Potential of novel drug delivery systems in the management of topical candidiasis

Abstract

High prevalence of topical fungal infections is perceived in majority of nations worldwide accounting for numerous serious systemic complications. Of several fungal infections, candidiasis is one of the widespread infections which is manifested due to localisation and proliferation of fungi. Present pharmacotherapy offers an effective treatment but possesses serious limitations like inadequate solubility, ineffectiveness in lowering diseased condition and patient incompliance. Several attempts to overcome these shortcomings and building suitable technology platforms for development of appropriate dosage forms which can enhance effectiveness, patient acceptability while maintaining safety, efficacy and affordability of drug delivery, have been made. Present review highlights on different types of fungal infections, its aetiology, pathophysiology, epidemiology and conventional formulations used. It also emphasises on applications of several novel approaches of anti-fungal drugs demonstrating advantages and limitations. Details regarding patterns of drug release and its site specificity with better patient compliance have been focussed. Etiology and pathogenesis of candidiasis should be understood clearly. Mentioned novel dosage forms should be explored to enhance therapeutic efficacy, subsequently investigating marketability and patentability. Nanoparticles seem to be a promising approach befitting all requirements.

Emerging trends in nanomedicine for topical delivery in skin disorders: Current and translational approaches

“…30 There is a list of nanocarriers for topical delivery like nanoemulsion, liposomes, niosomes, transfersomes, ethosomes, dendrimers, nanostructured lipid carriers (NLC), solid-lipid nanoparticles (SLN), polymeric nanoparticles, and carbon nanotubes that can be used. 31 Table 1 details some nanoformulations used for topical drug delivery.…”

Nanoliposome-loaded antifungal drugs for dermal administration: A review

“…Dermatophytes usually cannot penetrate deeper layers of the skin, and their infection is limited to the epidermis [4,5]. There are seven genera of dermatophytes (i.e., Trichophyton, Microsporum, Epidermophyton, Arthroderma, Nannizzia, Lophophyton, and Paraphyton) [3,4,[7][8][9][10]. Some fungal infections can spread throughout the world and affect up to 70% of the adult population [11].…”

“…Usage of liposomes, especially nanosized, as topical drug delivery systems to the skin can display various functions depending on their size, components, lamellarity, and surface charge [28]. Nanoliposomes can increase permeation through the stratum corneum [7,8,10,13,31], decrease systemic effects with their localizing actions, and overcome many obstacles of dermal drug delivery [8,26,27]. Dermal delivery means delivering drugs into a specific location within the skin to improve the local effects of drugs without systemic effects [32][33][34].…”

“…Antifungal drugs entrapped in liposomes have indicated improved skin penetration and localizing effects. This system also decreases percutaneous absorption [8,34,41], and since many liposomes consist of natural lipids and cholesterol, they do not show immunogenicity [42]. Summary of several possible mechanisms of liposome-skin interactions.…”

“… Summary of several possible mechanisms of liposome-skin interactions. A) Free drugs that release from liposomes on the surface of the skin, B) enhancers, like lecithin and other liposomes components, that enhance liposomes penetration, C) adsorption or fusion of liposomes by stratum corneum, D) penetration of intact liposomes to the skin, and E) trans appendageal penetration [ 30 , 38 ]. This figure was designed by Adobe Illustrator software (version 2020) with modification of some elements that were "Designed by macrovector- Upklyak- brgfx/Freepik" …”