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Atopic dermatitis (AD) is the most prevalent chronic disease that affects the skin and is featured by inflammation of the skin. Treatment of AD is entirely focused on to limit the itching, skin repairing as well as reducing the inflammation whenever required. A number of therapeutic agents are available for the treatment of AD. However, topical del...
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... and patient edu- cation. Along with this, skin care, anti-inflammatory therapy with topical calcineurin inhibitors (TCIs), corticosteroids and cure of skin infections are also recommended. Use of systemic corticos- teroids might also be employed in case of severity [3,[11][12][13][14]. A simplified treatment strategy of AD is described in Fig. 1. The avail- ability of the treatment with conventional products (like cream, ointment, lotion etc. as available in market listed in Table 1) showed several issues because of adverse effects specifically in long-term ...
Citations
... Different nanosized systems, starting with liposomes, have been developed to improve the deep absorption of drugs into the skin. Polymeric particulates, nanoparticles made of lipids, dendrimers, and dendritic-core multi-shell nano transporters are some of the carriers that have been examined [115,116]. ...
Atopic dermatitis (AD) is an inflammatory skin condition that frequently develops before the onset of allergic rhinitis or asthma. More than 10% of children are affected by this serious skin condition, which is painful for the sufferers. Recent research has connected the environment, genetics, the skin barrier, drugs, psychological factors, and the immune system to the onset and severity of AD. The causes and consequences of AD and its cellular and molecular origins are reviewed in this paper. The exploration of interleukins and their influence on the immunological pathway in AD has been facilitated by using relevant biomarkers in clinical trials. This approach enables the identification of novel therapeutic modalities, fostering the potential for targeted translational research within the realm of personalized medicine. This review focuses on AD’s pathophysiology and the ever-changing therapeutic landscape. Beyond the plethora of biologic medications in various stages of approval or development, a range of non-biologic targeted therapies, specifically small molecules, have emerged. These include Janus kinase (JAK) inhibitors like Baricitinib, Upadacitinib, and Abrocitinib, thus expanding the spectrum of therapeutic options. This review also addresses the latest clinical efficacy data and elucidates the scientific rationale behind each targeted treatment for atopic dermatitis.
... In particular, colloidal nanocarriers (nanoemulsions, nanocapsules, lipid nanoparticles, nanoemulgels, etc.) have gained much attention due to their biocompatibility, biodegradability, low toxicity, and ability to encapsulate hydrophobic active substances that are difficult to formulate, thereby increasing their bioavailability. Prolonged and controlled drug release, characteristic of colloidal nanocarriers, reduces the required amount of active substances and, consequently, eliminates potential side effects [25][26][27][28][29]. ...
Psoriasis is a chronic disorder that causes a rash with itchy, scaly patches. It affects nearly 2–5% of the worldwide population and has a negative effect on patient quality of life. A variety of therapeutic approaches, e.g., glucocorticoid topical therapy, have shown limited efficacy with systemic adverse reactions. Therefore, novel therapeutic agents and physicochemical formulations are in constant need and should be obtained and tested in terms of effectiveness and minimization of side effects. For that reason, the aim of our study was to design and obtain various hybrid systems, nanoemulgel–macroemulsion and nanoemulgel–oleogel (bigel), as vehicles for ursolic acid (UA) and to verify their potential as topical formulations used in psoriasis treatment. Obtained topical formulations were characterized by conducting morphological, rheological, texture, and stability analysis. To determine the safety and effectiveness of the prepared ursolic acid carriers, in vitro studies on human keratinocyte cell-like HaCaT cells were performed with cytotoxicity analysis for individual components and each formulation. Moreover, a kinetic study of ursolic acid release from the obtained systems was conducted. All of the studied UA-loaded systems were well tolerated by keratinocyte cells and had suitable pH values and stability over time. The obtained formulations exhibit an apparent viscosity, ensuring the appropriate time of contact with the skin, ease of spreading, soft consistency, and adherence to the skin, which was confirmed by texture tests. The release of ursolic acid from each of the formulations is followed by a slow, controlled release according to the Korsmeyer–Peppas and Higuchi models. The elaborated systems could be considered suitable vehicles to deliver triterpene to psoriatic skin.
... Topical nanocarrier-based formulations have the potential to enhance skin targeting and increase drug efficacy and decrease systemic side effects [2][3][4]. Even though nanoparticle drug delivery has been hailed as a game-changer, its potential for treating localized skin and systemic disorders has yet to be realized [12]. This article will present an exploration of pathophysiology, current ...
... Traditionally, topical delivery systems include ointments, creams, and gels in some form. Different carrier systems have been suggested to improve the penetration of drugs into the skin, facilitating their retention and, in some cases, enabling controlled release mechanisms [12,63]. Skin permeation is important for a variety of issues, including contamination by bacteria and chemicals, drug release to the skin (dermatological management), skincare, and safety (cosmetics) [62]. ...
Atopic dermatitis (AD) is a predominant and deteriorating chronic inflammation of the skin, categorized by a burning sensation and eczematous lesions in diverse portions of the body. The treatment of AD is exclusively focused to limit the itching, reduce inflammation, and repair the breached barrier of the skin. Several therapeutic agents for the treatment and management of AD have been reported and are in use in clinics. However, the topical treatment of AD has been an unswerving challenge for the medical fraternity owing to the impaired skin barrier function in this chronic skin condition. To surmount the problems of conventional drug delivery systems, numerous nanotechnology-based formulations are emerging as alternative new modalities for AD. Latter enhances the bioavailability and delivery to the target disease site, improves drug permeation and therapeutic efficacy with reduced systemic and off-target side effects, and thus improves patient health and promotes compliance. This review aims to describe the various pathophysiological events involved in the occurrence of AD, current challenges in treatment, evidence of molecular markers of AD and its management, combinatorial treatment options, and the intervention of nanotechnology-based formulations for AD therapeutics.
Graphical abstract
... Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory skin disease with a lifetime prevalence of up to 30% in children and 10% in adults and has been increasing over the past few decades worldwide [1,2]. ...
... Although the pathological process of this disease is not fully understood, it is the result of a complex interaction between skin barrier dysfunction and immune system dysregulation involving genetic, environmental, and infectious factors [2][3][4]. AD, as a very heterogeneous disease, is manifested in a wide clinical spectrum that includes different lesion morphologies and a distribution pattern that varies according to the age of the patient. In addition to skin lesions and pruritus, which are usually the most distressing symptoms, patients with AD often suffer from xerosis, skin pain, and sleep disturbances that severely impair their quality of life. ...
... Approaches to AD treatment focus on restoring the skin barrier, controlling itching, reducing inflammation, and preventing or reducing potential infections [2]. In terms of AD relapse prevention, it is important to take non-pharmacological measures, such as daily skin care, regular bathing, and avoiding contact with causative allergens [2,4]. ...
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by impaired skin barrier function. Amongst the various dermal formulations that are being used and/or investigated for AD treatment, one of the advanced approaches is the use of hydrogels as film-forming systems that are applied directly to the skin and have the added value of providing a physical barrier, which is lacking in atopic skin. Novel film-forming hydrogels based on two different nanocrystalline celluloses (NCCs) in combination with one of two natural polymers (alginate or pectin) were developed for incorporation of betamethasone dipropionate (BDP). Initially, the low water solubility of BDP was resolved by prior dissolution in a self-microemulsifying drug delivery system (SMEDDS). The mixture of Kolliphor® EL/Capryol® 90 in a ratio of 8/2 was chosen on the merit of its high BDP-saturated solubility and no BDP precipitation upon water dilution, enabling BDP to remain dissolved after incorporation into hydrogels. The solvent evaporation method was used to prepare the films, and their high water retention capacity was confirmed in vitro on artificial membranes and pig ear skin. The presented results thus confirm NCC-based film-forming hydrogels as a very promising drug delivery system for AD treatment.
... In order to increase skin bioavailability, NPs have also been advocated as a favoured solution to insufficient skin permeability and low drug solubility [97,98].Numerous types of nanoparticles, including antibiotics and corticosteroids, are being suggested for the topical drug delivery for a variety of medications helpful in treating AD [99,100]. Table 3 illustrates many nanoparticle kinds employed in topical medication delivery. ...
... Nanostructured systems are characterised by internal phase particle sizes in the range of 10-1000 nm. They have acquired significant attention because of their biocompatibility, biodegradability, low toxicity, and ability to encapsulate hydrophobic active substances which are difficult to formulate, thus increasing their bioavailability [14][15][16][17][18][19][20][21][22][23][24][25]. It has been shown that their use as a carrier makes it possible to lower the effective dose of the active substance and to maintain or even increase its biological activity [14][15][16][17][18]26,27]. ...
... They have acquired significant attention because of their biocompatibility, biodegradability, low toxicity, and ability to encapsulate hydrophobic active substances which are difficult to formulate, thus increasing their bioavailability [14][15][16][17][18][19][20][21][22][23][24][25]. It has been shown that their use as a carrier makes it possible to lower the effective dose of the active substance and to maintain or even increase its biological activity [14][15][16][17][18]26,27]. ...
The aim of this study was to develop a dressing with bioactive lavender in a new form of nanoemulsion, and to verify its biosafety and effectiveness in burn wound healing. As part of this research, the composition of the bioactive carrier of lavender oil in the form of a nanoemulsion obtained using ultrasound was optimised. The mean particle size of the internal phase and polydispersity were determined using the dynamic light scattering method using a Zestasizer NanoZS by Malvern and using cryo-transmission electron microscopy (TEM). These studies confirmed that the selected formulation had a particle size of approximately 180 nm and remained stable over time. The preparation was also subjected to rheological analysis (viscosity approximately 480 mPa·s) and a pH test (approximately 6). A macroemulsion (ME) with the same qualitative composition was developed as a reference. Nanoformulations and MEs were tested for skin penetration using Raman spectroscopy in an in vitro model. Research has shown that both formulations deliver oil to living layers of the skin. Subsequently, studies were conducted to confirm the effect of lavender oil in emulsion systems on the mitigation of the inflammatory reaction and its pro-regenerative effect on the wound healing process in an in vitro cell culture model. The safe concentration of the oil in the emulsion preparation was also determined based on preliminary in vivo tests of skin sensitisation and irritation as well as an hemocompatibility test of the preparation.
... Atopic dermatitis (AD), well known as atopic eczema, is a chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions (Akhtar et al., 2017;Zhuo et al., 2018;Weidinger et al., 2018). It is considered one of the most chronic inflammatory skin diseases worldwide that can be manifested at any time in life, but the incidence peaks in children (Akhtar et al., 2017;Weidinger et al., 2018). ...
... Atopic dermatitis (AD), well known as atopic eczema, is a chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions (Akhtar et al., 2017;Zhuo et al., 2018;Weidinger et al., 2018). It is considered one of the most chronic inflammatory skin diseases worldwide that can be manifested at any time in life, but the incidence peaks in children (Akhtar et al., 2017;Weidinger et al., 2018). It is estimated that an individual will develop AD throughout life with a probability of about 20% in developed countries (Weidinger et al., 2018;Souto et al., 2019). ...
... It seems to have a female preponderance, particularly in adolescence or adulthood (Silverberg, 2020). Although the pathological process of this disease is not fully understood, it appears to result from the complex interaction between skin barrier dysfunction and immune dysregulation, displaying underlying genetic, environmental, and infectious factors (Akhtar et al., 2017;Souto et al., 2019;Silverberg, 2020). AD is characterized to be a highly heterogeneous disorder with a wide spectrum of clinical, including several lesions morphologies, and a distribution pattern that varies according to patient age. ...
... Synthetic polymers include polylactides, PVA, poly(acrylic acid), polyacrylamide, PEG, and several others. These polymers have gained attention as a substrate for colloidal vehicles due to their blood stability, non-toxicity, non-thrombogenic, non-immunogenic, and non-inflammatory characteristics [163,164]. ...
... Its additional anti-oxidant, anti-inflammatory, and anti-microbial features make it an appropriate carrier for therapeutic delivery. Table 5 reports a compilation of polymeric nanocarriers for topical delivery of drugs, peptides, and genes [148][149][150][151][152][153][154][155][156][157][158][159][160][161][162][163][164][165]. Table 5. ...
Scientists are focusing immense attention on polymeric nanocarriers as a prominent delivery vehicle for several biomedical applications including diagnosis of diseases, delivery of therapeutic agents, peptides, proteins, genes, siRNA, and vaccines due to their exciting physicochemical characteristics which circumvent degradation of unstable drugs, reduce toxic side effects through controlled release, and improve bioavailability. Polymers-based nanocarriers offer numerous benefits for in vivo
drug delivery such as biocompatibility, biodegradability, non-immunogenicity, active drug targeting via surface modification, and controlled release due to their pH—and thermosensitive characteristics. Despite their potential for medicinal use, regulatory approval has been achieved for just a few. In this review, we discuss the historical development of polymers starting from their initial design to their evolution as nanocarriers for therapeutic delivery of drugs, peptides, and genes. The review article
also expresses the applications of polymeric nanocarriers in the pharmaceutical and medical industry with a special emphasis on oral, ocular, parenteral, and topical application of drugs, peptides, and genes over the last two decades. The review further examines the practical, regulatory, and clinical considerations of the polymeric nanocarriers, their safety issues, and directinos for future research.
... Researchers have recently indicated nanoparticles' clinical efficacy, including lipid nanoparticles, liposomes, and polymeric nanoparticles, as novel transdermal drug delivery systems in treating various skin disorders [155]. Importantly, nanoparticles seem to be a promising strategy for treating AD due to their unique properties such as controlled drug release, enhanced drug permeation into the skin, and the reduced need for multiple doses [156]. In this line, chitosan nanoparticles co-loaded with nicotinamide and tacrolimus showed an efficient permeation into the skin and synergistically enhanced the AD model's therapeutic efficacy compared to commercial tacrolimus ointment (Protopic) [157]. ...
Atopic dermatitis (AD) is a complicated, inflammatory skin disease, which numerous genetic and environmental factors play roles in its development. AD is categorized into different phenotypes and stages, although they are mostly similar in their pathophysiological aspects. Immune response alterations and structural distortions of the skin-barrier layer are evident in AD patients. Genetic makeup, lifestyle, and environment are also significantly involved in contextual factors. Genes involved in AD-susceptibility, including filaggrin and natural moisturizing, cause considerable structural modifications in the skin's lipid bilayer and cornified envelope. Additionally, the skin's decreased integrity and altered structure are accompanied by biochemical changes in the normal skin microflora’s dysbiosis. The dynamic immunological responses, genetic susceptibilities, and structural modifications associated with AD's pathophysiology will be extensively discussed in this review, each according to the latest achievements and findings.
... Especially, developing innovative nano and microparticulate drug delivery systems for treating and preventing communicable and chronic diseases. Atopic dermatitis (AD), or atopic eczema, is a chronic inflammatory skin disease 192 characterized by intense itching and recurrent eczematous lesions (1)(2)(3). It is considered one of 193 the most common skin diseases, which can be manifested at any time in life, but with a higher 194 prevalence in children (1,3). ...
... Atopic dermatitis (AD), or atopic eczema, is a chronic inflammatory skin disease 192 characterized by intense itching and recurrent eczematous lesions (1)(2)(3). It is considered one of 193 the most common skin diseases, which can be manifested at any time in life, but with a higher 194 prevalence in children (1,3). It is estimated that an individual will develop AD throughout life 195 with a probability of about 20%, particularly in developed countries (3, 4). ...
... It seems to have a 196 female preponderance, especially in adolescence or adulthood (5). Although the pathological 197 process of this disease is not fully understood, it appears to result from the complex interaction 198 between skin barrier dysfunction and immune dysregulation, displaying underlying genetic, 199 environmental, and infectious factors (1,4,5). AD is characterized to be a highly heterogeneous 200 disorder that presents several lesions morphologies, and a distribution pattern that varies 201 according to patient age. ...
Atopic dermatitis (AD) is a chronic disease that affects the skin and is characterized by
highly itchy inflammation. The current treatment consists of a multi-stage approach that
aims to establish persistent disease control towards the improvement of the quality of
life of the patients. Topical therapy is the basis of AD treatment, however, due to the
difficulty of crossing the skin barrier, topical application of drugs remains a challenge.
In fact, in addition to the low skin bioavailability, and limited accessibility to deeper skin
of the drugs − due to difficulty in penetrating the epidermis −, implemented drugs in the
clinical are associated with serious adverse effects, which are responsible for safety
and efficacy limitations, leading to a reduction in patients' compliance. Nanotechnology
arises as an emerging approach for the treatment of AD, allowing for controlled
release, targeted delivery, improved penetration, and bioavailability of drugs assets,
resulting in marked improved therapeutic efficacy and reduction of adverse effects.
Although its promising outputs, additional studies are needed to recognize the
toxicological characteristics, cost-benefit, and long-term safety of nanocarriers applied
to this end. Advanced drug delivery systems, particularly nanoemulsions, liposomes,
ethosomes, transfersomes, solid lipid nanoparticles, nanostructured lipid carriers,
nanocrystals, polymeric nanoparticles, and polymeric micelles have been used and are
thoroughly addressed in this review as promising nanoformulations for the topical
treatment of AD.
