Division of Pharmaceutical Sciences, South College School of Pharmacy, 400 Goody's Lane, Knoxville, TN 37931, USA.
Int J Pharm. 2013 Apr 15;447(1-2):75-93. doi: 10.1016/j.ijpharm.2013.02.030. Epub 2013 Feb 18.
Oral delivery of peptide and protein drugs faces immense challenge partially due to the gastrointestinal (GI) environment. In spite of considerable efforts by industrial and academic laboratories, no major breakthrough in the effective oral delivery of polypeptides and proteins has been accomplished. Upon oral administration, gastrointestinal epithelium acts as a physical and biochemical barrier for absorption of proteins resulting in low bioavailability (typically less than 1-2%). An ideal oral drug delivery system should be capable of (a) maintaining the integrity of protein molecules until it reaches the site of absorption, (b) releasing the drug at the target absorption site, where the delivery system appends to that site by virtue of specific interaction, and (c) retaining inside the gastrointestinal tract irrespective of its transitory constraints. Various technologies have been explored to overcome the problems associated with the oral delivery of macromolecules such as insulin, gonadotropin-releasing hormones, calcitonin, human growth factor, vaccines, enkephalins, and interferons, all of which met with limited success. This review article intends to summarize the physiological barriers to oral delivery of peptides and proteins and novel pharmaceutical approaches to circumvent these barriers and enhance oral bioavailability of these macromolecules.
口服肽类和蛋白质药物面临巨大挑战,部分原因是胃肠道(GI)环境。尽管工业和学术实验室做出了相当大的努力,但在多肽和蛋白质的有效口服递送方面尚未取得重大突破。口服给药后,胃肠道上皮作为蛋白质吸收的物理和生化屏障,导致生物利用度低(通常低于 1-2%)。理想的口服药物递送系统应该能够 (a) 在到达吸收部位之前保持蛋白质分子的完整性,(b) 在靶吸收部位释放药物,其中递送系统通过特定相互作用附加到该部位,以及 (c) 保留在胃肠道内,无论其暂时限制如何。已经探索了各种技术来克服与胰岛素、促性腺激素释放激素、降钙素、人生长因子、疫苗、脑啡肽和干扰素等大分子的口服递送相关的问题,但都取得了有限的成功。本文旨在总结肽类和蛋白质口服递送的生理障碍以及克服这些障碍和提高这些大分子口服生物利用度的新的药物制剂方法。