Sintov Amnon C, Levy Haim V, Greenberg Igor
Department of Biomedical Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Be'er Sheva, 84105, Israel.
Laboratory for Biopharmaceutics, Ben Gurion University of the Negev, E.D. Bergmann Campus, P.O. Box 653, Be'er Sheva, 84105, Israel.
Pharm Res. 2017 Jul;34(7):1459-1468. doi: 10.1007/s11095-017-2162-y. Epub 2017 Apr 12.
When levodopa (L-DOPA) is administered orally, it is eliminated from the body very quickly resulting in a series of sharp fluctuations in its blood concentrations. These frequent changes in blood levels are considered to be responsible for the development of late motor complications and dyskinesias, which are troubling clinical and treatment issues in Parkinson's disease. Transdermal drug delivery is a patient-compliant method for delivering therapeutics into the systemic circulation in a continuous and controlled manner. Transdermal delivery of L-DOPA can achieve continuous dopaminergic stimulation (CDS), thus reducing motor fluctuations.
However, there are two technical difficulties in the development of a transdermal patch for L-DOPA: (a) L-DOPA is poorly soluble in most pharmaceutically-acceptable solvents, and (b) L-DOPA has a limited permeability through the skin even from saturated solutions. We have, therefore, investigated the transdermal delivery of L-DOPA using an innovative self-assembling nano-micellar system (SANS), loaded with 2% L-DOPA and 1% carbidopa.
In vitro testing as well as in vivo pharmacokinetic studies (multiple-dose regimen) in rabbits have demonstrated for the first time a significantly increased percutaneous permeation and systemic absorption of L-DOPA.
It has therefore been proposed that either a once-daily or a twice-daily regimen could be therapeutically effective depending on the severity of the disease.
口服左旋多巴(L-DOPA)时,它会很快从体内消除,导致其血药浓度出现一系列急剧波动。血药水平的这些频繁变化被认为是导致晚期运动并发症和异动症的原因,而这些是帕金森病中令人困扰的临床和治疗问题。经皮给药是一种患者依从性好的方法,可将治疗药物持续、可控地输送到体循环中。经皮递送L-DOPA可实现持续多巴胺能刺激(CDS),从而减少运动波动。
然而,开发L-DOPA透皮贴剂存在两个技术难题:(a)L-DOPA在大多数药学上可接受的溶剂中溶解度很差,(b)即使从饱和溶液中,L-DOPA透过皮肤的渗透性也有限。因此,我们研究了使用一种创新的自组装纳米胶束系统(SANS)经皮递送L-DOPA,该系统负载2%的L-DOPA和1%的卡比多巴。
体外测试以及兔体内药代动力学研究(多剂量方案)首次证明L-DOPA的经皮渗透和全身吸收显著增加。
因此,有人提出根据疾病的严重程度,每日一次或每日两次的给药方案可能在治疗上有效。