The present invention relates to a minimally invasive method of diagnosing atopic dermatitis using a microneedle patch and a minimally invasive kit for diagnosing atopic dermatitis including a microneedle patch.
Numerous drugs and physiologically active substances have been developed for the treatment of diseases. However, in the delivery of drugs and physiologically active substances into the body, problems associated with passage through biological barriers (e.g., skin, oral mucosa, brain-vascular barrier, etc.) and with the efficiency of drug delivery still remain as problems to be solved.
Drugs and physiologically active substances are generally administered orally in tablet or capsule form, but many drugs cannot be effectively delivered by this administration method because they are digested or absorbed in the gastrointestinal tract or lost due to a liver mechanism. Furthermore, some drugs cannot effectively diffuse across the intestinal mucosa. For example, in the case of patients who have to take medications at specific time intervals or critical patients who cannot take medications, patient compliance also becomes a problem.
Another common technique for the delivery of drugs and bioactive substances is the use of a conventional injection needle. This method is more effective than oral administration, but has problems in that it causes pain at the injection site, local damage to the skin, bleeding, and disease infection at the injection site.
In order to solve the problems of oral administration and subcutaneous injection, transdermal administration using a patch is used. The transdermal administration using a patch has fewer side effects and high patient compliance is easy to maintain a constant blood drug concentration.
In order to solve the above problems, various microstructures including microneedles have been developed. As materials for the microneedle, metals and various polymer materials have been used. In recent years, biodegradable polymer materials have attracted attention as materials for the microneedles.
A representative method for fabricating a microstructure formed of a biodegradable material is a method using a mold. A mold having an intaglio corresponding to the shape of a microstructure to be formed is first fabricated by applying a semiconductor fabrication process, and a microstructure material is poured into such a mold, solidified and then separated from the mold, thereby forming a microstructure, that is, a microneedle.
The present applicant has a number of domestic and foreign patents related to a method of fabricating a microstructure using a droplet-born air blowing process, as a new fabrication method that may replace the mold-based microstructure fabrication method. The droplet-born air blowing process will be described in brief below. The droplet-born air blowing process includes: spotting a viscous biocompatible polymer substance either on the bottom layer of a patch placed on one substrate or on the bottom layer of the patch before being coupled to the patch; spotting the same biocompatible polymer substance either on the bottom layer of a patch placed on another substrate or on the bottom layer of the patch before being coupled to the patch (or omitting this operation); inverting the other substrate upside down; approaching the inverted other substrate toward the one substrate so that the spotted biocompatible polymer substance on the inverted other substrate is brought into contact with the spotted biocompatible polymer substance on the one substrate; spacing the two substrates apart from each other to stretch (elongate) the viscous biocompatible polymer substances which have been brought into contact with each other; performing air blowing after the stretching operation to fix the stretched state of the biocompatible polymer substance; and cutting a middle portion of the stretched biocompatible polymer substance so that the same microstructure is formed on each of the two substrates.
In the above, the technical meaning of the microstructure as a means for delivering drugs and bioactive substances, the method of fabricating the microstructure, and the like have been described in brief. The present applicant has reached the present invention and proposes to use the microstructure for a new purpose rather than the delivery of drugs and physiologically active substances. In other words, a patch including the microstructure, that is, a microneedle, is used for minimally invasive diagnosis of atopic dermatitis.
Atopic dermatitis is an inflammatory skin disease accompanied by itching, and is the most representative allergic disease along with allergic rhinitis and bronchial asthma. Atopic dermatitis occurs mainly in infants and children with a prevalence of 10 to 30%, but in recent years, atopic dermatitis in adults has increased. In the main pathological mechanism of atopic dermatitis, abnormalities in the skin barrier, immunological abnormalities, genetic predispositions, environmental predispositions, etc. are involved. Abnormalities in the skin barrier are caused by a decrease in the synthesis of numerous biological factors (such as filaggrin), which are involved in the differentiation of keratinocytes, and ceramide, which is an important component of skin barrier lipids, and cause skin dryness and itching. Immunological abnormalities are caused by the complex action of innate and adaptive immune responses caused by cells such as dendritic cells, T cells, and other innate immune cells (mast cells, eosinophils, basophils, neutrophils), which secrete various cytokines, such as TSLP, IL-4 and IL-13, and inflammatory substances such as chemokines. Thereamong, the most key cytokines in pathogenesis are IL-4 and IL-13. Recently, many biologic drugs targeting these markers have been developed and widely used as new therapeutic agents for intractable atopic dermatitis and exhibit very excellent effects.
Observation of changes in numerous biological substances related to the pathogenesis of atopic dermatitis as described above is associated with the development of new therapeutic drugs. In order to discover a new pathogenesis of atopic dermatitis, determine the effect of drugs on the treatment of atopic dermatitis, predict the prognosis of atopic dermatitis, and discover a new therapeutic agent, a method of biopsying the lesion site of atopic dermatitis and analyzing atopic dermatitis-related biological factors in the tissue is most commonly used.
A total of three types of microstructure patches were used in this study and include: a microstructure-free blank patch as a control for a microstructure patch; a hollow microstructure patch; and a soluble microstructure patch. The blank patch as a control is generally composed of only a hydrocolloid patch that is mainly used for wound healing. The hollow microstructure patch has advantages that it is possible to minimize pain and infection risk through a hole having a micro-sized cross-sectional area in the microstructure, and at the same time, drug delivery is possible. In the soluble microstructure patch, a microneedle including a pharmaceutical-grade hyaluronic acid component is formed on the hydrocolloid patch. Methods for fabricating microstructure patches include the above-described mold-based method and droplet-born air blowing method, and any fabrication method may be used as long as a microneedle including a hyaluronic acid component is formed on a patch. When these microstructure patches are applied to the skin, as shown in
An object of the present invention is to solve the problems of the conventional method of diagnosing atopic dermatitis by tissue biopsy or tape stripping.
Conventional tissue biopsy has disadvantages in that it requires the expert skill of an operating surgeon, causes repulsion due to pain caused to a patient, and leaves a scar at the biopsy site after the biopsy.
Conventional tape stripping has a disadvantage in that the substances attached to the tape are limited to the stratum corneum, and thus may be used only as an auxiliary diagnostic method and does not provide complete results.
An object of the present invention is to provide a novel minimally invasive method for diagnosing atopic dermatitis and a novel minimally invasive kit for diagnosing atopic dermatitis, which cause little pain, do not leave a scar, and may increase patient compliance, compared to conventional tissue biopsy, and at the same time, may increase the reliability of analysis results compared to conventional tape stripping by sampling skin biomarkers from the stratum corneum.
A minimally invasive method for diagnosing atopic dermatitis according to one embodiment of the present invention includes steps of: applying, to the skin of a subject, a microneedle patch including a plurality of microneedles, which are formed of biodegradable polymer hyaluronic acid and have a solid structure, and a bottom layer on which the plurality of microneedles are formed; maintaining the microneedle patch for a predetermined time in a state in which the microneedle patch is attached to the skin of the subject; separating the microneedle patch from the skin of the subject after the predetermined time and putting the separated microneedle patch into quantitative testing; reading the amounts of interleukin-4 and interleukin-13, adsorbed onto the microneedle surface of the microneedle patch, in the quantitative testing; and measuring the activity of atopic dermatitis based on the read amounts of interleukin-4 and interleukin-13 .
A minimally invasive kit for diagnosing atopic dermatitis according to one embodiment of the present invention includes: a device configured to quantitatively analyze the amount of protein extracted from the skin of a subject; and a microneedle patch including a plurality of microneedles, which are formed of biodegradable polymer hyaluronic acid and have a solid structure, and a bottom layer on which the plurality of microneedles are formed. The microneedle patch is applied to the skin of the subject, maintained for a predetermined time, and then separated from the skin, and in the separated state, the proteins from the subject, adsorbed onto surfaces of the microneedles of the microneedle patch, are quantitatively analyzed by the device. The device reads the amounts of interleukin-4 and interleukin-13 adsorbed onto surfaces of the microneedles of the microneedle patch. The activity of atopic dermatitis is evaluated based on the read amounts of interleukin-4 and interleukin-13.
In addition, an additional configuration may be further provided in the minimally invasive method for diagnosing atopic dermatitis or the minimally invasive kit for diagnosing atopic dermatitis according to the present invention.
According to the present invention, it is possible to solve the problems of the conventional method of diagnosing atopic dermatitis by tissue biopsy or tape stripping.
Conventional tissue biopsy has disadvantages in that it requires the expert skill of an operating surgeon, causes repulsion due to pain caused to a patient, and leaves a scar at the biopsy site after the biopsy.
Conventional tape stripping has a disadvantage in that the substances attached to the tape are limited to the stratum corneum, and thus may be used only as an auxiliary diagnostic method and does not provide complete results.
According to the present invention, it is possible to provide a novel minimally invasive method for diagnosing atopic dermatitis and a novel minimally invasive kit for diagnosing atopic dermatitis, which cause little pain, do not leave a scar, and may increase patient compliance, compared to conventional tissue biopsy, and at the same time, may increase the reliability of analysis results compared to conventional tape stripping by sampling skin biomarkers from the stratum corneum.
Reference is made to the accompanying drawings, which show, by way of illustration, specific embodiments in which the present invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the present invention. It should be understood that various embodiments of the present invention are different but need not be mutually exclusive. The following detailed description is not to be taken in a limiting sense, and the scope of the present invention should be construed as covering the scope of the claims and all equivalents thereto.
Hereinafter, various preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings in order to enable those of ordinary skill in the art to easily practice the present invention.
The upper left of
The x-axis of
What should be looked at carefully in the table of
The present inventors continued experiments and analyzed the cause of how this remarkable difference in the results appeared depending on the molecular weight of hyaluronic acid, which is a component of the microneedle patch, and found the cause in the rate of dissolution into the skin depending on the difference in the molecular weight. The microneedle component of a currently commercialized microneedle patch is generally a biocompatible and biodegradable polymer material. “Biocompatible material” refers to a material that is not toxic to the human body and is chemically inert. In addition, “biodegradable material” refers to a material that may be degraded in vivo by body fluids, enzymes or microorganisms. In addition, it is known that the dissolution rate of biodegradable materials in vivo tends to increase as the molecular weight becomes smaller, and tends to decrease as the molecular weight becomes higher. Meanwhile, the following materials are known as biocompatible polymers:
Hyaluronic acid (HA), gelatin, chitosan, collagen, alginic acid, pectin, carrageenan, chondroitin (sulfate), dextran (sulfate), polylysine, carboxymethyl chitin, fibrin, agarose, pullulan, cellulose, polyvinylpyrrolidone (PVP), polyethylene glycol (PEG), polyvinyl alcohol (PVA), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hydroxypropyl methyl cellulose (HPMC), sodium carboxymethylcellulose, polyalcohol, gum Arabic, alginate, cyclodextrin, dextrin, glucose, fructose, starch, trehalose, glucose, maltose, lactose, lactulose, fructose, turanose, melitose, melezitose, dextran, sorbitol, xylitol, palatinit, polylactic acid, polyglycolic acid, polyethylene oxide, polyacrylic acid, polyacrylamide, polymethacrylic acid, polymaleic acid, a poly(ethyleneglycol)/polyester) copolymer, chitosan/glycerol phosphate, polyphosphazene, polycaprolactone, polycarbonate, poly(ethylene glycol)/poly(propylene glycol), polycyanoacrylate, polyorthoester, poly(N-(2-hydroxyethyl)methacrylamide-lactate, poly(propylene phosphate), and the like.
When a microneedle patch is attached to the skin, protein may be extracted after it adheres to the biocompatible microneedle structure in a process in which the microneedles of the patch enter the dermal layer of the skin and in a process in which the microneedles are maintained after the entry. However, the low-molecular-weight hyaluronic acid microneedle has a relatively high dissolution rate even if protein in vivo adheres to the surface of the microneedle, and thus when the microneedle is attached to the skin for a long time, the protein attached to the surface may be lost while the microneedle itself is dissolved. It is believed that the experimental results in
Referring to the results in
The following facts can be seen from the experimental results shown in
In the case of the blank patch, there was no significant change in the results either when the attachment time was 10 seconds or when the attachment time was 30 seconds, and the table in
It is evaluated that the technical significance of the experiment shown in
Finally, the present inventors conducted the experiment (basic experiment 3) shown in
In the experiment shown in
The blank patch on the left side of
This clinical trial was conducted on 20 patients with atopic dermatitis (forearm). The study period was 5 months after IRB approval. The study method is as follows.
1) Week 0
2) Week 2
In this way, testing on each subject was conducted at week 0 and week 2, and the clinical usefulness of the testing method was evaluated by comparing the test result with the clinical course. In this evaluation, protein quantification was performed by BCA assay, and IL-4, IL-13, and IFN-gamma were quantified by performing ELISA assay. SPSS was used as a statistical analysis technique.
At week 0, skin samples were obtained using forearm biopsy, tape stripping, and three types of microneedle patches, and at week 2, skin samples were obtained using three types of microneedle patches. The obtained samples were placed in 60-mm dishes and immediately protein was extracted therefrom using an SDS solution in the laboratory and stored at -80° C.
The amount of quantified protein can be seen in the graph of
The expression levels of IL-4, IL-13 and IFN-gamma in the samples obtained from normal subjects and atopic dermatitis patients by tissue biopsy, the tape and microneedle were analyzed. In the case of tissue biopsy, RNA was isolated and the expression levels of IL-4, IL-13 and IFN-gamma were analyzed by qRT-PCR assay, and expression of the above targets in the samples from the normal subjects was not identified, unlike the samples from the patients with atopic dermatitis. Next, in the case of the tape and the microneedle, protein was isolated and the expression levels of IL-13 and IFN-gamma were analyzed by ELISA assay. As shown in
The expression of IL-4, IL-13 and IFN-gamma in the obtained samples was measured by ELISA assay. The results are shown in
From the measurement results in
More specifically, the measurement result in
For patient No. 1, the OD value of IL-4 at week 0 is 0.021, and the OD value of IL-4 at week 2 is 0.044.
For patient No. 2, the OD value of IL-4 at week 0 is 0.029, and the OD value of IL-4 at week 2 is 0.012.
For patient No. 2, the OD value of IL-4 at week 0 is 0.026, and the OD value of IL-4 at week 2 is 0.017.
For patient No. 6, the OD value of IL-4 at week 0 is 0.053, and the OD value of IL-4 at week 2 is 0.043.
For patient No. 8, the OD value of IL-4 at week 0 is 0.025, and the OD value of IL-4 at week 2 is 0.021.
For patient No. 9, the OD value of IL-4 at week 0 is 0.072, and the OD value of IL-4 at week 2 is 0.141.
For patient No. 10, the OD value of IL-4 at week 0 is 0.065, and the OD value of IL-4 at week 2 is 0.093.
For patient No. 11, the OD value of IL-4 at week 0 is 0.012, and the OD value of IL-4 at week 2 is 0.098.
For patient No. 12, the OD value of IL-4 at week 0 is 0.053, and the OD value of IL-4 at week 2 is 0.095.
For patient No. 13, the OD value of IL-4 at week 0 is 0.026, and the OD value of IL-4 at week 2 is 0.022.
For patient No. 14, the OD value of IL-4 at week 0 is 0.029, and the OD value of IL-4 at week 2 is 0.027.
For patient No. 15, the OD value of IL-4 at week 0 is 0.034, and the OD value of IL-4 at week 2 is 0.025.
For patient No. 17, the OD value of IL-4 at week 0 is 0.036, and the OD value of IL-4 at week 2 is 0.027.
For patient No. 18, the OD value of IL-4 at week 0 is 0.038, and the OD value of IL-4 at week 2 is 0.025.
For patient No. 19, the OD value of IL-4 at week 0 is 0.023, and the OD value of IL-4 at week 2 is 0.021.
For patient No. 21, the OD value of IL-4 at week 0 is 0.026, and the OD value of IL-4 at week 2 is 0.052.
For patient No. 22, the OD value of IL-4 at week 0 is 0.012, and the OD value of IL-4 at week 2 is 0.038.
For patient No. 23, the OD value of IL-4 at week 0 is 0.031, and the OD value of IL-4 at week 2 is 0.017.
For patient No. 24, the OD value of IL-4 at week 0 is 0.035, and the OD value of IL-4 at week 2 is 0.028.
For patient No. 25, the OD value of IL-4 at week 0 is 0.025, and the OD value of IL-4 at week 2 is 0.024.
More specifically, the measurement results in
For patient No. 1, the net OD value of IL-13 at week 0 is 0.0027, and the net OD value of IL-4 at week 2 is 0.0017.
For patient No. 2, the net OD value of IL-13 at week 0 is 0.0072, and the net OD value of IL-4 at week 2 is 0.0002.
For patient No. 3, the net OD value of IL-13 at week 0 is 0.0072, and the net OD value of IL-4 at week 2 is 0.0017.
For patient No. 6, the net OD value of IL-13 at week 0 is 0.0132, and the net OD value of IL-4 at week 2 is 0.0077.
For patient No. 8, the net OD value of IL-13 at week 0 is 0.0062, and the net OD value of IL-4 at week 2 is 0.0059.
For patient No. 9, the net OD value of IL-13 at week 0 is 0.0059, and the net OD value of IL-4 at week 2 is 0.0069.
For patient No. 10, the net OD value of IL-13 at week 0 is 0.0052, and the net OD value of IL-4 at week 2 is 0.0059.
For patient No. 11, the net OD value of IL-13 at week 0 is 0.0052, and the net OD value of IL-4 at week 2 is 0.0052.
For patient No. 12, the net OD value of IL-13 at week 0 is 0.0022, and the net OD value of IL-4 at week 2 is 0.0062.
For patient No. 13, the net OD value of IL-13 at week 0 is 0.0132, and the net OD value of IL-4 at week 2 is 0.0067.
For patient No. 14, the net OD value of IL-13 at week 0 is 0.0072, and the net OD value of IL-4 at week 2 is 0.0069.
For patient No. 15, the net OD value of IL-13 at week 0 is 0.0037, and the net OD value of IL-4 at week 2 is 0.0042.
For patient No. 17, the net OD value of IL-13 at week 0 is 0.0042, and the net OD value of IL-4 at week 2 is 0.0037.
For patient No. 18, the net OD value of IL-13 at week 0 is 0.0027, and the net OD value of IL-4 at week 2 is 0.0032.
For patient No. 19, the net OD value of IL-13 at week 0 is 0.0059, and the net OD value of IL-4 at week 2 is 0.0049.
For patient No. 21, the net OD value of IL-13 at week 0 is 0.0065, and the net OD value of IL-4 at week 2 is 0.0082.
For patient No. 22, the net OD value of IL-13 at week 0 is 0.0102, and the net OD value of IL-4 at week 2 is 0.0102.
For patient No. 23, the net OD value of IL-13 at week 0 is 0.0079, and the net OD value of IL-4 at week 2 is 0.0079.
For patient No. 24, the net OD value of IL-13 at week 0 is 0.0137, and the net OD value of IL-4 at week 2 is 0.0092.
For patient No. 25, the net OD value of IL-13 at week 0 is 0.0502, and the net OD value of IL-4 at week 2 is 0.0082.
More specifically, the measurement results in
For patient No. 1, the net OD value of IFN-gamma at week 0 is 0.0220, and the net OD value of IFN-gamma at week 2 is 0.0380.
For patient No. 2, the net OD value of IFN-gamma at week 0 is -0.0005, and the net OD value of IFN-gamma at week 2 is 0.0410.
For patient No. 3, the net OD value of IFN-gamma at week 0 is 0.0015, and the net OD value of IFN-gamma at week 2 is -0.0045.
For patient No. 6, the net OD value of IFN-gamma at week 0 is 0.0350, and the net OD value of IFN-gamma at week 2 is 0.0140.
For patient No. 8, the net OD value of IFN-gamma at week 0 is 0.0395, and the net OD value of IFN-gamma at week 2 is 0.0340.
For patient No. 9, the net OD value of IFN-gamma at week 0 is 0.0345, and the net OD value of IFN-gamma at week 2 is 0.0640.
For patient No. 10, the net OD value of IFN-gamma at week 0 is 0.0145, and the net OD value of IFN-gamma at week 2 is 0.0320.
For patient No. 11, the net OD value of IFN-gamma at week 0 is 0.0515, and the net OD value of IFN-gamma at week 2 is 0.0465.
For patient No. 12, the net OD value of IFN-gamma at week 0 is 0.0295, and the net OD value of IFN-gamma at week 2 is 0.0340.
For patient No. 13, the net OD value of IFN-gamma at week 0 is 0.0410, and the net OD value of IFN-gamma at week 2 is 0.0340.
For patient No. 14, the net OD value of IFN-gamma at week 0 is 0.0380, and the net OD value of IFN-gamma at week 2 is 0.0615.
For patient No. 15, the net OD value of IFN-gamma at week 0 is 0.0455, and the net OD value of IFN-gamma at week 2 is 0.0560.
For patient No. 17, the net OD value of IFN-gamma at week 0 is 0.0310, and the net OD value of IFN-gamma at week 2 is 0.0390.
For patient No. 18, the net OD value of IFN-gamma at week 0 is 0.0405, and the net OD value of IFN-gamma at week 2 is 0.0275.
For patient No. 19, the net OD value of IFN-gamma at week 0 is 0.0510, and the net OD value of IFN-gamma at week 2 is 0.0415.
For patient No. 21, the net OD value of IFN-gamma at week 0 is 0.0285, and the net OD value of IFN-gamma at week 2 is 0.0000.
For patient No. 22, the net OD value of IFN-gamma at week 0 is 0.0160, and the net OD value of IFN-gamma at week 2 is 0.0255.
For patient No. 23, the net OD value of IFN-gamma at week 0 is 0.0140, and the net OD value of IFN-gamma at week 2 is 0.0260.
For patient No. 24, the net OD value of IFN-gamma at week 0 is 0.0230, and the net OD value of IFN-gamma at week 2 is 0.0320.
For patient No. 24, the net OD value of IFN-gamma at week 0 is 0.0365, and the net OD value of IFN-gamma at week 2 is 0.0285.
The present inventors analyzed the correlation between the expression of target proteins in the skin samples, obtained by the hyaluronic acid microneedle patch, and the clinical course of atopic dermatitis by statistical analysis (SPSS). The results are shown in
For statistical analysis of the correlation, the present inventors assigned different scores according to the clinical course of the lesion. A score of -1 was assigned to patient Nos. 12 and 15, who were clinically judged to have significantly aggravated or slightly aggravated symptoms, and a score of 1 was assigned to all patients other than patent No. 15. Referring to the clinical course after 2 weeks shown on the rightmost side of the table in
The x-axis of the graph shown in the top of each of
In addition, using the minimally invasive kit for diagnosing atopic dermatitis according to one embodiment of the present invention, which consists of a microneedle patch formed of biodegradable polymer hyaluronic acid and a device capable of quantitative analysis of proteins obtained from human skin, it is possible to easily and accurately evaluate the activity of atopic dermatitis by simply comparing the values of the amounts of interleukin-4 and interleukin-13, obtained by the quantitative analysis device, with predetermined values without depending on the medical knowledge or experience of the medical personnel. The above-described evaluation of the activity of atopic dermatitis may also be automatically performed by a functional unit that may be included in the kit for diagnosing atopic dermatitis according to one embodiment of the present invention. In this case, the functional unit may be configured to include: a storage unit configured to store data on the amounts of interleukin-4 and interleukin-13 obtained from the quantitative analysis device and data on the correlation between these amounts and atopic dermatitis activity; an interface unit configured to transfer data from the quantitative analysis device; a comparison determination unit configured to compare and determine the data stored in the storage unit and the data transferred from the quantitative analysis device, thereby generating information on atopic dermatitis activity; and a display unit configured to display the information generated by the comparison determination unit.
Although the present invention has been described in detail described using specific matters such as specific components, limited embodiments, and the accompanying drawings, these embodiments are provided only for assisting in the entire understanding of the present invention, and the present invention is not limited to these embodiments. Various modifications and changes may be made by those skilled in the art to which the present invention pertains from this description.
Therefore, the spirit of the present invention should not be construed as being limited to the above-described embodiments, and the following claims as well as all modified equally or equivalently to the claims are intended to fall within the scopes and spirit of the present invention.
Number | Date | Country | Kind |
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10-2020-0041957 | Apr 2020 | KR | national |
Filing Document | Filing Date | Country | Kind |
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PCT/KR2020/007612 | 6/11/2020 | WO |