纳米医学在局部感染性和非感染性皮肤病治疗中的应用前景。

Q3 Medicine
Mahfoozur Rahman, S. Beg
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Although, the defensive properties of skin like acidic pH and significant antibacterial activity exhibited by its constituent components like Lauric acid and palmitoleic acid encompass the anti-infective mechanism against topical infections [4], however, in certain conditions like burns, wounds and diabetes mellitus, skin loses its defense mechanism with the entry of pathogens followed by the development of infection. Further, its barrier nature presents an arduous impediment for most drugs to be delivered into and through it owing to the prevailing patho-physiological conditions [5]. Besides, the drug’s intrinsic physico-chemical characteristics viz. pKa, molecular size, stability, binding affinity, solubility and partition coefficient remain unfavorable for drug delivery across the skin barrier [6-8]. Human beings are the natural hosts for many bacterial pathogens that colonize the skin as normal flora. Staphylococcus aureus and Streptococcus pyogenes account for a wide variety of bacterial infections. A wide variety of bacterial infections affect the normal physiology of skin including cellulitis, folliculitis, impetigo, carbuncle and furuncle. The predisposing factors to infection include minor trauma, pre-existing skin disease, poor hygiene, and rarely, impaired host immunity. Cellulitis is a superficial bacterial infection of the lower dermis and upper subcutaneous tissue frequently affecting the legs. The major causative organism of cellulitis is Group A beta-hemolytic Staphylococcus aureus along with other microbes like Pseudomonas aeruginosa, Escherichia coli and Klebsiella species [9]. Impetigo is a superficial cutaneous infection resulting from the direct invasion of healthy tissues, or occurs secondarily to an underlying skin disease especially around nose, mouth and wounds. It occurs in patients already exposed to eczema and diabetes caused mainly by Staphylococcus aureus and Staphylococcus pyogens [10]. Folliculitis is a cutaneous infection of the hair follicles such as the scalp, neck, beard area, axillae, buttocks and limbs characterized by follicular-based pustules. Carbuncles show inflamed skin and pus drainage from hair follicles [10]. The treatment strategies for bacterial skin infections include dicloxacillin, clavulanic acid, amoxicillin, erythromycin, clindamycin and vancomycin. Fungal and yeast topical infections include dermatophytosis, pityriasis versicolor and candidiasis. Dermatophytosis implies an infection caused due to Trichophyton rubrum, having high affinity for the keratinized tissue such as skin, hair and nails. The other prevalent type of fungal skin infection is caused by Candida species, namely Candida albicans. These include candida vulvovaginitis, intertrigo (skin fold infections), napkin dermatitis, chronic paronychia (nail fold infection) and onychomycosis (nail plate infection) [10]. Tinea versicolor is an opportunistic infection caused by yeast Malasezzia furfur. Tinea pedis affects the feet with scaling plaques on the soles. Tinea capitis is characterized by scaly, erythematous skin with hair loss. The treatment strategies for fungal topical infections include terbinafine, clotrimazole, econazole, fluconazole, ketoconazole and itraconazole [10]. Herpes simplex (HSV), Herpes zoster, Molluscum contagiosum, Erythema infectiosum, Roseola infantum, Herpes simplex and chicken pox are some of the viral topical infections. HSV infection is painful and characterized by grouped vesicles along with dermatitis. HSV I is associated with orofacial disease and HSV II with genital infection [10]. Molluscum contagiosum spreads by the direct contact and is caused by benign pox virus. 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引用次数: 0

摘要

当前各种细菌、真菌和病毒引起的皮肤感染危机导致发病率呈指数增长[1,2]。尽管最近在皮肤病学治疗方面取得了进展,但由于现有配方缺乏疗效,治疗时间较长且尚未完全恢复,局部感染的治疗一直是一个困难的命题。金黄色葡萄球菌、耐甲氧西林金黄色葡萄球菌(MRSA)、铜绿假单胞菌、革兰氏阳性、革兰氏阴性细菌和真菌等多种微生物的影响正在引起复杂的问题。此外,问题的严重程度还取决于皮肤层的结构和目标部位。虽然皮肤的防御特性,如酸性pH值和其组成成分如月桂酸和棕榈油酸所表现出的显著抗菌活性,包含了抗局部感染的抗感染机制,但在某些情况下,如烧伤、伤口和糖尿病,随着病原体的进入和感染的发展,皮肤失去了防御机制。此外,由于其普遍的病理生理条件,它的屏障性质对大多数药物进入和通过它提出了艰巨的障碍。此外,药物固有的物理化学特性,如pKa、分子大小、稳定性、结合亲和力、溶解度和分配系数,仍然不利于药物通过皮肤屏障传递[6-8]。人类是许多细菌病原体的天然宿主,它们以正常菌群的形式定植在皮肤上。金黄色葡萄球菌和化脓性链球菌是多种细菌感染的病因。各种各样的细菌感染会影响皮肤的正常生理机能,包括蜂窝织炎、毛囊炎、脓疱疮、痈和疖。感染的易感因素包括轻微创伤、先前存在的皮肤病、不卫生,以及很少的宿主免疫力受损。蜂窝织炎是一种浅表细菌感染下真皮和上层皮下组织经常影响腿。蜂窝织炎的主要致病菌是A群溶血性金黄色葡萄球菌,其他微生物如铜绿假单胞菌、大肠杆菌和克雷伯氏菌[9]。脓疱疮是一种浅表皮肤感染,由直接侵入健康组织引起,或继发于潜在的皮肤疾病,特别是在鼻子、嘴和伤口周围。它发生在已经暴露于主要由金黄色葡萄球菌和化脓性葡萄球菌引起的湿疹和糖尿病的患者中。毛囊炎是一种皮肤感染的毛囊,如头皮、颈部、胡须区域、腋窝、臀部和四肢,其特征是基于毛囊的脓疱。红肿表明皮肤发炎和脓液从毛囊流出。细菌性皮肤感染的治疗策略包括双氯西林、克拉维酸、阿莫西林、红霉素、克林霉素和万古霉素。真菌和酵母菌局部感染包括皮肤癣、花斑糠疹和念珠菌病。皮肤癣指由红毛癣引起的感染,对角质化组织如皮肤、头发和指甲有很高的亲和力。另一种常见的皮肤真菌感染是由念珠菌引起的,即白色念珠菌。这些包括念珠菌外阴阴道炎,三门间(皮肤褶感染),餐巾皮炎,慢性甲沟炎(甲褶感染)和甲真菌病(甲板感染)[10]。花斑癣是一种由酵母菌引起的机会性感染。足癣影响脚底的鳞状斑块。头癣的特征是皮肤呈鳞状、红斑并伴有脱发。真菌局部感染的治疗策略包括特比萘芬、克霉唑、益康唑、氟康唑、酮康唑和伊曲康唑[10]。单纯疱疹(HSV)、带状疱疹、传染性软疣、传染性红斑、婴儿玫瑰疹、单纯疱疹和水痘是一些病毒性局部感染。HSV感染是痛苦的,其特征是成组的囊泡伴皮炎。HSV I型与口腔面部疾病有关,HSV II型与生殖器感染有关。传染性软疣通过直接接触传播,由良性痘病毒引起。带状疱疹(带状疱疹)是一种急性、疼痛性皮炎,存在免疫抑制。病毒感染的常见治疗策略包括阿昔洛韦、伐昔洛韦和咪喹莫特。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perspective in Topical Infective and Non-infective Skin Diseases Therapy with Emergence of Nanomedicine.
The current crisis of skin infections caused by a wide range of bacteria, fungi and virus has resulted in an exponential increase in morbidity [1, 2]. Despite the recent advancements in dermatological treatments, the treatment of topical infections has always been a difficult proposition because of the lack of efficacy of existing formulations, longer period of treatment and yet incomplete recovery. Implication of various microbes like Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Gram-positive, Gram-negative bacteria and fungi is causing complex problems [3]. Moreover, the severity of the problem also depends on the structure of skin layers and the target site. Although, the defensive properties of skin like acidic pH and significant antibacterial activity exhibited by its constituent components like Lauric acid and palmitoleic acid encompass the anti-infective mechanism against topical infections [4], however, in certain conditions like burns, wounds and diabetes mellitus, skin loses its defense mechanism with the entry of pathogens followed by the development of infection. Further, its barrier nature presents an arduous impediment for most drugs to be delivered into and through it owing to the prevailing patho-physiological conditions [5]. Besides, the drug’s intrinsic physico-chemical characteristics viz. pKa, molecular size, stability, binding affinity, solubility and partition coefficient remain unfavorable for drug delivery across the skin barrier [6-8]. Human beings are the natural hosts for many bacterial pathogens that colonize the skin as normal flora. Staphylococcus aureus and Streptococcus pyogenes account for a wide variety of bacterial infections. A wide variety of bacterial infections affect the normal physiology of skin including cellulitis, folliculitis, impetigo, carbuncle and furuncle. The predisposing factors to infection include minor trauma, pre-existing skin disease, poor hygiene, and rarely, impaired host immunity. Cellulitis is a superficial bacterial infection of the lower dermis and upper subcutaneous tissue frequently affecting the legs. The major causative organism of cellulitis is Group A beta-hemolytic Staphylococcus aureus along with other microbes like Pseudomonas aeruginosa, Escherichia coli and Klebsiella species [9]. Impetigo is a superficial cutaneous infection resulting from the direct invasion of healthy tissues, or occurs secondarily to an underlying skin disease especially around nose, mouth and wounds. It occurs in patients already exposed to eczema and diabetes caused mainly by Staphylococcus aureus and Staphylococcus pyogens [10]. Folliculitis is a cutaneous infection of the hair follicles such as the scalp, neck, beard area, axillae, buttocks and limbs characterized by follicular-based pustules. Carbuncles show inflamed skin and pus drainage from hair follicles [10]. The treatment strategies for bacterial skin infections include dicloxacillin, clavulanic acid, amoxicillin, erythromycin, clindamycin and vancomycin. Fungal and yeast topical infections include dermatophytosis, pityriasis versicolor and candidiasis. Dermatophytosis implies an infection caused due to Trichophyton rubrum, having high affinity for the keratinized tissue such as skin, hair and nails. The other prevalent type of fungal skin infection is caused by Candida species, namely Candida albicans. These include candida vulvovaginitis, intertrigo (skin fold infections), napkin dermatitis, chronic paronychia (nail fold infection) and onychomycosis (nail plate infection) [10]. Tinea versicolor is an opportunistic infection caused by yeast Malasezzia furfur. Tinea pedis affects the feet with scaling plaques on the soles. Tinea capitis is characterized by scaly, erythematous skin with hair loss. The treatment strategies for fungal topical infections include terbinafine, clotrimazole, econazole, fluconazole, ketoconazole and itraconazole [10]. Herpes simplex (HSV), Herpes zoster, Molluscum contagiosum, Erythema infectiosum, Roseola infantum, Herpes simplex and chicken pox are some of the viral topical infections. HSV infection is painful and characterized by grouped vesicles along with dermatitis. HSV I is associated with orofacial disease and HSV II with genital infection [10]. Molluscum contagiosum spreads by the direct contact and is caused by benign pox virus. Herpes zoster (shingles) is an acute, painful dermatitis in the presence of immunosuppression. The common treatment strategies for viral infections include acyclovir, valacyclovir and imiquimod.
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来源期刊
Recent patents on anti-infective drug discovery
Recent patents on anti-infective drug discovery Medicine-Pharmacology (medical)
CiteScore
2.40
自引率
0.00%
发文量
1
期刊介绍: Recent Patents on Anti-Infective Drug Discovery publishes review articles on recent patents in the field of anti-infective drug discovery e.g. novel bioactive compounds, analogs & targets. A selection of important and recent patents on anti-infective drug discovery is also included in the journal. The journal is essential reading for all researchers involved in anti-infective drug design and discovery.
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