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Lefebvre È, Tawil N, Yahia L. Transdermal Delivery of Cannabidiol for the Management of Acute Inflammatory Pain: A Comprehensive Review of the Literature. Int J Mol Sci 2024; 25:5858. [PMID: 38892047 PMCID: PMC11172078 DOI: 10.3390/ijms25115858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
The emerging field of nanotechnology has paved the way for revolutionary advancements in drug delivery systems, with nanosystems emerging as a promising avenue for enhancing the therapeutic potential and the stability of various bioactive compounds. Among these, cannabidiol (CBD), the non-psychotropic compound of the Cannabis sativa plant, has gained attention for its therapeutic properties. Consequently, researchers have devoted significant efforts to unlock the full potential of CBD's clinical benefits, where various nanosystems and excipients have emerged to overcome challenges associated with its bioavailability, stability, and controlled release for its transdermal application. Therefore, this comprehensive review aims to explain CBD's role in managing acute inflammatory pain and offers an overview of the state of the art of existing delivery systems and excipients for CBD. To summarize this review, a summary of the cannabinoids and therapeutical targets of CBD will be discussed, followed by its conventional modes of administration. The transdermal route of administration and the current topical and transdermal delivery systems will also be reviewed. This review will conclude with an overview of in vivo techniques that allow the evaluation of the anti-inflammatory and analgesic potentials of these systems.
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Affiliation(s)
- Ève Lefebvre
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada;
| | - Nancy Tawil
- Qeen BioTechnologies, Gatineau, QC J9J 3K3, Canada;
| | - L’Hocine Yahia
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada;
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Areses-Huete T, Cordoba-Diaz D, Torres-Suárez AI, Cordoba-Diaz M. Development and Characterization of a Microemulsion Containing a Cannabidiol Oil and a Hydrophilic Extract from Sambucus ebulus for Topical Administration. Pharmaceutics 2024; 16:705. [PMID: 38931831 PMCID: PMC11206346 DOI: 10.3390/pharmaceutics16060705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Cannabidiol (CBD) is a safe and non-psychotropic phytocannabinoid with a wide range of potential therapeutic anti-inflamatory and antioxidant activities. Due to its lipophilicity, it is normally available dissolved in oily phases. The main aim of this work was to develop and characterize a new formulation of a microemulsion with potential anti-inflammatory and antioxidant activity for the topical treatment of inflammatory skin disorders. The microemulsion system was composed of a 20% CBD oil, which served as the hydrophobic phase; Labrasol/Plurol Oleique (1:1), which served as surfactant and cosurfactant (S/CoS), respectively; and an aqueous vegetal extract obtained from Sambucus ebulus L. (S. ebulus) ripe fruits, which has potential anti-oxidant and anti-inflammatory activity and which served as the aqueous phase. A pseudo-ternary phase diagram was generated, leading to the selection of an optimal proportion of 62% (S/CoS), 27% CBD oil and 11% water and, after its reproducibility was tested, the aqueous phases were replaced by the vegetal hydrophilic extract. The defined systems were characterized in terms of conductivity, droplet size (by laser scattering), compatibility of components (by differential scanning calorimetry) and rheological properties (using a rotational rheometer). The designed microemulsion showed good stability and slight pseudo-plastic behavior. The release properties of CBD from the oil phase and caffeic acid from the aqueous phase of the microemulsion were studied via in vitro diffusion experiments using flow-through diffusion cells and were compared to those of a CBD oil and a microemulsion containing only CBD as an active substance. It was found that the inclusion of the original oil in microemulsions did not result in a significant modification of the release of CBD, suggesting the possibility of including hydrophilic active compounds in the formulation and establishing an interesting strategy for the development of future formulations.
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Affiliation(s)
- Teresa Areses-Huete
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, E-28040 Madrid, Spain; (T.A.-H.); (D.C.-D.); (A.I.T.-S.)
| | - Damian Cordoba-Diaz
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, E-28040 Madrid, Spain; (T.A.-H.); (D.C.-D.); (A.I.T.-S.)
- University Institute of Industrial Pharmacy (IUFI), Complutense University of Madrid, E-28040 Madrid, Spain
| | - Ana Isabel Torres-Suárez
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, E-28040 Madrid, Spain; (T.A.-H.); (D.C.-D.); (A.I.T.-S.)
- University Institute of Industrial Pharmacy (IUFI), Complutense University of Madrid, E-28040 Madrid, Spain
| | - Manuel Cordoba-Diaz
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, E-28040 Madrid, Spain; (T.A.-H.); (D.C.-D.); (A.I.T.-S.)
- University Institute of Industrial Pharmacy (IUFI), Complutense University of Madrid, E-28040 Madrid, Spain
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3
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Bawa Z, Lewis D, Gavin PD, Libinaki R, Joubran L, El-Tamimy M, Taylor G, Meltzer R, Bedoya-Pérez M, Kevin RC, McGregor IS. An open-label feasibility trial of transdermal cannabidiol for hand osteoarthritis. Sci Rep 2024; 14:11792. [PMID: 38783008 PMCID: PMC11116491 DOI: 10.1038/s41598-024-62428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
Hand osteoarthritis (OA) is an irreversible degenerative condition causing chronic pain and impaired functionality. Existing treatment options are often inadequate. Cannabidiol (CBD) has demonstrated analgesic and anti-inflammatory effects in preclinical models of arthritis. In this open-label feasibility trial, participants with symptomatically active hand OA applied a novel transdermal CBD gel (4% w/w) three times a day for four weeks to their most painful hand. Changes in daily self-reported pain scores were measured on a 0-10 Numeric Pain Rating Scale (NPRS). Hand functionality was determined via daily grip strength measures using a Bluetooth equipped squeeze ball and self-report questionnaire. Quality of life (QoL) ratings around sleep, anxiety, stiffness and fatigue were also measured. All self-report measures and grip strength data were gathered via smartphone application. Urinalysis was conducted at trial end to determine systemic absorption of CBD. Eighteen participants were consented and 15 completed the trial. Pain ratings were significantly reduced over time from pre-treatment baseline including current pain (- 1.91 ± 0.35, p < 0.0001), average pain (- 1.92 ± 0.35, p < 0.0001) and maximum pain (- 1.97 ± 0.34, p < 0.0001) (data represent mean reduction on a 0-10 NPRS scale ± standard error of the mean (SEM)). A significant increase in grip strength in the treated hand (p < 0.0001) was observed although self-reported functionality did not improve. There were significant (p < 0.005) improvements in three QoL measures: fatigue, stiffness and anxiety. CBD and its metabolites were detected at low concentrations in all urine samples. Measured reductions in pain and increases in grip strength seen during treatment reverted back towards baseline during the washout phase. In summary, pain, grip strength and QoL measures, using smartphone technology, was shown to improve over time following transdermal CBD application suggesting feasibility of this intervention in relieving osteoarthritic hand pain. Proof of efficacy, however, requires further confirmation in a placebo-controlled randomised trial.Trial registration: ANZCTR public trials registry (ACTRN12621001512819, 05/11/2021).
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Affiliation(s)
- Zeeta Bawa
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Lewis
- The Daniel Lewis Rheumatology Centre, Melbourne, Victoria, Australia
| | - Paul D Gavin
- Avecho Biotechnology, Melbourne , Victoria, Australia
| | | | - Lida Joubran
- Avecho Biotechnology, Melbourne , Victoria, Australia
| | | | - Greg Taylor
- The NTF Group, Sydney, New South Wales, Australia
| | - Ryan Meltzer
- The NTF Group, Sydney, New South Wales, Australia
| | - Miguel Bedoya-Pérez
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard C Kevin
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia.
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.
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Cheng A, Zhang S, Meng F, Xing M, Liu H, Yang G, Gao Y. Nanosuspension-Loaded Dissolving Microneedle Patches for Enhanced Transdermal Delivery of a Highly Lipophilic Cannabidiol. Int J Nanomedicine 2024; 19:4061-4079. [PMID: 38736651 PMCID: PMC11088408 DOI: 10.2147/ijn.s452207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose Transdermal Drug Delivery System (TDDS) offers a promising alternative for delivering poorly soluble drugs, challenged by the stratum corneum's barrier effect, which restricts the pool of drug candidates suitable for TDDS. This study aims to establish a delivery platform specifically for highly lipophilic drugs requiring high doses (log P > 5, dose > 10 mg/kg/d), to improve their intradermal delivery and enhance solubility. Methods Cannabidiol (CBD, log P = 5.91) served as the model drug. A CBD nanosuspension (CBD-NS) was prepared using a bottom-up method. The particle size, polydispersity index (PDI), zeta potential, and concentration of the CBD-NS were characterized. Subsequently, CBD-NS was incorporated into dissolving microneedles (DMNs) through a one-step manufacturing process. The intradermal dissolution abilities, physicochemical properties, mechanical strength, insertion depth, and release behavior of the DMNs were evaluated. Sprague-Dawley (SD) rats were utilized to assess the efficacy of the DMN patch in treating knee synovitis and to analyze its skin permeation kinetics and pharmacokinetic performance. Results The CBD-NS, stabilized with Tween 80, exhibited a particle size of 166.83 ± 3.33 nm, a PDI of 0.21 ± 0.07, and a concentration of 46.11 ± 0.52 mg/mL. The DMN loaded with CBD-NS demonstrated favorable intradermal dissolution and mechanical properties. It effectively increased the delivery of CBD into the skin, extended the action's duration in vivo, and enhanced bioavailability. CBD-NS DMN exhibited superior therapeutic efficacy and safety in a rat model of knee synovitis, significantly inhibiting TNF-α and IL-1β compared with the methotrexate subcutaneous injection method. Conclusion NS technology effectively enhances the solubility of the poorly soluble drug CBD, while DMN facilitates penetration, extends the duration of action in vivo, and improves bioavailability. Furthermore, CBD has shown promising therapeutic outcomes in treating knee synovitis. This innovative drug delivery system is expected to offer a more efficient solution for the administration of highly lipophilic drugs akin to CBD, thereby facilitating high-dose administration.
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Affiliation(s)
- Aguo Cheng
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry of Chinese Academy of Sciences, Beijing, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Suohui Zhang
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry of Chinese Academy of Sciences, Beijing, People’s Republic of China
- Beijing CAS Microneedle Technology Ltd, Beijing, People’s Republic of China
| | - Fanda Meng
- School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, People’s Republic of China
| | - Mengzhen Xing
- Key Laboratory of New Material Research Institute, Department of Pharmaceutical Research Institute, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Han Liu
- Beijing CAS Microneedle Technology Ltd, Beijing, People’s Republic of China
| | - Guozhong Yang
- Beijing CAS Microneedle Technology Ltd, Beijing, People’s Republic of China
| | - Yunhua Gao
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry of Chinese Academy of Sciences, Beijing, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing, People’s Republic of China
- Beijing CAS Microneedle Technology Ltd, Beijing, People’s Republic of China
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Khairnar P, Phatale V, Shukla S, Tijani AO, Hedaoo A, Strauss J, Verana G, Vambhurkar G, Puri A, Srivastava S. Nanocarrier-Integrated Microneedles: Divulging the Potential of Novel Frontiers for Fostering the Management of Skin Ailments. Mol Pharm 2024; 21:2118-2147. [PMID: 38660711 DOI: 10.1021/acs.molpharmaceut.4c00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The various kinds of nanocarriers (NCs) have been explored for the delivery of therapeutics designed for the management of skin manifestations. The NCs are considered as one of the promising approaches for the skin delivery of therapeutics attributable to sustained release and enhanced skin penetration. Despite the extensive applications of the NCs, the challenges in their delivery via skin barrier (majorly stratum corneum) have persisted. To overcome all the challenges associated with the delivery of NCs, the microneedle (MN) technology has emerged as a beacon of hope. Programmable drug release, being painless, and its minimally invasive nature make it an intriguing strategy to circumvent the multiple challenges associated with the various drug delivery systems. The integration of positive traits of NCs and MNs boosts therapeutic effectiveness by evading stratum corneum, facilitating the delivery of NCs through the skin and enhancing their targeted delivery. This review discusses the barrier function of skin, the importance of MNs, the types of MNs, and the superiority of NC-loaded MNs. We highlighted the applications of NC-integrated MNs for the management of various skin ailments, combinational drug delivery, active targeting, in vivo imaging, and as theranostics. The clinical trials, patent portfolio, and marketed products of drug/NC-integrated MNs are covered. Finally, regulatory hurdles toward benchtop-to-bedside translation, along with promising prospects needed to scale up NC-integrated MN technology, have been deliberated. The current review is anticipated to deliver thoughtful visions to researchers, clinicians, and formulation scientists for the successful development of the MN-technology-based product by carefully optimizing all the formulation variables.
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Affiliation(s)
- Pooja Khairnar
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Vivek Phatale
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Shalini Shukla
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Akeemat O Tijani
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Aachal Hedaoo
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Jordan Strauss
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Gabrielle Verana
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Ganesh Vambhurkar
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Ashana Puri
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Saurabh Srivastava
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
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Sera L, Hempel-Sanderoff C. Cannabis Science and Therapeutics: An Overview for Clinicians. J Clin Pharmacol 2024; 64:499-513. [PMID: 38145388 DOI: 10.1002/jcph.2400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
Cannabis-based therapeutics have garnered increasing attention in recent years as patients seek alternative treatments for various medical conditions. This narrative review provides a comprehensive overview of the science behind the medical use of cannabis, focusing on the medical evidence for commonly treated conditions. In addition, the review addresses the practical considerations of using cannabis as a therapeutic agent, offering insights into dosing strategies, variations in cannabinoid formulation, and individual patient responses. Precautions, adverse consequences, and drug interactions are also discussed, with a focus on patient safety and the potential risks associated with cannabis use.
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Affiliation(s)
- Leah Sera
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Carrie Hempel-Sanderoff
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
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7
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Torabi A, Madsen FB, Skov AL. Permeation-Enhancing Strategies for Transdermal Delivery of Cannabinoids. Cannabis Cannabinoid Res 2024; 9:449-463. [PMID: 37751171 DOI: 10.1089/can.2023.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Introduction: This review aims to provide an overview of the advancements and status of clinical studies and potential permeation-enhancing strategies in the transdermal delivery of cannabinoids. Methods: A systematic and comprehensive literature search across academic databases, search engines, and online sources to identify relevant literature on the transdermal administration of cannabinoids. Results: Cannabinoids have proven beneficial in the treatment of wide-ranging physical and psychological disorders. A shift toward legalized cannabinoid products has increased both interests in cannabinoid research and the development of novel medicinal exploitations of cannabinoids in recent years. Oral and pulmonary delivery of cannabinoids has several limitations, including poor bioavailability, low solubility, and potential side effects. This has diverted scientific attention toward the transdermal route, successfully overcoming these hurdles by providing higher bioavailability, safety, and patient compliance. Yet, due to the barrier properties of the skin and the lipophilic nature of cannabinoids, there is a need to increase the permeation of the drugs to the underneath layers of skin to reach desired therapeutic plasma levels. Literature describing detailed clinical trials on cannabinoid transdermal delivery, either with or without permeation-enhancing strategies, is limited. Conclusion: The limited number of reports indicates that increased attention is needed on developing and examining efficient transdermal delivery systems for cannabinoids, including patch design and composition, drug-patch interaction, clinical effectiveness and safety in vivo, and permeation-enhancing strategies.
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Affiliation(s)
- Atefeh Torabi
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Frederikke Bahrt Madsen
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anne Ladegaard Skov
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
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8
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Kesavan Pillai S, Hassan Kera N, Kleyi P, de Beer M, Magwaza M, Ray SS. Stability, biofunctional, and antimicrobial characteristics of cannabidiol isolate for the design of topical formulations. SOFT MATTER 2024; 20:2348-2360. [PMID: 38372296 DOI: 10.1039/d3sm01466e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Cannabidiol (CBD) is a high-value natural compound of Cannabis Sativa plant. It is a non-psychotropic phytocannabinoid, attracting significant attention as a multifunctional active ingredient for topical applications. Although it is demonstrated that CBD can be used for specific dermatological ailments, reliable data on functionalities are limited. The present study aimed to investigate the structural stability, biofunctionality, and antimicrobial characteristics of CBD isolate to assist in the design of various topical formulations. The stability of CBD in solid and solubilized states was assessed to establish storage and formulation conditions. The performance of CBD solubilized in organic and aqueous media was evaluated for free radical scavenging, tyrosinase, and collagenase enzyme inhibition, which showed good prospects for the ingredient. The antimicrobial activity of solubilized CBD was evaluated against Gram-negative (E. coli, P. aeruginosa), Gram-positive bacterial strains (S. aureus, S. epidermidis, C. acnes), and fungal strains (C. albicans, M. furfur) using agar well diffusion and broth microdilution methods. Due to the presence of surfactants in CBD aqueous solution, it displayed a lack of antimicrobial activity against all the tested microorganisms. CBD solubilized in an organic medium showed no activity against Gram-negative bacterial strains but higher activity against tested Gram-positive bacterial and fungal strains.
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Affiliation(s)
- Sreejarani Kesavan Pillai
- Centre for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology Innovation Centre, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
| | - Nazia Hassan Kera
- Centre for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology Innovation Centre, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
- Department of Chemical Sciences, University of Johannesburg, Droonfontein 2028, Johannesburg, South Africa.
| | - Phumelele Kleyi
- Centre for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology Innovation Centre, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
| | - Marinda de Beer
- Centre for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology Innovation Centre, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
| | - Matin Magwaza
- Tautomer Bioscience Pty Ltd., 260 Cradock Ave, Lyttelton Manor, Centurion, 0157, South Africa
| | - Suprakas Sinha Ray
- Centre for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology Innovation Centre, Council for Scientific and Industrial Research, Pretoria 0001, South Africa.
- Department of Chemical Sciences, University of Johannesburg, Droonfontein 2028, Johannesburg, South Africa.
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9
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Zamarripa CA, Tilton HE, Lin S, Cone EJ, Winecker RE, Flegel RR, Kuntz D, Beals M, Jacques M, Clark M, Welsh ER, Wagner L, Bonn-Miller MO, Vandrey R, Spindle TR. Pharmacokinetics and pharmacodynamics of five distinct commercially available hemp-derived topical cannabidiol products. J Anal Toxicol 2024; 48:81-98. [PMID: 38217086 DOI: 10.1093/jat/bkae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/15/2024] Open
Abstract
Products containing cannabidiol (CBD) have proliferated after the 2018 Farm Bill legalized hemp (cannabis with ≤0.3% delta-9-tetrahydrocannabinol (Δ9-THC)). CBD-containing topical products have surged in popularity, but controlled clinical studies on them are limited. This study characterized the effects of five commercially available hemp-derived high CBD/low Δ9-THC topical products. Healthy adults (N = 46) received one of six study drugs: a CBD-containing cream (N = 8), lotion (N = 8), patch (N = 7), balm (N = 8), gel (N = 6) or placebo (N = 9; matched to an active formulation). The protocol included three phases conducted over 17 days: (i) an acute drug application laboratory session, (ii) a 9-day outpatient phase with twice daily product application (visits occurred on Days 2, 3, 7 and 10) (iii) a 1-week washout phase. In each phase, whole blood, oral fluid and urine specimens were collected and analyzed via liquid chromatography with tandem mass spectrometry (LC-MS-MS) for CBD, Δ9-THC and primary metabolites of each and pharmacodynamic outcomes (subjective, cognitive/psychomotor and physiological effects) were assessed. Transdermal absorption of CBD was observed for three active products. On average, CBD/metabolite concentrations peaked after 7-10 days of product use and were highest for the lotion, which contained the most CBD and a permeation enhancer (vitamin E). Δ9-THC/metabolites were below the limit of detection in blood for all products, and no urine samples tested "positive" for cannabis using current US federal workplace drug testing criteria (immunoassay cut-off of 50 ng/mL and confirmatory LC-MS-MS cut-off of 15 ng/mL). Unexpectedly, nine participants (seven lotions, one patch and one gel) exhibited Δ9-THC oral fluid concentrations ≥2 ng/mL (current US federal workplace threshold for a "positive" test). Products did not produce discernable pharmacodynamic effects and were well-tolerated. This study provides important initial data on the acute/chronic effects of hemp-derived topical CBD products, but more research is needed given the diversity of products in this market.
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Affiliation(s)
- C Austin Zamarripa
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Hayleigh E Tilton
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Spencer Lin
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Edward J Cone
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Ruth E Winecker
- RTI International, Research Triangle Park, 3040 East Cornwallis Rd., Durham, NC 27709, USA
| | - Ronald R Flegel
- Substance Abuse and Mental Health Services Administration (SAMHSA), Division of Workplace Programs (DWP), 5600 Fishers Lane, Rockville, MD 20857, USA
| | - David Kuntz
- Clinical Reference Laboratory, 8433 Quivira Rd, Lenexa, KS 66214, USA
| | - Melissa Beals
- Clinical Reference Laboratory, 8433 Quivira Rd, Lenexa, KS 66214, USA
| | - Martin Jacques
- Clinical Reference Laboratory, 8433 Quivira Rd, Lenexa, KS 66214, USA
| | - Michael Clark
- Clinical Reference Laboratory, 8433 Quivira Rd, Lenexa, KS 66214, USA
| | - Eric R Welsh
- Department of Defense (DoD), Office of Drug Demand Reduction Program (ODDR), 4100 Defense Pentagon, Room 5D636, Washington, DC 20301, USA
| | - Lynn Wagner
- Department of Defense (DoD), Office of Drug Demand Reduction Program (ODDR), 4100 Defense Pentagon, Room 5D636, Washington, DC 20301, USA
| | | | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Tory R Spindle
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
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10
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Lapteva M, Faro Barros J, Kalia YN. Cutaneous Delivery and Biodistribution of Cannabidiol in Human Skin after Topical Application of Colloidal Formulations. Pharmaceutics 2024; 16:202. [PMID: 38399256 PMCID: PMC10892191 DOI: 10.3390/pharmaceutics16020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 02/25/2024] Open
Abstract
The objective of this study was to investigate the cutaneous delivery of cannabidiol (CBD) from aqueous formulations developed for the targeted local treatment of dermatological conditions. CBD was formulated using a proprietary colloidal drug delivery system (VESIsorb®) into an aqueous colloidal solution at 2% (ACS 2%) and two colloidal gels (CG 1% and CG 2%, which contained 1% and 2% CBD, respectively). Two basic formulations containing CBD (5% in propylene glycol (PG 5%) and a 6.6% oil solution (OS 6.6%)) and two marketed CBD products (RP1 and RP2, containing 1% CBD) were used as comparators. Cutaneous delivery and cutaneous biodistribution experiments were performed using human abdominal skin (500-700 µm) under infinite- and finite-dose conditions with 0.5% Tween 80 in the PBS receiver phase. The quantification of CBD in the skin samples was performed using a validated UHPLC-MS/MS method and an internal standard (CBD-d3). The cutaneous deposition of CBD under finite-dose conditions demonstrated the superiority of CG 1%, CG 2%, and ACS 2% over the marketed products; CG 1% had the highest delivery efficiency (5.25%). Cutaneous biodistribution studies showed the superiority of the colloidal systems in delivering CBD to the viable epidermis, and the upper and lower papillary dermis, which are the target sites for the treatment of several dermatological conditions.
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Affiliation(s)
- Maria Lapteva
- School of Pharmaceutical Sciences, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland (J.F.B.)
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland
| | - Jonathan Faro Barros
- School of Pharmaceutical Sciences, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland (J.F.B.)
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland
| | - Yogeshvar N. Kalia
- School of Pharmaceutical Sciences, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland (J.F.B.)
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland
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Picco A, Segale L, Miletto I, Pollastro F, Aprile S, Locatelli M, Bari E, Torre ML, Giovannelli L. Spray-Dried Powder Containing Cannabigerol: A New Extemporaneous Emulgel for Topical Administration. Pharmaceutics 2023; 15:2747. [PMID: 38140088 PMCID: PMC10747370 DOI: 10.3390/pharmaceutics15122747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Cannabigerol (CBG), a cannabinoid from Cannabis sativa L., recently attracted noteworthy attention for its dermatological applications, mainly due to its anti-inflammatory, antioxidant, and antimicrobial effectiveness similar to those of cannabidiol (CBD). In this work, based on results from studies of in vitro permeation through biomimetic membranes performed with CBG and CBD in the presence and in the absence of a randomly substituted methyl-β-cyclodextrin (MβCD), a new CBG extemporaneous emulgel (oil-in-gel emulsion) formulation was developed by spray-drying. The powder (SDE) can be easily reconstituted with purified water, leading to a product with chemical-physical and technological characteristics that are comparable to those of the starting emulgels (E). Thermogravimetric analysis (TGA), attenuated total reflection-Fourier transformed infrared spectroscopy (ATR-FTIR), x-ray powder diffraction (XRPD), and high-performance liquid chromatography (HPLC) analyses demonstrated that the spray-drying treatment did not alter the chemical properties of CBG. This product can represent a metered-dosage form for the localized treatment of cutaneous afflictions such as acne and psoriasis.
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Affiliation(s)
- Alice Picco
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Lorena Segale
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
- APTSol S.R.L., Largo Donegani 2, 28100 Novara, Italy
| | - Ivana Miletto
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Federica Pollastro
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Silvio Aprile
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Monica Locatelli
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Elia Bari
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Maria Luisa Torre
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
| | - Lorella Giovannelli
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100 Novara, Italy; (A.P.); (L.S.); (I.M.); (F.P.); (S.A.); (M.L.); (E.B.); (M.L.T.)
- APTSol S.R.L., Largo Donegani 2, 28100 Novara, Italy
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12
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Hossain KR, Alghalayini A, Valenzuela SM. Current Challenges and Opportunities for Improved Cannabidiol Solubility. Int J Mol Sci 2023; 24:14514. [PMID: 37833962 PMCID: PMC10572536 DOI: 10.3390/ijms241914514] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Cannabidiol (CBD), derived from the cannabis plant, has gained significant attention due to its potential therapeutic benefits. However, one of the challenges associated with CBD administration is its low bioavailability, which refers to the fraction of an administered dose that reaches systemic circulation. This limitation necessitates the exploration of various approaches to enhance the bioavailability of CBD, thus helping to maximize its therapeutic potential. A variety of approaches are now emerging, including nanoemulsion-based systems, lipid-based formulations, prodrugs, nanocarriers, and alternative routes of administration, which hold promise for improving the bioavailability of CBD and pave the way for novel formulations that maximize the therapeutic potential of CBD in various medical conditions. This opinion piece presents the current understanding surrounding CBD bioavailability and considers strategies aimed at improving both its absorption and its bioavailability.
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Affiliation(s)
- Khondker Rufaka Hossain
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia; (K.R.H.); (A.A.)
| | - Amani Alghalayini
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia; (K.R.H.); (A.A.)
- ARC Research Hub for Integrated Device for End-User Analysis at Low-Levels (IDEAL), Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Stella M. Valenzuela
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia; (K.R.H.); (A.A.)
- ARC Research Hub for Integrated Device for End-User Analysis at Low-Levels (IDEAL), Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia
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Kwiecień E, Kowalczuk D. Therapeutic Potential of Minor Cannabinoids in Dermatological Diseases-A Synthetic Review. Molecules 2023; 28:6149. [PMID: 37630401 PMCID: PMC10459035 DOI: 10.3390/molecules28166149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Dermatological diseases pose a significant burden on the quality of life of individuals and can be challenging to treat effectively. In this aspect, cannabinoids are gaining increasing importance due to their therapeutic potential in various disease entities including skin diseases. In this synthetic review, we comprehensively analyzed the existing literature in the field of potential dermatological applications of a lesser-known subgroup of cannabinoids, the so-called minor cannabinoids, such as cannabidivarin (CBDV), cannabidiforol (CBDP), cannabichromene (CBC), tetrahydrocannabivarin (THCV), cannabigerolic acid (CBGA), cannabigerol (CBG), cannabielsoin (CBE), cannabimovone (CBM) or cannabinol (CBN), while drawing attention to their unique pharmacological properties. We systematically searched the available databases for relevant studies and analyzed the data to provide an overview of current thematic knowledge. We looked through the full-text, bibliographic and factographic databases, especially Scopus, Web of Science, PubMed, Polish Scientific Journals Database, and selected the most relevant papers. Our review highlights that minor cannabinoids exhibit diverse pharmacological activities, including anti-inflammatory, analgesic, antimicrobial, and anti-itch properties. Several studies have reported their efficacy in mitigating symptoms associated with dermatological diseases such as psoriasis, eczema, acne, and pruritus. Furthermore, minor cannabinoids have shown potential in regulating sebum production, a crucial factor in acne pathogenesis. The findings of this review suggest that minor cannabinoids hold therapeutic promise in the management of dermatological diseases. Further preclinical and clinical investigations are warranted to elucidate their mechanisms of action, determine optimal dosage regimens, and assess long-term safety profiles. Incorporating minor cannabinoids into dermatological therapies could potentially offer novel treatment options of patients and improve their overall well-being.
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Affiliation(s)
- Emilia Kwiecień
- Chair and Department of Medicinal Chemistry, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland;
- A-Sense Sp. z o.o., ul. Moscickiego 1, 24-100 Pulawy, Poland
| | - Dorota Kowalczuk
- Chair and Department of Medicinal Chemistry, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland;
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Filipiuc SI, Neagu AN, Uritu CM, Tamba BI, Filipiuc LE, Tudorancea IM, Boca AN, Hâncu MF, Porumb V, Bild W. The Skin and Natural Cannabinoids-Topical and Transdermal Applications. Pharmaceuticals (Basel) 2023; 16:1049. [PMID: 37513960 PMCID: PMC10386449 DOI: 10.3390/ph16071049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/02/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The chemical constituents of the Cannabis plant known as cannabinoids have been extensively researched for their potential therapeutic benefits. The use of cannabinoids applied to the skin as a potential method for both skin-related benefits and systemic administration has attracted increasing interest in recent years. This review aims to present an overview of the most recent scientific research on cannabinoids used topically, including their potential advantages for treating a number of skin conditions like psoriasis, atopic dermatitis, and acne. Additionally, with a focus on the pharmacokinetics and security of this route of administration, we investigate the potential of the transdermal delivery of cannabinoids as a method of systemic administration. The review also discusses the restrictions and difficulties related to the application of cannabinoids on the skin, emphasizing the potential of topical cannabinoids as a promising route for both localized and systemic administration. More studies are required to fully comprehend the efficacy and safety of cannabinoids in various settings.
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Affiliation(s)
- Silviu-Iulian Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Physiology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Anca-Narcisa Neagu
- Laboratory of Animal Histology, Faculty of Biology, "Alexandru Ioan Cuza" University of Iasi, Carol I bvd, No. 20A, 700505 Iasi, Romania
| | - Cristina Mariana Uritu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Bogdan-Ionel Tamba
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Leontina-Elena Filipiuc
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Ivona Maria Tudorancea
- Advanced Research and Development Center for Experimental Medicine (CEMEX), Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Andreea Nicoleta Boca
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | | | - Vlad Porumb
- Department Surgery, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, 16, 700115 Iasi, Romania
| | - Walther Bild
- Department of Physiology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Center of Biomedical Research of the Romanian Academy, 700506 Iasi, Romania
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15
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Ney LJ, Akosile W, Davey C, Pitcher L, Felmingham KL, Mayo LM, Hill MN, Strodl E. Challenges and considerations for treating PTSD with medicinal cannabis: the Australian clinician's perspective. Expert Rev Clin Pharmacol 2023; 16:1093-1108. [PMID: 37885234 DOI: 10.1080/17512433.2023.2276309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/24/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Preclinical and experimental research have provided promising evidence that medicinal cannabis may be efficacious in the treatment of posttraumatic stress disorder (PTSD). However, implementation of medicinal cannabis into routine clinical therapies may not be straightforward. AREAS COVERED In this review, we describe some of the clinical, practical, and safety challenges that must be addressed for cannabis-based treatment of PTSD to be feasible in a real-world setting. These issues are especially prevalent if medicinal cannabis is to be combined with trauma-focused psychotherapy. EXPERT OPINION Future consideration of the clinical and practical considerations of cannabis use in PTSD therapy will be essential to both the efficacy and safety of the treatment protocols that are being developed. These issues include dose timing and titration, potential for addiction, product formulation, windows of intervention, and route of administration. In particular, exposure therapy for PTSD involves recall of intense emotions, and the interaction between cannabis use and reliving of trauma memories must be explored in terms of patient safety and impact on therapeutic outcomes.
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Affiliation(s)
- Luke J Ney
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Wole Akosile
- Greater Brisbane Clinical School, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Chris Davey
- Department of Psychiatry, Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | | | - Kim L Felmingham
- School of Psychological Sciences, Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Leah M Mayo
- Department of Psychiatry, Mathison Centre for Mental Health Research, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Matthew N Hill
- Department of Psychiatry, Mathison Centre for Mental Health Research, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Esben Strodl
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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16
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Brewer J, Kimber A. Cannabidiol (CBD) for the treatment of subcutaneous treprostinil (Remodulin ®) site pain: a case report. Front Med (Lausanne) 2023; 10:1188083. [PMID: 37384049 PMCID: PMC10293745 DOI: 10.3389/fmed.2023.1188083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/02/2023] [Indexed: 06/30/2023] Open
Abstract
Background Pulmonary arterial hypertension occurs as a result of vascular remodeling and dysregulation of endothelial cells that narrows small pulmonary arteries and raises precapillary pressures. Pulmonary arterial hypertension is a rare and progressive disease characterized by dyspnea, chest pain, and syncope. Parenteral treprostinil is indicated for the treatment of pulmonary arterial hypertension to diminish symptoms associated with exercise. Up to 92% of patients treated with treprostinil via subcutaneous delivery experienced infusion site pain and approximately 23% discontinued treatment due to site pain. Cannabidiol salve may have analgesic and anti-inflammatory properties and could be an additional option for patients with infusion site pain. Case report Two patients with pulmonary arterial hypertension were treated with cannabidiol salve. Both patients reported a reduction in infusion site pain without the need for narcotics. Conclusion These two cases suggest that cannabidiol salve may help to minimize redness and alleviate pain at the infusion site. Additional studies are required to test the effectiveness of cannabidiol in a larger group of patients with infusion site pain.
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Affiliation(s)
| | - Amy Kimber
- United Therapeutics Corporation, Research Triangle Park, NC, United States
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Shi J, Ma Q, Su W, Liu C, Zhang H, Liu Y, Li X, Jiang X, Ge C, Kong F, Chen Y, Qu D. Effervescent cannabidiol solid dispersion-doped dissolving microneedles for boosted melanoma therapy via the "TRPV1-NFATc1-ATF3" pathway and tumor microenvironment engineering. Biomater Res 2023; 27:48. [PMID: 37198657 DOI: 10.1186/s40824-023-00390-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Conventional dissolving microneedles (DMNs) face significant challenges in anti-melanoma therapy due to the lack of active thrust to achieve efficient transdermal drug delivery and intra-tumoral penetration. METHODS In this study, the effervescent cannabidiol solid dispersion-doped dissolving microneedles (Ef/CBD-SD@DMNs) composed of the combined effervescent components (CaCO3 & NaHCO3) and CBD-based solid dispersion (CBD-SD) were facilely fabricated by the "one-step micro-molding" method for boosted transdermal and tumoral delivery of cannabidiol (CBD). RESULTS Upon pressing into the skin, Ef/CBD-SD@DMNs rapidly produce CO2 bubbles through proton elimination, significantly enhancing the skin permeation and tumoral penetration of CBD. Once reaching the tumors, Ef/CBD-SD@DMNs can activate transient receptor potential vanilloid 1 (TRPV1) to increase Ca2+ influx and inhibit the downstream NFATc1-ATF3 signal to induce cell apoptosis. Additionally, Ef/CBD-SD@DMNs raise intra-tumoral pH environment to trigger the engineering of the tumor microenvironment (TME), including the M1 polarization of tumor-associated macrophages (TAMs) and increase of T cells infiltration. The introduction of Ca2+ can not only amplify the effervescent effect but also provide sufficient Ca2+ with CBD to potentiate the anti-melanoma efficacy. Such a "one stone, two birds" strategy combines the advantages of effervescent effects on transdermal delivery and TME regulation, creating favorable therapeutic conditions for CBD to obtain stronger inhibition of melanoma growth in vitro and in vivo. CONCLUSIONS This study holds promising potential in the transdermal delivery of CBD for melanoma therapy and offers a facile tool for transdermal therapies of skin tumors.
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Affiliation(s)
- Jiachen Shi
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Qiuling Ma
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Wenting Su
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Congyan Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Huangqin Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Yuping Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Xiaoqi Li
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Xi Jiang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Chang Ge
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Fei Kong
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Yan Chen
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Ding Qu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China.
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Gaweł-Bęben K, Czech K, Luca SV. Cannabidiol and Minor Phytocannabinoids: A Preliminary Study to Assess Their Anti-Melanoma, Anti-Melanogenic, and Anti-Tyrosinase Properties. Pharmaceuticals (Basel) 2023; 16:ph16050648. [PMID: 37242431 DOI: 10.3390/ph16050648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Currently, there is an increased interest from both scientists and consumers in the application of cannabis/hemp/phytocannabinoids in skin-related disorders. However, most previous investigations assessed the pharmacological properties of hemp extracts, cannabidiol (CBD), or tetrahydrocannabinol (THC), with very few studies focusing on minor phytocannabinoids from hemp. In this context, the current work explored the in vitro anti-melanoma, anti-melanogenic, and anti-tyrosinase effects of cannabidiol (CBD) and three minor phytocannabinoids, namely cannabigerol (CBG), cannabinol (CBN), and cannabichromene (CBC). Among the tested human malignant melanoma cells (A375, SH4, and G361), only A375 cells were highly susceptible to the 48 h treatment with the four phytocannabinoids (IC50 values between 12.02 and 25.13 μg/mL). When melanogenesis was induced in murine melanoma B16F10 cells by α-melanocyte stimulating hormone (αMSH), CBD, CBG, and CBN significantly decreased the extracellular (29.76-45.14% of αMSH+ cells) and intracellular (60.59-67.87% of αMSH+ cells) melanin content at 5 μg/mL. Lastly, CBN (50-200 μg/mL) inhibited both mushroom and murine tyrosinase, whereas CBG (50-200 μg/mL) and CBC (100-200 μg/mL) down-regulated only the mushroom tyrosinase activity; in contrast, CBD was practically inactive. The current data show that tyrosinase inhibition might not be responsible for reducing the melanin biosynthesis in α-MSH-treated B16F10 cells. By evaluating for the first time the preliminary anti-melanoma, anti-melanogenic, and anti-tyrosinase properties of CBN and CBC and confirming similar effects for CBD and CBG, this study can expand the utilization of CBD and, in particular, of minor phytocannabinoids to novel cosmeceutical products for skin care.
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Affiliation(s)
- Katarzyna Gaweł-Bęben
- Department of Cosmetology, University of Information Technology and Management in Rzeszów, 35-225 Rzeszów, Poland
| | - Karolina Czech
- Department of Cosmetology, University of Information Technology and Management in Rzeszów, 35-225 Rzeszów, Poland
| | - Simon Vlad Luca
- Biothermodynamics, TUM School of Life Sciences, Technical University of Munich, 85354 Freising, Germany
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Hall N, James B, Bhuiyan MAN, Crane E, Falgout C, Murnane KS. Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain. J Cannabis Res 2023; 5:11. [PMID: 36991501 PMCID: PMC10061782 DOI: 10.1186/s42238-023-00179-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Cannabidiol (CBD) is a potential therapeutic for pain management. Yet, there exists a dearth of studies of its tolerability and efficacy, especially in special populations. Former elite athletes are a special population both susceptible to chronic pain and also highly trained and attuned to assess medication tolerability concerns. The purpose of the present open-label pilot study was to assess the tolerability of CBD in this population. MATERIALS AND METHODS Retrospective analysis was conducted in deidentified data from 20 individuals who were all previously professional athletes in US/American football, track and field, or basketball, with careers ranging from 4 to 10 years. Participants received topical CBD (10 mg twice daily by controlled dispenser) for chronic pain resulting from acute lower extremity injuries. Assessments of tolerability and secondary analyses of pain, pain-related disability, and activities of daily living were collected by self-report over the 6-week study period. Data were analyzed by descriptive statistics, pairwise t-test, and linear regression. RESULTS Seventy percent of participants completed the study. Of the individuals who completed the study, 50% reported minor adverse effects, none of which required medical attention, and 50% did not report any adverse effects. The mostly commonly reported effects were skin dryness (43% of study completers) and skin rash (21% of study completers), which rapidly resolved. There was a significant improvement in self-reported pain levels (intake mean 3.5 ± 0.29; exit mean 1.7 ± 0.23; P < 0.001) and pain-related disability, including family and home responsibilities, life support activities, occupational activities, recreational activities, self-care, sexual function, and social activities (all P < 0.001). DISCUSSION To the best of our knowledge, this is the first study to assess CBD treatment in elite athletes, who are disproportionally susceptible to disabling injuries. Topical administration of CBD was tolerated well by this population and resulted in only minor adverse effects. As elite athletes are trained and attuned to assess their own bodies due to their professional lives, this population is likely to detect tolerability concerns. However, this study was limited to a convenience sample and self-reported data. These pilot findings warrant further study of topical CBD in randomized and controlled studies of elite athletes.
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Affiliation(s)
- Nicole Hall
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | | | - Mohammad Alfrad Nobel Bhuiyan
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Erin Crane
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Carlie Falgout
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Kevin Sean Murnane
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA.
- Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA.
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA.
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Demisli S, Galani E, Goulielmaki M, Kyrilis FL, Ilić T, Hamdi F, Crevar M, Kastritis PL, Pletsa V, Nallet F, Savić S, Xenakis A, Papadimitriou V. Encapsulation of cannabidiol in oil-in-water nanoemulsions and nanoemulsion-filled hydrogels: A structure and biological assessment study. J Colloid Interface Sci 2023; 634:300-313. [PMID: 36535166 DOI: 10.1016/j.jcis.2022.12.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
HYPOTHESIS Lipophilic cannabidiol can be solubilized in oil-in water nanoemulsions, which can then be impregnated into chitosan hydrogels forming another colloidal system that will facilitate cannabidiol's release. The delivery from both systems was compared, alongside structural and biological studies, to clarify the effect of the two carriers' structure on the release and toxicity of the systems. EXPERIMENTS Oil-in-water nanoemulsions (NEs) and the respective nanoemulsion-filled chitosan hydrogels (NE/HGs) were formulated as carriers of cannabidiol (CBD). Size, polydispersity and stability of the NEs were evaluated and then membrane dynamics, shape and structure of both systems were investigated with EPR spin probing, SAXS and microscopy. Biocompatibility of the colloidal delivery systems was evaluated through cytotoxicity tests over normal human skin fibroblasts. An ex vivo permeation protocol using porcine ear skin was implemented to assess the release of CBD and its penetration through the skin. FINDINGS Incorporation of the NEs in chitosan hydrogels does not significantly affect their structural properties as evidenced through SAXS, EPR and confocal microscopy. These findings indicate the successful development of a novel nanocarrier that preserves the NE structure with the CBD remaining encapsulated in the oil core while providing new rheological properties advantageous over NEs. Moreover, NE/HGs proved to be more efficient as a carrier for the release of CBD. Cell viability assessment revealed high biocompatibility of the proposed colloids.
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Affiliation(s)
- Sotiria Demisli
- Institute of Chemical Biology, National Hellenic Research Foundation, Athens, Greece; Department of Biochemistry & Biotechnology, University of Thessaly, Larissa, Greece
| | - Eleni Galani
- Institute of Chemical Biology, National Hellenic Research Foundation, Athens, Greece; Department of Food Science & Human Nutrition, Agricultural University of Athens, Greece
| | - Maria Goulielmaki
- Institute of Chemical Biology, National Hellenic Research Foundation, Athens, Greece
| | - Fotios L Kyrilis
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Tanja Ilić
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade, Belgrade, Serbia
| | - Farzad Hamdi
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Milkica Crevar
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade, Belgrade, Serbia
| | | | - Vasiliki Pletsa
- Institute of Chemical Biology, National Hellenic Research Foundation, Athens, Greece
| | - Frédéric Nallet
- Centre de Recherche Paul Pascal (CRPP) UMR 5031 CNRS, University of Bordeaux, France
| | - Snežana Savić
- Department of Pharmaceutical Technology and Cosmetology, University of Belgrade, Belgrade, Serbia
| | - Aristotelis Xenakis
- Institute of Chemical Biology, National Hellenic Research Foundation, Athens, Greece
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Enhanced Skin Penetration of Cannabidiol Using Organosilane Particles as Transdermal Delivery Vehicles. Pharmaceutics 2023; 15:pharmaceutics15030798. [PMID: 36986659 PMCID: PMC10057149 DOI: 10.3390/pharmaceutics15030798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
There is potential for cannabidiol to act as an analgesic, anxiolytic and antipsychotic active ingredient; however, there is a need to find alternate administration routes to overcome its low oral bioavailability. In this work, we propose a new delivery vehicle based on encapsulation of cannabidiol within organosilica particles as drug delivery vehicles, which are subsequently incorporated within polyvinyl alcohol films. We investigated the long-term stability of the encapsulated cannabidiol, as well as its release rate, in a range of simulated fluids with different characterization techniques, including Fourier Transform Infrared (FT-IR) and High-performance Liquid Chromatography (HPLC). Finally, we determined the transdermal penetration in an ex vivo skin model. Our results show that cannabidiol is stable for up to 14 weeks within polyvinyl alcohol films at a range of temperatures and humidity. Release profiles are first-order, consistent with a mechanism involving diffusion of the cannabidiol (CBD) out of the silica matrix. The silica particles do not penetrate beyond the stratum corneum in the skin. However, cannabidiol penetration is enhanced and is detected in the lower epidermis, which was 0.41% of the total CBD in a PVA formulation compared with 0.27% for pure CBD. This is partly due to an improvement of its solubility profile as it is released from the silica particles, but we cannot rule out effects of the polyvinyl alcohol. Our design opens a route for new membrane technologies for cannabidiol and other cannabinoid products, where administration via non-oral or pulmonary routes can lead to better outcomes for patient cohorts in a range of therapeutics.
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Yu L, Madsen FB, Eriksen SH, Andersen AJC, Skov AL. A reliable quantitative method for determining CBD content and release from transdermal patches in Franz cells. PHYTOCHEMICAL ANALYSIS : PCA 2022; 33:1257-1265. [PMID: 36372393 PMCID: PMC10100468 DOI: 10.1002/pca.3188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION There are several cannabidiol (CBD) transdermal patches available on the market. However, none are FDA-approved. Furthermore, not much evidence has been published about CBD release and skin permeation from such patches, so the effectiveness and reliability remain unclear. OBJECTIVES We aimed to develop a method to determine the in vitro release and skin permeation of CBD from transdermal patches using Franz cell diffusion in combination with quantitative 1 H-NMR (qNMR). MATERIALS AND METHODS The study was conducted on CBD patches with known CBD content and six different commercially available or market-ready CBD patches using a Franz cell with a Strat-M™ membrane and with samples taken directly from the transdermal patch for qNMR analysis. RESULTS The use of qNMR yielded an average recovery of 100% ± 7% when samples with known CBD content were tested. Results from the testing of six commercially available patches indicated that five out of six patches did not contain the CBD amount stated by the manufacturer according to a ± 10% variance margin, of which four patches were under-labeled and one was over-labeled. The release rate of patches was determined, and significant differences between the patches were shown. Maximum release of CBD was calculated to occur after 39 to 70 h. CONCLUSION The established method was proven to be a reliable means of determining the quantity and release of CBD from transdermal patches and can be used to verify CBD content and release rate in transdermal patches.
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Affiliation(s)
- Liyun Yu
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Building 227Technical University of DenmarkKgs. LyngbyDenmark
| | - Frederikke Bahrt Madsen
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Building 227Technical University of DenmarkKgs. LyngbyDenmark
- GlysiousHolteDenmark
| | - Sofie Helvig Eriksen
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Building 227Technical University of DenmarkKgs. LyngbyDenmark
| | - Aaron J. C. Andersen
- Department of Biotechnology and Biomedicine, Building 221Technical University of DenmarkKgs. LyngbyDenmark
| | - Anne Ladegaard Skov
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Building 227Technical University of DenmarkKgs. LyngbyDenmark
- GlysiousHolteDenmark
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Practical Considerations for the Use of Cannabis in Cancer Pain Management—What a Medical Oncologist Should Know. J Clin Med 2022; 11:jcm11175036. [PMID: 36078963 PMCID: PMC9457511 DOI: 10.3390/jcm11175036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 12/29/2022] Open
Abstract
Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving interventions, including surgery, chemotherapy, and radiotherapy. Despite significant pharmacological advances and awareness campaigns, pain remains undertreated in one-third of patients. To date, opioids have been the mainstay of cancer pain management. The problematic side effects and unsatisfactory pain relief of opioids have revived patients’ and physicians’ interest in finding new solutions, including cannabis and cannabinoids. The medical use of cannabis has been prohibited for decades, and it remains in Schedule 1 of the Misuse of Drugs Regulations. Currently, the legal context for its usage has become more permissive. Various preclinical and observational studies have aimed to prove that cannabinoids could be effective in cancer pain management. However, their clinical utility must be further supported by high-quality clinical trials.
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24
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Salau O, Bagde A, Kalvala A, Singh M. Enhancement of transdermal permeation of cannabinoids and their pharmacodynamic evaluation in rats. Int J Pharm 2022; 624:122016. [PMID: 35863593 PMCID: PMC9812589 DOI: 10.1016/j.ijpharm.2022.122016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
The objective of the present study was to enhance the transdermal permeation of cannabinoids: cannabidiol (CBD), cannabigerol (CBG) and tetrahydrocannabivarin (THCV) using chemical permeation enhancer approach and evaluate them for their anti-inflammatory effect in vivo in a paw edema model in rats. Cannabinoids gel formulations were developed using FDA approved inactive ingredients: lactic acid (LA), polyethylene glycol-400 (PEG-400), N-methyl-2 pyrrolidone (NMP), dimethyl sulfoxide (DMSO). In vitro skin permeation testing (IVPT) showed flux of ∼ 13.25 μg/cm2/h for CBD, ∼9.38 μg/cm2/h for CBG and ∼ 51.74 μg/cm2/h for THCV. Additionally, IVPT study showed cumulative drug permeation of 610.96 ± 88.92 μg/cm2, 432.09 ± 35.59 μg/cm2 and 2384.44 ± 42.22 μg/cm2 from CBD, CBG and THCV gel formulations respectively. Further, effect of excipients on cannabinoid permeation showed that, formulation containing lactic acid, NMP and DMSO showed significantly (p < 0.0001) enhanced flux of cannabinoids as compared to formulation without LA, NMP and DMSO. In vivo studies showed that paw edema was significantly (p < 0.0001) reduced in the groups containing CBD, CBG, THCV as compared to control and placebo formulation. In conclusion, flux of CBD, CBG and THCV was significantly enhanced using chemical permeation enhancers approach which helped in reducing rat paw edema.
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Affiliation(s)
| | | | | | - Mandip Singh
- Corresponding author at: College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307. (M. Singh)
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25
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Tijani AO, Garg J, Frempong D, Verana G, Kaur J, Joga R, Sabanis CD, Kumar S, Kumar N, Puri A. Sustained drug delivery strategies for treatment of common substance use disorders: Promises and challenges. J Control Release 2022; 348:970-1003. [PMID: 35752256 DOI: 10.1016/j.jconrel.2022.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
Substance use disorders (SUDs) are a leading cause of death and other ill health effects in the United States and other countries in the world. Several approaches ranging from detoxification, behavioral therapy, and the use of antagonists or drugs with counter effects are currently being applied for its management. Amongst these, drug therapy is the mainstay for some drug abuse incidences, as is in place specifically for opioid abuse or alcohol dependence. The severity of the havocs observed with the SUDs has triggered constant interest in the discovery and development of novel medications as well as suitable or most appropriate methods for the delivery of these agents. The chronic need of such drugs in users warrants the need for their prolonged or sustained systemic availability. Further, the need to improve patient tolerance to medication, limit invasive drug use and overall treatment outcome are pertinent considerations for embracing sustained release designs for medications used in managing SUDs. This review aims to provide an overview on up-to-date advances made with regards to sustained delivery systems for the drugs for treatment of different types of SUDs such as opioid, alcohol, tobacco, cocaine, and cannabis use disorders. The clinical relevance, promises and the limitations of deployed sustained release approaches along with future opportunities are discussed.
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Affiliation(s)
- Akeemat O Tijani
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Jivesh Garg
- University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh 160014, India
| | - Dorcas Frempong
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Gabrielle Verana
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Jagroop Kaur
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
| | - Ramesh Joga
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500 037, Telangana, India.
| | - Chetan D Sabanis
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500 037, Telangana, India.
| | - Sandeep Kumar
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500 037, Telangana, India.
| | - Neeraj Kumar
- Department of Regulatory Affairs, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500 037, Telangana, India.
| | - Ashana Puri
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA.
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26
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Stephens KL, Heineman JT, Forster GL, Timko MP, DeGeorge BR. Cannabinoids and Pain for the Plastic Surgeon: What Is the Evidence? Ann Plast Surg 2022; 88:S508-S511. [PMID: 35502947 DOI: 10.1097/sap.0000000000003128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since the passage of the 2018 Farm Bill, practitioners have encountered more patients self-treating pain with over-the-counter topical cannabidiol (CBD) derived from hemp-Cannabis sativa with less than 0.3% delta-9-tetrahydrocannabinol-with reported improvements in pain control and activities of daily living. Cannabidiol has been touted for its capacity to improve inflammatory, arthritic, and neuropathic pain conditions, and increasing numbers of patients are exploring its use as potential replacement for opioids. However, limited rigorous clinical trials have been performed evaluating the safety and efficacy of cannabinoids for the treatment of pain. METHODS A systematic search of PubMed was performed using the Medical Subject Headings (MeSH) terms "cannabinoid" or "CBD" or "cannabidiol" or "cannabis" or "medical marijuana" and "pain." It yielded 340 article titles. Twelve full-text primary studies of oral or topical CBD for chronic pain were selected for review, including 6 animal (2 randomized clinical trial and 4 prospective trials) and 6 human (4 randomized clinical trial and 2 prospective trials) studies. RESULTS With respect to the safety and efficacy of oral and topical CBD for treating pain, animal and human studies have shown early positive results with limited minor side effects. However, all human studies may be underpowered with small sample sizes. CONCLUSIONS With respect to the safety and efficacy of oral and topical CBD for treating pain, the evidence remains inconclusive in that we have a paucity of data to share with our patients who are considering the use of these products, which may be associated with significant costs.
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Affiliation(s)
| | | | | | | | - Brent R DeGeorge
- Departments of Plastic and Orthopaedic Surgery, University of Virginia, Charlottesville, VA
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Lipid-Drug Conjugates and Nanoparticles for the Cutaneous Delivery of Cannabidiol. Int J Mol Sci 2022; 23:ijms23116165. [PMID: 35682847 PMCID: PMC9180973 DOI: 10.3390/ijms23116165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023] Open
Abstract
Lipid nanoparticles are currently used to deliver drugs to specific sites in the body, known as targeted therapy. Conjugates of lipids and drugs to produce drug-enriched phospholipid micelles have been proposed to increase the lipophilic character of drugs to overcome biological barriers. However, their applicability at the topical level is still minimal. Phospholipid micelles are amphiphilic colloidal systems of nanometric dimensions, composed of a lipophilic nucleus and a hydrophilic outer surface. They are currently used successfully as pharmaceutical vehicles for poorly water-soluble drugs. These micelles have high in vitro and in vivo stability and high biocompatibility. This review discusses the use of lipid-drug conjugates as biocompatible carriers for cutaneous application. This work provides a metadata analysis of publications concerning the conjugation of cannabidiol with lipids as a suitable approach and as a new delivery system for this drug.
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28
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Ocaña-Rios I, Okano L, Figueroa CG, Urban J, Church JS, Devedec FL, Urban KJ, Donkor KK. An improved method for the determination of cannabidiol in topical products using ultrasound-assisted extraction and gas chromatography-mass spectrometry. J Pharm Biomed Anal 2022; 217:114840. [DOI: 10.1016/j.jpba.2022.114840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
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Development of Stable Nano-Sized Transfersomes as a Rectal Colloid for Enhanced Delivery of Cannabidiol. Pharmaceutics 2022; 14:pharmaceutics14040703. [PMID: 35456536 PMCID: PMC9032849 DOI: 10.3390/pharmaceutics14040703] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 01/15/2023] Open
Abstract
Current cannabidiol (CBD) formulations are challenged with unpredictable release and absorption. Rational design of a rectal colloid delivery system can provide a practical alternative. In this study the inherent physiochemical properties of transferosomes were harnessed for the development of a nano-sized transfersomes to yield more stable release, absorption, and bioavailability of CBD as a rectal colloid. Transfersomes composed of soya lecithin, cholesterol, and polysorbate 80 were synthesized via thin film evaporation and characterized for size, entrapment efficiency (%), morphology, CBD release, ex vivo permeation, and physicochemical stability. The optimized formulation for rectal delivery entrapped up to 80.0 ± 0.077% of CBD with a hydrodynamic particle size of 130 nm, a PDI value of 0.285, and zeta potential of −15.97 mV. The morphological investigation via SEM and TEM revealed that the transfersomes were spherical and unilamellar vesicles coinciding with the enhanced ex vivo permeation across the excised rat colorectal membrane. Furthermore, transfersomes improved the stability of the encapsulated CBD for up to 6 months at room temperature and showed significant promise that the transfersomes promoted rectal tissue permeation with superior stability and afforded tunable release kinetics of CBD as a botanical therapeutic with inherent poor bioavailability.
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30
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Mahmoudinoodezh H, Telukutla SR, Bhangu SK, Bachari A, Cavalieri F, Mantri N. The Transdermal Delivery of Therapeutic Cannabinoids. Pharmaceutics 2022; 14:pharmaceutics14020438. [PMID: 35214170 PMCID: PMC8876728 DOI: 10.3390/pharmaceutics14020438] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/07/2023] Open
Abstract
Recently, several studies have indicated an increased interest in the scientific community regarding the application of Cannabis sativa plants, and their extracts, for medicinal purposes. This plant of enormous medicinal potential has been legalised in an increasing number of countries globally. Due to the recent changes in therapeutic and recreational legislation, cannabis and cannabinoids are now frequently permitted for use in clinical settings. However, with their highly lipophilic features and very low aqueous solubility, cannabinoids are prone to degradation, specifically in solution, as they are light-, temperature-, and auto-oxidation-sensitive. Thus, plant-derived cannabinoids have been developed for oral, nasal-inhalation, intranasal, mucosal (sublingual and buccal), transcutaneous (transdermal), local (topical), and parenteral deliveries. Among these administrations routes, topical and transdermal products usually have a higher bioavailability rate with a prolonged steady-state plasma concentration. Additionally, these administrations have the potential to eliminate the psychotropic impacts of the drug by its diffusion into a nonreactive, dead stratum corneum. This modality avoids oral administration and, thus, the first-pass metabolism, leading to constant cannabinoid plasma levels. This review article investigates the practicality of delivering therapeutic cannabinoids via skin in accordance with existing literature.
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Affiliation(s)
- Haleh Mahmoudinoodezh
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia; (H.M.); (S.R.T.); (A.B.)
| | - Srinivasa Reddy Telukutla
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia; (H.M.); (S.R.T.); (A.B.)
| | | | - Ava Bachari
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia; (H.M.); (S.R.T.); (A.B.)
| | - Francesca Cavalieri
- Applied Chemistry and Environmental Science, RMIT University, Melbourne, VIC 3000, Australia;
| | - Nitin Mantri
- The Pangenomics Lab, School of Science, RMIT University, Bundoora, VIC 3083, Australia; (H.M.); (S.R.T.); (A.B.)
- The UWA Institute of Agriculture, The University of Western Australia, Perth, WA 6009, Australia
- Correspondence:
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31
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Junaid MSA, Tijani AO, Puri A, Banga AK. In vitro percutaneous absorption studies of cannabidiol using human skin: Exploring the effect of drug concentration, chemical enhancers, and essential oils. Int J Pharm 2022; 616:121540. [PMID: 35124116 DOI: 10.1016/j.ijpharm.2022.121540] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 12/16/2022]
Abstract
Cannabidiol, a non-psychoactive constituent of cannabis, has garnered much attention after United States Food and Drug Administration approved Epidiolex® for oral use. Although therapeutic effect of cannabidiol after systemic absorption has been investigated extensively, its therapeutic potential in treating skin disorders after local delivery still needs further exploration. Our study has investigated the effect of cannabidiol concentration, chemical enhancers, and essential oils on percutaneous absorption of cannabidiol. In vitro permeation tests were conducted on human skin. The 24 h study results suggest no significant difference in amount of drug absorbed into skin, between 5% (242.41 ± 12.17 µg/cm2) and 10% (232.79 ± 20.82 cm2) cannabidiol solutions. However, 1% delivered (23.02 ± 4.74 µg/cm2) significantly lower amount of drug into skin than 5% and 10%. Transcutol and isopropyl myristate did not enhance delivery of cannabidiol. However, oleic acid was found to be useful as chemical enhancer. Oleic acid (43.07 ± 10.11 µg/cm2) had significantly higher cannabidiol delivery into skin than the group without oleic acid (10.98 ± 3.40 µg/cm2) after a 4 h in vitro permeation study. Essential oils at concentrations tested had lower total cannabidiol delivery when compared to control. This study's findings will help guide future research on the pharmacological effect of percutaneously delivered cannabidiol on inflammatory skin disorders.
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Affiliation(s)
- Mohammad Shajid Ashraf Junaid
- Center for Drug Delivery Research, Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA
| | - Akeemat O Tijani
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Ashana Puri
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Ajay K Banga
- Center for Drug Delivery Research, Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA.
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A Comprehensive Review on the Techniques for Extraction of Bioactive Compounds from Medicinal Cannabis. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27030604. [PMID: 35163863 PMCID: PMC8840415 DOI: 10.3390/molecules27030604] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 12/27/2022]
Abstract
Cannabis is well-known for its numerous therapeutic activities, as demonstrated in pre-clinical and clinical studies primarily due to its bioactive compounds. The Cannabis industry is rapidly growing; therefore, product development and extraction methods have become crucial aspects of Cannabis research. The evaluation of the current extraction methods implemented in the Cannabis industry and scientific literature to produce consistent, reliable, and potent medicinal Cannabis extracts is prudent. Furthermore, these processes must be subjected to higher levels of scientific stringency, as Cannabis has been increasingly used for various ailments, and the Cannabis industry is receiving acceptance in different countries. We comprehensively analysed the current literature and drew a critical summary of the extraction methods implemented thus far to recover bioactive compounds from medicinal Cannabis. Moreover, this review outlines the major bioactive compounds in Cannabis, discusses critical factors affecting extraction yields, and proposes future considerations for the effective extraction of bioactive compounds from Cannabis. Overall, research on medicinal marijuana is limited, with most reports on the industrial hemp variety of Cannabis or pure isolates. We also propose the development of sustainable Cannabis extraction methods through the implementation of mathematical prediction models in future studies.
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Chi Y, Huang Y, Kang Y, Dai G, Liu Z, Xu K, Zhong W. The effects of molecular weight of hyaluronic acid on transdermal delivery efficiencies of dissolving microneedles. Eur J Pharm Sci 2022; 168:106075. [PMID: 34813921 DOI: 10.1016/j.ejps.2021.106075] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/03/2021] [Accepted: 11/14/2021] [Indexed: 12/24/2022]
Abstract
Hyaluronic acid (HA) is widely adopted to fabricate dissolving microneedles for transdermal drug delivery applications, yet the structure-activity relationship between molecular weight of HA and transdermal delivery efficiency of microneedles (HA-MNs) has not been fully explored, particularly in the transdermal delivery of small molecule drugs. Herein, we report the fabrication of three types of HA-MNs of various molecular weights (10k, 74k and 290k Da), which incorporate rhodamine B as the model drug. We assess the influence of molecular weight of HA on the mechanical properties of HA-MNs and transdermal delivery of rhodamine B in vitro and in vivo. The mechanical strength of all types of HA-MNs exceeds the minimal force requirement for skin penetration, with the highest values of compression force found in 10k-HA-MN. Interestingly, 74k-HA-MN that owns a medium mechanical strength, exhibits the highest efficiency in transdermal delivery of rhodamine B in a porcine skin and a Franz cell transdermal model. Further in vivo fluorescence imaging of HA-MN-treated mice reveals a tunable transdermal delivery of rhodamine B, which is controllable according to the molecular weight of HA. Importantly, 74k-HA-MN treatment demonstrates the highest initial delivering amount and longest retention time of rhodamine B in mice. In addition, histological examinations of puncture sites of the skin tissues confirm the complete recovery of skin and excellent biocompatibility of HA-MNs.
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Affiliation(s)
- Yuquan Chi
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China
| | - Yanping Huang
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China
| | - Yixin Kang
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China
| | - Guoru Dai
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China
| | - Ziqi Liu
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China
| | - Keming Xu
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China; Key Laboratory of Biomedical Functional Materials, China Pharmaceutical University, Nanjing 210009, China.
| | - Wenying Zhong
- Department of Chemistry, China Pharmaceutical University, Nanjing 210009, China; Key Laboratory of Biomedical Functional Materials, China Pharmaceutical University, Nanjing 210009, China; Key Laboratory of Drug Quality Control and Pharmacovigilance, China Pharmaceutical University, Nanjing 210009, China.
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Polysaccharide Cryogels Containing β-Cyclodextrin for the Delivery of Cannabidiol. Pharmaceutics 2021; 13:pharmaceutics13111774. [PMID: 34834189 PMCID: PMC8618209 DOI: 10.3390/pharmaceutics13111774] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 01/18/2023] Open
Abstract
Cannabidiol (CBD) has attracted increasing interest due to its therapeutic potential for treating numerous diseases. However, CBD is very lipophilic and has very unfavorable pharmacokinetics and low bioavailability. Efforts are focused on developing drug delivery systems for enhanced solubilization and therapeutic activity of CBD. Here, we report the preparation of original super-macroporous cryogels from 2-hydroxyethyl cellulose (HEC) and β-cyclodextrin (β-CD) designed for the topical delivery of CBD. The cryogels were synthesized by photochemical crosslinking in a frozen aqueous system, purified, and then loaded with CBD. The effect of HEC/β-CD mass ratio (100:0; 50:50; 40:60 and 20:80) in the reaction mixture on the reaction efficiency, physico-mechanical properties of cryogels, drug release profile, and antineoplastic potential were evaluated in detail. The cryogels showed a bi-phasic release behavior: initial burst release in the first 3 hours followed by slower drug release which can be beneficial in the treatment of cutaneous neoplastic diseases.
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Vanti G, Grifoni L, Bergonzi MC, Antiga E, Montefusco F, Caproni M, Bilia AR. Development and optimisation of biopharmaceutical properties of a new microemulgel of cannabidiol for locally-acting dermatological delivery. Int J Pharm 2021; 607:121036. [PMID: 34438005 DOI: 10.1016/j.ijpharm.2021.121036] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/19/2022]
Abstract
Cannabidiol (CBD) is a pleiotropic phytocannabinoid, recently investigated to treat many skin diseases. This study aimed to develop a CBD-loaded O/A microemulsion (CBD-ME) formulated as microemulgel (CBD-MEgel), suitable for local administration. The developed CBD-ME consisted of Solutol HS 15 (20%, surfactant), Transcutol P (9%, cosolvent), isopropyl myristate (5%, oil phase), water (66%) and 1% w/w CBD. Globules had polydispersity index less than 0.23 ± 0.02 and size of 35 ± 2 nm; these values did not change after loading CBD and gelling the formulation with Sepigel 305 obtaining a clear and homogeneous formulation with a pH of 6.56 ± 0.20, suitable for cutaneous application. Viscosity properties were investigated by the rotational digital viscometer, at both 21 ± 2 °C and 35 ± 2 °C. Viscosities of CBD-MEgel were 439,000 ± 4,243 mPa·s and 391,000 ± 1,414 mPa·s respectively. The release studies displayed that 90 ± 24 μg/cm2 of CBD were released in 24 h. The CBD permeability, evaluated using Franz diffusion cells and rabbit ear skin, was 3 ± 1 μg/cm2. Skin-PAMPATM gave a CBD effective permeability of (1.67 ± 0.16) ·10-7 cm/s and an absorbed dose of 115.30 ± 16.99 µg/cm2 after 24 h. Lastly, physical and chemical stability of both CBD-ME and CBD-MEgel were evaluated over a period of 3 months, showing optimal shelf-life at the storage conditions.
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Affiliation(s)
- Giulia Vanti
- Department of Chemistry, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, FI, Italy
| | - Lucia Grifoni
- Department of Chemistry, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, FI, Italy
| | - Maria Camilla Bergonzi
- Department of Chemistry, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, FI, Italy
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Francesca Montefusco
- Department of Health Sciences, Section of Dermatology, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Marzia Caproni
- Department of Health Sciences, Section of Dermatology, USL Toscana Centro, Rare Diseases Unit, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - Anna Rita Bilia
- Department of Chemistry, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, FI, Italy.
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