A Compendium of Compounding Agents and Formulations, Part 3: Gentamicin Sulfate and Benzoyl Peroxide

Since antiquity, the safety and effectiveness of topical and transdermal medications in treating a host of somatic conditions, including disorders that afflict the skin, have been appreciated. Those drug-delivery forms offer convenient self-administration; obviate gastrointestinal-tract absorption and hepatic-first-pass metabolism, thereby improving bioavailability and maintaining sufficient drug concentration within the therapeutic window; and facilitate the transmission of the largest fraction of drug molecules to the target area, thus maximizing therapeutic potential and reducing systemic drug toxicity. In this article, gentamicin and benzoyl peroxide, neither of which is commercially available currently in an easily modifiable topical or transdermal form, are profiled, and 2 compounded formulations are provided for easy reference.

Rapid and Visual Detection of Benzoyl Peroxide in Food by a Colorimetric and Ratiometric Fluorescent Probe

A coumarin-based fluorescent probe was prepared for rapid and visual detection of benzoyl peroxide. The probe could quantitatively determine benzoyl peroxide with fast response (<6 min), high sensitivity, and low limit of detection (163 nM). The probe exhibited good response toward benzoyl peroxide with a significant color change from blue to yellow along with fluorescence color alteration from red to blue. The probe determined benzoyl peroxide in real food samples (wheat flour, noodle, and dumpling flour) with good recoveries (90-114%). Furthermore, the probe was prepared into a paper-based test kit to determine benzoyl peroxide (30-100 μM) in real food samples with noticeable color and fluorescence change.

Radical-scavenging activity of dietary phytophenols in combination with co-antioxidants using the induction period method

The radical-scavenging activity of dietary phytophenols has been investigated by many researches due to their antioxidant, anti-inflammatory and anticancer property but the radical-scavenging effect of 2-phytophenol and the phytophenol:co-antioxidants, vitamin C and thiol combination under nearly anaerobic conditions still remains unknown. The radical-scavenging activity for seventeen phytophenols and for six synthetic phenols (positive controls) was investigated using the induction period method in the polymerization of methyl methacrylates (MMA) initiated by thermal decomposition of benzoyl peroxide (BPO) by monitoring differential scanning calorimetery (DSC). The k_inh for the phytophenols was likely with the range 0.5 × 10³ M⁻¹s⁻¹−2.2 × 10³ M⁻¹s⁻¹, whereas that for synthetic phenols, hydroquinone and galvinoxyl, was with the range 7 × 10³ M⁻¹s⁻¹−8 × 10³ M⁻¹s⁻¹. Also, the additive scavenging effect of the (−)-epigallocatechin (EGC):(−)-epicatechin (EC) and the (+)-catechin:epicatechin (EC) combination was observed at 1:1 molar ratio, whereas that of the EC:quercetin combination showed the cancel (prooxidative) effect. Furthermore, the EGC:ASDB (L-ascorbyl 2,6-dibutylate) or 2-ME (2-mercaptoethanol) combination showed the prooxidative effect. Such enhancement of prooxidation in the combination may increase their toxic effects due to their cooxidation. Also, the synergic, additive or cancel effects of the flavonoid:vitamins E combination on the induction period in the BPO (a PhCOO* radical) and 2,2′-azobisisobutyronitrile (AIBN, an R* radical) systems are discussed.

Kinetic radical-scavenging activity of colchicine and tropolone

The kinetics of radical-scavenging activities for colchicine and tropolone remain unknown. Their antioxidant activities were determined by the induction period (IP) method in the polymerization of methyl methacrylate initiated by thermal decomposition of 2,2'-azobisisobutyronitrile (AIBN, R*) or benzoyl peroxide (BPO, PhCOO*) using differential scanning calorimetry (DSC) under nearly anaerobic conditions. The IPs for colchicine and tropolone were very short despite the addition of a high concentration of these compounds relative to initiators; the stoichiometric factor (n, the number of moles of PhCOO* trapped by the antioxidant) was approximately 0.03 and 0.04 for colchicine and tropolone, respectively. The n value of these compounds for R* was less than that for PhCOO*. The rate constant of inhibition to that of propagation (kinh/kp) for both compounds was 23-27, and the difference between them was considerably small. Both compounds had weak antioxidant properties at very high concentrations.

Radical-scavenging activity of natural methoxyphenols vs. synthetic ones using the induction period method

The radical-scavenging activities of the synthetic antioxidants 2-allyl-4-X-phenol (X = NO2, Cl, Br, OCH3, COCH3, CH3, t-(CH3)3, C6H5) and 2,4-dimethoxyphenol, and the natural antioxidants eugenol and isoeugenol, were investigated using differential scanning calorimetry (DSC) by measuring their anti-1,1-diphenyl-2-picrylhydrazyl (DPPH) radical activity and the induction period for polymerization of methyl methacrylate (MMA) initiated by thermal decomposition of 2,2'-azobisisobutyronitrile (AIBN) and benzoyl peroxide (BPO). 2-Allyl-4-methoxyphenol and 2,4-dimethoxy-phenol scavenged not only oxygen-centered radicals (PhCOO*) derived from BPO, but also carbon-centered radicals (R*) derived from the AIBN and DPPH radical much more efficiently, in comparison with eugenol and isoeugenol. 2-Allyl-4-methoxyphenol may be useful for its lower prooxidative activity.

Kinetics of radical-scavenging activity of hesperetin and hesperidin and their inhibitory activity on COX-2 expression

The radical-scavenging activities of the flavanones hesperetin and hesperidin were investigated by differential scanning calorimetry (DSC) monitoring of the polymerization of methyl methacrylate initiated by 2,2'-azobisisobutyronitrile (AIBN, an R* radical) or benzoylperoxide (BPO, a PhCOO* radical) at 70 degrees C under nearly anaerobic conditions. Their stoichiometric factor (number of free radicals trapped by one mole of antioxidant moiety (n)) and the ratio of the rate constant of inhibition to that of propagation (k(inh)/k(p)) were determined and compared with that for trolox The n value declined in the order trolox (2.0) > hesperetin (0.8) > hesperidin (0.2) in the AIBN system, whereas it declined in the order hesperetin (0.9) > trolox (0.1) > hesperidin (0.0) in the BPO system. The k(inh)/k(p) value declined in the order hesperidin (195) > hesperetin (33) > trolox (12) in the AIBN system, whereas it declined in the order hesperidin (362) > trolox (127) > hesperetin (18) in the BPO system. The n value of about 1 for hesperetin with a relatively small k(inh)/k(p) value suggests the formation of dimers, as a result of the coupling reaction of phenolic monomers. In contrast, n values << 1 for hesperidin and trolox in the BPO system resulted in very high values for k(inh)/k(p). Hesperidin was also much more able to suppress the growth of methyl methacrylate radicals, although its n value was small, suggesting that this compound may also suppress polyunsaturated fatty acid radicals. In the concentration range 250-500 microM, hesperetin and hesperidin showed potent inhibition of LPS-induced expression of the COX-2 gene in RAW 264.7 cells, suggesting the anti-inflammatory activity of these compounds. The ability of hesperetin and hesperidin to suppress COX-2 gene expression may be a consequence of their antioxidant activity.

Scavenging of benzylperoxyl radicals by carotenoids

Carotenoids scavenge simple lipid-like alkylperoxyl radicals. However, the rate constant is too low to be determined directly and the mechanism is likewise not known with certainty [Mortensen, A. and Skibsted, L.H. (1998) FEBS Lett. 426, 392-396]. It is demonstrated that carotenoids react with peroxyl radicals only slightly more reactive than lipidperoxyl radicals neither by electron transfer nor by hydrogen atom donation, but by adduct formation. Benzylperoxyl radicals are scavenged by the carotenoids beta-carotene and canthaxanthin with a second-order rate constant of at least 1 x 10(6) M(-1) s(-1) by formation of an adduct which decays in a first-order reaction.

Synergistic activity of benzoyl peroxide and erythromycin

BACKGROUND

Benzoyl peroxide (BP) is the most widely used topical agent for acne since its introduction in the 1960s. Concomitant topical treatment of BP and erythromycin is stated to be superior to BP alone. However, no synergistic activity has been found with this combination. Instead, such combination therapies are hypothesized to gain their efficacy by the coupled action of two effective treatments. The antibiotic kills all susceptible bacteria and the BP eliminates the resistant strains.

OBJECTIVE

The purpose was to compare radical production by BP alone and with various antibiotics to determine whether certain antibiotics increase radical formation by BP, as the antibacterial activity of BP may correlate with the amount of radicals it forms.

METHODS

Polymerization of tetraethylene glycol dimethacrylate was used as a test of BP radical activity.

RESULTS

The results suggest that radical activity increases upon addition of certain antibiotics, such as erythromycin, to a solution of BP.

CONCLUSION

Radical activity of BP in tetraethylene glycol dimethacrylate is increased when tested in consort with several antibiotics, such as the macrolides. We propose that the tertiary amines contained on certain antibiotics are responsible for catalysis of BP radical formation. If increased radical formation correlates with enhanced biological effect, then these data reveal the possibility of a biological synergism in mixtures of BP and antibiotics. An understanding of the mechanism of catalysis of BP radical formation by antibiotics may lead to the discovery of improved treatments for acne.

Fluoresceinated phosphoethanolamine for flow-cytometric measurement of lipid peroxidation

A new lipophilic fluorescein probe (fluor-DHPE) has been identified that can assay lipid peroxidation in mammalian cells on a cell-by-cell or selected-cell-subpopulation basis by flow cytometry. Application of this approach requires that the fluorescent probe be nonexchangeable among cells. Fluorescein is an appropriate fluorophore, since its fluorescence matches the specifications of common flow cytometers and the compound loses its fluorescence upon reaction with peroxyl radicals. Upon examination of four lipophilic derivatives of fluorescein, fluor-DHPE was found to be the only probe that was nonexchangeable among labeled and unlabeled rat RBC for at least 24 h. The exposure of fluor-DHPE-labeled RBC to benzoyl peroxide followed by mixing the sample with RBC unexposed to peroxide led to a decrease in fluorescence. Furthermore, the flow cytometer could clearly select the subpopulation of cells undergoing lipid peroxidation from those cells that were not. Fluor-DHPE-labeled-RBC obtained from rats and exposed to cumene hydroperoxide also displayed a gradual decrease in fluorescence. This decrease was preventable by either regulation of the vitamin E content in the animal diet or in vitro supplementation of cells with vitamin E. We conclude that fluor-DHPE is a stable and nonexchangeable probe for monitoring lipid peroxidation in cell subpopulations by flow cytometry.

The Microsponge Delivery System (MDS): a topical delivery system with reduced irritancy incorporating multiple triggering mechanisms for the release of actives

The Microsponge Delivery System (MDS) is a unique technology for the controlled release of topical agents and consists of macroporous beads, typically 10-25 microns in diameter, loaded with active agent. When applied to the skin, the MDS releases its active ingredient on a time mode and also in response to other stimuli (rubbing, temperature, pH, etc). MDS technology is being used currently in cosmetics, over-the-counter (OTC) skin care, sunscreens and prescription products. By delivering the active gradually to the skin, MDS-benzoyl peroxide formulations, for example, have excellent efficacy with minimal irritation. These are typical benefits from the use of the MDS.

The use of initiated cells as a test system for the detection of inhibitors of gap junctional intercellular communication

The effects of five non-mutagenic carcinogens--Aroclor 1260, benzoyl peroxide (BP), phenobarbital (PB), 12-O-tetradecanoyl-phorbol-13-acetate (TPA) and 1,1'-(2,2,2-trichloroethylidene)bis[4-chlorobenzene] (DDT)--on gap junctional intercellular communication (GJIC) were tested in a cell line consisting of initiated cells (3PC). Four agents suspected of tumor promotion activity--o-anisidine, clofibrate, L-ethionone and d-limonene--were also tested for their effects on GJIC. Finally sodium fluoride (NaF), whose carcinogenic property is still unclear, was tested for its effects on GJIC in the 3PC cell line. Four of the five selected tumor promoters (Aroclor 1260, BP, DDT and TPA) decreased GJIC between these initiated epidermal cells. The four non-mutagenic carcinogens with tumor-promoting activity in vivo (o-anisidine, clofibrate, L-ethionine and d-limonene) all inhibited GJIC, whereas NaF had no effect. Seven compounds (o-anisidine, Aroclor 1260, BP, DDT, L-ethionine, d-limonene and TPA) had a dose-dependent as well as time-dependent inhibitory effect on GJIC. Under the experimental conditions used, clofibrate showed only a dose-related inhibition of GJIC. PB showed no inhibitory effect on GJIC in the 3PC cell line. In order to determine the role of biotransformation in the tumor-promoting activity of PB, its effect on GJIC was also examined in the presence of an Aroclor 1254-induced rat liver homogenate (S9 mix) and in the hepatoma cell line HepG2. In the presence of rat liver homogenate PB decreased GJIC in the 3PC cell line, whereas in the HepG2 cells PB showed a time- and dose-dependent inhibitory effect. To study the potential differences in susceptibility of cells representing different stages in the process of tumor formation, the effect of the selected tumor promoters on GJIC was also investigated in primary mouse keratinocytes and in a mouse skin carcinoma-derived cell line (CA3/7). Primary keratinocytes were sometimes more (BP and clofibrate) and sometimes less sensitive (ethionine and limonene) for inhibitory effects on GJIC compared to the effects in the cell line 3PC. Except for TPA and anisidin, GJIC between the CA3/7 cells was less affected by the selected agents compared to the 3PC cell line. These results show that, during the process of tumor formation the susceptibility of cells to inhibition of GJIC by tumor promoters is variable. Overall the CA3/7 cells are less sensitive compared to 3PC cells. The susceptibility of primary keratinocytes is variable compared to 3PC cells, depending on the agent used. These results also show that GJIC is a valid parameter for testing the tumor-promoting activity of compounds. Finally, this study demonstrates that mouse keratinocyte cell lines could serve as an in vitro model for the detection of non-mutagenic carcinogens with diverse target organs in vivo. For this use the cell line consisting of initiated cells (3PC) is more sensitive than the carcinoma-derived cell line CA3/7.

Benzoyl peroxide: an integrated human safety assessment for carcinogenicity

Topical benzoyl peroxide has been used in the treatment of acne for over 30 years, with no reports of adverse effects that could be related to skin carcinogenesis. Two case-control epidemiological studies have found a lack of association between the specific use of benzoyl peroxide and skin cancer. In addition to these findings in humans, 23 carcinogenicity studies in rodents with benzoyl peroxide, including 16 employing topical application, have yielded negative results. An increase in skin carcinomas was reported in 1 study in which benzoyl peroxide in acetone was applied to the skin of SENCAR mice for a 1-year period; however, this study did not employ adequate control groups to fully understand the unusual findings, and the results were inconsistent with those of 6 other similar studies. While benzoyl peroxide is not a complete carcinogen in animals and has weak or no mutagenic potential, it has been found to be a tumor promoter in mouse skin using experimental two-stage models of carcinogenesis. Consistently positive results have been obtained in tumor promotion studies in which SENCAR mice were exposed to initiating doses of potent experimental carcinogens followed by promotion with benzoyl peroxide in acetone. Negative results have been obtained in similar studies with commercial formulations. However, the results of promotion studies with benzoyl peroxide do not carry significant weight for human safety assessment as evidenced by (i) the absence of demonstrated carcinogenicity in humans of a number of rodent tumor promoters despite long-term human exposure; (ii) the observation that tumor promotion in mouse skin occurs only under specific experimental conditions and predominantly in highly sensitive strains; (iii) clinical use scenarios markedly different from the conditions resulting in tumor promotion in mouse skin; and (iv) the significant physiological differences between mouse and human skin. Thus, to date, available scientific evidence does not allow the results of these rodent promotion studies to be meaningfully applied to human safety assessment. As such, significant scientific progress must be made before human safety estimations can be derived from rodent promotion data.(ABSTRACT TRUNCATED AT 400 WORDS)

Free radical production during metabolism of organic hydroperoxides by normal human keratinocytes

Evidence of a relationship between tumor production induced by various organic (hydro)peroxides and free radical formation has been shown in cultured murine keratinocytes and human skin-tumor cell line. In the present study the bioactivation of cumene hydroperoxide, t-butyl-hydroperoxide, and benzoyl peroxide via one-electron oxidation or reduction was compared in freshly isolated and in cultured normal human keratinocytes. The formation of methyl free radicals during the metabolism of cumene and t-butyl-hydroperoxide was shown by the electron spin resonance-spin trapping technique. Radical formation increased under hypoxic conditions. An intracellular activation site was demonstrated by the use of two spin-trapping agents, the hydrophilic, membrane-impermeable, 3,5-dibromo-4-nitrosobenzenesulfonic acid and the lipophilic, membrane-permeable alpha-(4-pyridyl-1-oxide)-N-t-butylnitrone. At 30 min incubation and 25 mM concentration, hydroperoxides exhibited cytotoxicity, as indicated by trypan blue exclusion and lactate dehydrogenase release assay; free radicals were concurrently trapped. Hydroperoxides at a lower concentration (1 mM) did not significantly affect cell viability. However, free radical production was still detected using a membrane-permeable spin trap. The incubation of keratinocytes with benzoyl peroxide did not show any peroxide-dependent radical adduct. No significant differences in bioactivation capability were demonstrated between freshly isolated and cultured human keratinocytes. The results indicate that cultured human keratinocytes can be used as a model system for the study of the metabolic activation to free radical intermediates of toxic and carcinogenic compounds in the epidermis.

Role of the benzoyloxyl radical in DNA damage mediated by benzoyl peroxide

Benzoyl peroxide (BzPO) is both a tumor promoter and progressor in mouse skin; however, BzPO is neither an initiator nor a complete carcinogen in this tissue. Although not mutagenic, BzPO has been observed to produce strand breaks in DNA of exposed cells. These actions are presumed to be mediated by free-radical derivatives of BzPO. Previous studies suggested that the metabolism of BzPO in keratinocytes proceeds via the initial cleavage of the peroxide bond, yielding benzoyloxy radicals which, in turn, can either fragment to form phenyl radicals and carbon dioxide or abstract H atoms from biomolecules to yield benzoic acid. Benzoic acid is the major stable metabolite of BzPO produced by keratinocytes. In the present study we have investigated the role of BzPO and its metabolites in the generation of strand scissions in a cell-free system using phi X-174 plasmid DNA. In this system BzPO produced DNA damage that was dose-dependent over a concentration range of 0.1-1 mM and required the presence of copper but not other transition metals. By contrast, benoic acid did not produce DNA damage in this system, either in the presence or in the absence of copper. The inclusion of spin trapping agents, such as N-tert-butyl-alpha-phenylnitrone (PBN), 3,5-dibromo-4-nitrosobenzenesulfonate, and nitrosobenzene, in incubations was found to significantly reduce the extent of DNA damage generated via the copper-mediated activation of BzPO. Electron paramagnetic resonance spectroscopy studies suggested that the primary radical trapped by PBN following copper-mediated decomposition of BzPO was the benzoyloxy radical.(ABSTRACT TRUNCATED AT 250 WORDS)

[Penetration of benzoyl peroxide in the skin]

Benzoyl peroxide preparations have proven to be effective agents in the treatment of acne. In comparison to the numerous clinical communications, very few reports exist concerning the pharmacokinetics of benzoyl peroxide. The benzoyl peroxide content of abraded horny layers and its metabolite benzoic acid were investigated by high-pressure liquid chromatography after application (1-2 min) of emulsion containing benzoyl peroxide. It was found that benzoyl peroxide penetrates the stratum corneum very quickly where it is rapidly degraded to benzoic acid. No benzoyl peroxide depot in the stratum corneum could be demonstrated.

Benzoyl peroxide: percutaneous penetration and metabolic disposition. II. Effect of concentration

The effect of drug concentrations of 2.5%, 5%, and 10% upon the transepidermal penetration of 14C-benzoyl peroxide in a lotion vehicle was assessed in excised human skin and in vivo in the rhesus monkey. In vitro, penetration of benzoyl peroxide was concentration-dependent, both as to rate and to amount, as measured by the hourly recovery of the metabolite, benzoic acid, from the dermal side of the model. In vivo, the higher the concentration of benzoyl peroxide applied, the greater the amount absorbed, as indicated by the urinary excretion of 14C-benzoic acid. Metabolic disposition of benzoyl peroxide, in turn, was unaffected by drug concentration. In all instances, the benzoyl peroxide absorbed was excreted rapidly in urine as benzoic acid; no hippuric acid was detected at any time. We conclude that (1) use of the excised human skin model for this compound can provide useful data in studies of the effects of vehicle and concentration on topical drug delivery, (2) the transepidermal delivery of benzoyl peroxide, but not its metabolic disposition, is concentration-dependent, and (3) the renal clearance of the systemically absorbed drug is so rapid that it precludes passage through the liver--therefore, no systemic toxicity due to drug accumulation can be expected.

Benzoyl peroxide: percutaneous penetration and metabolic disposition

The transepidermal penetration and metabolic disposition of 14C-benzoyl peroxide were assessed in vitro (excised human skin) and in vivo (rhesus monkey). In vitro, the benzoyl peroxide penetrated into the skin, through the stratum corneum or the follicular openings, or both, and was recovered on the dermal side as benzoic acid. In vivo, benzoic acid was recovered from urine in amounts equivalent to 45% and 98% of the radiolabel following, respectively, topical and intramuscular administration of small amounts of 14C-benzoyl peroxide. We conclude that benzoyl peroxide penetrates as such into the skin layers and is converted therein to benzoic acid, which, in turn is absorbed into the systemic circulation. Renal clearance of the metabolite is sufficiently rapid as to preclude its hepatic conjugation with glycine, since following topical administration to rhesus monkeys, no hippuric acid was found in the urine, as could have been expected had a significant amount of benzoic acid passed through the liver.