Patton John S
Nektar Therapeutics, 150 Industrial Road, San Carlos, CA 94070, USA.
Diabetes Obes Metab. 2005 Nov;7 Suppl 1:S5-8. doi: 10.1111/j.1463-1326.2005.00530.x.
As the incidence of diabetes reaches epidemic proportions, the use of new, alternative routes of insulin delivery to manage glycaemic control is becoming an ever more active area of research. The high permeability and large surface area of the lung make it an attractive alternative to subcutaneous (SC) insulin injections. This review discusses the technical factors that influence the efficacy of pulmonary drug delivery and describes how an appreciation of these issues has enabled the design of Exubera, a novel, non-invasive, pulmonary dry-powder human insulin delivery system currently in development by Pfizer and the Sanofi-Aventis Group in collaboration with Nektar Therapeutics. While clinical trials of this novel aerosol delivery of insulin are still ongoing in patients with diabetes, the results so far suggest it is simple to use and can provide reproducible doses of insulin in therapeutic amounts with only a few inhalations per dose. In addition, it has been shown to be comparable in terms of efficacy and safety to a conventional SC insulin injection regimen. Delivering aerosolized drugs via the lungs avoids the necessity for SC injections and thereby may increase the patient's acceptability of an insulin-based therapeutic regimen.
随着糖尿病发病率达到流行程度，采用新的、替代的胰岛素给药途径来控制血糖正成为一个日益活跃的研究领域。肺的高渗透性和大表面积使其成为皮下注射胰岛素的一个有吸引力的替代途径。本综述讨论了影响肺部药物递送疗效的技术因素，并描述了对这些问题的认识如何促成了Exubera的设计，Exubera是辉瑞公司、赛诺菲-安万特集团与耐科斯特治疗公司合作正在开发的一种新型、非侵入性、肺部干粉人胰岛素递送系统。虽然这种新型胰岛素气雾剂递送的临床试验仍在糖尿病患者中进行，但迄今为止的结果表明，它使用简单，每次剂量只需吸入几次就能提供治疗剂量的可重复胰岛素剂量。此外，已证明其在疗效和安全性方面与传统皮下胰岛素注射方案相当。通过肺部递送雾化药物避免了皮下注射的必要性，从而可能提高患者对基于胰岛素的治疗方案的接受度。
