Assessment of the nail penetration of antifungal agents, with different physico-chemical properties

PLoS One. 2020 Feb 27;15(2):e0229414. doi: 10.1371/journal.pone.0229414. eCollection 2020.

Abstract

Onychomycosis, or fungal nail infection, is a common fungal infection largely caused by dermatophyte fungi, such as Trichophyton rubrum or Trichophyton mentagrophytes, which affects a significant number of people. Treatment is either through oral antifungal medicines, which are efficacious but have significant safety concerns, or with topical antifungal treatments that require long treatment regimens and have only limited efficacy. Thus, an efficacious topical therapy remains an unmet medical need. Among the barriers to topical delivery through the nail are the physico-chemical properties of the antifungal drugs. Here, we explore the ability of a range of antifungal compounds with different hydrophilicities to penetrate the nail. Human nail discs were clamped within static diffusion (Franz) cells and dosed with equimolar concentrations of antifungal drugs. Using LC-MS/MS we quantified the amount of drug that passed through the nail disc and that which remained associated with the nail. Our data identified increased drug flux through the nail for the more hydrophilic compounds (caffeine as a hydrophilic control and fluconazole, with LogP -0.07 and 0.5, respectively), while less hydrophilic efinaconazole, amorolfine and terbinafine (LogP 2.7, 5.6 and 5.9 respectively) had much lower flux through the nail. On the other hand, hydrophilicity alone did not account for the amount of drug associated with/bound to the nail itself. While there are other factors that are likely to combine to dictate nail penetration, this work supports earlier studies that implicate compound hydrophilicity as a critical factor for nail penetration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / chemistry
  • Antifungal Agents / pharmacokinetics*
  • Antifungal Agents / pharmacology*
  • Humans
  • Hydrophobic and Hydrophilic Interactions
  • Mycoses / drug therapy*
  • Mycoses / metabolism
  • Mycoses / microbiology
  • Nail Diseases / drug therapy*
  • Nail Diseases / metabolism
  • Nail Diseases / microbiology
  • Nails / drug effects*
  • Nails / metabolism
  • Nails / microbiology
  • Permeability
  • Tissue Distribution

Substances

  • Antifungal Agents

Grants and funding

Heather Davies-Strickleton, Julie Cook, Christine Ridden, David Edwards, John Ridden and David Cook are employees of Blueberry Therapeutics Ltd. Sally Hannam, Alan Gibbs, Rhys Bennett are employees of Alderley Analytical Ltd. and responsible for the study design, analysis, and interpretation of data, writing the manuscript and decision to submit for publication. All research was funded by Blueberry Therapeutics Ltd.