Thitilertdecha Premrutai, Wannawittayapa Teerapat, Buranaporn Panyapat, Rejuso-Kalbit Cyryl Rae Benjamine Santiago, Kupwiwat Rosalyn, Poungpairoj Poonsin, Tantithavorn Varangkana, Onlamoon Nattawat, Manuskiatti Woraphong
Siriraj Research Group in Immunobiology and Therapeutic Sciences, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
Drug Deliv Transl Res. 2024 Dec 24. doi: 10.1007/s13346-024-01771-y.
Ablative fractional laser-assisted drug delivery has gained attention as a promising method for enhancing dermal drug absorption and improving therapeutic outcomes in dermatological conditions, particularly for hypertrophic and keloid scars. However, despite the growing number of clinical trials and case reports supporting its efficacy, there remains a scarcity of robust evidence on the topical bioavailability and dermato-pharmacokinetics of drugs in human subjects. This study aimed to examine the enhancement of triamcinolone acetonide (TAC) bioavailability following treatment with a fractional Erbium-Doped Yttrium Aluminum Garnet (Er: YAG) laser. Stratum corneum (SC) uptake and transport of TAC from 0.1% TAC cream and 10 mg/mL TAC solution/suspension with and without the laser pre-treatment were determined through tape stripping method for SC collection. TAC therein was quantified by an ultra-performance liquid chromatography coupled with photodiode array (UPLC-PDA) detection. TAC from both formulations without laser assistance was percutaneously absorbed within 6 h and TAC was delivered out from the solution to the SC remarkably higher. When the skin was pre-treated with the laser, permeability of TAC from the solution was escalated by 5 folds. TAC distribution profiles in the SC also confirmed this increased drug uptake, mainly the outer skin layers. On the other hand, amounts of absorbed TAC and their distribution patterns from the cream remained unchanged and low. No adverse events and unbearable pain were observed throughout the experiments. The fractional Er: YAG laser enhanced the dermal absorption of TAC, but this effect was confined to the solution formulation, with no significant improvement seen in the cream. This finding highlights the critical role that drug formulation plays in laser-assisted drug delivery. Moreover, factors such as drug selection, laser type, and optimal laser settings may also impact the efficacy of this approach and require further exploration.
剥脱性分数激光辅助药物递送作为一种有前景的方法，已引起关注，该方法可增强皮肤药物吸收并改善皮肤病治疗效果，尤其是对于肥厚性瘢痕和瘢痕疙瘩。然而，尽管越来越多的临床试验和病例报告支持其疗效，但关于人体受试者中药物的局部生物利用度和皮肤药代动力学的有力证据仍然匮乏。本研究旨在研究掺铒钇铝石榴石（Er：YAG）分数激光治疗后曲安奈德（TAC）生物利用度的提高情况。通过胶带剥离法收集角质层（SC），测定了在有和没有激光预处理的情况下，0.1% TAC乳膏以及10 mg/mL TAC溶液/混悬液中TAC的SC摄取和转运情况。其中的TAC通过超高效液相色谱-光电二极管阵列（UPLC-PDA）检测进行定量。两种未用激光辅助的制剂中的TAC在6小时内均可经皮吸收，并且从溶液中递送出来的TAC明显更高。当皮肤用激光预处理时，溶液中TAC的渗透率提高了5倍。SC中的TAC分布情况也证实了药物摄取的增加，主要是皮肤外层。另一方面，乳膏中吸收的TAC量及其分布模式保持不变且较低。在整个实验过程中未观察到不良事件和难以忍受的疼痛。掺铒YAG分数激光增强了TAC的皮肤吸收，但这种效果仅限于溶液制剂，乳膏中未见明显改善。这一发现突出了药物制剂在激光辅助药物递送中所起的关键作用。此外，药物选择、激光类型和最佳激光设置等因素也可能影响该方法的疗效，需要进一步探索。
