Treatment Modalities of Psoriasis: A Focus on Requisite for Topical Nanocarrier

Arya    K.   Ramanunny; Sheetu       Wadhwa; Divya       Thakur; Sachin    K.   Singh; Rajesh       Kumar
Abstract

Background and Objective: Psoriasis is an autoimmune skin disease involving cascading release of cytokines activated by the innate and acquired immune system. The increasing prevalence rate of psoriasis demands for more appropriate therapy. The existing chemical moiety is promising for better therapeutic outcome, but the selection of a proper channel for administration has to be reviewed. Hence there is a need to select the most appropriate dosage form and route of administration for improving the curative rate of psoriasis.
Results: A total of 108 systematic reviews of research and review articles were conducted to make the manuscript comprehensible. The role of inflammatory mediators in the pathogenesis of the disease is discussed for a better understanding of the selection of pharmacotherapy. The older and newer therapeutic moiety with its mode of administration for psoriasis treatment has been discussed. With a comparative review on topical and oral administration of first-line drugs such as methotrexate (MTX), cyclosporine (CsA), and betamethasone, its benefits-liabilities in the selected routes were accounted for. Emphasis has also been paid on advanced nanocarriers for dermatologic applications.
Conclusion: For a better therapeutic outcome, proper selection of drug moiety with its appropriate administration is the major requisite. With the advent of nanotechnology, the development of nanocarrier for dermatologic application has been successfully demonstrated in positioning the systemically administrated drug into topical targeted delivery. In a nutshell, to achieve successful treatment strategies towards psoriasis, there is a need to focus on the development of stable, non-toxic nanocarrier for topical delivery. Inclusion of the existing orally administered drug moiety into nanocarriers for topical delivery is proposed in order to enhance therapeutics payload with reduced side effects which serves as a better treatment approach for relief of the psoriasis condition.
Keywords: Skin, psoriasis, cytokines, nanocarriers, topical, route of administration.
Graphical Abstract

[1] 
Lowes, M.A.; Bowcock, A.M.; Krueger, J.G. Pathogenesis and therapy of psoriasis. Nature,  2007, 445(7130), 866-873.
[http://dx.doi.org/10.1038/nature05663] [PMID:  17314973] 
[2] 
World Health Organization. Global report on psoriasis. Available at:, http://www.apps.who.int/iris/bitstream/10665/204417/1/9789241565189_eng.pdf (Accessed October 2, 2018)
[3] 
Rapalli, V.K.; Singhvi, G.; Dubey, S.K.; Gupta, G.; Chellappan, D.K.; Dua, K. Emerging landscape in psoriasis management: From topical application to targeting biomolecules. Biomed. Pharmacother.,  2018, 106, 707-713.
[http://dx.doi.org/10.1016/j.biopha.2018.06.136] [PMID:  29990862] 
[4] 
International Federation of Psoriasis Associations. World Psoriasis Day, 2018 Available at:.https://ifpa-pso.com/our-actions/world-psoriasis-day (Accessed January 19, 2019)
[5] 
Albanesi, C.; Scarponi, C.; Giustizieri, M.L.; Girolomoni, G. Keratinocytes in inflammatory skin diseases. Curr. Drug Targets Inflamm. Allergy,  2005, 4(3), 329-334.
[http://dx.doi.org/10.2174/1568010054022033] [PMID:  16101542] 
[6] 
Lowes, M.A.; Russell, C.B.; Martin, D.A.; Towne, J.E.; Krueger, J.G. The IL-23/T17 pathogenic axis in psoriasis is amplified by keratinocyte responses. Trends Immunol.,  2013, 34(4), 174-181.
[http://dx.doi.org/10.1016/j.it.2012.11.005] [PMID:  23291100] 
[7] 
Ogawa, E.; Sato, Y.; Minagawa, A.; Okuyama, R. Pathogenesis of psoriasis and development of treatment. J. Dermatol.,  2018, 45(3), 264-272.
[http://dx.doi.org/10.1111/1346-8138.14139] [PMID:  29226422] 
[8] 
Ramanunny, A.K.; Wadhwa, S.; Singh, S.K.; Sharma, D.S.; Khursheed, R.; Awasthi, A. Treatment strategies against psoriasis: principle, perspectives and practices. Curr. Drug Deliv.,  2020, 17(1), 52-73.
[http://dx.doi.org/10.2174/1567201816666191120120551] [PMID:  31752655] 
[9] 
Fujita, H. The role of IL-22 and Th22 cells in human skin diseases. J. Dermatol. Sci.,  2013, 72(1), 3-8.
[http://dx.doi.org/10.1016/j.jdermsci.2013.04.028] [PMID:  23746568] 
[10] 
Liu, T.; Zhang, L.; Joo, D.; Sun, S.C. NF-κB signaling in inflammation. Signal Transduct. Target. Ther.,  2017, 2, 17023.
[http://dx.doi.org/10.1038/sigtrans.2017.23] [PMID:  29158945] 
[11] 
Zeng, J.; Luo, S.; Huang, Y.; Lu, Q. Critical role of environmental factors in the pathogenesis of psoriasis. J. Dermatol.,  2017, 44(8), 863-872.
[http://dx.doi.org/10.1111/1346-8138.13806] [PMID:  28349593] 
[12] 
Gelmetti, C. Therapeutic moisturizers as adjuvant therapy for psoriasis patients. Am. J. Clin. Dermatol.,  2009, 10(Suppl. 1), 7-12.
[http://dx.doi.org/10.2165/0128071-200910001-00002] [PMID:  19209948] 
[13] 
Nola, I.; Kostović, K.; Kotrulja, L.; Lugović, L. The use of emollients as sophisticated therapy in dermatology. Acta Dermatovenerol. Croat.,  2003, 11(2), 80-87.
[PMID:  12773264] 
[14] 
Fleischmann, H.E. Short-contact anthralin therapy for psoriasis. West. J. Med.,  1987, 147(4), 461.
[PMID:  18750341] 
[15] 
Loffler, H.; Effendy, I.; Happle, R. Skin susceptibility to dithranol: contact allergy or irritation? Eur. J. Dermatol.,  1999, 9(1), 32-34.
[PMID:  9920984] 
[16] 
Slutsky, J.B.; Clark, R.A.; Remedios, A.A.; Klein, P.A. An evidence-based review of the efficacy of coal tar preparations in the treatment of psoriasis and atopic dermatitis. J. Drugs Dermatol.,  2010, 9(10), 1258-1264.
[PMID:  20941951] 
[17] 
Péc, J.; Strmenová, M.; Palencárová, E.; Pullmann, R.; Funiaková, S.; Visnovský, P.; Buchanec, J.; Lazarová, Z. Salicylate intoxication after use of topical salicylic acid ointment by a patient with psoriasis. Cutis,  1992, 50(4), 307-309.
[PMID:  1424799] 
[18] 
Lee, C.S.; Koo, J. A review of acitretin, a systemic retinoid for the treatment of psoriasis. Expert Opin. Pharmacother.,  2005, 6(10), 1725-1734.
[http://dx.doi.org/10.1517/14656566.6.10.1725] [PMID:  16086658] 
[19] 
Weinstein, G.D.; Koo, J.Y.; Krueger, G.G.; Lebwohl, M.G.; Lowe, N.J.; Menter, M.A.; Lew-Kaya, D.A.; Sefton, J.; Gibson, J.R.; Walker, P.S. Tazarotene cream clinical study group. Tazarotene cream in the treatment of psoriasis: two multicenter, double-blind, randomized, vehicle-controlled studies of the safety and efficacy of tazarotene creams 0.05% and 0.1% applied once daily for 12 weeks. J. Am. Acad. Dermatol.,  2003, 48(5), 760-767.
[http://dx.doi.org/10.1067/mjd.2003.103] [PMID:  12734506] 
[20] 
Highton, A.; Quell, J. Calcipotriene study group. Calcipotriene ointment 0.005% for psoriasis: a safety and efficacy study. J. Am. Acad. Dermatol.,  1995, 32(1), 67-72.
[http://dx.doi.org/10.1016/0190-9622(95)90186-8] [PMID:  7822519] 
[21] 
Mahajan, B.B.; Singla, M. Evaluation of intralesional 5% 5-fluorouracil in resistant localized plaque psoriasis. Indian Dermatol. Online J.,  2014, 5(3), 287-290.
[http://dx.doi.org/10.4103/2229-5178.137779] [PMID:  25165645] 
[22] 
Tsuji, T.; Sugai, T. Topically administered fluorouracil in psoriasis. Arch. Dermatol.,  1972, 105(2), 208-212.
[http://dx.doi.org/10.1001/archderm.1972.01620050022003] [PMID:  5060863] 
[23] 
Olsen, E.A. Efficacy and safety of fluticasone propionate 0.005% ointment in the treatment of psoriasis. Cutis,  1996, 57(2)(Suppl.), 57-61.
[PMID:  8646872] 
[24] 
Olsen, E.A.; Cram, D.L.; Ellis, C.N.; Hickman, J.G.; Jacobson, C.; Jenkins, E.E.; Lasser, A.E.; Lebwohl, M.; Leibsohn, E.; Medansky, R.S. A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis. J. Am. Acad. Dermatol.,  1991, 24(3), 443-447.
[http://dx.doi.org/10.1016/0190-9622(91)70069-E] [PMID:  2061442] 
[25] 
Blum, G.; Yawalkar, S. A comparative, multicenter, double blind trial of 0.05% halobetasol propionate ointment and 0.1% betamethasone valerate ointment in the treatment of patients with chronic, localized plaque psoriasis. J. Am. Acad. Dermatol.,  1991, 25(6 Pt 2), 1153-1156.
[http://dx.doi.org/10.1016/0190-9622(91)70315-S] [PMID:  1757607] 
[26] 
Hengge, U.R.; Ruzicka, T.; Schwartz, R.A.; Cork, M.J. Adverse effects of topical glucocorticosteroids. J. Am. Acad. Dermatol.,  2006, 54(1), 1-15.
[http://dx.doi.org/10.1016/j.jaad.2005.01.010] [PMID:  16384751] 
[27] 
Wang, C.; Lin, A. Efficacy of topical calcineurin inhibitors in psoriasis. J. Cutan. Med. Surg.,  2014, 18(1), 8-14.
[http://dx.doi.org/10.2310/7750.2013.13059] [PMID:  24377467] 
[28] 
Matsuda, S.; Koyasu, S. Mechanisms of action of cyclosporine. Immunopharmacology,  2000, 47(2-3), 119-125.
[http://dx.doi.org/10.1016/S0162-3109(00)00192-2] [PMID:  10878286] 
[29] 
Lim, K.K.; Su, W.P.; Schroeter, A.L.; Sabers, C.J.; Abraham, R.T.; Pittelkow, M.R. Cyclosporine in the treatment of dermatologic disease: an update. Mayo Clin. Proc.,  1996, 71(12), 1182-1191.
[http://dx.doi.org/10.4065/71.12.1182] [PMID:  8945493] 
[30] 
Shen, S.; O’Brien, T.; Yap, L.M.; Prince, H.M.; McCormack, C.J. The use of methotrexate in dermatology: a review. Australas. J. Dermatol.,  2012, 53(1), 1-18.
[http://dx.doi.org/10.1111/j.1440-0960.2011.00839.x] [PMID:  22309324] 
[31] 
Torres, T.; Puig, L. Apremilast: a novel oral treatment for psoriasis and psoriatic arthritis. Am. J. Clin. Dermatol.,  2018, 19(1), 23-32.
[http://dx.doi.org/10.1007/s40257-017-0302-0] [PMID:  28597182] 
[32] 
Krueger, G.G.; Papp, K.A.; Stough, D.B.; Loven, K.H.; Gulliver, W.P.; Ellis, C.N.; Group, A.C.S. Alefacept Clinical Study Group. A randomized, double-blind, placebo-controlled phase III study evaluating efficacy and tolerability of 2 courses of alefacept in patients with chronic plaque psoriasis. J. Am. Acad. Dermatol.,  2002, 47(6), 821-833.
[http://dx.doi.org/10.1067/mjd.2002.127247] [PMID:  12451365] 
[33] 
García-Caballero, M.; Marí-Beffa, M.; Medina, M.A.; Quesada, A.R. Dimethylfumarate inhibits angiogenesis in vitro and in vivo: a possible role for its antipsoriatic effect? J. Invest. Dermatol.,  2011, 131(6), 1347-1355.
[http://dx.doi.org/10.1038/jid.2010.416] [PMID:  21289642] 
[34] 
Mrowietz, U.; Christophers, E.; Altmeyer, P. The German Fumaric Acid Ester Consensus Conference. Treatment of severe psoriasis with fumaric acid esters: scientific background and guidelines for therapeutic use. Br. J. Dermatol.,  1999, 141(3), 424-429.
[http://dx.doi.org/10.1046/j.1365-2133.1999.03034.x] [PMID:  10584060] 
[35] 
Sator, P.; Loewe, R.; Zamani, O.; Holzer, G.; Wolf, P.; Mlynek, A.; Berger, T.; Richter, L.; Schuller, E. Dimethyl fumarate is efficacious in severe plaque psoriasis: post hoc analysis from the BRIDGE trial in Austria. Wien. Klin. Wochenschr.,  2019, 131(19-20), 485-492.
[http://dx.doi.org/10.1007/s00508-019-01551-6] [PMID:  31591676] 
[36] 
Winterfield, L.S.; Menter, A.; Gordon, K.; Gottlieb, A. Psoriasis treatment: current and emerging directed therapies. Ann. Rheum. Dis.,  2005, 64(Suppl. 2), ii87-ii90.
[http://dx.doi.org/10.1136/ard.2004.032276] [PMID:  15708946] 
[37] 
Jenneck, C.; Novak, N. The safety and efficacy of alefacept in the treatment of chronic plaque psoriasis. Ther. Clin. Risk Manag.,  2007, 3(3), 411-420.
[PMID:  18488075] 
[38] 
Gottlieb, A.B. Alefacept for psoriasis and psoriatic arthritis. Ann. Rheum. Dis.,  2005, 64(Suppl. 4), iv58-iv60.
[http://dx.doi.org/10.1136/ard.2005.042655] [PMID:  16239390] 
[39] 
Srivastava, A. Itolizumab in psoriasis. Indian J. Dermatol.,  2017, 62(4), 418-421.
[http://dx.doi.org/10.4103/ijd.IJD_467_16] [PMID:  28794555] 
[40] 
Alzumab™ (Itolizumab) Solution for IV Infusion [Prescribing
Information] India: Biocon, Inc.; 2013. Available at: http://www. biocon.com/docs/prescribing_information/immunotherapy/alzumab _pi.pdf (Accessed October 30, 2019)
[41] 
US Food and Drug Administration. Efalizumab (marketed as Raptiva) information. Available at: , https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/efalizumab-marketed-raptiva-information (Accessed October 30, 2019)
[42] 
Gniadecki, R.; Bang, B.; Bryld, L.E.; Iversen, L.; Lasthein, S.; Skov, L. Comparison of long-term drug survival and safety of biologic agents in patients with psoriasis vulgaris. Br. J. Dermatol.,  2015, 172(1), 244-252.
[http://dx.doi.org/10.1111/bjd.13343] [PMID:  25132294] 
[43] 
Tyring, S.; Gordon, K.B.; Poulin, Y.; Langley, R.G.; Gottlieb, A.B.; Dunn, M.; Jahreis, A. Long-term safety and efficacy of 50 mg of etanercept twice weekly in patients with psoriasis. Arch. Dermatol.,  2007, 143(6), 719-726.
[http://dx.doi.org/10.1001/archderm.143.6.719] [PMID:  17576937] 
[44] 
Rønholt, K.; Iversen, L. Old and new biological therapies for psoriasis. Int. J. Mol. Sci.,  2017, 18(11), 2297.
[http://dx.doi.org/10.3390/ijms18112297] [PMID:  29104241] 
[45] 
CIMZIA. (certolizumab pegol) for Moderate-to-Severe Plaque Psoriasis.
   Available at: https://www.clinicaltrialsarena.com/projects/cimzia-certolizumab-pegol-treatment-moderate-severe-plaque-psoriasis/ (Accessed October 30, 2019)
[46] 
Papp, K.A.; Langley, R.G.; Sigurgeirsson, B.; Abe, M.; Baker, D.R.; Konno, P.; Haemmerle, S.; Thurston, H.J.; Papavassilis, C.; Richards, H.B. Efficacy and safety of secukinumab in the treatment of moderate-to-severe plaque psoriasis: a randomized, double-blind, placebo-controlled phase II dose-ranging study. Br. J. Dermatol.,  2013, 168(2), 412-421.
[http://dx.doi.org/10.1111/bjd.12110] [PMID:  23106107] 
[47] 
Wasilewska, A.; Winiarska, M.; Olszewska, M.; Rudnicka, L. Interleukin-17 inhibitors. A new era in the treatment of psoriasis and other skin diseases. Postepy Dermatol. Alergol.,  2016, 33(4), 247.
[http://dx.doi.org/10.5114/ada.2016.61599]] 
[48] 
Preuss, C.V.; Quick, J. Ixekizumab (Updated 2019 Sept 11). StatPearls (Internet); StatPearls Publishing: Treasure Island, FL, 2019.  Available at:
                    https://www.ncbi.nlm.nih.gov/books/NBK431088/
[49] 
Papp, K.A.; Leonardi, C.; Menter, A.; Ortonne, J.P.; Krueger, J.G.; Kricorian, G.; Aras, G.; Li, J.; Russell, C.B.; Thompson, E.H.; Baumgartner, S. Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis. N. Engl. J. Med.,  2012, 366(13), 1181-1189.
[http://dx.doi.org/10.1056/NEJMoa1109017] [PMID:  22455412] 
[50] 
McKeage, K.; Duggan, S. Risankizumab: first global approval. Drugs,  2019, 79(8), 893-900.
[http://dx.doi.org/10.1007/s40265-019-01136-7] [PMID:  31098898] 
[51] 
Skyirizi, INN - Risankizumab, European Medicines Agency https://www.ema.europa.eu/en/documents/product-information/skyrizi-epar-product-information_en.pdf (Accessed October 30, 2019)
[52] 
Frampton, J.E. Tildrakizumab: a review in moderate-to-severe plaque psoriasis. Am. J. Clin. Dermatol.,  2019, 20(2), 295-306.
[http://dx.doi.org/10.1007/s40257-019-00435-9] [PMID:  30924030] 
[53] 
Ilumya-FDA  Available at:. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/761067s000lbl.pdf (Accessed October 30, 2019)
[54] 
Janssen Announces, U.S. FDA Approval of Novel TREMFYA®
(guselkumab) One-Press Patient-controlled Injector for Adults with
Moderate-to-Severe Plaque Psoriasis 2019.https://www.jnj.com/janssen-announces-u-s-fda-approval-of-novel-tremfya-guselkumabone-press-patient-controlled-injector-for-adults-with-moderate-tosevere-plaque-psoriasis (Accessed October 30, 2019)
[55] 
Lapteva, M.; Santer, V.; Mondon, K.; Patmanidis, I.; Chiriano, G.; Scapozza, L.; Gurny, R.; Möller, M.; Kalia, Y.N. Targeted cutaneous delivery of ciclosporin A using micellar nanocarriers and the possible role of inter-cluster regions as molecular transport pathways. J. Control. Release,  2014, 196, 9-18.
[http://dx.doi.org/10.1016/j.jconrel.2014.09.021] [PMID:  25278258] 
[56] 
Pubchem. Betamethasone. Availaible at: https://pubchem.ncbi.nlm. nih.gov/compound/betamethasone (Accessed January 23, 2019)
[57] 
Gupta, R.; Gupta, S. Methotrexate-betamethasone weekly oral pulse in psoriasis. J. Dermatolog. Treat.,  2007, 18(5), 291-294.
[http://dx.doi.org/10.1080/09546630701487643] [PMID:  17852636] 
[58] 
Douglas, W.S.; Poulin, Y.; Decroix, J.; Ortonne, J.P.; Mrowietz, U.; Gulliver, W.; Krogstad, A.L.; Larsen, F.G.; Iglesias, L.; Buckley, C.; Bibby, A.J. A new calcipotriol/betamethasone formulation with rapid onset of action was superior to monotherapy with betamethasone dipropionate or calcipotriol in psoriasis vulgaris. Acta Derm. Venereol.,  2002, 82(2), 131-135.
[http://dx.doi.org/10.1080/00015550252948194] [PMID:  12125943] 
[59] 
Paul, C.; Stein Gold, L.; Cambazard, F.; Kalb, R.E.; Lowson, D.; Bang, B.; Griffiths, C.E.M. Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO-ABLE study. J. Eur. Acad. Dermatol. Venereol.,  2017, 31(1), 119-126.
[http://dx.doi.org/10.1111/jdv.13859] [PMID:  27531752] 
[60] 
Warren, R.B.; Griffiths, C.E. Systemic therapies for psoriasis: methotrexate, retinoids, and cyclosporine. Clin. Dermatol.,  2008, 26(5), 438-447.
[http://dx.doi.org/10.1016/j.clindermatol.2007.11.006] [PMID:  18755362] 
[61] 
Johnston, A.; Gudjonsson, J.E.; Sigmundsdottir, H.; Ludviksson, B.R.; Valdimarsson, H. The anti-inflammatory action of methotrexate is not mediated by lymphocyte apoptosis, but by the suppression of activation and adhesion molecules. Clin. Immunol.,  2005, 114(2), 154-163.
[http://dx.doi.org/10.1016/j.clim.2004.09.001] [PMID:  15639649] 
[62] 
Thomas, J.A.; Aithal, G.P. Monitoring liver function during methotrexate therapy for psoriasis: are routine biopsies really necessary? Am. J. Clin. Dermatol.,  2005, 6(6), 357-363.
[http://dx.doi.org/10.2165/00128071-200506060-00003] [PMID:  16343024] 
[63] 
Asawanonda, P.; Nateetongrungsak, Y. Methotrexate plus narrowband UVB phototherapy versus narrowband UVB phototherapy alone in the treatment of plaque-type psoriasis: a randomized, placebo-controlled study. J. Am. Acad. Dermatol.,  2006, 54(6), 1013-1018.
[http://dx.doi.org/10.1016/j.jaad.2006.01.004] [PMID:  16713455] 
[64] 
Panonnummal, R.; Jayakumar, R.; Anjaneyan, G.; Sabitha, M. In vivo anti-psoriatic activity, biodistribution, sub-acute and sub-chronic toxicity studies of orally administered methotrexate loaded chitin nanogel in comparison with methotrexate tablet. Int. J. Biol. Macromol.,  2018, 110, 259-268.
[http://dx.doi.org/10.1016/j.ijbiomac.2018.01.036] [PMID:  29355632] 
[65] 
Pinto, M.F.; Moura, C.C.; Nunes, C.; Segundo, M.A.; Costa Lima, S.A.; Reis, S. A new topical formulation for psoriasis: development of methotrexate-loaded nanostructured lipid carriers. Int. J. Pharm.,  2014, 477(1-2), 519-526.
[http://dx.doi.org/10.1016/j.ijpharm.2014.10.067] [PMID:  25445970] 
[66] 
Tripathi, P.; Kumar, A.; Jain, P.K.; Patel, J.R. Carbomer gel bearing methotrexate loaded lipid nanocontainers shows improved topical delivery intended for effective management of psoriasis. Int. J. Biol.Macromol., 2018, 120(Pt A), 1322-1334.
                    , 
[http://dx.doi.org/10.1016/j.ijbiomac.2018.08.136 ] [PMID: 30171962] 
[67] 
Panonnummal, R.; Sabitha, M. Anti-psoriatic and toxicity evaluation of methotrexate loaded chitin nanogel in imiquimod induced mice model. Int. J. Biol. Macromol.,  2018, 110, 245-258.
[http://dx.doi.org/10.1016/j.ijbiomac.2017.10.112] [PMID:  29054520] 
[68] 
Laburte, C.; Grossman, R.; Abi-Rached, J.; Abeywickrama, K.H.; Dubertret, L. Efficacy and safety of oral cyclosporin A (CyA; Sandimmun) for long-term treatment of chronic severe plaque psoriasis. Br. J. Dermatol.,  1994, 130(3), 366-375.
[http://dx.doi.org/10.1111/j.1365-2133.1994.tb02935.x] [PMID:  8148280] 
[69] 
Calzavara-Pinton, P.; Leone, G.; Venturini, M.; Sala, R.; Colombo, D.; La Parola, I.L.; Sitzia, N.; Ferraro, C.; Picardo, M. A comparative non randomized study of narrow-band (NB) (312 +/- 2 nm) UVB phototherapy versus sequential therapy with oral administration of low-dose Cyclosporin A and NB-UVB phototherapy in patients with severe psoriasis vulgaris. Eur. J. Dermatol.,  2005, 15(6), 470-473.
[PMID:  16280301] 
[70] 
Liu, H.; Li, S.; Wang, Y.; Yao, H.; Zhang, Y. Effect of vehicles and enhancers on the topical delivery of cyclosporin A. Int. J. Pharm.,  2006, 311(1-2), 182-186.
[http://dx.doi.org/10.1016/j.ijpharm.2005.12.029] [PMID:  16439077] 
[71] 
Jeong, H.R.; Kim, J.Y.; Kim, S.N.; Park, J.H. Local dermal delivery of cyclosporin A, a hydrophobic and high molecular weight drug, using dissolving microneedles. Eur. J. Pharm. Biopharm.,  2018, 127, 237-243.
[http://dx.doi.org/10.1016/j.ejpb.2018.02.014] [PMID:  29432892] 
[72] 
Paul, C.; Bang, B.; Lebwohl, M. Fixed combination calcipotriol plus betamethasone dipropionate aerosol foam in the treatment of psoriasis vulgaris: rationale for development and clinical profile. Expert Opin. Pharmacother.,  2017, 18(1), 115-121.
[http://dx.doi.org/10.1080/14656566.2016.1269749] [PMID:  27936972] 
[73] 
Stein Gold, L.; Bagel, J.; Allenby, K.; Sidgiddi, S. Betamethasone
dipropionate spray 0.05% alleviates troublesome symptoms of
plaque psoriasis. Cutis, 2020, 105(2), 97-102, E1. 
[PMID: 32186532] 
[74] 
Queille-Roussel, C.; Nielsen, J.; Lacour, J.P. Vasoconstrictor potency of fixed-dose combination calcipotriol (50 μg/g) and betamethasone dipropionate (0.5 mg/g) cutaneous foam versus other topical corticosteroids used to treat psoriasis vulgaris. J. Dermatolog. Treat.,  2019, 30(6), 529-533.
[http://dx.doi.org/10.1080/09546634.2018.1529385] [PMID:  30582717] 
[75] 
Abidi, A.; Rizvi, D.A.; Saxena, K.; Chaudhary, S.; Ahmad, A. The evaluation of efficacy and safety of methotrexate and pioglitazone in psoriasis patients: a randomized, open-labeled, active-controlled clinical trial. Indian J. Pharmacol.,  2020, 52(1), 16-22.
[http://dx.doi.org/10.4103/ijp.IJP_88_19] [PMID:  32201442] 
[76] 
Warren, R.B.; Mrowietz, U.; von Kiedrowski, R.; Niesmann, J.; Wilsmann-Theis, D.; Ghoreschi, K.; Zschocke, I.; Falk, T.M.; Blödorn-Schlicht, N.; Reich, K. An intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe plaque-type psoriasis (METOP): a 52 week, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet,  2017, 389(10068), 528-537.
[http://dx.doi.org/10.1016/S0140-6736(16)32127-4] [PMID:  28012564] 
[77] 
Ergun, T.; Seckin Gencosmanoglu, D.; Alpsoy, E.; Bulbul-Baskan, E.; Saricam, M.H.; Salman, A.; Onsun, N.; Sarioz, A. Efficacy, safety and drug survival of conventional agents in pediatric psoriasis: A multicenter, cohort study. J. Dermatol.,  2017, 44(6), 630-634.
[http://dx.doi.org/10.1111/1346-8138.13713] [PMID:  27943425] 
[78] 
Choi, E.; Cook, A.; Phuan, C.; Martin, A.; Yang, S.; Aw, D.; Chandran, N.S. Outcomes of prolonged and low-dose ciclosporin in an Asian population. J. Dermatolog. Treat.,  2019, 1-6.
[http://dx.doi.org/10.1080/09546634.2019.1662881] [PMID:  31469020] 
[79] 
Pradhan, M.; Singh, D.; Singh, M.R. Fabrication, optimization, and characterization of Triamcinolone acetonide loaded nanostructured lipid carriers for topical treatment of psoriasis: Application of Box Behnken design, in vitro and ex vivo studies. J. Drug Deliv. Sci. Technol.,  2017, 41, 325-333.
[http://dx.doi.org/10.1016/j.jddst.2017.07.024] 
[80] 
Ali, M.F.; Salah, M.; Rafea, M.; Saleh, N. Liposomal methotrexate hydrogel for treatment of localized psoriasis: preparation, characterization and laser targeting. Med. Sci. Monit.,  2008, 14(12), PI66-PI74.
[PMID:  19043379] 
[81] 
Nagle, A.; Goyal, A.K.; Kesarla, R.; Murthy, R.R. Efficacy study of vesicular gel containing methotrexate and menthol combination on parakeratotic rat skin model. J. Liposome Res.,  2011, 21(2), 134-140.
[http://dx.doi.org/10.3109/08982104.2010.492476] [PMID:  20557280] 
[82] 
Lakshmi, P.K.; Devi, G.S.; Bhaskaran, S.; Sacchidanand, S. Niosomal methotrexate gel in the treatment of localized psoriasis: phase I and phase II studies. Indian J. Dermatol. Venereol. Leprol.,  2007, 73(3), 157-161.
[http://dx.doi.org/10.4103/0378-6323.32709] [PMID:  17558046] 
[83] 
Ferreira, M.; Barreiros, L.; Segundo, M.A.; Torres, T.; Selores, M.; Costa Lima, S.A.; Reis, S. Topical co-delivery of methotrexate and etanercept using lipid nanoparticles: A targeted approach for psoriasis management. Colloids Surf. B Biointerfaces,  2017, 159, 23-29.
[http://dx.doi.org/10.1016/j.colsurfb.2017.07.080] [PMID:  28779637] 
[84] 
Benigni, M.; Pescina, S.; Grimaudo, M.A.; Padula, C.; Santi, P.; Nicoli, S. Development of microemulsions of suitable viscosity for cyclosporine skin delivery. Int. J. Pharm.,  2018, 545(1-2), 197-205.
[http://dx.doi.org/10.1016/j.ijpharm.2018.04.049] [PMID:  29698819] 
[85] 
Alam, M.S.; Ali, M.S.; Alam, N.; Alam, M.I.; Anwer, T.; Imam, F.; Shamim, M. Design and characterization of nanostructure topical gel of betamethasone dipropionate for psoriasis. J. Appl. Pharm. Sci.,  2012, 2(10), 148.
[86] 
Baboota, S.; Alam, M.S.; Sharma, S.; Sahni, J.K.; Kumar, A.; Ali, J. Nanocarrier-based hydrogel of betamethasone dipropionate and salicylic acid for treatment of psoriasis. Int. J. Pharm. Investig.,  2011, 1(3), 139-147.
[http://dx.doi.org/10.4103/2230-973X.85963] [PMID:  23071936] 
[87] 
Hanna, P.A.; Ghorab, M.M.; Gad, S. Development of betamethasone dipropionate-loaded nanostructured lipid carriers for topical and transdermal delivery. Antiinflamm. Antiallergy Agents Med. Chem.,  2019, 18(1), 26-44.
[http://dx.doi.org/10.2174/1871523017666181115104159] [PMID:  30430947] 
[88] 
Ferreira, H.; Gonçalves, V.M.F.; Silva, R.; Tiritan, M.E.; Teixeira, M. Development of Liposomes-in-Hydrogel Formulations Containing Betametha-sone for Topical Therapy. J. Pharmacol. Pharmaceut. Pharmacovigil.,  2017, 1(003)
[http://dx.doi.org/10.24966/PPP-5649/100005] 
[89] 
Mirtič, J.; Papathanasiou, F.; Temova Rakuša, Ž. GosencaMatjaž, M.; Roškar, R.; Kristl, J. Development of medicated foams that combine incompatible hydrophilic and lipophilic drugs for psoriasis treatment. Int. J. Pharm.,  2017, 524(1-2), 65-76.
[http://dx.doi.org/10.1016/j.ijpharm.2017.03.061] [PMID:  28359820] 
[90] 
Gabriel, D.; Mugnier, T.; Courthion, H.; Kranidioti, K.; Karagianni, N.; Denis, M.C.; Lapteva, M.; Kalia, Y.; Möller, M.; Gurny, R. Improved topical delivery of tacrolimus: A novel composite hydrogel formulation for the treatment of psoriasis. J. Control. Release,  2016, 242, 16-24.
[http://dx.doi.org/10.1016/j.jconrel.2016.09.007] [PMID:  27639683] 
[91] 
Wan, T.; Pan, J.; Long, Y.; Yu, K.; Wang, Y.; Pan, W.; Ruan, W.; Qin, M.; Wu, C.; Xu, Y. Dual roles of TPGS based microemulsion for tacrolimus: enhancing the percutaneous delivery and anti-psoriatic efficacy. Int. J. Pharm.,  2017, 528(1-2), 511-523.
[http://dx.doi.org/10.1016/j.ijpharm.2017.06.050] [PMID:  28629978] 
[92] 
Jain, A.; Doppalapudi, S.; Domb, A.J.; Khan, W. Tacrolimus and curcumin co-loaded liposphere gel: synergistic combination towards management of psoriasis. J. Control. Release,  2016, 243, 132-145.
[http://dx.doi.org/10.1016/j.jconrel.2016.10.004] [PMID:  27725194] 
[93] 
Viegas, J.S.R.; Praça, F.G.; Caron, A.L.; Suzuki, I.; Silvestrini, A.V.P.; Medina, W.S.G.; Del Ciampo, J.O.; Kravicz, M.; Bentley, M.V.L.B. Nanostructured lipid carrier co-delivering tacrolimus and TNF-α siRNA as an innovate approach to psoriasis. Drug Deliv. Transl. Res.,  2020, 1-15.
[http://dx.doi.org/10.1007/s13346-020-00723-6] [PMID:  32060883] 
[94] 
Pund, S.; Pawar, S.; Gangurde, S.; Divate, D. Transcutaneous delivery of leflunomide nanoemulgel: mechanistic investigation into physicomechanical characteristics, in vitro anti-psoriatic and anti-melanoma activity. Int. J. Pharm.,  2015, 487(1-2), 148-156.
[http://dx.doi.org/10.1016/j.ijpharm.2015.04.015] [PMID:  25869452] 
[95] 
Barradas, T.N.; Senna, J.P.; Cardoso, S.A.; de Holanda, E. Silva, K.G.; Elias Mansur, C.R. Formulation characterization and in vitro drug release of hydrogel-thickened nanoemulsions for topical delivery of 8-methoxypsoralen. Mater. Sci. Eng. C,  2018, 92, 245-253.
[http://dx.doi.org/10.1016/j.msec.2018.06.049] [PMID:  30184748] 
[96] 
Kassem, A.A.; Abd El-Alim, S.H.; Asfour, M.H. Enhancement of 8-methoxypsoralen topical delivery via nanosized niosomal vesicles: formulation development, in vitro and in vivo evaluation of skin deposition. Int. J. Pharm.,  2017, 517(1-2), 256-268.
[http://dx.doi.org/10.1016/j.ijpharm.2016.12.018] [PMID:  27956194] 
[97] 
Moghddam, S.R.M.; Ahad, A.; Aqil, M.; Imam, S.S.; Sultana, Y. Formulation and optimization of niosomes for topical diacerein delivery using 3-factor, 3-level Box-Behnken design for the management of psoriasis. Mater. Sci. Eng. C,  2016, 69, 789-797.
[http://dx.doi.org/10.1016/j.msec.2016.07.043] [PMID:  27612773] 
[98] 
Prasad, V.; Chaurasia, S. Performance evaluation of non-ionic surfactant based tazarotene encapsulated proniosomal gel for the treatment of psoriasis. Mater. Sci. Eng. C,  2017, 79, 168-176.
[http://dx.doi.org/10.1016/j.msec.2017.05.036] [PMID:  28629004] 
[99] 
Ramezanli, T.; Kilfoyle, B.E.; Zhang, Z.; Michniak-Kohn, B.B. Polymeric nanospheres for topical delivery of vitamin D3. Int. J. Pharm.,  2017, 516(1-2), 196-203.
[http://dx.doi.org/10.1016/j.ijpharm.2016.10.072] [PMID:  27810351] 
[100] 
Abu Hashim, I.I.; Abo El-Magd, N.F.; El-Sheakh, A.R.; Hamed, M.F.; Abd El-Gawad, A.E.H. Pivotal role of Acitretin nanovesicular gel for effective treatment of psoriasis: ex vivo-in vivo evaluation study. Int. J. Nanomedicine,  2018, 13, 1059-1079.
[http://dx.doi.org/10.2147/IJN.S156412] [PMID:  29503541] 
[101] 
Divya, G.; Panonnummal, R.; Gupta, S.; Jayakumar, R.; Sabitha, M. Acitretin and aloe-emodin loaded chitin nanogel for the treatment of psoriasis. Eur. J. Pharm. Biopharm.,  2016, 107, 97-109.
[http://dx.doi.org/10.1016/j.ejpb.2016.06.019] [PMID:  27368748] 
[102] 
Sathe, P.; Saka, R.; Kommineni, N.; Raza, K.; Khan, W. Dithranol-loaded nanostructured lipid carrier-based gel ameliorate psoriasis in imiquimod-induced mice psoriatic plaque model. Drug Dev. Ind. Pharm.,  2019, 45(5), 826-838.
[http://dx.doi.org/10.1080/03639045.2019.1576722] [PMID:  30764674] 
[103] 
Bahramizadeh, M.; Bahramizadeh, M.; Kiafar, B.; Jafarian, A.H.; Nikpoor, A.R.; Hatamipour, M.; Esmaily, H.; Rezaeemehr, Z.; Golmohammadzadeh, S.; Moosavian, S.A.; Jafari, M.R. Development, characterization and evaluation of topical methotrexate-entrapped deformable liposome on imiquimod-induced psoriasis in a mouse model. Int. J. Pharm.,  2019, 569118623
[http://dx.doi.org/10.1016/j.ijpharm.2019.118623] [PMID:  31419462] 
[104] 
Fratoddi, I.; Benassi, L.; Botti, E.; Vaschieri, C.; Venditti, I.; Bessar, H.; Samir, M.A.; Azzoni, P.; Magnoni, C.; Costanzo, A.; Casagrande, V.; Federici, M.; Bianchi, L.; Pellacani, G. Effects of topical methotrexate loaded gold nanoparticle in cutaneous inflammatory mouse model. Nanomedicine (Lond.),  2019, 17, 276-286.
[http://dx.doi.org/10.1016/j.nano.2019.01.006] [PMID:  30708054] 
[105] 
El-Gizaway, S.A.N.A.A.; Fadel, M.; Mourad, B.; Elnaby, F.E.Z.A. Betamethasone dipropionate gel for treatment of localized plaque psoriasis. Int. J. Pharm. Pharm. Sci.,  2017, 9, 173-182.
[http://dx.doi.org/10.22159/ijpps.2017v9i8.18571] 
[106] 
Walunj, M.; Doppalapudi, S.; Bulbake, U.; Khan, W. Preparation, characterization, and in vivo evaluation of cyclosporine cationic liposomes for the treatment of psoriasis. J. Liposome Res.,  2020, 30(1), 68-79.
[http://dx.doi.org/10.1080/08982104.2019.1593449] [PMID:  30897993] 
[107] 
Carreras, J.J.; Tapia-Ramirez, W.E.; Sala, A.; Guillot, A.J.; Garrigues, T.M.; Melero, A. Ultraflexible lipid vesicles allow topical absorption of cyclosporin A. Drug Deliv. Transl. Res.,  2019, 1-12.
[PMID:  31811620] 
[108] 
Essaghraoui, A.; Belfkira, A.; Hamdaoui, B.; Nunes, C.; Lima, S.A.C.; Reis, S. Improved dermal delivery of cyclosporine A Loaded in solid lipid nanoparticles. Nanomaterials (Basel),  2019, 9(9), 1204.
[http://dx.doi.org/10.3390/nano9091204] [PMID:  31461853] 
Cite As
Endocrine, Metabolic & Immune Disorders - Drug Targets

Treatment Modalities of Psoriasis: A Focus on Requisite for Topical Nanocarrier

Abstract

Graphical Abstract
