Kleinstreuer Clement, Feng Yu, Childress Emily
Clement Kleinstreuer, Yu Feng, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, United States.
World J Clin Cases. 2014 Dec 16;2(12):742-56. doi: 10.12998/wjcc.v2.i12.742.
Targeted drug delivery to solid tumors is a very active research area, focusing mainly on improved drug formulation and associated best delivery methods/devices. Drug-targeting has the potential to greatly improve drug-delivery efficacy, reduce side effects, and lower the treatment costs. However, the vast majority of drug-targeting studies assume that the drug-particles are already at the target site or at least in its direct vicinity. In this review, drug-delivery methodologies, drug types and drug-delivery devices are discussed with examples in two major application areas: (1) inhaled drug-aerosol delivery into human lung-airways; and (2) intravascular drug-delivery for solid tumor targeting. The major problem addressed is how to deliver efficiently the drug-particles from the entry/infusion point to the target site. So far, most experimental results are based on animal studies. Concerning pulmonary drug delivery, the focus is on the pros and cons of three inhaler types, i.e., pressurized metered dose inhaler, dry powder inhaler and nebulizer, in addition to drug-aerosol formulations. Computational fluid-particle dynamics techniques and the underlying methodology for a smart inhaler system are discussed as well. Concerning intravascular drug-delivery for solid tumor targeting, passive and active targeting are reviewed as well as direct drug-targeting, using optimal delivery of radioactive microspheres to liver tumors as an example. The review concludes with suggestions for future work, considereing both pulmonary drug targeting and direct drug delivery to solid tumors in the vascular system.
靶向给药至实体瘤是一个非常活跃的研究领域,主要集中在改进药物剂型以及相关的最佳给药方法/装置上。药物靶向有潜力极大地提高给药疗效、减少副作用并降低治疗成本。然而,绝大多数药物靶向研究都假定药物颗粒已经处于靶位点或至少在其紧邻区域。在本综述中,将通过实例讨论两个主要应用领域中的给药方法、药物类型和给药装置:(1)将吸入药物气雾剂递送至人肺气道;(2)用于实体瘤靶向的血管内给药。所解决的主要问题是如何将药物颗粒从进入/输注点有效地递送至靶位点。到目前为止,大多数实验结果都基于动物研究。关于肺部给药,除了药物气雾剂配方外,重点还在于三种吸入器类型的优缺点,即压力定量吸入器、干粉吸入器和雾化器。还讨论了计算流体-颗粒动力学技术以及智能吸入器系统的基础方法。关于用于实体瘤靶向的血管内给药,以将放射性微球最佳递送至肝肿瘤为例,综述了被动靶向和主动靶向以及直接药物靶向。综述最后针对未来工作提出了建议,同时考虑了肺部药物靶向和血管系统中实体瘤的直接药物递送。