Biologics can be life-changing treatments that deliver remarkable relief from psoriasis and psoriatic arthritis. But as anyone who takes a biologic knows, they also have one big downside: the needle.
Biologics are typically taken through an injection — often, a self-administered shot — or intravenous (IV) infusion. These needles can make biologics painful and inconvenient, and sometimes discourage patients from taking them.
But one day, those injections could be a thing of the past. A team of researchers, funded in part through the National Psoriasis Foundation, is developing a new device that will allow biologics to be applied through a skin patch. According to a March 2015 study in the peer-reviewed bioengineering journal Nano Letters, this patch, which is about one square centimeter in size, can effectively deliver a biologic drug transdermally, or through the skin.
To create the patch, researchers used an advanced technology called nanotopography, explained Dr. Jubin Ryu, who received a $75,000 National Psoriasis Foundation Discovery Grant in 2014 to help conduct the study alongside M.D./Ph.D. candidate and lead author Laura Walsh in Dr. Tejal Desai’s laboratory at the University of California, San Francisco. Nanotopography involves making miniscule features on the surface of something — in this case, tiny needles called microneedles. The size of these features are measured in nanometers, which are so small that, according to the National Nanotechnology Initiative, a single strand of hair is about 100,000 nanometers wide.
Nanotopographical features can interact with cells to change their activity, Ryu explained. The research team used nanotopography to change the activity of skin cells in a way that would allow them to absorb a biologic drug. To create the patch, they applied nanotopographical features onto the surface of microneedles – tiny needles about 350 micrometers long and 100 micrometers in diameter – used to penetrate the topmost layers of skin, he said.
(In case you’re wondering how big a micrometer is, about a thousand of them make up just one millimeter.)
Because microneedles do not reach the nerves deep in the skin, they are much less painful than needles typically used to inject drugs, Ryu said.
The researchers then tested how well these nanotopography-coated microneedles delivered Enbrel (etanercept), a biologic used to treat psoriatic disease, through the skin. They compared it to a patch made of microneedles without the topography. According to the results, the nanotopographical patch delivered approximately 35 times more Enbrel than the other patch.
Putting the two technologies together could be the key to creating a way for biologics to be applied topically, Ryu said.
“Our conclusion from the data was that you need both components. You need the microneedle component, but you also need to coat them with nanotopography in order to get the desired therapeutic effect,” Ryu said.
One reason the device can deliver a biologic drug through the skin, Ryu said, is because the nanotopographical features are able to open close spaces between cells — known as tight junctions — in the skin.
Tight junctions usually restrict the passage of molecules between skin cells, Ryu said. Opening them, he explained, may make room for drugs to pass through the skin.
Researchers are still studying the way that nanotopography affects the body, Ryu said. Chemicals, like drugs, aren’t the only thing that can change the behavior of cells, he explained.
“They’re also very much attuned to their mechanical environment,” Ryu said.
Dr. Desai’s lab is actively exploring new ways to use nanotopography to create new treatment options, he said.
“Our goal would be to make this class of medications more accessible to people with psoriasis so they could put on a painless patch, ideally, and not have to change it for a long period of time,” Ryu said. “It would offer patients something that would make it easier to take a biologic.”
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