Spironolactone loaded nanostructured lipid carrier gel for effective treatment of mild and moderate acne vulgaris: A randomized, double-blind, prospective trial

Efficacy and safety of topical spironolactone versus topical dapsone in the treatment of acne vulgaris

Acne vulgaris is a common skin disease that greatly impacts the quality of life of affected individuals. Several treatment modalities are available for acne, with variable degrees of success. Our aim was to compare the safety and efficacy of topical spironolactone 5% gel and topical dapsone 5% gel as treatment modalities for acne vulgaris. The study included 28 patients with mild to moderate acne. They were randomly divided into two equal groups. Group I treated with topical spironolactone 5% gel, and group II treated with topical dapsone 5% gel. In both groups, the gel was applied twice daily for 12 weeks, and patients were evaluated using the acne severity index. Group I included 14 patients [11 (78.6%) females and 3 (21.4%) males]. More than one-half of this group (64.3%) had moderate acne severity. Group II included 14 patients [12 (85.7%) females and 2 (14.3%) males]. Half of patients had moderate acne severity. Therapeutic response was poor, moderate, good, and excellent (14.3%), (28.6%), (50%), (7.1%), respectively, in topical spironolactone group versus poor, moderate, and good (50%), (42.9%), (7.1%), respectively, in topical dapsone group. The therapeutic response between the studied groups was statistically significant in favor of the topical spironolactone group. Regarding adverse effects, burning sensation was evident after application of topical spironolactone while itching was significantly common with topical dapsone. The data provided by the current study support the use of topical spironolactone 5% gel in treating acne vulgaris in both male and female patients.

Green Formulation of Spironolactone Loaded Chitosan-Coated Nano Lipid Carrier for Treatment of Acne Vulgaris: A Randomized Double-Blind Clinical Trial

Purpose

Spironolactone (SPN), which is classified as an anti-androgen, has demonstrated efficacy in treating acne. This study aimed to utilize ultrasonication to create a chitosan-coated nano lipid carrier (NLC) for enhancing the delivery of SPN to the skin and treating acne.

Methods

Various hydrophilic-lipophilic balance (HLB) values were investigated to optimize the SPN-NLCs. Photon correlation spectroscopy, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), transmission electron microscopy (TEM), and differential scanning calorimetry (DSC) were employed to characterize the solid state of SPN in nanoparticle form. Additionally, the optimized formulation was used in a double-blind, randomized clinical trial.

Results

Reducing the HLB of the surfactant mixtures resulted in a reduction in the size of SPNNLCs. The formula with the smallest particle diameter (238.4±0.74 nm) and the lowest HLB value (9.65) exhibited the highest encapsulation efficiency (EE) of 79.88±1.807%. Coating the optimized SPN-NLC with chitosan increased the diameter, polydispersity index (PDI), zeta potential (ZP), and EE. In vitro skin absorption studies demonstrated sustained release profiles for chitosan-coated SPN-NLC. In the double-blind trial, a gel containing chitosan-coated SPN-NLC effectively treated mild to moderate acne vulgaris, leading to improved healing and reduced lesion count after 8 weeks of therapy compared to the placebo. It successfully addressed both non-inflammatory and inflammatory lesions without adverse effects on the skin.

Conclusion

The findings indicate that chitosan-coated SPN-NLCs have the potential as nanoparticles for targeted SPN delivery to the skin, offering novel options for the treatment of acne vulgaris.

Masculinization of Red Tilapia (Oreochromis spp.) Using 17α-Methyltestosterone-Loaded Alkyl Polyglucosides Integrated into Nanostructured Lipid Carriers

The aim of the present study was to optimize a masculinization platform for the production of all-male red tilapia fry by oral administration of 30 and 60 ppm of MT and alkyl polyglucoside nanostructured lipid carriers (APG-NLC) loaded with MT, respectively, for 14 and 21 days. The characterization, encapsulation efficiency and release kinetics of MT in lipid-based nanoparticles were assessed in vitro. The results showed that the MT-loaded nanoparticles were spherical, ranging from 80 to 125 nm in size, and had a negative charge with a narrow particle distribution. The APG-NLC loaded with MT provided higher physical stability and encapsulation efficacy than the NLC. The release rate constants of MT from MT-NLC and MT-APG-NLC were higher than those of free MT, which is insoluble in aqueous media. There was no significant difference in survival between the fish administered MT or the those fed orally with MT-APG-NLC fish. According to the logistic regression analysis, the sex reversal efficacy of MT-APG-NLC (30 ppm) and MT (60 ppm), resulted in significantly higher numbers of males after 21 days of treatment compared with the controls. The production cost of MT-APG-NLC (30 ppm) after 21 days of treatment was reduced by 32.9% compared with the conventional MT treatment group (60 ppm). In all the treatments, the length-weight relationship (LWR) showed negatively allomeric growth behavior (b < 3), with a relative condition factor (K_n) of more than 1. Therefore, MT-APG-NLC (30 ppm) would seem to be a promising, cost-effective way to reduce the dose of MT used for the masculinization of farmed red tilapia.

Role of topical spironolactone in the treatment of acne: A systematic review of clinical trials-Does this therapy open a path towards favorable outcomes?

Acne vulgaris is the eighth most common disease worldwide and presents with inflammatory and noninflammatory skin lesions along with other dermal abnormalities. Oral spironolactone is used for treating acne vulgaris due to its antiandrogenic properties and inhibition of sebogenesis. Recent evidence shows that spironolactone in topical form has similar efficacy to its oral form with comparatively fewer adverse events associated with its use. However, to establish an evidence-based understanding, this systematic review aims to investigate the efficacy and safety of topical spironolactone in the treatment of acne vulgaris. PubMed, ClinicalTrials.gov, Cochrane library, and Google Scholar were comprehensively searched from the date of inception till March 18, 2022 All the clinical trials experimenting with the role of topical spironolactone in the treatment of acne were included. Articles examining the effects of oral spironolactone or other topical agents were excluded. The Cochrane risk of bias assessment tool (RoB 2.0, version 2019) was used to assess the risk of bias in each study. The study findings have been reported in line with PRISMA 2020 guidelines. The literature search yielded 600 articles. Five clinical trials with 195 patients were included in this review. Out of the five trials, two showed a high risk of bias while three had overall some concerns. Patients treated with topical spironolactone showed a significant decrease in the number of papules (p = 0.004), closed comedones (p < 0.05), and lesions (p < 0.05). Compared to placebo, treatment with 5% spironolactone showed a significant decrease in total lesion count (p = 0.007). In addition, 2% spironolactone showed efficacy over clindamycin and reduced the number of comedones (p < 0.0001), papules (p < 0.0001), and pustules (p < 0.0001) while the acne severity index was also considerably lowered (p < 0.0001). Spironolactone was not found to affect significant skin hydration, sebum, elasticity, melanin, and redness (p > 0.05). Topical spironolactone yields better results than other first-line treatments for acne and displays fewer side effects. However, further large-scale clinical trials are required before spironolactone can be used as the preferred treatment in the clinical management of acne.

Exploring the Synergistic Effect of Bergamot Essential Oil with Spironolactone Loaded Nano-Phytosomes for Treatment of Acne Vulgaris: In Vitro Optimization, In Silico Studies, and Clinical Evaluation

The foremost target of the current work was to formulate and optimize a novel bergamot essential oil (BEO) loaded nano-phytosomes (NPs) and then combine it with spironolactone (SP) in order to clinically compare the efficiency of both formulations against acne vulgaris. The BEO-loaded NPs formulations were fabricated by the thin-film hydration and optimized by 3² factorial design. NPs' assessments were conducted by measuring entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). In addition, the selected BEO-NPs formulation was further combined with SP and then examined for morphology employing transmission electron microscopy and three months storage stability. Both BEO-loaded NPs selected formula and its combination with SP (BEO-NPs-SP) were investigated clinically for their effect against acne vulgaris after an appropriate in silico study. The optimum BEO-NPs-SP showed PS of 300.40 ± 22.56 nm, PDI of 0.571 ± 0.16, EE% of 87.89 ± 4.14%, and an acceptable ZP value of -29.7 ± 1.54 mV. Molecular modeling simulations showed the beneficial role of BEO constituents as supportive/connecting platforms for favored anchoring of SP on the Phosphatidylcholine (PC) interface. Clinical studies revealed significant improvement in the therapeutic response of BEO-loaded NPs that were combined with SP over BEO-NPs alone. In conclusion, the results proved the ability to utilize NPs as a successful nanovesicle for topical BEO delivery as well as the superior synergistic effect when combined with SP in combating acne vulgaris.

Dermoscopic evaluation of the efficacy of combination of topical spironolactone 5% and minoxidil 5% solutions in the treatment of androgenetic alopecia: A cross sectional-comparative study

BACKGROUND

Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women.

AIM

To assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes.

PATIENTS AND METHODS

One hundred and twenty patients diagnosed with AGA were divided into three groups; each group is composed of 40 patients. Group A (n = 40) were treated with a 5% topical minoxidil solution, group B (n = 40) were treated with a 5% topical spironolactone solution, and group C (n = 40) were treated with a 5% topical minoxidil and spironolactone combination.

RESULTS

Following the initiation of treatment and at 6 weeks (midterm), reduction in all dermoscopic features was observed in all groups; however, it was not statistically significant except for vellus hair reduction (p = 0.033). On the contrary, upright regrowing hairs were insignificantly increased in all groups (p = 1.088). The pattern of dermoscopic features remained to insignificantly decrease toward the end of 12 weeks treatment (full term) in all studied groups except for vellus hair that showed further significant reduction toward the end of the study (p = 0.011).

CONCLUSION

Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice-daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages.

A Mini-Review on Solid Lipid Nanoparticles and Nanostructured Lipid Carriers: Topical Delivery of Phytochemicals for the Treatment of Acne Vulgaris

Acne vulgaris (acne) is one of the most common dermatological problems affecting adolescents and young adults. Although acne may not lead to serious medical complications, its psychosocial effects are tremendous and scientifically proven. The first-line treatment for acne is topical medications composed of synthetic compounds, which usually cause skin irritation, dryness and itch. Therefore, naturally occurring constituents from plants (phytochemicals), which are generally regarded as safe, have received much attention as an alternative source of treatment. However, the degradation of phytochemicals under high temperature, light and oxygen, and their poor penetration across the skin barrier limit their application in dermatology. Encapsulation in lipid nanoparticles is one of the strategies commonly used to deliver drugs and phytochemicals because it allows appropriate concentrations of these substances to be delivered to the site of action with minimal side effects. Solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) are promising delivery systems developed from the combination of lipid and emulsifier. They have numerous advantages that include biocompatibility and biodegradability of lipid materials, enhancement of drug solubility and stability, ease of modulation of drug release, ease of scale-up, feasibility of incorporation of both hydrophilic and lipophilic drugs and occlusive moisturization, which make them very attractive carriers for delivery of bioactive compounds for treating skin ailments such as acne. In this review, the concepts of SLNs and NLCs, methods of preparation, characterization, and their application in the encapsulation of anti-acne phytochemicals will be discussed.

Features, applications, and sustainability of lipid nanoparticles in cosmeceuticals

Cosmeceuticals are a branch of cosmetic products that forms a bridge between cosmetic and drug products. It is a fast-growing branch of the cosmetic industry, especially after the introduction of novel formulation and manufacturing techniques such as lipid nanoparticles (LNPs). These LNPs-based cosmeceutical products offer several advantages such as enhanced bioavailability of cosmeceutical active ingredients (CAIs), improved aesthetic appeal, and stability of the final products. However, the use of these LNPs may raise some concerns about possible side effects of these LNPs and potential hazards to the customer's health. Accordingly, an update that focuses on the use of this important branch of nanoparticles is necessary since most review papers are dealing with all types of nanocarriers in the same review with little focus on LNPs. Therefore, in the current review, a detailed analysis of the advantages and disadvantages of LNPs in this field was highlighted, to emphasize the LNPs-based cosmeceuticals on the market, as well as the potential risk posed by LNPs on exposure and recently introduced regulatory guidelines to address them. In addition, if these products can be a candidate as products that meet the sustainable development goals raised by the UN are discussed.

Lipid Nanoparticulate Drug Delivery Systems: Recent Advances in the Treatment of Skin Disorders

The multifunctional role of the human skin is well known. It acts as a sensory and immune organ that protects the human body from harmful environmental impacts such as chemical, mechanical, and physical threats, reduces UV radiation effects, prevents moisture loss, and helps thermoregulation. In this regard, skin disorders related to skin integrity require adequate treatment. Lipid nanoparticles (LN) are recognized as promising drug delivery systems (DDS) in treating skin disorders. Solid lipid nanoparticles (SLN) together with nanostructured lipid carriers (NLC) exhibit excellent tolerability as these are produced from physiological and biodegradable lipids. Moreover, LN applied to the skin can improve stability, drug targeting, occlusion, penetration enhancement, and increased skin hydration compared with other drug nanocarriers. Furthermore, the features of LN can be enhanced by inclusion in suitable bases such as creams, ointments, gels (i.e., hydrogel, emulgel, bigel), lotions, etc. This review focuses on recent developments in lipid nanoparticle systems and their application to treating skin diseases. We point out and consider the reasons for their creation, pay attention to their advantages and disadvantages, list the main production techniques for obtaining them, and examine the place assigned to them in solving the problems caused by skin disorders.

Efficacy, tolerability, and safety of montelukast versus finasteride for the treatment of moderate acne in women: A prospective, randomized, single-blinded, active-controlled trial

BACKGROUND

Acne is a chronic inflammatory skin disease which involves the pilosebaceous unit. Tissue inflammation isone of the crucial mechanisms, amongst others. Of the various cytokines, leukotriene B4 (LT-B4) is the most potentleucocyte chemotactic mediator. Montelukast is an antagonist of the LT-B4 receptor. Finasteride is an antiandrogen whichspecifically inhibits the 5α-reductase enzyme.

AIMS

This study aimed at comparing the efficacy, tolerability and safety of montelukast versus finasteride in the treatmentof moderate acne in women.

PATIENTS/METHOD

This randomized, single-blinded, prospective trial over 12 weeks recruited 65 female subjects with moderate acne vulgaris (Global Acne Grading System Scale) for evaluation. One group (n = 30) received oral montelukast (10 mg PO daily), while the second group (n = 25) received oral finasteride (2.5 mg PO daily) in combination with topical clindamycin 2% solution. Lesion count and acne severity were evaluated at time intervals of 0 (baseline), 4, 8, and 12 weeks. Adverse effects of the drugs were noted.

RESULTS

Both lesion count and severity of acne decreased significantly after treatment in both the groups as compared to the baseline. The acne severity score reached from 33.93 in time zero to 20.6 in the 12th week and 35.71 at baseline to 16.43 at the end of treatment in the Montelukast and Finasteride groups, respectively. Side effects were noted in 3 patients and 2 patients in the monteleukast and finasteride group, respectively, which were transient and non-serious in nature proving the satisfactory tolerability and safety of these two drugs.

CONCLUSION

The results of this study show that both montelukast and finasteride have good efficacy in the treatment of acne. Finasteride has more efficacy than montelukast for treating moderate acne in normo-androgenic women.

Treatment of Acne Vulgaris by Topical Spironolactone Solution Compared With Clindamycin Solution

Background: Acne vulgaris is a common skin problem that is encountered in daily clinical work, affecting mostly the adolescent and young adult age group. Many topical therapies have been used in the treatment of mild to moderate types of acne vulgaris. However, none of these modalities is uniformly effective; furthermore, acne vulgaris is also associated with relapse and many topical side effects.

Objective: To compare the effectiveness and side effects of topical 2% spironolactone solution and 1.5% clindamycin solution in the treatment of mild to moderate acne vulgaris.

Material and methods: This was a single-blinded therapeutic clinical comparative study conducted at the Dermatology Center at Medical City in Baghdad, Iraq, from April 2019 to March 2020. Sixty-eight patients with mild to moderate acne vulgaris on the face were included. All sociodemographic data related to the disease were recorded for each patient. Patients were divided into two groups according to the type of therapy: group A (35 patients) used 2% spironolactone solution and group B(33 patients) used 1.5% clindamycin solution. All cases in both groups were instructed to use the solutions twice a day for 12 weeks in the same manner. Patients were seen every two weeks to evaluate the response to therapy and to report any topical side effects; then, follow-up was carried out for one month after cessation of therapy to evaluate relapse.

Results: Spironolactone solution significantly decreased comedone count (p < 0.0001), while the clindamycin solution had no effect on comedones. Although spironolactone was slower than clindamycin solution in reaching the maximum therapeutic effect, the reduction in papules was comparable to that of clindamycin, but it exhibited a greater reduction of pustules (p > 0.05) and the Acne Severity Index (ASI; p > 0.05). Patients in the spironolactone group were more satisfied than those in the clindamycin group. Only minimal local side effects were reported in both groups that did not require cessation of therapy. 

Conclusion: Spironolactone solution is an effective and well-tolerated topical treatment for mild to moderate acne vulgaris and is superior to clindamycin solution.

Topical Treatment of Human Skin and Cultured Keratinocytes with High-Dose Spironolactone Reduces XPB Expression and Induces Toxicity

Spironolactone (SP) is used to treat a variety of disparate disease states ranging from heart failure to acne through antagonism of the mineralocorticoid and androgen receptors. Although normally taken as an oral medication, recent studies have explored the topical application of SP onto the skin. However, because SP induces the proteolytic degradation of the XPB protein, which plays critical roles in DNA repair and transcription, there may be safety concerns with the use of topical SP. In this study, we show that the topical application of a high concentration of either SP or its metabolite canrenone onto human skin ex vivo lowers XPB protein levels and induces toxic responses in the epidermis. Interestingly, although SP and canrenone both inhibit cell proliferation, induce replication stress responses, and stimulate apoptotic signaling at high concentrations in cultured keratinocytes in vitro, these effects were not correlated with XPB protein loss. Thus, high concentrations of SP and canrenone likely inhibit cell proliferation and induce toxicity through additional mechanisms to XPB proteolytic degradation. This work suggests that care may need to be taken when using high concentrations of SP directly on human skin.

Efficacy and safety of topical spironolactone 5% cream in the treatment of acne: A pilot study

BACKGROUND

Spironolactone is an effective treatment for female patients with acne vulgaris. However, topical spironolactone could be a valuable treatment option in both male and female acne patients due to the less possibility of systemic side effects with its topical formulation.

OBJECTIVE

To evaluate the efficacy and safety of 5% spironolactone cream in the treatment of mild to moderate acne vulgaris.

METHODS

In this pilot clinical trial, topical spironolactone 5% was evaluated to treat patients with mild to moderate acne twice a day for 8 weeks. The rate of improvement as any alterations in the number of open and closed comedones, facial inflammatory papules, and acne global grading scores were assessed. Moreover, skin biometric characteristics including skin hydration, erythema, transepidermal water loss (TEWL), pH, sebum, and Propionibacterium acnes bacteria activity were also assessed following the treatment.

RESULTS

Fifteen patients participated in our study with a mean age of 25 ± 4.87 years old. A total of 66.6% (n = 10) were female and 33.4% (n = 5) were male. The number of acne papules, open and closed comedones, and acne global grading score decreased significantly 4 and 8 weeks after the beginning of treatment (P < .05). No considerable side effect was reported. Moreover, there was no significant difference between the skin hydration, melanin, erythema, TEWL, pH index, sebum, and P acnes bacteria activity before, 4, and 8 weeks after the treatment with topical spironolactone cream (P > .05).

CONCLUSION

The topical 5% spironolactone cream seems to be an effective and safe treatment of acne vulgaris in both male and female patients.

Nanostructured lipid carriers (NLCs) as drug delivery platform: Advances in formulation and delivery strategies

NLCs have provoked the incessant impulsion for the development of safe and valuable drug delivery systems owing to their exceptional physicochemical and then biocompatible characteristics. Throughout the earlier period, a lot of studies recounting NLCs based formulations have been noticeably increased. They are binary system which contains both solid and liquid lipids aiming to produce less ordered lipidic core. Their constituents particularly influence the physicochemical properties and effectiveness of the final product. NLCs can be fabricated by different techniques which are classified according to consumed energy. More utilization NLCs is essential due to overcome barriers surrounded by the technological procedure of lipid-based nanocarriers' formulation and increased information of the core mechanisms of their transport via various routes of administration. They can be used in different applications and by different routes such as oral, cutaneous, ocular and pulmonary. This review article seeks to present an overview on the existing situation of the art of NLCs for future clinics through exposition of their applications which shall foster their lucid use. The reported records evidently demonstrate the promise of NLCs for innovate therapeutic applications in the future.

Polymeric micelle mediated follicular delivery of spironolactone: Targeting the mineralocorticoid receptor to prevent glucocorticoid-induced activation and delayed cutaneous wound healing

Impaired wound healing in patients receiving glucocorticoid therapy is a serious clinical concern: mineralocorticoid receptor (MR) antagonists can counter glucocorticoid-induced off-target activation of MR receptors. The aim of this study was to investigate the cutaneous delivery of the potent MR antagonist, spironolactone (SPL), from polymeric micelle nanocarriers, prepared using a biodegradable copolymer, methoxy-poly(ethylene glycol)-di-hexyl-substituted-poly(lactic acid). Immunofluorescent labelling of the MR showed that it was principally located in the pilosebaceous unit (PSU), justifying the study rationale since polymeric micelles accumulate preferentially in appendageal structures. Cutaneous biodistribution studies under infinite and finite dose conditions, demonstrated delivery of pharmacologically relevant amounts of SPL to the epidermis and upper dermis. Preferential PSU targeting was confirmed by comparing amounts of SPL in PSU-containing and PSU-free skin biopsies: SPL nanomicelles showed 5-fold higher delivery of SPL in the PSU-containing biopsies, 0.54 ± 0.18 ng/mm²vs. 0.10 ± 0.03 ng/mm², after application of a hydrogel in finite conditions. Canrenone, an active metabolite of SPL, was also quantified in skin samples. In addition to being used for the treatment of delayed cutaneous wound healing by site-specific antagonism of the MR, the formulation might also be used to treat pilosebaceous androgen-related skin diseases, e.g. acne vulgaris, since SPL is a potent androgen receptor antagonist.

Recent Advances in Nanomaterials for Dermal and Transdermal Applications

The stratum corneum, the most superficial layer of the skin, protects the body against environmental hazards and presents a highly selective barrier for the passage of drugs and cosmetic products deeper into the skin and across the skin. Nanomaterials can effectively increase the permeation of active molecules across the stratum corneum and enable their penetration into deeper skin layers, often by interacting with the skin and creating the distinct sites with elevated local concentration, acting as reservoirs. The flux of the molecules from these reservoirs can be either limited to the underlying skin layers (for topical drug and cosmeceutical delivery) or extended across all the sublayers of the epidermis to the blood vessels of the dermis (for transdermal delivery). The type of the nanocarrier and the physicochemical nature of the active substance are among the factors that determine the final skin permeation pattern and the stability of the penetrant in the cutaneous environment. The most widely employed types of nanomaterials for dermal and transdermal applications include solid lipid nanoparticles, nanovesicular carriers, microemulsions, nanoemulsions, and polymeric nanoparticles. The recent advances in the area of nanomaterial-assisted dermal and transdermal delivery are highlighted in this review.

Fabrication and Evaluation of Spironolactone-Loaded Nanostructured Lipid Carries for Cardiac Tissue Regeneration

Background:

Spironolactone (SP) is a lipophilic aldosterone receptor antagonist that few studies have reported its effect on cardiac remodeling. In addition, fewer researches have considered its influence on cardiomyocyte viability and potential benefits for myocardial tissue remodeling.

Method:

In this study, stearic acid (SA) (solid lipid) and oleic acid (OA) (liquid lipid) were utilized to produce nanostructured lipid carries (NLCs) (various ratios of SA to OA and water amount, F1: 80:20 [30 ml water], F2: 80:20 [60 ml water], F3: 70:30 [30 ml water], and F4: 70:30 [60 ml water]) containing SP and their particle size, polydispersity index, zeta potential, entrapment efficiency, and release profile were measured. The purpose of encapsulating SP in NLCs was to provide a sustain release system. Meanwhile, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay with different concentrations of SP-loaded NLCs (SP-NLCs) was conducted to evaluate the cytotoxicity of the NLCs on rat myocardium cells (H9C2).

Results:

Increase of oil content to 10 wt% reduced the particle size from 486 nm (F1) to 205 nm (F2). Zeta potential of the samples at around −10 mV indicated their agglomeration tendency. After 48 h, SP-NLCs with the concentrations of 5 and 25 μM showed significant improvement in cell viability while the same amount of free SP-induced cytotoxic effect on the cells. SP-NLCs with higher concentration (50 μM) depicted cytotoxic effect on H9C2 cells.

Conclusion:

It can be concluded that 25 μM SP-NLCs with sustain release profile had a beneficial effect on cardiomyocytes and can be used as a mean to improve cardiac tissue regeneration.

Emulsions with alkyl polyglucosides as carriers for off-label topical spironolactone - safety and stability evaluation

Androgens play an important role in the pathogenesis of acne. Being an anti-androgen drug with many side effects, spironolactone has recently been used in dermatology as a topical therapy for acne. Off-label drug use in dermatology is common, although those drugs are basically available as compounded formulations; the choice of a proper vehicle is often neglected in that case. Alkyl polyglucosides (APGs) are a FDA certified class of polyethylene glycol (PEG)-free surfactants produced from the renewable resources. Following the preformulation tests, two different APG emulsifiers were used in this study to stabilize emulsions as carriers for topical spironolactone. Assessment of the physical stability of emulsions per se and after incorporation of 5% of spironolactone was performed using polarization microscopy, electrical conductivity and pH measurements. The skin irritation profile and moisturizing potential was assessed in vivo on human volunteers. APG-based emulsions per se and with 5% of spironolactone showed acceptable skin irritation profiles and significant potential for skin hydration, which is important in acne treatment. Good physical stability and satisfying preliminary safety profile of all investigated samples were also obtained showing that moisturizing APG-based emulsions could be promoted as vehicles for off-label topical spironolactone.

A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study

Topical minoxidil 5% are effective in androgenetic alopecia (AGA). Spironolactone acts as an androgen antagonist by competitively blocking androgen receptors. Studying the effect of topical minoxidil 5% gel and spironolactone gel 1% in management of AGA. The study includes 60 patients diagnosed as AGA; (group I): treated with topical minoxidil gel 5%, (group II): with topical spironolactone gel 1% and group (III) treated with combined minoxidil 5% and spironolactone 1% gel. All patients were followed up monthly throughout the treatment period. Scalp biopsy was taken before and after 12 months. In group I, the clinical response was in 90% of patients with variable degrees in improvement, in group II, the clinical response was in 80% of patients, meanwhile, in group III the clinical response was in all patients (100%). Histopathological examination of skin biopsy after treatment revealed significant increase in anagen hair on the other hand, both telogen and vellus hair was significantly decreased meanwhile, the T/V ratio was significantly increased. The results of this work revealed that topical minoxidil gel 5% and topical spironolactone gel 1% were effective in treatment of AGA, while the combination of two agents was better in treatment.

Spironolactone and XPB: An Old Drug with a New Molecular Target

Spironolactone (SP) is commonly used for the treatment of heart failure, hypertension, and complications of cirrhosis by antagonizing the mineralocorticoid receptor. However, SP also antagonizes the androgen receptor, and thus SP has also been shown to be effective in the treatment of acne, hair loss, and hirsutism in women. Interestingly, recent drug repurposing screens have identified new and diverse functions for SP as a simulator of tumor immunosurveillance and as an inhibitor of DNA repair and viral infection. These novel pharmacological effects of SP have all been linked to the ability of SP to induce the rapid proteolytic degradation of the xeroderma pigmentosum group B (XPB) protein. XPB is a critical enzymatic component of the multi-subunit complex known as transcription factor II-H (TFIIH), which plays essential roles in both DNA repair and the initiation of transcription. Given the critical functions for XPB and TFIIH in these processes, the loss of XPB by SP could lead to mutagenesis. However, the ability of SP to promote cancer stem cell death and facilitate immune recognition may counteract the negative consequences of SP to mitigate carcinogenic risk. Thus, SP appears to have new and interesting pharmacological effects that may extend its potential uses.

Spironolactone-Loaded LeciPlexes as Potential Topical Delivery Systems for Female Acne: In Vitro Appraisal and Ex Vivo Skin Permeability Studies

Spironolactone (SP), an aldosterone antagonist with anti-androgen properties, has shown promising results in the treatment of female acne. However, its systemic side effects limit its clinical benefits. This study aimed to prepare and evaluate LeciPlexes for SP topical delivery. LeciPlexes were prepared by a one-step procedure and characterized using various techniques. Optimum LeciPlex preparation was incorporated into 1% methylcellulose gel and SP permeability was tested ex vivo in Sprague-Dawley rat skin. The maximum drug encapsulation efficiency obtained was 93.6 ± 6.9% and was dependent on the drug/phospholipid and surfactant/phospholipid ratios. A zeta potential of +49.3 ± 3.5 to +57.7 ± 3.3 mV and a size of 108 ± 25.3 to 668.5 ± 120.3 nm were observed for the LeciPlexes. FT-IR and DSC studies confirmed the incorporation of SP into the LeciPlexes through hydrophobic and hydrogen bonding interactions. SP release from the LeciPlex formulations was significantly slower than from the drug suspension. Cumulative SP permeated through rat skin from LeciPlex gel was about 2-fold higher than SP control gel. Cumulative SP deposited in the stratum corneum and other skin layers from the LeciPlex gel was about 1.8- and 2.6-fold higher than SP control gel, respectively. This new SP LeciPlex formulation is a promising carrier for the treatment of female acne.

Niosome-loaded antifungal drugs as an effective nanocarrier system: A mini review

Skin is an important organ of the body due to offering an accessible and convenient site for drug administration. One of the disadvantages of transdermal drug delivery is the low penetration rate of drugs through the skin. Over the past decades, nanoparticles have been used as drug delivery systems to increase therapeutic effects or reduce toxicity. Encapsulation of drugs in nanoparticulate vesicles simplifies the transports of drugs into and across the skin.

Niosome nanoparticles are among these drug delivery systems, which have numerous applications in drug delivery and targeting. Niosomes are frequently used for loading drugs serving different purposes (e.g., anticancer, antiviral, and antibacterial agents). In recent years, there has been much research on the use of niosomal systems for the delivery of fungal drugs. A review of the literature investigating the advantages of niosomes in antifungal drug delivery can elucidate the efficiency and superiority of this nanocarrier over other nanocarriers.

Nanostructured lipid carriers: A potential use for skin drug delivery systems

Skin application of pharmaceutical products is one of the methods used for drug administration. The problem of limited drug penetration via topical application makes searching for safe drug carriers that will provide an expected therapeutic effect of utmost importance. Research into safe drug carriers began with liposome structures, paving the way for work with nanocarriers, which currently play a large role as drug vehicles. Nanostructured lipid carriers (NLC) consist of blended solid and liquid lipids (oils) dispersed in an aqueous solution containing a surfactant. These carriers have many advantages: good biocompatibility, low cytotoxicity, high drug content; they enhance a drug's stability and have many possibilities of application (oral, intravenous, pulmonary, ocular, dermal). The following article presents properties, methods of preparation and tests to assess the quality and toxicity of NLC. This analysis indicates the possibility of using NLC for dermal and transdermal drug application.

Application of nanoparticles in percutaneous delivery of active ingredients in cosmetic preparations

Developments in nanotechnology have expanded novel nanoparticles for several applications, including cosmetic topical preparation. The aim of this article was to review recent literature on percutaneous delivery of cosmetics active ingredient by nanoparticles. The main focus here, is on lipid based nanoparticles since they are of great importance in skin cargo delivery and have vast application in current cosmetic formulations. Data were collected via electronic databases using MeSH keywords, including nanoparticles, lipid particles, cosmetic, dermal delivery and combinations of these words. According to literature nanoparticles play a major role in improving the usefulness of cosmetics. They are able to improve the physiochemical stability of the skin based cosmetic products. Based on data, lipid nanostructures can be added to current cosmetic formulations without any significant problem due to their physical stability and compatibility with other ingredients. However, due to their basically risky nature of nanoparticles, their risk assessment should be taken into consideration.

Armamentarium of nanoscaled lipid drug delivery systems customized for oral administration: In silico docking patronage, absorption phenomenon, preclinical status, clinical status and future prospects

Poor drug solubility and bioavailability remain a significant and frequently encountered concern for pharmaceutical scientists. Nanoscaled lipid drug delivery systems (NSLDDS) have exhibited great potentials in oral delivery of poorly water-soluble drugs, primarily for lipophilic drugs, with several successful clinical products. In the past few years, we have find out that optimized composition of drug in lipid, surfactant, or mixture of lipid and surfactant omits the solubility, permeability and bioavailability issues, which are potential limitations for oral absorption of poorly water-soluble drugs. Lipids not only vary in structures and physiochemical properties, but also in their digestibility and absorption pathway; therefore selection of lipid excipients and dosage form has a pronounced effect on biopharmaceutical aspects of drug absorption and distribution both in vitro and in vivo. Therefore, in current critical review, a comprehensive overview of the different lipid based nanostructured drug delivery systems intended for oral administration has been presented. In addition, implication of in silico docking in designing of NSLDDS as well as mechanism of absorption of different lipid based nanoformulations through intestinal absorption window has also been offered. Moreover, attention has also been paid to NSLDDS that are currently undergoing preclinical or clinical analysis.

Spironolactone for the treatment of acne in women, a retrospective study of 110 patients

BACKGROUND

There is limited evidence on the safety and efficacy of spironolactone in the treatment of women with acne. Thus, for many dermatologists spironolactone remains an alternative rather than a mainstay treatment for female patients with acne.

METHODS

An electronic medical records search tool was used to select data from a group of women who received spironolactone to treat acne and were evaluated with the comprehensive acne severity scale (CASS) before treatment and at all follow-up visits. Data points were collected for CASS scores at each follow-up visit, concurrent and previous treatments, and side effects. These data points were used to draw conclusions about the safety and efficacy of spironolactone in this patient population.

RESULTS

There were 110 patients that met all eligibility requirements. Of these, 94 patients saw an improvement in their CASS score and 61 patients completely cleared their score to 0. There were 16 patients who did not improve and six who relapsed after initial improvement. The women saw an average improvement in their acne by 73.1% for the face, 75.9% for the chest, and 77.6% for the back. Fifty-one women experienced side effects, but only six found them bothersome enough to stop taking spironolactone.

CONCLUSION

A majority of women in this study saw a dramatic improvement in their acne while treated with spironolactone. There were low rates of relapse or discontinuation of the medication. To further promote the use of spironolactone as a first-line systemic treatment for women with acne, there must be more prospective controlled trials.