Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Complutense University of Madrid, Spain; Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Spain; Instituto Universitario de Farmacia Industrial (IUFI), School of Pharmacy, Complutense University of Madrid, Spain.
Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Complutense University of Madrid, Spain; Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Spain; Instituto Universitario de Farmacia Industrial (IUFI), School of Pharmacy, Complutense University of Madrid, Spain.
Adv Drug Deliv Rev. 2018 Feb 15;126:127-144. doi: 10.1016/j.addr.2018.01.007. Epub 2018 Jan 12.
Pathologies affecting the optic nerve and the retina are one of the major causes of blindness. These diseases include age-related macular degeneration (AMD), diabetic retinopathy (DR) and glaucoma, among others. Also, there are genetic disorders that affect the retina causing visual impairment. The prevalence of neurodegenerative diseases of the posterior segment is increased as most of them are related with the elderly. Even with the access to different treatments, there are some challenges in managing patients suffering retinal diseases. One of them is the need for frequent interventions. Also, an unpredictable response to therapy has suggested that different pathways may be playing a role in the development of these diseases. The management of these pathologies requires the development of controlled drug delivery systems able to slow the progression of the disease without the need of frequent invasive interventions, typically related with endophthalmitis, retinal detachment, ocular hypertension, cataract, inflammation, and floaters, among other. Biodegradable microspheres are able to encapsulate low molecular weight substances and large molecules such as biotechnological products. Over the last years, a large variety of active substances has been encapsulated in microspheres with the intention of providing neuroprotection of the optic nerve and the retina. The purpose of the present review is to describe the use of microspheres in chronic neurodegenerative diseases affecting the retina and the optic nerve. The advantage of microencapsulation of low molecular weight drugs as well as therapeutic peptides and proteins to be used as neuroprotective strategy is discussed. Also, a new use of the microspheres in the development of animal models of neurodegeneration of the posterior segment is described.
影响视神经和视网膜的病变是导致失明的主要原因之一。这些疾病包括年龄相关性黄斑变性（AMD）、糖尿病性视网膜病变（DR）和青光眼等。此外，还有一些遗传性疾病也会影响视网膜，导致视力障碍。由于大多数此类疾病都与老年人有关，因此后节神经退行性疾病的患病率有所增加。尽管可以采用不同的治疗方法，但在管理患有视网膜疾病的患者方面仍存在一些挑战。其中之一是需要频繁干预。此外，对治疗的反应不可预测表明，不同的途径可能在这些疾病的发展中起作用。这些病变的管理需要开发能够控制药物输送系统，以减缓疾病的进展，而无需频繁进行侵入性干预，这些干预通常与眼内炎、视网膜脱离、眼内压升高、白内障、炎症和飞蚊症等有关。可生物降解的微球能够包裹低分子量物质和大分子物质，如生物技术产品。在过去的几年中，已经将多种活性物质封装在微球中，以提供视神经和视网膜的神经保护。本综述的目的是描述微球在影响视网膜和视神经的慢性神经退行性疾病中的应用。讨论了将低分子量药物以及治疗性肽和蛋白质包封微球作为神经保护策略的优势。还描述了微球在开发后节神经退行性疾病动物模型中的新用途。
