Barar Jaleh, Aghanejad Ayuob, Fathi Marziyeh, Omidi Yadollah
Research Centre for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
Bioimpacts. 2016;6(1):49-67. doi: 10.15171/bi.2016.07. Epub 2016 Mar 30.
Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis, retinochoroiditis), ocular hypertension and neuropathy, age-related macular degeneration and mucopolysaccharidosis (MPS) due to accumulation of glycosaminoglycans (GAGs). Such therapies appear to provide ultimate treatments, even though much more effective, yet biocompatible, noninvasive therapies are needed to control some disabling ocular diseases/disorders.
In the current study, we have reviewed and discussed recent advancements on ocular targeted therapies.
On the ground that the pharmacokinetic and pharmacodynamic analyses of ophthalmic drugs need special techniques, most of ocular DDSs/devices developments have been designed to localized therapy within the eye. Application of advanced DDSs such as Subconjunctival insert/implants (e.g., latanoprost implant, Gamunex-C), episcleral implant (e.g., LX201), cationic emulsions (e.g., Cationorm™, Vekacia™, Cyclokat™), intac/punctal plug DDSs (latanoprost punctal plug delivery system, L-PPDS), and intravitreal implants (I-vitaion™, NT-501, NT- 503, MicroPump, Thethadur, IB-20089 Verisome™, Cortiject, DE-102, Retisert™, Iluvein™ and Ozurdex™) have significantly improved the treatment of ocular diseases. However, most of these DDSs/devices are applied invasively and even need surgical procedures. Of these, use of de novo technologies such as advanced stimuli-responsive nanomaterials, multimodal nanosystems (NSs)/nanoconjugates (NCs), biomacromolecualr scaffolds, and bioengineered cell therapies need to be further advanced to get better compliance and higher clinical impacts.
Despite mankind successful battle on ocular diseases, our challenge will continue to battle the ocular disease that happen with aging. Yet, we need to understand the molecular aspects of eye diseases in a holistic way and develop ultimate treatment protocols preferably as non-invasive systems.
通过使用可植入给药系统(DDS)或装置(DDD)、刺激响应性先进生物材料、多模态纳米药物、细胞治疗方式和医用生物微机电系统等新的给药和靶向方法,眼部靶向治疗取得了巨大进展。这些技术可应对多种眼部疾病,如基于炎症的疾病(如巩膜炎、角膜炎、葡萄膜炎、虹膜炎、结膜炎、脉络膜视网膜炎、脉络膜炎、视网膜炎、视网膜脉络膜炎)、高眼压和神经病变、年龄相关性黄斑变性以及由于糖胺聚糖(GAG)积累导致的黏多糖贮积症(MPS)。尽管这些疗法似乎提供了最终的治疗手段,甚至更有效,但仍需要更具生物相容性、非侵入性的疗法来控制一些致残性眼部疾病/病症。
在本研究中,我们回顾并讨论了眼部靶向治疗的最新进展。
鉴于眼科药物的药代动力学和药效学分析需要特殊技术,大多数眼部DDS/装置的开发旨在实现眼内局部治疗。应用先进的DDS,如结膜下植入物/植入体(如拉坦前列素植入体、Gamunex-C)、巩膜上植入体(如LX201)、阳离子乳剂(如Cationorm™、Vekacia™、Cyclokat™)、泪小点/泪点塞给药系统(拉坦前列素泪点塞给药系统,L-PPDS)和玻璃体内植入体(I-vitaion™、NT-501、NT-503、微型泵、Thethadur、IB-20089 Verisome™、Cortiject、DE-102、Retisert™、Iluvein™和Ozurdex™)显著改善了眼部疾病的治疗。然而,这些DDS/装置大多采用侵入性应用,甚至需要手术操作。其中,先进的刺激响应性纳米材料、多模态纳米系统(NS)/纳米缀合物(NC)、生物大分子支架和生物工程细胞治疗等新技术的应用需要进一步推进,以获得更好的顺应性和更高的临床影响。
尽管人类已成功对抗眼部疾病,但我们面临的挑战将继续是对抗随着年龄增长而出现的眼部疾病。然而,我们需要从整体上了解眼部疾病的分子层面,并开发出最好作为非侵入性系统的最终治疗方案。