1
|
Rodríguez-Fonseca L, Llorente-Pendás S, García-Pola M. Risk of Prediabetes and Diabetes in Oral Lichen Planus: A Case-Control Study according to Current Diagnostic Criteria. Diagnostics (Basel) 2023; 13:diagnostics13091586. [PMID: 37174976 PMCID: PMC10178478 DOI: 10.3390/diagnostics13091586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of prediabetes and diabetes in patients with oral lichen planus (OLP). METHODS Prospective cohort, including consecutive patients diagnosed clinically and histologically with OLP from 2018 to 2022. Patients and controls were matched by age and gender. Fasting plasma glucose value collection from all patients. Multivariate regression analysis evaluated the relationship between prediabetes and diabetes variables according to current diagnostic criteria. RESULTS The sample comprised 275 patients (207 women; 75.3%), mean age 59.60 ± 12.18 years for both groups. Prediabetes was diagnosed according to the American Diabetes Association (ADA, 100-125 mg/dL), in 21.45% of OLP patients (59/275) and 14.55% (40/275) of control patients (p = 0.035). Patients with the atrophic-erosive form exhibited stronger association with taking oral antidiabetics (p = 0.011). Multivariate analysis showed that being over >60 years and having a cutaneous location was associated with ≥3 sites (OR 1.81 and OR 2.43). ADA prediabetes and oral antidiabetics drugs increased the probability of OLP (OR 1.60 (1.04-2.51), p = 0.03 and OR 2.20 (1.18-4.69), p = 0.017) after adjustment for sex and age. CONCLUSIONS Because glycemia 100-125 mg/dL was associated with OLP, testing serum fasting plasma glucose seems reasonable in order to prevent development of diabetes and deal with possible complications until new studies are complete.
Collapse
Affiliation(s)
- Lucía Rodríguez-Fonseca
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Sciences of the Health, Oviedo University, 33006 Oviedo, Spain
| | | | - María García-Pola
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Sciences of the Health, Oviedo University, 33006 Oviedo, Spain
| |
Collapse
|
2
|
Dubashynskaya NV, Skorik YA. Patches as Polymeric Systems for Improved Delivery of Topical Corticosteroids: Advances and Future Perspectives. Int J Mol Sci 2022; 23:12980. [PMID: 36361769 PMCID: PMC9657685 DOI: 10.3390/ijms232112980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 12/25/2023] Open
Abstract
Mucoadhesive polymer patches are a promising alternative for prolonged and controlled delivery of topical corticosteroids (CS) to improve their biopharmaceutical properties (mainly increasing local bioavailability and reducing systemic toxicity). The main biopharmaceutical advantages of patches compared to traditional oral dosage forms are their excellent bioadhesive properties and their increased drug residence time, modified and unidirectional drug release, improved local bioavailability and safety profile, additional pain receptor protection, and patient friendliness. This review describes the main approaches that can be used for the pharmaceutical R&D of oromucosal patches with improved physicochemical, mechanical, and pharmacological properties. The review mainly focuses on ways to increase the bioadhesion of oromucosal patches and to modify drug release, as well as ways to improve local bioavailability and safety by developing unidirectional -release poly-layer patches. Various techniques for obtaining patches and their influence on the structure and properties of the resulting dosage forms are also presented.
Collapse
Affiliation(s)
| | - Yury A. Skorik
- Institute of Macromolecular Compounds of the Russian Academy of Sciences, Bolshoy pr. V.O. 31, 199004 St. Petersburg, Russia
| |
Collapse
|
3
|
Hamilton CM, Winter MJ, Margiotta-Casaluci L, Owen SF, Tyler CR. Are synthetic glucocorticoids in the aquatic environment a risk to fish? ENVIRONMENT INTERNATIONAL 2022; 162:107163. [PMID: 35240385 DOI: 10.1016/j.envint.2022.107163] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 05/27/2023]
Abstract
The glucocorticosteroid, or glucocorticoid (GC), system is largely conserved across vertebrates and plays a central role in numerous vital physiological processes including bone development, immunomodulation, and modification of glucose metabolism and the induction of stress-related behaviours. As a result of their wide-ranging actions, synthetic GCs are widely prescribed for numerous human and veterinary therapeutic purposes and consequently have been detected extensively within the aquatic environment. Synthetic GCs designed for humans are pharmacologically active in non-mammalian vertebrates, including fish, however they are generally detected in surface waters at low (ng/L) concentrations. In this review, we assess the potential environmental risk of synthetic GCs to fish by comparing available experimental data and effect levels in fish with those in mammals. We found the majority of compounds were predicted to have insignificant risk to fish, however some compounds were predicted to be of moderate and high risk to fish, although the dataset of compounds used for this analysis was small. Given the common mode of action and high level of inter-species target conservation exhibited amongst the GCs, we also give due consideration to the potential for mixture effects, which may be particularly significant when considering the potential for environmental impact from this class of pharmaceuticals. Finally, we also provide recommendations for further research to more fully understand the potential environmental impact of this relatively understudied group of commonly prescribed human and veterinary drugs.
Collapse
Affiliation(s)
- Charles M Hamilton
- Biosciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon EX4 4QD, UK
| | - Matthew J Winter
- Biosciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon EX4 4QD, UK
| | - Luigi Margiotta-Casaluci
- Department of Analytical, Environmental & Forensic Sciences, School of Cancer & Pharmaceutical Sciences, King's College London, London SE1 9NH, UK
| | - Stewart F Owen
- AstraZeneca, Global Environment, Macclesfield, Cheshire SK10 2NA, UK
| | - Charles R Tyler
- Biosciences, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, Devon EX4 4QD, UK.
| |
Collapse
|
4
|
Chugh A, Patnana AK, Kumar P, Chugh VK, Singh S. The clinical efficacy of minocycline mouth rinse on recurrent aphthous stomatitis-A randomized controlled trial. Indian J Dent Res 2022; 33:24-29. [PMID: 35946240 DOI: 10.4103/ijdr.ijdr_478_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is one of the most common ulcerative diseases affecting the general population. The present study aimed to evaluate the clinical efficiency of 0.5% minocycline mouth rinse prescribed along with the topical anesthetic gel and vitamin supplement over the topical anesthetic gel and vitamin supplement prescribed alone for treating RAS. Materials and Methods A total of 60 participants were randomly divided into two groups-experimental group: 0.5% minocycline mouth rinse prescribed along with vitamin supplement and topical anesthetic gel; and control group: vitamin supplement and topical anesthetic gel alone. The pain symptoms were evaluated using the VAS scores at baseline and first follow-up visits. The data were analyzed using Student's t test. Results A significant reduction in the pain scores was observed in participants using the 0.5% minocycline mouth rinse prescribed along with vitamin supplement and topical anesthetic gel on the first follow-up visit (P = < 0.001). Conclusion The 0.5% minocycline mouth rinse prescribed along with vitamin supplement and topical anesthetic gel had shown more reduction in the pain symptoms when compared to topical anesthetic gel and vitamin supplement prescribed alone for the treatment of RAS.
Collapse
Affiliation(s)
- Ankita Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arun Kumar Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vinay Kumar Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Surjit Singh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
5
|
Rogulj AA, Z. Alajbeg I, Brailo V, Škrinjar I, Žužul I, Vučićević-Boras V, Alajbeg I. Topical NAVS naphthalan for the treatment of oral lichen planus and recurrent aphthous stomatitis: A double blind, randomized, parallel group study. PLoS One 2021; 16:e0249862. [PMID: 33831097 PMCID: PMC8031371 DOI: 10.1371/journal.pone.0249862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
AIM To evaluate the effectiveness of non-aromatic very rich in steranes (NAVS) naphthalan in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Null hypothesis was that there would be no difference between NAVS and topical steroids in the treatment of OLP and RAS. METHODS The study consisted of two sub-trials conducted as randomized, double-blind controlled studies: first included OLP patients and second patients with RAS. Patients received either NAVS or 0.05% betamethasone dipropionate. Primary outcomes were activity score (OLP patients), No of lesions and lesion diameter (RAS patients) and pain intensity (VAS) while secondary outcome included the impact of the disease on quality of life assessed by Oral health impact profile (OHIP 14). RESULTS No significant differences in terms of OLP clinical signs (p = 0.84, η2 = 0.001) and responses on the OHIP-14 (p = 0.81, η2 = 0.002) or on VAS (p = 0.14, η2 = 0.079) between NAVS and betamethasone groups were observed. In RAS patients, no significant differences between the groups in terms of lesion number (at days 3 and 5, p = 0.33 and p = 0.98, respectively), lesion diameter (days 3 and 5, p = 0.24 and p = 0.84, respectively) were observed. However, in NAVS group a significant reduction of lesions diameter was observed on the 3rd day, while in betamethasone group a significant reduction in lesions diameter was evident only after the 5th day. No significant differences in VAS (p > 0.05) and the OHIP-14 (p > 0.05) between groups were found. CONCLUSION No evidence of differences between the two compared interventions was found. REGISTRATION Retrospective registration of this trial was conducted in ClinicalTrials.gov on September 30, 2016; trial registration number: NCT02920658. https://clinicaltrials.gov/ct2/show/NCT02920658?term=NAVS&draw=2&rank=4.
Collapse
Affiliation(s)
- Ana Andabak Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Iva Z. Alajbeg
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Vlaho Brailo
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Ivana Škrinjar
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Ivona Žužul
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Vanja Vučićević-Boras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Ivan Alajbeg
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
- * E-mail:
| |
Collapse
|
6
|
Laryngeal Pemphigoid Evolution and Response to Treatment. J Voice 2021; 37:471.e7-471.e14. [PMID: 33583674 DOI: 10.1016/j.jvoice.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/01/2021] [Accepted: 01/07/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to present our experience in treating laryngeal pemphigoid (LP) patients, including disease course, treatment and treatment response, and to search for predictors of response to treatment. STUDY DESIGN A retrospective cohort study. METHODS The medical records of all patients with LP from March 2013 to August 2020 were reviewed. Potential relationships between disease severity and response to treatment and demographics, diagnosis, extent of laryngeal and extra-laryngeal involvement, comorbidities, immunostaining, and serology profile were explored. RESULTS Eight patients were included in the study (seven females, one male, mean age 79 years, mean follow-up 22 months). Diagnoses included mucous membrane pemphigoid (MMP, n = 5), bullous pemphigoid (BP, n = 3). Two patients achieved complete laryngeal remission, four achieved partial remission, and two had no remission. The time to achieve laryngeal disease control was longer than for extra-laryngeal disease (P = 0.02). Potential associations were found between the absence of immunoglobulin G (IgG)-type auto-antibodies deposits in the basement membrane zone and a laryngeal disease that responded to topical corticosteroids and between the presence of BP180-C-terminal IgG auto-antibodies and a resistant rapidly progressive laryngeal disease. CONCLUSIONS LP has a spectrum of severity, variable response and is more resistant to treatment. The absence of IgG-type auto-antibodies may indicate a response to topical corticosteroids. Based on our limited observation, the presence of IgG-type auto-antibodies that target BP180-C-terminal domain may indicate a more severe scarring disease. Early recognition of these "high-risk patients" will allow early initiation of advanced systemic treatment that may prevent the irreversible effects of scarring.
Collapse
|
7
|
Lodi G, Manfredi M, Mercadante V, Murphy R, Carrozzo M. Interventions for treating oral lichen planus: corticosteroid therapies. Cochrane Database Syst Rev 2020; 2:CD001168. [PMID: 32108333 PMCID: PMC7047223 DOI: 10.1002/14651858.cd001168.pub3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a relatively common chronic T cell-mediated disease, which can cause significant pain, particularly in its erosive or ulcerative forms. As pain is the indication for treatment of OLP, pain resolution is the primary outcome for this review. This review is an update of a version last published in 2011, but focuses on the evidence for corticosteroid treatment only. A second review considering non-corticosteroid treatments is in progress. OBJECTIVES To assess the effects and safety of corticosteroids, in any formulation, for treating people with symptoms of oral lichen planus. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 25 February 2019: Cochrane Oral Health's Trials Register, CENTRAL (2019, Issue 1), MEDLINE Ovid, and Embase Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. There were no restrictions on language or date of publication. SELECTION CRITERIA We considered randomised controlled clinical trials (RCTs) of any local or systemic corticosteroid treatment compared with a placebo, a calcineurin inhibitor, another corticosteroid, any other local or systemic (or both) drug, or the same corticosteroid plus an adjunctive treatment. DATA COLLECTION AND ANALYSIS Three review authors independently scanned the titles and abstracts of all reports identified, and assessed risk of bias using the Cochrane tool and extracted data from included studies. For dichotomous outcomes, we expressed the estimates of effects of an intervention as risk ratios (RR), with 95% confidence intervals (CI). For continuous outcomes, we used mean differences (MD) and 95% CI. The statistical unit of analysis was the participant. We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. MAIN RESULTS We included 35 studies (1474 participants) in this review. We assessed seven studies at low risk of bias overall, 11 at unclear and the remaining 17 studies at high risk of bias. We present results for our main outcomes, pain and clinical resolution measured at the end of the treatment course (between one week and six months), and adverse effects. The limited evidence available for comparisons between different corticosteroids, and corticosteroids versus alternative or adjunctive treatments is presented in the full review. Corticosteroids versus placebo Three studies evaluated the effectiveness and safety of topical corticosteroids in an adhesive base compared to placebo. We were able to combine two studies in meta-analyses, one evaluating clobetasol propionate and the other flucinonide. We found low-certainty evidence that pain may be more likely to be resolved when using a topical corticosteroid rather than a placebo (RR 1.91, 95% CI 1.08 to 3.36; 2 studies, 72 participants; I² = 0%). The results for clinical effect of treatment and adverse effects were inconclusive (clinical resolution: RR 6.00, 95% CI 0.76 to 47.58; 2 studies, 72 participants; I² = 0%; very low-certainty evidence; adverse effects RR 1.48, 95% 0.48 to 4.56; 3 studies, 88 participants, I² = 0%, very low-certainty evidence). Corticosteroids versus calcineurin inhibitors Three studies compared topical clobetasol propionate versus topical tacrolimus. We found very low-certainty evidence regarding any difference between tacrolimus and clobetasol for the outcomes pain resolution (RR 0.45, 95% CI 0.24 to 0.88; 2 studies, 100 participants; I² = 80%), clinical resolution (RR 0.61, 95% CI 0.38 to 0.99; 2 studies, 52 participants; I² = 95%) and adverse effects (RR 0.05, 95% CI 0.00 to 0.83; 2 studies, 100 participants; very low-certainty evidence) . One study (39 participants) compared topical clobetasol and ciclosporin, and provided only very low-certainty evidence regarding the rate of clinical resolution with clobetasol (RR 3.16, 95% CI 1.00 to 9.93), pain resolution (RR 2.11, 95% CI 0.76 to 5.86) and adverse effects (RR 6.32, 95% CI 0.84 to 47.69). Two studies (60 participants) that compared triamcinolone and tacrolimus found uncertain evidence regarding the rate of clinical resolution (RR 0.86, 95% CI 0.55 to 1.35; very low-certainty evidence) and that there may be a lower rate of adverse effects in the triamcinolone group (RR 0.47, 95% CI 0.22 to 0.99; low-certainty evidence). These studies did not report on pain resolution. AUTHORS' CONCLUSIONS Corticosteroids have been first line for the treatment of OLP. This review found that these drugs, delivered topically as adhesive gels or similar preparations, may be more effective than placebo for reducing the pain of symptomatic OLP; however, with the small number of studies and participants, our confidence in the reliability of this finding is low. The results for clinical response were inconclusive, and we are uncertain about adverse effects. Very low-certainty evidence suggests that calcineurin inhibitors, specifically tacrolimus, may be more effective at resolving pain than corticosteroids, although there is some uncertainty about adverse effects and clinical response to tacrolimus showed conflicting results.
Collapse
Affiliation(s)
- Giovanni Lodi
- University of MilanDepartment of Biomedical, Surgical and Dental SciencesVia Beldiletto 1/3MilanItaly20142
| | - Maddalena Manfredi
- University of ParmaPolo Clinico di Odontostomatologia, SBiBiT DepartmentVia Gramsci, 14ParmaItaly43100
| | - Valeria Mercadante
- University College of LondonEastman Dental Institute256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Ruth Murphy
- Sheffield Children's NHS Foundation TrustDepartment of Dermatology, Sheffield Children's HospitalSheffieldUKS10 2JF
| | - Marco Carrozzo
- University of Newcastle upon TyneDepartment of Oral Medicine, School of Dental SciencesFramlington PlaceNewcastle upon TyneUKNE2 4BW
| | | |
Collapse
|
8
|
O'Brien P, Young RC, Ghafoori SD, Harper CA, Wong RW. Central serous retinopathy associated with topical oral corticosteroid use: a case report. J Med Case Rep 2019; 13:201. [PMID: 31262360 PMCID: PMC6604175 DOI: 10.1186/s13256-019-2143-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/04/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Oral topical corticosteroid gels are widely used in dental medicine. Case studies of central serous retinopathy have been reported following administration of corticosteroids, but none so far coinciding with the use of topical fluocinonide gel. This case report further contributes to the database of potential risks of corticosteroid use. CASE PRESENTATION A 40-year-old South Asian woman presented with decreased vision, pigment epithelial detachments, and serous retinal detachments in both eyes 1 month after starting treatment with topical fluocinonide 0.05%, a topical oral corticosteroid gel. Her condition resolved 6 months after discontinuing the use of the steroid. CONCLUSIONS To the best of our knowledge, this is the first case of idiopathic central serous retinopathy associated with the use of oral fluocinonide gel. Discontinuing the use of the steroid may result in resolution of the serous retinal detachment and improvement of visual symptoms. Patients and their doctors who prescribe this medication should be aware of this association.
Collapse
Affiliation(s)
- Preston O'Brien
- Austin Retina Associates, 801 W. 38th St., Suite 200, Austin, TX, 78705, USA.
| | - Ryan C Young
- Austin Retina Associates, 801 W. 38th St., Suite 200, Austin, TX, 78705, USA.
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas, Austin, USA.
| | - Shelley Day Ghafoori
- Austin Retina Associates, 801 W. 38th St., Suite 200, Austin, TX, 78705, USA.
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas, Austin, USA.
| | - C Armitage Harper
- Austin Retina Associates, 801 W. 38th St., Suite 200, Austin, TX, 78705, USA.
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas, Austin, USA.
| | - Robert W Wong
- Austin Retina Associates, 801 W. 38th St., Suite 200, Austin, TX, 78705, USA.
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas, Austin, USA.
| |
Collapse
|
9
|
Ghalayani Esfahani A, Altomare L, Varoni EM, Bertoldi S, Farè S, De Nardo L. Electrophoretic bottom up design of chitosan patches for topical drug delivery. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:40. [PMID: 30919137 DOI: 10.1007/s10856-019-6242-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Abstract
Clobetasol propionate (CP) is a high-potency corticosteroid, representing the standard of care for the symptomatic treatment of different skin disorders as well as oral mucosal diseases. Several topical delivery systems are available for treating oral lesions, but the ideal one is still lacking. In this work, we propose a novel class of chitosan (CS) patches, loaded with CP, for the topical treatment of inflammatory chronic oral diseases. Chitosan patches have been fabricated via electrophoretic deposition (EPD), by using a one-pot approach in order to load controlled quantity of CP. Optimized structures showed a water uptake in the range of 200-360% and mechanical properties that allow the design of flexible patches in wet state (E = 0.6 MPa and σbr = 0.55 MPa). Ultraviolet-visible (UV-Vis) spectroscopy was used for the evaluation of both loading and release profile of CP in CS patches. The CP loading has been tuned by adjusting CP concentration in deposition bath-in the range 0.002-0.12 mg cm-2-while releasing curves show an in vitro CP burst of about 80% in the first two hours. Overall, the obtained properties paved the way for the application of this new class of patches for the local oral release of CP.
Collapse
Affiliation(s)
- Arash Ghalayani Esfahani
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Miiano, Piazza Leonardo da Vinci 32, Milano (Ml), Italy.
| | - Lina Altomare
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Miiano, Piazza Leonardo da Vinci 32, Milano (Ml), Italy
| | - Elena M Varoni
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Beldiletto 1, Milano (MI), Italy
| | - Serena Bertoldi
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Miiano, Piazza Leonardo da Vinci 32, Milano (Ml), Italy
| | - Silvia Farè
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Miiano, Piazza Leonardo da Vinci 32, Milano (Ml), Italy
| | - Luigi De Nardo
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Miiano, Piazza Leonardo da Vinci 32, Milano (Ml), Italy
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali (INSTM), Local Unit Politecnico di Milano, Via Giusti 9, 50121, Firenze (Fl), Italy
| |
Collapse
|
10
|
Esposito MC, Santos ALA, Bonfilio R, de Araújo MB. A Critical Review of Analytical Methods in Pharmaceutical Matrices for Determination of Corticosteroids. Crit Rev Anal Chem 2019; 50:111-124. [PMID: 30869528 DOI: 10.1080/10408347.2019.1581050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Corticosteroids are a class of hormones released by the adrenal cortex, which includes glucocorticoids and mineralocorticoids. Glucocorticoids have an important role in the metabolism of carbohydrates, proteins and calcium and effective anti-inflammatory and immunosuppressive activity. Due to their intense immunomodulatory and anti-inflammatory activity, glucocorticoids are used in the treatment of various inflammatory, malignant, allergic conditions such as rhinitis, asthma, dermatological, rheumatic, ophthalmic and neurological diseases, as well as after organ transplants. They are the most widely prescribed drugs in the world. The objective of this review is to provide an overview of the analytical methods in pharmaceutical matrices for determination of corticosteroids. In this study, the predominance of liquid chromatography methods for the analysis of corticosteroids from pharmaceutical products is evident for both liquid and semisolid dosage forms as well as for solids. The same can be said for topical, oral and parenteral formulations. Methods such as spectrophotometry are also used, but given the advantages of chromatographic methods such as better selectivity and sensitivity, they have become the choice for analysis of these drugs, however, most methods still do not meet the credentials of "green chemistry."
Collapse
Affiliation(s)
- Milena Carla Esposito
- Department of Food and Drug Administration, Faculty of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | | | - Rudy Bonfilio
- Department of Food and Drug Administration, Faculty of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Magali Benjamim de Araújo
- Department of Food and Drug Administration, Faculty of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| |
Collapse
|
11
|
Effect of Red Wine Intake on Serum and Salivary Melatonin Levels: A Randomized, Placebo-Controlled Clinical Trial. Molecules 2018; 23:molecules23102474. [PMID: 30261680 PMCID: PMC6222864 DOI: 10.3390/molecules23102474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 01/02/2023] Open
Abstract
Melatonin (MLT) is a recently discovered phytochemical in wine, but its influence on physiological MLT levels is still unknown. This study aimed at evaluating variations, in serum and saliva, of MLT concentrations after the intake of MLT-enriched red wine. Twelve healthy volunteers were recruited to receive 125 mL of red wine naturally lacking of MLT (placebo, PLC), or the same wine enriched with MLT (MLT+). A physiological steady decline of serum MLT was observed from baseline up to 90 min, for both wines. After PLC intake, the decrease was significantly faster than the one occurring after MLT+ wine, which thus delayed the drop down of serum MLT with a plateau at 30⁻60 min. Salivary MLT levels slightly peaked at 45 min after MLT+ wine intake, without statistical significance. Therefore, the intake of a glass of MLT-enriched red wine changed serum levels of the indoleamine, supporting the role of wine MLT in counteracting the physiological decline of the hormone into the bloodstream.
Collapse
|
12
|
Colley H, Said Z, Santocildes-Romero M, Baker S, D'Apice K, Hansen J, Madsen LS, Thornhill M, Hatton P, Murdoch C. Pre-clinical evaluation of novel mucoadhesive bilayer patches for local delivery of clobetasol-17-propionate to the oral mucosa. Biomaterials 2018; 178:134-146. [DOI: 10.1016/j.biomaterials.2018.06.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/29/2018] [Accepted: 06/06/2018] [Indexed: 12/24/2022]
|
13
|
Epiglottitis as the Presenting Sign of Mucous Membranous Pemphigoid: A Case Report. J Voice 2018; 32:101-103. [DOI: 10.1016/j.jvoice.2017.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 12/23/2022]
|
14
|
Thongprasom K. A Review of the Effectiveness and Side-Effects of Fluocinolone Acetonide 0.1% in the Treatment of Oral Mucosal Diseases. Acta Stomatol Croat 2017; 51:240-247. [PMID: 29225365 PMCID: PMC5708326 DOI: 10.15644/asc51/3/8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Topical steroids have been widely used in the treatment of symptomatic oral lesions to reduce pain and inflammation. Potent topical steroids such as clobetasol propionate, fluocinolone acetonide (FA), and fluocinonide have been widely used in the treatment of severe oral mucosal lesions. Many reports have demonstrated that these steroids were effective in treating oral lesions with only minor side-effects. This review describes the effectiveness and side-effects of using FA 0.1% in the treatment of symptomatic oral lichen planus (OLP), oral lichenoid drug reaction (OLDR), oral pemphigus, and herpes associated erythema multiforme (HAEM). FA 0.1% was effective and safe in the treatment of patients with multiple systemic diseases and a pregnant patient with HAEM. Moreover, this topical steroid rapidly reduced pain, inflammation, and enhanced lesion healing with no serious side-effects other than pseudomembranous candidiasis, which is easily treated. In some cases, a long-term treatment with FA 0.1% resulted in hyperpigmentation at the areas of previously healed oral lesions; however, this hyperpigmentation was gradually resolved after discontinuing topical steroid treatment.
Collapse
Affiliation(s)
- Kobkan Thongprasom
- Oral Medicine Department, Faculty of Dentistry Chulalongkorn University Bangkok, Thailand
| |
Collapse
|
15
|
|
16
|
Reply to: Details of the participants and medical intervention used in the study evaluating the effect of a mouth exercising device on burning sensation in oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:735-737. [PMID: 28412237 DOI: 10.1016/j.oooo.2017.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/20/2022]
|
17
|
Hidasi AO, Groh KJ, Suter MJF, Schirmer K. Clobetasol propionate causes immunosuppression in zebrafish (Danio rerio) at environmentally relevant concentrations. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2017; 138:16-24. [PMID: 27987419 DOI: 10.1016/j.ecoenv.2016.11.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
Synthetic glucocorticoids (GCs) are potential endocrine disrupting compounds that have been detected in the aquatic environment around the world in the low ng/L (nanomolar) range. GCs are used as immunosuppressants in medicine. It is of high interest whether clobetasol propionate (CP), a highly potent GC, suppresses the inflammatory response in fish after exposure to environmentally relevant concentrations. Bacterial lipopolysaccharide (LPS) challenge was used to induce inflammation and thus mimic pathogen infection. Zebrafish embryos were exposed to ≤1000nM CP from ~1h post fertilization (hpf) to 96 hpf, and CP uptake, survival after LPS challenge, and expression of inflammation-related genes were examined. Our initial experiments were carried out using 0.001% DMSO as a solvent vehicle, but we observed that DMSO interfered with the LPS challenge assay, and thus masked the effects of CP. Therefore, DMSO was not used in the subsequent experiments. The internal CP concentration was quantifiable after exposure to ≥10nM CP for 96h. The bioconcentration factor (BCF) of CP was determined to be between 16 and 33 in zebrafish embryos. CP-exposed embryos showed a significantly higher survival rate in the LPS challenge assay after exposure to ≥0.1nM in a dose dependent manner. This effect is an indication of immunosuppression. Furthermore, the regulation pattern of several genes related to LPS challenge in mammals supported our results, providing evidence that LPS-mediated inflammatory pathways are conserved from mammals to teleost fish. Anxa1b, a GC-action related anti-inflammatory gene, was significantly down-regulated after exposure to ≥0.05nM CP. Our results show for the first time that synthetic GCs can suppress the innate immune system of fish at environmentally relevant concentrations. This may reduce the chances of fish to survive in the environment, as their defense against pathogens is weakened.
Collapse
Affiliation(s)
- Anita O Hidasi
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Department of Environmental Toxicology, Dübendorf 8600, Switzerland; EPFL, School of Architecture, Civil and Environmental Engineering, Lausanne 1015, Switzerland
| | - Ksenia J Groh
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Department of Environmental Toxicology, Dübendorf 8600, Switzerland
| | - Marc J-F Suter
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Department of Environmental Toxicology, Dübendorf 8600, Switzerland; ETHZ, Institute of Biogeochemistry and Pollutant Dynamics, Zürich 8092, Switzerland
| | - Kristin Schirmer
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Department of Environmental Toxicology, Dübendorf 8600, Switzerland; EPFL, School of Architecture, Civil and Environmental Engineering, Lausanne 1015, Switzerland; ETHZ, Institute of Biogeochemistry and Pollutant Dynamics, Zürich 8092, Switzerland.
| |
Collapse
|
18
|
Yarom N, Zelig K, Epstein JB, Gorsky M. The efficacy of minocycline mouth rinses on the symptoms associated with recurrent aphthous stomatitis: a randomized, double-blind, crossover study assessing different doses of oral rinse. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:675-679. [PMID: 28411006 DOI: 10.1016/j.oooo.2017.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/30/2017] [Accepted: 02/14/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the study was to assess the efficacy of 2 different concentrations of minocycline mouthwashes on the symptoms of recurrent aphthous stomatitis (RAS). STUDY DESIGN The 2-year study was designed as a randomized, double-blind, crossover study. Healthy patients with frequent RAS episodes received 2 sealed and computer-randomized marked kits containing minocycline mouthwashes (0.2% and 0.5% solution). The patients were asked to use 1 of the kits on the first episode of RAS, starting with the first onset of prodromal symptoms, until the symptoms resolved or up to a maximum of 10 days (whichever came first). The patients were asked to use their second kit during a subsequent episode. RESULTS A total of 14 patients (8 males, 6 females) completed the 2 arms of the study. The mean intensity of pain was significantly lower when the 0.5% solution was used compared with the 0.2% solution (P = .027). The difference reached the level of statistical significance as soon as the end of the second day of use (P = .032). Only minor and temporary adverse reactions were documented. CONCLUSIONS We found that 0.5% minocycline mouth rinse was more effective than the 0.2% concentration, which had been suggested by our group in previous studies for the management of RAS.
Collapse
Affiliation(s)
- Noam Yarom
- Oral Medicine Unit, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Keren Zelig
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; and Consulting staff, City of Hope, Duarte, CA, USA
| | - Meir Gorsky
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
19
|
Otero-Rey EM, Suarez-Alen F, Peñamaria-Mallon M, Lopez-Lopez J, Blanco-Carrion A. Malignant transformation of oral lichen planus by a chronic inflammatory process. Use of topical corticosteroids to prevent this progression? Acta Odontol Scand 2014; 72:570-7. [PMID: 24850508 DOI: 10.3109/00016357.2014.914570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral lichen planus is a potentially malignant disorder with a capacity, although low, for malignant transformation. Of all the factors related to the process of malignant transformation, it is believed that the chronic inflammatory process plays a key role in the development of oral cancer. This inflammatory process is capable of providing a microenvironment based on different inflammatory cells and molecules that affect cellular growth, proliferation and differentiation. OBJECTIVES The objectives of our study are: to review the available evidence about the possible relationship between the chronic inflammatory process present in oral lichen planus and its malignant transformation, to discuss the potential therapeutic implications derived from this relationship and to study the role that topical corticosteroids play in the control of oral lichen planus inflammation and its possible progression to malignant transformation. CONCLUSION The maintenance of a minimum dose of topical corticosteroids could prevent the inflammatory progression of oral lichen planus to oral cancer.
Collapse
Affiliation(s)
- Eva Maria Otero-Rey
- Department of Stomatology, School of Dental Medicine, University of Santiago de Compostela , Spain
| | | | | | | | | |
Collapse
|
20
|
Noce CW, Gomes A, Shcaira V, Corrêa MEP, Moreira MCR, Silva Júnior A, Gonçalves LS, Garnica M, Maiolino A, Torres SR. Randomized Double-Blind Clinical Trial Comparing Clobetasol and Dexamethasone for the Topical Treatment of Symptomatic Oral Chronic Graft-Versus-Host Disease. Biol Blood Marrow Transplant 2014; 20:1163-8. [DOI: 10.1016/j.bbmt.2014.04.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 04/07/2014] [Indexed: 01/12/2023]
|
21
|
Decani S, Federighi V, Baruzzi E, Sardella A, Lodi G. Iatrogenic Cushing's syndrome and topical steroid therapy: case series and review of the literature. J DERMATOL TREAT 2013; 25:495-500. [DOI: 10.3109/09546634.2012.755252] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
22
|
Lodi G, Carrozzo M, Furness S, Thongprasom K. Interventions for treating oral lichen planus: a systematic review. Br J Dermatol 2012; 166:938-47. [DOI: 10.1111/j.1365-2133.2012.10821.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- G. Lodi
- Unit of Oral Pathology and Oral Medicine, Università degli Studi di Milano, Via Beldiletto 1, Milan 20142, Italy
| | - M. Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, U.K
| | - S. Furness
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, U.K
| | - K. Thongprasom
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|