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Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5.
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e - ISSN – XXXX-XXXX
Print ISSN - XXXX-XXXX
American Journal of Pharmaceutical Sciences
Journal homepage: www.mcmed.us/journal/ajps
ETHOSOMES: A NOVEL TRANSDERMAL DRUG DELIVERY
SYSTEM
Ananda Kumar CH*, Dr. Rajeswar Dutt
Department of Pharmaceutics, J.J.T.University, Rajasthan, Jhunjhunu.
Article Info
Received 22/10/2013
Revised 16/11/2013
Accepted 18/12/2013
Key words :-Stratum
Corneum (SC),
Liposome, Classic
Liposomes, Ethosomes,
Ethanol, Phospholipid,
Vesicles, Transdermal
Drug Delivery.
ABSTRACT
Skin acts as a major target as well as a principal barrier for topical/transdermal drug
delivery. Despite the many advantages of this system, the major obstacle is the low
diffusion rate of drugs across the stratum corneum. Several methods have been tried to
increase the permeation rate of drugs temporarily. One simple and convenient approach is
application of drugs in formulation with elastic vesicles or skin enhancers. Vesicular
system is one of the most convenient methods for transdermal delivery of active substances
and in that ethosomes are most useful vesicular systems. Ethosomal carriers are systems
containing soft vesicles, composed of hydroalcoholic or hydro/glycolic phospholipid in
which the concentration of alcohols is relatively high. The high concentration of ethanol
brings increase in fluidity of lipids hence increase in permeability of the skin and improves
the drug penetration. Ethosomal formulation may contain many drugs such as acyclovir,
salbutamol, Insulin, cyclosporine, fluconazole, minodixil, etc. These are prepared by hot
method and cold methods. The size of Ethosomal formulation can be decreased by
sonication and extrusion method. The high concentration of ethanol makes the ethosomes
unique and useful for transcellular delivery, delivery of hormones, anti-arthritis, anti-HIV
etc. Thus, it can be a logical conclusion that ethosomal formulation possesses promising
future in effective dermal/transdermal delivery of bioactive agents.
INTRODUCTION
TDDS are defined as self-contained, discrete
dosage forms which when applied to the intact skin, deliver
the drug through the skin, at a controlled rate to the
systemic circulation.For transdermal delivery of drugs,
stratum corneum is the main barrier for permeation of
drug. Now-a-days liposomes, niosomes, transferosomes
and ethosomes (vesicular and non- invasive drug delivery)
are used to increase the permeation of drug through the
stratum corneum. One of the major advances in vesicle
research was the finding that some modified vesicles
possessed properties that allowed them to successfully
deliver drugs in deeper layers of skin. Transdermal
Corresponding Author
Ananda Kumar CH
Email: anand33.chettupalli@gmail.com
delivery is important because it is a non-invasive procedure
for drug delivery.
Further, problem of drug degradation by digestive
enzymes after oral administration and discomfort
associated with parenteral drug administration can be
avoided. It is the most preferred route for systemic delivery
of drugs to pediatric, geriatric and patients having
dysphasia. Hence, transdermal dosage forms enjoy being
the most patient compliant mode of drug delivery.
INTRODUCTIOTO ETHOSOMES
These are lipid vesicle containing phospholipids,
alcohol in relatively high concentration and water.
Ethosomes are soft vesicles made of phospholipids and
ethanol and water37,38
. Ethosomes can entrap drug
molecules various physic chemical characteristics i.e. of
hydrophilic, lipophilic, or amphiphlic. The size range of
ethosomes may vary from 10 nanometers to microns.
Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5.
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Composition of ethosomes: Ethosomes are vesicle
carrier comprises of hydro alcoholic or hydro alcoholic
glycolic phospholipid in which the concentration of
alcohols or their combination is relatively high. Ethosomes
may contain phospholipid with various chemical structures
like phosphotidyl choline (PC), Hydrogenated
phosphotidyl choline (HPC), Phosphatic acid,
Phosphatidylserine,Phosphatidylethanolamine (PE)
Phosphatidylglycerol (PPG) Phosphatidylinositol (PI),
Alcohol, water and propylenrglycol. Drug delivery can be
modulated by altering alcohol: water or alcohol- polyol
water ratio some preferred phospholipids are soya
phospholipids such as phospholipon90 (PL-90). It is
usually employed in range of 0.5-10%w/w cholesterol at
concentration ranges between0.1 to1% can also be used,
include ethanol and isopropyl alcohol. Among glycols,
propylene glycol and from suite are generally used in
addition, nonionic surfactants can be combined with the
phospholipids in these preparations. Cationic lipids like
cocoamide, POE alkyl amines, dodecylamine, cetrimide
etc….
The concentration of alcohol in the final product
may range from 20to 50%. The concentration of
nonaqueous phase may range between22 to70%41
.
PERMIATION THROUGH SKIN:
The major problem associated with the dermal
delivery system is the excellent barrier property of the skin.
This resides in the outermost layer, the stratum cornea.
This unique membrane is only some 20 um thick but has
evolved to provide a layer that prevents us from losing
excessive amounts of water and limits the ingress of
chemicals with which come in to contact. The precise
mechanisms by which drugs permeate the stratum corneum
are still under debate but there is substantial evidence that
the route of permeation is a tortuous one following the
intercellular channels. The diffusion path length is between
300 and 500um rather than the 20 um suggested by the
thickness of the stratum corneum. However, the tortuosity
alone cannot account for the impermeability of the skin.
The intercellular channels contain a complex milieu of
lipids that are structured into ordered bilayer arrays. It is
the combination of the nature of these and the tortuous
route that is responsible. A diffusing drug has to cross,
sequentially, repeated bilayers and therefore encounters a
series of lipophilic and hydrophilic domains.
Advantages:
1. Delivery of large molecules is possible (peptides,
protein molecule)
2. It contains nontoxic raw material in formulation.
3. Enhanced permeation of drug through skin for
transdermal drug delivery.
4. It can be applied widely in pharmaceutical, veterinary,
cosmetic fields.
5. High patient compliance. The ethosomal drug is
administered in semisolid form hence producing higher
patient compliance.
6. Simple method for drug delivery in comparison to
iontophoresis and phonophoresis and other complicated
methods.
7. It is passive, noninvasive and is available for
immediate commercialization.
DISADVANTAGES:
1. May not be economical. Poor yield
2. Drugs that require high blood levels cannot be
administered – limited only to potent molecules, those
requiring a daily dose of 10mg or less.
3. In case if shell locking is ineffective then the
ethosomes may coalescence and fall apart on transfer into
water.
4. Loss of product during transfer from organic to water
media
MECHANISM OF PENETRATION:
The advantages of ethosomes over liposomes are
the increased permeation of the drugs. The mechanism of
the drug absorption from ethosomes is not clear. The drug
absorption probably occurs in following two phases:
1. Ethanol effect
2. Ethosomes effect
Ethanol effect: it acts as a penetration enhancer through
the skin. The mechanism of its penetration enhancer effect
is well known. It penetrates in to intercellular lipids and
increases the fluidity of cell membranes lipids and decrease
the density of lipid multilayer of cell membrane.
Ethosomes effect: Increased cell membrane lipid fluidity
caused by the ethanol of ethosomes results increased skin
permeability. In the case of ethosomes encapsulating
drugs, the higher positive zeta potential imparted by the
drug can improve skin attachment of the vesicles. While
encapsulated drug in classic liposomes remained primarily
at the surface of the skin the ethosomal system was showed
to be highly efficient carrier for enhanced drug delivery
through the skin due to increased fluidity of the lipids
Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5.
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METHOD OF PREPARATION: There are two methods
which can be used for the formulation and preparation of
ethosomes. These methods are very simple and convenient
and do not involve any sophisticated instrument or
complicated process. Ethosomes can be formulated by
following methods39
.
1. Hot method. 2. Cold method.
COLD METHOD:
HOT METHOD:
METHODS OF CHARACTERIZATION:
 Visualization:
Visualization of ethosomes can be done using
transmission electron microscopy (TEM) and by scanning
electron microscopy (SEM). Visualization by electron
microscopy reveals an ethosomal formulation exhibited
vesicular structure 300-400 nm in diameter.
 Scanning electron microscopy (SEM):
Different lipid types might influence the surface
morphology or shape of the particles (Cortesi et al. 2002).
Solid lipid microparticle suspensions were deposited on
metallic stubs then placed in liquid nitrogen and dried
under vacuum. The freeze-dried microparticles were coated
uniformly with gold. It is characterized for morphology
and surface properties using a scanning electron
microscope.
 Entrapment Efficiency:
The entrapment efficiency of drug by ethosomes
can be measured by the ultracentrifugation
technique[32].The chemical nature of the lipid is an
important factor in determining the EE of drug in the SLM
because lipid which forms highly crystalline particles with
a perfect lattice lead to drug expulsion (Westesen et al.
1997). On the other hand, the imperfection (lattice defects)
of the lipid structure could offer space to accommodate the
drug. The percentage EE ranged from 80.7–95.7%.The lost
or unentrapped drug could be due to the solubility of the
drug in the water–poloxamer phase. Schwarz and Mehnert
(1999) also reported a reduction in drugentrapment in the
presence of poloxamer. Dayan and Touitou [33] have
shown that entrapment efficiency of trihexyphenidyl
hydrochloride increased from 36% for liposomes to 75%
for ethosomes.
Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5.
4 | P a g e
 Differential scanning calorimertry (DSC):
Transition temperature (Tm) of the vesicular lipid
systems was determined by using the Mettler DSC 60
computerized with Mettler Toledo star software system
(Mettler, Switzerland).The transition temperature was
measured by using the aluminium crucibles at a heating
rate 10 degree/minute. Within a temperature range from
20º-300ºC.
 Vesicle size and Zeta potential:
Particle size and zeta potential can be determined
by dynamic light scattering (DLS) using a computerized
inspection system and photon correlation spectroscopy
(PCS) [34]. The size of ethosomes ranges between tens of
nanometers to microns and is influenced by the
composition of the formulation.
Zeta potential is an important and useful indicator
of particle surface charge, which can be used to predict and
control the stability. In general, particles could be
dispersed stably when the absolute value of zeta potential
was above30mV due to the electric repulsion between
particles (Mu¨ ller et al. 2001).
 Drug Content:
Drug can be quantified by a modified high
performance liquid chromatographic method .
 Surface Tension Activity Measurement:
The surface tension activity of drug in aqueous solution
can be measured by the ring method in a Du Nouy ring
tensiometer
 Vesicle Stability:
The stability of vesicles can be determined by assessing the
size and structure of the vesicles over time. Mean size is
measured by DLS and structure changes are observed by
TEM.
 Transition Temperature:
The transition temperature of the vesicular lipid systems
can be determined by using differential scanning
calorimetry.
 Penetration and Permeation Studies:
Depth of penetration from ethosomes can be visualized by
confocal laser scanning microscopy
CONCLUSION
New and alternative drug delivery systems are
currently the focus of many research activities. Efficacy,
safety and convenience of use are important factors that
need to be considered when developing alternate drug
delivery systems. In recent years, the transdermal route of
drug delivery has evolved considerably and it now
competes with oral treatment. Most of the device-induced
transdermal drug delivery techniques are still in the early
stages of commercialization. All device-induced
transdermal delivery techniques have a common concern
regarding the safety of use, and skin reactions arising due
to perturbing the stratum corneum – even though it is only
temporary. Ethosomal carrier opens new challenges and
opportunities for the development of novel improved
therapies.
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ETHOSOMES: A NOVEL TRANSDERMAL DRUG DELIVERY SYSTEM

  • 1. Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5. 1 | P a g e e - ISSN – XXXX-XXXX Print ISSN - XXXX-XXXX American Journal of Pharmaceutical Sciences Journal homepage: www.mcmed.us/journal/ajps ETHOSOMES: A NOVEL TRANSDERMAL DRUG DELIVERY SYSTEM Ananda Kumar CH*, Dr. Rajeswar Dutt Department of Pharmaceutics, J.J.T.University, Rajasthan, Jhunjhunu. Article Info Received 22/10/2013 Revised 16/11/2013 Accepted 18/12/2013 Key words :-Stratum Corneum (SC), Liposome, Classic Liposomes, Ethosomes, Ethanol, Phospholipid, Vesicles, Transdermal Drug Delivery. ABSTRACT Skin acts as a major target as well as a principal barrier for topical/transdermal drug delivery. Despite the many advantages of this system, the major obstacle is the low diffusion rate of drugs across the stratum corneum. Several methods have been tried to increase the permeation rate of drugs temporarily. One simple and convenient approach is application of drugs in formulation with elastic vesicles or skin enhancers. Vesicular system is one of the most convenient methods for transdermal delivery of active substances and in that ethosomes are most useful vesicular systems. Ethosomal carriers are systems containing soft vesicles, composed of hydroalcoholic or hydro/glycolic phospholipid in which the concentration of alcohols is relatively high. The high concentration of ethanol brings increase in fluidity of lipids hence increase in permeability of the skin and improves the drug penetration. Ethosomal formulation may contain many drugs such as acyclovir, salbutamol, Insulin, cyclosporine, fluconazole, minodixil, etc. These are prepared by hot method and cold methods. The size of Ethosomal formulation can be decreased by sonication and extrusion method. The high concentration of ethanol makes the ethosomes unique and useful for transcellular delivery, delivery of hormones, anti-arthritis, anti-HIV etc. Thus, it can be a logical conclusion that ethosomal formulation possesses promising future in effective dermal/transdermal delivery of bioactive agents. INTRODUCTION TDDS are defined as self-contained, discrete dosage forms which when applied to the intact skin, deliver the drug through the skin, at a controlled rate to the systemic circulation.For transdermal delivery of drugs, stratum corneum is the main barrier for permeation of drug. Now-a-days liposomes, niosomes, transferosomes and ethosomes (vesicular and non- invasive drug delivery) are used to increase the permeation of drug through the stratum corneum. One of the major advances in vesicle research was the finding that some modified vesicles possessed properties that allowed them to successfully deliver drugs in deeper layers of skin. Transdermal Corresponding Author Ananda Kumar CH Email: anand33.chettupalli@gmail.com delivery is important because it is a non-invasive procedure for drug delivery. Further, problem of drug degradation by digestive enzymes after oral administration and discomfort associated with parenteral drug administration can be avoided. It is the most preferred route for systemic delivery of drugs to pediatric, geriatric and patients having dysphasia. Hence, transdermal dosage forms enjoy being the most patient compliant mode of drug delivery. INTRODUCTIOTO ETHOSOMES These are lipid vesicle containing phospholipids, alcohol in relatively high concentration and water. Ethosomes are soft vesicles made of phospholipids and ethanol and water37,38 . Ethosomes can entrap drug molecules various physic chemical characteristics i.e. of hydrophilic, lipophilic, or amphiphlic. The size range of ethosomes may vary from 10 nanometers to microns.
  • 2. Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5. 2 | P a g e Composition of ethosomes: Ethosomes are vesicle carrier comprises of hydro alcoholic or hydro alcoholic glycolic phospholipid in which the concentration of alcohols or their combination is relatively high. Ethosomes may contain phospholipid with various chemical structures like phosphotidyl choline (PC), Hydrogenated phosphotidyl choline (HPC), Phosphatic acid, Phosphatidylserine,Phosphatidylethanolamine (PE) Phosphatidylglycerol (PPG) Phosphatidylinositol (PI), Alcohol, water and propylenrglycol. Drug delivery can be modulated by altering alcohol: water or alcohol- polyol water ratio some preferred phospholipids are soya phospholipids such as phospholipon90 (PL-90). It is usually employed in range of 0.5-10%w/w cholesterol at concentration ranges between0.1 to1% can also be used, include ethanol and isopropyl alcohol. Among glycols, propylene glycol and from suite are generally used in addition, nonionic surfactants can be combined with the phospholipids in these preparations. Cationic lipids like cocoamide, POE alkyl amines, dodecylamine, cetrimide etc…. The concentration of alcohol in the final product may range from 20to 50%. The concentration of nonaqueous phase may range between22 to70%41 . PERMIATION THROUGH SKIN: The major problem associated with the dermal delivery system is the excellent barrier property of the skin. This resides in the outermost layer, the stratum cornea. This unique membrane is only some 20 um thick but has evolved to provide a layer that prevents us from losing excessive amounts of water and limits the ingress of chemicals with which come in to contact. The precise mechanisms by which drugs permeate the stratum corneum are still under debate but there is substantial evidence that the route of permeation is a tortuous one following the intercellular channels. The diffusion path length is between 300 and 500um rather than the 20 um suggested by the thickness of the stratum corneum. However, the tortuosity alone cannot account for the impermeability of the skin. The intercellular channels contain a complex milieu of lipids that are structured into ordered bilayer arrays. It is the combination of the nature of these and the tortuous route that is responsible. A diffusing drug has to cross, sequentially, repeated bilayers and therefore encounters a series of lipophilic and hydrophilic domains. Advantages: 1. Delivery of large molecules is possible (peptides, protein molecule) 2. It contains nontoxic raw material in formulation. 3. Enhanced permeation of drug through skin for transdermal drug delivery. 4. It can be applied widely in pharmaceutical, veterinary, cosmetic fields. 5. High patient compliance. The ethosomal drug is administered in semisolid form hence producing higher patient compliance. 6. Simple method for drug delivery in comparison to iontophoresis and phonophoresis and other complicated methods. 7. It is passive, noninvasive and is available for immediate commercialization. DISADVANTAGES: 1. May not be economical. Poor yield 2. Drugs that require high blood levels cannot be administered – limited only to potent molecules, those requiring a daily dose of 10mg or less. 3. In case if shell locking is ineffective then the ethosomes may coalescence and fall apart on transfer into water. 4. Loss of product during transfer from organic to water media MECHANISM OF PENETRATION: The advantages of ethosomes over liposomes are the increased permeation of the drugs. The mechanism of the drug absorption from ethosomes is not clear. The drug absorption probably occurs in following two phases: 1. Ethanol effect 2. Ethosomes effect Ethanol effect: it acts as a penetration enhancer through the skin. The mechanism of its penetration enhancer effect is well known. It penetrates in to intercellular lipids and increases the fluidity of cell membranes lipids and decrease the density of lipid multilayer of cell membrane. Ethosomes effect: Increased cell membrane lipid fluidity caused by the ethanol of ethosomes results increased skin permeability. In the case of ethosomes encapsulating drugs, the higher positive zeta potential imparted by the drug can improve skin attachment of the vesicles. While encapsulated drug in classic liposomes remained primarily at the surface of the skin the ethosomal system was showed to be highly efficient carrier for enhanced drug delivery through the skin due to increased fluidity of the lipids
  • 3. Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5. 3 | P a g e METHOD OF PREPARATION: There are two methods which can be used for the formulation and preparation of ethosomes. These methods are very simple and convenient and do not involve any sophisticated instrument or complicated process. Ethosomes can be formulated by following methods39 . 1. Hot method. 2. Cold method. COLD METHOD: HOT METHOD: METHODS OF CHARACTERIZATION:  Visualization: Visualization of ethosomes can be done using transmission electron microscopy (TEM) and by scanning electron microscopy (SEM). Visualization by electron microscopy reveals an ethosomal formulation exhibited vesicular structure 300-400 nm in diameter.  Scanning electron microscopy (SEM): Different lipid types might influence the surface morphology or shape of the particles (Cortesi et al. 2002). Solid lipid microparticle suspensions were deposited on metallic stubs then placed in liquid nitrogen and dried under vacuum. The freeze-dried microparticles were coated uniformly with gold. It is characterized for morphology and surface properties using a scanning electron microscope.  Entrapment Efficiency: The entrapment efficiency of drug by ethosomes can be measured by the ultracentrifugation technique[32].The chemical nature of the lipid is an important factor in determining the EE of drug in the SLM because lipid which forms highly crystalline particles with a perfect lattice lead to drug expulsion (Westesen et al. 1997). On the other hand, the imperfection (lattice defects) of the lipid structure could offer space to accommodate the drug. The percentage EE ranged from 80.7–95.7%.The lost or unentrapped drug could be due to the solubility of the drug in the water–poloxamer phase. Schwarz and Mehnert (1999) also reported a reduction in drugentrapment in the presence of poloxamer. Dayan and Touitou [33] have shown that entrapment efficiency of trihexyphenidyl hydrochloride increased from 36% for liposomes to 75% for ethosomes.
  • 4. Ananda Kumar CH. et al. / American Journal of Pharmaceutical Sciences. 2014;1(1):1-5. 4 | P a g e  Differential scanning calorimertry (DSC): Transition temperature (Tm) of the vesicular lipid systems was determined by using the Mettler DSC 60 computerized with Mettler Toledo star software system (Mettler, Switzerland).The transition temperature was measured by using the aluminium crucibles at a heating rate 10 degree/minute. Within a temperature range from 20º-300ºC.  Vesicle size and Zeta potential: Particle size and zeta potential can be determined by dynamic light scattering (DLS) using a computerized inspection system and photon correlation spectroscopy (PCS) [34]. The size of ethosomes ranges between tens of nanometers to microns and is influenced by the composition of the formulation. Zeta potential is an important and useful indicator of particle surface charge, which can be used to predict and control the stability. In general, particles could be dispersed stably when the absolute value of zeta potential was above30mV due to the electric repulsion between particles (Mu¨ ller et al. 2001).  Drug Content: Drug can be quantified by a modified high performance liquid chromatographic method .  Surface Tension Activity Measurement: The surface tension activity of drug in aqueous solution can be measured by the ring method in a Du Nouy ring tensiometer  Vesicle Stability: The stability of vesicles can be determined by assessing the size and structure of the vesicles over time. Mean size is measured by DLS and structure changes are observed by TEM.  Transition Temperature: The transition temperature of the vesicular lipid systems can be determined by using differential scanning calorimetry.  Penetration and Permeation Studies: Depth of penetration from ethosomes can be visualized by confocal laser scanning microscopy CONCLUSION New and alternative drug delivery systems are currently the focus of many research activities. Efficacy, safety and convenience of use are important factors that need to be considered when developing alternate drug delivery systems. In recent years, the transdermal route of drug delivery has evolved considerably and it now competes with oral treatment. Most of the device-induced transdermal drug delivery techniques are still in the early stages of commercialization. All device-induced transdermal delivery techniques have a common concern regarding the safety of use, and skin reactions arising due to perturbing the stratum corneum – even though it is only temporary. Ethosomal carrier opens new challenges and opportunities for the development of novel improved therapies. BIBILOGRAPHY: 1. International Journal of Current Pharmaceutical Research ISSN-0975-1491 Vol-2, issue 4, 2010- Ethosomes- A Non- invasive approach for Transdermal Drug Delivery- D. Akiladevi, Sachinandan Basak. 2. Der Pharmacia Lettre, 2010, 2(5) pg.no:216. 3. Lauer AC, Ramachandran C, Lieb L.M, Niemiec S, Weiner ND. Targeted delivery to the pilosebaceous unit via liposomes. Adv. Drug Delivery 1996; 18: 311-324. 4. Johnsen SG, Bennett EP, Jensen, VG Lance, Therapeutic effectiveness of oral testosterone. 1974; 2:1473-1475. 5. Jain S, Vesicular approaches for transdermal delivery of bioactive agent. Ph.D thesis, Dr. H.S. Gour University, Sagar, India, 2005. 6. Fang J, Hong C, Chiu W, Wang Y. Effect of liposomes and niosomes on skin permeation of enoxacin. Int. J. Pharm. 2001. 7. Kim S, Chien YW. Toxicity of cationic lipids and cationic polymers in gene delivery J. Control. Release. 1996; 40: 67-76. 8. Jain S, Uma Maheshwari RB, Bhadra D, Jain NK, Ethosomes: A novel vesicular carriers for enhanced transdermal delivery of an anti HIV agent. Ind J Pharm Sci 2004; 66:72-81. 9. Spruance, S.L. Semin. The natural history of recurrent oral facial herpes simplex virus infection. Dermatol. 1992; 11:200- 206. 10. Fiddan AP, Yeo JM, Strubbings R, Dean D. Vesicular Approach for Drug Delivery into or Across the Skin Br. Med. J. 1983; 286, 701, 1699. 11. Horwitz E, Pisanty S, Czerninsky R, Helser M, Eliav E, Touitou E. Oral Surg Oral Pathol Oral Radiol Endod, 1999; 88:700-05. 12. Chetty DJ, Chien YW. Transdermal Delivery of CaCO3-Nanoparticles Containing Insulin Crit Rev Ther Drug Carrier Syst.1998; 15: 629-670. 13. Verma DD, Fahr A. Synergistic penetration effect of ethanol and phospholipids on the topical delivery of Cyclosporin A. J. Control Release.2004; 97:55-66. 14. Paolino D, Lucania G, Mardente D, Alhaique F, Fresta M. Innovative Drug Delivery Systems for the Administration of Natural Compounds J. Control. Release. 2005; 106: 99-110.
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