Wolfram Joy, Zhu Motao, Yang Yong, Shen Jianliang, Gentile Emanuela, Paolino Donatella, Fresta Massimo, Nie Guangjun, Chen Chunying, Shen Haifa, Ferrari Mauro, Zhao Yuliang
No. 11, Beiyitiao, Zhongguancun, Beijing 100190, China.
Curr Drug Targets. 2015;16(14):1671-81. doi: 10.2174/1389450115666140804124808.
Nanomedicine involves the use of nanoparticles for therapeutic and diagnostic purposes. During the past two decades, a growing number of nanomedicines have received regulatory approval and many more show promise for future clinical translation. In this context, it is important to evaluate the safety of nanoparticles in order to achieve biocompatibility and desired activity. However, it is unwarranted to make generalized statements regarding the safety of nanoparticles, since the field of nanomedicine comprises a multitude of different manufactured nanoparticles made from various materials. Indeed, several nanotherapeutics that are currently approved, such as Doxil and Abraxane, exhibit fewer side effects than their small molecule counterparts, while other nanoparticles (e.g. metallic and carbon-based particles) tend to display toxicity. However, the hazardous nature of certain nanomedicines could be exploited for the ablation of diseased tissue, if selective targeting can be achieved. This review discusses the mechanisms for molecular, cellular, organ, and immune system toxicity, which can be observed with a subset of nanoparticles. Strategies for improving the safety of nanoparticles by surface modification and pretreatment with immunomodulators are also discussed. Additionally, important considerations for nanoparticle safety assessment are reviewed. In regards to clinical application, stricter regulations for the approval of nanomedicines might not be required. Rather, safety evaluation assays should be adjusted to be more appropriate for engineered nanoparticles.
纳米医学涉及使用纳米颗粒用于治疗和诊断目的。在过去二十年中,越来越多的纳米药物已获得监管批准,还有更多的纳米药物显示出未来临床转化的前景。在这种情况下,评估纳米颗粒的安全性以实现生物相容性和期望的活性非常重要。然而,对纳米颗粒的安全性做出一概而论的陈述是没有根据的,因为纳米医学领域包含由各种材料制成的多种不同的人造纳米颗粒。事实上,目前已获批的几种纳米疗法,如阿霉素脂质体(Doxil)和白蛋白结合型紫杉醇(Abraxane),其副作用比小分子对应物更少,而其他纳米颗粒(如金属和碳基颗粒)往往表现出毒性。然而,如果能够实现选择性靶向,某些纳米药物的有害性质可被用于消融病变组织。本综述讨论了一部分纳米颗粒可能出现的分子、细胞、器官和免疫系统毒性机制。还讨论了通过表面修饰和用免疫调节剂进行预处理来提高纳米颗粒安全性的策略。此外,还综述了纳米颗粒安全性评估的重要考虑因素。关于临床应用,可能不需要对纳米药物的批准制定更严格的法规。相反,安全评估检测方法应调整为更适合工程纳米颗粒。