Indian Journal of Paediatric Dermatology

CME ARTICLE
Year
: 2019  |  Volume : 20  |  Issue : 4  |  Page : 290--294

Nanotechnology in pediatric dermatology


Sandipan Dhar1, Ramkumar Rammoorthy2, Samujjala Deb3, Deepak Parikh4,  
1 Department of Pediatric Dermatology, Institute of Child Health, Kolkata, West Bengal, India
2 Department of Pediatric Dermatology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
3 Department of Dermatology, Bardhaman Medical College, Kolkata, West Bengal, India
4 Department of Pediatric Dermatology, Wadia Children Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr Sandipan Dhar
Flat 9C, Palazzo, 35, Panditia Road, Kolkata- 700 029
India

Abstract

Nanotechnology is the manipulation of material with size <100 μ. Application of nanotechnology in medicine is also known as nanomedicine. Nanotechnology has found varied applications in medicine, ranging from diagnostic devices, contrast agents, tools for analysis, and most importantly in the field of drug delivery.



How to cite this article:
Dhar S, Rammoorthy R, Deb S, Parikh D. Nanotechnology in pediatric dermatology.Indian J Paediatr Dermatol 2019;20:290-294


How to cite this URL:
Dhar S, Rammoorthy R, Deb S, Parikh D. Nanotechnology in pediatric dermatology. Indian J Paediatr Dermatol [serial online] 2019 [cited 2019 Nov 14 ];20:290-294
Available from: http://www.ijpd.in/text.asp?2019/20/4/290/268404


Full Text



 Introduction



Nanomedicine is the field of science dealing with the application of nanotechnology in medicine.[1] Nanotechnology encompasses the science behind the manipulation of particles of size <100 μ. The concepts of nanotechnology were put forward by the famed physicist Richard Feynman. The term “nano-technology” was used in the year 1974 by Norio Taniguchi. Since then, this field has expanded exponentially and has found widespread application in all aspects of life. In medicine too, nanotechnology has revolutionized the understanding and application of biological sciences.

In nanomedicine, there has been extensive interest and research for applications in newer techniques for drug delivery, diagnostic modalities, contrast agents, and analytical tools.

In pediatric dermatology too, there has been interest in applying nanotechnology to aid in the diagnosis and management of various conditions.

This review seeks to explore this nascent concept of nanotechnology in the field of dermatology, potentially pediatric dermatology.

 Types of Nanoparticles



Nanoparticles are substances measuring between 1 nm and 100 nm. They can be either organic or inorganic. They can also be further classified on the basis of their size, shape, surface, or physicochemical properties.[2]

They can also be differentiated into rigid and malleable types. Malleable nanoparticles can be made to change their shape by stress or on coming in contact with other substances.[2]

The various malleable and rigid particles are elaborated in [Table 1].{Table 1}

 Future Directions in Nanodermatology Research



Nanodermatology is being explored in a multitude of ways to evaluate its utility in various areas.[17]

Some of the avenues being explored are the field of consumer products such as sunscreens, dressings, antimicrobials and insect repellants, diagnostic equipment for real-time visualization of tumors and sentinel lymph nodes, real-time diagnosis of infections and malignancies, and minimally invasive biopsies, and lastly the most important application in the field of therapeutics such as antimicrobials, fillers, corticosteroids, vaccines, and skin treatments with optical, magnetic, thermal, and radiofrequency devices.

Thus, nanodermatology has made a foray into every conceivable aspect and thus shows a very promising future.

 Mode of Action of Nanomaterials



The absorption of substance across the skin is under the control of the epidermal barrier. Thus, it has to cross the various layers of the skin before it can be absorbed into the systemic circulation. This is a tightly controlled and highly regulated process. Sometimes, products such as cosmeceutical are not required to be absorbed into the systemic circulation but have to be able to be absorbed into the skin.[18] Some of the mechanisms that have been described for the transepidermal absorption are the transfollicular, transcellular, and intercellular pathways.[18],[19],[20]

The maximum size that can permeate through the skin is around 400 Daltons.[21] The skin by itself acts as a mechanical barrier which is porous to nano-sized particles and is traversed by a plenty of semi-circular-to-circular channels. A number of research publications have demonstrated that these pores often measure between 0.4 and 36.0 nm. Moreover, different molecules which are passively absorbed pass through these channels. It has thus been shown that nanoparticles actively participate in movement through these channels.[18],[22]

Some of the systems that are being used to transport substances in topical formulations are liposomes and noisomes, cyclodextrins, microparticles, and nanoparticles. These nanoparticles are the most promising as they have high levels of physicochemical stability along with no technological limitations and can be used in various formulations.[18],[23],[24]

Moreover, it is not just the delivery of topical formulations that have found nanoparticles to be effective. Nanoparticles (especially liposomes) are being tried in drug delivery for malignancies such as skin cancers. Thus, these nanoparticles can encapsulate the drug, enhancing drug absorption and delivery to the target site while minimizing the toxicity of the same.

 Applications in Pediatric Dermatology



Sunscreens

Nanotechnology has found wide use in the field of photoprotection. The compounds which have been developed are nanoparticle titanium dioxide and zinc oxide.[25]

The advantage of these nano-formulations is that they cause less skin whitening as compared to conventional organic sunscreen agents, thus making them more effective in absorbing or deflecting ultraviolet radiation as well as better esthetic acceptability among caregivers.

One of the concerns which has come up is the absorption of these nanoparticles if the skin barrier is damaged in any way, thus requiring further studies and evaluations till they become accepted as mainstream products.[26],[27],[28],[29],[30],[31],[32],[33],[34],[35],[36],[37]

Another concern is regarding the generation of free radicals and reactive oxygen species by these nanoparticles on exposure to ultraviolet radiation. These free radicals can damage DNA, thus causing mutations as well as irreversible cell damage.[38],[39]

Therapeutics for inflammatory disorders

This has a very promising potential in the management of one of the most common pediatric dermatologic disorders such as atopic dermatitis. In atopic dermatitis, there is an impairment of the barrier function of the skin.[2] This damaged barrier needs to be repaired with the help of emollients and creams and at the same time prevent further damage to it from the irritant effect of the topical medication.

Nanoparticles have found their way in this scenario due to the fact that nanoparticle-containing barrier creams and emollients are more effective than lipid-containing moisturizers against loss of water and also decrease the chance of developing contact dermatitis.[40]

Similarly, nanoparticle-containing corticosteroids have also found to be more beneficial than conventional preparations. They reach the target site of action easily and the chance of developing steroid-induced side effects such as atrophy are also less.[41] Similar results have also been demonstrated with liposomal delivery formulations of cyclosporine A and tacrolimus as well.[42],[43]

Antiseptics

This is another important area of nanotechnology research and development. A nanoparticle-containing formulation of chlorhexidine gluconate (Nanochlorex®) was found to have an earlier onset of antibacterial effect due to enhanced absorption along with extended duration of action due to slow and gradual liberation from the nanoparticles.[44],[45]

One of the more common and widely used antibacterial-containing nanoparticles in the recent times is nanosilver and there are plenty of products currently available in the markets.[2],[46]

Therapeutics in pilosebaceous dermatoses

The sebaceous glands open into the hair follicles. As has been previously discussed, transfollicular route is an important pathway for percutaneous absorption. Thus, it is more than natural that nanoparticles have been evaluated for the management of disorders of the pilosebaceous units.[2]

In pediatric dermatology, one of the most common complaints in the growing up years is that of or acne vulgaris. In a study done by Rolland et al., adapalene when conjugated with polymerized particles such as poly(lactic acid) and poly(lactic-co-glycolic acid), the intrafollicular drug delivery and distribution was found to be much better in comparison to conventional formulations.[47]

Other nanoparticles which have been studied for intrafollicular delivery include liposomes, solid lipid nanoparticles, and polymerized nanoparticles.

Other retinoids which have been evaluated for nanoparticle formulations include liposomal retinol and tretinoin.[48],[49]

The greatest advantage of these nano-formulations is decreased irritation due to retinoid as well as enhanced drug delivery and minimal systemic side effect.[50] Both these factors together enhance patient compliance which is of utmost importance, especially in the pediatric age group.

These advancements in acne therapy have not been limited to retinoids alone. It has been evaluated for other drugs as well such as benzoyl peroxide creams, benzoyl peroxide facewash, and antiandrogens.[51],[52],[53]

Therapeutics for scalp dermatoses

Based on the principle of enhanced absorption of nanoparticles across the intrafollicular pathway, formulations containing these have a better suitability as compared to aqueous and alcoholic solutions in the treatment of conditions such as alopecia areata and androgenetic alopecia.[2]

Encapsulation of hinokitiol, a substance commonly used in hair tonics, substantially increased the transition from telogen to anagen phase for the hair in comparison to conventional solutions for the same.[54] Similarly, Minoxidil when formulated with polyethylene glycol nanoparticles had improved permeability in the hair follicles.[55]

Novel areas for the treatment of alopecia areata are liposomal formulations of cyclosporine A and have been experimentally tried in rats.[56]

 Nanotechnology in Diagnostics



Nanoparticles have found enhanced interest in the field of diagnostics due to the fact that smaller quantities of tissue samples are required along with higher sensitivity, specificity, and rapidity of the method for detection.[2]

The two promising modalities that are currently being extensively studied are optical fiber and quantum dots.[57]

Fabrics made from optical fibers have great application in pediatric dermatology. They can be used in a number of situations such as mapping of nevi and studying the course of diseases such as atopic dermatitis.[58]

Quanta are fluorescent particles. They can be used to locate malignancies and also sentinel lymph nodes. Thus, they are being evaluated in the diagnosis of various malignancies.[59]

 Risk of Nanotechnology



Nanotechnology and nanomedicine are relatively new fields of scientific research. Thus, extensive data regarding the efficacy and safety are yet to be determined.

Since the materials being used are in the range of nanometric scale, they are prone to chemical volatility; there is a chance that there may be a possibility of tissue and cellular damage. There is still scarce data describing the environmental and biological interactions with nanoparticles. The most important concerns are regarding the life cycle of these particles in the body, the various routes of exposure, and lastly their behavior inside the human body.[60]

Furthermore, there is no data correlating the effects of these particlesin vitro(cellular and molecular) andin vivo(animal studies).[61]

A study by Crosera M et al. is one of the few studies which has attempted to establish the various physicochemical properties of these nanoparticles and their interactions in animal models.[60] However, still there is scarce data elucidating the immediate toxic effect and long-term oncogenic potential of nanoparticles in comparison to asbestos, which was proven to have a definite role in the development of mesothelioma on chronic exposure.[61],[62] It thus becomes imperative to determine the exact pharmacokinetics/pharmacodynamics, toxicities, efficacy, and lastly benefits.[63] Thus, there is still a long way to go with adequate studies before nanoparticles and nanomedicine become accepted in mainstream medicine.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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