Work

Chitosan-PVA microneedle-assisted continuous transdermal administration of triamcinolone acetonide for the treatment of granulomatous mastitis

Year: 2025

Type: article

Abstract: OBJECTIVE: Granulomatous mastitis (GM) is a refractory chronic inflammatory breast disease. Current first-line treatments, such as intralesional triamcinolone acetonide (TA) injections, are limited by short duration of efficacy, systemic side effects, and poor patient compliance. This study aimed to develop a novel chitosan (CS)-based TA-loaded polyvinyl alcohol (PVA) microneedle delivery system (MNs@TA-CS) for localized and sustained transdermal therapy. METHODS: TA-CS nanoparticles were prepared using ionic gelation and subsequently incorporated into PVA microneedles. The resulting MNs@TA-CS was characterized for morphology, mechanical strength, and drug release profile. A rat GM model was induced by hyperprolactinemia and tissue homogenate-Freund's adjuvant. Therapeutic efficacy was evaluated through lesion size measurement, cytokine analysis, histopathological examination, and macrophage polarization assessment. RESULTS: The MNs@TA-CS exhibited excellent mechanical properties and a biphasic drug release profile. In the GM rat model, MNs@TA-CS demonstrated comparable therapeutic efficacy to conventional TA injections, significantly reducing lesion area (82.7% reduction), downregulating pro-inflammatory cytokines (IL-1β, TNF-α, and IL-6), and modulating macrophage polarization. Histopathological and immunohistochemical analyses confirmed marked reduction in granulomatous inflammation and fibrosis. Notably, the MNs@TA-CS showed good biocompatibility with no signs of liver or kidney toxicity. CONCLUSION: The MNs@TA-CS achieves comparable efficacy to traditional injections while offering sustained drug release and minimized systemic exposure. Its biphasic release mode provides both rapid onset and prolonged therapeutic effect, making it a promising minimally invasive, patient-friendly alternative for GM treatment.

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000004612