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Abd-Elsalam WH, Abouelatta SM. Contemporary Techniques and Potential Transungual Drug Delivery Nanosystems for The Treatment of Onychomycosis. AAPS PharmSciTech 2023; 24:150. [PMID: 37421509 DOI: 10.1208/s12249-023-02603-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/04/2023] [Indexed: 07/10/2023] Open
Abstract
The humanoid nail is considered an exceptional protective barrier that is formed mainly from keratin. Onychomycosis is the cause of 50% of nail infections that is generally caused by dermatophytes. Firstly, the infection was regarded as a cosmetic problem but because of the tenacious nature of onychomycosis and its relapses, these infections have attracted medical attention. The first line of therapy was the oral antifungal agents which were proven to be effective; nevertheless, they exhibited hepato-toxic side effects, alongside drug interactions. Following, the opportunity was shifted to the topical remedies, as onychomycosis is rather superficial, yet this route is hindered by the keratinized layers in the nail plate. A potential alternative to overcome the obstacle was applying different mechanical, physical, and chemical methods to boost the penetration of drugs through the nail plate. Unfortunately, these methods might be expensive, require an expert to be completed, or even be followed by pain or more serious side effects. Furthermore, topical formulations such as nail lacquers and patches do not provide enough sustaining effects. Recently, newer therapies such as nanovesicles, nanoparticles, and nanoemulsions have emerged for the treatment of onychomycosis that provided effective treatment with possibly no side effects. This review states the treatment strategies such as mechanical, physical, and chemical methods, and highlights various innovative dosage forms and nanosystems developed in the last 10 years with a focus on advanced findings regarding formulation systems. Furthermore, it demonstrates the natural bioactives and their formulation as nanosystems, and the most relevant clinical outcomes.
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Affiliation(s)
- Wessam H Abd-Elsalam
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Samar M Abouelatta
- Department of Pharmaceutics, Faculty of Pharmacy, Ahram Candian University, 6 October, Cairo, Egypt
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2
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Bellmann T, Luber R, Kischio L, Karl B, Pötzinger Y, Beekmann U, Kralisch D, Wiegand C, Fischer D. Bacterial nanocellulose patches as a carrier for hydrating formulations to improve the topical treatment of nail diseases. Int J Pharm 2022; 628:122267. [DOI: 10.1016/j.ijpharm.2022.122267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 10/31/2022]
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3
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Shukla S, Huston RH, Cox BD, Satoskar AR, Narayan RJ. Transdermal delivery via medical device technologies. Expert Opin Drug Deliv 2022; 19:1505-1519. [PMID: 36222232 DOI: 10.1080/17425247.2022.2135503] [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]
Abstract
INTRODUCTION Despite their effectiveness and indispensability, many drugs are poorly solvated in aqueous solutions. Over recent decades, the need for targeted drug delivery has led to the development of pharmaceutical formulations with enhanced lipid solubility to improve their delivery properties. Therefore, a dependable approach for administering lipid-soluble drugs needs to be developed. AREAS COVERED The advent of 3D printing or additive manufacturing (AM) has revolutionized the development of medical devices, which can effectively enable the delivery of lipophilic drugs to the targeted tissues. This review focuses on the use of microneedles and iontophoresis for transdermal drug delivery. Microneedle arrays, inkjet printing, and fused deposition modeling have emerged as valuable approaches for delivering several classes of drugs. In addition, iontophoresis has been successfully employed for the effective delivery of macromolecular drugs. EXPERT OPINION Microneedle arrays, inkjet printing, and fused deposition are potentially useful for many drug delivery applications; however, the clinical and commercial adoption rates of these technologies are relatively low. Additional efforts is needed to enable the pharmaceutical community to fully realize the benefits of these technologies.
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Affiliation(s)
- Shubhangi Shukla
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, USA
| | - Ryan H Huston
- Department of Microbiology, The Ohio State University, 484 W. 12 Ave, Columbus, OH 43210, USA
| | - Blake D Cox
- Division of Anatomy, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA
| | - Abhay R Satoskar
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, USA
| | - Roger J Narayan
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, USA
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4
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Martins Andrade JF, da Cunha Miranda T, Cunha-Filho M, Taveira SF, Gelfuso GM, Gratieri T. Iontophoresis application for drug delivery in high resistivity membranes: nails and teeth. Drug Deliv Transl Res 2022; 13:1272-1287. [PMID: 36209312 DOI: 10.1007/s13346-022-01244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
Iontophoresis has been vastly explored to improve drug permeation, mainly for transdermal delivery. Despite the skin's electrical resistance and barrier properties, it has a relatively high aqueous content and is permeable to many drugs. In contrast, nails and teeth are accessible structures for target drug delivery but possess low water content compared to the skin and impose significant barriers to drug permeation. Common diseases of these sites, such as nail onychomycosis and endodontic microbial infections that reach inaccessible regions for mechanical removal, often depend on time-consuming and ineffective treatments relying on drug's passive permeation. Iontophoresis application in nail and teeth structures may be a safe and effective way to improve drug transport across the nail and drug distribution through dental structures, making treatments more effective and comfortable for patients. Here, we provide an overview of iontophoresis applications in these "hard tissues," considering specificities such as their high electrical resistivity. Iontophoresis presents a promising option to enhance drug permeation through the nail and dental tissues, and further developments in these areas could lead to widespread clinical use.
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Affiliation(s)
| | - Thamires da Cunha Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil
| | - Marcílio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil
| | - Stephânia Fleury Taveira
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Federal University of Goias (UFG), Goiânia, GO, 74605-170, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil.
| | - Taís Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil.
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5
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Alkilani AZ, Nasereddin J, Hamed R, Nimrawi S, Hussein G, Abo-Zour H, Donnelly RF. Beneath the Skin: A Review of Current Trends and Future Prospects of Transdermal Drug Delivery Systems. Pharmaceutics 2022; 14:1152. [PMID: 35745725 PMCID: PMC9231212 DOI: 10.3390/pharmaceutics14061152] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
The ideal drug delivery system has a bioavailability comparable to parenteral dosage forms but is as convenient and easy to use for the patient as oral solid dosage forms. In recent years, there has been increased interest in transdermal drug delivery (TDD) as a non-invasive delivery approach that is generally regarded as being easy to administer to more vulnerable age groups, such as paediatric and geriatric patients, while avoiding certain bioavailability concerns that arise from oral drug delivery due to poor absorbability and metabolism concerns. However, despite its many merits, TDD remains restricted to a select few drugs. The physiology of the skin poses a barrier against the feasible delivery of many drugs, limiting its applicability to only those drugs that possess physicochemical properties allowing them to be successfully delivered transdermally. Several techniques have been developed to enhance the transdermal permeability of drugs. Both chemical (e.g., thermal and mechanical) and passive (vesicle, nanoparticle, nanoemulsion, solid dispersion, and nanocrystal) techniques have been investigated to enhance the permeability of drug substances across the skin. Furthermore, hybrid approaches combining chemical penetration enhancement technologies with physical technologies are being intensively researched to improve the skin permeation of drug substances. This review aims to summarize recent trends in TDD approaches and discuss the merits and drawbacks of the various chemical, physical, and hybrid approaches currently being investigated for improving drug permeability across the skin.
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Affiliation(s)
- Ahlam Zaid Alkilani
- Department of Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa 13110, Jordan; (J.N.); (S.N.); (G.H.); (H.A.-Z.)
| | - Jehad Nasereddin
- Department of Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa 13110, Jordan; (J.N.); (S.N.); (G.H.); (H.A.-Z.)
| | - Rania Hamed
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Sukaina Nimrawi
- Department of Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa 13110, Jordan; (J.N.); (S.N.); (G.H.); (H.A.-Z.)
| | - Ghaid Hussein
- Department of Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa 13110, Jordan; (J.N.); (S.N.); (G.H.); (H.A.-Z.)
| | - Hadeel Abo-Zour
- Department of Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa 13110, Jordan; (J.N.); (S.N.); (G.H.); (H.A.-Z.)
| | - Ryan F. Donnelly
- Medical Biology Centre, School of Pharmacy, Queen’s University Belfast, Belfast BT7 1NN, UK;
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6
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Pereira R, Silva SG, Pinheiro M, Reis S, do Vale ML. Current Status of Amino Acid-Based Permeation Enhancers in Transdermal Drug Delivery. MEMBRANES 2021; 11:343. [PMID: 34067194 PMCID: PMC8151591 DOI: 10.3390/membranes11050343] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022]
Abstract
Transdermal drug delivery (TDD) presents many advantages compared to other conventional routes of drug administration, yet its full potential has not been achieved. The administration of drugs through the skin is hampered by the natural barrier properties of the skin, which results in poor permeation of most drugs. Several methods have been developed to overcome this limitation. One of the approaches to increase drug permeation and thus to enable TDD for a wider range of drugs consists in the use of chemical permeation enhancers (CPEs), compounds that interact with skin to ultimately increase drug flux. Amino acid derivatives show great potential as permeation enhancers, as they exhibit high biodegradability and low toxicity. Here we present an overview of amino acid derivatives investigated so far as CPEs for the delivery of hydrophilic and lipophilic drugs across the skin, focusing on the structural features which promote their enhancement capacity.
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Affiliation(s)
- Rui Pereira
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, 4169-007 Porto, Portugal; (R.P.); (S.G.S.)
| | - Sandra G. Silva
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, 4169-007 Porto, Portugal; (R.P.); (S.G.S.)
| | - Marina Pinheiro
- LAQV-REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; (M.P.); (S.R.)
| | - Salette Reis
- LAQV-REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; (M.P.); (S.R.)
| | - M. Luísa do Vale
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, 4169-007 Porto, Portugal; (R.P.); (S.G.S.)
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7
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Helmy AM. Overview of recent advancements in the iontophoretic drug delivery to various tissues and organs. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Chen K, Puri V, Michniak-Kohn B. Iontophoresis to Overcome the Challenge of Nail Permeation: Considerations and Optimizations for Successful Ungual Drug Delivery. AAPS JOURNAL 2021; 23:25. [PMID: 33439400 DOI: 10.1208/s12248-020-00552-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022]
Abstract
Iontophoresis is a widely used drug delivery technique that has been used clinically to improve permeation through the skin for drugs and other actives in topical formulations. It is however not commonly used for the treatment of nail diseases despite its potential to improve transungual nail delivery. Instead, treatments for nail diseases are limited to relatively ineffective topical passive permeation techniques, which often result in relapses of nail diseases due to the thickness and hardness of the nail barrier resulting in lower permeation of the actives. Oral systemic antifungal agents that are also used are often associated with various undesirable side effects resulting in low patient compliance. This review article discusses what is currently known about the field of transungual iontophoresis, providing evidence of its efficacy and practicality in delivering drug to the entire surface of the nail for extended treatment periods. It also includes relevant details about the nail structure, the mechanisms of iontophoresis, and the associated in vitro and in vivo studies which have been used to investigate the optimal characteristics for a transungual iontophoretic drug delivery system. Iontophoresis is undoubtedly a promising option to treat nail diseases, and the use of this technique for clinical use will likely improve patient outcomes.Graphical abstract.
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Affiliation(s)
- Kevin Chen
- Ernest Mario School of Pharmacy, Department of Pharmaceutics, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.,Center for Dermal Research, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Vinam Puri
- Ernest Mario School of Pharmacy, Department of Pharmaceutics, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.,Center for Dermal Research, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Bozena Michniak-Kohn
- Ernest Mario School of Pharmacy, Department of Pharmaceutics, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA. .,Center for Dermal Research, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA. .,Life Sciences Building, Rutgers, The State University of New Jersey, 145, Bevier Road, Piscataway, New Jersey, 08854, USA.
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9
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Garg A, Sharma GS, Goyal AK, Ghosh G, Si SC, Rath G. Recent advances in topical carriers of anti-fungal agents. Heliyon 2020; 6:e04663. [PMID: 32904164 PMCID: PMC7452444 DOI: 10.1016/j.heliyon.2020.e04663] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 11/22/2019] [Accepted: 08/05/2020] [Indexed: 12/19/2022] Open
Abstract
Fungal skin infections are the most common global issue for skin health. Fungal infections are often treated by topical or systemic anti-fungal therapy. Topical fungal therapy is usually preferred because of their targeted therapy and fewer side effects. Advanced topical carriers because of their distinct structural and functional features, overcome biopharmaceutical challenges associated with conventional drug delivery systems like poor retention and low bioavailability. Literature evidence indicated topical nanocarriers loaded with anti-fungal agents display superior therapeutic response with minimum toxicity. Nanocarriers often used for topical anti-fungal medication includes Solid-Lipid nanoparticles, Microemulsions, Liposomes, Niosomes, Microsponge, Nanogel, Nanoemulsion, Micelles etc. This review summarizes recent advances in novel strategies employed in topical carriers to improve the therapeutic performance of anti-fungal drugs.
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Affiliation(s)
- Abhinava Garg
- Department of Pharmaceutics, I.S.F.College of Pharmacy, Moga, Punjab, India
| | - Ganti S. Sharma
- Department of Pharmaceutics, I.S.F.College of Pharmacy, Moga, Punjab, India
| | - Amit K. Goyal
- School of Chemical Sciences and. Pharmacy, Central University of Rajasthan, India
| | - Goutam Ghosh
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Sudam Chandra Si
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Goutam Rath
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
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10
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Šveikauskaitė I, Briedis V. Potential of Naftifine Application for Transungual Delivery. Molecules 2020; 25:E3043. [PMID: 32635240 PMCID: PMC7411873 DOI: 10.3390/molecules25133043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/03/2022] Open
Abstract
Naftifine is used to treat fungal skin infections as it inhibits dermatophytes, which are the cause of onychomycosis. However, naftifine's ability to permeate the human nail barrier has not been investigated, thus, the antimycotic potential is not clearly established. This work aims to evaluate the effect of penetration enhancing factors on the accumulation of naftifine hydrochloride through human nail clippings. Naftifine polymeric nail lacquers with Eudragit RL100 were developed as a suitable delivery system. Low penetration of naftifine into nail has been determined as less than 10% of applied drug dose accumulated in the nail layers. Incorporation of thioglycolic acid into formulations resulted in increased accumulation of antifungal agent in the nail layers by 100% compared with a control group. Salicylic acid did not effect naftifine accumulation in the human nail. The permeation of naftifine through the nail increased by threefold when the thioglycolic acid-containing formulation was applied and the nail was pretreated with a fractional CO2 laser. Structural changes of the nail barrier, induced by fractional CO2 laser, were visualized by microscopy. The results suggest, that naftifine nail penetration could be significantly increased when physical and chemical enhancing factors are applied.
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Affiliation(s)
- Indrė Šveikauskaitė
- Department of Clinical Pharmacy, Lithuanian University of Health Sciences, Sukilėlių pr. 13, Kaunas 50161, Lithuania;
- Institute of Pharmaceutical Technologies, Lithuanian University of Health Sciences, Sukilėlių pr. 13, Kaunas 50161, Lithuania
| | - Vitalis Briedis
- Department of Clinical Pharmacy, Lithuanian University of Health Sciences, Sukilėlių pr. 13, Kaunas 50161, Lithuania;
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11
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Tampucci S, Terreni E, Zucchetti E, Burgalassi S, Chetoni P, Monti D. Formulations Based on Natural Ingredients for the Treatment of Nail Diseases. Curr Pharm Des 2020; 26:556-565. [DOI: 10.2174/1381612826666200122150248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022]
Abstract
Nail is a strong and resistant structure, characterized by a low permeability to foreign molecules. Nails
can be subjected to many diseases, among which fungal infections (e.g. onchomycosis) are the most common and
responsible for nail structure alteration. Many formulations have been produced for the delivery of active ingredients
to treat nail disorders, based on newly synthesized active molecules or containing chemical enhancers or
chemically-modified polymers able to improve the drug transungual penetration. To avoid permanent alterations
of the nail structure due to the use of chemical compounds or organic solvent-based formulation, researchers have
developed novel formulations focusing on the use of new natural-based compounds. The purpose of this review is
to provide information on the outcoming of natural ingredients-based formulations that have been developed in
the last years as potential alternative to chemical-based formulations.
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Affiliation(s)
| | | | | | | | | | - Daniela Monti
- Department of Pharmacy, University of Pisa, Pisa, Italy
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12
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Abstract
A deteriorating nail standard is a growing problem as the global prevalence of diabetes is increasing. Systemic treatment with mineral supplements may not be recommended, mainly due to the high doses required to deliver optimal therapeutic concentrations. In this work, we evaluate nail polish formulations for the local delivery of strengthening elements to the nail plate. Specifically, we assess calcium and silicon release from nail polish base coat formulations containing three different concentrations of White Portland Cement to water, as well as to artificial and human nails. The delivery of calcium and silicon to the dorsal nail plate was determined by inductively coupled plasma optical emission spectrometry, scanning electron microscopy, and energy dispersive X-ray spectroscopy. To the best of our knowledge, this is the first study showing that such dual elemental delivery to human nails can be achieved from nail polish formulations. Hence, this work may form the basis for new inventions where therapeutic functionalities can be integrated with the mechanical and cosmetic properties of a base coat nail polish. Future permeability studies are required to verify long-term effects on the nail standard, induced by the formulations under study.
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13
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Vikas A, Rashmin P, Mrunali P, Chavan RB, Kaushik T. Mechanistic Insights of Formulation Approaches for the Treatment of Nail Infection: Conventional and Novel Drug Delivery Approaches. AAPS PharmSciTech 2020; 21:67. [PMID: 31938980 DOI: 10.1208/s12249-019-1591-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
Onychomycosis is a chronic disorder that is difficult to manage and hard to eradicate with perilous trends to relapse. Due to increased prevalence of HIV, use of immunosuppressant drugs and lifestyle-related factors, population affected with fungal infection of nail (Onychomycosis) happens to increase extensively in last two decades. Modalities available for the treatment of onychomycosis include systemically administered antifungals, mechanical procedures, and topical drug therapy. But the efficacy of the most of approaches to deliver drug at targeted site, i.e., deep-seated infected nail bed is limited due to compact and highly keratinized nail structure. A series of advanced formulation approaches, such as transfersomes, liposomes, nano/micro emulsion, nail lacquers etc., have been attempted to improve the drug penetration into nail plate more efficiently. The manuscript reviews these formulation approaches with their possible mechanisms by which they improve the drug penetration.Comparative analysis of available treatment modalities for onychomycosis has been provided with pros and cons of each alternatives. Additionally, ongoing research about the application of biological materials such as modified cationic antimicrobial peptides (AMPs), plant-derived proteins, and synthetic antimicrobial peptidomimetics have also been explored.
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Ciclopirox and Efinaconazole Transungual Permeation, Antifungal Activity, and Proficiency To Induce Resistance in Trichophyton rubrum. Antimicrob Agents Chemother 2019; 63:AAC.00442-19. [PMID: 31332076 PMCID: PMC6761538 DOI: 10.1128/aac.00442-19] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/14/2019] [Indexed: 12/22/2022] Open
Abstract
Onychomycosis is a nail fungal infection, mostly caused by dermatophytes. The treatment efficacy is impaired by difficulties of reaching effective drug levels at the site of infection; frequent relapses occur after cessation of antifungal therapy. The aim of the study was to compare two commercial products containing ciclopirox or efinaconazole for antimycotic activity and antifungal drug resistance. A study of permeation and penetration through bovine hoof membranes, as a nail model, was performed to evaluate the antimycotic activity of permeates against clinical isolates of selected fungi, and the frequency of spontaneous in vitro Trichophyton rubrum-resistant strains was assessed by broth microdilution assays. The results suggest that ciclopirox creates a depot in the nail, leading to a gradual release of the drug over time with action on both the nail plate and bed. Conversely, efinaconazole, mildly interacting with nail keratin, mainly exerts its antifungal activity in the nail bed. However, in the case of T. rubrum, the antifungal activities of the drugs in the nail plate seem comparable. Finally, efinaconazole showed a potential for induction of resistance in T. rubrum, which may limit its efficacy over time. Ciclopirox did not show any potential to induce resistance in T. rubrum and appears endowed with a more complete activity than efinaconazole in the management of onychomycosis as the nail keratin is a substrate for the growth of fungal cells, and the availability of drug in large concentration just in the nail bed may not be sufficient to guarantee the complete eradication of pathogens.
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15
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Overcoming hurdles in iontophoretic drug delivery: is skin the only barrier? - an update. Ther Deliv 2019; 10:211-214. [PMID: 30991922 DOI: 10.4155/tde-2019-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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16
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Cutrín-Gómez E, Anguiano-Igea S, Delgado-Charro MB, Gómez-Amoza JL, Otero-Espinar FJ. Effect on Nail Structure and Transungual Permeability of the Ethanol and Poloxamer Ratio from Cyclodextrin-Soluble Polypseudorotaxanes Based Nail Lacquer. Pharmaceutics 2018; 10:pharmaceutics10030156. [PMID: 30208659 PMCID: PMC6160925 DOI: 10.3390/pharmaceutics10030156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022] Open
Abstract
Aqueous-based nail lacquers have shown potential in promoting the diffusion of drugs into the nail. In our laboratory, we have recently developed a transungual delivery system based on an aqueous dispersion of cyclodextrin-poloxamer soluble polypseudorotaxanes, supramolecular host−guest assemblies that improves the drug permeation into the nail. However, the high-water content and the rheological and adhesive properties of this lacquer negatively affect properties that play a fundamental role in the patients’ acceptance such as stickiness, nail film formation or drying rate, properties. In this work, we have optimized the composition of these lacquers to improve these properties whilst maintaining good drug permeation profiles. Incorporating ethanol into the vehicle and reducing the proportion of Poloxamer 407 (PL), provided a good strategy. The use of hydro-ethanolic mixtures (>50% ethanol) and the reduction of the poloxamer concentration significantly improved the lacquer drying speed by reducing the stickiness and promoting film formation on the nail surface. Additionally, in a surprising way, the use of hydro-ethanolic vehicles further enhanced the permeation of ciclopirox olamine and clobetasol propionate, used for the treatment of onychomycosis and nail psoriasis respectively, into the nail and hooves.
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Affiliation(s)
- Elena Cutrín-Gómez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Soledad Anguiano-Igea
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | | | - José Luis Gómez-Amoza
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
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