Biomedical Engineering Center, Draper Laboratory, Cambridge, MA 02139, United States.
Expert Opin Drug Deliv. 2011 Sep;8(9):1161-74. doi: 10.1517/17425247.2011.588207. Epub 2011 May 26.
Advances in molecular biology and in the basic understanding of the mechanisms associated with sensorineural hearing loss and other diseases of the inner ear are paving the way towards new approaches for treatments for millions of patients. However, the cochlea is a particularly challenging target for drug therapy, and new technologies will be required to provide safe and efficacious delivery of these compounds. Emerging delivery systems based on microfluidic technologies are showing promise as a means for direct intracochlear delivery. Ultimately, these systems may serve as a means for extended delivery of regenerative compounds to restore hearing in patients suffering from a host of auditory diseases.
Recent progress in the development of drug delivery systems capable of direct intracochlear delivery is reviewed, including passive systems such as osmotic pumps, active microfluidic devices and systems combined with currently available devices such as cochlear implants. The aim of this article is to provide a concise review of intracochlear drug delivery systems currently under development and ultimately capable of being combined with emerging therapeutic compounds for the treatment of inner ear diseases.
Safe and efficacious treatment of auditory diseases will require the development of microscale delivery devices, capable of extended operation and direct application to the inner ear. These advances will require miniaturization and integration of multiple functions, including drug storage, delivery, power management and sensing, ultimately enabling closed-loop control and timed-sequence delivery devices for treatment of these diseases.
分子生物学的进步以及对感音神经性听力损失和内耳其他疾病相关机制的基本认识,为为数百万患者的治疗方法开辟了新的途径。然而,耳蜗是药物治疗的一个特别具有挑战性的靶点,需要新的技术来提供这些化合物的安全有效的输送。基于微流控技术的新兴输送系统作为直接向耳蜗内输送的手段显示出了前景。最终,这些系统可能成为将再生化合物进行长期输送的手段,以恢复患有多种听觉疾病的患者的听力。
本文综述了能够进行直接耳蜗内输送的药物输送系统的最新进展,包括被动系统(如渗透泵)、主动微流控装置以及与现有的设备(如耳蜗植入物)相结合的系统。本文的目的是对当前正在开发的、最终能够与新兴治疗化合物结合以治疗内耳疾病的耳蜗内药物输送系统进行简要综述。
安全有效的听觉疾病治疗需要开发微尺度输送装置,该装置能够进行扩展操作并直接应用于内耳。这些进展将需要对多个功能进行小型化和集成,包括药物储存、输送、电源管理和传感,最终实现用于治疗这些疾病的闭环控制和定时序列输送装置。