Safety and efficacy of epicutaneous immunotherapy with DBV712 (peanut patch) in peanut allergy

INTRODUCTION

DBV712 250 µg (also referred to as Viaskin Peanut or peanut patch; Viaskin is a trademark of DBV Technologies) is an innovative approach to epicutaneous immunotherapy (EPIT). The patch-based technology system facilitates peanut protein (allergen) absorption into the intact non-vascularized epidermis to promote desensitization to peanut while limiting systemic allergen exposure.

AREAS COVERED

Efficacy and safety in children have been evaluated in four completed phase 3 studies. Overall, the results from these studies have demonstrated the peanut patch to be superior in desensitization compared with placebo and safe for daily use over multiple years.

EXPERT OPINION

These findings, as well as supportive evidence from phase 2 studies, confirm the potential for an effective treatment of peanut allergy in children. The purpose of this review is to summarize the safety and efficacy of the peanut patch in the treatment of peanut allergy.

Skin patch based makeup finish assessment technique by deep neural network

BACKGROUND

Skin color and texture play a significant role in influencing impressions. To understand the influence of skin appearance and to develop better makeup products, objective evaluation methods for makeup finish have been explored. This study aims to apply machine learning technology, specifically deep neural network (DNN), to accurately analyze and evaluate delicate and complex cosmetic skin textures.

METHODS

"Skin patch datasets" were extracted from facial images and used to train a DNN model. The advantages of using skin patches include retaining fine texture, eliminating false correlations from non-skin features, and enabling visualization of the inferred results for the entire face. The DNN was trained in two ways: a classification task to classify skin attributes and a regression task to predict the visual assessment of experts. The trained DNNs were applied for the evaluation of actual makeup conditions.

RESULTS

In the classification task training, skin patch-based classifiers for age range, presence or absence of base makeup, formulation type (powder/liquid) of the applied base makeup, and immediate/while after makeup application were developed. The trained DNNs on regression task showed high prediction accuracy for the experts' visual assessment. Application of DNN to the evaluation of actual makeup conditions clearly showed appropriate evaluation results in line with the appearance of the makeup finish.

CONCLUSION

The proposed method of using DNNs trained on skin patches effectively evaluates makeup finish. This approach has potential applications in visual science research and cosmetics development. Further studies can explore the analysis of different skin conditions and the development of personalized cosmetics.

Superior efficacy of a skin-applied microprojection device for delivering a novel Zika DNA vaccine

Zika virus (ZIKV) infections are spreading silently with limited global surveillance in at least 89 countries and territories. There is a pressing need to develop an effective vaccine suitable for equitable distribution globally. Consequently, we previously developed a proprietary DNA vaccine encoding secreted non-structural protein 1 of ZIKV (pVAX-tpaNS1) to elicit rapid protection in a T cell-dependent manner in mice. In the current study, we evaluated the stability, efficacy, and immunogenicity of delivering this DNA vaccine into the skin using a clinically effective and proprietary high-density microarray patch (HD-MAP). Dry-coating of pVAX-tpaNS1 on the HD-MAP device resulted in no loss of vaccine stability at 40°C storage over the course of 28 days. Vaccination of mice (BALB/c) with the HD-MAP-coated pVAX-tpaNS1 elicited a robust anti-NS1 IgG response in both the cervicovaginal mucosa and systemically and afforded protection against live ZIKV challenge. Furthermore, the vaccination elicited a significantly higher magnitude and broader NS1-specific T helper and cytotoxic T cell response in vivo compared with traditional needle and syringe intradermal vaccination. Overall, the study highlights distinctive immunological advantages coupled with an excellent thermostability profile of using the HD-MAP device to deliver a novel ZIKV DNA vaccine.

Reusable and Porous Skin Patches with Thermopneumatic Adhesion Control Capability and High Water Vapor Permeability

We present a reusable and porous skin patch (RPS patch) capable of controlling adhesion force with a thermal-pneumatic method for repetitive use as well as improving moisture permeability for long-term use without skin troubles. Previous skin patches cause skin troubles due to high adhesion force (∼30 kPa) and low moisture permeability (∼382 g/m2/day), hindering them from repeatable and long-term use. We control the skin adhesion force of the RPS patch using thermopneumatic pressure generated by an embedded heater on multiple chamber arrays. The RPS patch controls the adhesion force ranging from 8 to 29 kPa on both dry and wet skin while keeping the stable adhesion force for 48 h. It shows repeatable adhesion up to 100 times, and the adhesion force is restored after the RPS patch is washed with water, thus enabling repetitive skin adhesion. We improve the moisture permeability of the RPS patch to 733 g/m2/day while maintaining the adhesion force by making the RPS patch with porous materials. The RPS patch shows no skin troubles for 7 days of attachment, thereby being available for long-term skin attachment. The RPS patch, having adhesion control capability and high moisture permeability, shows potential for use in daily life in biomedical applications, including wearable sensors, medical adhesives, and rehabilitation robots.

Piezoelectric Activatable Nanozyme-Based Skin Patch for Rapid Wound Disinfection

Nanozymes are promising new-generation antibacterial agents owing to their low cost, high stability, broad-spectrum activity, and minimal antimicrobial resistance. However, the inherent low catalytic activity of nanozymes tends to limit their antibacterial efficacy. Herein, a heterostructure of zinc oxide nanorod@graphdiyne nanosheets (ZnO@GDY NR) with unparallel piezocatalytic enzyme mimic activity is reported, which concurrently possesses intrinsic peroxidase-like activity and strong piezoelectric responses and effectively promotes the decomposition of hydrogen peroxide (H2O2) and generation of reactive oxygen species under ultrasound irradiation. Moreover, this piezocatalytic nanozyme exhibits almost 100% antibacterial efficacy against multidrug-resistant pathogens involving methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa in vitro and in vivo. In addition, a piezoelectric activatable nanozyme-based skin patch is developed for rapid skin wound disinfections with satisfactory hemocompatibility and cytocompatibility. This work not only sheds light on the development of an innovative piezoelectric activatable nanozyme-based skin patch for rapid wound disinfection but also provides new insights on the engineering of piezocatalytic nanozymes for nanozyme antibacterial therapy.

Strain Sensing Behavior of 3D Printable and Wearable Conductive Polymer Composites Filled with Silane-Modified MWCNTs

3D printing of conductive polymers is an attractive technique for achieving high flexibility, wearability, and sensing characteristics without geometrical limitations. However, there is an urgent need to integrate printability, conductivity, and sensing capability. Herein, a conductive polymer ink for 3D printing that combines the desirable features of high electrical conductivity, flexible stretchability, and strain-sensing monitoring is prepared. The ink matrix is polydimethylsiloxane and synergistically enhanced by acetylene carbon black (ACB) and multi-walled carbon nanotubes (MWCNTs) (silane or un-silane-modified). The inks are screened step-by-step to explore their printability, rheology, mechanical properties, and electrical performance upon loading. The formation of an electrically conductive network, electrical properties upon tensile load, and strain sensing stability under cyclic stretching are investigated intensively. It is demonstrated that conductive polymers filled by ACB and silane-modified, MWCNTs (MWCNTs-MTES) possess superior printability, stretchability, conductivity, and strain sensing behaviors. Finally, a flexible wearable strain-sensing skin patch is printed, and it successfully records joint motion signals on human fingers, wrists, and elbows with good stability and repeatability. Those results show the extent of potential applications in healthcare and motion monitoring fields. This work provides an efficient and simple route to achieve comfortably wearable and high-performance strain sensors.

Conducting Polymer-Reinforced Laser-Irradiated Graphene as a Heterostructured 3D Transducer for Flexible Skin Patch Biosensors

Flexible skin patch biosensors are promising for the noninvasive determination of physiological parameters in perspiration for fitness and health monitoring. However, various prerequisites need to be met for the development of such biosensors, including the creation of a flexible conductive platform, bending/contact stability, fast electrochemical kinetics, and immobilization of biomolecules. Here, we describe a conducting polymer-reinforced laser-irradiated graphene (LIG) network as a heterostructured three-dimensional (3D) transducer for flexible skin patch biosensors. LIG with a hierarchically interconnected graphene structure is geometrically patterned on polyimide via localized laser irradiation as a flexible conductive platform, which is then reinforced by poly(3,4-ethylenedioxythiophene) (PEDOT) as a conductive binder (PEDOT/LIG) with improved structural/contact stability and electrochemical kinetics. The interconnected pores of the reinforced PEDOT/LIG function as a 3D host matrix for high loading of "artificial" (Prussian blue, PB) and natural enzymes (lactate oxidase, LOx), forming a compact and heterostructured 3D transducer (LOx/PB-PEDOT/LIG) for lactate biosensing with excellent sensitivity (11.83 μA mM^-1). We demonstrated the fabrication of flexible skin patch biosensors comprising a custom-built integrated three-electrode system achieve amperometric detection of lactate in artificial sweat over a wide physiological linear range of 0-18 mM. The advantage of this facile and versatile transducer is further illustrated by the development of a folded 3D wristband lactate biosensor and a dual channel biosensors for simultaneous monitoring of lactate and glucose. This innovative design concept of a heterostructured transducer for flexible biosensors combined with a versatile fabrication approach could potentially drive the development of new wearable and skin-mountable biosensors for monitoring various physiological parameters in biofluids for noninvasive fitness and health management.

Post Market Clinical Follow up Results of the Steady State Coherent Bio-modulator Patch for tinnitus

OBJECTIVES

To follow up with a survey for the safety and performance of the coherent biomodulator patch as a device for tinnitus when in clinical use.

MATERIALS AND METHODS

A survey with 20 questions was emailed to device users a few weeks after fulfilled treatment. Collected data from 927 responders from February 2017 to July 2020 was exported and analyzed. The treatment time was 3 weeks, and the patches were changed daily and placed behind one year. The analysis was performed in order to investigate the possibility of subgroups and if the effect of one or more treatments are different, and is the relief dependent on how long the users have had troublesome tinnitus, the age of the user, and the severity of the tinnitus.

RESULTS

Most users were 45 years and older with a gender ratio of 1.65 men vs women. In general, the users reported highly bothersome tinnitus with 82% answering frequently to a lot before treatment. This follow up survey showed that 33% experienced any kind of improvement. The majority of those that reported improvement came from the subgroup of 4-10 years suffered from tinnitus. A very low frequency of side-effects was reported with no new risks or unexpected issues.

CONCLUSION

When considering the intended purpose of the steady state coherent biomodulator and the provided information in this survey, the device remains suitable for the intended tinnitus users.

Honeycomb-like MoS2 Nanotube Array-Based Wearable Sensors for Noninvasive Detection of Human Skin Moisture

Technological advances in wearable electronics have driven the necessity of a highly sensitive humidity sensor that can precisely detect physiological signals from the human body in real time. Herein, we introduce the anodic aluminum oxide (AAO)-assisted MoS₂ honeycomb structure as a resistive humidity sensor with superior sensing performance. The unique honeycomb-like structure consists of MoS₂ nanotubes, which can amplify the sensing performance because of their open pores and wider surface absorption sites. The formation of uniform MoS₂ nanotubes inside the AAO membrane was manipulated by the number of vacuum filtration cycles of the (NH₄)₂MoS₄ solution. The proposed humidity sensor exhibits an elevated sensitivity that is 2 orders of magnitudes higher than the MoS₂ film-based humidity sensor at the relative humidity range of 20-85%. Moreover, the sensor showed significantly faster response and recovery times of 0.47 and 0.81 s. In addition, we demonstrate the multifunctional applications such as noncontact sensation of human fingertips, human breath, speech recognition, and regional sweat rate, which show its promising potential for the next-generation wearable sensors.

Transdermal Delivery of AT1 Receptor Antagonists Reduce Blood Pressure and Reveal a Vasodilatory Effect on Kidney Blood Vessels

BACKGROUND

The Renin Angiotensin System (RAS) is pharmacologically targeted to reduce blood pressure, and patient compliance to oral medications is a clinical issue. The mechanisms of action of angiotensin receptor blockers (ARBs) in reducing blood pressure are not well understood and are purported to be via a reduction of angiotensin II signaling.

OBJECTIVE

We aimed to develop a transdermal delivery method for ARBs (losartan potassium and valsartan) and to determine if ARBs reveal a vasodilatory effect of the novel RAS peptide, alamandine. In addition, we determined the anti-hypertensive effects of the transdermal delivery patch.

METHODS

In vitro and in vivo experiments were performed to develop an appropriate therapeutic system, promising an alternative and more effective therapy in the treatment of hypertension. A variety of penetration enhancers were selected such as isopropyl myristate, propylene glycol, transcutol and dimenthyl sulfoxide to obtain a constant release of drugs through human skin. Small resistance vessels (kidney interlobar arteries) were mounted in organ baths and incubated with an ARB. Vasodilatory curves to alamandine were constructed.

RESULTS

The in vivo studies demonstrate that systemic absorption of valsartan and losartan potassium using the appropriate formulations provide a steady state release and anti-hypertensive effect even after 24 hours of transdermal administration. No apparent skin irritations (erythema, edema) were observed with the tested formulations. We also show that blocking the AT1 receptor of rabbit interlobar arteries in vitro reveals a vasodilatory effect of alamandine.

CONCLUSION

This study reveals the potential mechanism of AT1 receptor blockade via alamandine, and is an important contribution in developing a favorable, convenient and painless antihypertensive therapy of prolonged duration through transdermal delivery of AT1 blockers.

Novel skin patch combining human fibroblast-derived matrix and ciprofloxacin for infected wound healing

Skin injuries are frequently encountered in daily life, but deep wounds often poorly self-heal and do not recover completely. In this study, we propose a novel skin patch that combines antibiotic, cell-derived extracellular matrix (ECM) and biocompatible polyvinyl alcohol (PVA) hydrogel.

Methods: Decellularized human lung fibroblast-derived matrix (hFDM) was prepared on tissue culture plate (TCP) and PVA solution was then poured onto it. After a freeze-thaw process, PVA was peeled off from TCP along with hFDM tightly anchored to PVA. Subsequently, ciprofloxacin (Cipro)-incorporated PVA/hFDM (PVA/Cipro/hFDM) was fabricated via diffusion-based drug loading.

Results: In vitro analyses of PVA/Cipro/hFDM show little cytotoxicity of ciprofloxacin, stability of hFDM, rich fibronectin in hFDM, and good cell attachment, respectively. In addition, hFDM proved to be beneficial in promoting cell migration of dermal fibroblasts and human umbilical vein endothelial cells (HUVECs) using transwell inserts. The antibacterial drug Cipro was very effective in suppressing colony growth of gram-negative and -positive bacteria as identified via an inhibition zone assay. For animal study, infected wound models in BALB/c mice were prepared and four test groups (control, PVA, PVA/Cipro, PVA/Cipro/hFDM) were administered separately and their effect on wound healing was examined for up to 21 days. The results support that Cipro successfully reduced bacterial infection and thus encouraged faster wound closure. Further analysis using histology and immunofluorescence revealed that the most advanced skin regeneration was achieved with PVA/Cipro/hFDM, as assessed via re-epithelialization, collagen texture and distribution in the epidermis, and skin adnexa (i.e., glands and hair follicles) regeneration in the dermis.

Conclusion: This work demonstrates that our skin patch successfully consolidates the regenerative potential of ECM and the antibacterial activity of Cipro for advanced wound healing.

Novel Whole-Cell Inactivated Neisseria Gonorrhoeae Microparticles as Vaccine Formulation in Microneedle-Based Transdermal Immunization

Neisseria gonorrhoeae is a strict human pathogen responsible for more than 100 million new sexually transmitted infections worldwide each year. Due to the global emergence of antibiotic resistance, the Center for Disease control (CDC) recently listed N. gonorrhoeae as an urgent threat to public health. No vaccine is available in spite of the huge disease burden and the possibility of untreatable gonorrhea. The aim of this study is to investigate the immunogenicity of a novel whole-cell-based inactivated gonococcal microparticle vaccine formulation loaded in dissolvable microneedles for transdermal administration. The nanotechnology-based vaccine formulation consists of inactivated whole-cell gonococci strain CDC-F62, spray dried and encapsulated into biodegradable cross-linked albumin matrix with sustained slow antigen release. The dry vaccine nanoparticles were then loaded in a dissolvable microneedle skin patch for transdermal delivery. The efficacy of the whole-cell microparticles vaccine formulation loaded in microneedles was assessed in vitro using dendritic cells and macrophages as well as in vivo mouse model. Antibody titers were measured using an enzyme immunosorbent assay (ELISA) and antigen-specific T lymphocytes were assessed in spleens and lymph nodes. Here we report that whole-cell-based gonococcal microparticle vaccine loaded in dissolvable microneedles for transdermal administration induced significant increase in antigen-specific IgG antibody titers and antigen-specific CD4 and CD8 T lymphocytes in mice compared to gonococcal antigens in solution or empty microneedles. Significant increase in antigen-specific IgG antibody levels was observed at the end of week 2 in groups that received the vaccine compared to the group receiving empty nanoparticles. The advantages of using formalin-fixed whole-cell gonococci that all immunogenic epitopes are covered and preserved from degradation. The spherical shaped micro and nanoparticles are biological mimics of gonococci, therefore present to the immune system as invaders but without the ability to suppress adaptive immunity. In conclusion, the transdermal delivery of microparticles vaccine via a microneedle patch was shown to be an effective system for vaccine delivery. The novel gonorrhea nanovaccine is cheap to produce in a stable dry powder and can be delivered in microneedle skin patch obviating the need for needle use or the cold chain.

A Review of a Steady State Coherent Bio-modulator for Tinnitus Relief and Summary of Efficiency and Safety Data from the Clinical Study Program and Post Market Clinical Follow-up

OBJECTIVES

To evaluate a non-energy consuming light bio-modulator patch creating coherency for tinnitus relief.

MATERIALS AND METHODS

Three independent clinical studies and continuous post market clinical follow up have been performed during the year 2012 to 2018. The first study was a limited interventional investigation with 10 patients, the second was a larger interventional study with finally 48 patients further investigated, and the third a randomized, placebo-controlled, double-blind study with 82 patients. In the clinical studies patch performance evaluated with questionnaires related to tinnitus, quality-of-life, and safety were assessed prior, during and after the end of treatment. In all studies the treatment time was 3 weeks and the patches were placed behind one year.

RESULTS

The first study indicated a relief with half of the patients at the end of the treatment. Still two years after the study one third reported tinnitus relief. However, the numbers of patients were low. The second study showed a responder relief in 58% directly after end of treatment and 60% one month after. The third study showed that the biomodulator patch had statistical significant three times more responders than placebo one month after end of treatment, measured as a decrease from baseline in at least 2 points in tinnitus annoyance visual analogue scale as a minimal clinical significant difference. Tinnitus handicap inventory was improved by mean-16 points significantly for the active responder group, but with no statistically significant changes for the placebo group or between the groups. The biomodulator patch was safe and well-tolerated in all three studies. The post market clinical follow up has shown a 30% reported relief and with no new risks or unexpected issues affecting the effectiveness or safety.

CONCLUSION

Taken under consideration the lack of easy-to-use alternative and the low risk profile, this patch device could highly be recommended to try for tinnitus relief as a conclusion based on the clinical studies and post market surveys. Further studies of how this bio-modulator more specific act on the auditory system, how long this may sustain and if there can be subgroups of patients or variations in the treatment time, delayed onset, number of patches, and frequency for more efficiency needs to be considered.

Measuring head impacts: accelerometers and other sensors

Understanding the biomechanics of head injuries is essential for the development of preventive strategies and protective equipment design. However, there are many challenges associated with determining the forces that cause injury. Acceleration of the skull is often measured because it is relatively easy to quantify and relates to severity of impact, but it is difficult to relate those measurements to the type and extent of injury that occurs. Experimental work in the laboratory has used either human cadavers or volunteers. Cadavers can be instrumented with high-grade sensors that are tightly coupled to the skull for accurate measurements, but they cannot exhibit a functional response to determine a threshold for brain injury. Volunteers can also be instrumented with high-grade sensors in controlled laboratory experiments, but any head accelerations they experience must be well below an injurious level. Athletes participating in contact sports present a unique opportunity to collect biomechanical data from populations that have increased exposure to head impacts and a higher risk of head injury than the general population. Recent advances in sensor technology have allowed for more accurate measurements from instrumented athletes during play, but it is challenging to tightly couple the instrumentation to the skull to provide meaningful measurements. Because of the challenges associated with on-field measurements, it is important to consider the type of sensor used and its accuracy in the field when evaluating head impact data from athletes.

Organic transdermal iontophoresis patch with built-in biofuel cell

A completely organic iontophoresis patch is reported. A built-in biofuel cell is mounted on the patch that generates transdermal iontophoretic administration of compounds into the skin. The amplitude of transdermal current is tuned by integrating a conducting polymer-based stretchable resistor of predetermined resistance.