Giannitrapani Lydia, Soresi Maurizio, Bondì Maria Luisa, Montalto Giuseppe, Cervello Melchiorre
Lydia Giannitrapani, Maurizio Soresi, Giuseppe Montalto, Unit of Internal Medicine, Biomedical Department of Internal Medicine and Specialties DiBiMIS, University of Palermo, 90127 Palermo, Italy.
World J Gastroenterol. 2014 Jun 21;20(23):7242-51. doi: 10.3748/wjg.v20.i23.7242.
Chronic liver diseases represent a major global health problem both for their high prevalence worldwide and, in the more advanced stages, for the limited available curative treatment options. In fact, when lesions of different etiologies chronically affect the liver, triggering the fibrogenesis mechanisms, damage has already occurred and the progression of fibrosis will have a major clinical impact entailing severe complications, expensive treatments and death in end-stage liver disease. Despite significant advances in the understanding of the mechanisms of liver fibrinogenesis, the drugs used in liver fibrosis treatment still have a limited therapeutic effect. Many drugs showing potent antifibrotic activities in vitro often exhibit only minor effects in vivo because insufficient concentrations accumulate around the target cell and adverse effects result as other non-target cells are affected. Hepatic stellate cells play a critical role in liver fibrogenesis , thus they are the target cells of antifibrotic therapy. The application of nanoparticles has emerged as a rapidly evolving area for the safe delivery of various therapeutic agents (including drugs and nucleic acid) in the treatment of various pathologies, including liver disease. In this review, we give an overview of the various nanotechnology approaches used in the treatment of liver fibrosis.
慢性肝病是一个重大的全球健康问题,这是由于其在全球范围内的高患病率,以及在疾病的更晚期阶段可采用的治愈性治疗选择有限。事实上,当不同病因的病变长期影响肝脏,触发纤维化机制时,损害已经发生,纤维化的进展将产生重大的临床影响,包括严重的并发症、昂贵的治疗费用以及终末期肝病导致的死亡。尽管在理解肝脏纤维化形成机制方面取得了显著进展,但用于治疗肝纤维化的药物仍然疗效有限。许多在体外显示出强大抗纤维化活性的药物在体内往往只产生轻微效果,因为目标细胞周围积累的浓度不足,而且当其他非目标细胞受到影响时会产生不良反应。肝星状细胞在肝纤维化形成中起关键作用,因此它们是抗纤维化治疗的目标细胞。纳米颗粒的应用已成为一个快速发展的领域,用于在包括肝病在内的各种疾病治疗中安全递送各种治疗剂(包括药物和核酸)。在本综述中,我们概述了用于治疗肝纤维化的各种纳米技术方法。