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结肠靶向给药系统的药物学方法。

Pharmaceutical approaches to colon targeted drug delivery systems.

作者信息

Chourasia M K, Jain S K

机构信息

Pharmaceutics Research Projects Laboratory, Department of Pharmaceutical Sciences, Dr. Hari Singh Gour University, Sagar, India.

出版信息

J Pharm Pharm Sci. 2003 Jan-Apr;6(1):33-66.

Abstract

PURPOSE

Although oral delivery has become a widely accepted route of administration of therapeutic drugs, the gastrointestinal tract presents several formidable barriers to drug delivery. Colonic drug delivery has gained increased importance not just for the delivery of the drugs for the treatment of local diseases associated with the colon but also for its potential for the delivery of proteins and therapeutic peptides. To achieve successful colonic delivery, a drug needs to be protected from absorption and /or the environment of the upper gastrointestinal tract (GIT) and then be abruptly released into the proximal colon, which is considered the optimum site for colon-targeted delivery of drugs. Colon targeting is naturally of value for the topical treatment of diseases of colon such as Chron's diseases, ulcerative colitis, colorectal cancer and amebiasis. Peptides, proteins, oligonucleotides and vaccines pose potential candidature for colon targeted drug delivery.

METHODS

The various strategies for targeting orally administered drugs to the colon include covalent linkage of a drug with a carrier, coating with pH-sensitive polymers, formulation of timed released systems, exploitation of carriers that are degraded specifically by colonic bacteria, bioadhesive systems and osmotic controlled drug delivery systems. Various prodrugs (sulfasalazine, ipsalazine, balsalazine and olsalazine) have been developed that are aimed to deliver 5-amino salicylic acid (5-ASA) for localized chemotherapy of inflammatory bowl disease (IBD). Microbially degradable polymers especially azo crosslinked polymers have been investigated for use in targeting of drugs to colon. Certain plant polysaccharides such as amylose, inulin, pectin and guar gum remains unaffected in the presence of gastrointestinal enzymes and pave the way for the formulation of colon targeted drug delivery systems. The concept of using pH as a rigger to release a drug in the colon is based on the pH conditions that vary continuously down the gastrointestinal tract. Times dependent drug delivery systems have been developed that are based on the principle to prevent release of drug until 3-4 h after leaving the stomach. Redox sensitive polymers and bioadhesive systems have also been exploited to deliver the drugs into the colon.

RESULTS

The approach that is based on the formation of prodrug involves covalent linkage between drug and carrier. The type of linkage that is formed between drug and carrier would decide the triggering mechanism for the release of drug in colon. The presence of azo reductase enzymes play pivotal role in the release of drug from azo bond prodrugs while glycosidase activity of the colonic microflora is responsible for liberation of drugs from glycosidic prodrugs. Release of drugs from azo polymer coated dosage forms is supposed to take place after reduction and thus cleavage of the azo bonds by the azoreductase enzymes present in the colonic microflora. Natural polysaccharides have been used as tools to deliver the drugs specifically to the colon. These polysaccharides remain intact in the physiological environment of stomach and small intestine but once the dosage form enters into colon, it is acted upon by polysaccharidases, which degrades the polysaccharide and releases the drug into the vicinity of bioenvironment of colon. However, they should be protected while gaining entry into stomach and small intestine due to enormous swelling and hydrophilic properties of polysaccharides. This has been achieved either by chemical crosslinking or by addition of a protective coat. Formulation coated with enteric polymers releases drug when pH move towards alkaline range while as the multicoated formulation passes the stomach, the drug is released after a lag time of 3-5 h that is equivalent to small intestinal transit time. Drug coated with a bioadhesive polymer that selectively provides adhesion to the colonic mucosa may release drug in the colon.

CONCLUSIONS

Improved drug delivery systems are required for drugs currently in use to treat localized diseases of the colon. The advantages of targeting drugs specifically to the diseased colon are reduced incidence of systemic side effects, lower dose of drug, supply of the drug to the biophase only when it is required and maintenance of the drug in its intact form as close as possible to the target site.

摘要

目的

尽管口服给药已成为治疗药物广泛接受的给药途径,但胃肠道对药物递送存在若干巨大障碍。结肠给药不仅对于治疗与结肠相关的局部疾病的药物递送愈发重要,而且对于蛋白质和治疗性肽的递送潜力也日益凸显。为实现成功的结肠递送,药物需要免受上消化道(GIT)的吸收和/或环境影响,然后突然释放到近端结肠,近端结肠被认为是药物结肠靶向递送的最佳部位。结肠靶向对于结肠疾病如克罗恩病、溃疡性结肠炎、结直肠癌和阿米巴病的局部治疗自然具有重要价值。肽、蛋白质、寡核苷酸和疫苗是结肠靶向药物递送的潜在候选物。

方法

将口服药物靶向结肠的各种策略包括药物与载体的共价连接、用pH敏感聚合物包衣、定时释放系统的制剂、利用被结肠细菌特异性降解的载体、生物粘附系统和渗透控释药物递送系统。已开发出各种前药(柳氮磺胺吡啶、偶氮拉嗪、巴柳氮和奥沙拉嗪),旨在递送5-氨基水杨酸(5-ASA)用于炎症性肠病(IBD)的局部化疗。已研究了微生物可降解聚合物,特别是偶氮交联聚合物用于药物结肠靶向。某些植物多糖如直链淀粉、菊粉、果胶和瓜尔胶在胃肠道酶存在下不受影响,为结肠靶向药物递送系统的制剂开辟了道路。利用pH作为触发剂在结肠中释放药物的概念基于胃肠道中pH条件的持续变化。已开发出基于在离开胃后3-4小时内防止药物释放原理的时间依赖性药物递送系统。氧化还原敏感聚合物和生物粘附系统也已被用于将药物递送至结肠。

结果

基于前药形成的方法涉及药物与载体之间的共价连接。药物与载体之间形成的连接类型将决定药物在结肠中释放的触发机制。偶氮还原酶的存在在药物从偶氮键前药中释放中起关键作用,而结肠微生物群的糖苷酶活性负责从糖苷前药中释放药物。药物从偶氮聚合物包衣剂型中的释放应该在还原后发生,从而通过结肠微生物群中存在的偶氮还原酶裂解偶氮键。天然多糖已被用作将药物特异性递送至结肠的工具。这些多糖在胃和小肠的生理环境中保持完整,但一旦剂型进入结肠,它就会被多糖酶作用,多糖酶降解多糖并将药物释放到结肠生物环境附近。然而,由于多糖的巨大膨胀和亲水性质,它们在进入胃和小肠时应受到保护。这已通过化学交联或添加保护涂层来实现。用肠溶聚合物包衣的制剂在pH值向碱性范围移动时释放药物,而多层包衣制剂通过胃后,药物在相当于小肠转运时间的3-5小时滞后时间后释放。涂有生物粘附聚合物的药物,该聚合物选择性地与结肠粘膜提供粘附力,可能在结肠中释放药物。

结论

对于目前用于治疗结肠局部疾病的药物,需要改进的药物递送系统。将药物特异性靶向患病结肠的优点是全身副作用发生率降低、药物剂量降低、仅在需要时将药物供应到生物相以及使药物尽可能以完整形式维持在靶部位附近。

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