Iontophoretic pulsatile transdermal delivery of human parathyroid hormone (1-34)

Effect of continuous and multi-phasic current profiles on the iontophoretic transport of pramipexole, rasagiline and huperzine A: Depicting temporal variation and biodistribution in the skin

Transdermal iontophoresis is an interesting option for the non-invasive controlled delivery of therapeutic agents to treat neurodegenerative diseases. The current profile controls drug delivery kinetics and enables complex drug input profiles to be obtained. The aim of this study was to investigate the temporal variation in transport of pramipexole (PRA), rasagiline (RAS) and huperzine A (HUP) using continuous and multi-phasic current profiles by measuring cumulative permeation, transdermal flux and drug retention in the skin upon modulation of the applied current profile during a single experiment in vitro. Initial experiments with continuous current were conducted to establish a correlation between total delivery of PRA, RAS and HUP (i.e. sum of the cumulative permeation and skin deposition) and the amount of charge transferred. Subsequent experiments with multi-phasic current profiles, confirmed that the relationship between amounts of charge transferred and total delivery was able to predict the total delivery of each drug. Experimental values were within ± 15% of the predicted values. Current density and duration of current application were also shown to have a significant impact on the skin biodistribution of PRA. These results also provide insight into the rate of formation of iontophoretic drug reservoirs in the skin.

Facile transdermal delivery of upconversion nanoparticle by iontophoresis-responsive magneto-upconversion oleogel

The effective application of upconversion nanoparticle (UCNP) as a photo-medicine in skin cancers critically depends on a facile transdermal delivery process through topical route. Herein, combining two non-invasive techniques, i.e. skin permeation enhancement and alternating current (AC) induced iontophoresis, we report a controlled transdermal delivery of UCNP with a time advantage. We have synthesized a series of soybean oil-based oleogels termed as magneto-upconversion (MU) gels by incorporating a fixed amount of UCNP and different proportions of magnetic nanoparticle (MNP) using stearic acid-based gelator as a skin permeation enhancing agent. The microstructures of the synthesized MU gels were characterized by microscopy, X-Ray diffraction and vibrational spectroscopy. A detailed analysis of the electrical properties revealed a gradual increase in the electrical conductance in the MU gel series with increasing proportion of MNP. Such trend of conductance imparted proportional iontophoretic response within the respective MU gels, validated through the release of ciprofloxacin hydrochloride as a model drug preloaded within the oleogels. Through a series of skin permeation experiment using pig ear skin as animal model, we established that the UCNP was able to permeate the whole thickness of the skin within as little as 3 h, only when the two conditions, i.e. the presence of skin permeation enhancer and iontophoresis were met. Within the same time, UCNP permeation was enhanced by the presence of MNP in the MU gels upto 2 folds. Our study developed a rational method for the transdermal delivery of any electrically non-conducting nanoparticle in a faster and tunable way.

Development of natural calcium- and phosphate-donating microparticles and a new iontophoretic apparatus for the topical treatment of local osteoporosis. Preliminary in vitro and in vivo studies

AIM

We wished to develop a new iontophoretic device suitable for the treatment of local bone loss such as after fractures or in osteodystrophy.

METHODS

The new iontophoretic apparatus consists of two parts. The first part consists of two natural-based, chemically modified particles as potential medicines, while the other part is a 3-electrode electrophoretic device based on a new principle. This device 'knocks out' Ca²(+) and PO₄ ³⁻ ions from the particles with its impulse-like positive and negative charges transmitted through its electrodes placed on the skin. The current and the voltage of the electrodes can be adjusted separately in both leads. Subsequently, these 'knocked out' ions are channelled into the porotic bones with the help of the 3rd-reference-electrode.

RESULTS

In our preliminary in vitro studies, we used porcine tissues to test their calcium and phosphate content after iontophoresis; with or without using molecules. This preliminary analysis revealed that both calcium and phosphate ions became incorporated into the bone. Some in vivo data are also presented. Iontophoretic treatment increased speed of sound (SOS) as determined by ultrasonography in ovariectomized rats.

CONCLUSION

Our results suggest that topical iontophoresis may be suitable to treat local osteoporosis or bone defects.

Transdermal Delivery of Cytochrome C—A 12.4 kDa Protein—Across Intact Skin by Constant–Current Iontophoresis

PURPOSE

To demonstrate the transdermal iontophoretic delivery of a small (12.4 kDa) protein across intact skin.

MATERIALS AND METHODS

The iontophoretic transport of Cytochrome c (Cyt c) across porcine ear skin in vitro was investigated and quantified by HPLC. The effect of protein concentration (0.35 and 0.7 mM), current density (0.15, 0.3 or 0.5 mA.cm(-2) applied for 8 h) and competing ions was evaluated. Co-iontophoresis of acetaminophen was employed to quantify the respective contributions of electromigration (EM) and electroosmosis (EO).

RESULTS

The data confirmed the transdermal iontophoretic delivery of intact Cyt c. Electromigration was the principal transport mechanism, accounting for approximately 90% of delivery; correlation between EM flux and electrophoretic mobility was consistent with earlier results using small molecules. Modest EO inhibition was observed at 0.5 mA.cm(-2). Cumulative permeation at 0.3 and 0.5 mA.cm(-2) was significantly greater than that at 0.15 mA.cm(-2); fluxes using 0.35 and 0.7 mM Cyt c in the absence of competing ions (J ( tot ) = 182.8 +/- 56.8 and 265.2 +/- 149.1 microg.cm(-2).h(-1), respectively) were statistically equivalent. Formulation in PBS (pH 8.2) confirmed the impact of competing charge carriers; inclusion of approximately 170 mM Na(+) resulted in a 3.9-fold decrease in total flux.

CONCLUSIONS

Significant amounts ( approximately 0.9 mg.cm(-2) over 8 h) of Cyt c were delivered non-invasively across intact skin by transdermal electrotransport.

Effect of electroporation and pH on the iontophoretic transdermal delivery of human insulin

The synergistic effect of electroporation (EP) and iontophoresis (IP) on the in vivo percutaneous absorption of human insulin was evaluated in rats. Passive diffusion and IP alone (0.4 mA/cm(2)) resulted in almost no skin permeation of insulin at pH 7, whereas EP treatment (150 or 300 V, 10 ms, and 10 pulses) resulted in a high plasma level of insulin and the combined use of EP and IP led to a further increase of the plasma level of insulin compared with that measured after EP alone. Interestingly, a much higher plasma level was observed when the pH of the insulin solution at 7 was increased to 10. One of the reasons was the different aggregation properties of insulin at pH 7 and pH 10. The nonassociation ratio of insulin was significantly higher at pH 10 than at pH 7. Insulin monomers and dimers were observed in addition to the normal form of insulin, hexamer, albeit in low percentages, at pH 10, whereas most of the insulin was in the hexamer form at pH 7. To confirm the influence of the aggregation properties of insulin, the commercially available human insulin analogue insulin lispro was then evaluated. Its skin permeation was found to be extremely high compared to that of conventional human insulin without increasing the solution pH. Marked decreases in blood glucose levels reflecting the increases in the plasma concentration of insulin were also observed after EP/IP treatment. The present study suggests that percutaneous absorption of insulin is synergistically enhanced by a combined use of EP and IP and that altering the aggregation properties of insulin is important to enhance the percutaneous absorption of insulin by IP and/or EP.

Prediction of iontophoretic transport across the skin

The objective of this work was to demonstrate that the efficiency of iontophoretic transport across the skin (which is measured in terms of an ion's transport number), either for drug delivery or for therapeutic drug monitoring, depends implicitly on the molar fraction of the species of interest over a wide range of experimental conditions both in vitro and in vivo. Three sets of data from the literature were assessed to establish the direct relationship between transport number and mole fraction. Linear regression between these parameters yielded slopes which correlated with the charge-carrying efficiency of the ion considered. The latter, furthermore, was proportional to the corresponding aqueous mobility and to the transport number of the ion when it is the sole species available for migration from its electrode solution (the so-called "single-carrier" situation). Finally, the principles illustrated here were equally applicable to in vitro experiments and to in vivo data obtained in a clinically relevant study (specifically, the reverse iontophoretic monitoring of lithiemia in bipolar patients). Not only does this validate an in vitro model typically used in iontophoresis research, it also demonstrates the potential of this approach to predict the feasibility of iontophoretic transport across the skin.

Delivery of parathyroid hormone for the treatment of osteoporosis

Parathyroid hormone (PTH), along with its fragments and analogues, potently restores bone mass and biomechanical strength in animal models of osteoporosis, and reduces fractures by up to 65% in clinical trials in osteoporotic patients. Despite this demonstrated efficacy, patient acceptance and compliance with PTH is limited by the need for daily subcutaneous injections. The development of an equally efficacious, noninjectable form of PTH would significantly expand the present market. A challenge to the development of an alternative delivery system is the requirement for low-dose, daily, intermittent pulses of PTH to induce the anabolic actions on bone. In this review, recent basic and clinical efforts to deliver PTH by oral, buccal, sublingual, transdermal, nasal and pulmonary approaches will be addressed.

Effect of charge and molecular weight on transdermal peptide delivery by iontophoresis

PURPOSE

The study was conducted to investigate the impact of charge and molecular weight (MW) on the iontophoretic delivery of a series of dipeptides.

METHODS

Constant current iontophoresis of lysine and 10 variously charged lysine- and tyrosine-containing dipeptides was performed in vitro.

RESULTS

Increasing MW was compensated by additional charge; for example, Lys (MW = 147 Da, +1) and H-Lys-Lys-OH (MW = 275 Da, +2) had equivalent steady-state fluxes of 225 +/- 48 and 218 +/- 40 nmol cm(-2) h(-1), respectively. For peptides with similar MW, e.g., H-Tyr-D-Arg-OH (MW = 337 Da, +1) and H-Tyr-D-Arg-NH(2) (MW = 336 Da, +2), the higher valence ion displayed greater flux (150 +/- 26 vs. 237 +/- 35 nmol cm(-2) h(-1)). Hydrolysis of dipeptides with unblocked N-terminal residues, after passage through the stratum corneum, suggested the involvement of aminopeptidases. The iontophoretic flux of zwitterionic dipeptides was less than that of acetaminophen and dependent on pH.

CONCLUSIONS

For the series of dipeptides studied, flux is linearly correlated to the charge/MW ratio. Data for zwitterionic peptides indicate that they do not behave as neutral ("charge-less") molecules, but that their iontophoretic transport is dependent on the relative extents of ionization of the constituent ionizable groups, which may also be affected by neighboring amino acids.

Iontophoretic drug delivery using the IOMED Phoresor®system

Iontophoresis, or electromotive drug administration, is a process that enhances the delivery of drugs through a biological membrane via the application of low-intensity electrical current. This technology offers several advantages over oral and injection drug delivery. Key advantages of iontophoretic drug delivery include the avoidance of pain and potential for infection associated with needle injection, the ability to control the rate of drug delivery, the ability to programme the drug-delivery profile and the minimisation of local tissue trauma. Research using iontophoresis has shown delivery of a number of drug classes. By controlling the applied electric current one can tailor a dosage regimen with a drug delivery profile specific for an indication and the needs of the patient. Advances in iontophoretic electrode design, microelectronics and methods to optimise iontophoretic drug delivery have improved the ability to safely deliver both older, off-patent drugs, as well as new chemical entities being developed to treat a variety of diseases. In addition to transdermal applications, current research indicates that iontophoresis may prove to be a viable noninvasive drug delivery method for treating conditions that affect the back of the eye.

Pharmacokinetic aspects of biotechnology products

In recent years, biotechnologically derived peptide and protein-based drugs have developed into mainstream therapeutic agents. Peptide and protein drugs now constitute a substantial portion of the compounds under preclinical and clinical development in the global pharmaceutical industry. Pharmacokinetic and exposure/response evaluations for peptide and protein therapeutics are frequently complicated by their similarity to endogenous peptides and proteins as well as protein nutrients. The first challenge frequently comes from a lack of sophistication in various analytical techniques for the quantification of peptide and protein drugs in biological matrices. However, advancements in bioassays and immunoassays--along with a newer generation of mass spectrometry-based techniques--can often provide capabilities for both efficient and reliable detection. Selection of the most appropriate route of administration for biotech drugs requires comprehensive knowledge of their absorption characteristics beyond physicochemical properties, including chemical and metabolic stability at the absorption site, immunoreactivity, passage through biomembranes, and active uptake and exsorption processes. Various distribution properties dictate whether peptide and protein therapeutics can reach optimum target site exposure to exert the intended pharmacological response. This poses a potential problem, especially for large protein drugs, with their typically limited distribution space. Binding phenomena and receptor-mediated cellular uptake may further complicate this issue. Elimination processes--a critical determinant for the drug's systemic exposure--may follow a combination of numerous pathways, including renal and hepatic metabolism routes as well as generalized proteolysis and receptor-mediated endocytosis. Pharmacokinetic/pharmacodynamic (PK/PD) correlations for peptide and protein-based drugs are frequently convoluted by their close interaction with endogenous substances and physiologic regulatory feedback mechanisms. Extensive use of pharmacokinetic and exposure/response concepts in all phases of drug development has in the past been identified as a crucial factor for the success of a scientifically driven, evidence-based, and thus accelerated drug development process. Thus, PK/PD concepts are likely to continue and expand their role as a fundamental factor in the successful development of biotechnologically derived drug products in the future.

Iontophoretic drug delivery

The composition and architecture of the stratum corneum render it a formidable barrier to the topical and transdermal administration of therapeutic agents. The physicochemical constraints severely limit the number of molecules that can be considered as realistic candidates for transdermal delivery. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. The principal distinguishing feature is the control afforded by iontophoresis and the ability to individualize therapies. This may become significant as the impact of interindividual variations in protein expression and the effect on drug metabolism and drug efficacy is better understood. In this review we describe the underlying mechanisms that drive iontophoresis and we discuss the impact of key experimental parameters-namely, drug concentration, applied current and pH-on iontophoretic delivery efficiency. We present a comprehensive and critical review of the different therapeutic classes and molecules that have been investigated as potential candidates for iontophoretic delivery. The iontophoretic delivery of peptides and proteins is also discussed. In the final section, we describe the development of the first pre-filled, pre-programmed iontophoretic device, which is scheduled to be commercialized during the course of 2004.

Anabolic and catabolic bone effects of human parathyroid hormone (1-34) are predicted by duration of hormone exposure

Parathyroid hormone (PTH)(1-34), given once daily, increases bone mass in a variety of animal models and humans with osteoporosis. However, continuous PTH infusion has been shown to cause bone loss. To determine the pharmacokinetic profile of PTH(1-34) associated with anabolic and catabolic bone responses, PTH(1-34) pharmacokinetic and serum biochemical profiles were evaluated in young male rats using dosing regimens that resulted in either gain or loss of bone mass. Once-daily PTH(1-34) or 6 PTH(1-34) injections within 1 h, for a total daily dose of 80 microg/kg, induced equivalent increases in proximal tibia bone mass. In contrast, 6 PTH(1-34) injections/day over 6 h for a total dose of 80 microg/kg/day or 3 injections/day over 8 h for a total of 240 microg/kg/day decreased tibia bone mass. The PTH(1-34) pharmacokinetics of the different treatment regimens were distinctive. The magnitude of the maximum serum concentrations (Cmax) of PTH(1-34) and area under the curve (AUC) did not predict the catabolic bone outcome. Compared to the anabolic pharmacokinetic profile of a transient increase in PTH(1-34) with rapid decreases in serum calcium and phosphate, the catabolic regimen was associated with PTH(1-34) concentrations remaining above baseline values during the entire 6-h dosing period with a trend toward an increase in serum calcium and a prolonged decrease in phosphate. The pharmacokinetic profiles suggest that the anabolic or catabolic response of bone to PTH(1-34) is determined primarily by the length of time each day that serum concentrations of PTH(1-34) remain above baseline levels of endogenous PTH and only secondarily by the Cmax or AUC of PTH(1-34) achieved.

Prevention of bone loss in ovariectomized rats by pulsatile transdermal iontophoretic administration of human PTH(1-34)

Serum human parathyroid hormone (1-34)[hPTH(1-34)] levels and the anabolic effect of hPTH(1-34) were compared after administration using multiple pulses of iontophoresis or subcutaneous (sc) intermittent injections to ovariectomized (OVX) Sprague Dawley rats. Triple-pulse iontophoretic administration of hPTH(1-34) (doses: 40-400 microg/patch), achieved by repeated 30-min applications of a 0.1 mA/cm(2) current separated by 45-min rest intervals, produced three sharp peaks in the serum hPTH(1-34) level in response to application of the current. Each peak appeared at the end of the 30-min current application period and was proportional to the hPTH(1-34) dose. Compared with once-daily sc injections (7 pulses/week), triple-pulses iontophoretic administered 3 times/week (9 pulses/week) for 4 weeks produced dose-related increases in the bone mineral density (BMD) of the distal 1/3 femur. For the sc administration, the relative BMD values using the vehicle injection as a reference standard for 1, 5, and 25 microg/kg/day were 104, 114, and 121%, respectively. For iontophoretic administration, the relative BMD values using the placebo patch as a reference standard for 40, 120, and 400 microg/patch were 104, 110, and 116%, respectively. The increase in the BMD plotted against the area under the hPTH(1-34) serum level-time curve (AUC) over 1 week resulted in similar straight lines in the 9 pulses/week iontophoretic administration and the 7 pulses/week sc administration groups. The estimated iontophoretic dose giving an equivalent BMD to once-daily sc administration at 5 microg/kg/day was 120 microg/patch. These findings strongly suggest that three iontophoretic pulses administered on alternate days will exert an anabolic effect equivalent to that of daily sc administration at doses giving the same weekly AUC. Furthermore, this method of administering hPTH(1-34) might enable self-medication, a useful advance in the treatment of osteoporosis.