University of Bath, Department of Pharmacy and Pharmacology, Claverton Down, Bath, BA2 7AY, UK.
Expert Opin Drug Deliv. 2012 Jan;9(1):91-103. doi: 10.1517/17425247.2012.642364. Epub 2011 Dec 7.
Topical drug delivery to treat nail diseases such as onychomycosis and psoriasis is receiving increasing attention. Topical nail delivery is challenged by the complicated structure of the nail and the low permeability of most drugs across the nail plate. Considerable effort has been directed at developing methods to promote drug permeation across the nail plate. Iontophoresis efficiently enhances molecular transport across the skin and the eye and is now being tested for its potential in ungual delivery.
This review covers the basic mechanisms of transport (electro-osmosis and -migration) and their relative contribution to nail iontophoresis as well as the key factors governing nail permselectivity and ionic transport numbers. Methodological issues concerning research in this area are summarized. The data available in vivo on nail iontophoresis of terbinafine specifically are reviewed in separate sections.
Our understanding of nail iontophoresis has improved considerably since 2007; most decisively, the feasibility of nail iontophoresis in vivo has been clearly demonstrated. Future work is required to establish the adequate implementation of the technique so that its clinical efficacy to treat onychomycosis and nail psoriasis can be unequivocally determined.
局部药物递送治疗甲病（如甲真菌病和银屑病）越来越受到关注。局部甲给药受到甲的复杂结构和大多数药物穿过甲板的低渗透性的挑战。人们已经投入大量精力开发促进药物穿过甲板渗透的方法。离子电渗有效地增强了分子在皮肤和眼睛中的跨膜运输，目前正在测试其在指甲给药中的潜力。
这篇综述涵盖了基本的传输机制（电渗流和电迁移）及其对指甲离子电渗的相对贡献，以及控制指甲的选择性渗透性和离子迁移数的关键因素。总结了该领域研究中的方法学问题。专门针对特比萘芬的指甲离子电渗的体内可用数据在单独的部分进行了综述。
自 2007 年以来，我们对指甲离子电渗的理解有了很大的提高；最具决定性的是，体内指甲离子电渗的可行性已经得到了明确的证明。需要进一步的工作来确定该技术的适当实施，以便明确确定其治疗甲真菌病和甲银屑病的临床疗效。
