Studies on in vitro and in vivo transdermal flux enhancement of methotrexate by a combinational approach in comparison to oral delivery

Chiral 4-O-acylterpineol as transdermal permeation enhancers: insights of the enhancement mechanisms of a transdermal enantioselective delivery system for flurbiprofen

In order to devise more effective penetration enhancers, 4-O-acylterpineol derivatives which were expected to be hydrolyzed into nontoxic metabolites by esterase in the living epidermis, were synthesized from 4-terpineol (4-TER) enantiomers and straight chain fatty acids. Their promoting activities on the SR-flurbiprofen and its enantiomers were tested across full-thickness rabbit skin, as well as to correlate under in vitro and in vivo conditions. The permeation studies indicated that both d-4-O-acylterpineol and l-4-O-acylterpineol had significant enhancing effects, interestingly, d-4-O-aclyterpineol had higher enhancing effects than l-4-O-aclyterpineol with the exception of d-4-methyl-1-(1-methylethyl)-3-cyclohexen-1-yl octadec-9-enoate (d-4-T-dC18). The mechanism of 4-O-acylterpineol facilitating the drug penetration across the skin was confirmed by Attenuated total reflection-Fourier transformed infrared spectroscopy (ATR-FTIR) and molecular simulation. The mechanism of penetration enhancers promoting drug release was explored by the in vitro release experiment. Finally, a relative safety skin irritation of enhancers was also investigated by in vivo histological evaluation. The present research suggested that d-4-O-aclyterpineol and l-4-O-aclyterpineol could significantly promote the penetration of SR-flurbiprofen and its enantiomers both in vitro and in vivo, with the superiorities of high flux and low dermal toxicity.

Hyaluronic Acid-Based Dissolving Microneedle Patch Loaded with Methotrexate for Improved Treatment of Psoriasis

Methotrexate (MTX) is one of the first-line treatments for moderate to severe psoriasis, while the side effects caused by injection and oral administration of MTX greatly restrict its clinical application. Transdermal drug delivery offers a desirable alternative to the conventional approaches, but the performances of the currently available skin penetration enhancement techniques are not so satisfactory. To address these limitations, we developed a dissolving microneedle (MN) patch made of hyaluronic acid (HA) with excellent water solubility, biocompatibility, biodegradability, and mechanical properties. The amount of MTX encapsulated in the needles of the patch could be controlled during the fabrication process for precise dosage. Interestingly, the MTX-loaded MNs successfully penetrated imiquimod (IMQ)-induced thickened epidermis in mice and delivered the drug intralesionally. Meanwhile, fast dissolution of HA endowed the MNs with operability for patients. We found that the MTX-loaded MNs not only showed well-maintained inhibitory effect in vitro but also alleviated the psoriasis-like skin inflammation in mice. Moreover, the MTX-loaded MNs were significantly more efficacious than taking the same dose of drug orally. Consequently, a higher oral dose of MTX was required for a comparable amelioration, which in turn increased its systemic toxicity. Taken together, the proposed MTX-loaded dissolving MN patch strategy provides a new opportunity for efficient and safe treatment of psoriasis.

Electrically and Ultrasonically Enhanced Transdermal Delivery of Methotrexate

In this study, we used sonophoresis and iontophoresis to enhance the in vitro delivery of methotrexate through human cadaver skin. Iontophoresis was applied for 60 min at a 0.4 mA/sq·cm current density, while low-frequency sonophoresis was applied at a 20 kHz frequency (2 min application, and 6.9 W/sq·cm intensity). The treated skin was characterized by dye binding, transepidermal water loss, skin electrical resistance, and skin temperature measurement. Both sonophoresis and iontophoresis resulted in a significant reduction in skin electrical resistance as well as a marked increase in transepidermal water loss value (p < 0.05). Furthermore, the ultrasonic waves resulted in a significant increase in skin temperature (p < 0.05). In permeation studies, the use of iontophoresis led to a significantly higher drug permeability than the untreated group (n = 4, p < 0.05). The skin became markedly more permeable to methotrexate after the treatment by sonophoresis than by iontophoresis (p < 0.01). A synergistic effect for the combined application of sonophoresis and iontophoresis was also observed. Drug distribution in the skin layers revealed a significantly higher level of methotrexate in the sonicated skin than that in iontophoresis and untreated groups. Iontophoresis and low-frequency sonophoresis were found to enhance the transdermal and intradermal delivery of methotrexate in vitro.

Transdermal delivery of methotrexate: past, present and future prospects

Methotrexate has been reported as an immunosuppressant and an antimetabolite widely used in the treatment of rheumatoid arthritis and psoriasis. However, it causes various toxicities and has low bioavailability when taken orally, thus, it is desirable that the drug be delivered transdermally. The water solubility and charged structure of methotrexate, however, limits its use via the transdermal route mainly due to the highly organized microstructure of the stratum corneum. Hence, various technologies, such as chemical enhancers, iontophoresis, electroporation, ultrasound and microneedles, either alone or in combination, are being explored to enhance its permeability by disrupting the barrier property of the skin. The present article discusses the past, present and future of transdermal delivery of methotrexate.

Biophysical assessment of DC iontophoresis and current density on transdermal permeation of methotrexate

INTRODUCTION

The effect of DC iontophoresis using low (0.2 mA/cm(2)) and high current density (0.5 mA/cm(2)) on transdermal permeation of methotrexate loaded into polyacrylamide hydrogel patch was investigated.

RESULTS

Flux of 20.57 ± 1.02 μg/cm(2)/h and 36.8 ± 2.21 μg/cm(2)/h was achieved with low and high current density DC iontophoresis, respectively. Attenuated total reflectance-Fourier Transform infrared (ATR-FTIR) spectra and microscopic studies of the treated skin samples supported the permeation results. A greater decrease in the peak height of asymmetric, symmetric C-H stretching vibration and ester peak was noticed with 0.5 mA/cm(2) current density as compared to 0.2 mA/cm(2) current density samples. Furthermore, an increase in the ratio of amide I and amide II bands from 2.6 to 11 with increase in current density was noticed, thus indicating that hydration levels are associated with iontophoresis and play an important role in increasing the drug permeation. Scanning electron microscopy revealed increase in pore size of the hair follicles. Light microscopy studies of the skin samples treated with low current density DC iontophoresis demonstrated epidermal thinning and focal disruptions, spongiosis and appendageal dilatations. With higher current density, disruption of epidermis in almost half of the sectioned area, loss of appendages and fractured collagen in the dermis was noticed. Moreover, the reversibility studies conducted in vivo on mice revealed that the recovery process had started within 24 h and is complete in 48 h for lower current density treated animals. However, the histological changes associated with 0.5 mA/cm(2) current density were not reversible in 48 h and edema, appendageal dilatations along with focal disruption of epidermis persisted.

CONCLUSION

Hence our study suggests that high density current is not well-tolerated by the skin.

The effect of permeation enhancers on the viscosity and the release profile of transdermal hydroxypropyl methylcellulose gel formulations containing diltiazem HCl

BACKGROUND AND METHOD

The objective of this study was to characterize the release of Diltiazem HCl (DTM HCl) from hydroxypropyl methylcellulose gels containing the following permeation enhancers at a 0.5% (w/w): sodium lauryl sulfate, dimethyl sulfoxide (DMSO), polysorbate 80, propylene glycol, N-methylpyrrolidone (NMP), fatty acids (oleic acid, caprylic acid, and myristic acid), and isopropyl myristate (IPM). The enhancers' effects on the gel's viscosity were also investigated.

RESULTS

The novel findings of this study were the following: (i) polysorbate 80 was used for the first time as an enhancer with a hydrophilic compound in a hydrophilic carrier and it rendered the highest permeation flux (57.1 +/- 0.9 microg/cm(2)/h) compared with the rest of the enhancers, (ii) myristic acid (a 14-carbon-chain fatty acid) rendered the highest permeation flux (18.4 +/- 0.49 microg/cm(2)/h) among all fatty acids because of a decrease in the gel's viscosity, (iii) NMP (46.5 +/- 0.7 microg/cm(2)/h) and IPM (15.3 +/- 0.41 microg/cm(2)/h) increased the permeation flux from the second day onward. Both enhancers increased the gel's viscosity, (iv) sodium lauryl sulfate decreased the viscosity of the gel and the drug's permeation flux (8.1 +/- 0.21 microg/cm(2)/h) because of its binding with the drug, (v) propylene glycol decreased the permeation flux (10.2 +/- 0.32 microg/cm(2)/h) by increasing the gel viscosity, and (vi) DMSO increased the permeation flux (13.8 +/- 0.4 microg/cm(2)/h) without altering the viscosity.

CONCLUSION

These findings indicate that to formulate DTM HCl into a hydroxypropyl methylcellulose gel the enhancers of choice should be polysorbate 80, myristic acid, DMSO, NMP, and IPM or combinations thereof.