Cramer Samantha A, Adjei Isaac M, Labhasetwar Vinod
Lerner Research Institute, Cleveland Clinic, Department of Biomedical Engineering/ND20 , 9500 Euclid Avenue, Cleveland, OH 44195 , USA +1 216 445 9364 ; +1 216 444 9198 ;
Expert Opin Drug Deliv. 2015;12(9):1501-12. doi: 10.1517/17425247.2015.1021678. Epub 2015 Mar 5.
Advancements in epigenetic treatments are not only coming from new drugs, but also from modifications or encapsulation of the existing drugs into different formulations leading to greater stability and enhanced delivery to the target site. The epigenome is highly regulated and complex; therefore, it is important that off-target effects of epigenetic drugs be minimized. The step from in vitro to in vivo treatment of these drugs often requires development of a method of effective delivery for clinical translation.
This review covers epigenetic mechanisms such as DNA methylation, chromatin remodeling and small-RNA-mediated gene regulation. There is a section in the review with examples of diseases where epigenetic alterations lead to impaired pathways, with an emphasis on cancer. Epigenetic drugs, their targets and clinical status are presented. Advantages of using a delivery method for epigenetic drugs as well as examples of current advancements and challenges are also discussed.
Epigenetic drugs have the potential to be very effective therapy against a number of diseases, especially cancers and neurological disorders. As with many chemotherapeutics, undesired side effects need to be minimized. Finding a suitable delivery method means reducing side effects and achieving a higher therapeutic index. Each drug may require a unique delivery method exploiting the drug's chemistry or other physical characteristic requiring interdisciplinary participation and would benefit from a better understanding of the mechanisms of action.
表观遗传治疗的进展不仅来自新药,还来自对现有药物的修饰或将其封装成不同剂型,从而提高稳定性并增强向靶位点的递送。表观基因组受到高度调控且十分复杂;因此,将表观遗传药物的脱靶效应降至最低非常重要。这些药物从体外治疗到体内治疗的过程通常需要开发一种有效的递送方法以实现临床转化。
本综述涵盖了诸如DNA甲基化、染色质重塑和小分子RNA介导的基因调控等表观遗传机制。综述中有一部分列举了表观遗传改变导致通路受损的疾病实例,重点是癌症。介绍了表观遗传药物、其靶点和临床现状。还讨论了使用递送方法治疗表观遗传药物的优势以及当前进展和挑战的实例。
表观遗传药物有潜力成为治疗多种疾病,尤其是癌症和神经疾病的非常有效的疗法。与许多化疗药物一样,需要将不良副作用降至最低。找到合适的递送方法意味着减少副作用并实现更高的治疗指数。每种药物可能都需要一种独特的递送方法,利用药物的化学性质或其他物理特性,这需要跨学科参与,并且更好地理解其作用机制将有助于此。