Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Stanford, CA 94304, USA.
J Control Release. 2019 Aug 28;308:232-239. doi: 10.1016/j.jconrel.2019.07.009. Epub 2019 Jul 9.
Chronic wounds remain a significant burden to both the healthcare system and individual patients, indicating an urgent need for new interventions. Deferoxamine (DFO), an iron-chelating agent clinically used to treat iron toxicity, has been shown to reduce oxidative stress and increase hypoxia-inducible factor-1 alpha (HIF-1α) activation, thereby promoting neovascularization and enhancing regeneration in chronic wounds. However due to its short half-life and adverse side effects associated with systemic absorption, there is a pressing need for targeted DFO delivery. We recently published a preclinical proof of concept drug delivery system (TDDS) which showed that transdermally applied DFO is effective in improving chronic wound healing. Here we present an enhanced TDDS (eTDDS) comprised exclusively of FDA-compliant constituents to optimize drug release and expedite clinical translation. We evaluate the eTDDS to the original TDDS and compare this with other commonly used delivery methods including DFO drip-on and polymer spray applications. The eTDDS displayed excellent physicochemical characteristics and markedly improved DFO delivery into human skin when compared to other topical application techniques. We demonstrate an accelerated wound healing response with the eTDDS treatment resulting in significantly increased wound vascularity, dermal thickness, collagen deposition and tensile strength. Together, these findings highlight the immediate clinical potential of DFO eTDDS to treating diabetic wounds. Further, the topical drug delivery platform has important implications for targeted pharmacologic therapy of a wide range of cutaneous diseases.
慢性伤口仍然是医疗系统和患者个人的重大负担,这表明迫切需要新的干预措施。去铁胺(DFO)是一种临床上用于治疗铁毒性的铁螯合剂,已被证明可减轻氧化应激并增加缺氧诱导因子-1α(HIF-1α)的激活,从而促进慢性伤口的新生血管形成和再生。然而,由于其半衰期短且与全身吸收相关的不良反应,因此迫切需要靶向 DFO 递药。我们最近发表了一项临床前概念验证药物递送系统(TDDS),表明经皮应用 DFO 可有效改善慢性伤口愈合。在这里,我们提出了一种增强型 TDDS(eTDDS),仅由符合 FDA 要求的成分组成,以优化药物释放并加快临床转化。我们将 eTDDS 与原始 TDDS 进行了评估,并将其与其他常用的递送方法(包括 DFO 滴注和聚合物喷雾应用)进行了比较。与其他局部应用技术相比,eTDDS 显示出优异的物理化学特性,并明显改善了 DFO 向人皮肤的递送。我们证明了 eTDDS 治疗可加速伤口愈合反应,导致伤口血管生成、真皮厚度、胶原蛋白沉积和拉伸强度显著增加。这些发现共同强调了 DFO eTDDS 治疗糖尿病伤口的直接临床潜力。此外,这种局部药物递送平台对于广泛的皮肤疾病的靶向药物治疗具有重要意义。