眼部后段的近期药物输送系统综述。

A review on recent drug delivery systems for posterior segment of eye.

机构信息

Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Opposite AirForce station, Palaj Basan Road, Village Palaj (Gandhinagar), Gujarat, 382355, India.

Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Opposite AirForce station, Palaj Basan Road, Village Palaj (Gandhinagar), Gujarat, 382355, India.

出版信息

Biomed Pharmacother. 2018 Nov;107:1564-1582. doi: 10.1016/j.biopha.2018.08.138. Epub 2018 Sep 5.

Abstract

Eye is the unique sense organ with complex and sophisticated anatomy and physiology. Being most instrumental for vision, it is secured by varied protective barriers; ranging from static (membranous) to dynamic (vascular) barrier. Although these barriers are very efficient to protect eye from exogenous substances and external stress, it is caught by various irreversible vision impairing ailments like cataract, conjunctivitis, glaucoma, uveitis, diabetic retinopathy (DR), diabetic macular edema (DME), age related macular degeneration (AMD), cytomegalovirus (CMV) retinitis, retinitis pigmentosa (RP), retinal vein occlusion (RVO), endophthalmitis affecting both anterior and posterior segment of eye. The treatment needed to reach the site of action is restricted by its characteristic barriers. The protective mechanism turns into hurdles when it comes to drug delivery especially in case of posterior segment of eye. Most common and preferable routes for ocular drug delivery are topical and systemic routes owing to their compliance and non-invasive nature, however they turned inefficient in delivering drugs to posterior segment. Currently, other local routes like intraocular and periocular (subconjunctival, subtenon, posterior juxtascleral, retrobulbar, peribulbar) are being explored and are showing positive outcomes in terms of symptomatic relief for a certain time period. But as these are invasive techniques, they also have some hidden long-term drawbacks on other side. Various advancements have been achieved till date in delivery of drug to posterior segment of eye, however despite these advancements; there is need of non-invasive or preferably less invasive technique considering prolonged treatments for such ailments. At times, dependency on invasive techniques may cause problems like patient incompliance, inflammation, contact cataract, retinal detachment, endophthalmitis etc. Here, in this review, barriers in ocular delivery, routes and recent advances in drug delivery to eye including patented commercial formulations with emphasis on posterior segment will be discussed.

摘要

眼睛是具有复杂而精细的解剖结构和生理功能的独特感觉器官。作为视觉最主要的器官,眼睛受到多种保护屏障的保护;从静态(膜性)到动态(血管)屏障。虽然这些屏障非常有效地保护眼睛免受外来物质和外部压力的伤害,但它仍然会受到各种不可逆转的视力损害疾病的困扰,如白内障、结膜炎、青光眼、葡萄膜炎、糖尿病性视网膜病变(DR)、糖尿病性黄斑水肿(DME)、年龄相关性黄斑变性(AMD)、巨细胞病毒(CMV)视网膜炎、视网膜色素变性(RP)、视网膜静脉阻塞(RVO)、影响眼前段和后段的眼内炎。到达作用部位所需的治疗受到其特征性屏障的限制。当涉及药物输送时,这种保护机制就变成了障碍,特别是在后段眼睛的情况下。最常见和首选的眼部药物输送途径是局部和全身途径,因为它们具有顺应性和非侵入性的特点,但在输送药物到后段时效率不高。目前,其他局部途径,如眼内和眼周(结膜下、Tenon 下、后巩膜下、球后、眼周)正在被探索,并在一定时期内为缓解症状方面显示出积极的结果。但由于这些是侵入性技术,它们在另一方面也存在一些隐藏的长期缺点。迄今为止,在将药物输送到后段眼睛方面已经取得了各种进展,然而,尽管有这些进展;考虑到这些疾病需要长期治疗,仍然需要非侵入性或最好是侵入性较小的技术。有时,对侵入性技术的依赖可能会导致一些问题,如患者不配合、炎症、接触性白内障、视网膜脱离、眼内炎等。在这里,在这篇综述中,我们将讨论眼部药物输送的屏障、途径以及将药物输送到眼睛的最新进展,包括专利的商业制剂,并重点介绍后段。

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