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Lee SW, Goo BL. High-Intensity Focused Ultrasound Enhances Drug Penetration into the Human Skin in the Franz Diffusion Cell. Clin Cosmet Investig Dermatol 2024; 17:1711-1721. [PMID: 39071845 PMCID: PMC11283244 DOI: 10.2147/ccid.s457145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/23/2024] [Indexed: 07/30/2024]
Abstract
Purpose High-intensity focused ultrasound (HIFU)-assisted drug delivery is a non-invasive tool to deliver drugs to targeted areas, currently used mainly for treating cancer and cardiovascular diseases. However, in terms of transdermal drug delivery, HIFU technology is still poorly understood. Accordingly, this study sought to investigate the effectiveness of HIFU on drug penetration into the skin using human skin tissues. Methods Gel-type drugs whose ingredient is glutathione were labelled with fluorescein isothiocyanate, in turn the drugs were allowed to penetrate to the human skin tissue in the Franz diffusion cell for 24 hours in control and HIFU treatment groups, and their fluorescence intensity was measured using a multiple microplate reader at one, two, six, and 24 hours after drug application. In addition, tissue slice analysis was performed in each tissue slice at 24 hours post-drug application. The % area, fluorescence intensity per area, and penetration depth of the drug were measured using a fluorescence microscope. Results The fluorescence intensity increased with time in all groups. Specifically, at 24 hours after drug application, the fluorescence intensity (a.u). of the 10-shot HIFU treatment group was significantly enhanced compared to that of the control group (p < 0.05). The tissue slice analysis demonstrated that the % area of fluorescent drug and the fluorescence intensity per area (a.u.) were all significantly increased in both HIFU treatment groups compared to the control group (p < 0.05, p < 0.001). In addition, the penetration depth (μm) also markedly rose in both HIFU treatment groups compared to the control group (p < 0.01, p < 0.05). Conclusion It was demonstrated for the first time that HIFU significantly facilitated topical drug penetration into the human skin, strongly implying that HIFU can be a useful option for transdermal drug delivery.
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Affiliation(s)
- Seung-Won Lee
- Department of Physiology, College of Medicine, Korea University, Seoul, Korea
| | - Boncheol Leo Goo
- Skin Rehabilitation Center, Naeum Dermatology and Aesthetics Clinic, Seoul, Korea
- Clinical Trial Center, Corederm Inc, Seoul, Korea
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MOHAMED MH, ELSOGHIER OM, ALI AF, AHMED AA, ASAL MS, KADRY AM. Indomethacin phonophoresis treatment of chronic nonbacterial prostatitis symptoms: randomized single blinded controlled trial. Chirurgia (Bucur) 2023. [DOI: 10.23736/s0394-9508.22.05400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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3
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Vella D, Mrzel A, Drnovšek A, Shvalya V, Jezeršek M. Ultrasonic photoacoustic emitter of graphene-nanocomposites film on a flexible substrate. PHOTOACOUSTICS 2022; 28:100413. [PMID: 36276232 PMCID: PMC9579491 DOI: 10.1016/j.pacs.2022.100413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/16/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Photoacoustic devices generating high-amplitude and high-frequency ultrasounds are attractive candidates for medical therapies and on-chip bio-applications. Here, we report the photoacoustic response of graphene nanoflakes - Polydimethylsiloxane composite. A protocol was developed to obtain well-dispersed graphene into the polymer, without the need for surface functionalization, at different weight percentages successively spin-coated onto a Polydimethylsiloxane substrate. We found that the photoacoustic amplitude scales up with optical absorption reaching 11 MPa at ∼ 228 mJ/cm2 laser fluence. We observed a deviation of the pressure amplitude from the linearity increasing the laser fluence, which indicates a decrease of the Grüneisen parameter. Spatial confinement of high amplitude (> 40 MPa, laser fluence > 55 mJ/cm2) and high frequency (Bw-6db ∼ 21.5 MHz) ultrasound was achieved by embedding the freestanding film in an optical lens. The acoustic gain promotes the formation of cavitation microbubbles for moderate fluence in water and in tissue-mimicking material. Our results pave the way for novel photoacoustic medical devices and integrated components.
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Affiliation(s)
- Daniele Vella
- Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
| | - Aleš Mrzel
- Jožef Stefan Institute, Department of Complex Matter, Jamova 39, 1000 Ljubljana, Slovenia
| | - Aljaž Drnovšek
- Jožef Stefan Institute, Department of Thin Films and Surfaces, Jamova 39, 1000 Ljubljana, Slovenia
| | - Vasyl Shvalya
- Jožef Stefan Institute, Department of Gaseous Electronic, Jamova 39, 1000 Ljubljana, Slovenia
| | - Matija Jezeršek
- Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
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Li S, Xu J, Li R, Wang Y, Zhang M, Li J, Yin S, Liu G, Zhang L, Li B, Gu Q, Su Y. Stretchable Electronic Facial Masks for Sonophoresis. ACS NANO 2022; 16:5961-5974. [PMID: 35363481 DOI: 10.1021/acsnano.1c11181] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We introduce a stretchable electronic facial mask (SEFM) as a platform for facial healthcare, which can integrate with various sensors and actuators. As a demonstration, an SEFM for sonophoresis enabling the promotion of the delivery effect of a drug mask is developed. To overcome the technique challenges, several approaches including the design of the joined silicone layer by two planar half-face portions and the single-side soft pressing (SSSP) technique for encapsulation are exploited in this work, which could be extended to the design and fabrication of other stretchable electronics. The mechanical, thermal, electrical, and ultrasonic characteristics of the SEFM are all verified by the finite element analysis and experiments. Finally, we prove the effect of the SEFM on accelerating the delivery of hyaluronic acid (HA) through animal experiments and confirm that the SEFM can enhance the skin moisture content by 20% via human facial experiments.
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Affiliation(s)
- Shuang Li
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jingwen Xu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Rui Li
- State Key Laboratory of Structural Analysis for Industrial Equipment, Department of Engineering Mechanics, and International Research Center for Computational Mechanics, Dalian University of Technology, Dalian 116024, China
| | - Yongkang Wang
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Maoyi Zhang
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jie Li
- Institute for Advanced Ceramics, State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150001, China
| | - Shizhen Yin
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guodong Liu
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lijuan Zhang
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Baoqiang Li
- Institute for Advanced Ceramics, State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150001, China
| | - Qi Gu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Yewang Su
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing 100049, China
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing 100190, China
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Park D, Won J, Lee G, Lee Y, Kim CW, Seo J. Sonophoresis with ultrasound-responsive liquid-core nuclei for transdermal drug delivery. Skin Res Technol 2022; 28:291-298. [PMID: 35034386 PMCID: PMC9907662 DOI: 10.1111/srt.13129] [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: 08/10/2021] [Accepted: 12/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sonophoresis can increase the delivery efficiency of various drugs into the skin. A recent advance in sonophoresis is the use of ultrasound-responsive liquid-core nuclei (URLN) to increase the probability of cavitation. In this study, we developed a URLN and ultrasound device, and demonstrated its effectiveness through in vitro and clinical tests. MATERIALS AND METHODS Three types of experiments were designed to evaluate the efficiency of sonophoresis with URLN. First, a Franz diffusion cell with cosmetic ingredients was used to analyze quantitatively the amount of drug delivered to the porcine skin. Second, after the application of sonophoresis with URLN, the porcine skin surface was examined using scanning electron microscopy (SEM) to see the changes in morphology. Finally, a clinical test was performed to verify the utility of sonophoresis with URLN. RESULTS The results indicate that sonophoresis with URLN can increase the amount of compound delivered by approximately 11.9-fold over 6 h for niacinamide and by 7.33-fold over 6 h for adenosine. In addition, we observed approximately 20-30 μm sized pores on porcine skin in SEM images. In clinical testing, the application of sonophoresis with cosmetics containing URLN for 3 min improved the efficiency of transdermal drug delivery by 1.9-fold, the depth of absorption by 2.0-fold, and the speed of absorption by 2.0-fold at 30 min after application. CONCLUSION We expect that sonophoresis with specialized URLN in transdermal drug delivery could be used widely for various skin-related applications.
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Affiliation(s)
- Donghee Park
- BioInfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, Jongno-Gu, Seoul, Republic of Korea
| | - Jongho Won
- BioInfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, Jongno-Gu, Seoul, Republic of Korea
| | - Gyounjung Lee
- BiSang Soft, 405, Medical Industry Techno Tower, Wonju, Gangwon-do, Republic of Korea
| | - Yongheum Lee
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Chul-Woo Kim
- BioInfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, Jongno-Gu, Seoul, Republic of Korea
| | - Jongbum Seo
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
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6
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Shin Low S, Nong Lim C, Yew M, Siong Chai W, Low LE, Manickam S, Ti Tey B, Show PL. Recent ultrasound advancements for the manipulation of nanobiomaterials and nanoformulations for drug delivery. ULTRASONICS SONOCHEMISTRY 2021; 80:105805. [PMID: 34706321 PMCID: PMC8555278 DOI: 10.1016/j.ultsonch.2021.105805] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/08/2021] [Accepted: 10/20/2021] [Indexed: 05/04/2023]
Abstract
Recent advances in ultrasound (US) have shown its great potential in biomedical applications as diagnostic and therapeutic tools. The coupling of US-assisted drug delivery systems with nanobiomaterials possessing tailor-made functions has been shown to remove the limitations of conventional drug delivery systems. The low-frequency US has significantly enhanced the targeted drug delivery effect and efficacy, reducing limitations posed by conventional treatments such as a limited therapeutic window. The acoustic cavitation effect induced by the US-mediated microbubbles (MBs) has been reported to replace drugs in certain acute diseases such as ischemic stroke. This review briefly discusses the US principles, with particular attention to the recent advancements in drug delivery applications. Furthermore, US-assisted drug delivery coupled with nanobiomaterials to treat different diseases (cancer, neurodegenerative disease, diabetes, thrombosis, and COVID-19) are discussed in detail. Finally, this review covers the future perspectives and challenges on the applications of US-mediated nanobiomaterials.
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Affiliation(s)
- Sze Shin Low
- Continental-NTU Corporate Lab, Nanyang Technological University, 50 Nanyang Drive, Singapore 637553, Singapore; Department of Chemical and Environmental Engineering, Faculty of Science and Engineering, University of Nottingham Malaysia, Jalan Broga, Semenyih 43500, Selangor Darul Ehsan, Malaysia
| | - Chang Nong Lim
- School of Engineering and Physical Sciences, Heriot-Watt University Malaysia, No. 1, Jalan Venna P5/2, Precinct 5, Putrajaya 62200, Malaysia
| | - Maxine Yew
- Department of Mechanical, Materials and Manufacturing Engineering, University of Nottingham Ningbo China, 199 Taikang East Road, Ningbo 315100, Zhejiang, China
| | - Wai Siong Chai
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, Shenzhen 518055, Guangdong, China
| | - Liang Ee Low
- Biofunctional Molecule Exploratory (BMEX) Research Group, School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia; Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310058, Zhejiang, China.
| | - Sivakumar Manickam
- Petroleum and Chemical Engineering, Faculty of Engineering, Universiti Teknologi Brunei, Jalan Tungku Link Gadong, Bandar Seri Begawan, BE1410, Brunei Darussalam.
| | - Beng Ti Tey
- Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia; Chemical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
| | - Pau Loke Show
- Department of Chemical and Environmental Engineering, Faculty of Science and Engineering, University of Nottingham Malaysia, Jalan Broga, Semenyih 43500, Selangor Darul Ehsan, Malaysia.
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7
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Zhang D, Chen B, Mu Q, Wang W, Liang K, Wang L, Wang Q. Topical delivery of gambogic acid assisted by the combination of low-frequency ultrasound and chemical enhancers for chemotherapy of cutaneous melanoma. Eur J Pharm Sci 2021; 166:105975. [PMID: 34391880 DOI: 10.1016/j.ejps.2021.105975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
Anti-cutaneous melanoma activity of the skin-delivered gambogic acid (GA) has been reported in our previous study. However, it is difficult for GA to diffuse passively through intact skin without any enhancement means. In this study, a combination of chemical enhancers (EN: azone and propylene glycol) and physical ultrasound (US) was used to improve the percutaneous permeation of GA and enhance the anti-melanoma activity. The enhancement effect of the combination of EN and US (EN-US) on GA in vitro and in vivo was studied, and the enhancement mechanism and skin irritation were also evaluated. We showed that the parameters of US application at a constant frequency (30 kHz) with a duty cycle of 100% and intensity of 1.75 W/cm2 for 20 min were optimal. In vitro, EN-US showed a considerable enhancement of the permeation of GA, and the enhancement effect was stronger than that with the use of EN or US alone. In vivo antitumor study showed that the tumor growth was significantly inhibited after percutaneous administration of GA by EN-US, more than in the intravenous injection group. The penetration enhancement mechanism revealed that EN-US not only altered the structure of lipid bilayers and keratins to reduce the barrier effect of the stratum corneum but also produced diffusion channels in the skin under the cavitation effect of US, thereby promoting the skin penetration of GA. In addition, there was no observable skin irritation in mice after treatment with EN-US. Our study demonstrated that the combination of EN and US improved the skin permeation and retention of GA to enhance the anti-melanoma activity. This method also provides technical guidance for the future development of topical and transdermal therapeutic system of GA.
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Affiliation(s)
- Ding Zhang
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China
| | - Boqi Chen
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China
| | - Qingke Mu
- School of Bioengineering, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Wei Wang
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China
| | - Kaili Liang
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China
| | - Liyan Wang
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China
| | - Qing Wang
- State Key Laboratory of Fine Chemicals, Department of Pharmaceutical Sciences, School of Chemical Engineering, Dalian University of Technology, No. 2 Linggong Road, Ganjingzi District, Dalian, Liaoning 116024, China.
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8
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Yu YQ, Yang X, Wu XF, Fan YB. Enhancing Permeation of Drug Molecules Across the Skin via Delivery in Nanocarriers: Novel Strategies for Effective Transdermal Applications. Front Bioeng Biotechnol 2021; 9:646554. [PMID: 33855015 PMCID: PMC8039394 DOI: 10.3389/fbioe.2021.646554] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/25/2021] [Indexed: 12/28/2022] Open
Abstract
The transdermal route of administration provides numerous advantages over conventional routes i.e., oral or injectable for the treatment of different diseases and cosmetics applications. The skin also works as a reservoir, thus deliver the penetrated drug for more extended periods in a sustained manner. It reduces toxicity and local irritation due to multiple sites for absorption and owes the option of avoiding systemic side effects. However, the transdermal route of delivery for many drugs is limited since very few drugs can be delivered at a viable rate using this route. The stratum corneum of skin works as an effective barrier, limiting most drugs' penetration posing difficulty to cross through the skin. Fortunately, some non-invasive methods can significantly enhance the penetration of drugs through this barrier. The use of nanocarriers for increasing the range of available drugs for the transdermal delivery has emerged as a valuable and exciting alternative. Both the lipophilic and hydrophilic drugs can be delivered via a range of nanocarriers through the stratum corneum with the possibility of having local or systemic effects to treat various diseases. In this review, the skin structure and major obstacle for transdermal drug delivery, different nanocarriers used for transdermal delivery, i.e., nanoparticles, ethosomes, dendrimers, liposomes, etc., have been discussed. Some recent examples of the combination of nanocarrier and physical methods, including iontophoresis, ultrasound, laser, and microneedles, have also been discussed for improving the therapeutic efficacy of transdermal drugs. Limitations and future perspectives of nanocarriers for transdermal drug delivery have been summarized at the end of this manuscript.
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Affiliation(s)
- Yi-Qun Yu
- Scientific Research and Education Department, Chun’an First People’s Hospital (Zhejiang Provincial People’s Hospital Chun’an Branch), Hangzhou, China
- Nursing Department, Chun’an First People’s Hospital (Zhejiang Provincial People’s Hospital Chun’an Branch), Hangzhou, China
| | - Xue Yang
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xiao-Fang Wu
- Nursing Department, Chun’an First People’s Hospital (Zhejiang Provincial People’s Hospital Chun’an Branch), Hangzhou, China
| | - Yi-Bin Fan
- Department of Dermatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
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Encompassment of phthalyl sulfacetamide in α- and β-cyclodextrin using ultrasonication: Physicochemical and computational modeling investigations. J Mol Liq 2020. [DOI: 10.1016/j.molliq.2020.114184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Rigby JH, Hagan AM, Kelcher AR, Ji C. Dexamethasone Sodium Phosphate Penetration During Phonophoresis at 2 Ultrasound Frequencies. J Athl Train 2020; 55:628-635. [PMID: 32320285 DOI: 10.4085/1062-6050-556-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The effect of ultrasound frequency on phonophoresis drug delivery in humans is unknown. OBJECTIVE To determine if a low (45-kHz) or high (1-MHz) frequency delivered a higher dexamethasone (Dex) concentration through the skin. DESIGN Controlled laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 40 healthy men between the ages of 18 and 45 years (age = 23.1 ± 2.6 years, height = 176.1 ± 7.2 cm, mass = 88.5 ± 19.4 kg, posterior calf subcutaneous thickness measured using musculoskeletal ultrasound imaging = 0.6 ± 0.2 cm). INTERVENTION(S) Participants were randomly assigned to 1 of 4 groups (ultrasound frequency at microdialysis probe depth): (1) 45-kHz frequency at 1 mm, (2) 45-kHz frequency at 4 mm, (3) 1-MHz frequency at 1 mm, or (4) 1-MHz frequency at 4 mm (n = 10 in each group). Three linear microdialysis probes were inserted at the desired tissue depth. We rubbed dexamethasone sodium phosphate (Dex-P) into the skin and then applied a 15-minute phonophoresis treatment. MAIN OUTCOME MEASURE(S) Dialysate was collected during the treatment and 60 minutes posttreatment and analyzed for Dex-P, Dex, and the metabolite form of Dex. The sum of the 3 analytes was calculated as total dexamethasone (Dex-total), and differences between the 45-kHz and 1-MHz treatment groups were determined by a repeated-measures analysis of variance. RESULTS At 1 mm, 3 (30%) participants in the 45-kHz and 4 (40%) participants in the 1-MHz group had measurable levels of Dex-P. Total dexamethasone increased after the treatment ceased, independent of ultrasound frequency (P < .001), with a trend of the 45-kHz treatment to produce a greater increase in drug concentration (P = .006). At 4 mm, 5 (50%) participants in the 45-kHz and 1 (10%) participant in the 1-MHz group had measurable levels of Dex-P. We observed no difference in Dex-total concentration between treatment groups at 4 mm (P = .72). CONCLUSIONS Phonophoresis provided a mechanism for Dex-total delivery at the 1- and 4-mm tissue depths. However, the effectiveness of the ultrasound frequencies varied between the 2 measured tissue depths.
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Affiliation(s)
| | | | | | - Chang Ji
- Texas State University, San Marcos
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11
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Shanei A, Sazgarnia A. An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2019; 22:848-855. [PMID: 31579439 PMCID: PMC6760485 DOI: 10.22038/ijbms.2019.29584.7142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/16/2019] [Indexed: 12/26/2022]
Abstract
Acoustic cavitation which occurs at high intensities of ultrasound waves can be fatal for tumor cells. The existence of dissolved gases and also the presence of nanoparticles (NPs) in a liquid, irradiated by ultrasound, decrease the acoustic cavitation onset threshold and the resulting bubbles collapse. On the other hand, due to unique capabilities and optical properties of gold nanoparticles (GNPs), they have been emphasized as effective NPs in the field of tumor therapy. Absorption of the laser light by GNPs causes the water molecules around the NPs to evaporate and produces vapor cavities. In this paper, we have reviewed published studies in the fields of ultrasound therapy, sonodynamic therapy (SDT) and synergism of low-level ultrasound and also laser radiation in the presence of GNPs.
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Affiliation(s)
- Ahmad Shanei
- Medical Physics Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ameneh Sazgarnia
- Medical Physics research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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12
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Chang H, Jang WH, Lee S, Kim B, Kim MJ, Kim WO, Ryoo YW, Oh BH, Kim KH. Moxifloxacin Labeling-Based Multiphoton Microscopy of Skin Cancers in Asians. Lasers Surg Med 2019; 52:373-382. [PMID: 31338864 DOI: 10.1002/lsm.23138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Although multiphoton microscopy (MPM) can visualize both cell and extracellular matrix (ECM) structures of the skin in high-contrast without exogenous labeling, label-free MPM is usually too slow to image clinically relevant large regions. A high-speed MPM method would be beneficial for evaluating clinical skin specimens by increasing the imaging area. In this study, moxifloxacin labeling-based MPM (moxifloxacin MPM) was characterized in various human skin cancer specimens. STUDY DESIGN/MATERIALS AND METHODS Moxifloxacin ophthalmic solution was used for cell-labeling and MPM imaging was conducted afterwards. Moxifloxacin MPM was characterized in ex vivo normal human skin and skin cancer specimens in comparison with the label-free MPM and fluorescence confocal microscopy (FCM) using acridine orange as a labeling agent. Then, moxifloxacin MPM was applied to various ex vivo human skin cancer specimens including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dermatofibrosarcoma protuberans (DFSP). Results of moxifloxacin MPM were compared with bright-field clinical and histopathologic findings. RESULTS Moxifloxacin MPM imaged both cells and collagen in the skin, similarly to label-free MPM, but with enhanced fluorescence intensities in cells and enhanced imaging speeds. Moxifloxacin MPM imaged cells in the skin similarly to acridine orange-based FCM. Moxifloxacin MPM of various human skin cancer specimens imaged their specific cellular features. The microscopic features detected in moxifloxacin MPM were confirmed with histological images. CONCLUSIONS This observational pilot study demonstrated that moxifloxacin MPM could detect specific cellular features of various skin cancers in good correlation with histopathological images in Asian patients at the higher imaging speed than label-free MPM. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Hoonchul Chang
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Won Hyuk Jang
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Seunghun Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Bumju Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, Asan University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Won Oh Kim
- Department of Dermatology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Young Wook Ryoo
- Department of Dermatology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Byung Ho Oh
- Department of Dermatology, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ki Hean Kim
- Division of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea.,Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
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13
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Freire Dos Santos MJ, Carvalho R, Arnaut LG. Split-Face, Randomized, Placebo-Controlled, Double-Blind Study to Investigate Passive Versus Active Dermal Filler Administration. Aesthetic Plast Surg 2018; 42:1655-1663. [PMID: 30076447 DOI: 10.1007/s00266-018-1208-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/21/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND QueryHyaluronic acid (HA) is a large polymer increasingly used as dermal filler. HA does not permeate through healthy skin and is administered using various injection techniques. As HA procedures become more popular, the number of complications in facial rejuvenation procedures is likely to increase. Alternative methods may be necessary to satisfy the increasing demand for HA procedures. High-frequency high-intensity ultrasound is a painless and noninvasive method to deliver large molecules to the skin that is expected to deliver HA with visible results. OBJECTIVE Assess facial rejuvenation with HA delivered with high-frequency high-intensity ultrasound. METHODS Fifteen women (mean age 55) willing to participate in a randomized, double-blind, face-split trial with HA and placebo formulations in different sides of the face, were subject to five treatment sessions with high-frequency high-intensity ultrasound. Photographs taken before the procedure and after the last procedure were evaluated by a panel of five experts, blind to which side was treated with the HA or with the placebo. RESULTS The expert panel identified a noticeable facial rejuvenation in the HA side relative to the placebo with a very statistically significant difference between the two sides (p < 0.0001). CONCLUSIONS Administration of HA with high-frequency high-intensity ultrasound is safe and leads to unambiguous facial rejuvenation. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Mário Jorge Freire Dos Santos
- Cirurgia Plástica, Centro Cirúrgico de Coimbra, Coimbra, Portugal
- Unit of Plastic and Reconstructive Surgery and Burns Unit, University of Coimbra Hospitals, Coimbra, Portugal
| | - Ricardo Carvalho
- Centro de Cirurgia Plástica e Estética, Sanfil, Coimbra, Portugal
| | - Luis G Arnaut
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
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14
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Nguyen HX, Banga AK. Electrically and Ultrasonically Enhanced Transdermal Delivery of Methotrexate. Pharmaceutics 2018; 10:pharmaceutics10030117. [PMID: 30081603 PMCID: PMC6161078 DOI: 10.3390/pharmaceutics10030117] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 12/29/2022] Open
Abstract
In this study, we used sonophoresis and iontophoresis to enhance the in vitro delivery of methotrexate through human cadaver skin. Iontophoresis was applied for 60 min at a 0.4 mA/sq·cm current density, while low-frequency sonophoresis was applied at a 20 kHz frequency (2 min application, and 6.9 W/sq·cm intensity). The treated skin was characterized by dye binding, transepidermal water loss, skin electrical resistance, and skin temperature measurement. Both sonophoresis and iontophoresis resulted in a significant reduction in skin electrical resistance as well as a marked increase in transepidermal water loss value (p < 0.05). Furthermore, the ultrasonic waves resulted in a significant increase in skin temperature (p < 0.05). In permeation studies, the use of iontophoresis led to a significantly higher drug permeability than the untreated group (n = 4, p < 0.05). The skin became markedly more permeable to methotrexate after the treatment by sonophoresis than by iontophoresis (p < 0.01). A synergistic effect for the combined application of sonophoresis and iontophoresis was also observed. Drug distribution in the skin layers revealed a significantly higher level of methotrexate in the sonicated skin than that in iontophoresis and untreated groups. Iontophoresis and low-frequency sonophoresis were found to enhance the transdermal and intradermal delivery of methotrexate in vitro.
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Affiliation(s)
- Hiep X Nguyen
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA.
| | - Ajay K Banga
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA.
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15
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López-Marín LM, Rivera AL, Fernández F, Loske AM. Shock wave-induced permeabilization of mammalian cells. Phys Life Rev 2018; 26-27:1-38. [PMID: 29685859 DOI: 10.1016/j.plrev.2018.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 12/18/2022]
Abstract
Controlled permeabilization of mammalian cell membranes is fundamental to develop gene and cell therapies based on macromolecular cargo delivery, a process that emerged against an increasing number of health afflictions, including genetic disorders, cancer and infections. Viral vectors have been successfully used for macromolecular delivery; however, they may have unpredictable side effects and have been limited to life-threatening cases. Thus, several chemical and physical methods have been explored to introduce drugs, vaccines, and nucleic acids into cells. One of the most appealing physical methods to deliver genes into cells is shock wave-induced poration. High-speed microjets of fluid, emitted due to the collapse of microbubbles after shock wave passage, represent the most significant mechanism that contributes to cell membrane poration by this technique. Herein, progress in shock wave-induced permeabilization of mammalian cells is presented. After covering the main concepts related to molecular strategies whose applications depend on safer drug delivery methods, the physics behind shock wave phenomena is described. Insights into the use of shock waves for cell membrane permeation are discussed, along with an overview of the two major biomedical applications thereof-i.e., genetic modification and anti-cancer shock wave-assisted chemotherapy. The aim of this review is to summarize 30 years of data showing underwater shock waves as a safe, noninvasive method for macromolecular delivery into mammalian cells, encouraging the development of further research, which is still required before the introduction of this promising tool into clinical practice.
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Affiliation(s)
- Luz M López-Marín
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Boulevard Juriquilla 3001, 76230 Querétaro, Qro., Mexico.
| | - Ana Leonor Rivera
- Instituto de Ciencias Nucleares & Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510 Ciudad de México, Mexico.
| | - Francisco Fernández
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Boulevard Juriquilla 3001, 76230 Querétaro, Qro., Mexico.
| | - Achim M Loske
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Boulevard Juriquilla 3001, 76230 Querétaro, Qro., Mexico.
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16
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Abstract
Background: The application of therapeutic agents to the skin addresses three general objectives: (a) the treatment of a variety of dermatologic diseases; (b) the “targeted” delivery of drugs to deeper subcutaneous tissues, with a concomitant reduction in systemic exposure; and (c) socalled transdermal administration to elicit a systemic pharmacologic effect. Objective: Recently, significant progress towards all three goals has been recorded and the level of research and development activity remains high. We aim to discuss these advances from mechanistic and clinical standpoints. Results: For the topical treatment of skin disease, novel vehicles (e.g., stabilized, supersaturated systems and liposomal formulations) have led to dramatic improvements in local drug bioavailability. Transdermal delivery of drugs for systemic effect, though limited in terms of the number of compounds, is perhaps the most commercially successful (in terms of the number of products) of the controlled release technologies. Considerable activity continues to enhance drug delivery (and hence to extend the range of drugs for which transdermal delivery can be used). Existing patches use formulations that contain solvents and adjuvants capable of reducing the barrier function of the skin. Much effort is directed at iontophoresis (electrically enhanced transport), particularly for small peptides that are difficult to administer by other routes. “Reverse iontophoresis” may allow the extraction of glucose (without skin puncture) so that continuous, noninvasive monitoring of blood sugar in diabetics approaches realization. Conclusion: In the not too distant future, the skin may also play a role not only in drug delivery, but also with respect to measurements in clinical chemistry.
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Affiliation(s)
- Virginia Merino
- Centre Interuniversitaire de Recherche et d'Enseignement, “Pharmapeptides,” Campus Universitaire, Parc d'Affaires International, Archamps, France
- Departamento de Farmacia y Tecnologia Farmaceutica. Facultad de Farmacia, Universidad de Valencia. Burjassot, Valencia, Spain
| | - Ingo Alberti
- Centre Interuniversitaire de Recherche et d'Enseignement, “Pharmapeptides,” Campus Universitaire, Parc d'Affaires International, Archamps, France
- Faculté des Sciences — Section Pharmacie, Laboratoire de Pharmacie Galénique, Université de Genève, Genève, Switzerland
| | - Yogeshvar N. Kalia
- Centre Interuniversitaire de Recherche et d'Enseignement, “Pharmapeptides,” Campus Universitaire, Parc d'Affaires International, Archamps, France
- Faculté des Sciences — Section Pharmacie, Laboratoire de Pharmacie Galénique, Université de Genève, Genève, Switzerland
| | - Richard H. Guy
- Centre Interuniversitaire de Recherche et d'Enseignement, “Pharmapeptides,” Campus Universitaire, Parc d'Affaires International, Archamps, France
- Faculté des Sciences — Section Pharmacie, Laboratoire de Pharmacie Galénique, Université de Genève, Genève, Switzerland
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17
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Abstract
Very high frequency ultrasound (VHF-US) is new therapy method with a broad application spectrum in dermatology and aesthetic medicine. In this method, ultrasound waves with frequencies over 10 MHz, which were for a long time only used in ultrasound diagnostics, are applied for therapeutic purposes. Such US waves demonstrate specific biophysical efficiencies which warrant their application for the treatment of the skin efflorescences, chronic wounds and hypertrophic scars as well as in anti-aging and skin improvement procedures in aesthetic medicine. VHF-US can be applied not only for stand-alone treatments, but also as a supportive pre- and posttreatment method in combination with laser, radiofrequency currents, injection lipolysis, etc. as well as in aesthetic plastic surgery.
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18
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Park D, Song G, Jo Y, Won J, Son T, Cha O, Kim J, Jung B, Park H, Kim CW, Seo J. Sonophoresis Using Ultrasound Contrast Agents: Dependence on Concentration. PLoS One 2016; 11:e0157707. [PMID: 27322539 PMCID: PMC4913954 DOI: 10.1371/journal.pone.0157707] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 05/09/2016] [Indexed: 11/17/2022] Open
Abstract
Sonophoresis can increase skin permeability to various drugs in transdermal drug delivery. Cavitation is recognized as the predominant mechanism of sonophoresis. Recently, a new logical approach to enhance the efficiency of transdermal drug delivery was tried. It is to utilize the engineered microbubble and its resonant frequency for increase of cavitation activity. Actively-induced cavitation with low-intensity ultrasound (less than ~1 MPa) causes disordering of the lipid bilayers and the formation of aqueous channels by stable cavitation which indicates a continuous oscillation of bubbles. Furthermore, the mutual interactions of microbubble determined by concentration of added bubble are also thought to be an important factor for activity of stable cavitation, even in different characteristics of drug. In the present study, we addressed the dependence of ultrasound contrast agent concentration using two types of drug on the efficiency of transdermal drug delivery. Two types of experiment were designed to quantitatively evaluate the efficiency of transdermal drug delivery according to ultrasound contrast agent concentration. First, an experiment of optical clearing using a tissue optical clearing agent was designed to assess the efficiency of sonophoresis with ultrasound contrast agents. Second, a Franz diffusion cell with ferulic acid was used to quantitatively determine the amount of drug delivered to the skin sample by sonophoresis with ultrasound contrast agents. The maximum enhancement ratio of sonophoresis with a concentration of 1:1,000 was approximately 3.1 times greater than that in the ultrasound group without ultrasound contrast agent and approximately 7.5 times greater than that in the control group. These results support our hypothesis that sonophoresis becomes more effective in transdermal drug delivery due to the presence of engineered bubbles, and that the efficiency of transdermal drug delivery using sonophoresis with microbubbles depends on the concentration of microbubbles in case stable cavitation is predominant.
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Affiliation(s)
- Donghee Park
- Department of Pathology, Tumor Immunity Medical Research Center, Cancer Research Institute, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Gillsoo Song
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Yongjun Jo
- Gumi Electronics & Information Technology Research Institute, Gumi, Gyeongsangbuk-do, Republic of Korea
| | - Jongho Won
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Taeyoon Son
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Ohrum Cha
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Jinho Kim
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Byungjo Jung
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Hyunjin Park
- School of Electronic Electrical Engineering, Sungkyunkwan University, Suwon, Gyeonggi-do, Republic of Korea
| | - Chul-Woo Kim
- Department of Pathology, Tumor Immunity Medical Research Center, Cancer Research Institute, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Jongbum Seo
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea
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19
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Novel delivery approaches for cancer therapeutics. J Control Release 2015; 219:248-268. [PMID: 26456750 DOI: 10.1016/j.jconrel.2015.09.067] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/09/2015] [Accepted: 09/30/2015] [Indexed: 02/07/2023]
Abstract
Currently, a majority of cancer treatment strategies are based on the removal of tumor mass mainly by surgery. Chemical and physical treatments such as chemo- and radiotherapies have also made a major contribution in inhibiting rapid growth of malignant cells. Furthermore, these approaches are often combined to enhance therapeutic indices. It is widely known that surgery, chemo- and radiotherapy also inhibit normal cells growth. In addition, these treatment modalities are associated with severe side effects and high toxicity which in turn lead to low quality of life. This review encompasses novel strategies for more effective chemotherapeutic delivery aiming to generate better prognosis. Currently, cancer treatment is a highly dynamic field and significant advances are being made in the development of novel cancer treatment strategies. In contrast to conventional cancer therapeutics, novel approaches such as ligand or receptor based targeting, triggered release, intracellular drug targeting, gene delivery, cancer stem cell therapy, magnetic drug targeting and ultrasound-mediated drug delivery, have added new modalities for cancer treatment. These approaches have led to selective detection of malignant cells leading to their eradication with minimal side effects. Lowering multi-drug resistance and involving influx transportation in targeted drug delivery to cancer cells can also contribute significantly in the therapeutic interventions in cancer.
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20
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Aldwaikat M, Alarjah M. Investigating the sonophoresis effect on the permeation of diclofenac sodium using 3D skin equivalent. ULTRASONICS SONOCHEMISTRY 2015; 22:580-587. [PMID: 24916997 DOI: 10.1016/j.ultsonch.2014.02.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 06/03/2023]
Abstract
Ultrasound temporally increases skin permeability by altering stratum corneum SC function (sonophoresis). The objective of this study was to evaluate the effect of variable ultrasound conditions on the permeation of diclofenac sodium DS with range of physicochemical properties through EpiDerm™. Permeation studies were carried out in vitro using Franz diffusion cell. HPLC method was used for the determination of the concentration of diclofenac sodium in receiving compartment. Parameters like ultrasound frequency, application time, amplitude, and mode of sonication and distance of ultrasound horn from skin were investigated, and the conditions where the maximum enhancement rate obtained were determined. Application of ultrasound enhanced permeation of diclofenac sodium across EpiDerm™ by fivefolds. The most effective enhancing parameters were power sonication of 20kHz frequency, 20% amplitude at continuous mode for 5min.
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Affiliation(s)
- Mai Aldwaikat
- Faculty of Pharmacy, Umm Alqura University, Makkah, Saudi Arabia.
| | - Mohammed Alarjah
- Faculty of Pharmacy, Umm Alqura University, Makkah, Saudi Arabia.
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21
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Han T, Das DB. Potential of combined ultrasound and microneedles for enhanced transdermal drug permeation: a review. Eur J Pharm Biopharm 2014; 89:312-28. [PMID: 25541440 DOI: 10.1016/j.ejpb.2014.12.020] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 11/28/2022]
Abstract
Transdermal drug delivery (TDD) is limited by the outer layer of the skin, i.e., the stratum corneum. Research on TDD has become very active in the recent years and various technologies have been developed to overcome the resistance of the stratum corneum to molecular diffusion. In particular, researchers have started to consider the possibility of combining the TDD technologies in order to have further increase in drug permeability. Both microneedles (MNs) and ultrasound are promising technologies. They achieve enhancement in drug permeation via different mechanisms and therefore give a good potential for combining with each other. This review will focus on discussing the potential of this combinational technique along with other important issues, e.g., the mechanisms of ultrasound and MNs as it is and these mechanisms which are coupled via the two systems (i.e. MNs and ultrasound). We discuss the possible ways to achieve this combination as well as how this combination would increase the permeability. Some of the undeveloped (weaker) research areas of MNs and sonophoresis are also discussed in order to understand the true potential of combining the two technologies when they are developed further in the future. We propose several hypothetical combinations based on the possible mechanisms involved in MNs and ultrasound. Furthermore, we carry out a cluster analysis by which we determine the significance of this combinational method in comparison with some other selected combinational methods for TDD (e.g., MNs and iontophoresis). Using a time series analysis tool (ARIMA model), the current trend and the future development of combined MNs and ultrasound are also analysed. Overall, the review in this paper indicates that combining MNs and ultrasound is a promising TDD method for the future.
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Affiliation(s)
- Tao Han
- Chemical Engineering Department, Loughborough University, Loughborough, UK
| | - Diganta Bhusan Das
- Chemical Engineering Department, Loughborough University, Loughborough, UK.
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22
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Rich KT, Hoerig CL, Rao MB, Mast TD. Relations between acoustic cavitation and skin resistance during intermediate- and high-frequency sonophoresis. J Control Release 2014; 194:266-77. [PMID: 25135791 DOI: 10.1016/j.jconrel.2014.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 07/24/2014] [Accepted: 08/06/2014] [Indexed: 10/24/2022]
Abstract
Enhanced skin permeability is known to be achieved during sonophoresis due to ultrasound-induced cavitation. However, the mechanistic role of cavitation during sonophoresis has been extensively investigated only for low-frequency (LFS, <100 kHz) applications. Here, mechanisms of permeability-enhancing stable and inertial cavitation were investigated by passively monitoring subharmonic and broadband emissions arising from cavitation isolated within or external to porcine skin in vitro during intermediate- (IFS, 100-700 kHz) and high-frequency sonophoresis (HFS, >1 MHz). The electrical resistance of skin, a surrogate measure of the permeability of skin to a variety of compounds, was measured to quantify the reduction and subsequent recovery of the skin barrier during and after exposure to pulsed (1 second pulse, 20% duty cycle) 0.41 and 2.0 MHz ultrasound over a range of acoustic powers (0-21.7 W) for 30 min. During IFS, significant skin resistance reductions and acoustic emissions from cavitation were measured exclusively when cavitation was isolated outside of the skin. Time-dependent skin resistance reductions measured during IFS correlated significantly with subharmonic and broadband emission levels. During HFS, significant skin resistance reductions were accompanied by significant acoustic emissions from cavitation measured during trials that isolated cavitation activity either outside of skin or within skin. Time-dependent skin resistance reductions measured during HFS correlated significantly greater with subharmonic than with broadband emission levels. The reduction of the skin barrier due to sonophoresis was reversible in all trials; however, effects incurred during IFS recovered more slowly and persisted over a longer period of time than HFS. These results quantitatively demonstrate the significance of cavitation during sonophoresis and suggest that the mechanisms and post-treatment longevity of permeability enhancement due to IFS and HFS treatments are different.
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Affiliation(s)
- Kyle T Rich
- Biomedical Engineering Program, University of Cincinnati, Cincinnati, OH, USA
| | - Cameron L Hoerig
- Electrical Engineering Program, University of Cincinnati, Cincinnati, OH, USA
| | - Marepalli B Rao
- Biomedical Engineering Program, University of Cincinnati, Cincinnati, OH, USA; Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - T Douglas Mast
- Biomedical Engineering Program, University of Cincinnati, Cincinnati, OH, USA.
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23
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Yoshida K, Obata K, Tsukamoto A, Ushida T, Watanabe Y. Limited damage of tissue mimic caused by a collapsing bubble under low-frequency ultrasound exposure. ULTRASONICS 2014; 54:1603-1609. [PMID: 24751130 DOI: 10.1016/j.ultras.2014.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/27/2014] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
In this study, we investigated the bubble induced serious damage to tissue mimic exposed to 27-kHz ultrasound. The initial bubble radius ranged from 80 to 100 μm, which corresponded approximately to the experimentally-evaluated resonant radius of the given ultrasound frequency. The tissue mimic consisted of 10 wt% gelatine gel covered with cultured canine kidney epithelial cells. The collapsing bubble behaviour during the ultrasound exposure with negative peak pressures of several hundred kPa was captured by a high-speed camera system. After ultrasound exposure, a cell viability test was conducted based on microscopic bright-field images and fluorescence images for living and dead cells. In the viability test, cells played a role in indicating the damaged area. The bubble oscillations killed the cells, and on occasion detached layers of cultured cells from the gel. The damaged area was comparable or slightly larger than the initial bubble size, and smaller than the maximum bubble size. We concluded that only a small area in close proximity to the bubble could be damaged even above transient cavitation threshold.
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Affiliation(s)
- Kenji Yoshida
- Laboratory of Ultrasonic Electronics, Doshisha University, 610-0321 Kyotanabe, Kyoto, Japan; Center for Frontier Medical Engineering, Chiba University, 263-8522 Chiba, Japan.
| | - Kazuya Obata
- Laboratory of Ultrasonic Electronics, Doshisha University, 610-0321 Kyotanabe, Kyoto, Japan
| | - Akira Tsukamoto
- Department of Applied Physics, National Defense Academy of Japan, 239-8686 Yokosuka, Kanagawa, Japan
| | - Takashi Ushida
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, 113-0033 Bunkyo-ku, Tokyo, Japan
| | - Yoshiaki Watanabe
- Laboratory of Ultrasonic Electronics, Doshisha University, 610-0321 Kyotanabe, Kyoto, Japan
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24
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Azagury A, Khoury L, Enden G, Kost J. Ultrasound mediated transdermal drug delivery. Adv Drug Deliv Rev 2014; 72:127-43. [PMID: 24463344 DOI: 10.1016/j.addr.2014.01.007] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 12/24/2013] [Accepted: 01/14/2014] [Indexed: 01/06/2023]
Abstract
Transdermal drug delivery offers an attractive alternative to the conventional drug delivery methods of oral administration and injections. However, the stratum corneum serves as a barrier that limits the penetration of substances to the skin. Application of ultrasound (US) irradiation to the skin increases its permeability (sonophoresis) and enables the delivery of various substances into and through the skin. This review presents the main findings in the field of sonophoresis in transdermal drug delivery as well as transdermal monitoring and the mathematical models associated with this field. Particular attention is paid to the proposed enhancement mechanisms and future trends in the fields of cutaneous vaccination and gene therapy.
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Affiliation(s)
- Aharon Azagury
- Department of Chemical Engineering, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Luai Khoury
- Department of Biomedical Engineering, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Giora Enden
- Department of Biomedical Engineering, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Joseph Kost
- Department of Chemical Engineering, Ben-Gurion University, Beer-Sheva 84105, Israel.
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25
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Razavi A, Clement D, Fowler RA, Birer A, Chavrier F, Mestas JL, Romano F, Chapelon JY, Béglé A, Lafon C. Contribution of inertial cavitation in the enhancement of in vitro transscleral drug delivery. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1216-1227. [PMID: 24613634 DOI: 10.1016/j.ultrasmedbio.2013.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/08/2013] [Accepted: 12/31/2013] [Indexed: 06/03/2023]
Abstract
In ocular drug delivery, the sclera is a promising pathway for administering drugs to both the anterior and posterior segments of the eye. Due to the low permeability of the sclera, however, efficient drug delivery is challenging. In this study, pulsed ultrasound (US) was investigated as a potential method for enhancing drug delivery to the eye through the sclera. The permeability of rabbit scleral tissue to a model drug compound, sodium fluorescein, was measured after US-irradiation at 1.1 MHz using time-averaged acoustic powers of 0.5-5.4 W (6.8-12.8 MPa peak negative pressure), with a fixed duty cycle of 2.5% for two different pulse repetition frequencies of 100 and 1000 Hz. Acoustic cavitation activity was measured during exposures using a passive cavitation detector and was used to quantify the level of bubble activity. A correlation between the amount of cavitation activity and the enhancement of scleral permeability was demonstrated with a significant enhancement in permeability of US exposed samples compared to controls. Transmission electron microscopy showed no evidence of significant alteration in viability of tissue exposed to US exposures. A pulsed US protocol designed to maximum cavitation activity may therefore be a viable method for enhancing drug delivery to the eye.
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Affiliation(s)
- Arash Razavi
- Inserm, Unité 1032, Lab TAU, Lyon, France; EyeTechCare, Rillieux la Pape, France.
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26
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Park D, Park H, Seo J, Lee S. Sonophoresis in transdermal drug deliverys. ULTRASONICS 2014; 54:56-65. [PMID: 23899825 DOI: 10.1016/j.ultras.2013.07.007] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 06/01/2013] [Accepted: 07/02/2013] [Indexed: 05/15/2023]
Abstract
Transdermal drug delivery (TDD) has several significant advantages compared to oral drug delivery, including elimination of pain and sustained drug release. However, the use of TDD is limited by low skin permeability due to the stratum corneum (SC), the outermost layer of the skin. Sonophoresis is a technique that temporarily increases skin permeability such that various medications can be delivered noninvasively. For the past several decades, various studies of sonophoresis in TDD have been performed focusing on parameter optimization, delivery mechanism, transport pathway, or delivery of several drug categories including hydrophilic and high molecular weight compounds. Based on these various studies, several possible mechanisms of sonophoresis have been suggested. For example, cavitation is believed to be the predominant mechanism responsible for drug delivery in sonophoresis. This review presents details of various studies on sonophoresis including the latest trends, delivery of various therapeutic drugs, sonophoresis pathways and mechanisms, and outlook of future studies.
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Affiliation(s)
- Donghee Park
- Department of Biomedical Engineering, Yonsei University, Wonju 220-710, Republic of Korea
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Sadick NS. Device-assisted transepidermal delivery of cosmeceuticals: a new way to enhance aesthetic procedures? Aesthetic Plast Surg 2013; 37:973-4. [PMID: 23860818 DOI: 10.1007/s00266-013-0183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Neil S Sadick
- Department of Dermatology, Weill Medical College of Cornell University, 445 E 69th St, New York, NY, 10021, USA,
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Abstract
During the past 20 years, tremendous progress has been made in our understanding of the molecular basis of many genetic skin conditions. The translation of these laboratory findings into effective therapies for affected individuals has been slow, however, in large part due to the risk of carcinogenesis from random viral genomic integration and the lack of efficacy of topically applied genetic material and most proteins. As intervention at the gene level still appears remote for most genetic disorders, increased knowledge about the cellular and biochemical pathogenesis of disease allows specific targeting of pathways with existing and/or novel drugs and molecules. In contrast to the requirement for personalization of most gene-based approaches, pathogenesis-based therapy is pathway specific, and in theory, it should have broader applicability. In this chapter, we provide an overview of the pathoetiology of the various types of ichthyoses and demonstrate how a pathogenesis-based approach can potentially lead to innovative treatments for these conditions. Notably, this strategy has been successfully validated for the treatment of the rare X-linked dominant condition, CHILD syndrome, in which topical applications of cholesterol and lovastatin together to affected skin resulted in marked improvement of the skin phenotype.
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Affiliation(s)
- Joey E Lai-Cheong
- St John's Institute of Dermatology, King's College London, London, United Kingdom
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Subramony JA. Needle free parenteral drug delivery: leveraging active transdermal technologies for pediatric use. Int J Pharm 2013; 455:14-8. [PMID: 23916825 DOI: 10.1016/j.ijpharm.2013.07.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
Abstract
Administration of medications via the parenteral route directly to the systemic circulation is an effective way of overcoming the first pass effect, obtaining quicker onset of action, and achieving higher bioavailability. However, needle phobia and the pain perceived during the injection process often make this a less preferred route than oral in terms of patient acceptance and compliance, particularly for pediatrics. Needleless injection technologies that deliver medications via the transdermal interface have been an active area of pharmaceutical research for many years. This review summarizes the various emerging technologies in the area of active transdermal delivery that can be potentially extended to pediatric applications.
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Affiliation(s)
- J Anand Subramony
- Novartis Institutes for BioMedical Research, 500 Technology Square, Cambridge, MA 02139, USA.
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Han T, Das DB. Permeability enhancement for transdermal delivery of large molecule using low-frequency sonophoresis combined with microneedles. J Pharm Sci 2013; 102:3614-22. [PMID: 23873449 DOI: 10.1002/jps.23662] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/12/2013] [Accepted: 06/18/2013] [Indexed: 12/31/2022]
Abstract
Transdermal drug delivery is limited by the high resistance of skin towards diffusion of high-molecular-weight drugs. This is mainly because of the fact that the outer layer of the skin, that is the stratum corneum, can prevent diffusion of molecules whose molecular weight is greater than 500 Da. Sonophoresis can be used to enhance the permeability of the skin. However, in the delivery of large molecules, ultrasound alone cannot provide sufficient permeability enhancement. In addressing this issue, we propose optimised ultrasound combined with microneedles to further increase the permeation rates. In this paper, we use porcine ear skin to simulate human skin and treat the skin samples with both ultrasound and microneedles. Further, bovine serum albumin (BSA) is used as a model of larger molecular weight molecule. Our results show that the permeability of BSA is increased to 1 μm/s with the combination of 1.5 mm microneedles patch and 15-W ultrasound output which is about 10 times higher than the permeability obtained in passive diffusion. Diffusion with only microneedles or ultrasound pre-treatment is also tested. The maximum permeability from microneedles and ultrasound treatment reached 0.43 and 0.4 μm/s, respectively.
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Affiliation(s)
- Tao Han
- Department of Chemical Engineering, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
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31
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Sá GF, Serpa C, Arnaut LG. Stratum corneum permeabilization with photoacoustic waves generated by piezophotonic materials. J Control Release 2013; 167:290-300. [DOI: 10.1016/j.jconrel.2013.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 02/10/2013] [Indexed: 10/27/2022]
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Bloom BS, Brauer JA, Geronemus RG. Ablative fractional resurfacing in topical drug delivery: an update and outlook. Dermatol Surg 2013; 39:839-48. [PMID: 23294061 DOI: 10.1111/dsu.12111] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The effective delivery of therapeutic molecules to varied targets in the skin and elsewhere has been an area of ongoing research and development. OBJECTIVE To review the structure of the skin with an emphasis on topical drug delivery and to present the rationale for the use of ablative and nonablative fractional resurfacing in assisted drug delivery. METHODS AND MATERIALS Review of the currently available scientific literature on laser-assisted drug delivery. RESULTS A number of strategies can be employed to enhance topical drug delivery. Ablative fractional resurfacing (AFR) has been demonstrated to be effective in enhancing drug delivery. Further studies are needed to assess the use of nonablative fractional resurfacing in assisted drug delivery. CONCLUSION AFR-assisted drug delivery is a promising tool for the future of dermatology. We expect to see a number of agents to be paired with AFR for enhanced drug delivery. Further investigation is necessary to evaluate appropriate drug specific channel density and depth parameters. Factors that must be considered include the physicochemical properties of the drug, the target tissue, skin wounding, and cost when evaluating the drugs and conditions that will most benefit from this promising new drug delivery system.
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Affiliation(s)
- Bradley S Bloom
- Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York 10016, USA.
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33
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Delgado-Charro M. Richard Guy and His Collaborators:Crackling'the Skin Code. Skin Pharmacol Physiol 2013; 26:302-12. [DOI: 10.1159/000351937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/11/2013] [Indexed: 11/19/2022]
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Physical methods for genetic plant transformation. Phys Life Rev 2012; 9:308-45. [DOI: 10.1016/j.plrev.2012.06.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 06/04/2012] [Indexed: 01/27/2023]
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35
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Elias PM, Williams ML, Feingold KR. Abnormal barrier function in the pathogenesis of ichthyosis: therapeutic implications for lipid metabolic disorders. Clin Dermatol 2012; 30:311-22. [PMID: 22507046 DOI: 10.1016/j.clindermatol.2011.08.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ichthyoses, including inherited disorders of lipid metabolism, display a permeability barrier abnormality in which the severity of the clinical phenotype parallels the prominence of the barrier defect. The pathogenesis of the cutaneous phenotype represents the consequences of the mutation for epidermal function, coupled with a "best attempt" by affected epidermis to generate a competent barrier in a terrestrial environment. A compromised barrier in normal epidermis triggers a vigorous set of metabolic responses that rapidly normalizes function, but ichthyotic epidermis, which is inherently compromised, only partially succeeds in this effort. Unraveling mechanisms that account for barrier dysfunction in the ichthyoses has identified multiple, subcellular, and biochemical processes that contribute to the clinical phenotype. Current treatment of the ichthyoses remains largely symptomatic: directed toward reducing scale or corrective gene therapy. Reducing scale is often minimally effective. Gene therapy is impeded by multiple pitfalls, including difficulties in transcutaneous drug delivery, high costs, and discomfort of injections. We have begun to use information about disease pathogenesis to identify novel, pathogenesis-based therapeutic strategies for the ichthyoses. The clinical phenotype often reflects not only a deficiency of pathway end product due to reduced-function mutations in key synthetic enzymes but often also accumulation of proximal, potentially toxic metabolites. As a result, depending upon the identified pathomechanism(s) for each disorder, the accompanying ichthyosis can be treated by topical provision of pathway product (eg, cholesterol), with or without a proximal enzyme inhibitor (eg, simvastatin), to block metabolite production. Among the disorders of distal cholesterol metabolism, the cutaneous phenotype in Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects (CHILD syndrome) and X-linked ichthyosis reflect metabolite accumulation and deficiency of pathway product (ie, cholesterol). We validated this therapeutic approach in two CHILD syndrome patients who failed to improve with topical cholesterol alone, but cleared with dual treatment with cholesterol plus lovastatin. In theory, the ichthyoses in other inherited lipid metabolic disorders could be treated analogously. This pathogenesis (pathway)-driven approach possesses several inherent advantages: (1) it is mechanism-specific for each disorder; (2) it is inherently safe, because natural lipids and/or approved drugs often are utilized; and (3) it should be inexpensive, and therefore it could be used widely in the developing world.
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Affiliation(s)
- Peter M Elias
- Dermatology Service, Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121, USA.
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Abstract
Facilitated/modulated drug-delivery systems have emerged as a possible solution for delivery of drugs of interest to pre-allocated sites at predetermined doses for predefined periods of time. Over the past decade, the use of different physical methods and mechanisms to mediate drug release and delivery has grown significantly. This emerging area of research has important implications for development of new therapeutic drugs for efficient treatments. This review aims to introduce and describe different modalities of physically facilitating drug-delivery systems that are currently in use for cancer and other diseases therapy. In particular, delivery methods based on ultrasound, electrical, magnetic and photo modulations are highlighted. Current uses and areas of improvement for these different physically facilitating drug-delivery systems are discussed. Furthermore, the main advantages and drawbacks of these technologies reviewed are compared. The review ends with a speculative viewpoint of how research is expected to evolve in the upcoming years.
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37
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Park D, Ryu H, Kim HS, Kim YS, Choi KS, Park H, Seo J. Sonophoresis using ultrasound contrast agents for transdermal drug delivery: an in vivo experimental study. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:642-50. [PMID: 22341597 DOI: 10.1016/j.ultrasmedbio.2011.12.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 12/07/2011] [Accepted: 12/16/2011] [Indexed: 05/12/2023]
Abstract
Sonophoresis temporally increases skin permeability such that various medications can be delivered noninvasively. Previous sonophoresis studies have suggested that cavitation plays an important role in enhancing transdermal drug delivery (TDD). In this study, the feasibility of controlled cavitation using ultrasound contrast agents (UCAs) at high frequency was explored through in vivo experiments in a rat model. Two commercially available UCAs, SonoVue® and Definity®, were used at 2.47 MHz and 1.12 MHz, respectively. Fluorescein isothiocyanate (FITC)-dextran with 0.1% UCA was used as the drug to be delivered through the skin. Ultrasound with a 10 ms pulse and a 1% duty cycle at 1 MPa acoustic pressure for 30 min was applied in all sonication sessions. The efficacy of sonophoresis with UCAs was quantitatively analyzed using an optical imaging system that was used to count photons emitted from fluorescein. The results showed that the proposed sonophoresis method significantly improved drug penetration compared with the traditional sonophoresis method with 4 kD, 20 kD and 150 kD FITC-dextrans at 1.12 MHz, and with 4 kD and 20 kD FITC-dextrans at 2.47 MHz. Sonophoresis for TDD was performed more effectively with the aid of UCAs. Sonophoresis with UCAs has excellent potential for broad applications in drug delivery for diseases requiring the chronic administration of medications such as diabetes.
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Affiliation(s)
- Donghee Park
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
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38
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Hartzell TL, Rubinstein R, Herman M. Therapeutic modalities--an updated review for the hand surgeon. J Hand Surg Am 2012; 37:597-621. [PMID: 22305724 DOI: 10.1016/j.jhsa.2011.12.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 12/27/2011] [Indexed: 02/02/2023]
Abstract
The number of therapeutic modalities available to the hand surgeon has greatly increased over the past several decades. A field once predicated only on heat, massage, and cold therapy now uses electrical stimulators, ultrasound, biofeedback, iontophoresis, phonophoresis, mirror therapy, lasers, and a number of other modalities. With this expansion in choices, there has been a concurrent effort to better define which modalities are truly effective. In this review, we aim to characterize the commonly used modalities and provide the evidence available that supports their continued use.
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Affiliation(s)
- Tristan L Hartzell
- Department of Orthopedic Surgery, Box 9569902, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-6902, USA.
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Ahmadi F, McLoughlin IV, Chauhan S, ter-Haar G. Bio-effects and safety of low-intensity, low-frequency ultrasonic exposure. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2012; 108:119-38. [PMID: 22402278 DOI: 10.1016/j.pbiomolbio.2012.01.004] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 01/30/2012] [Indexed: 11/25/2022]
Abstract
Low-frequency (LF) ultrasound (20-100 kHz) has a diverse set of industrial and medical applications. In fact, high power industrial applications of ultrasound mainly occupy this frequency range. This range is also used for various therapeutic medical applications including sonophoresis (ultrasonic transdermal drug delivery), dentistry, eye surgery, body contouring, the breaking of kidney stones and eliminating blood clots. While emerging LF applications such as ultrasonic drug delivery continue to be developed and undergo translation for human use, significant gaps exist in the coverage of safety standards for this frequency range. Accordingly, the need to understand the biological effects of LF ultrasound is becoming more important. This paper presents a broad overview of bio-effects and safety of LF ultrasound as an aid to minimize and control the risk of these effects. Its particular focus is at low intensities where bio-effects are initially observed. To generate a clear perspective of hazards in LF exposure, the mechanisms of bio-effects and the main differences in action at low and high frequencies are investigated and a survey of harmful effects of LF ultrasound at low intensities is presented. Mechanical and thermal indices are widely used in high frequency diagnostic applications as a means of indicating safety of ultrasonic exposure. The direct application of these indices at low frequencies needs careful investigation. In this work, using numerical simulations based on the mathematical and physical rationale behind the indices at high frequencies, it is observed that while thermal index (TI) can be used directly in the LF range, mechanical index (MI) seems to become less reliable at lower frequencies. Accordingly, an improved formulation for the MI is proposed for frequencies below 500 kHz.
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Affiliation(s)
- Farzaneh Ahmadi
- School of Computer Engineering, Nanyang Technological University, N4-02b-52, Nanyang Avenue, Singapore 639798, Singapore
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40
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Polat BE, Hart D, Langer R, Blankschtein D. Ultrasound-mediated transdermal drug delivery: mechanisms, scope, and emerging trends. J Control Release 2011; 152:330-48. [PMID: 21238514 PMCID: PMC3436072 DOI: 10.1016/j.jconrel.2011.01.006] [Citation(s) in RCA: 248] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 01/07/2011] [Indexed: 10/18/2022]
Abstract
The use of ultrasound for the delivery of drugs to, or through, the skin is commonly known as sonophoresis or phonophoresis. The use of therapeutic and high frequencies of ultrasound (≥0.7MHz) for sonophoresis (HFS) dates back to as early as the 1950s, while low-frequency sonophoresis (LFS, 20-100kHz) has only been investigated significantly during the past two decades. Although HFS and LFS are similar because they both utilize ultrasound to increase the skin penetration of permeants, the mechanisms associated with each physical enhancer are different. Specifically, the location of cavitation and the extent to which each process can increase skin permeability are quite dissimilar. Although the applications of both technologies are different, they each have strengths that could allow them to improve current methods of local, regional, and systemic drug delivery. In this review, we will discuss the mechanisms associated with both HFS and LFS, specifically concentrating on the key mechanistic differences between these two skin treatment methods. Background on the relevant physics associated with ultrasound transmitted through aqueous media will also be discussed, along with implications of these phenomena on sonophoresis. Finally, a thorough review of the literature is included, dating back to the first published reports of sonophoresis, including a discussion of emerging trends in the field.
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Affiliation(s)
- Baris E. Polat
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Douglas Hart
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Robert Langer
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Daniel Blankschtein
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Elias PM, Crumrine D, Paller A, Rodriguez-Martin M, Williams ML. Pathogenesis of the cutaneous phenotype in inherited disorders of cholesterol metabolism: Therapeutic implications for topical treatment of these disorders. DERMATO-ENDOCRINOLOGY 2011; 3:100-6. [PMID: 21695019 PMCID: PMC3117009 DOI: 10.4161/derm.3.2.14831] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 01/13/2011] [Indexed: 11/20/2022]
Abstract
Molecular geneticists tend to conceptualize disease pathogenesis from the mutated gene outward, an approach that does not take into account the impact of barrier requirements in determining disease phenotype. An ‘outside-to-inside’ perspective has provided quite different explanations for the ichthyoses, including several of the disorders of distal cholesterol metabolism. Elucidation of responsible pathogenic mechanisms also is pointing to appropriate, pathogenesis (pathway)-based therapeutic strategies. In the case of the lipid metabolic disorders, it takes full advantage of new molecular, genetic and cellular pathogenesis information to correct or bypass the metabolic abnormality. This approach fully exploits the unique accessibility of the skin to a topical approach. Moreover, since it will utilize topical lipids and lipid-soluble, and often generic, lipid-soluble drugs, these treatments should be readily transported across the stratum corneum. If successful, this approach could initiate an entirely new departure for the therapy of the ichthyoses. Finally, because these agents are relatively safe and inexpensive, this form of treatment has the potential to be widely-deployed, even in the developing world.
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Affiliation(s)
- Peter M Elias
- Dermatology Service; Department of Veterans Affairs Medical Center and Dermatology; University of California, San Francisco; San Francisco, CA USA
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42
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Yoon J, Park D, Son T, Seo J, Nelson JS, Jung B. A physical method to enhance transdermal delivery of a tissue optical clearing agent: combination of microneedling and sonophoresis. Lasers Surg Med 2010; 42:412-7. [PMID: 20583247 DOI: 10.1002/lsm.20930] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Various physical methods, such as microneedling, laser ablation, sonophoresis, and sandpaper, have been widely studied to enhance the transdermal delivery of tissue optical clearing (TOC) agents. A previous study demonstrated that the microneedling method could effectively enhance the permeability of a TOC agent through the skin barrier. STUDY DESIGN/MATERIALS AND METHODS In this study, we introduce a new physical combination method which utilizes both microneedling and sonophoresis to further enhance the transdermal delivery of a TOC agent, glycerol. Porcine skin samples were divided into a control group treated only with the microneedle roller and a test group treated with both the microneedle roller and sonophoresis. Glycerol was applied topically after microneedling. The optimal concentration and transdermal delivery efficacy of glycerol were quantitatively evaluated. RESULTS A 70% glycerol solution was determined to be the optimal concentration for the combination method. The combination method resulted in approximately a 2.3-fold higher transdermal diffusion rate of glycerol when compared to the microneedling method alone. CONCLUSION The combination method and optimal glycerol concentration effectively enhanced transdermal delivery of glycerol by accelerating the diffusion rate through the skin barrier.
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Affiliation(s)
- Jinhee Yoon
- Department of Biomedical Engineering, Yonsei University, Wonju-si 220-710, Korea
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43
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Cancel LM, Tarbell JM, Ben-Jebria A. Fluorescein permeability and electrical resistance of human skin during low frequency ultrasound application. J Pharm Pharmacol 2010; 56:1109-18. [PMID: 15324479 DOI: 10.1211/0022357044193] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Transdermal drug delivery offers an alternative to injections and oral medication but is limited by the low skin permeability of most drugs. The use of low-frequency ultrasound over long periods of time, typically over an hour, has been shown to enhance skin permeability, a phenomenon referred to as sonophoresis. In this study, we investigated the effects of short time sonication of human skin at 20 kHz and at variable intensities and duty cycles on the dynamics of fluorescein transport across the skin (permeability) as well as the changes in the skin's structural integrity (electrical resistance). We found that a short application of ultrasound enhanced the transport of fluorescein across human skin by a factor in the range of 2–9 for full thickness skin samples and by a factor in the range of 2–28 000 for heat-stripped stratum corneum samples (however, samples with very high (103) enhancement were likely to have been damaged by ultrasound). The electrical resistance of the skin decreased by an average of 20% for full thickness samples and 58% for stratum corneum samples. Increasing the duty cycle from 10 to 60% caused a significant increase in permeability enhancement from 2.3 to 9.1, and an increase in intensity from 8 to 23 mW cm2 induced a significant increase in permeability enhancement from 2 to 7.4, indicating a clear dependence of the permeability on both duty cycle and intensity. The increase in solute flux upon ultrasound exposure was immediate, demonstrating for the first time the fast response dynamics of sonophoretic enhancement. In addition, a quantitative analysis of the thermal and convective dispersion effects associated with ultrasound application showed that each contributes significantly to the overall permeability enhancement observed.
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Affiliation(s)
- Limary M Cancel
- Biomolecular Transport Dynamics Laboratory, Department of Chemical Engineering, The Pennsylvania State University, University Park, PA 16802, USA.
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44
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Meshali M, Abdel-Aleem H, Sakr F, Nazzal S, El-Malah Y. Effect of gel composition and phonophoresis on the transdermal delivery of ibuprofen: in vitro and in vivo evaluation. Pharm Dev Technol 2010; 16:93-101. [PMID: 20100032 DOI: 10.3109/10837450903499358] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of this study was to evaluate the effect of formulation composition and continuous ultrasound at 1.5 W/Cm² intensity on the permeation of ibuprofen across polymeric and biological barriers. In vitro studies were performed using cellulose membrane and rabbit skin, whereas in vivo studies were performed on rabbits. Overall, higher transport data were obtained with the cellulose membrane. Nonetheless, with both barriers, transport was higher with the gel formulation than oleaginous or emulsion based preparations, which was also dependent on the viscosity of the gel and the concentration of the formulation additives. Transport increased with the increase in alcohol concentration and decreased with the addition of propylene glycol. Ultrasound had a significant effect on ibuprofen transport. For example, an 11-fold increase in drug permeation across cellulose membrane was observed after the application of ultrasound. Similar effect was observed in animal studies. Ibuprofen plasma concentration increased with the concentration of the drug in the gel, which significantly increased after the application of ultrasound. It was concluded that aqueous gel formulations act as ideal coupling agents for topical application of drugs. Nonetheless, in addition to ultrasound, the composition of the gel is expected to have a significant effect on the transdermal delivery of drugs.
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Abstract
OBJECTIVES Use of ultrasound in therapeutics and drug delivery has gained importance in recent years, evident by the increase in patents filed and new commercial devices launched. The present review discusses new advancements in sonophoretic drug delivery in the last two decades, and highlights important challenges still to be met to make this technology of more use in the alleviation of diseases. KEY FINDINGS Phonophoretic research often suffers from poor calibration in terms of the amount of ultrasound energy emitted, and therefore current research must focus on safety of exposure to ultrasound and miniaturization of devices in order to make this technology a commercial reality. More research is needed to identify the role of various parameters influencing sonophoresis so that the process can be optimized. Establishment of long-term safety issues, broadening the range of drugs that can be delivered through this system, and reduction in the cost of delivery are issues still to be addressed. SUMMARY Sonophoresis (phonophoresis) has been shown to increase skin permeability to various low and high molecular weight drugs, including insulin and heparin. However, its therapeutic value is still being evaluated. Some obstacles in transdermal sonophoresis can be overcome by combination with other physical and chemical enhancement techniques. This review describes recent advancements in equipment and devices for phonophoresis, new formulations tried in sonophoresis, synergistic effects with techniques such as chemical enhancers, iontophoresis and electroporation, as well as the growing use of ultrasound in areas such as cancer therapy, cardiovascular disorders, temporary modification of the blood-brain barrier for delivery of imaging and therapeutic agents, hormone replacement therapy, sports medicine, gene therapy and nanotechnology. This review also lists patents pertaining to the formulations and techniques used in sonophoretic drug delivery.
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Affiliation(s)
- Rekha Rao
- M. M. College of Pharmacy, M. M. University, Mullana, 133001, India
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Husseini GA, Pitt WG. Ultrasonic-activated micellar drug delivery for cancer treatment. J Pharm Sci 2009; 98:795-811. [PMID: 18506804 DOI: 10.1002/jps.21444] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The use of nanoparticles and ultrasound in medicine continues to evolve. Great strides have been made in the areas of producing micelles, nanoemulsions, and solid nanoparticles that can be used in drug delivery. An effective nanocarrier allows for the delivery of a high concentration of potent medications to targeted tissue while minimizing the side effect of the agent to the rest of the body. Polymeric micelles have been shown to encapsulate therapeutic agents and maintain their structural integrity at lower concentrations. Ultrasound is currently being used in drug delivery as well as diagnostics, and has many advantages that elevate its importance in drug delivery. The technique is noninvasive, thus no surgery is needed; the ultrasonic waves can be easily controlled by advanced electronic technology so that they can be focused on the desired target volume. Additionally, the physics of ultrasound are widely used and well understood; thus ultrasonic application can be tailored towards a particular drug delivery system. In this article, we review the recent progress made in research that utilizes both polymeric micelles and ultrasonic power in drug delivery.
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Affiliation(s)
- Ghaleb A Husseini
- Chemical Engineering Department, American University of Sharjah, Sharjah, United Arab Emirates.
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47
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Smith NB. Applications of ultrasonic skin permeation in transdermal drug delivery. Expert Opin Drug Deliv 2009; 5:1107-20. [PMID: 18817516 DOI: 10.1517/17425247.5.10.1107] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Transdermal ultrasound-mediated drug delivery has been studied as a method for needle-less, non-invasive drug administration. Potential obstacles include the stratum corneum, which is not sufficiently passively permeable to allow effective transfer of many medications into the bloodstream without active methods. A general review of the transdermal ultrasound drug delivery literature has shown that this technology offers promising potential for non-invasive drug administration. Included in this review are the reported acoustic parameters used for achieving delivery, along with the known intensities and exposure times. Ultrasound mechanisms are discussed as well as spatial field characteristics. Accurate and precise quantification of the acoustic field used in drug delivery experiments is essential to ensure safety versus efficacy and to avoid potentially harmful bioeffects.
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Affiliation(s)
- Nadine Barrie Smith
- Graduate Program in Acoustics, The Pennsylvania State University 21 Hallowell Building, University Park, PA 16802, USA.
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Ueda H, Mutoh M, Seki T, Kobayashi D, Morimoto Y. Acoustic Cavitation as an Enhancing Mechanism of Low-Frequency Sonophoresis for Transdermal Drug Delivery. Biol Pharm Bull 2009; 32:916-20. [DOI: 10.1248/bpb.32.916] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hideo Ueda
- Faculty of Pharmaceutical Sciences, Josai University
| | - Mizue Mutoh
- Faculty of Pharmaceutical Sciences, Josai University
| | - Toshinobu Seki
- Faculty of Pharmaceutical Sciences, Josai University
- Research Institute of TTS Technology
| | | | - Yasunori Morimoto
- Faculty of Pharmaceutical Sciences, Josai University
- Research Institute of TTS Technology
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Frenkel V. Ultrasound mediated delivery of drugs and genes to solid tumors. Adv Drug Deliv Rev 2008; 60:1193-208. [PMID: 18474406 DOI: 10.1016/j.addr.2008.03.007] [Citation(s) in RCA: 336] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Accepted: 03/04/2008] [Indexed: 12/21/2022]
Abstract
It has long been shown that therapeutic ultrasound can be used effectively to ablate solid tumors, and a variety of cancers are presently being treated in the clinic using these types of ultrasound exposures. There is, however, an ever-increasing body of preclinical literature that demonstrates how ultrasound energy can also be used non-destructively for increasing the efficacy of drugs and genes for improving cancer treatment. In this review, a summary of the most important ultrasound mechanisms will be given with a detailed description of how each one can be employed for a variety of applications. This includes the manner by which acoustic energy deposition can be used to create changes in tissue permeability for enhancing the delivery of conventional agents, as well as for deploying and activating drugs and genes via specially tailored vehicles and formulations.
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50
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Nishikawa M, Takakura Y, Hashida M. Pharmacokinetic considerations regarding non-viral cancer gene therapy. Cancer Sci 2008; 99:856-62. [PMID: 18294288 PMCID: PMC11158855 DOI: 10.1111/j.1349-7006.2008.00774.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Cancer gene therapy, in which pharmacologically active compounds are administered to cancer patients in a genetic form, has been examined not only in animals but also in cancer patients. Viral vector-induced severe side effects in patients have greatly underscored the importance of non-viral gene transfer methods. Even though the importance of pharmacokinetics is undoubtedly understood in the development of anticancer therapies, its importance has been less well recognized in non-viral cancer gene therapy. When transgene products express their activity within transduced cells, such as herpes simplex virus type 1 thymidine kinase and short hairpin RNA, the pharmacokinetics of the vectors and the expression profiles of the transgenes will determine the efficacy of gene transfer. The percentage of cells transduced is highly important if few by-stander effects are expected. If transgene products are secreted from cells into the blood circulation, such as interferons and interleukins, the pharmacokinetics of transgenes becomes a matter of significant importance. Then, any approach to increasing the level and duration of transgene expression will increase the therapeutic effects of cancer gene therapy. Here we review the pharmacokinetics of both non-viral vectors and transgene products, and discuss what should be done to achieve safer and more effective non-viral cancer gene therapy.
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Affiliation(s)
- Makiya Nishikawa
- Department of Biopharmaceutics and Drug Metabolism, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Kyoto 606-8501, Japan.
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