Development and Evaluation of Novel Miltefosine-polyphenol Co-loaded Second Generation Nano-transfersomes for the Topical Treatment of Cutaneous Leishmaniasis

: To test the hypothesis that miltefosine (MTF)-polyphenol co-loaded second-generation nano-transfersomes (SGNTs) can be an effective approach for the topical treatment of cutaneous leishmaniasis (CL).: The co-loaded SGNTs with various MTF-polyphenol combinations were developed, evaluated and compared for the entrapment efficiency, vesicle size, deformability index, permeation, cytotoxicity, and anti-leishmanial potential, using both and models.: The co-loaded SGNTs were spherical in shape, with an average size of 119 ± 1.5 nm and a high entrapment efficiency of 73.7 ± 3.7%. The study displayed a 3.2-fold higher permeation of MTF when entrapped in co-loaded SGNTs, whereas cytotoxicity potential of co-loaded SGNTs was 43.2% higher than the MTF solution. A synergistic interaction was observed between MTF and apigenin (APG) among all polyphenols and an 8.0-fold lower IC was found against amastigotes of DsRed , compared with the plain MTF solution. Moreover, the studies displayed a 9.5-fold reduced parasitic burden in the infected BALB/c mice treated with MTF-APG co-loaded SGNTs gel.: The potential of MTF-APG co-loaded SGNTs topical formulation is established for the first time as an effective drug delivery strategy against CL.