Abstract
Psoriasis and atopic dermatitis are widespread pathologies with a need to improve their treatment. Topical administration of cyclosporine A (CyA) could be used if targeted to the skin, thus avoiding systemic levels. Unfortunately, CyA molecular weight and lipophilicity prevent its diffusion through human skin. Four novel lipid vesicles have been prepared by different methodologies to overcome this problem. The vesicles were characterized in terms of particle size, size polydispersity, Z-potential, morphology, drug encapsulation, phospholipid content, and vesicle flexibility. Freeze-drying in presence and absence of cryoprotective agents was also performed, to guarantee long-term stability. The ability to deliver CyA into the skin was assessed using human epidermis in Franz diffusion cells and compared with the delivery of drug solutions with enhancers. The technical characteristics of four types of vesicle make them suitable to carry drugs. Moreover, these liposomal formulations were able to effectively deliver CyA in vitro into the skin. The present work introduces a promising approach for the topical treatment of skin pathologies with an immune component.
Similar content being viewed by others
Abbreviations
- CyA:
-
Cyclosporine A
- CL:
-
Conventional liposomes
- CL-SON:
-
Sonicated conventional liposomes
- CL-EXT:
-
Extruded conventional liposomes
- Cv:
-
Concentration of drug in the donor compartment
- DLS:
-
Dynamic light scattering
- EE%:
-
Encapsulation efficiency
- Etho:
-
Ethosomes
- Etho-EXT:
-
Extruded ethosomes
- HHSE:
-
Human heat-separated epidermis
- J :
-
Flux
- J max :
-
Maximum flux
- J SS :
-
Steady-state flux
- MLV:
-
Multilamellar vesicles
- PBS:
-
Phosphate buffer solution
- PC:
-
Phosphatidylcholine
- PC%:
-
Phosphatidylcholine content
- PDI:
-
Polydispersity index
- Q :
-
Amount
- S v :
-
Solubility of the drug in the vehicle
- TEM:
-
Transmission electron microscopy
- T1:
-
Transfersomes type 1
- T1-SON:
-
Sonicated transfersomes type 1
- T1-EXT:
-
Extruded transfersomes type 1
- T2:
-
Transfersomes type 2
- T2-SON:
-
Sonicated transfersomes type 2
- T2-EXT:
-
Extruded transfersomes type 2
References
Griffiths CEM, van de Kerkhof P, Czarnecka-Operacz M. Psoriasis and atopic dermatitis. Dermatol Ther (Heidelb). 2017;7(Suppl 1):31–41.
Colombo MD, Cassano N, Bellia G, Vena GA. Cyclosporine regimens in plaque psoriasis: an overview with special emphasis on dose, duration, and old and new treatment approaches. ScientificWorldJournal [Internet]. 2013 25 [cited 2019 Feb15]; 2013. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745987/
Freeman DJ. Pharmacology and pharmacokinetics of cyclosporine. Clin Biochem. 1991;24(1):9–14.
Rosmarin DM, Lebwohl M, Elewski BE, Gottlieb AB. National Psoriasis Foundation. Cyclosporine and psoriasis: 2008 National Psoriasis Foundation Consensus Conference. J Am Acad Dermatol. 2010;62(5):838–53.
Durnian JM, Stewart RM, Tatham R, Batterbury M, Kaye SB. Cyclosporin-A associated malignancy. Clin Ophthalmol. 2007;1(4):421–30.
Amor KT, Ryan C, Menter A. The use of cyclosporine in dermatology: part I. J Am Acad Dermatol. 2010;63(6):925–46 quiz 947–8.
Lee SS, Tan AWH, Giam YC. Cyclosporin in the treatment of severe atopic dermatitis: a retrospective study. Ann Acad Med Singap. 2004;33(3):311–3.
Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85.
Ryan C, Amor KT, Menter A. The use of cyclosporine in dermatology: part II. J Am Acad Dermatol. 2010;63(6):949–72 quiz 973–4.
Lopes LB, Collett JH, Bentley MVLB. Topical delivery of cyclosporin A: an in vitro study using monoolein as a penetration enhancer. Eur J Pharm Biopharm. 2005;60(1):25–30.
van Smeden J, Janssens M, Gooris GS, Bouwstra JA. The important role of stratum corneum lipids for the cutaneous barrier function. Biochim Biophys Acta (BBA) - Mol Cell Biol Lipids. 20141;1841(3):295–313.
Choi HK, Flynn GL, Amidon GL. Percutaneous absorption and dermal delivery of cyclosporin A. J Pharm Sci. 1995;84(5):581–3.
Guo J, Ping Q, Chen Y. Pharmacokinetic behavior of cyclosporin A in rabbits by oral administration of lecithin vesicle and Sandimmun Neoral. Int J Pharm. 2001;216(1–2):17–21.
Lopes LB, Ferreira DA, de Paula D, Garcia MTJ, Thomazini JA, Fantini MCA, et al. Reverse hexagonal phase nanodispersion of monoolein and oleic acid for topical delivery of peptides: in vitro and in vivo skin penetration of cyclosporin A. Pharm Res. 2006;23(6):1332–42.
Liu H, Li S, Pan W, Wang Y, Han F, Yao H. Investigation into the potential of low-frequency ultrasound facilitated topical delivery of Cyclosporin A. Int J Pharm. 2006;326(1):32–8.
Chen M, Kumar S, Anselmo AC, Gupta V, Slee DH, Muraski JA, et al. Topical delivery of cyclosporine A into the skin using SPACE-peptide. J Control Release. 2015;199:190–7.
Maheshwari RGS, Tekade RK, Sharma PA, Darwhekar G, Tyagi A, Patel RP, et al. Ethosomes and ultradeformable liposomes for transdermal delivery of clotrimazole: a comparative assessment. Saudi Pharm J. 2012;20(2):161–70.
Mostafa M, Alaaeldin E, Aly UF, Sarhan HA. Optimization and characterization of thymoquinone-loaded liposomes with enhanced topical anti-inflammatory Activity. AAPS PharmSciTech. 2018;19(8):3490–500.
Fetterly GJ, Straubinger RM. Pharmacokinetics of paclitaxel-containing liposomes in rats. AAPS PharmSci. 2003;5(4):E32.
Harel E, Rubinstein A, Nissan A, Khazanov E, Nadler Milbauer M, Barenholz Y, et al. Enhanced transferrin receptor expression by proinflammatory cytokines in enterocytes as a means for local delivery of drugs to inflamed gut mucosa. PLoS One. 2011;6(9):e24202.
Ghanbarzadeh S, Arami S. Enhanced transdermal delivery of diclofenac sodium via conventional liposomes, ethosomes, and transfersomes. Biomed Res Int. 2013;2013:616810.
Bozzuto G, Molinari A. Liposomes as nanomedical devices. Int J Nanomedicine. 2015;10:975–99.
Kumar R, Dogra S, Amarji B, Singh B, Kumar S, Null S, et al. Efficacy of novel topical liposomal formulation of cyclosporine in mild to moderate stable plaque psoriasis: a randomized clinical trial. JAMA Dermatol. 2016;152(7):807–15.
Singh HP, Utreja P, Tiwary AK, Jain S. Elastic liposomal formulation for sustained delivery of colchicine: in vitro characterization and in vivo evaluation of anti-gout activity. AAPS J. 2009;11(1):54–64.
Abd E, Roberts MS, Grice JE. A comparison of the penetration and permeation of caffeine into and through human epidermis after application in various vesicle formulations. Skin Pharmacol Physiol. 2016;29(1):24–30.
Cevc G, Blume G. Lipid vesicles penetrate into intact skin owing to the transdermal osmotic gradients and hydration force. Biochim Biophys Acta. 1992;1104(1):226–32.
Touitou E, Dayan N, Bergelson L, Godin B, Eliaz M. Ethosomes - novel vesicular carriers for enhanced delivery: characterization and skin penetration properties. J Control Release. 2000;65(3):403–18.
Melero A, Garrigues TM, Almudever P, Villodre AMN, Lehr CM, Schäfer U. Nortriptyline hydrochloride skin absorption: development of a transdermal patch. Eur J Pharm Biopharm. 2008;69(2):588–96.
Williams AC, Barry BW. Penetration enhancers. Adv Drug Deliv Rev. 2004;56(5):603–18.
Zhang Y-T, Shen L-N, Wu Z-H, Zhao J-H, Feng N-P. Comparison of ethosomes and liposomes for skin delivery of psoralen for psoriasis therapy. Int J Pharm. 2014;471(1–2):449–52.
Danaei M, Dehghankhold M, Ataei S, Hasanzadeh Davarani F, Javanmard R, Dokhani A, et al. Impact of particle size and polydispersity index on the clinical applications of lipidic nanocarrier systems. Pharmaceutics [Internet]. 2018 18 [cited 2019 May 19];10(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027495/
Ahad A, Al-Saleh AA, Al-Mohizea AM, Al-Jenoobi FI, Raish M, Yassin AEB, et al. Formulation and characterization of Phospholipon 90 G and tween 80 based transfersomes for transdermal delivery of eprosartan mesylate. Pharm Dev Technol. 2018;23(8):787–93.
Epstein H, Gutman D, Cohen-Sela E, Haber E, Elmalak O, Koroukhov N, et al. Preparation of alendronate liposomes for enhanced stability and bioactivity: in vitro and in vivo characterization. AAPS J. 2008;10(4):505–15.
Akbarzadeh A, Rezaei-Sadabady R, Davaran S, Joo SW, Zarghami N, Hanifehpour Y, et al. Liposome: classification, preparation, and applications. Nanoscale Res Lett. 2013;8(1):102.
El Maghraby GM, Williams AC, Barry BW. Oestradiol skin delivery from ultradeformable liposomes: refinement of surfactant concentration. Int J Pharm. 2000;196(1):63–74.
Isailović BD, Kostić IT, Zvonar A, Đorđević VB, Gašperlin M, Nedović VA, et al. Resveratrol loaded liposomes produced by different techniques. Innovative Food Sci Emerg Technol. 2013;19:181–9.
Subongkot T, Wonglertnirant N, Songprakhon P, Rojanarata T, Opanasopit P, Ngawhirunpat T. Visualization of ultradeformable liposomes penetration pathways and their skin interaction by confocal laser scanning microscopy. Int J Pharm. 2013;441(1–2):151–61.
Shen L-N, Zhang Y-T, Wang Q, Xu L, Feng N-P. Enhanced in vitro and in vivo skin deposition of apigenin delivered using ethosomes. Int J Pharm. 2014;460(1–2):280–8.
Tanrıverdi ST, Özer Ö. Novel topical formulations of terbinafine-HCl for treatment of onychomycosis. Eur J Pharm Sci. 2013;48(4–5):628–36.
Sabeti B, Noordin MI, Mohd S, Hashim R, Dahlan A, Javar HA. Development and characterization of liposomal doxorubicin hydrochloride with palm oil. Biomed Res Int. 2014;2014:765426.
Baxa U. Imaging of liposomes by transmission electron microscopy. Methods Mol Biol. 1682;2018:73–88.
Dayan N, Touitou E. Carriers for skin delivery of trihexyphenidyl HCl: ethosomes vs. liposomes. Biomaterials. 2000;21(18):1879–85.
Burckart GJ, Venkataramanan R, Ptachcinski RJ, Starzl TE, Griffith BP, Hakala TR, et al. Cyclosporine pharmacokinetic profiles in liver, heart, and kidney transplant patients as determined by high-performance liquid chromatography. Transplant Proc. 1986;18(6 Suppl 5):129–36.
USP. Farmacopéicos Validation Procedures, in: United States Pharmacopeia 33. USA: Rockville; 2011. p. 802–5.
Rouser G, Fkeischer S, Yamamoto A. Two dimensional then layer chromatographic separation of polar lipids and determination of phospholipids by phosphorus analysis of spots. Lipids. 1970;5(5):494–6.
Jain S, Jain P, Umamaheshwari RB, Jain NK. Transfersomes--a novel vesicular carrier for enhanced transdermal delivery: development, characterization, and performance evaluation. Drug Dev Ind Pharm. 2003;29(9):1013–26.
Zhou W, Liu W, Zou L, Liu W, Liu C, Liang R, et al. Storage stability and skin permeation of vitamin C liposomes improved by pectin coating. Colloids Surf B: Biointerfaces. 2014;117:330–7.
Caddeo C, Díez-Sales O, Pons R, Carbone C, Ennas G, Puglisi G, et al. Cross-linked chitosan/liposome hybrid system for the intestinal delivery of quercetin. J Colloid Interface Sci. 2016;461:69–78.
Chen C, Han D, Cai C, Tang X. An overview of liposome lyophilization and its future potential. J Control Release. 2010;142(3):299–311.
Stark B, Pabst G, Prassl R. Long-term stability of sterically stabilized liposomes by freezing and freeze-drying: effects of cryoprotectants on structure. Eur J Pharm Sci. 2010;41(3–4):546–55.
Kligman AM, Christophers E. Preparation of isolated sheets of human stratum corneum. Arch Dermatol. 1963;88:702–5.
Mathes C, Melero A, Conrad P, Vogt T, Rigo L, Selzer D, et al. Nanocarriers for optimizing the balance between interfollicular permeation and follicular uptake of topically applied clobetasol to minimize adverse effects. J Control Release. 2016;223:207–14.
Sinico C, Manconi M, Peppi M, Lai F, Valenti D, Fadda AM. Liposomes as carriers for dermal delivery of tretinoin: in vitro evaluation of drug permeation and vesicle-skin interaction. J Control Release. 2005;103(1):123–36.
Melero A, Ferreira Ourique A, Stanisçuaski Guterres S, Raffin Pohlmann A, Lehr C-M, Ruver Beck RC, et al. Nanoencapsulation in lipid-core nanocapsules controls mometasone furoate skin permeability rate and its penetration to the deeper skin layers. Skin Pharmacol Physiol. 2014;27(4):217.
Ourique AF, Melero A, de Bona da Silva C, Schaefer UF, Pohlmann AR, Guterres SS, et al. Improved photostability and reduced skin permeation of tretinoin: development of a semisolid nanomedicine. Eur J Pharm Biopharm. 2011;79(1):95–101.
Zhang Q, Li P, Roberts MS. Maximum transepidermal flux for similar size phenolic compounds is enhanced by solvent uptake into the skin. J Control Release. 2011;154(1):50–7.
Hinna A, Steiniger F, Hupfeld S, Stein P, Kuntsche J, Brandl M. Filter-extruded liposomes revisited: a study into size distributions and morphologies in relation to lipid-composition and process parameters. J Liposome Res. 2016;26(1):11–20.
Castoldi A, Herr C, Niederstraßer J, Labouta HI, Melero A, Gordon S, et al. Calcifediol-loaded liposomes for local treatment of pulmonary bacterial infections. Eur J Pharm Biopharm. 2017;118:62–7.
Silva R, Ferreira H, Little C, Cavaco-Paulo A. Effect of ultrasound parameters for unilamellar liposome preparation. Ultrason Sonochem. 2010;17(3):628–32.
Chen M, Liu X, Fahr A. Skin penetration and deposition of carboxyfluorescein and temoporfin from different lipid vesicular systems: In vitro study with finite and infinite dosage application. Int J Pharm. 2011;408(1–2):223–34.
Putri DCA, Dwiastuti R, Marchaban M, Nugroho AK. Optimization of mixing temperature and sonication duration in liposome preparation. J Pharm Sci Commun. 2017;14(2):79–85.
Badran M. Formulation and in vitro evaluation of flufenamic acid loaded deformable liposomes for improved skin delivery. Digest J Nanomater Biostruct. 2014;9:83–91.
Abdulbaqi IM, Darwis Y, Assi RA, Khan NAK. Transethosomal gels as carriers for the transdermal delivery of colchicine: statistical optimization, characterization, and ex vivo evaluation. Drug Des Devel Ther. 2018;12:795–813.
Iqbal MA, Md S, Sahni KJ, Baboota S, Dang S, Ali K. Naostructured lipid carriers system: recent advances in drug delivery. J Drug Target. 2012;20(10):813–30.
Duangjit S, Opanasopit P, Rojanarata T, Ngawhirunpat T. Characterization and in vitro skin permeation of meloxicam-loaded liposomes versus transfersomes. J Drug Deliv 2011;2011:418316.
Dubey V, Mishra D, Nahar M, Jain V, Jain NK. Enhanced transdermal delivery of ananti-HIV agent via ethanolic liposomes. Nanomedicine. 2010;6(4):590–6.
Alavi M, Karimi N, Safaei M. Application of various types of liposomes in drug delivery systems. Adv Pharm Bull. 2017;7(1):3–9.
Emami S, Azadmard-Damirchi S, Peighambardoust SH, Valizadeh H, Hesari J. Liposomes as carrier vehicles for functional compounds in food sector. J Exp Nanosci. 2016;11(9):737–59.
Khale A. Lipid characterization study in preparation of liposomes of salbutamol sulphate. J Pharm Res. 2011;(4):3.
Venuri S, Yu C, DeGroot JS, Wangsatornthnakun V, Venkat-aram S. Effect of sugars on freeze-thaw and lyophilizationof liposomes. Drug Dev Ind Pharm. 1991;17:327–48.
Garvey CJ, Lenné T, Koster KL, Kent B, Bryant G. Phospholipid membrane protection by sugar molecules during dehydration—insights into molecular mechanisms using scattering techniques. Int J Mol Sci 2013;14(4):8148–8163.
Bos JD, Meinardi MM. The 500 Dalton rule for the skin penetration of chemical compounds and drugs. Exp Dermatol. 2000;9:165–9.
Dreier J, Sørensen JA, Brewer JR. Superresolution and fluorescence dynamics evidence reveal that intact liposomes do not cross the human skin barrier. PLoS One. 2016;11(1):e0146514.
Bragagni M, Mennini N, Maestrelli F, Cirri M, Mura P. Comparative study of liposomes, transfersomes and ethosomes as carriers for improving topical delivery of celecoxib. Drug Deliv. 2012;19(7):354–61.
Ascenso A, Raposo S, Batista C, Cardoso P, Mendes T, Praça FG, et al. Development, characterization, and skin delivery studies of related ultradeformable vesicles: transfersomes, ethosomes, and transethosomes. Int J Nanomedicine. 2015;10:5837–51.
Guo J, Ping Q, Sun G, Jiao C. Lecithin vesicular carriers for transdermal delivery of cyclosporin A. Int J Pharm. 2000;194(2):201–7.
Romero EL, Morilla MJ. Highly deformable and highly fluid vesicles as potential drug delivery systems: theoretical and practical considerations. Int J Nanomedicine. 2013;8:3171–86.
Jain S, Umamaheshwari RB, Bhadra D, Jain NK. Ethosomes: a novel vesicular carrier for enhanced transdermal delivery of an AntiHIV agent. Indian J Pharm Sci 2004;66(1):72.
Liu H, Li S, Wang Y, Yao H, Zhang Y. Effect of vehicles and enhancers on the topical delivery of cyclosporin A. Int J Pharm. 2006;311(1–2):182–6.
Verma DD, Fahr A. Synergistic penetration enhancement effect of ethanol and phospholipids on the topical delivery of cyclosporin A. J Control Release. 2004;97(1):55–66.
Benigni M, Pescina S, Grimaudo MA, Padula C, Santi P, Nicoli S. Development of microemulsions of suitable viscosity for cyclosporine skin delivery. Int J Pharm. 2018;545(1–2):197–205.
Aggarwal N, Goindi S. Preparation and evaluation of antifungal efficacy of griseofulvin loaded deformable membrane vesicles in optimized guinea pig model of microsporum canis--dermatophytosis. Int J Pharm. 2012;437(1–2):277–87.
Alvarez-Figueroa MJ, Abarca-Riquelme JM, González-Aramundiz JV. Influence of protamine shell on nanoemulsions as a carrier for cyclosporine—a skin delivery. Pharm Dev Technol. 2019;24(5):630–8.
Hussain A, Haque MW, Singh SK, Ahmed FJ. Optimized permeation enhancer for topical delivery of 5-fluorouracil-loaded elastic liposome using Design Expert: part II. Drug Deliv. 2016;23(4):1242–53.
Saoji SD, Atram SC, Dhore PW, Deole PS, Raut NA, Dave VS. Influence of the component excipients on the quality and functionality of a transdermal film formulation. AAPS PharmSciTech. 2015;16(6):1344–56.
Brandl M. Liposomes as drug carriers: a technological approach. Biotechnol Annu Rev. 2001;7:59–85.
Acknowledgments
The authors would like to thank Dra. Isabel Moreno, the surgery team and skin donors.
Funding
The authors would like to thank the Spanish Ministry of Economy and Competitiveness-FEDER (SAF2017-85806-R) and the Conselleria d’Educacio, Cultura i Esport of the Generalitat Valenciana “Proyecto Emergente GV2015-054”, which supported this work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The skin permeability study was approved by the Ethical Committee of the University of Valencia, under the protocol number: H1381683846659. Abdominal skin was obtained from female patients, after signed informed consent.
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 146853 kb)
Rights and permissions
About this article
Cite this article
Carreras, J.J., Tapia-Ramirez, W.E., Sala, A. et al. Ultraflexible lipid vesicles allow topical absorption of cyclosporin A. Drug Deliv. and Transl. Res. 10, 486–497 (2020). https://doi.org/10.1007/s13346-019-00693-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13346-019-00693-4