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Vaccine Adjuvants in Immunotoxicology
Published in Mesut Karahan, Synthetic Peptide Vaccine Models, 2021
The most important side effect of aluminum-derived adjuvants is the formation of local granulomas at the injection site. This situation develops especially when an intradermal or subcutaneous injection is administered instead of intramuscular. Local pain, inflammation, swelling, ulcer, and necrosis at the injection site may also be observed (Maughan, Preston, and Williams 2015). Other important side effects are tendency to allergy and potential neurotoxicities with increased IgE production. Aluminum is usually excreted from the body through the kidneys. In kidney dysfunction, aluminum accumulates in the body. High levels of aluminum affect the brain and bone tissues in particular. Aluminum intoxication has also been associated with Alzheimer’s disease. Magnesium hydroxide (Mg(OH)2), zinc sulphate (ZnSO4), calcium phosphate (Ca3(PO4)2), and iron and zirconium salts are used as alternative mineral salts (Yurdakök and İnce 2008; Maughan, Preston, and Williams 2015).
Stepronin
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 20-year-old man was hospitalized for bronchospasm that had occurred approximately 8 hours after the third inhalation of an aerosol product containing stepronin for acute bronchitis. At the time of admission, the patient presented a hacking cough, dyspnea, and wheezing, as well as a maculopapular eruption in the perioral region (the area that had been covered by the aerosol mask) and conjunctival injection. Prick and intradermal skin tests were then performed with stepronin (1.8 mg/ml in normal saline). A positive reaction was observed 8 hours after intradermal injection of 0.02 ml. At 24 h, an indurated, erythematous zone 22 mm in diameter was present at the test site and persisted for 3 days. A patch test using 0.1 ml of a normal saline solution containing stepronin 180 mg/ml was also positive at the 48 and 72 hour readings. Control tests in five volunteers were negative. A bronchial aerosol challenge resulted in a progressive decrease in the FEV (forced expiratory volume) of 33% after 4 hours, at which point the patient began to complain of dyspnea and moderate weakness, the blood pressure dropped to 90/50 mm Hg and facial erythema, conjunctival injection, and fever developed. Wheezing, previously absent, could be heard over all lung fields. It was concluded that the obstructive bronchial reaction with a maculopapular eruption and conjunctival injection were caused by delayed hypersensitivity to stepronin (2).
Microneedles for Drug Delivery
Published in Tapash K. Ghosh, Dermal Drug Delivery, 2020
Lisa A. Dick, Daniel M. Dohmeier, Ann M. Purrington, Scott A. Burton
A phase I study reported by Troy et al. studied the immune response to inactivated polio vaccine (IPV) delivered intradermally using the MicronJet600™ hollow microneedle system in HIV-infected adults (Troy, et al., 2015). The study found that intradermal administration of 40% of the standard dose of IPV produced an immune response comparable to delivery of the standard dose administered intramuscularly. Intradermal administration showed a higher incidence of local side effects including redness and itching, but a similar incidence of systemic side effects, and study participants reported a preference for intradermal administration over intramuscular administration.
Biopredictive tools for the development of injectable drug products
Published in Expert Opinion on Drug Delivery, 2022
Mônica Villa Nova, Kennard Gan, Matthias G. Wacker
Injectable drug products cover a wide variety of potential injection sites involving different physiologies and formulations. Most frequently, intravenous, subcutaneous, intramuscular, and intradermal injections are being used. Additionally, there are several less common injection sites including the intracranial [46], intrathecal [47–49], intra-articular [50], or intraosseous [51] route of administration. A formulation-centric approach requires the material and quality attributes of the delivery system to be considered. Most injectables are liquids with the drug being dissolved or dispersed in a vehicle. Their absorption kinetics is affected by a variety of physiological parameters responsible for the distribution of the drug after the injection. They include the vascularization and structure of the injection site as well as the access to other tissues, such as the lymphatic system [52]. Regarding the subcutaneous route of administration, the preferred injection site varies between Asian and Western countries, leading to differences in the absorption rate as well [6].
Targeting delivery and minimizing epidermal diffusion of tranexamic acid by hyaluronic acid-coated liposome nanogels for topical hyperpigmentation treatment
Published in Drug Delivery, 2021
Ying Liu, Yue Han, Tingting Zhu, Xianglei Wu, Wenxin Yu, Jiafang Zhu, Ying Shang, Xiaoxi Lin, Tianlan Zhao
The delivery of TA into melanocytes becomes the challenge of hyperpigmentation treatment (Mobasher et al., 2020; Nautiyal & Wairkar, 2021). Although the intradermal injection and oral administration are used in clinical application, they are each problematic, the former being invasive while the latter suffers from efficacy issues (Bala et al., 2018; Wang et al., 2019). In contrast, topical delivery is an attractive alternative in dermatology, improving drug utilization as well as eliminating potential systemic side effects (Sabir et al., 2019; Batool et al., 2021). However, TA, a hydrophilic molecules, is inefficient for topical delivery into melanocytes in the basal layer of epidermis for following reasons: (1) TA is difficult to pass through lipid barriers of the stratum corneum (SC); (2) TA is poorly retained in basal layer of epidermis to adequately enter melanocytes (Kim et al., 2016). Therefore, the effective delivery of TA into melanocytes is the primary concern in hyperpigmentation treatment. In this regard, topical formulations of TA must be able to overcome the SC barrier and be sufficiently retained in the epidermis to target melanocytes.
Intradermal tranexamic acid injections to prevent post-inflammatory hyperpigmentation after solar lentigo removal with a Q-switched 532-nm Nd:YAG laser
Published in Journal of Cosmetic and Laser Therapy, 2018
Punyaphat Sirithanabadeekul, Rattima Srieakpanit
The side effects from intradermal TA injections are minimal, and include burning sensations, wheals, erythema, and local bruising, which were well tolerated by the patients in previous studies (20,28,29). Our study’s findings also indicated that the side effects from the intradermal TA injections were minimal, with two subjects whose solar lentigines were treated with TA experiencing immediate burning sensations in the areas of the lesions, but these symptoms were resolved within 1 h. Limitation of our study is, we did not measure blood coagulogram. However, we injected only small amount of medicine. Moreover, according to Angchaisuksiri et al, they found that long-term systemic treatment of TA in melasma has elicited no evidence of systemic fibrinolytic suppression and thrombogenic effect (30).