Photodynamic Therapy treatment of onychomycosis with Aluminium-Phthalocyanine Chloride nanoemulsions: A proof of concept clinical trial

Lam

et al. 2020

IAD

Background : Onychomycosis is a common fungal infection of the nail. Objective: The study aimed to provide an update on the evaluation, diagnosis, and treatment of onychomycosis. Methods: A PubMed search was completed in Clinical Queries using the key term “onychomycosis”. The search was conducted in May 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. The search was restricted to English literature. Patents were searched using the key term “onychomycosis” in www.freepatentsonline.com. Results : Onychomycosis is a fungal infection of the nail unit. Approximately 90% of toenail and 75% of fingernail onychomycosis are caused by dermatophytes, notably Trichophyton mentagrophytes and Trichophyton rubrum. Clinical manifestations include discoloration of the nail, subungual hyperkeratosis, onycholysis, and onychauxis. The diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide wet-mount preparation, histopathologic examination of the trimmed affected nail plate with a periodic-acid-Schiff stain, fungal culture, or polymerase chain reaction assays. Laboratory confirmation of onychomycosis before beginning a treatment regimen should be considered. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis and is a therapeutic option when oral antifungal agents are contraindicated or cannot be tolerated. Recent patents related to the management of onychomycosis are also discussed. Conclusion: Oral antifungal therapies are effective, but significant adverse effects limit their use. Although topical antifungal therapies have minimal adverse events, they are less effective than oral antifungal therapies, due to poor nail penetration. Therefore, there is a need for exploring more effective and/or alternative treatment modalities for the treatment of onychomycosis which are safer and more effective.

Section: Treatmentmentioning

confidence: 99%

Onychomycosis: An Updated Review

Lam

et al. 2020

IAD

“…The majority of clinical trials published on devices originate from South American (e.g., Brazil) and East Asian countries (e.g., Japan, Korea, China) . Device‐based treatments in combination with other therapies may help improve the penetration of antifungal drugs and treatment efficacy .…”

Section: Global Approvalsmentioning

confidence: 99%

“…Fungi are able to absorb photosensitizers so PDT can be an alternative way of treating onychomycosis. A few clinical trials have been published on PDT, [45][46][47][48][49][50][51] demonstrating that PDT is effective and well tolerated. PDT appears to be a promising alternative to conventional antifungal therapy.…”

Section: Physical Modalitiesmentioning

confidence: 99%

“…The majority of clinical trials published on devices originate from South American (e.g., Brazil) and East Asian countries (e.g., Japan, Korea, China). 45,47,[49][50][51][55][56][57][58] Device-based treatments in combination with other therapies may help improve the penetration of antifungal drugs and treatment efficacy. [58][59][60] For instance, mycological and clinical cure rates after 24 weeks of treatment were significantly higher when topical terbinafine treatment was combined with laser therapy as compared to terbinafine or laser therapy alone (P < 0.05).…”

Section: Global Approvalsmentioning

confidence: 99%

See 1 more Smart Citation

Global perspectives for the management of onychomycosis

et al. 2018

Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult‐to‐treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.

“…Along this line, light-based therapeutics have gathered enormous interest from researchers in the past two decades for various biomedical applications such as diagnosis, drug delivery, and imaging, among others. These treatment strategies, particularly photothermal therapy (PTT) and photodynamic therapy (PDT) [ 1 ], have emerged as promising alternatives to the traditional chemotherapeutic approaches and surgery practices, due to beneficial properties such as minimal invasiveness [ 2 , 3 , 4 ], high efficacy [ 3 , 4 ], preferential localization [ 5 , 6 ], excellent tissue penetration [ 7 , 8 , 9 , 10 ], and improved patient compliance [ 2 , 4 , 5 , 11 , 12 ]. Oftentimes these strategies are controlled by using specific sensitizers that are preferentially located at the desired site and subsequently activated in the presence of light to perform their therapeutic duties.…”

Section: Introductionmentioning

confidence: 99%

Leveraging Engineering of Indocyanine Green-Encapsulated Polymeric Nanocomposites for Biomedical Applications

et al. 2018

In recent times, photo-induced therapeutics have attracted enormous interest from researchers due to such attractive properties as preferential localization, excellent tissue penetration, high therapeutic efficacy, and minimal invasiveness, among others. Numerous photosensitizers have been considered in combination with light to realize significant progress in therapeutics. Along this line, indocyanine green (ICG), a Food and Drug Administration (FDA)-approved near-infrared (NIR, >750 nm) fluorescent dye, has been utilized in various biomedical applications such as drug delivery, imaging, and diagnosis, due to its attractive physicochemical properties, high sensitivity, and better imaging view field. However, ICG still suffers from certain limitations for its utilization as a molecular imaging probe in vivo, such as concentration-dependent aggregation, poor in vitro aqueous stability and photodegradation due to various physicochemical attributes. To overcome these limitations, much research has been dedicated to engineering numerous multifunctional polymeric composites for potential biomedical applications. In this review, we aim to discuss ICG-encapsulated polymeric nanoconstructs, which are of particular interest in various biomedical applications. First, we emphasize some attractive properties of ICG (including physicochemical characteristics, optical properties, metabolic features, and other aspects) and some of its current limitations. Next, we aim to provide a comprehensive overview highlighting recent reports on various polymeric nanoparticles that carry ICG for light-induced therapeutics with a set of examples. Finally, we summarize with perspectives highlighting the significant outcome, and current challenges of these nanocomposites.