Broz Pavel, Ben-Haim Nadav, Grzelakowski Mariusz, Marsch Stephan, Meier Wolfgang, Hunziker Patrick
Medical Intensive Care Unit, Basel, Switzerland.
J Cardiovasc Pharmacol. 2008 Mar;51(3):246-52. doi: 10.1097/FJC.0b013e3181624aed.
Ruptures of macrophage-rich atherosclerotic plaques in the coronary arteries are the main reason for heart attack. Targeted therapeutic interventions with an inhibitory effect on the macrophages promise to be beneficial, but currently available drugs such as statins achieve event reductions of only 30%. Dose-limiting adverse effects in remote organs prohibit achieving higher drug levels known to have strong inhibitory effects on macrophages. Receptor-specific targeting using statin-loaded nanometer-sized triblock copolymer vesicles with targeting moieties might allow high-dose treatment for improved efficacy, while minimizing toxicity in other cells. Vesicle uptake by target cells but not other cell types and slow intracellular content release was observed. A major improvement in biologic efficacy was observed for polymer vesicles compared to free drug, whereas no increased cytotoxicity was observed in muscle cells. Such high-dose, targeted therapy of statins through cell-specific polymer vesicles allows novel treatment paradigms not only for atherosclerosis, but appears promising for a wide range of drugs and diseases.
冠状动脉中富含巨噬细胞的动脉粥样硬化斑块破裂是心脏病发作的主要原因。对巨噬细胞具有抑制作用的靶向治疗干预有望带来益处,但目前可用的药物如他汀类药物只能使事件减少30%。远端器官的剂量限制不良反应阻碍了达到已知对巨噬细胞具有强抑制作用的更高药物水平。使用带有靶向部分的载有他汀类药物的纳米级三嵌段共聚物囊泡进行受体特异性靶向可能允许进行高剂量治疗以提高疗效,同时将其他细胞中的毒性降至最低。观察到靶细胞而非其他细胞类型对囊泡的摄取以及细胞内内容物的缓慢释放。与游离药物相比,聚合物囊泡的生物学功效有了重大改善,而在肌肉细胞中未观察到细胞毒性增加。通过细胞特异性聚合物囊泡对他汀类药物进行这种高剂量、靶向治疗不仅为动脉粥样硬化带来了新的治疗模式,而且对广泛的药物和疾病似乎都很有前景。