Buxton Denis B
Advanced Technologies & Surgery Branch, Division of Cardiovascular Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD 20892, USA.
Nanomedicine (Lond). 2009 Apr;4(3):331-9. doi: 10.2217/nnm.09.8.
Nanotechnology provides a broad range of opportunities to develop new solutions for clinical problems. For the pulmonary field, nanotechnology promises better delivery of drugs and nucleic acid-based therapeutics to disease sites. Administration of therapeutics via inhalation provides the opportunity for direct delivery to the lung epithelium, the lining of the respiratory tract. By appropriate selection of particle size, deep lung delivery can be obtained with control of phagocytic uptake, the removal of particles by resident macrophages. Nanotechnology can also help in pulmonary therapies administered by intravenous and oral routes through targeting specific cell types and controlling bioavailability and release kinetics. In the hematology field, nanotechnology can counter multiple drug resistance in leukemia by blocking drug efflux from cancer cells, and provide effective delivery of siRNA into lymphocytes to block apoptosis in sepsis. Controlling the surface properties of materials on devices such as valves and stents promises improved biocompatibility by inhibition of thrombosis, the formation of blood clots, and regulating cell adhesion and activation. Nanoparticle-based thrombolytic agents have the potential to improve the effectiveness of clot removal. Treatment of both lung and blood diseases is also likely to benefit from nano-scaffold-based methods for controlling the differentiation and proliferation of stem and progenitor cells.
纳米技术为开发临床问题的新解决方案提供了广泛的机会。对于肺部领域,纳米技术有望将药物和基于核酸的治疗剂更好地递送至疾病部位。通过吸入给药提供了直接递送至肺上皮(呼吸道内衬)的机会。通过适当选择颗粒大小,可以在控制吞噬摄取(驻留巨噬细胞对颗粒的清除)的情况下实现肺部深部递送。纳米技术还可以通过靶向特定细胞类型并控制生物利用度和释放动力学,帮助通过静脉内和口服途径进行肺部治疗。在血液学领域,纳米技术可以通过阻止癌细胞的药物外排来对抗白血病中的多药耐药性,并将siRNA有效递送至淋巴细胞以阻止败血症中的细胞凋亡。控制诸如瓣膜和支架等装置上材料的表面性质有望通过抑制血栓形成(血凝块的形成)以及调节细胞粘附和活化来提高生物相容性。基于纳米颗粒的溶栓剂有可能提高血栓清除的有效性。肺部和血液疾病的治疗也可能受益于基于纳米支架的方法来控制干细胞和祖细胞的分化和增殖。