MedImmune, LLC, USA.
MedImmune, LLC, USA.
J Control Release. 2018 Feb 28;272:159-168. doi: 10.1016/j.jconrel.2018.01.009. Epub 2018 Jan 19.
Nanotechnology ushered the field of medicine in to a new era. Miniaturization, increased surface area, and the unique physicochemical properties in the nano dimension were explored for new applications. Pharmaceutical industry picked up the technology and early success came fast for oral drug delivery through improvement in dissolution properties of the active molecules. Many products were launched using the nanocrystal technology on the oral side. Further development of polymeric nanoparticles led to wide spread research of nanocarriers for parenteral delivery. While considerable efforts have gone in the last two decades for testing nanoparticles for tumor targeting, delivery into tumors has remained challenging and suboptimal. Inadequate in vivo models that didn't accurately reflect the age and vascularity of human tumors, and inability to reproducibly target therapeutic drugs to the tissue of interest due to intrinsic biodistribution of the particles and hence side effects, limited the number of studies that advanced to the clinic. Our article addresses the questions commonly asked by scientific researchers in nanomedicine: "Has nanoparticle technology yielded on its initial promise that scientists predicted towards improving therapeutic index and avoid toxicity by delivering molecules to target tissues or was it more of wishful thinking that had several roadblocks?" We answer this question by linking the relevance of nanoparticles to cancer immunotherapy. The advent of immunotherapy has begun to show the potential applicability of nanoparticles in a different light, to target the immune system. In this approach, nanoparticles may positively influence the immune system rather than create the targeted "magic bullet". Utilizing the intrinsic properties of nanoparticles for immune targeting as opposed to targeting the tumor can bring about a positive difference due to the underlying complex cancer mechanisms that can potentially overlap with the heterogeneous biodistribution of nanoparticles towards improving the acquired and innate immune responses. In this review, we have followed the progress of nanotechnology in pharmaceutical applications with key insights from oral and parenteral drug delivery, and how to modify our thinking to better utilize nanoparticles for immuno-oncology. In contrast to conventional "local" tumor targeting by nanoparticles, we propose a new mechanism whereby nanoparticles trigger priming of the T cells towards tumor destruction. The heterogenous biodistribution of nanoparticles lends itself to stimulating immune cells systemically in a "global" manner and with the right therapeutic combinations will be able to trigger tumor antigens to continually activate, retain memory effects and destroy tumor cells.
纳米技术将医学领域带入了一个新时代。人们探索了微型化、增加表面积以及纳米尺寸下独特的物理化学特性,以寻求新的应用。制药行业采用了这项技术,并且通过改善活性分子的溶解性能,很快就在口服药物传递方面取得了早期成功。许多产品都采用纳米晶体技术在口服方面推出。聚合物纳米粒子的进一步发展导致了广泛的纳米载体用于肠外给药的研究。尽管在过去的二十年中,人们为了测试用于肿瘤靶向的纳米粒子付出了相当大的努力,但将药物输送到肿瘤中仍然具有挑战性,效果也不尽如人意。由于粒子的内在生物分布和由此产生的副作用,体内模型不能准确反映人类肿瘤的年龄和血管生成,并且不能将治疗药物重复靶向到感兴趣的组织,从而限制了许多研究进展到临床阶段。我们的文章解决了纳米医学领域的科学研究人员经常提出的问题:“纳米粒子技术是否实现了科学家最初的承诺,即通过将分子递送到靶组织来提高治疗指数并避免毒性,还是说这只是一种有很多障碍的一厢情愿的想法?”我们通过将纳米粒子与癌症免疫治疗联系起来回答了这个问题。免疫治疗的出现开始以不同的方式展示纳米粒子在靶向免疫系统方面的潜在适用性。在这种方法中,纳米粒子可以积极影响免疫系统,而不是制造靶向“神奇子弹”。与靶向肿瘤相比,利用纳米粒子的固有特性进行免疫靶向可能会带来积极的差异,因为潜在的复杂癌症机制可能与纳米粒子的异质生物分布重叠,从而改善获得性和固有免疫反应。在这篇综述中,我们跟踪了纳米技术在药物传递方面的进展,包括口服和肠外药物传递,以及如何改变我们的思维,以更好地将纳米粒子用于免疫肿瘤学。与传统的纳米粒子“局部”肿瘤靶向相反,我们提出了一种新的机制,即纳米粒子触发 T 细胞对肿瘤破坏的启动。纳米粒子的异质生物分布本身就可以以“全局”的方式刺激全身的免疫细胞,并且通过正确的治疗组合,将能够触发肿瘤抗原持续激活、保留记忆效应并破坏肿瘤细胞。
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