throbber

`
`In Vitro Percutaneous Penetration: Evaluation of the
`Utility of Hairless Mouse Skin
`
`Robert S. Hinz, Ph.D.. Connie D. HodsOn, 13.8.. Cynthia R. Lorence, B.S.. and Richard H. Guy, Ph.D.
`Departments of Pharmacy and Pharmaceutical Chemistry. University of California. San Francisco; San Francisco. California. USA.
`
`is used to deposit a penettant on human skin. We suggest.
`The permeability barrier of hairless mouse skin has been
`therefore. that acetone~mediated facilitation ofpercutaneous
`determined in vitro after ex
`sure ofthe epidermal surface to
`volumes of acetone typical-l: used in human in vivo skin
`absorption in humans is unlikely. A further conclusion ofthis
`work is that in vitro solvent-deposition enetration experi-
`penetration studies. It has been shown that the transport of
`ments using hairless mouse skin shou d provide reliable
`tritiated water {when applied for limited 5-h periods} across
`trans
`hairless mouse skin is not affected by acetone treatments of
`rt information for at least 48 h postadministration.
`Although hairless mouse skin is more permeable than its
`approximately 15 til/cm? Submersion of the membranes be-
`tween :1 ueous donor and receptor phases for periods greater
`human counterpart, in vitro measurements using the murine
`than 2411. however. leads to significant and catastrophic bar-
`barrier should. therefore. provide useful and relevant guide-
`lines fot
`risk assessment calculations and bioavailability
`rier impairment. The acetone dose in the experiments re-
`
`determinations] Invest Dermatol 93:37—91, 1989
`ported is greater than that employed in vivo when the solvent
`
`he use of animal skin in the study of percutaneous
`absorption has provided fundamental knowledge
`toward our understanding ofharrier function. There
`are important differences, however. in the permeabil—
`ities of skin taken from different species and these
`inconsistencies have been highlighted in a number ofpublications
`[I — 4]. Currently. there is considerable activity in the area of in vitro
`skin permeation measurement. At least three major driving forces
`for this effort can be identified: 1) The U.S. Food and Drug Admin-
`istration recently 5
`nsored a workshop on in vitro methods for the
`purpose ofcstablishihg guidelines that could be followed when new
`topical drug formulations are under development [5]. 2) There is a
`continuing need for reliable. and meaningful. procedures that can be
`used to predict the health risk resulting from dermal exposure to
`toxic substances [6]. 3) The emergence of transdermal drug delivery
`to provide systemic pharmacologic efi'ect has introduced percutane-
`ous penetration measurement as a key component of the pharma-
`ceutic research and development effort [7].
`The heightened interest in assessing percutaneous transport has
`led several
`investigators to use substitutes for human skin. It is
`sometimes difficult to obtain human tissue in a regular or timely
`fashion; in addition. the high level of variability associated with
`cadaver skin [3] has frustrated researchers and has directed them to
`consider alternatives. OFthe various models that have been studied
`the skin of the hairless mouse is probably the most
`pular. There is
`no doubt that this tissue has enabled a number 0 key studies that
`have greatly increased our understanding of the skin permeation
`process. For example,
`it has allowed fundamental research into
`structure—penetration relationships [9 12!. concurrent transport
`and metabolism [13 - 16]. and the effects of skin damage on barrier
`
`Manuscript received June 21. 1983: accepted for publication January 6.
`1989.
`Institutes of Health grants
`This work was supported by National
`GMv33395 and HD-23010 and by the U.S. Environmental Protection
`Agency through cooperative agreement. CPL—812474.
`Re rint requests to: Dr. R, H. Guy, School of Pharmacy. University of
`Call oruia. San Francisco. CA 94143-0446.
`
`function [17 7 19]. The advantages of hairless mouse skin include its
`availability and reproducibility. It is more permeable than human
`skin. too. and this is an asset for both bioavailability and risk assess-
`ment. as a result obtained with hairless mouse skin will err on the
`conservative side. In risk assessment. for instance. a permeation
`measurement through hairless mouse skin will not lead to an under-
`estimate of dermal exposure in humans. This higher permeability.
`however. is also considered by sortie to be a major disadvantage of
`the tissue. although there is little evidence to document this con-
`cern. A more serious question. though. pertains to the response of
`hairless mouse skin. relative to that of human skin. to situations or
`circumstances often encountered in percutaneous penetration work.
`e.g.. the effect ofhydration and of organic solvents. The hydration
`issue was recently addressed by Bond and Barry [20]. who showed
`that prolonged expo
`sure of hairless mouse skin to aqueous donor
`and receptor phases in simple diffusion cells caused considerable
`derangement of barrier function. The interests of our laboratory
`have centered on in vivo evaluation of
`rc-utaneous absorption
`chemicals has involved
`[21—25]. Typically. topical application or
`deposition from an organic solvent. usually acetone. The question
`posed by the research
`resented here. therefore. was: "Does the
`amount of acetone used)
`as the vehicle in human skin penetration
`studies cause significant changes to the barrier function of hairless
`mouse skin in vitro?" A negative response would imply that 1)
`human skin in vivo is not damaged by the acetone deposition and
`delivery process and 2) in vitro hairless mouse skin ex
`riments
`orrnation
`involving chemical application in acetone may provide in?6
`relevant to percutaneous absorption in humans.
`MATERIALS AND METHODS
`
`To assess barrier function status of hairless mouse skin. the perme-
`ability of tritiated water (314,0. 0.05 .uCi/ml. New En land Nu-
`clear. BOston. MA) was determined at designated times a ter various
`acetone treatments. Permeation experiments were performed in
`conventional flow-throu h diffusion cells (Laboratory Glass Appa-
`ratus. Berkeley. CA} [26%
`The area of skin exposed was 3.14 cmz'.
`the volume of the rcce tor phase was approximately 5 cm’. The
`flow-rate was adjusted E
`y a cassette pump (Manostat. New York.
`
`DOZZ-ZUZX/S‘J/Smjfl Copyright © 1989 by The Society for Investigative Dermatology. Inc.
`87
`
`Noven Pharmaceuticals. Inc.
`EX2018
`
`0001
`
`Mylan Tech., Inc. v. Noven Pharma, Inc.
`lPR2018-00173
`
`

`

`88 HINZ er AL
`
`THE JOURNAL OF INVESTIGATIVE DERMATOLOGY
`
`10
`
`20
`
`so
`
`a
`
`3
`
`2
`
`1
`
`o
`
`o
`
`b £0 8u
`
`52
`
`tlma (hr)
`Figure 1. Permeation (mean flux :l: SD, n = 8) of 31-120 through hairless
`mouse skin when the membrane is sandwiched between aqueous solutions
`for 24 h [experiment I).
`
`contact. Indeed. in six out of eight cells, the membrane has been so
`damaged that 3H245) flux decreases at later times due to the substan-
`tial depletion of radiolabel in the donor phase.
`The results of experiments “I and IV are summarized in Figures 3
`and 4. respectively. It is apparent that when water is dosed intermit-
`tently to the skin surface for 5-h
`riods, pretreatment with acetone
`does not cause any significant di erence to the permeability behav-
`ior. This conclusion was substantiated b
`statistical comparisons
`(paired Wilcoxon and Student’s t—tests) o the cumulative amounts
`of water transported across the control and acetone-treated mem-
`branes. following the 5-h ap lications. Acetone elicited an insignifi-
`cant effect {a > 0.2. p > 0.1 on water permeation. Figure 5. which
`contains the data from ex
`riment V. demonstrates that repeated
`acetone administration be ore dosing with water also elicits no sig-
`nificant derangement of barrier function. Although Figures 3. 4.
`and 5 appear to suggest that, regardless of acetone treatment or not.
`the
`rmcability of 31-120 increases with time, the trend is not statis-
`ticall; significant. It is perhaps reasonable, however. to conclude
`that hydration and the detrimental ellects thereof. can continue
`during the water “ofF” periods.
`Finally. Figure 6 illustrates the results ofex eriment VI, in which
`the permeation of “I120 was followed 24 h allier acetone treatment.
`Again, no difl'erence from the control studies was observed al»
`
`NY) so that the receptor solution was completely exchanged in 1 h.
`The receptor phase was normal saline in phosphate buffer at pH 7.4.
`Pcrfusate was collected in test tubes mounted on a fraction collector
`(Gilson FC-220. Middleton, WI) and the samples were then ana-
`lyzed by liquid scintillation counting {Searle Mark 11] Model 6880.
`Elk Grove, IL). The difi‘usion cells were thermcistatted at 35°C
`throughout the experiments; under these conditions. with the skin
`Open to the laboratory atomosphcre, the surface temperature of the
`membrane was 32°C 1 1°C.
`
`In all experiments, full-thickness skin from hairless mice (HRS/
`hr h r. 6 — 16 wk. Simonsen Laboratories, Gilroy, CA was used. The
`skin was removed from the animal immediately a tct killing. any
`small fatty deposits were carefully removed, and the membrane was
`then mounted in the diffusion cell. Typically. eight diffusion cells
`were used in each experiment. requiring skin from four mice.
`When comparisons were made within a run (acetone treatment vs.
`no treatment. for exam le). the four skins were halved so that each
`animal contributed to oth the “control” and “test” set of cells.
`Because of the time involved in setting up eight diffusion cells and
`adjusting the receptor solution flow-rate appropriately, an experi-
`ment was typically started within 2 h after
`illing of the animals.
`The experiments performed are summarized in Table I. The de-
`sign was selected to test the effects of an acetone dose on barrier
`function and tissue constancy. The water treatments involved appli-
`cation ofl cmJ of’HZO to the skin surface. To prevent evaporation.
`the upper half of the diffusion cell was then covered until the water
`was removed. W henevet water was not in contact with the skin, the
`surface was open to ambient conditions. Acetone treatments in-
`volved a plication of 50 p] of the solvent by a capillary pi et. As
`pcformed in vivo. the acetone was distributed evenly over t e skin
`surface, which. again. was open to the laboratory atmosphere.
`When water was administered subsequent to acetone treatment (ex-
`periments Illa, lVa, V) there was a 2- to 3-min time lapse between
`solvent applications. No liquid acetone remained at this point.
`Experiments I and II simply determined water permeation over
`24— and 48-h periods, in the absence of acetone treatment. Experi-
`ments III and IV used short S-h exposures of the tissue to water and
`assessed the long-term consequences of an acetone close at r '= 0.
`Ex
`riment V involved a greater potential insult to the tissue and
`inclfided three volatile solvent treatments. Ex eriment VI consid-
`ered the effect ofa time delay postacetone app ication followed by
`prolonged water contact.
`
`RESU LTS
`
`In experiments I and II. the skin remained sandwiched between
`aqueous solutions throughout the measurement periods (24 and 48
`h. respectively). Figure 1 showr that in experiment I. 311,0 flux is
`essentially constant over the 3- to 20-h postapplication period, cor-
`responding to a permeability coefficient ofabout 2.95 X 10"" cm/h
`{in good agreement with recently published data [20]). Increased
`permeation. however, is suggested by the later time points. an infer—
`ence confirmed by experiment II. Figure 2 indicates that prolonged
`and complete hydration leads to barrier breakdown after 24 h of
`
`
`
`Table 1. Experimental Design Summary (n = number of replicates)
`
`
`Experiment
`n
`Treatments
`
`T
`T
`T
`T
`T
`
`1
`
`l
`T
`T
`T
`l
`
`T
`
`1
`T
`1
`
`l
`s
`I
`l
`8
`1|
`l
`'l
`8
`In;
`l
`l
`3
`mb
`l
`l
`'1
`12
`IVa
`l
`l
`l
`16
`Nb
`'1
`‘1
`‘l
`4
`v
`v1:
`12
`'
`l
`T
`
`vn
`12
`l
`T
`32
`28
`24
`48
`Time (hours)
`
`" V Sllyl acetone: l I water on; I - water rslT
`
`o
`
`4
`
`a
`
`12
`
`16
`
`20
`
`36
`
`so
`
`44
`
`52
`
`56
`
`0002
`
`

`

`VOL. 93. NO.
`
`I
`
`jULY I989
`
`[N w‘rno SKIN PENETRATION 89
`
`%doselhr
`
`0
`
`1O
`
`20
`
`30
`
`40
`
`50
`
`time(hr)
`Figure 2. Permeation of 31120 through hairless mouse skinI when the
`membrane is sandwiched between aqueous solutions for 48 h (experiment
`[I]. The results from eight separate experiments are shown. The average
`3H20 permeability coefficient during the 5—IS-l1 postdosing period is
`1.2}I X10" cth.
`
`though. as before. prolonged exposure to aqueous solutions did
`begin to compromise the skin.
`DISCUSSION
`
`r-
`The experiments performed in this investi ation lead to two irn
`tant conclusions. First, as recently reporte by Bond and Barry 20].
`the barrier function of hairless mouse skin does not withstand pro-
`longed submersion in aqueous solution. The data in Figures 1 and 2
`
`_l "I
`
`1.0%doseihr
`
`time (hr)
`Figure «I. Effect of acetone pretreatment {I S Jnl/cm’) on tritiatcd water flux
`(mean i SI), 11 a 12:] across hairless mouse skin after appiications from t =
`0—5 h. t = 24—29 h. and I = 48—53 h (experiment IV).
`
`clearly reveal that exposure of the tissue to aqueous solutions, in
`both donor and receiver compartments. for periods in excess of24 h,
`leads to substantial degeneration of the stratum corneum. The sec-
`ond key finding revealed by this study is that treatment of hairless
`mouse skin with acetone, in a fashion that mimics a typical "sol-
`ventqieposition" a plication procedure [22-— 251does not appear to
`alter permanently the barrier to water to any significant degree. The
`results ofexpetiments III, IV, and V indicate that acetone adminis-
`tration Pct sc does not contribute to derangement of the stratum
`corneum. The data also suggest that ifa penetrant were delivered in
`
`1.5
`
`2.0
`
`1.0
`
`%dosefhr
`
`O
`
`1 0
`
`2 O
`
`3 O
`
`tlme (hr)
`Figure 3. Effect of acetone pretreatment (15 til/cm?) on tritiated water flux
`(mean i SD, n -= 3) across hairless mouse skin after applications from
`t= 0—5 h and t = 24—29 h {experiment III}.
`
`dose!hr
`
`%
`
`
`
`20
`30
`no
`so
`so
`
`
`time (hr)
`Figure 5. Tritiated water flux (mean i 51‘), n :- 4} across hairless mouse
`skin after applications from r= 0— 5 h. := 24— 29 h. and! =43 -- 53 h. Before
`mull administration of water. the skin was pretreated with acetone at a dose of
`15 plfcm’.
`
`0003
`
`

`

`90 umz ET AL
`
`THE jOURNAL OF INVESTIGATIVE DERMATOLOGY
`
`2.0
`
`1.5
`
`1.0
`
`0.5
`
`doselhr
`
`%
`
`
`
`time {hr)
`Figure 6. Permeation (mean flux i SD. n = 12) of 3H20 through hairless
`mouse skin 24 h after mounting the membrane in the difl'usion cell. and after
`treating the “acetone';:lpecimens with a solvent dose of 15 ,ul/cmz. For the
`subsequent 24-h peri
`of observation presented here. the sltin is sand-
`wiched between aqueous donor and receptor phases (ex
`riment VI). Based
`on the essentially constant 31120 fluxes between 5 an
`10 h. permeability
`coefficients for the control and acetone-treated membranes are calculated to
`be 1.83 X 10 ’ cm/h and 1.83 X 10" em/h. respectively.
`
`an acetone vehicle under similar circumstances. one may expect the
`barrier function of hairless mouse skin to remain reasonably con-
`stant for at least 48 h. The short 5-h snzo applications were de«
`si ned to test the skin permeability while minimizing hydration
`cigars. In this respect. they would ap ear to have fulfilled their
`function adequately. Experiment V cha lenged the tissue further by
`considerin multiple acetone treatments. Again. however. no sig-
`nificant eigeet of the solvent, over that observed in the controls
`(experiment
`lVb). was ap arcnt. Furthermore. experiment VI
`showed that air-exposure o the epidermal surface for 24 h [acetone
`pretreated or not) did not significantly alter subsequent 3H20 per-
`meation compared with the “control". i.e.. experiment 1.
`One ramification of our research is that the warning of Bond and
`Barry [20].
`that “ .
`.
`. hairless mouse skin should not be
`used .
`.
`.
`in .
`.
`. permeation studies incorporating long~term
`hydration. as erroneous results can be expected after .
`.
`. 3 days."
`appears somewhat conservative. On the basis ofour data. we would
`be reluctant to draw conclusions from any flux measurements made
`after 24 h submersion. More important. though. we have shown
`that administration of acetone. at a dose of a proximately 15 ul/
`c1112. does not ap ear to alter significantly t be stratum corneum
`
`barrier function ofhairless mouse skin. Given that a typical tapical
`
`in penetra—
`dose ofacetone in a solvent-deposition. human in vivo 5
`tion study is less than 10 till/cm2 [22-25]. it seems reasonable to
`sag est that no acetone-mediated Facilitation of transport will be
`evitfcnt. In addition. one may also deduce that an in vitro penetra-
`tion study using hairless mouse skin and solvent-deposition ofpene-
`trant from acetone {at a dose of 15 til/Cm: or less). should provide a
`reasonable model ex
`riment for the in vivo situation. We recog-
`nize. however. that t e latter two conclusions are based on observa-
`tions that use water as the model permeant. It remains to be seen
`whether these deductions are sustained when the penetating mole-
`cule is lipophilic in character. Finally. although hairless mouse skin
`is generally more permeable than its human counterpart [20]. the
`a plication of small volatile solvent volumes does not 9.13
`at to
`place the murine barrier under measurable stress. The e ects of
`
`larger volumes of solvent or of more structurally destructive chemi-
`cals (e.g.. penetration enhancers) [27] will. no doubt, be greater and
`may be amplified in the less substantial stratum corneum of the
`hairless mouse.
`
`We thank Dr. Larry L. Hall ofthe Environmenmi Pruterti'on Agencyfilr his interest
`and input. Nan Spencerfar manuscript preparation.
`
`REFERENCES
`
`I. Bartok M]. LaBaddeJA: Pcrcutaneous absorption in vitro. In: Maibach
`HI (ed). Animal Models in Dermatology. New York. Churchill
`Livingstone. 191'). pp 103 — 120
`2. Bronaugh RL. Stewart RF: Methods for in vitro percutaneous absorp-
`tion studies. [1. Animal models for human skin. Toxicol Appl Phar—
`macol 62:11-31 — 438. 1932
`3. Westcr RC. Maibach HI: Animal models [or percutaneous absorption.
`In: Maibacb ['11. Lowe N] (eds). Models in Dermatology. vol. 2.
`Base]. Karger. 1985. pp 159- 169
`4. Reifenrath WG, Chellquist EM, Shi wash EAJederberg WW: Eval-
`uation of animal models For pr
`icting skin penetration in man.
`Fundam Appl Toxicol 45224—5230. 1984
`5. Skelly jl’. Shah VP. Maibach HI. Guy RH. Westct RC. Flynn G.
`Yacohi A: FDA and AAPS report ofthe workshOp on principles and
`practices of in vitro percutancous penetration studies: Relevance to
`ioavailability and hioequivalence. Pharmcol Res Commun 4:265-
`267. 198?
`
`6. Mathias CGT. Hinz R5. Guy RH. Maibach H1: Percutaneous absorp~
`tion: interpretation of in vitro data and risk assessment. In: Honey-
`cutt RC. Zweig G. Ragsdale NN (eds). Dermal Exposure Related to
`Pesticide Use. Washington. DC. American Chemical Society.
`1985. pp 3- l?
`7. Guy RH. Hadgraftj: Selection ofdmg candidates for transderrnal dnig
`delivery. In: Hadgraft j. Guy RH (eds). Transdermal Drug Deliv-
`ery: Developmental issues and research initiatives. New York. Mar-
`cel Dekker. 1989. pp 59—81
`8. Barry BW: Dcrmatologicai formulations: percutaneous absorption.
`New Yorlt, Marcel Deltltet. 1983. pp 235- 236
`9. Belil CR. Flynn CL. Kurihara T. Harper N. Smith W. Higuchi WI.
`Ho NFH. Pierson CL: Hydration and percutaneous absorption. 1.
`Influence of hydration on alkanol permeation through hairless
`mouse slain. j Invest Dermatol 25:346- 352. 1930
`10. Durrbcim HH. Flynn GL. Higuchi W]. Behl CR: Permeation of
`hairless mouse skin. 1. Experimental methods and comparison with
`human epidermal permeatitin by alkanok.) Pharm Sci 69:?81 —786.
`1930
`
`l I. Flynn GL. Durrheim HH. Higuchi W1: Permeation of hairless mouse
`skin. I]. Membrane sectioning techniques and influences on alkanol
`permeabilities. _] Pharm Sci 7052— 56. 1981
`12. Flynn GL: Mechanism ofpercutaneous absorption from physicochem-
`ical evidence. In: Bronaugh RL. Maibach HI (eds). Percuuneous
`Absorption. New York. Marcel Deklter. 1935. pp 1? —42
`13. Yu CD. Foij. Ho NFH. Higuchi WI: Physical model evaluationof
`topical prodrug delivery— Simultaneous transport and bioconver-
`sion of vidarabine—S'walerate.
`1. Physical model development. _]
`Pharm Sci 6811341 - 1346. 1979
`14. Yu CD. Foij. Ho NFH. Higuchi WI: Physical model evaluationof
`topical prodrug dclivery— Simultaneous trans
`rt and bio-conver-
`sion of vidarabine-5’-valerate. ll. Parameter delii'iitions.] Pharm Sci
`68:1347 —135'.-'. 1979
`15. For jL. Yu CD. Higucbi WI. Ho NFH: General physical model for
`simultaneous diffusion and metabolism in biological membranes.
`The computational approach for the steady-state case. Int] Pharm
`2211-1 — 5?. 1979
`
`16. Saiitus G. Watati N. Hint RS. Benet LZ. Guy RH: Cutaneous metabo-
`lism of transdermally delivered nitroglycerin in vitro. In: Shroot B,
`Schaefer H (eds). Skin Pharmacoltinctics. Basel. Karger. 1987. pp
`240 — 244
`
`17. Behl CR. Flynn GL. Kurihara T. Smith W. Gatrnaitan 0. Higuehi
`WI. Ho NFH. Pierson CL: Permeability ofthermally damaged skin.
`1. Immediate influences of 60°C scalding on hairless mouse skin.)
`Invest Dermatol 25:340— 345. 1980
`
`0004
`
`

`

`VOL. 93, NO.
`
`I
`
`JULY 1989
`
`IN VITRO SKIN PENETRATION 91
`
`18. Belt] CR. Flynn GL. Barrett M. Linn BE. Higuehi WI. Ho NFH.
`Pierson CL: Permeability of thermally damaged skin. IV. Influence
`of branding iron temperature on the mass transfer of water and
`n-alltanois across hairless mouse skin. Burns 8:36-98. 1981.
`19. Flynn CL. Behl CR. Linn EE. Higuchi WI. Ho NFH, Pierson CL:
`Permeability of thermally damaged skin. V Permeability over the
`course of maturation of a deep partial thickness burn. Burns 8: l 96 —
`202. I931
`'20. Honrl 1R. Barry HW: Limitations nfhairlms mature skin as a model for
`in vitro permeation studies through human skin: hydration damage.
`j Invest Dermatoi 90:486 — 439. 1988
`21. Guy RH, Hadgraft J. Hinz RS. Roskos KV. Bucks DAW: In vivo
`evaluations of transdermal drug delivery. In: Chien YW (ed).
`Transdermal controlled systemic medications. New York. Martel
`Dekkcr. 198?. pp 119—224
`22. Bucks DAW. Maibach HI. Guy RH: Pereutaneous absorption of
`steroids: effect of repeated application.) Pharm Sci ?$:1337 - 1339.
`1985
`
`23.
`
`24,
`
`25.
`
`26.
`
`2?.
`
`Guy RH. Carlsttoni EM. Bucks DAW. Hinz R5. Maibach HI: Peren-
`taneons penetration of nieotinates: in vivo and in vitro measure-
`ments] Pharm Sci ?5:968 — 93?, 1936
`Rosina KV, Maibaeh HI. Guyr RH: Percutaneous absorption in the
`aged. In: Gilchrest B {ed.]. Dennatologic Clinics. vol 6: The aging
`skin. Philadelphia. W.B. Saunders. 1986. pp 455—465
`Bucks UAW. McMasterjR. Maibach HI, Guy RH: Bioavailabiliry of
`topically administered steroids: 2 " mass balance" technique._] Invest
`Dermatol 90:29-33. 1988
`
`Gummer CL. Hinz RS. Maibaclt HI: The skin penetration cell: A
`design update. Int] Pharm 40:101-104. 1981'
`MirejoVsky D. Takmri H: Dermal penetration enhancement profile of
`hexametbvlenelauramide and its homologues: in vitro versus in vivo
`behavior ofenhancers in the penetration ofhvdrocmtisonej Pharm
`Sci T5:1039— 1093. 1936
`
`0005
`
`

This document is available on Docket Alarm but you must sign up to view it.


Or .

Accessing this document will incur an additional charge of $.

After purchase, you can access this document again without charge.

Accept $ Charge
throbber

Still Working On It

This document is taking longer than usual to download. This can happen if we need to contact the court directly to obtain the document and their servers are running slowly.

Give it another minute or two to complete, and then try the refresh button.

throbber

A few More Minutes ... Still Working

It can take up to 5 minutes for us to download a document if the court servers are running slowly.

Thank you for your continued patience.

This document could not be displayed.

We could not find this document within its docket. Please go back to the docket page and check the link. If that does not work, go back to the docket and refresh it to pull the newest information.

Your account does not support viewing this document.

You need a Paid Account to view this document. Click here to change your account type.

Your account does not support viewing this document.

Set your membership status to view this document.

With a Docket Alarm membership, you'll get a whole lot more, including:

  • Up-to-date information for this case.
  • Email alerts whenever there is an update.
  • Full text search for other cases.
  • Get email alerts whenever a new case matches your search.

Become a Member

One Moment Please

The filing “” is large (MB) and is being downloaded.

Please refresh this page in a few minutes to see if the filing has been downloaded. The filing will also be emailed to you when the download completes.

Your document is on its way!

If you do not receive the document in five minutes, contact support at support@docketalarm.com.

Sealed Document

We are unable to display this document, it may be under a court ordered seal.

If you have proper credentials to access the file, you may proceed directly to the court's system using your government issued username and password.


Access Government Site

We are redirecting you
to a mobile optimized page.





Document Unreadable or Corrupt

Refresh this Document
Go to the Docket

We are unable to display this document.

Refresh this Document
Go to the Docket