux SM, Weiss AS, Hee CK, Daniels R. Novel Recombinant Tropoelastin Implants Restore Skin Extracellular Matrix. J Drugs Dermatol 2021; 19:1166-1172. [PMID: 33346526 DOI: 10.36849/jdd.2020.5375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Elastin is an essential component of the dermis, providing skin with elasticity and integrity. Elastin and other dermal components are gradually lost through aging, sun damage, and following injury, highlighting a need to replace these components to repair the skin. Tropoelastin (TE) in monomeric form was previously shown to be utilized as a substrate by dermal fibroblasts during the production of elastin fibers in vitro. OBJECTIVE To analyze coaccumulation of elastin and collagen and gene expression of biomarkers associated with elastin production, examine the ex vivo effects of recombinant human TE (rhTE) and hyaluronic acid (HA) on epidermal and dermal structures, and evaluate the in vivo response following intradermal injections of rhTE and HA. METHODS Human dermal fibroblasts and 3-D skin patch models were cultured for in vitro analysis. Ex vivo analysis was performed using skin explants. In vivo studies were done in 6-week-old male CD Hairless rats. Different formulations of rhTE, soluble or crosslinked using derivatized HA (dHA), were tested and analyzed. RESULTS rhTE in monomeric form was utilized as a substrate by dermal fibroblasts during the production of branched elastin and fibrous collagen networks in vitro. Formulations of rhTE crosslinked with dHA demonstrated increased expression of hyaluronic acid synthase 1 and ex vivo results revealed increased moisture content and glycosaminoglycan (GAG) deposition versus dermal filler control. Intradermal rhTE‒dHA injection produced colocalized human‒rat elastin fibers in vivo. CONCLUSIONS These results suggest that the novel rhTE‒dHA matrix is an attractive material to support skin tissue repair.J Drugs Dermatol. 2020;19(12): doi:10.36849/JDD.2020.5375.
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Patel A, Reuschel EL, Xu Z, Zaidi FI, Kim KY, Scott DP, Mendoza J, Ramos S, Stoltz R, Feldmann F, Okumura A, Meade-White K, Haddock E, Thomas T, Rosenke R, Lovaglio J, Hanley PW, Saturday G, Muthumani K, Feldmann H, Humeau LM, Broderick KE, Weiner DB. Intradermal delivery of a synthetic DNA vaccine protects macaques from Middle East respiratory syndrome coronavirus. JCI Insight 2021; 6:146082. [PMID: 33886507 PMCID: PMC8262283 DOI: 10.1172/jci.insight.146082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/02/2021] [Indexed: 12/30/2022] Open
Abstract
Emerging coronaviruses from zoonotic reservoirs, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been associated with human-to-human transmission and significant morbidity and mortality. Here, we study both intradermal and intramuscular 2-dose delivery regimens of an advanced synthetic DNA vaccine candidate encoding a full-length MERS-CoV spike (S) protein, which induced potent binding and neutralizing antibodies as well as cellular immune responses in rhesus macaques. In a MERS-CoV challenge, all immunized rhesus macaques exhibited reduced clinical symptoms, lowered viral lung load, and decreased severity of pathological signs of disease compared with controls. Intradermal vaccination was dose sparing and more effective in this model at protecting animals from disease. The data support the further study of this vaccine for preventing MERS-CoV infection and transmission, including investigation of such vaccines and simplified delivery routes against emerging coronaviruses.
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Affiliation(s)
- Ami Patel
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Emma L. Reuschel
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Ziyang Xu
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Faraz I. Zaidi
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Kevin Y. Kim
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Dana P. Scott
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Janess Mendoza
- Inovio Pharmaceuticals Inc., Plymouth Meeting, Pennsylvania, USA
| | - Stephanie Ramos
- Inovio Pharmaceuticals Inc., Plymouth Meeting, Pennsylvania, USA
| | - Regina Stoltz
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Friederike Feldmann
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Atsushi Okumura
- Laboratory of Virology, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Kimberly Meade-White
- Laboratory of Virology, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Elaine Haddock
- Laboratory of Virology, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Tina Thomas
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Rebecca Rosenke
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Jamie Lovaglio
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Patrick W. Hanley
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | - Kar Muthumani
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA
| | | | | | - David B. Weiner
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
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43
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Trindade de Almeida AR, Noriega LF, Bechelli L, Suárez MV. Randomized Controlled Trial Comparing the Efficacy and Safety of Two Injection Techniques of IncobotulinumtoxinA for Axillary Hyperhidrosis. J Drugs Dermatol 2021; 19:765-770. [PMID: 32726556 DOI: 10.36849/jdd.2020.4989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Botulinum toxin A (BoNT-A) is an effective treatment for axillary hyperhidrosis (AH) typically applied by multiple injection punctures. Objective: To compare the efficacy and safety of two BoNT-A injection techniques for AH. Methods: Randomized, evaluator-blinded trial, in which each axilla of the same patient received 50 U of incobotulinumtoxin A (IncoA; Xeomin), one injected intradermally using multiple punctures, the other subcutaneously by radial approach. Follow-up visits occurred after 30, 120, 180, and 270 days. Outcomes included procedure duration and pain, gravimetry and starch-iodine tests and safety. Results: Twenty-four patients with severe hyperhidrosis were included; 67% were female and mean age was 34.7 years. Radial injection was faster applied than multiple punctures (P<0.001) but showed higher pain scores (P=0.001). Pre- and post-treatment gravimetric measures showed that IncoA led to a significant sweat reduction, by both techniques, with 95% of responders (≥50% reduction from baseline) after 30 days of treatment. Similarly, Minor's test showed an excellent response (90-100% reduction) by most patients regardless of the technique used, after 30 days and sustained for at least 270 days. At most time points, there were no significant differences between the two techniques; however, multiple punctures showed a higher reduction of gravimetric measures at days 30 and 180, and of Minor's test at day 270. Treatment was well tolerated. Conclusions: IncoA is an effective and safe treatment for AH irrespective to the technique used for injection. Our study suggests that multiple punctures injection may confer better outcomes at some time points. J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.4989.
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Altrichter S, Wang Y, Schumacher P, Alraboni O, Church MK, Maurer M. Acetylcholine-induced whealing in cholinergic urticaria - What does it tell us? J Dermatol Sci 2021; 103:10-15. [PMID: 34049770 DOI: 10.1016/j.jdermsci.2021.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/18/2021] [Accepted: 05/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cholinergic urticaria (CholU) is characterized by the occurrence of itchy wheals induced by sweating. Intradermal injections of acetylcholine (ACh) have been proposed to help with diagnosing CholU and subgrouping of patients, but controlled studies are largely missing. OBJECTIVE To compare the rates of positive ACh test results in well characterized CholU patients and controls and to identify clinical features of CholU linked to ACh reactivity. METHODS Acetylcholine was injected intradermally into 38 CholU patients and 73 matched healthy controls. Wheal and flare skin responses were assessed after 15 and 30 min and correlated with clinical features of CholU. RESULTS At 15 min after intradermal injections of ACh, wheal and flare responses were significantly more frequent in CholU patients than healthy controls, wheals: 34 % vs.15% (P = 0.028); flares: 50 % vs.18 % (P <0.001). Also, wheals were 37 % and flares 172 % larger and of longer duration in CholU patients than in healthy controls (both P < 0.01). CholU patients with ACh-induced wheals (ACh+) had larger flare but not wheal responses in response to histamine than those without (ACh-; P = 0.011). Also, ACh-induced wheal responses were significantly correlated with sweating (r = 0.54, P = 0.046) in CholU patients. Finally, wheal responses lasted longer in ACh+ than in ACh- patients (P = 0.03). CONCLUSION Intradermal ACh testing does not allow for the identification of CholU patients due to its low sensitivity. ACh-induced wheals, in patients with CholU, is linked to sweating and longer lasting symptoms. Intradermal ACh testing is an interesting tool for mechanistic studies in CholU.
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Affiliation(s)
- Sabine Altrichter
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany; Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria
| | - Yiyu Wang
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany; Department of Dermatology, The General Hospital of Air Force, Haidian District, Beijing, China
| | - Pia Schumacher
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Ola Alraboni
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Martin K Church
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Dpt. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
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Hashimoto K, Yamada Y, Sekiguchi K, Matsuda S, Mori S, Matsumoto T. Induction of alopecia areata in C3H/HeJ mice using cryopreserved lymphocytes. J Dermatol Sci 2021; 102:177-183. [PMID: 33994063 DOI: 10.1016/j.jdermsci.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disease resulting in non-scarring hair loss. Animal models are useful means to identify candidates for therapeutic agents. The C3H/HeJ mouse AA model induced via transferring cultured lymphoid cells isolated from AA-affected mice is widely used for AA research. However, this conventional method requires the continuous breeding of AA mice. OBJECTIVE We aimed to establish a new method to generate AA model using the transfer of cryopreserved cells, which allows the rapid induction of a large number of AA mice when needed. METHODS We cryopreserved lymph node cells soon after isolation from AA-affected mice and injected thawed-cultured cells into recipient mice. H&E staining, immunohistochemical staining, quantitative real-time PCR and ELISA were conducted to identify pathological characteristics. Flow cytometry was performed to reveal the profile of transferred cells. RESULTS More than 90 % of recipient mice developed AA-like hair loss and showed inflammatory cell infiltration around anagen hair follicles, markedly increased mRNA expressions of interferon-γ, CXCL11, and granzyme B, and elevated interferon-α protein levels in the skin compared with naïve mice. Higher percentages of effector memory T cells and dendritic cells in transferred cells resulted in a higher incidence of AA. CONCLUSION This is the first report to establish a method for generating AA mice using cryopreserved lymphocytes. These AA mice have similar pathological characteristics to AA mice generated with the conventional method and AA patients. This convenient and reproducible method is expected to be valuable for AA study.
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Affiliation(s)
| | | | | | | | - Sachi Mori
- Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
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Yadav N, Vishwakarma P, Khatri R, Siddqui G, Awasthi A, Ahmed S, Samal S. Comparative immunogenicity analysis of intradermal versus intramuscular administration of SARS-CoV-2 RBD epitope peptide-based immunogen In vivo. Microbes Infect 2021; 23:104843. [PMID: 34098108 PMCID: PMC8238661 DOI: 10.1016/j.micinf.2021.104843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022]
Abstract
COVID-19 pandemic has caused severe disruption of global health and devastated the socio-economic conditions all over the world. The disease is caused by SARS-CoV-2 virus that belongs to the family of Coronaviruses which are known to cause a wide spectrum of diseases both in humans and animals. One of the characteristic features of the SARS-CoV-2 virus is the high reproductive rate (R0) that results in high transmissibility of the virus among humans. Vaccines are the best option to prevent and control this disease. Though, the traditional intramuscular (IM) route of vaccine administration is one of the effective methods for induction of antibody response, a needle-free self-administrative intradermal (ID) immunization will be easier for SARS-CoV-2 infection containment, as vaccine administration method will limit human contacts. Here, we have assessed the humoral and cellular responses of a RBD-based peptide immunogen when administered intradermally in BALB/c mice and side-by-side compared with the intramuscular immunization route. The results demonstrate that ID vaccination is well tolerated and triggered a significant magnitude of humoral antibody responses as similar to IM vaccination. Additionally, the ID immunization resulted in higher production of IFN-γ and IL-2 suggesting superior cellular response as compared to IM route. Overall, our data indicates immunization through ID route provides a promising alternative approach for the development of self-administrative SARS-CoV-2 vaccine candidates.
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Affiliation(s)
- Naveen Yadav
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Preeti Vishwakarma
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Ritika Khatri
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Gazala Siddqui
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Amit Awasthi
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Shubbir Ahmed
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Sweety Samal
- Infection and Immunology Laboratory, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India.
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Rosenbaum P, Tchitchek N, Joly C, Rodriguez Pozo A, Stimmer L, Langlois S, Hocini H, Gosse L, Pejoski D, Cosma A, Beignon AS, Dereuddre-Bosquet N, Levy Y, Le Grand R, Martinon F. Vaccine Inoculation Route Modulates Early Immunity and Consequently Antigen-Specific Immune Response. Front Immunol 2021; 12:645210. [PMID: 33959127 PMCID: PMC8093451 DOI: 10.3389/fimmu.2021.645210] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 01/12/2023] Open
Abstract
Vaccination is one of the most efficient public healthcare measures to fight infectious diseases. Nevertheless, the immune mechanisms induced in vivo by vaccination are still unclear. The route of administration, an important vaccination parameter, can substantially modify the quality of the response. How the route of administration affects the generation and profile of immune responses is of major interest. Here, we aimed to extensively characterize the profiles of the innate and adaptive response to vaccination induced after intradermal, subcutaneous, or intramuscular administration with a modified vaccinia virus Ankara model vaccine in non-human primates. The adaptive response following subcutaneous immunization was clearly different from that following intradermal or intramuscular immunization. The subcutaneous route induced a higher level of neutralizing antibodies than the intradermal and intramuscular vaccination routes. In contrast, polyfunctional CD8+ T-cell responses were preferentially induced after intradermal or intramuscular injection. We observed the same dichotomy when analyzing the early molecular and cellular immune events, highlighting the recruitment of cell populations, such as CD8+ T lymphocytes and myeloid-derived suppressive cells, and the activation of key immunomodulatory gene pathways. These results demonstrate that the quality of the vaccine response induced by an attenuated vaccine is shaped by early and subtle modifications of the innate immune response. In this immunization context, the route of administration must be tailored to the desired type of protective immune response. This will be achieved through systems vaccinology and mathematical modeling, which will be critical for predicting the efficacy of the vaccination route for personalized medicine.
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Affiliation(s)
- Pierre Rosenbaum
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Nicolas Tchitchek
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Candie Joly
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - André Rodriguez Pozo
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Lev Stimmer
- INSERM, U1169, Kremlin-Bicêtre, France
- CEA – INSERM, MIRCen, UMS27, Fontenay-aux-Roses, France
| | - Sébastien Langlois
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Hakim Hocini
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
- INSERM, U955, Team 16, Clinical and Infectious Diseases Department, Hospital Henri Mondor, University of Paris East, Créteil, France
| | - Leslie Gosse
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - David Pejoski
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Antonio Cosma
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Anne-Sophie Beignon
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Nathalie Dereuddre-Bosquet
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Yves Levy
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
- INSERM, U955, Team 16, Clinical and Infectious Diseases Department, Hospital Henri Mondor, University of Paris East, Créteil, France
| | - Roger Le Grand
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
| | - Frédéric Martinon
- UMR1184 IMVA-HB, IDMIT Department, Université Paris-Saclay – INSERM U1184 – CEA, Fontenay-aux-Roses, France
- Vaccine Research Institute, Henri Mondor Hospital, Créteil, France
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48
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Saleem AF, Mach O, Yousafzai MT, Kazi Z, Baig A, Sajid M, Jeyaseelan V, Sutter RW, Zaidi AKM. One-Year Decline of Poliovirus Antibodies Following Fractional-Dose Inactivated Poliovirus Vaccine. J Infect Dis 2021; 223:1214-1221. [PMID: 32798224 PMCID: PMC8030725 DOI: 10.1093/infdis/jiaa504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fractional dose (one-fifth of full intramuscular dose) of inactivated poliovirus vaccine (fIPV) administered intradermally is used as IPV dose-sparing strategy. We compared the rate of decline of poliovirus antibodies (PVA) in recipients of 2 doses of fIPV or IPV. METHODS A community-based randomized controlled trial was conducted in Karachi, Pakistan. Children aged 14 weeks were randomized into fIPV or full IPV (study arms A, B) and received 1 vaccine dose at age 14 weeks and 1 at age 9 months. PVAs were measured at age 14, 18 weeks and 10, 21 months. RESULTS Seroprevalence of poliovirus type 2 antibodies in 170/250 (68%) children after 2 IPV or fIPV doses at age 10 months in A and B reached 100% vs 99% (P = .339), and at 21 months, 86% vs 67% (P = .004). Between age 10 and 21 months antibody log2 titers dropped from ≥ 10.5 to 6.8 in A and from 9.2 to 3.7 in B. CONCLUSIONS There was a significant decline in antibody titers 12 months following the second IPV dose. The slope of decline was similar for full IPV and fIPV recipients. The results provide further evidence that fIPV is a viable option for IPV dose-sparing. CLINICAL TRIALS REGISTRATION NCT03286803.
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Affiliation(s)
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Vishali Jeyaseelan
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Roland W Sutter
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Anita K M Zaidi
- Aga Khan University, Karachi, Pakistan
- Bill and Melinda Gates Foundation, Seattle, USA
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49
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Zhao Y, Urbonaviciute V, Xu B, Cai W, Sener Z, Ge C, Holmdahl R. Cartilage Oligomeric Matrix Protein Induced Arthritis-A New Model for Rheumatoid Arthritis in the C57BL/6 Mouse. Front Immunol 2021; 12:631249. [PMID: 33708221 PMCID: PMC7940517 DOI: 10.3389/fimmu.2021.631249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/07/2021] [Indexed: 12/29/2022] Open
Abstract
The most commonly used strains in experimental research, including genetically modified strains, are C57BL/6 mice. However, so far, no reliable model for rheumatoid arthritis is available, mainly due to the restriction by the MHC class II haplotype H-2b. Collagen-induced arthritis (CIA) is the most widely used animal model of rheumatoid arthritis, but C57BL/6 strain is resistant to CIA because there is no collagen II peptide associated with H-2b. To establish a rheumatoid arthritis model in C57BL/6 mice, we immunized C57BL/6NJ (B6N) mice with human cartilage oligomeric matrix protein (COMP), which induced severe arthritis with high incidence, accompanied by a strong auto-antibody response. Native COMP was required, as denatured COMP lost its ability to induce arthritis in B6N mice. An immunodominant COMP peptide was identified as the key T cell epitope, with a perfect fit into the Ab class II peptide binding pocket. A critical amino acid in this peptide was found to be phenylalanine at position 95. Recombinant COMP mutated at position 95 (COMP_F95S) lost its ability to induce arthritis or a strong immune response in the B6N mice. In conclusion, A new model for RA has been established using C57BL/6 mice through immunization with COMP, which is dependent on a COMP specific peptide binding Ab, thus in similarity with CIA in Aq expressing strains.
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Affiliation(s)
- Yunjuan Zhao
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Vilma Urbonaviciute
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Bingze Xu
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Weiwei Cai
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Zeynep Sener
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Changrong Ge
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Rikard Holmdahl
- Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
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50
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Egunsola O, Clement F, Taplin J, Mastikhina L, Li JW, Lorenzetti DL, Dowsett LE, Noseworthy T. Immunogenicity and Safety of Reduced-Dose Intradermal vs Intramuscular Influenza Vaccines: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2035693. [PMID: 33560425 PMCID: PMC7873776 DOI: 10.1001/jamanetworkopen.2020.35693] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Low-dose intradermal influenza vaccines could be a suitable alternative to full intramuscular dose during vaccine shortages. OBJECTIVE To compare the immunogenicity and safety of the influenza vaccine at reduced or full intradermal doses with full intramuscular doses to inform policy design in the event of vaccine shortages. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies published from 2010 until June 5, 2020. STUDY SELECTION All comparative studies across all ages assessing the immunogenicity or safety of intradermal and intramuscular influenza vaccinations were included. DATA EXTRACTION AND SYNTHESIS Data were extracted by a single reviewer and verified by a second reviewer. Discrepancies between reviewers were resolved through consensus. Random-effects meta-analysis was conducted. MAIN OUTCOMES AND MEASURES Primary outcomes included geometric mean titer, seroconversion, seroprotection, and adverse events. RESULTS A total of 30 relevant studies were included; 29 studies were randomized clinical trials with 13 759 total participants, and 1 study was a cohort study of 164 021 participants. There was no statistically significant difference in seroconversion rates between the 3-µg, 6-µg, 7.5-µg, and 9-µg intradermal vaccine doses and the 15-µg intramuscular vaccine dose for each of the H1N1, H3N2, and B strains, but rates were significantly higher with the 15-µg intradermal dose compared with the 15-µg intramuscular dose for the H1N1 strain (rate ratio [RR], 1.10; 95% CI, 1.01-1.20) and B strain (RR, 1.40; 95% CI, 1.13-1.73). Seroprotection rates for the 9-µg and 15-µg intradermal doses did not vary significantly compared with the 15-µg intramuscular dose for all the 3 strains, except for the 15-µg intradermal dose for the H1N1 strain, for which rates were significantly higher (RR, 1.05; 95% CI, 1.01-1.09). Local adverse events were significantly higher with intradermal doses than with the 15-µg intramuscular dose, particularly erythema (3-µg dose: RR, 9.62; 95% CI, 1.07-86.56; 6-µg dose: RR, 23.79; 95% CI, 14.42-39.23; 9-µg dose: RR, 4.56; 95% CI, 3.05-6.82; 15-µg dose: RR, 3.68; 95% CI, 3.19-4.25) and swelling (3-µg dose: RR, 20.16; 95% CI, 4.68-86.82; 9-µg dose: RR, 5.23; 95% CI, 3.58-7.62; 15-µg dose: RR, 3.47 ; 95% CI, 2.21-5.45). Fever and chills were significantly more common with the 9-µg intradermal dose than the 15-µg intramuscular dose (fever: RR, 1.36; 95% CI, 1.03-1.80; chills: RR, 1.24; 95% CI, 1.03-1.50) while all other systemic adverse events were not statistically significant for all other doses. CONCLUSIONS AND RELEVANCE These findings suggest that reduced-dose intradermal influenza vaccination could be a reasonable alternative to standard dose intramuscular vaccination.
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Affiliation(s)
- Oluwaseun Egunsola
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - Fiona Clement
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - John Taplin
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - Liza Mastikhina
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - Joyce W. Li
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - Diane L. Lorenzetti
- Department Community Health Sciences, University of Calgary Alberta, Canada
- Health Sciences Library, University of Calgary, Alberta, Canada
| | - Laura E. Dowsett
- Department Community Health Sciences, University of Calgary Alberta, Canada
| | - Tom Noseworthy
- Department Community Health Sciences, University of Calgary Alberta, Canada
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