Hydroxychloroquine niosomes: A new trend in topical management of oral lichen planus

Hydroxychloroquine for the management of recalcitrant oral lichen planus

OBJECTIVE

The objective of this study is to describe the efficacy of hydroxychloroquine (HCQ) in patients with oral lichen planus (OLP) refractory to conventional therapy.

STUDY DESIGN

In this single-center retrospective study, patients were prescribed HCQ 200 mg twice daily. Pain, reticulation, erythema, and ulceration scores were recorded. Two-sample and paired t tests were used to evaluate mean and paired pain scores and paired t test to determine substantial differences in paired REU scores, at HCQ initiation visit and final follow-up at 12 to 24 months.

RESULTS

Thirty-six patients (69.4% female) with a median age of 70 ± 12.0 (range 48-99) were initiated on HCQ. Only 30 patients were evaluable because pruritus developed in 5 patients (13.9%) and gastrointestinal symptoms in 1 (2.8%). The mean follow-up was 23.2 months (range 1-74). In 19 patients, there was a significant decline in the worst pain score from a mean of 3.9 (SD± 2.8, n = 19) to 1.9 (SD ± 2.4, n = 19) (t = 2.837, P < .006). Paired reticulation, erythema, and ulceration (REU scores) decreased from a weighted mean score of 16.0 (SD ± 8.0, n = 12) to 12.0 (SD ± 6.3, n = 12) (t = 2.07, P < .032).

CONCLUSION

Hydroxychloroquine was a suitable option and effective in reducing symptoms and disease severity in patients with recalcitrant OLP who do not adequately respond to standard therapy.

Niosome as a promising tool for increasing the effectiveness of anti-inflammatory compounds

Niosomes are drug delivery systems with widespread applications in pharmaceutical research and the cosmetic industry. Niosomes are vesicles of one or more bilayers made of non-ionic surfactants, cholesterol, and charge inducers. Because of their bilayer characteristics, similar to liposomes, niosomes can be loaded with lipophilic and hydrophilic cargos. Therefore, they are more stable and cheaper in preparation than liposomes. They can be classified into four categories according to their sizes and structures, namely small unilamellar vesicles (SUVs), large unilamellar vesicles (LUVs,), multilamellar vesicles (MLVs), and multivesicular vesicles (MVVs). There are many methods for niosome preparation, such as thin-film hydration, solvent injection, and heating method. The current study focuses on the preparation methods and pharmacological effects of niosomes loaded with natural and chemical anti-inflammatory compounds in kinds of literature during the past decade. We found that most research was carried out to load anti-inflammatory agents like non-steroidal anti-inflammatory drugs (NSAIDs) into niosome vesicles. The studies revealed that niosomes could improve anti-inflammatory agents' physicochemical properties, including solubility, cellular uptake, stability, encapsulation, drug release and liberation, efficiency, and oral bioavailability or topical absorption. See also the graphical abstract(Fig. 1).

A Comprehensive Review on Niosomes as a Tool for Advanced Drug Delivery

Over the past few decades, advancements in nanocarrier-based therapeutic delivery have been significant, and niosomes research has recently received much interest. The self-assembled nonionic surfactant vesicles lead to the production of niosomes. The most recent nanocarriers, niosomes, are self-assembled vesicles made of nonionic surfactants with or without the proper quantities of cholesterol or other amphiphilic molecules. Because of their durability, low cost of components, largescale production, simple maintenance, and high entrapment efficiency, niosomes are being used more frequently. Additionally, they enhance pharmacokinetics, reduce toxicity, enhance the solubility of poorly water-soluble compounds, & increase bioavailability. One of the most crucial features of niosomes is their controlled release and targeted diffusion, which is utilized for treating cancer, infectious diseases, and other problems. In this review article, we have covered all the fundamental information about niosomes, including preparation techniques, niosomes types, factors influencing their formation, niosomes evaluation, applications, and administration routes, along with recent developments.

Hydroxychloroquine: Key therapeutic advances and emerging nanotechnological landscape for cancer mitigation

Hydroxychloroquine (HCQ) is a unique class of medications that has been widely utilized for the treatment of cancer. HCQ plays a dichotomous role by inhibiting autophagy induced by the tumor microenvironment (TME). Preclinical studies support the use of HCQ for anti-cancer therapy, especially in combination with conventional anti-cancer treatments since they sensitize tumor cells to drugs, potentiating the therapeutic activity. However, clinical evidence has suggested poor outcomes for HCQ due to various obstacles, including non-specific distribution, low aqueous solubility and low bioavailability at target sites, transport across tissue barriers, and retinal toxicity. These issues are addressable via the integration of HCQ with nanotechnology to produce HCQ-conjugated nanomedicines. This review aims to discuss the pharmacodynamic, pharmacokinetic and antitumor properties of HCQ. Furthermore, the antitumor performance of the nanoformulated HCQ is also reviewed thoroughly, aiming to serve as a guide for the HCQ-based enhanced treatment of cancers. The nanoencapsulation or nanoconjugation of HCQ with nanoassemblies appears to be a promising method for reducing the toxicity and improving the antitumor efficacy of HCQ.

PEGylated Tween 80-functionalized chitosan-lipidic nano-vesicular hybrids for heightening nose-to-brain delivery and bioavailability of metoclopramide

A PEGylated Tween 80-functionalized chitosan-lipidic (PEG-T-Chito-Lip) nano-vesicular hybrid was developed for intranasal administration as an alternative delivery route to help improve the poor oral bioavailability of BCS class-III model/antiemetic (metoclopramide hydrochloride; MTC). The influence of varying levels of chitosan, cholesterol, PEG 600, and Tween 80 on the stability/release parameters of the formulated nanovesicles was optimized using Draper-Lin Design. Two optimized formulations (Opti-Max and Opti-Min) with both maximized and minimized MTC-release goals, were predicted, characterized, and proved their vesicular outline via light/electron microscopy, along with the mutual prompt/extended in-vitro release patterns. The dual-optimized MTC-loaded PEG-T-Chito-Lip nanovesicles were loaded in intranasal in-situ gel (ISG) and further underwent in-vivo pharmacokinetics/nose-to-brain delivery valuation on Sprague-Dawley rats. The absorption profiles in plasma (plasma-AUC_0-∞) of the intranasal dual-optimized MTC-loaded nano-vesicular ISG formulation in pretreated rats were 2.95-fold and 1.64-fold more than rats pretreated with orally administered MTC and intranasally administered raw MTC-loaded ISG formulation, respectively. Interestingly, the brain-AUC_0-∞ of the intranasal dual-optimized MTC-loaded ISG was 10 and 3 times more than brain-AUC_0-∞ of the MTC-oral tablet and the intranasal raw MTC-loaded ISG, respectively. It was also revealed that the intranasal dual-optimized ISG significantly had the lowest liver-AUC_0-∞ (862.19 ng.g^-1.h^-1) versus the MTC-oral tablet (5732.17 ng.g^-1.h^-1) and the intranasal raw MTC-loaded ISG (1799.69 ng.g^-1.h^-1). The brain/blood ratio profile for the intranasal dual-optimized ISG was significantly enhanced over all other MTC formulations (P < 0.05). Moreover, the 198.55% drug targeting efficiency, 75.26% nose-to-brain direct transport percentage, and 4.06 drug targeting index of the dual-optimized formulation were significantly higher than those of the raw MTC-loaded ISG formulation. The performance of the dual-optimized PEG-T-Chito-Lip nano-vesicular hybrids for intranasal administration evidenced MTC-improved bioavailability, circumvented hepatic metabolism, and enhanced brain targetability, with increased potentiality in heightening the convenience and compliance for patients.

Niosome as an Effective Nanoscale Solution for the Treatment of Microbial Infections

Numerous disorders go untreated owing to a lack of a suitable drug delivery technology or an appropriate therapeutic moiety, particularly when toxicities and side effects are a major concern. Treatment options for microbiological infections are not fulfilled owing to significant adverse effects or extended therapeutic options. Advanced therapy options, such as active targeting, may be preferable to traditional ways of treating infectious diseases. Niosomes can be defined as microscopic lamellar molecules formed by a mixture of cholesterol, nonionic surfactants (alkyl or dialkyl polyglycerol ethers), and sometimes charge-inducing agents. These molecules comprise both hydrophilic and hydrophobic moieties of varying solubilities. In this review, several pathogenic microbes such as Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Plasmodium, Leishmania, and Candida spp. have been evaluated. Also, the development of a proper niosomal formulation for the required application was discussed. This review also reviews that an optimal formulation is dependent on several aspects, including the choice of nonionic surfactant, fabrication process, and fabrication parameters. Finally, this review will give information on the effectiveness of niosomes in treating acute microbial infections, the mechanism of action of niosomes in combating microbial pathogens, and the advantages of using niosomes over other treatment modalities.

Application of Box-Behnken Design in the Preparation, Optimization, and In-Vivo Pharmacokinetic Evaluation of Oral Tadalafil-Loaded Niosomal Film

Benign prostatic hyperplasia (BPH) affects about 90% of men whose ages are over 65. Tadalafil, a selective PDE-5 inhibitor, was approved by FDA for BPH, however, its poor aqueous solubility and bioavailability are considered major drawbacks. This work intended to develop and evaluate oral fast dissolving film containing tadalafil-loaded niosomes for those who cannot receive the oral dosage form. Niosomes were statistically optimized by Box-Behnken experimental design and loaded into a polymeric oral film. Niosomes were assessed for their vesicular size, uniformity, and zeta potential. The thickness, content uniformity, folding endurance, tensile strength, disintegration time, and surface morphology were evaluated for the prepared polymeric film. The optimized niosomes revealed high entrapment efficiency (99.78 ± 2.132%) and the film was smooth with good flexibility and convenient thickness (110 ± 10 µm). A fast release of tadalafil was achieved within 5 min significantly faster than the niosomes-free drug film. The in-vivo bioavailability in rats established that the optimized niosomal film enhanced tadalafil systemic absorption, with higher peak concentration (Cmax = 0.63 ± 0.03 µg/mL), shorter Tmax value (0.66-fold), and relative bioavailability of 118.4% compared to the marketed tablet. These results propose that the oral film of tadalafil-loaded niosomes is a suitable therapeutic application that can be passed with ease to geriatric patients who suffer from BPH.

A state-of-the-art review on the recent advances of niosomes as a targeted drug delivery system

The buildup of nonionic surfactants in the aqueous environment produces niosomes. The usage of niosomes is becoming increasingly frequent due to their sustainability, low cost of components and assembly, large-scale manufacture, and, finally, easy maintenance of the niosomes to the other. Because of their nonionic characteristics, niosomes play a critical role in medication delivery systems. Controlled release and targeted distribution of niosomes to treat cancer, infectious illnesses, and other disorders are one of their most important properties. Niosomes can also be injected by ocular and transdermal routes, which are less common than oral and parenteral administration. Using niosomes to manufacture biotechnology goods and novel vaccines is one of the most exciting research fields today. The molecular structure of niosomes, the physicochemical characteristics of nonionic surfactants in their formulation, the influence of external stimuli on niosomes, the many methods of niosomes administration, and their diverse therapeutic qualities are all explored in this study.

Tailoring of Selenium-Plated Novasomes for Fine-Tuning Pharmacokinetic and Tumor Uptake of Quercetin: In Vitro Optimization and In Vivo Radiobiodistribution Assessment in Ehrlich Tumor-Bearing Mice

Quercetin (QRC) is a bioflavonoid with anti-inflammatory, antioxidant, and anticancer activities, yet QRC poor bioavailability has hampered its clinical implementation. The aim of the current work was to harness novasomes (NOVs), free fatty acid enriched vesicles, as a novel nano-cargo for felicitous QRC delivery with subsequent functionalization with selenium (SeNOVs), to extend the systemic bio-fate of NOVs and potentiate QRC anticancer efficacy through the synergy with selenium. QRC-NOVs were primed embedding oleic acid, Brij 35, and cholesterol adopting thin-film hydration technique according to Box–Behnken design. Employing Design-Expert^® software, the impact of formulation variables on NOVs physicochemical characteristics besides the optimum formulation election were explored. Based on the optimal NOVs formulation, QRC-SeNOVs were assembled via electrostatic complexation/in situ reduction method. The MTT cytotoxicity assay of the uncoated, and coated nanovectors versus crude QRC was investigated in human rhabdomyosarcoma (RD) cells. The in vivo pharmacokinetic and biodistribution studies after intravenous administrations of technetium-99m (^99mTc)-labeled QRC-NOVs, QRC-SeNOVs, and QRC-solution were scrutinized in Ehrlich tumor-bearing mice. QRC-NOVs and QRC-SeNOVs disclosed entrapment efficiency of 67.21 and 70.85%, vesicle size of 107.29 and 129.16 nm, ζ potential of −34.71 and −43.25 mV, and accumulatively released 43.26 and 31.30% QRC within 24 h, respectively. Additionally, QRC-SeNOVs manifested a far lower IC₅₀ of 5.56 μg/mL on RD cells than that of QRC-NOVs (17.63 μg/mL) and crude QRC (38.71 μg/mL). Moreover, the biodistribution study elicited higher preferential uptake of ^99mTc-QRC-SeNOVs within the tumorous tissues by 1.73- and 5.67-fold as compared to ^99mTc-QRC-NOVs and ^99mTc-QRC-solution, respectively. Furthermore, the relative uptake efficiency of ^99mTc-QRC-SeNOVs was 5.78, the concentration efficiency was 4.74 and the drug-targeting efficiency was 3.21. Hence, the engineered QRC-SeNOVs could confer an auspicious hybrid nanoparadigm for QRC delivery with fine-tuned pharmacokinetics, and synergized antitumor traits.

Hydroxychloroquine- A new treatment option for erosive oral lichen planus

Context

Oral Lichen planus (OLP) is a chronic, debilitating, immune-mediated disease whose management is considered a challenge in medical science.

Aims

To quantitatively evaluate the effect of administration of enteral hydroxychloroquine (HCQS) as a monotherapy for six months on the extent and severity of erosive OLP using reticular score, erythema score and ulcerative score (REU score), and to subjectively evaluate the success of HCQS as a therapeutic drug for OLP-e using Tel Aviv-San Francisco Scale, visual analogue scale (VAS) and severity of burning sensation (BURN score).

Settings and Design

Prospective clinical trial.

Methods and Material

A total of 45 subjects received 200 mg of HCQS bid for six months. REU, VAS, BURN scores and Tel Aviv-San Francisco Scale readings were taken at the beginning of the study (baseline) and three- and six-month intervals post administration of enteral HCQS. Subjects were examined for any adverse drug outcomes for one year after the cessation of enteric HCQS therapy. Data were analysed with SPSS version 25.

Results

There was a stark reduction in REU, VAS and BURN scores during the study period, with a statistically significant reduction (P < 0.05) seen at three- and six-month time intervals as compared to baseline. Further, the mean of change in R, E and U scores showed a statistically significant difference, with the highest reduction seen at baseline to six-month time interval. The Tel Aviv-San Francisco Scale showed 70%-100% remission in disease in more than 70% of subjects.

Conclusions

Enteral HCQS can be considered a viable treatment option for the enigma that is erosive OLP.

Design, optimization, and in-vivo hypoglycaemic effect of nanosized glibenclamide for inhalation delivery

The aim of this research was the development and optimization of nanoniosomes for delivery of glibenclamide (Gbn) as hypoglycaemic agent to the lung in an inhaler dosage form. Fifteen formulae of niosomal dispersions were prepared according to Box-Behnken design. The effect of drug amount, Cholesterol molar ratio, and Hydrophilic lipophilic balance (HLB) values of the surfactant on the mean vesicle size, Zeta potential (ZP), polydispersity index (PDI), entrapment efficiency, and in-vitro released of Gbn were investigated. A quality control check was performed on an inhaler filled with the optimum nanoniosomal formula. The in-vivo hypoglycaemic effect of nanoniosomal inhalation was also evaluated. The vesicle size observed of the optimized formula was 172 ± 4.6 nm, PDI was 0.304 ± 0.06 and ZP was -49.9 ± 1.5 mv with 69 ± 9.3% in-vitro drug release after 2 h. The Cholesterol molar ratio and the HLB value showed a statistically significant effect on dependent variables. In-vivo results proved that nanoniosomes were efficiently delivered from the inhalation canister showing a mass median aerodynamic diameter of 1.4 micron. The inhaled nanoniosomal dispersion loaded with Gbn showed a decrease in blood glucose level of hyperglycaemic rats by 51.42 ± 5.2%± after 180 min which was nearly two folds compared to oral Gbn. Gibenclamide nanoniosomes inhaler could be suggested as a novel effective dosage form for the treatment of Diabetes mellitus.

Skin penetration/permeation success determinants of nanocarriers: Pursuit of a perfect formulation

The advent of nanocarriers in the field of pharmaceutical drug delivery, while exhibiting considerable advantages, has created challenges for researchers. Among the applications of nanocarriers, drug delivery to the skin has attracted increasing attention in recent decades due to its advantages over oral and parenteral administration. Accordingly, this work attempts to discuss the major obstacles surrounding topically applied formulations and different nanocarriers' potential to overcome these barriers to investigate whether their passive penetration through the skin is likely. Therefore, skin anatomical views and transcutaneous pathways are briefly reviewed. Factors commonly thought to influence skin penetration are discussed from the perspective of particularly penetrating nanocarriers. The formulation of these nanocarriers is outlined, and promising constituents are highlighted to help investigators optimize nanocarrier formulations.

Nanomedicine Reformulation of Chloroquine and Hydroxychloroquine

The chloroquine family of antimalarials has a long history of use, spanning many decades. Despite this extensive clinical experience, novel applications, including use in autoimmune disorders, infectious disease, and cancer, have only recently been identified. While short term use of chloroquine or hydroxychloroquine is safe at traditional therapeutic doses in patients without predisposing conditions, administration of higher doses and for longer durations are associated with toxicity, including retinotoxicity. Additional liabilities of these medications include pharmacokinetic profiles that require extended dosing to achieve therapeutic tissue concentrations. To improve chloroquine therapy, researchers have turned toward nanomedicine reformulation of chloroquine and hydroxychloroquine to increase exposure of target tissues relative to off-target tissues, thereby improving the therapeutic index. This review highlights these reformulation efforts to date, identifying issues in experimental designs leading to ambiguity regarding the nanoformulation improvements and lack of thorough pharmacokinetics and safety evaluation. Gaps in our current understanding of these formulations, as well as recommendations for future formulation efforts, are presented.

Research progress in the application of in situ hydrogel system in tumor treatment

The in situ hydrogel drug delivery system is a hot research topic in recent years. Combining both properties of hydrogel and solution, in situ hydrogels can provide many advantages for drug delivery application, including easy application, high local drug concentration, prolonged drug retention time, reduced drug dose in vivo, good biocompatibility and improved patient compliance, thus has potential in tumor treatment. In this paper, the related literature reports in recent years were reviewed to summarize and discuss the research progress and development prospects in the application of in situ hydrogels in tumor treatment.

Niosomal Drug Delivery Systems for Ocular Disease-Recent Advances and Future Prospects

The eye is a complex organ consisting of several protective barriers and particular defense mechanisms. Since this organ is exposed to various infections, genetic disorders, and visual impairments it is essential to provide necessary drugs through the appropriate delivery routes and vehicles. The topical route of administration, as the most commonly used approach, maybe inefficient due to low drug bioavailability. New generation safe, effective, and targeted drug delivery systems based on nanocarriers have the capability to circumvent limitations associated with the complex anatomy of the eye. Nanotechnology, through various nanoparticles like niosomes, liposomes, micelles, dendrimers, and different polymeric vesicles play an active role in ophthalmology and ocular drug delivery systems. Niosomes, which are nano-vesicles composed of non-ionic surfactants, are emerging nanocarriers in drug delivery applications due to their solution/storage stability and cost-effectiveness. Additionally, they are biocompatible, biodegradable, flexible in structure, and suitable for loading both hydrophobic and hydrophilic drugs. These characteristics make niosomes promising nanocarriers in the treatment of ocular diseases. Hereby, we review niosome based drug delivery approaches in ophthalmology starting with different preparation methods of niosomes, drug loading/release mechanisms, characterization techniques of niosome nanocarriers and eventually successful applications in the treatment of ocular disorders.

Niosomes: Do They Increase the Potency of Topical Natamycin Ketorolac Formula in Treating Aspergillus Keratitis? An Experimental Study

Purpose: Formulation of new drug delivery system as Natamycin (NT)-loaded nanoparticle niosomal formulae mixed in different polymer gel, with the addition of ketorolac tromethamine (KETR). Pharmaceutical and experimental assessments to evaluate their safety and efficacy in treating Aspergillus keratitis. Methods: NT nanoparticle niosomes prepared by reverse-phase evaporation technique were mixed in different polymers, with the addition of KETR. Two formulae are evaluated in this study: F1 [NT-loaded nanoparticle niosomes/0.5% KETR 4% carboxymethyl cellulose (Na.CMC) gel], F2 [NT-loaded nanoparticle niosomes/0.5% KETR 2% hydroxypropylmethyl cellulose (HPMC)-E4 gel], and mixed marketed products (MMP), namely Natamet^® and Ketoroline^® suspension eye drops. NT-loaded nanoparticle niosomes/0.5% KETR were evaluated through viscosity determination, mucoadhesive attractive force, and in vitro NT release studies. The in vivo antifungal evaluation was performed on 45 albino rabbits, Aspergillus species were inoculated in right corneas of all rabbits, and then rabbits were subdivided into 3 groups, 15 rabbits each: Group A: received F1, Group B: received F2, and Group C: received MMP. Daily examination of rabbits was performed for evaluation of corneal infiltration, and signs of iritis. Two weeks later, rabbits were euthanized; their corneas were dissected at the limbus and sent for histopathological evaluation. Results: F1 had a higher viscosity and more mucoadhesive power than F2, and showed better results on corneal infiltration, and level of hypopyon. These results were consistent with the histopathological examination. Conclusion: The formula of NT-loaded nanoparticle niosomes/0.5% KT 4% Na.CMC gel has the best results from all pharmaceutical in vitro evaluations and a better cure percent in experimental application.

Development and ex-vivo skin permeation studies of finasteride–poly(lactic acid-co-glycolic acid) and minoxidil–chitosan nanoparticulate systems

This study was designed to improve the permeability of two drugs (finasteride and minoxidil) through the skin. Finasteride-loaded poly(lactic acid- co-glycolic acid) and minoxidil-loaded chitosan nanoparticles were prepared by nanoprecipitation and ionic gelation method, respectively, and subsequently incorporated into semisolid Carbopol 940 gel. These fabricated nanoparticles were characterized for their pharmaceutical and chemical behavior. Nanoparticles were found a nearly spherical shape in the scanning electron microscopic studies and exhibited particle size in a range of 211–1012 nm. Finasteride- and minoxidil-loaded nanoparticles were optimized for relatively higher entrapment efficiency of 98% and 95%, respectively, by using the optimal concentration of polymers and stabilizers. All formulations were clear with smooth homogeneous texture and having pH values compatible with that of skin. This nanoparticulate system suspended in gel prolonged the release of drugs for up to 24 h and enhanced the drug permeability through the skin and retention of drug-loaded nanoparticles within the hair follicular routes. Therefore, these nanoparticles incorporated in the gel were found as a promising candidate for topical application in the treatment of alopecia by reducing the dosing frequency and adverse effects and as an effective strategy for improving the patient compliance toward therapy.

The Why, Where, Who, How, and What of the vesicular delivery systems

Though vesicular delivery systems have been widely explored and reviewed, no comprehensive review exists that covers their development from the inception of the concept to its culmination in the form of regulated marketed formulations. With the advancement of scientific research in the field of nanomedicine, certain category of vesicular delivery systems have successfully reached the global market. Despite extensive research and highly encouraging results in a plethora of pathological conditions in the preclinical studies, translation of these nanomedicines from laboratory to market has been very limited. Aim of this review is to describe comprehensively the various colloidal delivery systems, focusing mainly on their conventional and advanced methods of preparation, different characterization techniques and main success stories of their journey from bench to bedside of the patient. The review also touches the finer nuances of the use of modern formulation approach of DoE (Design of Experiments) in their formulation and the status of regulatory guidelines for the approval of these nanomedicines.

Recent advances in non-ionic surfactant vesicles (niosomes): Fabrication, characterization, pharmaceutical and cosmetic applications

Development of nanocarriers for drug delivery has received considerable attention due to their potential in achieving targeted delivery to the diseased site while sparing the surrounding healthy tissue. Safe and efficient drug delivery has always been a challenge in medicine. During the last decade, a large amount of interest has been drawn on the fabrication of surfactant-based vesicles to improve drug delivery. Niosomes are self-assembled vesicular nano-carriers formed by hydration of non-ionic surfactant, cholesterol or other amphiphilic molecules that serve as a versatile drug delivery system with a variety of applications ranging from dermal delivery to brain-targeted delivery. A large number of research articles have been published reporting their fabrication methods and applications in pharmaceutical and cosmetic fields. Niosomes have the same advantages as liposomes, such as the ability to incorporate both hydrophilic and lipophilic compounds. Besides, niosomes can be fabricated with simple methods, require less production cost and are stable over an extended period, thus overcoming the major drawbacks of liposomes. This review provides a comprehensive summary of niosomal research to date, it provides a detailed overview of the formulation components, types of niosomes, effects of components on the formation of niosomes, fabrication and purification methods, physical characterization techniques of niosomes, recent applications in pharmaceutical field such as in oral, ocular, topical, pulmonary, parental and transmucosal drug delivery, and cosmetic applications. Finally, limitations and the future outlook for this delivery system have also been discussed.

Clinical Management of Oral Lichen Planus: A Systematic Review

Aim:

The clinical management of OLP represents a considerable challenge for the oral physician. The aim of this review is to assess the main intervention used in the management of OLP and the efficacy of every type of treatment.

Materials & Methods:

We searched and analyzed PubMed database for articles on OLP management. Only randomized controlled trials, comparing an active treatment with placebo, or between different active treatments, were considered in this systematic review. Only patients with symptomatic OLP were included and interventions of all types were considered (topical treatment, systemic drugs, non pharmacological intervention).

Results:

A total of 25 randomized controlled trials were examined and included in this review. Steroids are the most frequently employed drug in the treatment of OLP and their efficacy and safety are demonstrated. Also calcineurin inhibitors and photo-dynamic therapy are used in different studies for OLP management, with positive results.

Conclusion:

Topical steroids remain the first-line treatment for symptomatic OLP, however, many different pharmacological and non-pharmacological therapies would represent a valid alternative for its management, but, nowadays they require further investigations.

In vitro and in vivo investigation for optimization of niosomal ability for sustainment and bioavailability enhancement of diltiazem after nasal administration

Diltiazem hydrochloride (DTZ) is a calcium channel antagonist depicted by extensive first pass metabolism and low oral bioavailability. The aim of this work was to develop niosomes for potential nasal delivery of DTZ. Niosomes protect hydrophilic drugs inside their core while nasal route offers both rapid onset and evasion of first-pass metabolism. Niosomes were prepared using a combination of Span 60 or Brij-52 with cholesterol (CHOL) in different molar ratios followed by determination of entrapment efficiency, particle size and in vitro drug release. A parallel design was adopted to evaluate the pharmacokinetic performance of DTZ-loaded niosomes in male Wistar rats. Non-compartmental analysis was performed where Cmax, Tmax, t1/2, MRT, area under the release curve (AUC) and Ke were assessed. The prepared niosomes were spherical with mean particle size 0.82-1.59 μm. Span 60-cholesterol niosomes (1:1 molar ratio) showed the highest entrapment and release efficiencies. In vivo study revealed an increase in MRT, t1/2 and AUC with a decrease in Ke. In conclusion, nasal niosomal formulation of DTZ expressed suitable pharmacokinetic parameters and bioavailability through prolonged duration of action inside the body as well as low rate of elimination depicting a promising alternate to the conventional oral route.

Development of Polyethylene Glycol and Hard Fat-Based Mucoadhesive Tablets Containing Various Types of Polyvinyl Alcohols as Mucoadhesive Polymers for Buccal Application

Topical drug application has the advantage of avoiding systemic side effects. We attempted to develop a long-acting matrix-type tablet containing indomethacin (IM) with low physical stimulus and potent mucoadhesive force to treat pain caused by oral aphtha. A mixture of polyethylene glycol (PEG) and hard fat was used as the tablet base. Ethylcellulose was added to the base in an attempt to control drug release. Tablets with PEG as a base were also prepared for comparison. Polyvinyl alcohols (PVAs) with various degrees of saponification were added to increase the mucoadhesive force. From the optical microscopic observations, formulations using PEG and hard fat exhibit PEG/hard fat dispersions caused by the stabilizing effects of PVA. Although the tablets using PEG and hard fat showed sufficient adhesiveness and sustained drug release, those using PEG as the base did not. Drug release was controlled by the amount of hard fat and the saponification degree of PVA. The drug release rate was most increased in a tablet containing PVA with an intermediate degree of saponification, PEG and hard fat. From differential scanning calorimetry and powder X-ray diffraction, IM was considered to exist in the molecular phase. From the results of buccal administration of tablets to rats, highest tissue concentrations were observed in the tablet containing PVA with the intermediate degree of saponification using PEG and hard fat, and the plasma concentrations were sufficiently low in comparison.

Oral delivery of allopurinol niosomes in treatment of gout in animal model

CONTEXT

Gout is a painful disorder which does not have an efficient delivery system for its treatment.

OBJECTIVE

Development and in vitro, in vivo evaluation of allopurinol-loaded nonionic surfactant-based niosomes was envisaged.

MATERIALS AND METHODS

Niosomes were prepared with Span 20 and Tween 20 (1:1 molar ratio) using ether injection method. The formulations were screened for entrapment efficiency, particle size analysis, zeta potential, release kinetics, in vivo activity, and stability studies.

RESULT

Stable, spherical vesicles of average particle size 304 nm with zeta-potential and entrapment efficiency of 22.2 mV and 79.44 ± 0.02%, respectively, were produced. In vitro release study revealed 82.16 ± 0.04% release of allopurinol within 24 h. The niosomal formulation was further evaluated for its antigout potential in monosodium urate (MSU) crystal induced gout animal model. The formulation demonstrated significant uric acid level reduction and enhanced antigout activity when compared with the pure allopurinol.

DISCUSSION

The better antigout activity displayed by niosomal formulation could be attributed to sustained release of drug, higher drug solubility within biological fluids, better membrane interaction, smaller size, and presence of cholesterol and surfactant.

CONCLUSIONS

This study reveals that niosomes can be an efficient delivery system for the treatment of gout.

Non-Ionic Surfactant Vesicles (Niosomes) as New Drug Delivery Systems

Lipid vesicular systems composed of hydrated amphihiles with or without bilayer inducing agents such as cholesterol. On the basis of used amphiphilic molecule different nomenclature are used as liposomes, ufasomes and niosomes. Nonionic surfactants with mono-, di- or trialkyl chains form niosomes which are lipid vesicles with more chemical stability in comparison with phospholipids of liposomes. Both hydrophobic and hydrophilic chemicals can be encapsulated in niosomes as a new drug delivery system. This drug carrier system could have administered via injection, oral, pulmonary, vaginal, rectal, ophthalmic, nasal or transdermal routes with penetration enhancing potential. This chapter presents a detailed explain about niosome forming components, methods of preparation and routes of administration. Many examples for drug delivery potential of niosomes are also available in this review. Vaccine adjuvant and genetic substances vector capabilities are not given here.

Non-Ionic Surfactant Vesicles (Niosomes) as New Drug Delivery Systems

Lipid vesicular systems composed of hydrated amphihiles with or without bilayer inducing agents such as cholesterol. On the basis of used amphiphilic molecule different nomenclature are used as liposomes, ufasomes and niosomes. Nonionic surfactants with mono-, di- or trialkyl chains form niosomes which are lipid vesicles with more chemical stability in comparison with phospholipids of liposomes. Both hydrophobic and hydrophilic chemicals can be encapsulated in niosomes as a new drug delivery system. This drug carrier system could have administered via injection, oral, pulmonary, vaginal, rectal, ophthalmic, nasal or transdermal routes with penetration enhancing potential. This chapter presents a detailed explain about niosome forming components, methods of preparation and routes of administration. Many examples for drug delivery potential of niosomes are also available in this review. Vaccine adjuvant and genetic substances vector capabilities are not given here.

Topically applied lipid- and surfactant-based nanoparticles in the treatment of skin disorders

INTRODUCTION

In the treatment of dermatological disorders, topical drug administration is a mainstay. However, nanoparticle-based carrier systems could improve and expand the current therapeutic range via localized delivery of active ingredients. Areas covered: This review gives a detailed description of lipid- and surfactant-based drug delivery systems which have been explored for topical drug administration. To guide researchers in their choice of delivery system, an informative decision tree is included. Moreover, this review provides a complete overview of the topical or transdermal drug products, currently on the market or under clinical investigation, delivered via the discussed carriers, in the treatment of skin disorders. Expert opinion: Conventional liposomes are still popular in the domain of topical or transdermal drug delivery and dominate the market landscape. However, several other carriers, such as exosomes and niosomes, are being explored which offer distinct advantages over liposomes and should therefore not be disregarded when selecting a proper drug delivery system.

Trans-nasal zolmitriptan novasomes: in-vitro preparation, optimization and in-vivo evaluation of brain targeting efficiency

Migraine attack is a troublesome physiological condition associated with throbbing, intense headache, in one half of the head. Zolmitriptan is a potent second-generation triptan, prescribed for patients with migraine attacks, with or without an aura, and cluster headaches. The absolute bioavailability of zolmitriptan is about 40% for oral administration; due to hepatic first metabolism. Nasal administration would circumvent the pre-systemic metabolism thus increasing the bioavailability of zolmitriptan. In addition, due to the presence of microvilli and high vasculature, the absorption is expected to be faster compared to oral route. However, the bioavailability of nasal administered drugs is particularly restricted by poor membrane penetration. Thus, the aim of this work is to explore the potential of novel nanovesicular fatty acid enriched structures (novasomes) for effective and enhanced nasal delivery of zolmitriptan and investigate their nose to brain targeting potential. Novasomes were prepared using nonionic surfactant, cholesterol in addition to a free fatty acid. A 2³ full factorial design was adopted to study the influence of the type of surfactant, type of free fatty acid and ratio between the free fatty acid and the surfactant on novasomes properties. The particle size, entrapment efficiency, polydispersity index, zeta potential and % zolmitriptan released after 2 h were selected as dependent variables. Novasomes were further optimized using Design Expert® software (version 7; Stat-Ease Inc., Minneapolis, MN), and an optimized formulation composed of Span® 80:Cholesterol:stearic acid (in the ratio 1:1:1) was selected. This formulation showed zolmitriptan entrapment of 92.94%, particle size of 149.9 nm, zeta potential of -55.57 mV, and released 48.43% zolmitriptan after 2 h. The optimized formulation was further examined using transmission electron microscope, which revealed non-aggregating multi-lamellar nanovesicles with narrow size distribution. DSC, XRD examination of the optimized formulation confirmed that the drug have been homogeneously dispersed throughout the novasomes in an amorphous state. In-vivo bio-distribution studies of ^99mTc radio-labeled intranasal zolmitriptan loaded novasomes were done on mice, the pharmacokinetic parameters were compared with those following administration of intravenous ^99mTc-zolmitriptan solution. Results revealed the great enhancement in zolmitriptan targeting to the brain, with drug targeting potential of about 99% following intranasal administration of novasomes compared with the intravenous drug solution. Zolmitriptan loaded novasomes administered via the nasal route may therefore constitute an advance in the management of acute migraine attacks.

Advances in lipid-based drug delivery: enhancing efficiency for hydrophobic drugs

INTRODUCTION

Many drug candidates with high therapeutic efficacy have low water solubility, which limits the administration and transport across physiological barriers, for example, the tumor tissue barrier. Therefore, strategies are needed to permeabilize the physiological barriers safely so that hydrophobic drugs may be delivered efficiently.

AREAS COVERED

This review focuses on prospects for therapeutic application of lipid-based drug delivery carriers that increase hydrophobic drugs to improve their solubility, bioavailability, drug release, targeting and absorption. Moreover, novel techniques to prepare for lipid-based drug delivery to extend pharmaceuticals with poor bioavailability such as surface modifications of lipid-based drug delivery are presented. Industrial developments of several drug candidates employing these strategies are discussed, as well as applications and clinical trials.

EXPERT OPINION

Overall, hydrophobic drugs can be encapsulated in the lipid-based drug delivery systems, represent a relatively safe and promising strategy to extend drug retention, lengthen the lifetime in the circulation, and allow active targeting to specific tissues and controllable drug release in the desirable sites. However, there are still noticeable gaps that need to be filled before the theoretical advantage of these formulations may truly be realized such as investigation on the use of lipid-based drug delivery for administration routes. This research may provide further interest within the area of lipid-based systems, both in industry and in the clinic.