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用于治疗尿路疾病的膀胱内治疗进展。

Advances in intravesical therapy for urinary tract disorders.

作者信息

Tyagi Pradeep, Kashyap Mahendra, Hensley Harvey, Yoshimura Naoki

机构信息

a Department of Urology , University of Pittsburgh , Pittsburgh , PA 15213 , USA.

b Small animal Imaging Facility , Fox chase cancer center , Philadelphia , PA 19111 , USA.

出版信息

Expert Opin Drug Deliv. 2016;13(1):71-84. doi: 10.1517/17425247.2016.1100166. Epub 2015 Oct 19.

Abstract

INTRODUCTION

Intravesical therapy is a valuable option in the clinical management of urinary tract disorders such as interstitial cystitis/ painful bladder syndrome (IC/PBS) and refractory overactive bladder. This review will cover the latest advances in this field using polymer and liposomes as delivery platform for drugs, protein and nucleic acids.

AREAS COVERED

This review summarizes the significance of intravesical therapy for lower urinary tract disorders. The recent advancement of liposomes as a drug delivery platform for botulinum toxin, tacrolimus and small interfering RNA is discussed. The importance of polymers forming indwelling devices and hydrogels are also discussed, where all preparations improved efficacy parameters in rodent models. Clinical experience of treating IC/PBS with indwelling devices and liposomes are summarized and preclinical evidence about the downregulation of target gene expression in rodent bladder with liposomes complexed with siRNA is also reviewed.

EXPERT OPINION

There have been several advances in the field of intravesical therapy for improving clinical outcomes. One of the most promising research avenues is the repurposing of drugs, given previously by other routes of administration, such as tacrolimus. Intravesical therapy also opens up novel therapeutic targets with improved efficacy and safety for underactive bladder.

摘要

引言

膀胱内治疗是间质性膀胱炎/膀胱疼痛综合征(IC/PBS)和难治性膀胱过度活动症等泌尿系统疾病临床管理中的一种重要选择。本综述将涵盖该领域的最新进展,这些进展以聚合物和脂质体作为药物、蛋白质和核酸的递送平台。

涵盖领域

本综述总结了膀胱内治疗对下尿路疾病的重要性。讨论了脂质体作为肉毒杆菌毒素、他克莫司和小干扰RNA药物递送平台的最新进展。还讨论了形成植入装置的聚合物和水凝胶的重要性,所有这些制剂在啮齿动物模型中均改善了疗效参数。总结了使用植入装置和脂质体治疗IC/PBS的临床经验,并综述了关于与小干扰RNA复合的脂质体下调啮齿动物膀胱中靶基因表达的临床前证据。

专家观点

膀胱内治疗领域在改善临床结果方面取得了多项进展。最有前景的研究途径之一是重新利用以前通过其他给药途径给予的药物,如他克莫司。膀胱内治疗还为膀胱活动不足开辟了具有更高疗效和安全性的新型治疗靶点。

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