Hamman Josias H, Enslin Gill M, Kotzé Awie F
School of Pharmacy, Tshwane University of Technology, Pretoria, South Africa.
BioDrugs. 2005;19(3):165-77. doi: 10.2165/00063030-200519030-00003.
A wide variety of peptide drugs are now produced on a commercial scale as a result of advances in the biotechnology field. Most of these therapeutic peptides are still administered by the parenteral route because of insufficient absorption from the gastrointestinal tract. Peptide drugs are usually indicated for chronic conditions, and the use of injections on a daily basis during long-term treatment has obvious drawbacks. In contrast to this inconvenient and potentially problematic method of drug administration, the oral route offers the advantages of self-administration with a high degree of patient acceptability and compliance. The main reasons for the low oral bioavailability of peptide drugs are pre-systemic enzymatic degradation and poor penetration of the intestinal mucosa. A considerable amount of research has focused on overcoming the challenges presented by these intestinal absorption barriers to provide effective oral delivery of peptide and protein drugs. Attempts to improve the oral bioavailability of peptide drugs have ranged from changing the physicochemical properties of peptide molecules to the inclusion of functional excipients in specially adapted drug delivery systems. However, the progress in developing an effective peptide delivery system has been hampered by factors such as the inherent toxicities of absorption-enhancing excipients, variation in absorption between individuals, and potentially high manufacturing costs. This review focuses on the intestinal barriers that compromise the systemic absorption of intact peptide and protein molecules and on the advanced technologies that have been developed to overcome the barriers to peptide drug absorption.
由于生物技术领域的进展,现在有多种肽类药物已实现商业化生产。由于胃肠道吸收不足,这些治疗性肽类药物大多仍通过非肠道途径给药。肽类药物通常用于治疗慢性病,在长期治疗期间每天进行注射存在明显缺点。与这种不便且可能存在问题的给药方法相比,口服途径具有患者自我给药的优势,且患者接受度和依从性较高。肽类药物口服生物利用度低的主要原因是体循环前的酶降解和肠道黏膜穿透性差。大量研究致力于克服这些肠道吸收障碍带来的挑战,以实现肽类和蛋白质药物的有效口服递送。提高肽类药物口服生物利用度的尝试包括改变肽分子的物理化学性质,以及在特殊设计的药物递送系统中加入功能性辅料。然而,开发有效的肽递送系统的进展受到多种因素的阻碍,如吸收增强辅料的固有毒性、个体间吸收差异以及潜在的高制造成本。本综述重点关注影响完整肽和蛋白质分子全身吸收的肠道屏障,以及为克服肽类药物吸收障碍而开发的先进技术。
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