Viewed from a few feet away, the microneedle patch in Nicole Brogden’s palm doesn’t look like a needle at all. It’s a small sliver of metal with no sharp tip. But an up-close look reveals a dozen or more rows of tiny needles—needles that deliver a painless prick when probed with a finger.
“Microneedle patches for drug and vaccine delivery are fascinating because they are a convergence of pharmaceutics, engineering, and biology,” says Brogden, an assistant professor of pharmaceutical sciences and experimental therapeutics at the University of Iowa College of Pharmacy.
Brogden’s innovative micropatch research could significantly expand outreach efforts of international aid groups eager to provide millions of people worldwide with life-saving vaccines and medications. Unlike hypodermic needles, micropatches can be applied to the skin in a manner similar to a band-aid and don’t require trained medical technicians to administer them. After the micropatch is applied, it is replaced with a special occlusive covering that delivers medicine through small channels, or micropores, created by the micropatch.
“If you think about the immense medical needs of third-world countries, micropatches could make a big difference,” says Brogden. “People in rural communities could be trained how to use them and could provide vaccinations or medicine delivery without significant oversight from doctors or nurses. It could be a game changer.”
To make that vision a reality, Brogden and research partner Nkanyezi (Kanya) Ferguson, clinical director and assistant professor of dermatology at the UI’s Roy J. and Lucille A. Carver College of Medicine, are recruiting members of ethnically diverse populations to participate in micropatch testing. These clinical studies are among the first of their kind, and the results could determine how micropatches are used in the future.
“Much of the research that has been done so far with micropatches for drug and vaccine delivery has been done on Caucasians,” says Brogden, who previously conducted research on the use of these technologies in elderly populations. “If we know that in the near future we will need to use micropatches on diverse populations, and if we don’t study how micropatches work with these populations, then that’s a huge failure.”
Dermatological research on skin of color is an area of medicine that historically has not received significant attention, but that is changing as scientific and medical experts such as Ferguson push forward with new research and clinical outreach efforts. Ferguson, who heads the Ethnic Skin Care Clinic at the UI Hospital & Clinics, is particularly interested in skin conditions that affect people with darker skin.
“I have created an ethnic skin care practice that really is focused on meeting the needs of different groups in culturally sensitive and culturally competent ways,” says Ferguson, who spent part of her childhood in Zimbabwe, the homeland of her father. “Even common conditions such as acne and eczema can affect darker skin differently.”
When Brogden presented some preliminary results from her research at the Fifth International Microneedle Conference in Vancouver, Canada, in May 2018, she says the reaction from many in the audience, including representatives of health care nonprofits, was enthusiastic.
“There was a lot of excitement around the topic because there is just so little of this type of research out there,” Brogden says.
Shanda Boyle, a program officer with the Bill & Melinda Gates Foundation, heard Brogden’s microneedle patch presentation. She says further microneedle patch testing is imperative to gauge effectiveness and safety. The Gates Foundation is known worldwide for championing innovative approaches to delivering health services to those who need it most.
“Microneedle patch technology could potentially increase the equitable coverage of vaccines in low- and middle-income countries by transforming the way injectable vaccines are delivered in field settings, thereby impacting vaccination coverage rates in many hard-to-reach places,” says Boyle.
The UI microneedle patch research is funded by a National Institutes of Health grant referred to as an R35 Maximizing Investigators’ Research Award. These grants, which are extremely competitive, provide researchers with more freedom to explore new concepts. For her research, Brogden uses various instruments to measure the hydration, color, healing rate, and sebum content of skin that has been treated with a micropatch. She wants to understand how quickly the skin heals and determine if there are any other side effects related to micropatch use, and if either vary for people of different skin colors.
“It is crucial to better understand how the rates of micropore closure vary in different skin types populations because this could also affect drug delivery,” she says.
One of the challenges of conducting research on genetically diverse skin is finding clinical trial participants, Brogden and Ferguson say. Members of some ethnic groups are hesitant to take part in scientific and medical trials because of the history surrounding past trials that took advantage of ethnic groups to advance science, in some cases even resulting in the deaths of participants. That history, and the distrust that it seeded, is difficult to overcome, says Ferguson.
“We’re really trying to switch the narrative around medical trials and let people know that everyone is responsible for advancing medicine and ensuring that it represents your population and how diseases affect you and other people like you,” says Ferguson.
The researchers have worked together to find local participants for the micropatch clinical studies and have been successful in recruiting Asian and Latino participants. However, they are still looking to recruit African American participants. Ferguson says she discusses the trial with patients who come to her clinic and encourages them to get involved. She hopes more people in Iowa will learn about the UI Hospitals & Clinics’ Ethnic Skin Care Clinic as well as the benefits of medical trials.
“I think it says a lot about the University of Iowa that we’re trying to address the health needs of everyone in the state,” says Ferguson. “And that we’re also training future doctors to be sensitive to the needs of different populations.”