Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

Ibrahim, Omer; Wenande, Emily; Hogan, Sara; Arndt, Kenneth A.; Hædersdal, Merete; Dover, Jeffrey S.

doi:10.1002/lsm.22769

Cited by 42 publications

(46 citation statements)

References 57 publications

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“…Ablative lasers have the capability to remove or compromise the stratum corneum through their photothermal effect, thus promoting transdermal delivery of drugs . Fractional Er:YAG laser (2,940 nm) is a common type of ablative laser that can form a series of microscopic vertical channels of ablated tissue on the skin surface.…”

Section: Introductionmentioning

confidence: 99%

Transdermal delivery of water‐soluble fluorescent antibody mediated by fractional Er:YAG laser for the diagnosis of lupus erythematosus in mice

et al. 2018

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Objectives Although transdermal drug delivery system (TDDS) has been successfully used for delivering small molecules, its application in the delivery of diagnostic antibodies has been limited due to their large size. In this study, we aim to obtain a broad insight in the dynamics of TRITC‐conjugated Goat Anti‐Mouse IgG (T‐IgG) uptake in fractional Er:YAG laser pretreated skin and provide a new technical option for detecting lupus erythematosus (LE) in mice. Methods The skins of SD and MRL/lpr mice were treated by fractional Er:YAG laser followed by external application of T‐IgG. The classic Franz diffusion method was used to observe the effects of different fractional fluences, densities and antibody concentrations on transdermal delivery of T‐IgG at different time points (2, 4, 6, 8, 20, and 24 hours). Frozen tissue sections and confocal microscopy were used to observe the distribution of T‐IgG on the sagittal and coronal planes of murine skin. Results Increased laser fluence (12.5 J/cm2 to 37.5 J/cm2) within 24 hours resulted in the obvious increase in transdermal amounts of T‐IgG during the early stage (before 8 hours). However, increasing laser density (100 pores/cm2 to 200 pores/cm2) produced a significant increase in T‐IgG permeation during the late stage (20 and 24 hours). Unlike fluence and density, increase in T‐IgG loading concentration (0.5 to 2 μg/μl) led to continuous increase in the whole process of transdermal delivery. T‐IgG appeared in the micro‐pores of SD mice skin within 4 hours after treatment in vivo. After 24 hours, it was observed in the skin. In MRL/lpr mice, positive lupus band testing (LBT) could be found on the skin lesion after laser and T‐IgG external application. Conclusions Fractional Er:YAG laser can help antibodies (150 kDa) to implement effective and controllable transdermal delivery. LBT can be achieved in MRL/lpr mice using TDDS in vivo, which may contribute to the minimally invasive diagnosis of LE. Lasers Surg. Med. 51:268–277, 2019. © 2018 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Transdermal delivery of water‐soluble fluorescent antibody mediated by fractional Er:YAG laser for the diagnosis of lupus erythematosus in mice

et al. 2018

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“…If the penetration reaches the target location of photoaging therapy, which is the superficial dermis layer, the long-term effects of therapy will be achieved. 23 Research conducted by Seo et al found that a provision of conditioned medium (CM) from human embryonic stem cells (hESC) after micro-needling radiofrequency for skin rejuvenation therapy had a lightening effect through inhibition of melanin synthesis and tyrosinase activity, and it can reduce the expression of melanogenic enzymes. 24 It was expected that the addition of vitamin C to MP-AMSC would work synergistically, providing a quicker improvement than MP-AMSC alone.…”

Section: Discussionmentioning

confidence: 99%

Long Term Effects of Combination of Metabolite Product Amniotic Membrane Stem Cell (MP-AMSC) and Vitamin C after Fractional CO2 Laser for Photoaging Treatment

Adiningtyas

Listiawan

Astari

2020

BIKK

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Background: Metabolite Products Amniotic Membrane Stem Cell (MP-AMSC) originating from the amniotic membrane has a skin rejuvenation effect by stimulating collagen synthesis. Vitamin C functions as an antioxidant in photoaging treatment. It is expected that the application of a combination of MP-AMSC and vitamin C after fractional CO2 laser treatment as Laser-Assisted Drug Delivery (LADD) to provide better long-term effects on clinical improvement of photoaged skin. As the drug penetration reaching the target, long-term effects and no side effects are expected. This promises as an option for photoaging therapy in the future. Purpose: This study aimed to evaluate the long-term effects of a combination of topical MP-AMSC mixtures and vitamin C after fractional CO2 laser treatment on wrinkles, spots, pores, and skin tones. Methods: Thirty adult women with photoaged skins were selected as samples, and were observed for wrinkles, spots, pores, and skin tones examination. The observation involved computer-simulated photographic devices, Facial Skin Scope System Janus-II for three months after the topical administration of MP-AMSC mixture and vitamin C, three times fractional CO2 laser, tretinoin 0.025% cream, and sun protection factor (SPF) 30 sunscreen as maintenance therapy. Result: The data analysis result was not statistically significant (p>0.05). Conclusion: There was a long-term effect of the application of a mixture of topical MP-AMSC and vitamin C after fractional CO2 laser treatment, and no side effect was observed.

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“…Similar to our study drugs, Aloe vera gel and rhEGF are hydrophilic substances (logP < 0) that may increase penetration via the deeper channel. However, increasing the pulse energy for deeper MTZs and larger CZ may increase the risk of PIH, blistering, and scarring . Haak et al examined the relation between laser density and skin deposition using methyl aminolevulinate and showed that epidermal concentration stabilized when increasing the dermal concentrations and laser density up to 5%.…”

Section: Discussionmentioning

confidence: 99%

Comparison between topical recombinant human epidermal growth factor and Aloe vera gel in combination with ablative fractional carbon dioxide laser as treatment for striae alba: A randomized double‐blind trial

2019

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Objectives Striae distensae are linear atrophic dermal scars. Despite several currently available therapeutic modalities, no consistently effective therapies have been established. This study aimed to evaluate and compare the efficacy of topical recombinant human epidermal growth factor (rhEGF) and ablative fractional carbon dioxide (CO2) laser (AFXL) versus ablative fractional CO2 laser and topical Aloe vera gel in treating striae alba. Methods A total of 24 participants with striae alba were enrolled. Patients’ striae were divided into the left and right sides. Participants were treated with fractional CO2 laser on both sides for three sessions at 4‐week intervals. Immediately after the laser treatment, each side of the striae was randomly assigned to either rhEGF or Aloe vera gel treatment. Patients were required to apply the medication twice daily up to 1 month after the last laser treatment session. Texture, average melanin, and melanin variation were assessed at pretreatment, 1 month after the first, second, and third treatments, and 6 months after the last treatment. Participants were asked to complete a self‐administered questionnaire. Nine participants underwent skin biopsies of the nontreated and treated striae, which were obtained from each treated side. Results Both sides of the treatment area showed significant improvement in texture starting from 1‐month follow‐up, which sustained up to 6 months after the final treatment, albeit without statistically significant difference between the rhEGF‐ and Aloe vera‐treated sides (P < 0.001, 0.003, and 0.002 for the AFXL–rhEGF‐treated side and P = 0.024, 0.001, and 0.001 for the AFXL–Aloe‐treated side at 1 month after the first treatment, 1 month after the last treatment, and 6 months after the last treatment, respectively). Participants expressed satisfaction with the AFXL–rhEGF‐treated side, which showed significantly greater marked improvement (at 50%) than the AFXL–Aloe‐treated side at 6 months after the final treatment (P = 0.034). Post‐inflammatory hyperpigmentation (PIH) occurred in 95.8% of participants, which decreased after 6 months compared with baseline. Both treatments improved melanin variation at 6 months after the final treatment, although without significant difference from pretreatment between both groups. Skin biopsy revealed a statistically significant increase in epidermal thickness and decrease in elastic fragmentation in both groups. Conclusion AFXL–rhEGF and AFXL–Aloe significantly improved the striae surface texture. PIH was the most common side effect, which improved at 6 months. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

Cited by 42 publications

References 57 publications

Transdermal delivery of water‐soluble fluorescent antibody mediated by fractional Er:YAG laser for the diagnosis of lupus erythematosus in mice

Transdermal delivery of water‐soluble fluorescent antibody mediated by fractional Er:YAG laser for the diagnosis of lupus erythematosus in mice

Long Term Effects of Combination of Metabolite Product Amniotic Membrane Stem Cell (MP-AMSC) and Vitamin C after Fractional CO2 Laser for Photoaging Treatment

Comparison between topical recombinant human epidermal growth factor and Aloe vera gel in combination with ablative fractional carbon dioxide laser as treatment for striae alba: A randomized double‐blind trial

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