Efficacy of Acitretin in Severe Psoriasis

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Massachusetts Institute of Technology Summary: Using ultrasound waves, engineers have found a way to enhance the permeability of skin to drugs, making transdermal drug delivery more efficient. This technology could pave the way for noninvasive drug delivery or needle-free vaccinations, according to the researchers.

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Ultrasound -- sound waves with frequencies greater than the upper limit of human hearing -- can increase skin permeability by lightly wearing away the top layer of the skin, an effect that is transient and pain-free. In a paper appearing in the Journal of Controlled Release, the research team found that applying two separate beams of ultrasound waves -- one of low frequency and one of high frequency -- can uniformly boost permeability across a region of skin more rapidly than using a single beam of ultrasound waves.

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Senior authors of the paper are Daniel Blankschtein, the Herman P. Other authors include Baris Polat, one of the lead authors and a former doctoral student in the Blankschtein and Langer groups, and Douglas Hart, a professor of mechanical engineering at MIT. Two frequencies are better than one When ultrasound waves travel through a fluid, they create tiny bubbles that move chaotically.

Once the bubbles reach a certain size, they become unstable and implode. Surrounding fluid rushes into the empty space, generating high-speed "microjets" of fluid that create microscopic abrasions on the skin.

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In this case, the fluid could be water or a liquid containing the drug to be delivered. However, those systems usually produce abrasions in scattered, random spots across the treated area. In the new study, the MIT team found that combining high and low frequencies offers better results. The high-frequency ultrasound waves generate additional bubbles, which are popped by the low-frequency waves.

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The high-frequency ultrasound waves also limit the lateral movement of the bubbles, keeping them contained in the desired treatment area and creating more uniform abrasion, Schoellhammer says. The researchers tested their new approach using pig skin and found can psoriasis be cured without medication it boosted permeability much more than a single-frequency system.

This study highlights data from two existing clinical trials to capture PASI 50 and PASI 75 responder rates which represent a common metric used in current psoriasis clinical trials. A review of pharmacokinetics, safety and a discussion of relapse rate establish acitretin as an efficacious, convenient, oral treatment for initial and maintenance therapy of severe psoriasis. Mechanism of action The efficacy of acitretin in psoriasis is mainly explained by the fact that this compound acts on a pathological epidermis to reduce proliferation and stimulate differentiation.

First, they delivered the ultrasound waves, then applied either glucose or inulin a carbohydrate to the treated skin. Glucose was absorbed 10 times better, and inulin four times better.

Efficacy of Acitretin in Severe Psoriasis

Noninvasive drug delivery Such a system could be used to deliver any type of drug that is currently given by capsule, potentially increasing the dosage that can be administered. It could also be used to deliver drugs for skin conditions such as acne or psoriasis, or to enhance the activity of transdermal patches already in use, such as nicotine patches.

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Following ultrasound treatment, improved permeability can last up to 24 hours, allowing for delivery of insulin or other drugs over an extended period of time. Such devices also hold potential for administering vaccines, according to the researchers. It has already been shown that injections into the skin can can psoriasis be cured without medication the type of immune response necessary for immunization, so vaccination by skin patch could be a needle-free, pain-free way to deliver vaccines.

Efficacy of Acitretin in Severe Psoriasis

This would be especially beneficial in developing countries, since the training required to administer such patches would be less intensive than that needed to give injections. The Blankschtein and Langer groups are now pursuing this line of research.

can psoriasis be cured without medication

They are also working on a prototype for a handheld ultrasound device, and on ways to boost skin permeability even more. Safety tests in animals would be needed before human tests can begin. The U. Food and Drug Administration has previously approved single-frequency ultrasound transdermal systems based on Langer and Blankschtein's work, so the researchers are hopeful that the improved system will also pass the safety tests.

The research was funded by the National Institutes of Health. Note: Content may be edited for style and length. Journal Reference: Carl M. Schoellhammer, Baris E. Hart, Robert Langer, Daniel Blankschtein.

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Rapid skin permeabilization by the simultaneous application of dual-frequency, high-intensity ultrasound.