Tabansky Inna, Messina Mark D, Bangeranye Catherine, Goldstein Jeffrey, Blitz-Shabbir Karen M, Machado Suly, Jeganathan Venkatesh, Wright Paul, Najjar Souhel, Cao Yonghao, Sands Warren, Keskin Derin B, Stern Joel N H
Department of Neurobiology and Behavior, The Rockefeller University, New York, NY, USA.
Department of Neurology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
Immunol Res. 2015 Dec;63(1-3):58-69. doi: 10.1007/s12026-015-8719-0.
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by demyelination of neurons and loss of neuronal axons and oligodendrocytes. In MS, auto-reactive T cells and B cells cross the blood-brain barrier (BBB), causing perivenous demyelinating lesions that form multiple discrete inflammatory demyelinated plaques located primarily in the white matter. In chronic MS, cortical demyelination and progressive axonal transections develop. Treatment for MS can be stratified into disease-modifying therapies (DMTs) and symptomatic therapy. DMTs aim to decrease circulating immune cells or to prevent these cells from crossing the BBB and reduce the inflammatory response. There are currently 10 DMTs approved for the relapsing forms of MS; these vary with regard to their efficacy, route and frequency of administration, adverse effects, and toxicity profile. Better drug delivery systems are being developed in order to decrease adverse effects, increase drug efficacy, and increase patient compliance through the direct targeting of pathologic cells. Here, we address the uses and benefits of advanced drug delivery systems, including nanoparticles, microparticles, fusion antibodies, and liposomal formulations. By altering the properties of therapeutic particles and enhancing targeting, breakthrough drug delivery technologies potentially applicable to multiple disease treatments may rapidly emerge.
多发性硬化症（MS）是一种中枢神经系统的慢性炎症性自身免疫疾病。其特征为神经元脱髓鞘以及神经元轴突和少突胶质细胞的丧失。在MS中，自身反应性T细胞和B细胞穿过血脑屏障（BBB），导致静脉周围脱髓鞘病变，形成多个主要位于白质的离散性炎性脱髓鞘斑块。在慢性MS中，会出现皮质脱髓鞘和进行性轴突横断。MS的治疗可分为疾病修正疗法（DMTs）和对症治疗。DMTs旨在减少循环免疫细胞或阻止这些细胞穿过血脑屏障并减轻炎症反应。目前有10种DMTs被批准用于复发型MS；它们在疗效、给药途径和频率、不良反应及毒性方面各不相同。为了减少不良反应、提高药物疗效并通过直接靶向病理细胞来提高患者依从性，正在开发更好的药物递送系统。在此，我们探讨先进药物递送系统的用途和益处，包括纳米颗粒、微粒、融合抗体和脂质体制剂。通过改变治疗颗粒的性质并增强靶向性，可能会迅速出现适用于多种疾病治疗的突破性药物递送技术。
