Researchers from George Washington University (GW) have discovered that topically applied nitric oxide-releasing nanoparticles (NO-np) are a feasible treatment for deep fungal infections caused by dermatophytes on the skin. Currently, these infections are being treated with systemic antifungals.
Adam Friedman, MD (Credit. George Washington University)
Dermatophytosis, also known as ringworm, refers to a fungal infection of the nails, hair or skin that affects millions of people spread all over the world. Often, superficial infections are managed with topical agents, however, fungal infections which penetrate the hair follicle or spread into deeper layers of the skin can be treated effectively only with the help of oral or systemic antifungal therapies. Limited penetration through the skin is offered by topical antifungals.
Systemic antifungals, while effective, can come with some baggage, given the duration of treatment can be lengthy. They are also known for their ability to adversely interact with many commonly used medications such as blood thinners and anti-hypertensives, or even cause various side effects themselves. The purpose of this study was to explore whether nanotechnology — materials that are billionths of a meter — could be used to overcome need for systemic medications, which would ultimately be safer and easier on the patient.
Adam Friedman, MD, Associate Professor of Dermatology at the GW School of Medicine and Health Sciences and Senior Author of the study
Friedman along with collaborators at the Albert Einstein College of Medicine turned to nitric oxide as the perfect agent for treatment. Nitric oxide is a natural, gaseous immunomodulator with broad-spectrum, multi-faceted antimicrobial activity.
“While we have known for decades that nitric oxide has tremendous potential in so many areas of medicine, its use has been limited due to the lack of effective delivery systems,” Friedman said. “Here we used a well-studied nanoparticle that can actually make nitric oxide, not just release it, and deliver therapeutic levels over time to attack these deep and difficult to reach infections.”
In an animal model, the Researchers discovered that NO-np facilitated a more impactful, quicker response to treatment in comparison to the commercially available topical terbinafine, proving 95% of infection clearance by the third day of treatment. These findings are consistent with several earlier reports utilizing the NO-np against bacterial and fungal surgical wound and burn infection.
The next step is to scale up the technology for clinical trial use in several therapeutic areas given the diverse clinical implications of the nitric oxide producing nanoformulation, as well as the platform overall given its unique ability to encapsulate and deliver a broad range of active ingredients. Dermatophyte infections impact such a large, diverse population, so it’s important to find new treatments that are safe and more effective for all patients.
Adam Friedman, MD, A ssociate P rofessor of D e rmatology at the GW School of Medicine and Health Sciences and S enior A uthor o f t he stu dy