Breaking boundaries: the advancements in transdermal delivery of antibiotics

Transdermal drug delivery systems (TDDS) for antibiotics have seen significant advances in recent years that aimed to improve the efficacy and safety of these drugs. TDDS offer many advantages over other conventional delivery systems such as non-invasiveness, controlled-release pattern, avoidance of first-pass metabolism. The objective of this review is to provide an overview on the recent advances in the TDDS of different groups of antibiotics including β-lactams, tetracyclines, macrolides, and lincosamides, utilized for their effective delivery through the skin and to explore the challenges associated with this field. The majority of antibiotics do not have favorable properties for passive transdermal delivery. Thus, novel strategies have been employed to improve the delivery of antibiotics through the skin, such as the use of nanotechnology (nanoparticles, solid-lipid nanoparticles, nanoemulsions, vesicular carriers, and liposomes) or the physical enhancement techniques like microneedles and ultrasound. In conclusion, the transdermal delivery systems could be a promising method for delivering antibiotics that have the potential to improve patient outcomes and enhance the efficacy of drugs. Further research and development are still needed to explore the potential of delivering more antibiotic drugs by using various transdermal drug delivery approaches.

Minoxidil Nanosuspension-Loaded Dissolved Microneedles for Hair Regrowth

Minoxidil (MIN) is used topically to treat alopecia. However, its low absorption limits its use, warranting a new strategy to enhance its delivery into skin layers. The objective of this study was to evaluate the dermal delivery of MIN by utilizing dissolved microneedles (MNs) loaded with MIN nanosuspension (MIN-NS) for hair regrowth. MIN-NS was prepared by the solvent-antisolvent precipitation technique. The particle size of MIN-NS was 226.7 ± 9.3 nm with a polydispersity index of 0.29 ± 0.17 and a zeta potential of -29.97 ± 1.23 mV. An optimized formulation of MIN-NS was selected, freeze-dried, and loaded into MNs fabricated with sodium carboxymethyl cellulose (Na CMC) polymeric solutions (MIN-NS-loaded MNs). MNs were evaluated for morphology, dissolution rate, skin insertion, drug content, mechanical properties, ex vivo permeation, in vivo, and stability studies. MNs, prepared with 14% Na CMC, were able to withstand a compression force of 32 N for 30 s, penetrate Parafilm M® sheet at a depth of 374-504 µm, and dissolve completely in the skin within 30 min with MIN %recovery of 95.1 ± 6.5%. The release of MIN from MIN-NS-loaded MNs was controlled for 24 h. MIN-NS-loaded MNs were able to maintain their mechanical properties and chemical stability for 4 weeks, when kept at different storage conditions. The in vivo study of the freeze-dried MIN-NS and MIN-NS-loaded MNs proved hair regrowth on rat skin after 11 and 7 days, respectively. These results showed that MIN-NS-loaded MNs could potentially improve the dermal delivery of MIN through the skin to treat alopecia.

Development and characterization of magnetic hydrogels loaded with greenly synthesized iron-oxide nanoparticles conjugated with cisplatin

A novel approach was devised to address the challenges in delivering cisplatin (CIS) for lung cancer treatment. This involved the development of a non-invasive hydrogel delivery system, aiming to minimize side effects associated with its administration. Using carbopol 971 (CP) and chitosan (CH) at varying ratios, the hydrogels were prepared and loaded with eco-friendly iron oxide nanoparticles (IONPs) conjugated to CIS. The physical properties, yield, drug loading, and cytotoxicity against lung cancer cell lines (A549) were assessed, along with hydrogel rheological properties and in vitro drug diffusion. Hydrogel A1 that composed of 1:1 of CP:CH hydrogel loaded with 100 mg IONPs and 250 µg CIS demonstrated distinctive properties that indicate its suitability for potential delivery. The loaded greenly synthesized IONPs@CIS exhibited a particle size of 23.0 nm, polydispersity index of 0.47, yield of 71.6%, with 88.28% drug loading. They displayed significant cytotoxicity (61.7%) against lung cancer cell lines (A549), surpassing free CIS cytotoxicity (28.1%). Moreover, they demonstrated shear-thinning behaviour, viscoelastic properties, and Fickian drug release profile over 24 h (flux 2.34 µg/cm2/h, and permeability 0.31 cm/h).

THE BIO-STIMULATORY EFFECT OF ADVANCE PLATELET RICH FIBRIN COMBINED WITH LASER ON DENTAL IMPLANT STABILITY: AN EXPERIMENTAL STUDY ON SHEEP

Implant stability is the major important requirement for the progress of a dental implant in the bone bed before loading the dental implant without clinical micro motion of the macula. Advance platelet rich fibrin (A-PRF) can be considered a "tissue engineering marvel" due to the typical properties of an osteo promoting matrix that improve the sustained release of growth factors that modulate and support osteoblast proliferation, migration, and adhesion, and at the same time regulates the production of collagen proteins. Low level laser therapy (LLLT) biostimulation increases blood circulation, promotes the revitalization process, reduces the risk of infection, improves metabolic activity, and accelerates the healing of damaged tissues. This study aimed to assess the effect of Advance platelet rich fibrin (A- prf) with low level laser therapy biostimulation (LLL Biostimulation) on implant stability. Four healthy male sheep were randomly divided into 2 groups (two in each group).Group 1 (control), at of which ten implants were placed on one side of the tibia and ten dental implants on the other side of the tibia with no additions for a total of 10 implants and Group 2 (study) where ten implants were placed on one side and ten dental implants on the other side of the tibia augmented with Advanced Platelet Rich Fibrin Membrane and LLLT Bio stimulation. Primary and secondary dental implant stability were recorded by radiofrequency evaluation using Osstell device immediately after placement, four and eight weeks postoperatively. The results of the current study showed no significant difference between control and study group in implant stability at baseline (day of surgery) but after four and eight weeks there was a significant difference between the control group and the study group. Advance platelet rich fibrin (A- prf) with low level laser therapy biostimulation (LLL Biostimulation) plays a role in new bone formation and enhance implant stability.

Implications of different analgesic models on inflammatory markers after laparoscopic cholecystectomy

BACKGROUND

Despite its advantages, laparoscopic surgery causes significant shoulder and abdominal pain in 35%-80% of patients. The cause of post-laparoscopy pain is not fully understood, but it is assumed to be a multifactorial referred pain.

AIM OF THE STUDY

To evaluate the effect of different analgesia techniques on post-laparoscopic pain and inflammatory markers.

METHODS

Patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to receive local hepatic and right subdiaphragmatic infiltration of one of the 4 study drug combinations: Group 1 (G1) received 20 ml bupivacaine 0.25%; Group 2 (G2) received 20 ml bupivacaine 0.25% +3 mg morphine sulphate; Group 3 (G3) received 20 ml bupivacaine 0.25% + 3 mg morphine sulphate +200 µg/kg ketamine; and Group 4 (G4) received 20 ml isotonic saline as the control group.

RESULTS

In G3, both shoulder pain on the verbal numerical rating scale and inflammatory marker levels were lower compared with the other groups. The highest levels of inflammatory markers were observed in the control group; this difference was statistically significant. No side effects or complications were observed in the study groups.

CONCLUSION

The addition of ketamine and morphine to bupivacaine for hepatic and subdiaphragmatic infiltration produced good analgesia and reduced inflammatory marker levels after laparoscopic cholecystectomy.

Development and Comparative Evaluation of Ciprofloxacin Nanoemulsion-Loaded Bigels Prepared Using Different Ratios of Oleogel to Hydrogels

Nanoemulsions and bigels are biphasic delivery systems that can be used for topical applications. The aim of this study was to incorporate an oil-in-water ciprofloxacin hydrochloride nanoemulsion (CIP.HCl NE) into two types of bigels, Type I (oleogel (OL)-in-hydrogel (WH)) and Type II (WH-in-OL) to enhance drug penetration into skin and treat topical bacterial infections. Bigels were prepared at various ratios of OL and WH (1:1, 1:2, and 1:4). Initially, CIP.HCl NE was prepared and characterized in terms of droplet size, zeta potential, polydispersity index, morphology, and thermodynamic and chemical stability. Then CIP.HCl NE was dispersed into the OL or WH phase of the bigel. The primary physical stability studies showed that Type I bigels were physically stable, showing no phase separation. Whereas Type II bigels were physically unstable, hence excluded from the study. Type I bigels were subjected to microstructural, rheological, in vitro release, antimicrobial, and stability studies. The microscopic images showed a highly structured bigel network with nanoemulsion droplets dispersed within the bigel network. Additionally, bigels exhibited pseudoplastic flow and viscoelastic properties. A complete drug release was achieved after 4-5 h. The in vitro and ex vivo antimicrobial studies revealed that bigels exhibited antimicrobial activity against different bacterial strains. Moreover, stability studies showed that the rheological properties and physical and chemical stability varied based on the bigel composition over three months. Therefore, the physicochemical and rheological properties, drug release rate, and antimicrobial activity of Type I bigels could be modified by altering the OL to WH ratio and the phase in which the nanoemulsion dispersed in.

In Vitro and In Vivo Characterization of the Transdermal Gel Formulation of Desloratadine for Prevention of Obesity and Metabolic Syndrome

Chronic use of antihistamines can induce abnormalities in lipid absorption with potential excessive accumulation of lipids in the mesentery that can lead to the development of obesity and a metabolic syndrome. The focus of the present work was to develop a transdermal gel formulation of desloratadine (DES) to prevent/reduce obesity and metabolic syndromes. Nine formulations were prepared to contain hydroxypropyl methylcellulose (2-3%), DES (2.5-5.0%), and Transcutol^® (15-20%). The formulations were evaluated for cohesive and adhesive properties, viscosity, drug diffusion through synthetic and pig ear skin, and pharmacokinetics in New Zealand white rabbits. Drug permeation was faster through the skin compared to synthetic membranes. The drug had good permeation, as indicated by very short lag time (0.08-0.47 h) and high flux (59.3-230.7 μg/cm².h). The maximum plasma concentration (C_max) and area under the curve (AUC) of transdermal gel formulations were 2.4 and 3.2 fold that of the Clarinex tablet formulation. In conclusion, as indicated by the higher bioavailability, transdermal gel formulation of DES may decrease the dose of the drug, compared to commercial formulation. It has the potential to reduce or eliminate metabolic syndromes associated with oral antihistamine therapy.

Formulation and Evaluation of Azithromycin-Loaded Niosomal Gel: Optimization, In Vitro Studies, Rheological Characterization, and Cytotoxicity Study

Several novel, innovative approaches for improving transdermal delivery of BCS class III drugs have been proposed. Despite their great aqueous solubility, BCS class III drugs have the drawback of limited permeability. The objective of the current work was to screen the suitability of niosomes as a nanocarrier in permeation enhancement of azithromycin (AZM) transdermal delivery. Niosomes were prepared by an ether injection method using a nonionic surfactant (Span 60) and cholesterol at different concentrations. The ζ potential (ZP), polydispersity index (PDI), and particle size (PS) of AZM-loaded niosomes were evaluated. The size of the niosomes was found to vary between 288 and 394 nm. The results revealed that the niosomes prepared in a ratio of 2:1 (Span 60: cholesterol) had larger vesicle sizes, but all of them were characterized by narrow size distributions (PDI <0.95). Niosomal gel was successfully prepared using different polymers. The appearance, pH, viscosity, and ex vivo drug release of niosomal gel formulations were all examined. The flow curves showed that the niosomal gel displayed lower viscosity values than its corresponding conventional gels. Niosomal and conventional gels exhibited a domination of the elastic modulus (G') over the viscous modulus (G″) (G'>G″) in the investigated frequency range (0.1-100 rad/s), indicating stable gels with more solid-like properties. Ex vivo skin permeation studies for the niosomal gel show 90.83 ± 3.19% of drug release in 24 h as compared with the conventional gel showing significantly lower (P < 0.001) drug release in the same duration (1.25 ± 0.12%). Overall, these results indicate that niosomal gel could be an effective transdermal nanocarrier for enhancing the permeability of AZM, a BCS class III drug. In conclusion, this study suggests that transdermal formulations of AZM in the niosomal gel were successfully developed and could be used as an alternative route of administration.

Beneath the Skin: A Review of Current Trends and Future Prospects of Transdermal Drug Delivery Systems

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.

Preparation and Evaluation of Polyvinylpyrrolidone Electrospun Nanofiber Patches of Pioglitazone for the Treatment of Atopic Dermatitis

Nanofibers have many promising biomedical applications. They can be used for designing transdermal and dermal drug delivery systems. This project aimed to prepare and characterize polyvinylpyrrolidone-based nanofibers as a dermal and transdermal drug delivery system using pioglitazone. Pioglitazone is an oral antidiabetic drug. In addition, it can act as an inflammatory process modulator, making it a good candidate for managing different skin inflammatory conditions such as atopic dermatitis, skin ulcers, and diabetic foot wound healing. Several nanofiber formulations were prepared using the electrospinning method at different drug loadings, polyvinylpyrrolidone concentrations, and flow rates. A cast film with the exact composition of selected nanofiber formulations was prepared as a control. Nanofibers were characterized using a scanning electron microscope to calculate the diameter. Fourier-transform infrared spectroscopy, differential scanning calorimetry, thermogravimetric analysis, and powder X-ray diffraction were performed for physical and biochemical characterizations. In vitro release, drug loading efficiency, and swelling studies were performed. Ex vivo permeation studies were performed using Franz diffusion cells with or without applying a solid microneedle roller. Round uniform nanofibers with a smooth surface were obtained. The diameter of nanofibers was affected by the drug loading and polymer concentration. Fourier-transform infrared spectra showed a potential physical interaction between the drug and the polymer. According to X-ray diffraction, pioglitazone existed in an amorphous form in prepared nanofibers, with partial crystallinity in the casted film. Nanofibers showed a higher swelling rate compared to the casted film. The drug dissolution rate for nanofibers was 2.3-folds higher than the casted films. The polymer concentration affected the drug dissolution rate for nanofibers; however, drug loading and flow rate did not affect the drug dissolution rate for nanofibers. The application of solid microneedles slightly enhances the total amount of drug permeation. However, it did not affect the flux of the drug through the separated epidermis layer for pioglitazone. The drug permeation flux in nanofibers was approximately five times higher than the flux of the casted film. It was observed that pioglitazone is highly retained in skin layers. Graphical abstract.

Recent exploration of nanoemulsions for drugs and cosmeceuticals delivery

BACKGROUND

Nanoemulsions (NEs) have been explored as nanocarriers for the delivery of many drugs and cosmeceuticals. The extraordinary expansion of using NEs is due to their capability to conquer the main challenges of conventional delivery systems such as short residence time with low patient acceptance, poor stability, low aqueous solubility, permeability, and hence bioavailability.

METHODS

This review recapitulated the most recent pharmaceutical and cosmeceutical applications of NEs as effective delivery nanocarriers. The outputs of our research studies and the literature review on the latest NEs applications were assessed to highlight the NEs components, preparations, applications, and the improved quality and elegance of the used product.

RESULTS

NEs are stable submicronic translucent dispersions with narrow droplet size distribution. They exhibited excellent ability to efficiently encapsulate therapeutics of diverse nature of drugs and cosmeceuticals. NE formulations showed superiority over conventional delivery approaches with overabundances of advantages through different routes of administration. This novel technology exhibited better aesthetic appeal, higher bioavailability, and a longer duration compared to the conventional delivery systems.

CONCLUSION

This novel technology holds promise for different therapeutics fields. However, the success of NEs use advocated the development of robust formulations, proper choice of equipment, ample process characterization, and assurance of their efficacy, stability, safety and cosmetic appeal.

Development and characterization of k-carrageenan platforms as periodontal intra-pocket films

Purpose: To prepare emulsion-based Intrapocket polymeric films for the treatment of periodontitis. Method: Films were fabricated by dehydration of an emulsion containing k-carrageenan (KC) in aqueous phase and Compritol® 888 ATO (Compritol® ) or Dimodan® UJ (DU® ) or different ratios of both. The resulting films were characterized by mechanical texture analyser to determine Young’s modulus and tensile strength. Glass transition temperature (Tg) of the films was evaluated by dynamic mechanical and thermal analyser while surface morphology was evaluated using scanning electron microscope. In-vitro drug release was conducted in pre-warmed phosphate buffer. Bacterial adherence was assessed after 24 h. Results: Young’s modulus was highest for KC films to which no lipid was added (5.33 ± 0.38 GPa) and decreased following lipid incorporation. Tg was highest in KC films (106.25 ± 4.53 ° C) but decreased upon addition of lipids. The surface of KC was smooth but roughness increased with increasing Compritol® load. Drug release from KC films was complete (99.80 ± 8.43 %) after 2 h; however, upon adding lipid, the release was extended 8 h and was affected by lipid type and ratio. Microbiologic assay demonstrated noticeable reduction in viable count compared to control and was affected by lipid type and ratio. The film formulated from a combination of DU® and Compritol® in a ratio of 80:20 was strong, flexible and reduced microbial adherence. Moreover, it showed a smooth surface and extended release for over 8 h. Conclusion: Intra-pocket films were prepared by drying emulsion-based films. Resulted films were strong, flexible, prolonged drug release over 8 h and could lower bacterial growth. The prepared film may offer efficient treatment in periodontitis patients.

Optimism Bias, Pessimism Bias, Magical Beliefs, and Conspiracy Theory Beliefs Related to COVID-19 among the Jordanian Population

The outbreak of the novel SARS-CoV-2 virus has an enormous impact on health. People's views about the virus impact public health efforts to mitigate the pandemic. In this study, we measured misconceptions toward coronavirus in the Jordanian population; 2,544 participants from the Jordanian population completed an online survey. Questions in the survey addressed misconceptions divided into four categories: optimism bias, pessimism bias, magical beliefs, and conspiracy theory beliefs. Questions were evaluated on a Likert scale, and average/median scores for each category were evaluated ("one" high misconception to "five" low misconception). Overall, the most common misconceptions involved conspiracy theory beliefs (2.68 ± 0.83), whereas the least common involved magical beliefs (2.25 ± 0.75). Females had more misconceptions than males (2.52 versus 2.47, P = 0.04). Participants who had attended a lecture on coronavirus, had a higher level of education, worked in a medical field, lived in urban area, or resided in Amman or northern Jordan had fewer misconceptions about SARS-CoV-2/COVID-19 (2.64, 2.34, 2.33, 2.50 and 2.50 versus 2.53, 2.73, 2.72, 2.64, and 2.66, respectively, P < 0.001). The use of social media appeared to be an important factor influencing the likelihood of false beliefs (2.61 versus 2.38, P < 0.001). Understanding of the factors influencing public perceptions surrounding the SARS-CoV-2/COVID-19 pandemic will help public health authorities improve public understanding and compliance with public health recommendations directed at combatting the virus, including the use of surgical masks, thorough handwashing, and avoiding close contact. These messages will be better received by the public through correcting misconceptions surrounding COVID-19.

Development of stable amorphous solid dispersion and quantification of crystalline fraction of lopinavir by spectroscopic-chemometric methods

This study aimed to improve the dissolution of the poorly soluble drug lopinavir (LPV) by preparing amorphous solid dispersions (ASDs) using solvent evaporation method. The ASD formulations were prepared with ternary mixtures of LPV, Eudragit® E100, and microcrystalline cellulose (MCC) at various weight ratios. The ASDs were subjected to solid-state characterization and in vitro drug dissolution testing. Chemometric models based on near infrared spectroscopy (NIR) and NIR-hyperspectroscopy (NIR-H) data were developed using the partial least squares (PLS) regression and externally validated to estimate the percent of the crystalline LPV in the ASD. Initially, the solid-state characterization data of ASDs showed transformation of the drug from crystalline to amorphous. Negligible fraction of crystalline LPV was present in the ASD (3%). Compared to pure LPV, ASDs showed faster and higher drug dissolution (<2% vs. 60.3-73.5%) in the first 15 min of testing. The ASD was stable against crystallization during stability testing at 40 °C/75% for a month. In conclusion, the prepared ASD was stable against devitrification and enhance the dissolution of LPV.

Impact of diet on human gut microbiome and disease risk

The gut microbiome of humans comprises a diverse group of trillions of microorganisms including symbiotic organisms, opportunistic pathogens and commensal organisms. This microbiota plays a major role in digesting food; it also helps with absorbing and synthesizing some nutrients and releases their metabolites, which may deliver a variety of growth-promoting and growth-inhibiting factors that influence human health either directly or indirectly. The balance between microbial species, especially those responsible for the fermentation of different substrates within the microbial community, which are in the majority, depends on daily diet. Therefore, an unbalanced diet may lead to the progression and development of human diseases. These include metabolic and inflammatory disorders, cancer and depression, as well as infant health and longevity. We provide an overview of the effect of diet on the human microbiome and assess the related risk of disease development.

Diclofenac diethylamine nanosystems-loaded bigels for topical delivery: development, rheological characterization, and release studies

The objective of this study was to develop novel topical drug delivery systems of the nonsteroidal anti-inflammatory drug diclofenac diethylamine (DDEA). Toward this objective, DDEA was loaded into two nanosystems, the oil in water (O/W) nanoemulsion (DDEA-NE) and the gold nanorods (GNR) that were conjugated to DDEA, forming DDEA-GNR. The DDEA-NE and DDEA-GNR were characterized in terms of particle size, zeta potential, morphology, thermodynamic stability, DDEA loading efficiency, and UV-Vis spectroscopy. These nanosystems were then incorporated into the biphasic gel-based formulations (bigels) for topical delivery. The rheological characterization and release studies of the DDEA NE- and DDEA GNR-incorporated bigels were performed and compared to those of DDEA traditional bigel. DDEA-NE exhibited a droplet size 15.2 ± 1.5 nm and zeta potential -0.37 ± 0.06 mV. The particle size of GNR was approximately 66 nm × 17 nm with an aspect ratio of approximately 3.8. The bigels showed composition-dependent viscoelastic properties, which in turn play a vital role in determining the rate and mechanism of DDEA release from the bigels. Bigels showed a controlled-release pattern where 61.6, 91.7, and 50.0% of the drug was released from DDEA traditional bigel, DDEA NE-incorporated bigel, and DDEA GNR-incorporated bigel, respectively, after 24 h. The ex vivo permeation studies showed that the amount of DDEA permeated through excised skin was relatively low, between 2.7% and 18.2%. The results suggested that the incorporation of the nanosystems NE and GNR into bigels can potentially improve the topical delivery of DDEA.

Surface rheological properties alter aerosol formation from mucus mimetic surfaces

The effects of surface tension and surface viscoelastic properties on the formation of aerosol droplets generated from mucus-like viscoelastic gels (mucus mimetics) during shearing with a high velocity air stream were investigated. Mucus mimetic samples were formulated with similar composition (94% water and 6% dissolved solids, consisting of mucins, proteins, and ions), surface tension (via the addition of surfactant to the mimetic surface) and bulk viscoelastic properties (via crosslinking of mucin macromolecules in the mimetic) to that of native non-diseased tracheal mucus. The surface tension of the mucus mimetic was decreased by spreading one of two surfactants, dipalmitoyl phosphatidylcholine (DPPC) or calf lung surfactant (Infasurf®), on the mimetic surface. Aerosols were generated from the mimetic surfaces during simulated coughing using an enhanced simulated cough machine (ESCM) operating under controlled environmental conditions. The size distribution of aerosol droplets generated during simulated coughing from the surfactant-coated mimetic surfaces was multimodal, while no droplets were generated from the bare mimetic surface due to its high surface viscoelastic properties and high surface tension. The concentration of aerosols generated from the DPPC-coated mimetic was higher than that of the Infasurf®-coated mimetic, even though the surface tension of the two interfaces was the same. The experimental results suggest that a balance of surface elastic behavior and surface viscous behavior is required for the generation of aerosols from the viscoelastic surfaces.

The Effect of Enzymes and Sodium Lauryl Sulfate on the Surface Tension of Dissolution Media: Toward Understanding the Solubility and Dissolution of Carvedilol

The objective of this work was to study the effect of the physiologically relevant enzymes pepsin, pancreatin, and the synthetic surfactant sodium lauryl sulfate (SLS) on the surface tension of the dissolution media and the solubility and dissolution of the weakly basic drug carvedilol. Compendial dissolution media and buffer solutions that simulate the gastrointestinal fluid, prepared with and without the addition of SLS, were used in this study. The surface tension of the dissolution media; critical micelle concentration (CMC) of SLS in buffer solutions; and size, polydispersity index, and zeta potential of SLS micelles loading carvedilol were determined. The solubility and dissolution of carvedilol were investigated and compared with those of the corresponding media prepared without the addition of pepsin, pancreatin, and SLS. Results showed that the addition of pepsin, pancreatin, and SLS lowered the surface tension of the dissolution media to 54.8, 55.7, and ~ 30 mN/m, respectively. The solubility of carvedilol was significantly enhanced with pepsin and SLS; however, no significant difference was found with pancreatin. The dissolution rate of carvedilol was fast in simulated gastric fluid with and without pepsin. The dissolution was further enhanced in media with pancreatin and SLS. The dissolution data were corroborated with the molar micellar solubilization (X) of SLS, ranging between 0.02 and 3.09. Understanding the effect of pepsin, pancreatin, and SLS on the surface tension of the dissolution media and the solubility and dissolution of poorly soluble drugs can improve our knowledge of the performance of these drugs in vivo.

Gelation and rheological characterization of Carbopol® in simulated gastrointestinal fluid of variable chemical properties

Carbopol® is a hydrophilic polymer commonly used in the preparation of oral controlled-release matrix tablets. These matrices are subjected to dissolution testing to investigate the rate and mechanism of drug release. The rate of drug release from these matrices is influenced by the viscoelastic properties of the gel layer formed upon hydration and surrounded tablet core. This study evaluates the gelation behavior and rheological characterization of Carbopol® in dispersion media, of varied chemical properties, commonly used in dissolution testing. The rheological properties of Carbopol® polymer underwent gelation were determined using a controlled-stress rheometer. Carbopol® gelation was not found in simulated gastric fluid of low pH (1.2-5.0) and simulated intestinal fluid of pH (5.0-6.5) during fasted (Fa) and fed (Fe) conditions. However, in water and at high pH (6.8-7.8), gelation occurred in phosphate buffers of high buffering capacity (β). Furthermore, no gelation was found in sodium chloride solutions of different ionic strengths (µ). These results highlight the importance of investigating the gelation behavior and rheological characterization of Carbopol® in dispersion media prior to dissolution testing. These preliminary studies can give an insight on the formation/absence of the gel layer around Carbopol® matrices which is responsible for controlling the release of drugs.

Physiological parameters of the gastrointestinal fluid impact the dissolution behavior of the BCS class IIa drug valsartan

The objective of this study was to investigate the effect of the physiological parameters (pH, buffer capacity, and ionic strength) of the gastrointestinal (GI) fluid on the dissolution behavior of the class II weakly acidic (BCS class IIa) drug valsartan. A series of in vitro dissolution studies was carried out on Diovan^® immediate release tablets using media that cover the physiological range of pH (1.2-7.8), buffer capacity (0-0.047 M/ΔpH), and ionic strength (0-0.4 mol/L) of the GI fluid during fasted and fed states using the conventional USP II apparatus. Valsartan exhibited pH- and buffer capacity-dependent dissolution behavior, where valsartan release was slow and incomplete in media simulating gastric fluid with low pH, and fast and complete in media simulating intestinal fluid with high pH. In addition, the rate of valsartan release increased with increasing the buffer capacity of the dissolution medium. In water and NaCl solutions, valsartan release was incomplete and the dissolution profiles were similar regardless of the ionic strength of the medium, indicating an ionic strength-independent dissolution behavior. These results highlight the significant effect of the physiological parameters of the GI fluid on the dissolution behavior of BCS class IIa drugs.

Preferential Accumulation of Phospholipid-PEG and Cholesterol-PEG Decorated Gold Nanorods into Human Skin Layers and Their Photothermal-Based Antibacterial Activity

Herein, a library of gold nanorods (GNR) decorated with polyethylene glycol-thiol (PEG-SH) containing different functionalities were synthesized and characterized by optical absorption spectroscopy, zeta potential, dynamic light scattering (DLS), transmission electron microscope (TEM) and proton nuclear magnetic resonance (1H-NMR). The colloidal stability of GNR when exposed to skin, and their preferential accumulation into excised human skin layers were investigated. Confocal laser scanning microscopy, transmission electron microscope (TEM) and inductively coupled plasma-optical emission spectroscopy (ICP-OES) were utilized to track the penetration of GNR into different skin layers. The results demonstrated that cholesterol-PEG coated GNR were preferentially loaded up in the upper layers of skin (stratum corneum), while phospholipid-PEG coated counterparts were drastically deposited in skin dermis. Neutral methoxy-PEG-coated GNR were distributed in both SC and dermis skin layers, while charged GNR (anionic-carboxylic acid-PEG-GNR and cationic-amine-PEG-GNR) revealed a minimal accumulation into skin. DSPE-PEG-GNR and Chol-PEG-GNR demonstrated antibacterial activities against Staphylococcus aureus (S aureus) at MIC values of 0.011 nM and 0.75 nM, respectively. Photothermal treatment for S. aureus at sub-MIC concentrations resulted in a significant bactericidal effect when using Chol-PEG-GNR but not DSPE-PEG-GNR. Gold-based nanoscale systems have great value as a promising platform for skin diseases therapy.

Transfer Behavior of the Weakly Acidic BCS Class II Drug Valsartan from the Stomach to the Small Intestine During Fasted and Fed States

The objective of this study was to investigate the transfer behavior of the weakly acidic BCS class II drug valsartan from the stomach to the small intestine during fasted and fed states. An in vitro transfer model previously introduced by Kostewicz et al. (J Pharm Pharmacol 56(1):43-51, 2004) based on a syringe pump and a USP paddle apparatus was used to determine the concentration profiles of valsartan in the small intestine. Donor phases of simulated gastric fluid during fasted (FaSSGF) and fed (FeSSGF) states were used to predisperse Diovan® tablets (160 mg valsartan). The initial concentrations of valsartan in FaSSGF and FeSSGF were 6.2 and 91.8%, respectively. Valsartan dispersions were then transferred to acceptor phases that simulate intestinal fluid and cover the physiological properties (pH, buffer capacity, and ionic strength) of the gastrointestinal fluid at a flow rate of 2 mL/min. The pH measurements were reported at time intervals corresponded to those of the transfer experiments to investigate the effect of percent dissolved of valsartan in the donor phase on lowering the pH of the acceptor phases. The f2 similarity test was used to compare the concentration profiles in the acceptor phases. In fasted state, the concentration of valsartan in the acceptor phases ranged between 33.1 and 89.4% after 240 min. Whereas in fed state, valsartan was fully dissolved in all acceptor phases within a range of 94.5-104.9% after 240 min. Therefore, the transfer model provides a useful screen for the concentrations of valsartan in the small intestine during fasted and fed states.

Development of hydrogels, oleogels, and bigels as local drug delivery systems for periodontitis

Periodontal disease is a chronic inflammation of gum and tissues that surround and support the teeth. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used in the treatment of periodontitis to ease swelling and inflammation. One approach of treating periodontitis is loading the NSAIDs in local drug delivery systems. Therefore, the objective of this study was to investigate the local delivery of the NSAIDs model drug ibuprofen to treat periodontitis using different types of gel formulations (hydrogel, oleogel, and bigel). Gel formulations were characterized in terms of their rheological properties (flow behavior, viscoelastic, and bioadhesive properties) using a controlled-stress rheometer. The in vitro drug release of ibuprofen from gel formulations was investigated using Franz diffusion cells. Gels exhibited more solid-like (elastic) behavior. The viscosity and viscoelastic properties were in the order of oleogel > bigel > hydrogel, respectively. In bioadhesion study, mucin dispersion/plain ibuprofen-hydrogel mixture showed a frequency-dependent interaction of ΔG' = -31 and ΔG' = + 53 Pa at 1 and 10 rad/s, respectively. A strong positive interaction (ΔG' = + 6000 and +130,667 Pa at 1 and 10 rad/s, respectively) was found in mucin dispersion/plain ibuprofen-oleogel mixture. The extent of the negative interaction increased in mucin dispersion/plain ibuprofen-bigel mixture (ΔG' = -59,000 and -79,375 Pa at 1 and 10 rad/s, respectively). After 6 h, ibuprofen release from hydrogel, oleogel, and bigel was 59.5 ± 2.2, 80.6 ± 3.9, and 94.6 ± 3.2%, respectively. Results showed that the rheological and bioadhesive properties and in vitro drug release were influenced by the type of gel formulations.

Formulation and evaluation of diclofenac controlled release matrix tablets made of HPMC and Poloxamer 188 polymer: An assessment on mechanism of drug release

In this study, hydrophilic hydroxypropyl methylcellulose matrices with various concentrations of Poloxamer 188 were used in the development of oral controlled release tablets containing diclofenac sodium. Four formulations of hydrophilic matrix tablets containing 16.7% w/w HPMC and 0, 6.7, 16.7 and 25.0% w/w Poloxamer 188, respectively, were developed. Tablets were prepared by direct compression and characterized for diameter, hardness, thickness, weight and uniformity of content. The influence of various blends of hydroxypropyl methylcellulose and Poloxamer 188 on the in vitro dissolution profile and mechanism of drug release of was investigated. In the four formulations, the rate of drug release decreased with increasing the concentration of Poloxamer 188 at the initial dissolution stages due to the increase in the apparent viscosity of the gel diffusion layer. However, in the late dissolution stages, the rate of drug release increased with increasing Poloxamer 188 concentration due to the increase in wettability and dissolution of the matrix. The kinetic of drug release from the tablets followed non-Fickian mechanism, as predicted by Korsmeyer-Peppas model, which involves diffusion through the gel layer and erosion of the matrix system.

Interactions of mussel-inspired polymeric nanoparticles with gastric mucin: Implications for gastro-retentive drug delivery

Mussel-inspired polydopamine (pD) coatings have several unique characteristics such as durability, versatility, and robustness. In this study, we have designed pD-coated nanoparticles (NPs) of methoxy polyethylene glycol-b-poly(ε-caprolactone) (mPEG-PCL@pD) as prospective nanoscale mucoadhesive platforms for gastro-retentive drug delivery. Successful pD coating on the NPs was confirmed by Transmission Electron Microscopy and X-ray Photoelectron Spectroscopy. Mucoadhesion of pD-coated NPs was investigated in vitro using commercially available mucin under stomach lumen-mimetic conditions. Mucin-NP interactions were monitored by dynamic light scattering, which showed a significant change in particle size distribution of pD-coated NPs at mucin/NP ratios of 1:1, 1:2, and 1:4w/w. Turbidity measurements indicated the formation of large mucin-NP aggregates causing a significant increase in turbidity at mucin/NP ratios of 2:1 and 4:1w/w. pD-coated NPs exhibited a significantly higher mucin adsorption ability compared to uncoated NPs at mucin/NP ratios of 1:4, 1:2, and 1:1w/w. Zeta potential measurements demonstrated that mucin-pD-coated NP interactions were not electrostatic in nature. An ex vivo wash-off test conducted using excised sheep stomach revealed that 78% of pD-coated NPs remained attached to the mucosa after 8h of incubation, compared to only 33% of uncoated NPs. In vitro release of rifampicin, used as a model drug, showed a similar controlled release profile from both pD-coated and uncoated NPs. Our results serve to expand the versatility of mussel-inspired coatings to the design of mucoadhesive nanoscale vehicles for oral drug delivery.

Correlation between the viscoelastic properties of the gel layer of swollen HPMC matrix tablets and their in vitro drug release

Drug release from hydroxypropyl methylcellulose (HPMC) hydrophilic matrix tablets is controlled by drug diffusion through the gel layer of the matrix-forming polymer upon hydration, matrix erosion or combination of diffusion and erosion mechanisms. In this study, the relationship between viscoelastic properties of the gel layer of swollen intact matrix tablets and drug release was investigated. Two sets of quetiapine fumarate (QF) matrix tablets were prepared using the high viscosity grade HPMC K4M at low (70 mg/tablet) and high (170 mg/tablet) polymer concentrations. Viscoelastic studies using a controlled stress rheometer were performed on swollen matrices following hydration in the dissolution medium for predetermined time intervals. The gel layer of swollen tablets exhibited predominantly elastic behavior. Results from the in vitro release study showed that drug release was strongly influenced by the viscoelastic properties of the gel layer of K4M tablets, which was further corroborated by results from water uptake studies conducted on intact tablets. The results provide evidence that the viscoelastic properties of the gel layer can be exploited to guide the selection of an appropriate matrix-forming polymer, to better understand the rate of drug release from matrix tablets in vitro and to develop hydrophilic controlled-release formulations.

pH-Dependent Solubility and Dissolution Behavior of Carvedilol--Case Example of a Weakly Basic BCS Class II Drug

The objective of this study was to investigate the pH-dependent solubility and dissolution of weakly basic Biopharmaceutical Classification Systems (BCS) class II drugs, characterized by low solubility and high permeability, using carvedilol, a weak base with a pK a value of 7.8, as a model drug. A series of solubility and in vitro dissolution studies was carried out using media that simulate the gastric and intestinal fluids and cover the physiological pH range of the GI from 1.2 to 7.8. The effect of ionic strength, buffer capacity, and buffer species of the dissolution media on the solubility and dissolution behavior of carvedilol was also investigated. The study revealed that carvedilol exhibited a typical weak base pH-dependent solubility profile with a high solubility at low pH (545.1-2591.4 μg/mL within the pH range 1.2-5.0) and low solubility at high pH (5.8-51.9 μg/mL within the pH range 6.5-7.8). The dissolution behavior of carvedilol was consistent with the solubility results, where carvedilol release was complete (95.8-98.2% released within 60 min) in media simulating the gastric fluid (pH 1.2-5.0) and relatively low (15.9-86.2% released within 240 min) in media simulating the intestinal fluid (pH 6.5-7.8). It was found that the buffer species of the dissolution media may influence the solubility and consequently the percentage of carvedilol released by forming carvedilol salts of varying solubilities. Carvedilol solubility and dissolution decreased with increasing ionic strength, while lowering the buffer capacity resulted in a decrease in carvedilol solubility and dissolution rate.

Nanoemulsion-based gel formulation of diclofenac diethylamine: design, optimization, rheological behavior and in vitro diffusion studies

Chronic oral administration of the non-steroidal anti-inflammatory drug, diclofenac diethylamine (DDEA), is often associated with gastrointestinal ulcers and bleeding. As an alternative to oral administration, a nanoemulsion-based gel (NE gel) formulation of DDEA was developed for topical administration. An optimized formulation for the o/w nanoemulsion of oil, surfactant and cosurfactant was selected based on nanoemulsion mean droplet size, clarity, stability, and flowability, and incorporated into the gelling agent Carbopol® 971P. Rheological studies of the DDEA NE gel were conducted and compared to those of conventional DDEA gel and emulgel. The three gels exhibited an elastic behavior, where G' dominated G″ at all frequencies, indicating the formation of strong gels. NE gel exhibited higher G' values than conventional gel and emulgel, which indicated the formation of a stronger gel network. Strat-M® membrane, a synthetic membrane with diffusion characteristics that are well correlated to human skin, was used for the in vitro diffusion studies. The release of DDEA from conventional gel, emulgel and NE gel showed a controlled release pattern over 12 h, which was consistent with the rheological properties of the gels. DDEA release kinetics from the three gels followed super case II transport as fitted by Korsmeyer-Peppas model.

Factor structure and reliability of the Arabic adaptation of the Hypomania Check List-32, second revision (HCL-32-R2)

OBJECTIVE

To assess the psychometric properties of the Arabic adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) inpatients suffering a current major depressive episode (MDE).

METHOD

The "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" Arabic module of the HCL-32-R2 was administered to mother-tongue Arabic MDE inpatients between March 2013 and October 2014. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls.

RESULTS

In our sample (n=500, of whom, BD-I=329; BD-II=70; MDD=101), using a cut-off of 17 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2(-)) and "sub-threshold bipolar depression" (HCL-32-R2(+)) with sensitivity=82% and specificity=77%. Area under the curve was .883; positive and negative predictive values were 93.44% and 73.23% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factors analyses. Item n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the HCL-32 loaded onto F1, though very slightly. Cronbach's alphas were F1=.86 and F2=.60.

LIMITATIONS

No cross-validation with any additional validated screening tool. Inpatients only sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, or record of severity of current MDE.

CONCLUSIONS

In our sample, the HCL-32 fairly discriminated between MDD and BD-I but not BD-II, therefore soliciting for replication studies for use in Arabic-speaking depressed inpatients.

Synthetic tracheal mucus with native rheological and surface tension properties

In this study, the development of a model tracheal mucus with chemical composition and physical properties (bulk viscoelasticity and surface tension) matched to that of native tracheal mucus is described. The mucus mimetics (MMs) were formulated using components that are abundant in tracheal mucus (glycoproteins, proteins, lipids, ions, and water) at concentrations similar to those found natively. Pure solutions were unable to achieve the gel behavior observed with native mucus. The addition of a bifunctional cross-linking agent enabled control over the viscoelastic properties of the MMs by tailoring the concentration of the cross-linking agent and the duration of cross-linking. Three MM formulations with different bulk viscoelastic properties, all within the normal range for nondiseased tracheal mucus, were chosen for investigation of surfactant spreading at the air-mimetic interface. Surfactant spread quickly and completely on the least viscoelastic mimetic surface, enabling the surface tension of the mimetic to be lowered to match native tracheal mucus. However, surfactant spreading on the more viscoelastic mimetics was hindered, suggesting that the bulk properties of the mimetics dictate the range of surface properties that can be achieved.

Podocyte proteins in Galloway-Mowat syndrome

Galloway-Mowat syndrome is an autosomal recessive disorder characterized by early onset nephrotic syndrome and central nervous system anomalies. Mutations in podocyte proteins, such as nephrin, alpha-actinin 4, and podocin, are associated with proteinuria and nephrotic syndrome. The genetic defect in Galloway-Mowat syndrome is as yet unknown. We postulated that in Galloway-Mowat syndrome the mutation would be in a protein that is expressed both in podocytes and neurons, such as synaptopodin, GLEPP1, or nephrin. We therefore analyzed kidney tissue from normal children (n=3), children with congenital nephrotic syndrome of the Finnish type (CNF, n=3), minimal change disease (MCD, n=3), focal segmental glomerulosclerosis (FSGS, n=3), and Galloway-Mowat syndrome (n=4) by immunohistochemistry for expression of synaptopodin, GLEPP1, intracellular domain of nephrin (nephrin-I), and extracellular domain of nephrin (nephrin-E). Synaptopodin, GLEPP1, and nephrin were strongly expressed in normal kidney tissue. Nephrin was absent, and synaptopodin and GLEPP1 expression were decreased in CNF. The expression of all three proteins was reduced in MCD and FSGS; the decrease in expression being more marked in FSGS. Synaptopodin, GLEPP1, and nephrin expression was present, although reduced in Galloway-Mowat syndrome. We conclude that the reduced expression of synaptopodin, GLEPP1, and nephrin in Galloway- Mowat syndrome is a secondary phenomenon related to the proteinuria, and hence synaptopodin, GLEPP1, and nephrin are probably not the proteins mutated in Galloway-Mowat syndrome.