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Physiological influences on drug transport across human stratum corneum in vivo
( Jui Chen Tsai ),( Hamm Ming Sheu ),( Ming Kai Lin ) 한국피부장벽학회 2008 한국피부장벽학회지 Vol.10 No.2
This paper discusses the influences of physiological factors including anatomical sites and sebum secretion on drug transport across human stratum corneum (SC) in vivo by utilizing noninvasive, quantitative attenuated-total-reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) technology. 4-Cyanophenol (CP) and cimetidine (CM) were selected as two model compounds of different lipophilicity and molecular size. To investigate regional variation, saturated solutions of CP and CM were applied to the skin surface of Chinese males, at five anatomical sites, including forearm, back, thigh, leg, and abdomen, followed by sequential tape-stripping of SC. The drug concentration profiles in the tape-stripped SC were determined using ATR-FTIR spectroscopy. Thickness of the SC was estimated simultaneously using two-point measurements of transepidermal water loss before and after completion of tape stripping. Estimation of partition, diffusion and permeability coefficients was achieved by analysis of the data using the unsteady-state diffusion equation. The results demonstrated the rank order of regional variation in permeability coefficients was similar for both drugs and decreased in the order of back > forearm > thigh > leg ≥ abdomen, but the variation was more prominent for CM. Regional variation in SC transport of CP was mainly influenced by its intrinsic diffusivity across the SC, whereas variation in transport of CM could be attributed to both thermodynamic and kinetic differences among different anatomical skin sites. Similar methodology was applied to study the effects of sebum on SC drug transport. We found that sebum supplement increased the SC permeability of CM at the forearm for more than three fold, but not that of CP. The increase in SC permeability of CM was mainly attributed to the enhanced SC diffusivity. Sebum removal at the forehead has small, but significant effect on the SC permeability of CM. SC permeability of CM was linearly correlated to the frequency shift of CH2 asymmetric/symmetric stretching in the ATR-FTIR spectra of the SC due to sebum treatment. Sebum treatment increased the SC permeability of relatively hydrophilic drug and altered the barrier function of stratum corneum by disordering structures of the intercellular lipid molecules.
( Chao Chun Yang ),( Chun Te Lee ),( Chao Kai Hsu ),( Yi Pei Lee ),( Tak Wah Wong ),( Sheau Chiou Chao ),( Julia Yu Yun Lee ),( Hamm Ming Sheu ),( Wenchieh Chen ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.4
Background: Spontaneous recovery of severe alopecia areata is rare and the condition is difficult to treat. Objective: The aim of this study is to investigate and compare the effects and safety of steroid pulse therapy between oral and intravenous administrations between 1999 and 2010 at the Department of Dermatology, National Cheng Kung University Hospital. Methods: Data were retrospectively retrieved. A satisfactory response was defined as more than 75% hair regrowth in the balding area. Results: A total of 85 patients with more than 50% hair loss were identified and treated, with an overall satisfactory response rate of 51.8%. The mean follow-up time was 37.6 months, with a relapse rate of 22.7%. Patients with alopecia areata (hereafter, AA) of recent onset within one year showed higher response rates (p< 0.001) and lower relapse rates compared to patients with AA persisting for more than 1 year. Further, even in patients with alopecia totalis, alopecia universalis or ophiasis type, early treatment resulted in a satisfactory response rate of 47% among the treated patients. In general, oral therapy was as effective and well-tolerated as intravenous therapy. Conclusion: The response rate is determined by disease severity and time of intervention, not by the administration form of steroid pulse therapy. Oral steroid pulse therapy can be considered as the first-line treatment for patients with severe AA of recent onset within one year. (Ann Dermatol 25(4) 471∼474, 2013)