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PubMed2001

Methods for evaluation of peripheral neurovascular dysfunction.

Measurement of skin blood flow is a sensitive marker of C-fiber neurovascular dysfunction. It precedes development of abnormalities in diabetes mellitus, correlates with in vivo indices of the metabolic syndrome, and may be a "benchmark" for future studies on agents to improve microvascular dysfunction in diabetes mellitus. Skin blood flow can be measured under basal and stimulated conditions. There are different methods of evaluation. Iontophoresis and microdialysis are novel methods of drug delivery and the latter may be used as a means of extracting analytes in the skin. Theses methods are not invasive (iontophoresis) or minimally invasive (microdialysis). They can be performed repeatedly and safely in most patients. The use of microdialysis may be limited by sampling only water-soluble molecules. An alternative to microdialysis is iontophoresis, which works better with polar molecules. A combination of microdialysis and iontophoresis techniques can be useful in assessment of the pharmacokinetics of polar and nonpolar agents and the physiology and pathophysiology of the skin neurovascular system.

Diabetic Angiopathies↗

PubMed1987

Lack of efficacy of adenosine-5'-monophosphate against HSV-1 ocular shedding in rabbits.

Adenosine-5'-monophosphate (AMP) was evaluated for efficacy in the prevention of spontaneous and induced herpes simplex virus type 1 (HSV-1) ocular shedding in latently infected rabbits with strain McKrae. Intraperitoneal injections (IP) of AMP (100 mg/kg) or NaCl (10 mg/kg) were given on postinoculation (PI) days 16-39. Spontaneous viral shedding was monitored by ocular tear film swabs on PI days 20-39. In the induced rabbits, one group received AMP (IP) and a second group received NaCl (IP) on PI days 66-77. In a third group, AMP (100 mg/kg) was given twice a day IP on PI days 66-77, and AMP was applied by iontophoresis to these eyes on PI days 68-74. In these three groups, ocular viral shedding was induced by ocular iontophoresis of 6-hydroxydopamine on PI day 70 followed by topical application of epinephrine for 5 days (PI days 70-74). HSV-1 ocular shedding was monitored on PI days 66-78. There were no significant differences in spontaneous or induced shedding patterns between the AMP (systemic or systemic plus ocular iontophoresis) and the NaCl groups. These results suggest that this dose of systemically administered AMP plus iontophoresis of AMP does not reduce ocular HSV-1 shedding in rabbits.

Adenosine Monophosphate↗

PubMed1995

Ocular toxicity of iontophoretic foscarnet in rabbits.

Transscleral iontophoresis of foscarnet is a noninvasive drug delivery system for the local treatment of cytomegalovirus (CMV) retinopathy. We determined the retinotoxic effects of transscleral iontophoresis of foscarnet. Slit-lamp biomicroscopy revealed no toxic effects for any of the treated eyes. Indirect ophthalmoscopy showed retinal and choroidal burns 1-3 mm in diameter at the site of iontophoresis in both foscarnet-treated eyes and saline-treated control eyes. Light and electron microscopy revealed focal retinal, retinal pigment epithelial, and choroidal necrosis at the site of iontophoresis but no abnormalities elsewhere. Ganzfeld electroretinographic studies revealed no response differences between foscarnet-treated eyes vs. controls.

Animals↗

PubMed2002

Transient hyperaemic response to assess vascular reactivity of skin; effect of locally iontophoresed sodium nitroprusside.

BACKGROUND: We aimed to study if brief compression (20 s) of the brachial artery could provoke a hyperaemic response in forearm skin. In addition, we studied the effect of pre-dilating the skin vessels with locally iontophoresed sodium nitroprusside on the hyperaemic response. METHODS: Ten healthy male volunteers were studied. A custom-made perspex iontophoresis chamber was attached to the anterior aspect of the distal forearm; this chamber allowed simultaneous administration of drugs by iontophoresis and measurement of skin blood flow flux by the laser Doppler probe. The flow flux signal, measured in volts, was continuously recorded onto a paper chart recorder. Three control transient hyperaemic response (THR) tests were performed by releasing the manual occlusion of the brachial artery maintained for 20 s. Thereafter, 2% sodium nitroprusside was iontophoresed using a current of 100 mAmp for 240 s. The THR tests were repeated three more times. From the recordings, baseline blood flow flux immediately before the onset of compression (or F1) and maximum blood flow flux immediately after the release of compression (or F2) were taken for analysis. The THR ratio (THRR) was calculated as: THRR = F2/F1. Average values of F1 and THRR were taken from the tests before and after iontophoresis and a paired t-test was used for analysing the changes. RESULTS: Nine of the 10 subjects showed a hyperaemic response at the release of compression. Iontophoresis of sodium nitroprusside significantly increased the baseline flow flux from 0.77 (range 0.29-1.61) to 1.88 V (0.73-2.91). It also completely abolished the THR in all subjects; THRR decreased from 1.65 (1.00-2.78) to 1.00 (0.98-1.03). CONCLUSION: A brief compression of the brachial artery results in a significant hyperaemic response in the forearm skin; this response is abolished by pre-dilatation of skin vessels. These findings support the hypothesis that the THR test assesses true vasodilatation occurring during arterial compression.

Adult↗

PubMed2006

Iontophoretic treatment of experimental pseudomonas keratitis in rabbit eyes using gentamicin-loaded hydrogels.

PURPOSE: To evaluate the efficacy of iontophoresis using a hydrogel probe containing gentamicin for the treatment of Pseudomonas keratitis in the rabbit cornea. METHODS: Five groups (Groups 1-5) of 8 rabbits each were infected by injecting Pseudomonas aeruginosa into their corneas. Three dosings of corneal iontophoresis were performed, at intervals of 3.5 hours, using soft disposable gentamicin-loaded hydroxyethyl methacrylate hydrogel discs mounted on a portable iontophoretic device. Groups 1 and 2 were treated with corneal iontophoresis for 60 seconds and a current of 0.5 and 0.2 mA. Groups 3 and 4 were treated with hydrogel loaded with 0.9% NaCl solution, using a current of 0.2 mA and mock iontophoresis. Group 5 was treated with eye drops of 1.4% gentamicin every hour for 8 hours. One and a half hours after the last treatment, the animals were killed, and the corneas were excised and cultured for P. aeruginosa count after 24-hour incubation. RESULTS: After iontophoretic treatment of gentamicin with a current of 0.5 mA (Group 1), the logarithmic value of Pseudomonas colony-forming units (CFUs) was 2.96 +/- 0.45. After lower current iontophoretic treatment (Group 2), the logarithmic Pseudomonas count was 5.25 +/- 0.54 CFUs. At the control groups (Groups 3-5), the Pseudomonas counts were found to be much higher, 7.62 +/- 0.28, 7.22 +/- 0.29, and 6.29 +/- 0.45 CFUs, respectively. CONCLUSION: A short iontophoretic treatment using gentamicin-loaded hydrogels has potential clinical value in treating corneal infections.

Animals↗

PubMed1996

Noradrenalin enhances the activity of cochlear nucleus neurons in the rat.

The cochlear nucleus of rats is heavily innervated by noradrenergic fibres from the locus coeruleus. The physiological meaning of this innervation is poorly understood. Therefore, iontophoretically applied noradrenalin was tested on single neurons of the cochlear nucleus in urethane-anaesthetized rats. Iontophoresis of noradrenalin had a dual effect. During application noradrenalin led to moderate inhibition of tone-evoked activity in 37% of the tested neurons. In contrast, approximately 20-30 s after the onset of iontophoresis a long-lasting increase in discharge activity was found in most neurons. Data from iontophoresis of the alpha1-receptor agonist phenylephrine and the alpha2-receptor agonist clonidine suggest that the fast moderate inhibition is mediated by alpha2-receptors while the pronounced long-lasting elevated neuronal firing is mediated by alpha1-receptors. However, these data do not exclude the possibility that part of the response to noradrenalin is also mediated by beta-receptors. Electrical stimulation of the locus coeruleus resulted in an increase in discharge activity comparable with iontophoresis of noradrenalin or phenylephrine. Thus, activation of the locus coeruleus predominantly increases spontaneous and tone-evoked neuronal firing in the cochlear nucleus of the rat. This alpha-receptor-mediated enhanced discharge activity may serve to increase the sensitivity of acoustic processing mechanisms or to lower the threshold for short-latency acoustic reflexes.

Acoustic Stimulation↗

PubMed1998

Midbrain periaqueductal gray (PAG) inhibits nociceptive inputs to sacral dorsal horn nociceptive neurons through alpha2-adrenergic receptors.

Modulation of sacral spinal dorsal horn neurons by the ventrolateral PAG was studied by extracellular recording combined with microiontophoretic applications of alpha-adrenergic agonists or antagonists. Bicuculline (BIC, 15 ng) microinjected into the ventrolateral PAG produced a consistent inhibition of the responses of nociceptive dorsal horn neurons. After PAG-BIC applications, the total number of spikes per heat stimulation period was significantly decreased to a mean of 37 +/- 19% (n = 8) of the pre-BIC control. Local iontophoresis of the selective alpha2-adrenoceptor antagonists idazoxan or yohimbine but not the selective alpha1 antagonist benoxathian significantly reversed PAG-BIC-evoked inhibition. At low ejection currents, clonidine, an alpha2-adrenoceptor agonist, markedly reduced noxious heat-evoked responses but had no consistent action on the responses to iontophoresed excitatory amino acids [EAA; N-methyl--aspartate (NMDA) or kainic acid]. At ejection currents higher than required to block descending inhibition, idazoxan potentiated responses to both heat and EAA iontophoresis. At higher ejection currents, EAA responses were inhibited by clonidine. This indicates that both presynaptic and postsynaptic alpha2 receptors are capable of inhibiting the recorded neurons. Activation of the alpha1 adrenoceptors by iontophoresis of methoxamine often led to a marked increase in the responses to kainic acid and, to a lesser extent, to NMDA iontophoresis or noxious heat. Together with previously reported work, the current experiments demonstrate that PAG neurons inhibit nociceptive dorsal horn neurons primarily through an indirect alpha2 adrenoceptor mechanism. In this same population of dorsal horn neurons, norepinephrine has a direct alpha1-mediated excitatory effect.

Adrenergic alpha-Agonists↗

PubMed2001

Dendritic calcium spikes in layer 5 pyramidal neurons amplify and limit transmission of ligand-gated dendritic current to soma.

Long-lasting, dendritic, Ca(2+)-dependent action potentials (plateaus) were investigated in layer 5 pyramidal neurons from rat neocortical slices visualized by infrared-differential interference contrast microscopy to understand the role of dendritic Ca(2+) spikes in the integration of synaptic input. Focal glutamate iontophoresis on visualized dendrites caused soma firing rate to increase linearly with iontophoretic current until dendritic Ca(2+) responses caused a jump in firing rate. Increases in iontophoretic current caused no further increase in somatic firing rate. This limitation of firing rate resulted from the inability of increased glutamate to change evoked plateau amplitude. Similar nonlinear patterns of soma firing were evoked by focal iontophoresis on the distal apical, oblique, and basal dendrites, whereas iontophoresis on the soma and proximal apical dendrite only evoked a linear increase in firing rate as a function of iontophoretic current without plateaus. Plateau amplitude recorded in the soma decreased as the site of iontophoresis was moved farther from the soma, consistent with decremental propagation of the plateau to the soma. Currents arriving at the soma summed if plateaus were evoked on separate dendrites or if subthreshold responses were evoked from sites on the same dendrite. If plateaus were evoked at two sites on the same dendrite, only the proximal plateau was seen at the soma. Just-subthreshold depolarizations at two sites on the same dendrite could sum to evoke a plateau at the proximal site. We conclude that the plateaus prevent current from ligand-gated channels distal to the plateau-generating region from reaching the soma and directly influencing firing rate. The implications of plateau properties for synaptic integration are discussed.

Action Potentials↗

PubMed2005

Transdermal delivery of tea catechins by electrically assisted methods.

Tea polyphenols, including (+)-catechin, (-)-epicatechin, and (-)-epigallocatechin-3-gallate (EGCG), have been shown to possess potent antioxidant and chemopreventive activities. The aim of this study was to assess the effects of electroporation, iontophoresis, and their combination on the transdermal delivery of tea catechins across porcine skin. The permeation characteristics were investigated using various analogues of catechins, pH values, and modes of electroporation and iontophoresis. The mechanisms by which these catechins were transported via the skin were elucidated by examining the electric conductivity, transepidermal water loss (TEWL), and fusion of stratum corneum lipid liposomes (SCLL). The isomers, (+)-catechin and (-)-epicatechin, showed different behaviors of skin permeation and local skin deposition with the electrically assisted methods. The results suggest evidence of selective skin absorption of (-)-epicatechin over (+)-catechin. A synergistic effect was detected for (+)-catechin but not for (-)-epicatechin after application of electroporation followed by iontophoresis. The presence of a gallic acid ester in the structure of EGCG significantly increased the skin uptake of catechins. However, a negligible amount of or no EGCG molecules permeated across the skin. The mechanisms involved in the enhancement of electroporation may be the skin reservoir effect and an increase in skin permeability. The TEWL profiles suggest that in addition to the force of electrorepulsion, the skin hydration effect and structural alterations may also have contributed to the enhancement by iontophoresis. Electroporation did not influence the skin barrier function, although the skin permeability increased according to the SCLL fusion study.

Administration, Cutaneous↗

PubMed1992

Iontophoretic transmyocardial drug delivery. A novel approach to antiarrhythmic drug therapy.

BACKGROUND: Antiarrhythmic drugs often fail to achieve therapeutic effects without toxic systemic levels. Direct transport of drugs into the myocardium may circumvent this problem and may also provide new insights into antiarrhythmic drug effect on arrhythmogenic tissues. In a canine model, procainamide (PA) was delivered iontophoretically using pulsed current synchronized with the ventricular depolarization via an implantable defibrillator patch electrode that was modified to contain a 3.6-ml chamber. Myocardial tissue concentrations of PA were evaluated in 7-day myocardial infarcts (n = 16) that were exposed to 10 minutes of iontophoretic PA delivery and compared with passive diffusion (n = 5) and intravenous (n = 16) PA. These dogs were followed for 3 hours. The infarcted tissue PA levels were compared with normal myocardium. Coronary and systemic blood levels of PA, effective refractory period (ERP), diastolic threshold, and efficacy of ventricular tachycardia (VT) suppression were evaluated throughout the follow-up period. METHODS AND RESULTS: Three hours after 10 minutes of iontophoretic, passive, and intravenous PA, the epicardial layer concentration in the center of the infarcted zone was 840 +/- 853 micrograms/g, 93 +/- 90 micrograms/g, and 15 +/- 8 micrograms/g of tissue, respectively. In the endocardial layer, the PA concentrations with iontophoresis were 38 +/- 57 micrograms/g and were significantly higher than those achieved with either passive diffusion 38 +/- (4 +/- 2 micrograms/g) or with intravenous delivery (11 +/- 5 micrograms/g) (p less than 0.05). Epicardial tissue PA concentrations 3 hours after iontophoresis, passive diffusion, and intravenous PA in the normally perfused tissues were 14 +/- 13 micrograms/g, 3 +/- 2 micrograms/g, and 16 +/- 8 micrograms/g of PA, respectively. Venous blood levels were 2 +/- 3 micrograms/ml 3 hours after iontophoresis, 1 +/- 1 microgram/ml 3 hours after passive PA delivery, and 11 +/- 7 micrograms/ml with intravenous administration (p less than 0.05 intravenous versus passive and iontophoresis). Iontophoretic delivery of PA resulted in 22 +/- 29 msec ERP prolongation intramurally in the infarcted zone with no significant normal tissue ERP prolongation. Passive delivery of PA produced no significant changes in ERP. After intravenous infusion, the ERP in the infarcted zone increased by 35 +/- 29 msec and 13 +/- 12 msec in the normal tissue. Sustained monomorphic VT was induced in 20 animals. In one of these animals, only nonsustained VT could be induced at baseline; however, after intravenous PA, VT could be induced and remained inducible throughout the 3-hour follow-up period. In the iontophoretic delivery group, PA suppressed VT in all of the animals, with termination time ranging from 20 seconds to 7 minutes. In three cases, sustained monomorphic VT could be reinduced, two after 60 minutes and one after 120 minutes. However, in seven dogs, VT could not be induced during the 3-hour follow-up period. None of the dogs in which PA was delivered iontophoretically into the infarcted myocardium developed VT that was not induced before delivery of the drug. Intravenous PA administration resulted in VT suppression in one of 10 dogs. In two dogs, VT could not be induced before intravenous infusion of PA. However, after intravenous PA, VT could be induced. Immunohistochemical mapping of the PA within the infarcted tissue revealed transmural PA distribution. CONCLUSIONS: These data show that 1) the delivery of high transmural concentrations of PA directly into infarcted myocardium is both feasible and effective...

Animals↗

PubMed2003

Oligohydrosis and hyperthermia: pilot study of a novel topiramate adverse effect.

A 6-year-old boy with partial complex seizures developed recurrent episodes of hyperthermia 2 months after topiramate was introduced into his antiepilepsy drug regimen. Further investigation revealed that the febrile episodes were related to environmental temperature and physical activity. A pilocarpine iontophoresis sweat test showed that the amount of sweat produced by the child was 5% that of age-matched controls. Topiramate discontinuation resulted in the disappearance of febrile episodes and normalization of sweat quantity in repeat sweat testing. Based on this observation and the previous data on zonisamide and isolated case reports on topiramate-related hyperthermia and the effect on sweat production, topiramate was suspected of causing oligohydrosis. A pilot study was carried out involving 13 additional children and young adults (age range 1-37 years) receiving topiramate. All patients were directly questioned regarding symptoms of decreased sweating and heat intolerance, went through a pilocarpine iontophoresis sweat test, and were compared with 14 age-matched controls who went through the sweat test for unrelated reasons. Nine of the patients were found to have reduced sweat quantity on the pilocarpine iontophoresis sweat test (including index case) (mean 0.089 g/30 minutes, SD 0.082; age-matched control: mean 0.21 g/30 minutes, SD 0.06). Eight of them were children (below 16 years). However, only three patients revealed symptoms related to heat intolerance. Topiramate is most likely responsible for decreased sweat production as detected by a pilocarpine iontophoresis sweat test. The effect seems to be more significant in children than in adults. There is a discrepancy between test results and clinical symptoms. Interestingly, oligohydrosis was found to be a relatively common side effect of zonisamide. Both zonisamide and topiramate share a carbonic anhydrase inhibitor activity. The significance of oligohydrosis in hot climates should not be underestimated. Its extent, the role of sweat test prediction, and clinical significance during topiramate treatment should be further estimated.

Adolescent↗

PubMed2002

Electrically enhanced transdermal delivery of a macromolecule.

The purpose of this study was to establish the delivery parameters for the enhanced transdermal delivery of dextran sulfate (MW 5000 Da). Full-thickness pig skin or epidermis separated from human cadaver skin was used. Silver-silver chloride electrodes were used to deliver the current (0.5 mA cm-2). For electroporation experiments, one or more pulses were given using an exponential decay pulse generator. The correct polarity for iontophoresis and pulsing was first established as cathode in the donor. The amount of drug delivered increased with increasing donor concentration up to a point, but not any further. The amount delivered also increased with pulse voltage, the delivery being twice as much as with iontophoresis alone (144.5+/-10.35 microg cm(-2)), when 6 pulses of 500 V were applied at time zero before iontophoresis (276+/-45.2 microg cm(-2)). It was observed that the amount delivered was a function of increasing pulse length when the apparent charge delivered was kept constant. Transport through pig skin (107.4+/-24.4 microg cm(-2)) was found to be comparable with that through human epidermis (84.9+/-18.4 microg cm(-2)). In conclusion, we have demonstrated the transdermal delivery of a 5000 Da molecular weight dextran sulfate using iontophoresis. It was also seen that iontophoretic delivery could be enhanced by simultaneous electroporation.

Administration, Cutaneous↗

PubMed2004

Acid-induced pain and its modulation in humans.

Despite the discovery of ion channels that are activated by protons, we still know relatively little about the signaling of acid pain. We used a novel technique, iontophoresis of protons, to investigate acid-induced pain in human volunteers. We found that transdermal iontophoresis of protons consistently caused moderate pain that was dose-dependent. A marked desensitization occurred with persistent stimulation, with a time constant of approximately 3 min. Recovery from desensitization occurred slowly, over many hours. Acid-induced pain was significantly augmented in skin sensitized by acute topical application of capsaicin. However, skin desensitized by repeated capsaicin application showed no significant reduction in acid-induced pain, suggesting that both capsaicin-sensitive and insensitive sensory neurons contribute to acid pain. Furthermore, topical application of non-steroidal anti-inflammatory drugs (NSAIDs) significantly attenuated acid-evoked pain but did not affect the heat pain threshold, suggesting a specific interaction between NSAIDs and peripheral acid sensors. Subcutaneous injection of amiloride (1 mm) also significantly inhibited the pain induced by iontophoresis of acid, suggesting an involvement of acid-sensing ion channel (ASIC) receptors. Conversely, iontophoresis of acid over a wide range of skin temperatures from 4 to 40 degrees C produced only minor changes in the induced pain. Together these data suggest a prominent role for ASIC channels and only a minor role for transient receptor potential vanilloid receptor-1 as mediators of cutaneous acid-induced pain.

Acid Sensing Ion Channels↗

PubMed2002

Quantification of topically delivered 5-aminolevulinic acid by lontophoresis across ex vivo human stratum corneum.

Iontophoretic transport of the prodrug 5-aminolevulinic acid (ALA), which is used for photodynamic therapy (PDT), across human stratum corneum (SC) was studied quantitatively in vitro. The experiments were carried out in a three-compartment iontophoresis cell consisting of two electrode chambers equipped with Ag-AgCl electrodes, each separated from a central acceptor chamber by a sheet of SC, supported by a dialysis membrane, to mimic the side-by-side configuration normally used in vivo. Acceptor fluid samples were collected every hour for a period of 30 h in a fraction collector and analyzed by high-performance liquid chromatography-fluorometry after derivatization of the ALA. The iontophoretic ALA flux was studied as a function of the applied current density and the ALA concentration in the donor solution (1, 2.5 or 10% ALA). Depending on the ALA concentration in the donor cell, iontophoresis enhances the flux from close to the detection limit of 0.23 nmol cm(-2) h(-1) at zero current density (passive diffusion) to several hundred or thousand nanomoles per square centimeter per hour at current densities ranging from 100 to 1000 microA cm(-2). For example, interpolating our data we find that with an ALA concentration of 2% in the donor chamber, a current density of 0.255 mA cm(-2) transports 0.065 micromol cm(-2) ALA across the SC in 10 min (conditions of Rhodes et al. (1997), J. Invest. Dermatol. 108, 87-91). For passive diffusion we find that a 5 h topical application of 20% ALA results in the transport of 0.05 micromol cm(-2). Thus, the amount of ALA that passively diffuses through the SC in several hours, leading to therapeutic levels of protoporphyrin IX (PpIX) in the epidermis, can be delivered by iontophoresis in 10 min or less. However, because the formation of sufficient PpIX also requires several hours and also because the SC overlying skin lesions such as basal cell carcinoma (BCC) is not intact, the clinical benefit of topical ALA delivery by iontophoresis for PDT of BCC is yet to be established.

Administration, Topical↗

PubMedDate not supplied

An electrophoretic method to deliver topical drugs to the eye.

It is possible that many patients avoid complete ophthalmic exams because pupil dilation is slow, reversal sluggish, and vision blurred. Others experience incomplete dilation during exams or prior to surgery when good dilation is essential to successful outcome. Iontophoresis, the application of low-level electrical current to promote traversal of desired molecules across a boundary, has been used for many years and has recently become common in transdermal drug delivery. We now investigate iontophoresis as a method of accelerating drug absorption into the ocular anterior segment. In vivo rabbit studies assessed iontophoresis effects on the performance of dilators and constrictors. 1-mA and 4-mA direct current levels applied for 2-minute durations yielded dilation time-history measurements. Subsequent in vitro tests at a wide range of current densities showed minimal chemical modifications in ocular pharmaceuticals. Drug samples processed through high-performance liquid chromatography (HPLC) pinpointed minimal structural changes. Detailed in vivo rabbit testing is under way. Using 2 dilators and constrictors in crossed testing with 0.5-mA to 1.25-mA current levels and 20-sec to 60-sec durations, we recorded dilation progress by digital photography. Initial studies showed faster, larger dilations and quicker reversal using iontophoresis. Drug testing showed chemical structures remaining constant for clinically useful current levels, < or = 1 mA (< or = 1.25 mA/cm2 current density). Drug pH and HPLC retention times were constant within this range, and resistivity varied linearly as expected for increasing current. Rabbit testing will quantify improved drug speed and efficacy, validate the charge delivery electrode design, and indicate iontophoretic current and duration for further use. Tested ocular drugs showed no degradation when exposed to clinically useful iontophoretic currents. Preliminary results indicate significant time reductions for dilation and reversal, plus increases in maximum dilation. This procedure may aid clinicians by allowing more rapid complete examinations and surgical preparations for patients. Making dilation more convenient will also improve patient acceptance of exams, aiding earlier detection and treatment of ocular disease.

Animals↗

PubMed2002

Failure to detect dexamethasone phosphate in the local venous blood postcathodic lontophoresis in humans.

STUDY DESIGN: A single-blind, 2-factor (4 treatments by 8 time points) repeated-measures study design. OBJECTIVE: To analytically determine dexamethasone and dexamethasone phosphate concentrations in plasma derived from proximal effluent venous blood, following cathodic iontophoresis. METHODS AND MEASURES: Six volunteers received the following dexamethasone phosphate (2.5 ml, 4 mg/ml) treatments to their wrists on separate occasions: cathodic iontophoresis (4 mA, 10 minutes or 4 mA, 20 minutes), passive application (10 or 20 minutes). Plasma samples from the ipsilateral antecubital vein were obtained 10 minutes prior to and half way through the treatment (5 or 10 minutes), at the end of the treatment (10 or 20 minutes), and posttreatment (15, 30, 60, 90, and 120 minutes). The present investigation examined: (1) the sensitivity and linearity of extraction and analysis of dexamethasone and dexamethasone phosphate; (2) the necessity for determining both; and (3) the plasma levels from proximal effluent venous blood following cathodic iontophoresis. RESULTS: The aggregate (n = 18) of the 6-point standard curves were linear for dexamethasone (r > 0.974) and dexamethasone phosphate (r > 0.829). In vitro dephosphorylation of dexamethasone phosphate to dexamethasone occurred in plasma at 37 degrees C and during freeze-thaw. Measurable dexamethasone or dexamethasone phosphate concentrations were absent at all time points and under all conditions in the human subjects. CONCLUSIONS: These results demonstrate the sensitivity of the current assay and the need for evaluating both forms of the drug, as in vitro dephosphorylation results in the presence of dexamethasone and dexamethasone phosphate in samples. Absence of measurable dexamethasone or dexamethasone phosphate in the proximal effluent venous blood may require re-evaluation of the extent of drug delivery during the clinical iontophoresis of dexamethasone phosphate.

Adult↗

PubMed1987

HSV-1 latency: thymidine kinase requirement and the round-trip theory.

The present study used the rabbit iontophoresis model to examine the thymidine kinase (TK) requirement for HSV-1 latency, and test the round trip theory of latency with emergent phenotypic mutations of the HSV-1 TK negative (TK-) inoculating strain. The results demonstrated repeated induced ocular shedding of latent HSV-1 in 14-100% of rabbits. The TK phenotype of recovered tear film following spontaneous shedding and repeated iontophoresis induction was thymidine kinase negative in 90% of eyes. Sequential shedding of TK- virus from the same eye over time was demonstrated in 21% of eyes in 33% of rabbits. We conclude that TK is not an absolute requirement for the establishment or reactivation of latent HSV-1 in the rabbit model. The round trip theory of latency was not supported as TK+ isolates and syncytial variants of the TK- inoculating strain which were recovered at the ocular surface after the initial iontophoresis could not be demonstrated following subsequent trials of iontophoresis.

Animals↗

PubMed1987

Adrenergically induced recurrent HSV-1 corneal epithelial lesions.

Herpes simplex virus type 1 (HSV-1) ocular shedding and recurrent HSV-1 corneal epithelial lesions were assessed after ocular iontophoresis of 0.1% 6-hydroxydopamine followed by topical ocular instillation of 0.1% Propine in ten rabbits latently infected with HSV-1 strain McKrae. Iontophoresis was performed once at 0.5 mAmp for five minutes and 0.1% Propine drops were instilled four times a day beginning three days after iontophoresis and continuing for five consecutive days. Over an eight day period beginning three days after iontophoresis, ocular tear film samples were collected on Dacron swabs with care taken to avoid contact with the corneal epithelium. The corneas were examined daily for the presence of epithelial lesions using a slit-lamp biomicroscope. Three types of lesions were observed: deep punctate lesions, dendritic lesions, and geographic epithelial defects. The ratio of positive HSV-1 eye swabs to total eye swabs was 36/157 (23%). The ratio of total positive days of corneal lesions to total days was 40/160 (25%). There were 23 deep punctate lesions, 13 dendritic lesions, and four geographic epithelial defects. There were 24/36 (67%) positive HSV-1 eye swabs associated with concurrent HSV-1 corneal epithelial lesions. There were 105/121 (87%) negative eye swabs with concurrent negative slit-lamp examinations. Chi square analysis showed significant (p less than 0.001) association of HSV-1 positive eye swabs and HSV-1 corneal lesions. These results suggest that adrenergic ocular treatment may induce both HSV-1 ocular shedding (reactivation) and HSV-1 corneal epithelial lesions (recurrence) in rabbits latently infected with HSV-1 strain McKrae.

Animals↗