Permeabilization of human stratum corneum and full-thickness skin samples by a direct dielectric barrier discharge

Electrochemotherapy for head and neck cancers: possibilities and limitations

Head and neck cancer continues to be among the most prevalent types of cancer globally, yet it can be managed with appropriate treatment approaches. Presently, chemotherapy and radiotherapy stand as the primary treatment modalities for various groups and regions affected by head and neck cancer. Nonetheless, these treatments are linked to adverse side effects in patients. Moreover, due to tumor resistance to multiple drugs (both intrinsic and extrinsic) and radiotherapy, along with numerous other factors, recurrences or metastases often occur. Electrochemotherapy (ECT) emerges as a clinically proven alternative that offers high efficacy, localized effect, and diminished negative factors. Electrochemotherapy involves the treatment of solid tumors by combining a non-permeable cytotoxic drug, such as bleomycin, with a locally administered pulsed electric field (PEF). It is crucial to employ this method effectively by utilizing optimal PEF protocols and drugs at concentrations that do not possess inherent cytotoxic properties. This review emphasizes an examination of diverse clinical practices of ECT concerning head and neck cancer. It specifically delves into the treatment procedure, the choice of anti-cancer drugs, pre-treatment planning, PEF protocols, and electroporation electrodes as well as the efficacy of tumor response to the treatment and encountered obstacles. We have also highlighted the significance of assessing the spatial electric field distribution in both tumor and adjacent tissues prior to treatment as it plays a pivotal role in determining treatment success. Finally, we compare the ECT methodology to conventional treatments to highlight the potential for improvement and to facilitate popularization of the technique in the area of head and neck cancers where it is not widespread yet while it is not the case with other cancer types.

Invasive and non-invasive electrodes for successful drug and gene delivery in electroporation-based treatments

Electroporation is an effective physical method for irreversible or reversible permeabilization of plasma membranes of biological cells and is typically used for tissue ablation or targeted drug/DNA delivery into living cells. In the context of cancer treatment, full recovery from an electroporation-based procedure is frequently dependent on the spatial distribution/homogeneity of the electric field in the tissue; therefore, the structure of electrodes/applicators plays an important role. This review focuses on the analysis of electrodes and in silico models used for electroporation in cancer treatment and gene therapy. We have reviewed various invasive and non-invasive electrodes; analyzed the spatial electric field distribution using finite element method analysis; evaluated parametric compatibility, and the pros and cons of application; and summarized options for improvement. Additionally, this review highlights the importance of tissue bioimpedance for accurate treatment planning using numerical modeling and the effects of pulse frequency on tissue conductivity and relative permittivity values.

Thermo and Photoresponsive Emulgel Loaded with Copaifera reticulata Ducke and Chlorophylls: Rheological, Mechanical, Photodynamic and Drug Delivery Properties in Human Skin

Recently, the number of new cases of cutaneous leishmaniasis has been of concern among health agencies. Research that offers new therapeutic alternatives is advantageous, especially those that develop innovative drugs. Therefore, this paper presents the incorporation of Copaifera reticulata Ducke and chlorophyll extract into Pluronic^®® F127 and Carbopol gels, under optimized polymer quantities. The chlorophyll extract (rich in photosensitizing compounds) was obtained by continuous-flow pressurized liquid extraction (PLE), a clean, environmentally friendly method. The system aims to act as as a leishmanicidal, cicatrizant, and antibiotic agent, with reinforcement of the photodynamic therapy (PDT) action. Rheological and mechanical analyses, permeation studies and bioadhesiveness analyses on human skin, and PDT-mediated activation of Staphylococcus aureus were performed. The emulgels showed gelation between 13° and 15 °C, besides pseudoplastic and viscoelastic properties. Furthermore, the systems showed transdermal potential, by releasing chlorophylls and C. reticulata Ducke into the deep layers of human skin, with good bioadhesive performance. The application of PDT reduced three logarithmic colony-forming units of S. aureus bacteria. The results support the potential of the natural drug for future clinical trials in treating wounds and cutaneous leishmania.

Amorphization of Drugs for Transdermal Delivery-a Recent Update

Amorphous solid dispersion is a popular formulation approach for orally administered poorly water-soluble drugs, especially for BCS class II. But oral delivery could not be an automatic choice for some drugs with high first-pass metabolism susceptibility. In such cases, transdermal delivery is considered an alternative if the drug is potent and the dose is less than 10 mg. Amorphization of drugs causes supersaturation and enhances the thermodynamic activity of the drugs. Hence, drug transport through the skin could be improved. The stabilization of amorphous system is a persistent challenge that restricts its application. A polymeric system, where amorphous drug is dispersed in a polymeric carrier, helps its stability. However, high excipient load often becomes problematic for the polymeric amorphous system. Coamorphous formulation is another approach, where one drug is mixed with another drug or low molecular weight compound, which stabilizes each other, restricts crystallization, and maintains a single-phase homogenous amorphous system. Prevention of recrystallization along with enhanced skin permeation has been observed by the transdermal coamorphous system. But scalable manufacturing methods, extensive stability study and in-depth in vivo evaluation are lacking. This review has critically studied the mechanistic aspects of amorphization and transdermal permeation by analyzing recent researches in this field to propose a future direction.

A Review of Potential Use of Amazonian Oils in the Synthesis of Organogels for Cosmetic Application

New strategies for the delivery of bioactives in the deeper layers of the skin have been studied in recent years, using mainly natural ingredients. Among the strategies are organogels as a promising tool to load bioactives with different physicochemical characteristics, using vegetable oils. Studies have shown satisfactory skin permeation, good physicochemical stability mainly due to its three-dimensional structure, and controlled release using vegetable oils and low-molecular-weight organogelators. Within the universe of natural ingredients, vegetable oils, especially those from the Amazon, have a series of benefits and characteristics that make them unique compared to conventional oils. Several studies have shown that the use of Amazonian oils brings a series of benefits to the skin, among which are an emollient, moisturizing, and nourishing effect. This work shows a compilation of the main Amazonian oils and their nutraceutical and physicochemical characteristics together with the minority polar components, related to health benefits, and their possible effects on the synthesis of organogels for cosmetic purposes.

The molecular and physiological consequences of cold plasma treatment in murine skin and its barrier function

Cold plasma technology is an emerging tool facilitating the spatially controlled delivery of a multitude of reactive species (ROS) to the skin. While the therapeutic efficacy of plasma treatment has been observed in several types of diseases, the fundamental consequences of plasma-derived ROS on skin physiology remain unknown. We aimed to bridge this gap since the epidermal skin barrier and perfusion plays a vital role in health and disease by maintaining homeostasis and protecting from environmental damage. The intact skin of SKH1 mice was plasma-treated in vivo. Gene and protein expression was analyzed utilizing transcriptomics, qPCR, and Western blot. Immunofluorescence aided the analysis of percutaneous skin penetration of curcumin. Tissue oxygenation, perfusion, hemoglobin, and water index was investigated using hyperspectral imaging. Reversed-phase liquid-chromatography/mass spectrometry was performed for the identification of changes in the lipid composition and oxidation. Transcriptomic analysis of plasma-treated skin revealed modulation of genes involved in regulating the junctional network (tight, adherence, and gap junctions), which was confirmed using qPCR, Western blot, and immunofluorescence imaging. Plasma treatment increased the disaggregation of cells in the stratum corneum (SC) concomitant with increased tissue oxygenation, gap junctional intercellular communication, and penetration of the model drug curcumin into the SC preceded by altered oxidation of skin lipids and their composition in vivo. In summary, plasma-derived ROS modify the junctional network, which promoted tissue oxygenation, oxidation of SC-lipids, and restricted penetration of the model drug curcumin, implicating that plasma may provide a novel and sensitive tool of skin barrier regulation.

The emerging potential of cold atmospheric plasma in skin biology

The maintenance of skin integrity is crucial to ensure the physiological barrier against exogenous compounds, microorganisms and dehydration but also to fulfill social and aesthetic purposes. Besides the development of new actives intended to enter a formulation, innovative technologies based on physical principles have been proposed in the last years. Among them, Cold Atmospheric Plasma (CAP) technology, which already showed interesting results in dermatology, is currently being studied for its potential in skin treatments and cares. CAP bio-medical studies gather several different expertise ranging from physics to biology through chemistry and biochemistry, making this topic hard to pin. In this review we provide a broad survey of the interactions between CAP and skin. In the first section, we tried to give some fundamentals on skin structure and physiology, related to its essential functions, together with the main bases on cold plasma and its physicochemical properties. In the following parts we dissected and analyzed each CAP parameter to highlight the already known and the possible effects they can play on skin. This overview aims to get an idea of the potential of cold atmospheric plasma technology in skin biology for the future developments of dermo-cosmetic treatments, for example in aging prevention.

Plasma Permeabilization of Human Excised Full-Thickness Skin by µs- and ns-pulsed DBD

INTRODUCTION

Cold atmospheric plasma (CAP) is gaining increasing importance as a medical or cosmetic treatment for various indications. The technology is best suited to the treatment of surfaces such as the skin and is already used in wound care and, in exemplary case studies, the reduction of superficial tumors. Several plasma sources have been reported to affect the skin barrier function and potentially enable drug delivery across or into plasma-treated skin.

OBJECTIVE

In this study, this effect was quantified for different plasma sources in order to elucidate the influence of voltage rise time, pulse duration, and power density in treatments of full-thickness skin.

METHODS

We compared three different dielectric barrier discharges (DBDs) as to their permeabilization efficiency using Franz diffusion cell permeation experiments and measurements of the transepithelial electrical resistance (TEER) with full-thickness human excised skin.

RESULTS

We found a significant reduction of the TEER for all three plasma sources. Permeation of the hydrophilic sodium fluorescein molecule was enhanced by a factor of 11.7 (low power) to 41.6 (high power) through µs-pulsed DBD-treated skin. A smaller effect was observed after treatment with the ns-pulsed DBD.

CONCLUSIONS

The direct treatment of excised human full-thickness skin with CAP, specifically a DBD, can lead to pore formation and enhances transdermal transport of sodium fluorescein.

Influence of pulse characteristics and power density on stratum corneum permeabilization by dielectric barrier discharge

BACKGROUND

In recent years, the medical use of cold atmospheric plasma has received much attention. Plasma sources can be suited for widely different indications depending on their physical and chemical characteristics. Being interested in the enhancement of drug transport across the skin by plasma treatment, we evaluated three dielectric barrier discharges (DBDs) as to their potential use in permeabilizing human isolated stratum corneum (SC).

METHODS

Imaging techniques (electrochemical and redox-chemical imaging, fluorescence microscopy), transepithelial electrical resistance measurements and permeation studies were employed to study the permeabilizing effect of different DBD-treatments on SC.

RESULTS

Filamentous μs-pulsed DBDs induced robust pore formation in SC. Increasing the power of the μs-pulsed DBD lead to more pronounced pore formation but might increase the risk of undesired side-effects. Plasma permeabilization was much smaller for the ns-pulsed DBD, which left SC samples largely intact.

CONCLUSIONS

The comparison of different DBDs provided insight into the mechanism of DBD-induced SC permeabilization. It also illustrated the need to tailor electrical characteristics of a DBD to optimize it for a particular treatment modality. For future applications in drug delivery it would be beneficial to monitor the permeabilization during a plasma treatment.

GENERAL SIGNIFICANCE

Our results provide mechanistic insight into the potential of an emerging interdisciplinary technology - plasma medicine - as a prospective tool or treatment option. While it might become a safe and pain-free method to enhance skin permeation of drug substances, this is also a mechanism to keep in mind when tailoring plasma sources for other uses.

Surface Treatment with Non-thermal Humid Argon Plasma as a Treatment for Allergic Contact Dermatitis in a Mouse Model

Cold plasma generated at atmospheric pressure has attracted intense interest in biomedical applications, particularly as an antimicrobial treatment. Here we report the therapeutic effect of humidified cold argon plasma on allergic contact dermatitis (ACD) in a mouse model. Treatment was carried out with different gas compositions: argon gas containing small amounts of either N₂, O₂, or H₂O. The best effect was obtained using humid plasma (H₂O addition), where the ACD symptoms decreased after one or two 1-min plasma treatments. Even for severe ACD with ulcers and crust formation, the humid plasma-treated mice recovered faster than the control group. Histopathological analysis by H&E-staining showed enhanced epithelialization with formation of collagen and hair follicles in the affected skin after humid plasma exposure. The therapeutic ability of the humid argon plasma discharge was proposed to be induced by reactive oxygen species (H_xO_y) transported from the discharge zone, which are adhesive and accumulate on the skin surface, penetrating the subcutis to eliminate inflammation. However, in treatments using plasma with addition of oxygen or nitrogen (without water) the active gaseous species are blocked due to poor adhesion to and penetration into the dry ACD skin, with correspondingly poor treatment effects. The enhanced in vivo healing in ACD mice indicate the non-thermal humid plasma could be a potential alternative approach for therapy of ACD and other inflammatory skin diseases.