Tattoo artists may soon be faced with the prospect of a career change into the world of medicine thanks to the revelation that tattooing technology can be effectively applied in the delivery of vaccines and anti-parasitic drugs to the upper layers of the dermis.
Would you like the flaming skull? No thanks, could I be vaccinated instead? Sure…
The traditional method for vaccination is the intradermal administration of attenuated (weakened) viral particles to induce the production of T-cells which mediate an immune response and henceforth confer a resistance to that particular microbe. It has been found that DNA encoding proteins expressed by a virus or bacterium on their surface membrane (an antigen) can be transfected into our cells via intramuscular injection to elicit the expression and production of these exogenous proteins which are then recognised by T-cells to initiate an immune response. However, the acquisition of immunity via this method is slow, taking up to a month for sufficient resistance to have built up in stark contrast to the rapid response following viral infection. This could be explained by the low efficiency of DNA uptake and low levels of subsequent antigen expression.
The following research describes a novel vaccination-delivery technique utilising tattoo technology which fantastically improves the efficiency of the DNA vaccination strategy, generating functional T- and B-cells within a minimal timeframe. The study involved comparing the effectiveness of administering DNA which encoded influenza A nucleoprotein epitope via intramuscular injection and by the use of a simple tattoo device. The resultant T-cell response could be quantified by calculating the proportion of T-cells present in the blood which respond to an influenza A nucleoprotein assault and it was concluded that administration via tattoo did yield sufficient T-cell production and proved to be more effective than intramuscular injection in this respect.
This increase in efficacy is probably explained by the fact that tattoo-delivery is able to transfect cells of the dermis and epidermis in which a relatively high concentration of APCs (antigen-presenting cells) reside in comparison to the muscles.
It was further found that immunity could be acquired over a much smaller time frame when administering the vaccine using tattoo technology. When administered on a short-interval basis (treatment on day 0, 3 and 6) intramuscular injection did not yield any detectable T-cell response, whereas the response to DNA tattooing was significant. This is hugely advantageous when posed with the threat of outbreaks of Ebola, influenza A or severe acute respiratory syndrome. Furthermore, as tattooing has received continual development in the cosmetic industry, the technique is robust, easy to use and cheap!
Tattoos in the treatment of infection:
Tattooing technology is not only useful in the administration of DNA vaccinations. It has also been effectively utilised in the administration of antibiotics in the treatment of cutaneous leishmaniasis (CL). CL is a parasitic infection of the skin in which Leishmania invade macrophages resident in the upper layers of the skin and replicate resulting in lesions with a visible necrotic centre (an area of dead or dying cells).
However, current treatment options involve the injection of a class of drugs known as antimonials (containing antimony (a metalloid)) into the lesion itself and treatment can be long, painful and distressing. This form of therapy is also not recommend for those which a leishmaniasis infection of the lymph, arteries, cartilage or lesions within close proximity to an orifice. Other treatment options via the systemic are not favourable due to adverse side-effects and although the use of topical creams or ointments would avoid these pit-falls, these are poorly absorbed and are further poorly retained at the site of infection.
Tattooing technology was tested for its ability to target drug to the site of infection. Mice which were infected with Leishmania at the base of their tail were used in investigations to assess the effectiveness of treatment utilising tattooing technology. The drug OIPC had previously been shown to efficiently kill Leishmania parasites both residing in macrophages and extracellularly in the dermis. OIPC was then administered to the test mice via tattooing equipment directly to the lesion at the base of the mouse’s tail, a topical treatment to the same area and a larger dose systemic injection. To quantify the effectiveness of treatment the size of the lesion was tracked over 28 days and after 28 days the lesion was excised, homogenised and the parasites counted.
Although the topical treatment was able to control the spread of the parasitic infection, only the systemic treatment and tattooing technology were able to visibly reduce the size of the lesion, and by day 28 of the experiment on treatment using tattooing technology was shown to completely eradicate the infection, both in terms of lesion size and the number of resident parasites still residing in the skin.
Overall, the administration of drugs and vaccinations via tattoo technology is proving to be greatly efficient and is even being shown to be better than traditional forms of targeted delivery in current use. Hopefully this will pave the way to more successful vaccination and medical programs in developing countries and at home.
Bins AD, Jorritsma A, Wolkers MC, Hung CF, Wu TC, Schumacher TN, & Haanen JB (2005). A rapid and potent DNA vaccination strategy defined by in vivo monitoring of antigen expression. Nature medicine, 11 (8), 899-904 PMID: 15965482
Shio MT, Paquet M, Martel C, Bosschaerts T, Stienstra S, Olivier M, & Fortin A (2014). Drug delivery by tattooing to treat cutaneous leishmaniasis. Scientific reports, 4 PMID: 24561704