Investigation on the synergistic effect of a combination of chemical enhancers and modulated iontophoresis for transdermal delivery of insulin

The Fate of 1,8-cineole as a Chemical Penetrant: A Review

The stratum corneum continues to pose the biggest obstacle to transdermal drug delivery. Chemical penetrant, the first generation of transdermal drug delivery system, offers a lot of potential. In order to fully examine the permeation mechanism of 1,8-cineole, a natural monoterpene, this review summarizes the effects of permeation-enhancing medications on drugs that are lipophilic and hydrophilic as well as the toxicity of this substance on the skin and other tissues. For lower lipophilic drugs, 1,8-cineole appears to have a stronger osmotic-enhancing impact. An efficient and secure tactic would be to combine enhancers and dose forms. 1,8-cineole is anticipated to be further developed in the transdermal drug delivery system and even become a candidate drug for brain transport due to its permeability and low toxicity.

Transdermal drug delivery systems for the effective management of type 2 diabetes mellitus: A review

Type 2 Diabetes mellitus (T2DM) is characterized by either insufficient insulin production or the inability to take it up for the glycemic regulation in the human body. According to WHO reports, T2DM will be the seventh-largest syndrome resulting in mortality by 2030. To tackle this chronic metabolic disorder, the person with diabetes population depends on subcutaneous administration (Sub-Q) of insulin and certain oral hypoglycemic drugs. However, these current invasive practices suffered from painful injections, needle phobia, multiple doses, risk of infection and poor-patient compliance. Hence, the search for a non-invasive and patient-friendly insulin administration system was high in the past decades leading to the development of Transdermal Drug Delivery Systems (TDDS). These can offer rapid and sustained release of therapeutic compounds at controlled rates with no pain during the administration. In recent years, the usage of such TDDS has been increasing at an exponential rate in Type 2 diabetes management. In the present review, the scholarly works on the different modes of TDDS were comprehensively reported chronlogically to appreciate their developments. Conclusively, this review critically identified prevailing research gaps in the current TDDS research and presented potential research hotspots for the prospect development in T2DM management.

Controlled Transdermal Iontophoresis of Insulin from Water-Soluble Polypyrrole Nanoparticles: An In Vitro Study

The iontophoresis delivery of insulin (INS) remains a serious challenge due to the low permeability of the drug through the skin. This work aims to investigate the potential of water-soluble polypyrrole nanoparticles (WS-PPyNPs) as a drug donor matrix for controlled transdermal iontophoresis of INS. WS-PPyNPs have been prepared via a simple chemical polymerization in the presence of sodium dodecyl sulfate (SDS) as both dopant and the stabilizing agent. The synthesis of the soluble polymer was characterized using field emission scanning electron microscopy (FESEM), dynamic light scattering (DLS), fluorescence spectroscopy, and Fourier transform infrared (FT–IR) spectroscopy. The loading mechanism of INS onto the WS-PPyNPs is based on the fact that the drug molecules can be replaced with doped dodecyl sulfate. A two-compartment Franz-type diffusion cell was employed to study the effect of current density, formulation pH, INS concentration, and sodium chloride concentration on anodal iontophoresis (AIP) and cathodal iontophoresis (CIP) of INS across the rat skin. Both AIP and CIP delivery of INS using WS-PPyNPs were significantly increased compared to passive delivery. Furthermore, while the AIP experiment (60 min at 0.13 mA cm^–2) show low cumulative drug permeation for INS (about 20.48 µg cm⁻²); the CIP stimulation exhibited a cumulative drug permeation of 68.29 µg cm⁻². This improvement is due to the separation of positively charged WS-PPyNPs and negatively charged INS that has occurred in the presence of cathodal stimulation. The obtained results confirm the potential applicability of WS-PPyNPs as an effective approach in the development of controlled transdermal iontophoresis of INS.

Delivery of Insulin via Skin Route for the Management of Diabetes Mellitus: Approaches for Breaching the Obstacles

Insulin is used for the treatment of diabetes mellitus, which is characterized by hyperglycemia. Subcutaneous injections are the standard mode of delivery for insulin therapy; however, this procedure is very often invasive, which hinders patient compliance, particularly for individuals requiring insulin doses four times a day. Furthermore, cases have been reported of sudden hypoglycemia occurrences following multidose insulin injections. Such an invasive and intensive approach motivates the quest for alternative, more user-friendly insulin administration approaches. For example, transdermal delivery has numerous advantages, such as prolonged drug release, low variability in the drug plasma level, and improved patient compliance. In this paper, the authors summarize different approaches used in transdermal insulin delivery, including microneedles, chemical permeation enhancers, sonophoresis, patches, electroporation, iontophoresis, vesicular formulations, microemulsions, nanoparticles, and microdermabrasion. Transdermal systems for insulin delivery are still being widely researched. The conclusions presented in this paper are extracted from the literature, notably, that the transdermal route could effectively and reliably deliver insulin into the circulatory system. Consistent progress in this area will ensure that some of the aforementioned transdermal insulin delivery systems will be introduced in clinical practice and commercially available in the near future.

Iontophoretic Transdermal Delivery of Human Growth Hormone (hGH) and the Combination Effect of a New Type Microneedle, Tappy Tok Tok®

Transdermal drug administration presents several advantages and it is therefore favorable as an alternative drug delivery route. However, transdermal delivery of biopharmaceutical drugs is made difficult by the skin barrier. Microneedle application and iontophoresis are strategies which can be used to overcome this barrier. Therefore, recombinant human growth hormone (rhGH) was used as a model macromolecular drug and was transdermally delivered using microneedle application and iontophoresis. Methylene blue staining, stereomicroscopy and scanning electron microscope (SEM) imaging were used to characterize the microchannels produced. To optimize the iontophoresis protocol, the effects of molecular charge and current density on transdermal delivery were evaluated in an in vitro permeation study using excised rat skin tissues. Using the optimized iontophoresis protocol, the combination effects of iontophoretic delivery via microchannels were evaluated in three different experimental designs. The flux obtained with anodal iontophoresis in citrate buffer was approximately 10-fold higher that that with cathodal iontophoresis in phosphate buffered saline (PBS). Flux also increased with current density in anodal iontophoresis. The combination of iontophoresis and microneedle application produced higher flux than single application. These results suggest that anodal iontophoresis with higher current density enhances the permeation of macromolecules through microchannels created by microneedles. In conclusion, the combination of iontophoresis and microneedles is a potential strategy for the enhancement of transdermal delivery of macromolecular drugs.

Novel drug delivery system: an immense hope for diabetics

CONTEXT

Existing medication systems for the treatment of diabetes mellitus (DM) are inconvenient and troublesome for effective and safe delivery of drugs to the specific site. Therefore, investigations are desired to deliver antidiabetics using novel delivery approaches followed by their commercialization.

OBJECTIVE

The present review aims to provide a compilation on the latest development in the field of novel drug delivery systems (NDDSs) for antidiabetics with special emphasis on particulate, vesicular and miscellaneous systems.

METHODS

Review of literature (restricted to English language only) was done using electronic databases like Pubmed® and Scirus, i.e. published during 2005-2013. The CIMS/MIMS India Medical Drug Information eBook was used regarding available marketed formulation of antidiabetic drugs. Keywords used were "nanoparticle", "microparticle", "liposomes", "niosomes", "transdermal systems", "insulin", "antidiabetic drugs" and "novel drug delivery systems". Single inclusion was made for one article. If in vivo study was not done then article was seldom included in the manuscript.

RESULTS

The curiosity to develop NDDSs of antidiabetic drugs with special attention to the nanoparticulate system followed by microparticulate and lipid-based system is found to emerge gradually to overcome the problems associated with the conventional dosage forms and to win the confidence of end users towards the higher acceptability.

CONCLUSION

In the current scientific panorama when the area of novel drug delivery system has been recognized for its palpable benefits, unique potential of providing physical stability, sustained and site-specific drug delivery for a scheduled period of time can open new vistas for precise, safe and quality treatment of DM.

Overcoming the challenges in administering biopharmaceuticals: formulation and delivery strategies

The formulation and delivery of biopharmaceutical drugs, such as monoclonal antibodies and recombinant proteins, poses substantial challenges owing to their large size and susceptibility to degradation. In this Review we highlight recent advances in formulation and delivery strategies--such as the use of microsphere-based controlled-release technologies, protein modification methods that make use of polyethylene glycol and other polymers, and genetic manipulation of biopharmaceutical drugs--and discuss their advantages and limitations. We also highlight current and emerging delivery routes that provide an alternative to injection, including transdermal, oral and pulmonary delivery routes. In addition, the potential of targeted and intracellular protein delivery is discussed.

Modulation of electroosmosis and flux through skin: effect of propylene glycol

The effect of propylene glycol (PG) on transdermal flux under current was investigated using conventional in vitro iontophoresis methodology. The results were evaluated to explain how PG affects the electroosmotic volume flow (EVF) and electromigrational flux through skin. As a marker molecule for the direction and magnitude of EVF, a non-charged neutral molecule, acetaminophen (AAP), was used. At pH 7.4, the direction of EVF was from anode to cathode. During anodal and cathodal current application, PG decreased AAP flux and this decrease was proportional to the concentration of PG, indicating that the presence of PG in the medium decreased the EVF. This decrease is likely due to the decrease in dielectric constant of the medium and the increases in medium viscosity by the addition of PG. The increase in AAP solubility and the viscosity of the medium by PG may also contribute to the decrease in diffusional flux. The magnitude of EVF was estimated to be about 4.2 μl/cm(2 )h. The effect of PG on the flux of a positively charged drug, donepezil hydrochloride (DH), was further investigated using pH 4.6 phosphate buffer solution. The permselectivity of skin in this solution was also investigated and revealed that the isoelectric point of hairless mouse skin is higher than pH 4.6. Anodal delivery showed much higher flux than cathodal and passive flux, indicating that electromigration is playing the major role for DH flux. As the concentration of PG increased, anodal flux of DH decreased. The main reason for this decrease in electromigration is likely due to the increase in medium viscosity. These results and discussions clearly suggest that the incorporation of frequently used organic cosolvents and penetration enhancers into the iontophoretic formulation should be carefully chosen with a thorough investigation for their effect on flux. Overall, these results provided further mechanistic insights into the role of electroosmosis and electromigration in flux across skin, and how they can be modulated by organic cosolvent, PG.

Oral delivery of human biopharmaceuticals, autoantigens and vaccine antigens bioencapsulated in plant cells

Among 12billion injections administered annually, unsafe delivery leads to >20million infections and >100million reactions. In an emerging new concept, freeze-dried plant cells (lettuce) expressing vaccine antigens/biopharmaceuticals are protected in the stomach from acids/enzymes but are released to the immune or blood circulatory system when plant cell walls are digested by microbes that colonize the gut. Vaccine antigens bioencapsulated in plant cells upon oral delivery after priming, conferred both mucosal and systemic immunity and protection against bacterial, viral or protozoan pathogens or toxin challenge. Oral delivery of autoantigens was effective against complications of type 1 diabetes and hemophilia, by developing tolerance. Oral delivery of proinsulin or exendin-4 expressed in plant cells regulated blood glucose levels similar to injections. Therefore, this new platform offers a low cost alternative to deliver different therapeutic proteins to combat infectious or inherited diseases by eliminating inactivated pathogens, expensive purification, cold storage/transportation and sterile injections.

Novel engineered systems for oral, mucosal and transdermal drug delivery

Technological advances in drug discovery have resulted in increasing number of molecules including proteins and peptides as drug candidates. However, how to deliver drugs with satisfactory therapeutic effect, minimal side effects and increased patient compliance is a question posted before researchers, especially for those drugs with poor solubility, large molecular weight or instability. Microfabrication technology, polymer science and bioconjugate chemistry combine to address these problems and generate a number of novel engineered drug delivery systems. Injection routes usually have poor patient compliance due to their invasive nature and potential safety concerns over needle reuse. The alternative non-invasive routes, such as oral, mucosal (pulmonary, nasal, ocular, buccal, rectal, vaginal), and transdermal drug delivery have thus attracted many attentions. Here, we review the applications of the novel engineered systems for oral, mucosal and transdermal drug delivery.

Transdermal insulin delivery using microdermabrasion

PURPOSE

Transdermal insulin delivery is an attractive needle-free alternative to subcutaneous injection conventionally used to treat diabetes. However, skin's barrier properties prevent insulin permeation at useful levels.

METHODS

We investigated whether microdermabrasion can selectively remove skin's surface layers to increase skin permeability as a method to administer insulin to diabetic rats. We further assessed the relative roles of stratum corneum and viable epidermis as barriers to insulin delivery.

RESULTS

Pretreatment of skin with microdermabrasion to selectively remove stratum corneum did not have a significant effect on insulin delivery or reduction in blood glucose level (BGL). Removal of full epidermis by microdermabrasion significantly reduced BGL, similar to the positive control involving subcutaneous injection of 0.1U insulin. Significant pharmacokinetic differences between microdermabrasion and subcutaneous injection were faster time to peak insulin concentration after injection and larger peak insulin concentration and area-under-the-curve after microdermabrasion.

CONCLUSIONS

Microdermabrasion can increase skin permeability to insulin at levels sufficient to reduce BGL. Viable epidermis is a barrier to insulin delivery such that removal of full epidermis enables significantly more insulin delivery than removal of stratum corneum alone.