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Wu S, Guo W, Li B, Zhou H, Meng H, Sun J, Li R, Guo D, Zhang X, Li R, Qu W. Progress of polymer-based strategies in fungal disease management: Designed for different roles. Front Cell Infect Microbiol 2023; 13:1142029. [PMID: 37033476 PMCID: PMC10073610 DOI: 10.3389/fcimb.2023.1142029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/22/2023] [Indexed: 04/11/2023] Open
Abstract
Fungal diseases have posed a great challenge to global health, but have fewer solutions compared to bacterial and viral infections. Development and application of new treatment modalities for fungi are limited by their inherent essential properties as eukaryotes. The microorganism identification and drug sensitivity analyze are limited by their proliferation rates. Moreover, there are currently no vaccines for prevention. Polymer science and related interdisciplinary technologies have revolutionized the field of fungal disease management. To date, numerous advanced polymer-based systems have been developed for management of fungal diseases, including prevention, diagnosis, treatment and monitoring. In this review, we provide an overview of current needs and advances in polymer-based strategies against fungal diseases. We high light various treatment modalities. Delivery systems of antifungal drugs, systems based on polymers' innate antifungal activities, and photodynamic therapies each follow their own mechanisms and unique design clues. We also discuss various prevention strategies including immunization and antifungal medical devices, and further describe point-of-care testing platforms as futuristic diagnostic and monitoring tools. The broad application of polymer-based strategies for both public and personal health management is prospected and integrated systems have become a promising direction. However, there is a gap between experimental studies and clinical translation. In future, well-designed in vivo trials should be conducted to reveal the underlying mechanisms and explore the efficacy as well as biosafety of polymer-based products.
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Affiliation(s)
- Siyu Wu
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Wenlai Guo
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Bo Li
- Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Huidong Zhou
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Hongqi Meng
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Junyi Sun
- Changchun American International School, Changchun, China
| | - Ruiyan Li
- Orthpoeadic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, China
| | - Deming Guo
- Orthpoeadic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, China
| | - Xi Zhang
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Xi Zhang, ; Rui Li, ; Wenrui Qu,
| | - Rui Li
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
- *Correspondence: Xi Zhang, ; Rui Li, ; Wenrui Qu,
| | - Wenrui Qu
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
- *Correspondence: Xi Zhang, ; Rui Li, ; Wenrui Qu,
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Mingorance Álvarez E, Martínez Quintana R, Pérez Pico AM, Mayordomo R. Predictive Model of Nail Consistency Using Scanning Electron Microscopy with Energy-Dispersive X-Ray. BIOLOGY 2021; 10:biology10010053. [PMID: 33445794 PMCID: PMC7828269 DOI: 10.3390/biology10010053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
Simple Summary Scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS) is a useful technique to analyse elemental composition in the nail plate. The dorsal, intermediate, and ventral layers are differentiated by the levels of the elements present in each layer. The level of calcium in the dorsal layer is the main predictive variable in calculating the predictive model of consistency. This model will provide further knowledge of the factors that determine nail consistency in individuals and help health professionals to better understand nail characteristics and objectively determine nail consistency. Abstract The nail plate is made up of tightly packed keratin-rich cells. Factors such as the special distribution of the intermediate filaments in each layer (dorsal, intermediate, and ventral), the relative thickness of the layers, and their chemical composition define the characteristics of each nail. The main objective of this study is to determine nail consistency by calculating a predictive model based on elemental composition analysis using scanning electron microscopy. Nail consistency was determined in 57 participants (29 women and 28 men) in two age groups (young people and adults). Elemental composition was analysed in each layer using scanning SEM-EDS, and nail plate thickness was measured by image analysis. A total of 12 elements were detected in nail plates, of which carbon, nitrogen, phosphorus, sulphur, and calcium showed significant differences between layers (p-values ≤ 0.01). The level of calcium in the dorsal layer was the main predictive variable in calculating the predictive model of consistency, with 75.4% correctly classified cases. Elemental analysis in each layer of the nail plate by SEM-EDS can be used to develop a predictive model of nail consistency that will help health professionals to objectively determine nail consistency.
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Affiliation(s)
- Esther Mingorance Álvarez
- Department of Anatomy and Cell Biology, University Center of Plasencia, University of Extremadura, Avda. Virgen del Puerto 2, 10600 Plasencia, Cáceres, Spain;
| | - Rodrigo Martínez Quintana
- Department of Mathematics, University Center of Plasencia, University of Extremadura, Avda. Virgen del Puerto 2, 10600 Plasencia, Cáceres, Spain;
| | - Ana Mª Pérez Pico
- Department of Nursing, University Center of Plasencia, University of Extremadura, Avda. Virgen del Puerto 2, 10600 Plasencia, Cáceres, Spain;
| | - Raquel Mayordomo
- Department of Anatomy and Cell Biology, University Center of Plasencia, University of Extremadura, Avda. Virgen del Puerto 2, 10600 Plasencia, Cáceres, Spain;
- Correspondence: ; Tel.: +34-636526498; Fax: +34-927425209
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Yang F, Yu X, Shao W, Guo P, Cao S, Wang M, Wang Y, Wu C, Xu Y. Co-delivery of terbinafine hydrochloride and urea with an in situ film-forming system for nail targeting treatment. Int J Pharm 2020; 585:119497. [PMID: 32504773 DOI: 10.1016/j.ijpharm.2020.119497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/20/2020] [Accepted: 05/31/2020] [Indexed: 10/24/2022]
Abstract
Onychomycosis is a chronic nail disorder consisting of a fungal infection that causes physical and psychosocial discomfort to patients. However, its treatment remains challenging owing to the barrier of the highly keratinized nail plate and the short time that conventional formulations reside on nails. In this work, we developed an in situ film-forming system(IFFS) based on Eudragit® RLPO to co-deliver terbinafine hydrochloride (TBH) and urea, i.e., TBH-urea-RLPO IFFS, with the aim of overcoming the nail barrier, prolonging the residence time, and efficiently treating onychomycosis. The IFFS formulation formed a thin film with good appearance and adhesion upon application in situ. The physical states of TBH and urea in the film were evaluated with polarization microscopy and powder X-ray diffraction. TBH and urea were both amorphousmiscible components within the RLPO film. TBH release from TBH-urea-RLPO IFFS fitted to the Korsmeyer-Pappas model, and the cumulative release at 72 h was significantly higher than that from commercial preparations (Lamisil Pedisan® once). In vitro permeation of TBH from TBH-urea-RLPO IFFS through bovine hoof membranes was evaluated in comparison with the film containing TBH alone (TBH-RLPO) and commercial preparations. The retention and cumulative permeated amount of TBH were significantly enhanced for the TBH-urea-RLPO IFFS (170.80 ± 44.63 μg/cm2vs 75.49 ± 21.50 μg/cm2vs 60.25 ± 27.38 μg/cm2; 61.81 ± 16.09 μg/cm2vs 21.80 ± 11.56 μg/cm2vs 7.91 ± 1.03 μg/cm2, respectively), and the membranes treated with different formulations were observed with SEM and FTIR to identify the denaturing effect of urea on bovine hoof keratin. In vitro antifungal tests against Trichophyton rubrum,Microsporum canis, Fusarium, and Aspergillus fumigatus were cultured on Muller-Hinton agar; the findings indicated that TBH-urea-RLPO IFFS enhanced TBH antifungal activity. Overall, the results support that TBH-urea-RLPO IFFS is an efficient and promising approach for onychomycosis targeting treatment.
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Affiliation(s)
- Fengdie Yang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Xiuming Yu
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Weiyan Shao
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Penghao Guo
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Sisi Cao
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Meng Wang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Yixuan Wang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Chuanbin Wu
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Yuehong Xu
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
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Abstract
A deteriorating nail standard is a growing problem as the global prevalence of diabetes is increasing. Systemic treatment with mineral supplements may not be recommended, mainly due to the high doses required to deliver optimal therapeutic concentrations. In this work, we evaluate nail polish formulations for the local delivery of strengthening elements to the nail plate. Specifically, we assess calcium and silicon release from nail polish base coat formulations containing three different concentrations of White Portland Cement to water, as well as to artificial and human nails. The delivery of calcium and silicon to the dorsal nail plate was determined by inductively coupled plasma optical emission spectrometry, scanning electron microscopy, and energy dispersive X-ray spectroscopy. To the best of our knowledge, this is the first study showing that such dual elemental delivery to human nails can be achieved from nail polish formulations. Hence, this work may form the basis for new inventions where therapeutic functionalities can be integrated with the mechanical and cosmetic properties of a base coat nail polish. Future permeability studies are required to verify long-term effects on the nail standard, induced by the formulations under study.
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Sil BC, Patel A, Crowther JM, Moore DJ, Hadgraft J, Hilton ST, Lane ME. A Preliminary Investigation of Additive Manufacture to Fabricate Human Nail Plate Surrogates for Pharmaceutical Testing. Pharmaceutics 2019; 11:pharmaceutics11060250. [PMID: 31141993 PMCID: PMC6630397 DOI: 10.3390/pharmaceutics11060250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 12/31/2022] Open
Abstract
In vitro permeation studies using nail clippings or nail plates are commonly used in the development of transungual formulations. However, there are ethical, safety and cost issues associated with sourcing such tissues. Herein, we describe a preliminary approach is described for the design and manufacture of a human nail model surrogate based on 3D printing. To evaluate these 3D printed constructs, nails were mounted in conventional glass Franz cells and a commercial antifungal lacquer formulation containing ciclopirox olamine was applied daily to the surrogate printed surfaces for a period of 14 days. On days 8 and 14, the surfaces of the 3D printed nails were washed with ethanol to remove excess formulation. Confocal Raman spectroscopy (CRS) was used to profile the drug in the 3D printed nail. At the end of the Franz cell studies, no drug was observed in the receptor phase. CRS studies confirmed penetration of the active into the model nails with reproducible depth profiles. Our ongoing work is focused on synthesising commercial and non-commercial printable resins that can replicate the physical and chemical characteristics of the human nail. This will allow further evaluation of actives for ungual therapy and advance the development of the surrogate nail tissue model.
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Affiliation(s)
- Bruno C Sil
- School of Human Sciences, London Metropolitan University, 166-220 Holloway Road, London N7 8DB, UK.
| | - Avnish Patel
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK.
| | | | - David J Moore
- GSK Consumer Healthcare, Skin Health R&D, Weybridge KT13 0DE, UK.
| | - Jonathan Hadgraft
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK.
| | - Stephen T Hilton
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK.
| | - Majella E Lane
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK.
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