-
Drug and Therapeutics Bulletin Dec 2023Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to... (Review)
Review
Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6-8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.
Topics: Humans; Female; Isotretinoin; Acne Vulgaris; Benzoyl Peroxide; Anti-Bacterial Agents; Adapalene
PubMed: 38154809
DOI: 10.1136/dtb.2023.000051 -
PloS One 2023Herbicides cause oxidative stress in nontarget microorganisms, which may exhibit adaptive responses to substances they have not previously encountered. Nevertheless, it...
Bacterial adaptation to rhizosphere soil is independent of the selective pressure exerted by the herbicide saflufenacil, through the modulation of catalase and glutathione S-transferase.
Herbicides cause oxidative stress in nontarget microorganisms, which may exhibit adaptive responses to substances they have not previously encountered. Nevertheless, it is unclear whether these characteristics occur in bacteria isolated from agricultural soil. Two possible adaptation strategies of Stenotrophomonas sp. CMA26 was evaluated in agricultural soil in Brazil, which is considered stressful due to the intense use of pesticides. The study focused on degradation and antioxidant enzymes in response to the herbicide Heat, which was absent at the isolation site. The results indicated that higher concentrations of herbicide led to more intense stress conditions during the initial periods of growth. This was evidenced by elevated levels of malondialdehyde and peroxide, as well as a significant reduction in growth. Our data show that herbicide degradation is a selection-dependent process, as none of the 35 isolates from the same environment in our collection were able to degrade the herbicide. The stress was controlled by changes in the enzymatic modulation of catalase activity in response to peroxide and glutathione S-transferase activity in response to malondialdehyde, especially at higher herbicide concentrations. This modulation pattern is related to the bacterial growth phases and herbicide concentration, with a specific recovery response observed during the mid phase for higher herbicide concentrations. The metabolic systems that contributed to tolerance did not depend on the specific prior selection of saflufenacil. Instead, they were related to general stress responses, regardless of the stress-generating substance. This system may have evolved in response to reactive oxygen species, regardless of the substance that caused oxidative stress, by modulating of the activities of various antioxidant enzymes. Bacterial communities possessing these plastic tolerance mechanisms can survive without necessarily degrading herbicides. However, their presence can lead to changes in biodiversity, compromise the functionality of agricultural soils, and contribute to environmental contamination through drift.
Topics: Herbicides; Catalase; Antioxidants; Glutathione Transferase; Soil; Rhizosphere; Peroxides; Malondialdehyde; Soil Pollutants
PubMed: 37963158
DOI: 10.1371/journal.pone.0292967 -
Materials (Basel, Switzerland) Oct 2023The integrity of delaminated composite structures can be restored by introducing a thermally-based healing effect on continuous fiber-reinforced thermoplastic composites...
The integrity of delaminated composite structures can be restored by introducing a thermally-based healing effect on continuous fiber-reinforced thermoplastic composites (CFRTPC). The phenomenon of thermoplastics retaining their properties after melting and consolidation has been applied by heating the delaminated composite plates above their glass transition temperature under pressure. In the current investigation, the composite is comprised of Methyl methacrylate (MMA)-based infusible lamination resin combined with benzoyl peroxide initiator, which polymerizes into a Polymethyl methacrylate (PMMA) matrix. For the reinforcement, unidirectional 220 gr/m glass filament fabric was used. Delamination damage is artificially induced during the fabrication of laminate plates. The distributed delamination region before and after thermally activated healing was determined by using non-destructive testing with active thermography. An experimental approach is employed to characterize the thermal healing effect on mechanical properties. Experimentally determined technological parameters for thermal healing have been successfully applied to repair delamination defects on composite plates. Based on the compression-after-impact (CAI) test methodology, the intact, damaged, and healed composite laminates were loaded cyclically to evaluate the healing effect on stiffness and strength. During the CAI test, the 3D digital image correlation (DIC) technique was used to measure the displacement and deformation fields. Experimental results reveal the difference between the behavior of healed and damaged specimens. Additionally, the numerical models of intact, damaged, and healed composite laminates were developed using the finite element code LS-Dyna. Numerical models with calibrated material properties and tie-break contact constants provide good correlation with experimental results and allow for the prediction of the mechanical behavior of intact, damaged, and healed laminated plates. The comparison analysis based on CAI test results and modal characteristics obtained by the 3D Laser Doppler Vibrometer (Polytec GmbH, Karlsbad, Germany) proved that thermal healing partially restores the mechanical properties of damaged laminate plates. In contrast, active thermography does not necessarily indicate a healing effect.
PubMed: 37895746
DOI: 10.3390/ma16206764 -
Clinical, Cosmetic and Investigational... 2023Cutaneous lupus erythematosus (CLE) is a group of diseases within the spectrum of lupus that primarily manifests with skin lesions. Discoid lupus erythematosus (DLE) is...
Cutaneous lupus erythematosus (CLE) is a group of diseases within the spectrum of lupus that primarily manifests with skin lesions. Discoid lupus erythematosus (DLE) is the most common subtype of CLE. Currently, there is no specific medication available for the treatment of CLE. Here, we reported the efficacy and safety of upadacitinib, a JAK1 selective inhibitor, in treating one DLE patient for 28 weeks. Upadacitinib 15mg QD alone improved DLE lesions significantly, while reduction of the drug to 15mg QOD led to a relapse of the skin lesions. Upadacitinib showed favorable safety in this DLE patient in the 28-week period, except for acne, which was controlled by topical application of benzoyl peroxide gel. In this case, we observed rapid and sustained improvement of DLE lesions using upadacitinib with favorable safety, which provided the opportunity to use upadacitinib as an alternative therapy for DLE.
PubMed: 37841060
DOI: 10.2147/CCID.S419344 -
Dermatology and Therapy Dec 2023Rosacea is a chronic inflammatory disease with a multifactorial pathogenesis. The wide spectrum of clinical phenotypes, including erythema, telangiectasia, inflammatory... (Review)
Review
Rosacea is a chronic inflammatory disease with a multifactorial pathogenesis. The wide spectrum of clinical phenotypes, including erythema, telangiectasia, inflammatory papules and pustules, and phyma, demand an individualized approach to treatment. This narrative review offers an updated reference for rosacea management by covering the latest developments in both topical and systemic treatments, including data from newly approved therapies, updates to current treatment modalities and ongoing clinical trials. Although use of benzoyl peroxide as a treatment for rosacea has typically been limited due to irritation, the improved tolerability due to microencapsulation of benzoyl peroxide 5% cream provides a new therapeutic option for patients with rosacea. Minocycline foam and topical ivermectin cream add to our armamentarium of treatment options, particularly for inflammatory papules and pustules. Sarecycline has a narrower spectrum of antibacterial activity, which might reduce the development of antibiotic resistance and disruption of the microbiome compared to other oral antibiotics. Brimonidine gel and oxymetazoline cream provide topical options for redness and flushing. There is emerging evidence about the role of hydroxychloroquine and intradermal botulinum toxin A, which may improve rosacea through their effects on mast cells. The clinical trials pipeline includes agents with a variety of mechanisms, including mast cell stabilization, antimicrobial, anti-inflammatory, and vasoconstrictive effects. However, the clinical pipeline for rosacea appears limited, and there remain important unmet needs for patients with more recalcitrant rosacea or phymatous disease. In addition, there is a need for comparative effectiveness studies to identify the highest value treatment approaches for patients with rosacea.
PubMed: 37824060
DOI: 10.1007/s13555-023-01048-1 -
Cutis Aug 2023A range of treatment options are available for both mild to moderate and moderate to severe acne, and these options vary widely in their clinical uses, effectiveness,... (Review)
Review
A range of treatment options are available for both mild to moderate and moderate to severe acne, and these options vary widely in their clinical uses, effectiveness, and costs. With the continued rise of dermatologic drug prices and increased cost-sharing due to high-deductible health plans, the importance of cost-effective treatment continues to grow. Failure to consider cost-effective, patient-centered care may lead to increased financial toxicity, reduced adherence, and ultimately worse outcomes and patient satisfaction. Combination topical products offer improved efficacy and convenience, which are associated with better adherence and outcomes. Generic fixed-dose adapalene-benzoyl peroxide (BPO) and fixed-dose clindamycin-BPO can be highly cost-effective options for patients with mild to moderate acne. Hormonal agents such as combined oral contraceptives (COCs) and spironolactone are inexpensive and likely reflect a highly cost-effective option that could reduce reliance on oral antibiotics in patients with moderate to severe acne. Doxycycline and isotretinoin also are cost-effective options for more severe acne. Frequent laboratory monitoring for spironolactone and isotretinoin continues to be prevalent despite little evidence to support its clinical utility, and it is associated with a major cost burden to the patient and health care system. The reduction of laboratory monitoring is an opportunity to provide higher-value care.
Topics: Humans; Dermatologic Agents; Benzoyl Peroxide; Isotretinoin; Adapalene; Cost-Benefit Analysis; Spironolactone; Drug Combinations; Acne Vulgaris; Treatment Outcome; Gels
PubMed: 37820334
DOI: 10.12788/cutis.0844 -
Archives of Dermatological Research Dec 2023Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several... (Review)
Review
Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several areas, including the chemical, food, and pharmaceutical industries. Over-the-counter skin products often contain ingredients that readily and unevenly degrade upon contact with the skin. Enclosing these substances within a silica shell can enhance their stability and better regulate their delivery onto and into the skin. Silica microencapsulation uses silica as the matrix material into which ingredients can be embedded to form microcapsules. The FDA recognizes amorphous silica as a safe inorganic excipient and recently approved two new topical therapies for the treatment of rosacea and acne. The first approved formulation uses a novel silica-based controlled vehicle delivery technology to improve the stability of two active ingredients that are normally not able to be used in the same formulation due to potential instability and drug degradation. The formulation contains 3.0% benzoyl peroxide (BPO) and 0.1% tretinoin topical cream to treat acne vulgaris in adults and pediatric patients. The second formulation contains silica microencapsulated 5.0% BPO topical cream to treat inflammatory rosacea lesions in adults. Both formulations use the same amorphous silica sol-gel microencapsulation technology to improve formulation stability and skin compatibility parameters.
Topics: Adult; Humans; Child; Dermatologic Agents; Benzoyl Peroxide; Acne Vulgaris; Tretinoin; Pharmaceutical Vehicles; Rosacea; Nonprescription Drugs; Gels; Treatment Outcome; Drug Combinations
PubMed: 37792034
DOI: 10.1007/s00403-023-02725-z -
Journal of the American Academy of... Nov 2023A three-pronged acne treatment approach-combining an antibiotic, antibacterial agent, and retinoid-may provide greater efficacy than single/double treatments. Topical...
BACKGROUND
A three-pronged acne treatment approach-combining an antibiotic, antibacterial agent, and retinoid-may provide greater efficacy than single/double treatments. Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide (BPO) 3.1% gel (IDP-126) is the first fixed-dose triple-combination in development for acne.
OBJECTIVE
To confirm efficacy, safety, and tolerability of IDP-126 gel in acne treatment.
METHODS
Two phase 3, double-blind, 12-week studies randomized participants aged ≥9 years with moderate-to-severe acne (N = 183; N = 180) 2:1 to once-daily IDP-126 or vehicle gel. Co-primary endpoints comprised participants achieving ≥2-grade reduction from baseline in Evaluator's Global Severity Score (EGSS) and clear/almost clear skin (treatment success) and change from baseline in inflammatory/noninflammatory lesion counts. Treatment-emergent adverse events (TEAEs) were assessed.
RESULTS
At week 12, 49.6% and 50.5% of participants achieved treatment success with IDP-126 versus 24.9% and 20.5% with vehicle (P < .01, both). IDP-126 also provided significantly greater reductions in inflammatory/noninflammatory lesions versus vehicle (least-squares mean percent range: 72.7% to 80.1% vs 47.6% to 59.6%; P < .001, all). Most TEAEs were of mild-moderate severity.
LIMITATIONS
Inter-observer bias/variation in acne severity ratings, limited treatment duration, and population differences that may not generalize to real-world populations.
CONCLUSION
The innovative fixed-dose, triple-combination IDP-126 gel was efficacious and well tolerated in 2 clinical studies of participants with moderate-to-severe acne.
PubMed: 37656094
DOI: 10.1016/j.jaad.2022.08.069 -
Dental Materials : Official Publication... Oct 2023Novel self-healing resin-based composites containing microcapsules have been developed to improve the mechanical performance of dental restorations. However, the...
OBJECTIVE
Novel self-healing resin-based composites containing microcapsules have been developed to improve the mechanical performance of dental restorations. However, the long-term fatigue behaviour of these self-healing composites has still been hardly investigated. Therefore, this manuscript studied the fatigue behaviour of self-healing composites containing microcapsules by subjecting the specimens to traditional staircase tests and ageing in a custom-designed chewing simulator (Rub&Roll) to simulate oral ageing physiologically relevant conditions.
METHODS
To prepare self-healing composite, poly(urea-formaldehyde) microcapsules containing acrylic self-healing liquids were synthesized. Subsequently, these microcapsules (10 wt%) and initiator (benzoyl peroxide, BPO, 2 wt%) were incorporated into a commercial flowable resin-based composite. Microcapsule-free resin-based composites with and without BPO were also prepared as control specimens. A three-point flexural test was used to measure the initial flexural strength (S). Subsequently, half of the specimens were used for fatigue testing using a common staircase approach to measure the fatigue strengths (FS). In addition, the other specimens were aged in the Rub&Roll machine for four weeks where after the final flexural strength (S) was measured.
RESULTS
Compared to S, FS of all tested specimens significantly decreased as measured through staircase testing. After 4 weeks of ageing in the Rub&Roll machine, S was significantly reduced compared to S for microcapsule-free resin-based composites, but not for the self-healing composites (p = 0.3658). However, the self-healing composites are still in the experimental phase characterized by a low mechanical strength, which still impedes further clinical translation.
SIGNIFICANCE
Self-healing composites containing microcapsules exhibit improved fatigue resistance compared to microcapsule-free non-self-healing composites.
Topics: Benzoyl Peroxide; Dental Materials; Flexural Strength; Formaldehyde; Materials Testing
PubMed: 37643923
DOI: 10.1016/j.dental.2023.08.172