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目前延长治疗性蛋白半衰期的策略。

Current strategies in extending half-lives of therapeutic proteins.

机构信息

Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.

School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.

出版信息

J Control Release. 2019 May 10;301:176-189. doi: 10.1016/j.jconrel.2019.02.016. Epub 2019 Mar 5.

Abstract

Macromolecular protein and peptide therapeutics have been proven to be effective in treating critical human diseases precisely. Thanks to biotechnological advancement, a huge number of proteins and peptide therapeutics were made their way to pharmaceutical market in past few decades. However, one of the biggest challenges to be addressed for protein therapeutics during clinical application is their fast degradation in serum and quick elimination owing to enzymatic degradation, renal clearance, liver metabolism and immunogenicity, attributing to the short half-lives. Size and hydrophobicity of protein molecules make them prone to kidney filtration and liver metabolism. On the other hand, proteasomes responsible for protein destruction possess the capability of specifically recognizing almost all kinds of foreign proteins while avoiding any unwanted destruction of cellular components. At present almost all protein-based drug formulations available in market are administered intravenously (IV) or subcutaneously (SC) with high dosing at frequent interval, eventually creating dose-fluctuation-related complications and reducing patient compliance vastly. Therefore, artificially increasing the therapeutic half-life of a protein by attaching to it a molecule that increases the overall size (eg, PEG) or helps with receptor mediated recycling (eg, albumin), or manipulating amino acid chain in a way that makes it more prone towards aggregate formation, are some of the revolutionary approaches to avoid the fast degradation in vivo. Half-life extension technologies that are capable of dramatically enhancing half-lives of proteins in circulation (2-100 folds) and thus improving their overall pharmacokinetic (PK) parameters have been successfully applied on a wide range of protein therapeutics from hormones and enzymes, growth factor, clotting factor to interferon. The focus of the review is to assess the technological advancements made so far in enhancing circulatory half-lives and improving therapeutic potency of proteins.

摘要

大分子蛋白质和肽类治疗药物已被证明能精确治疗人类的重大疾病。得益于生物技术的进步,过去几十年里有大量的蛋白质和肽类治疗药物进入了药物市场。然而,蛋白质治疗药物在临床应用中面临的最大挑战之一是由于酶降解、肾清除、肝代谢和免疫原性,它们在血清中的快速降解和快速消除,导致半衰期较短。蛋白质分子的大小和疏水性使它们容易被肾脏过滤和肝脏代谢。另一方面,负责蛋白质破坏的蛋白酶体具有特异性识别几乎所有种类的外来蛋白质的能力,同时避免对细胞成分的任何不必要的破坏。目前,市场上几乎所有的蛋白质类药物制剂都是通过静脉注射(IV)或皮下注射(SC)给药,高剂量、频繁给药,最终导致剂量波动相关的并发症,并大大降低了患者的依从性。因此,通过将增加整体大小的分子(例如 PEG)或有助于受体介导的循环利用(例如白蛋白)附着在蛋白质上,或者以使其更易于聚集形成的方式操纵氨基酸链,人为地增加蛋白质的治疗半衰期,是避免体内快速降解的一些革命性方法。能够显著延长蛋白质在循环中的半衰期(2-100 倍),从而改善其整体药代动力学(PK)参数的半衰期延长技术已成功应用于广泛的蛋白质治疗药物,包括激素和酶、生长因子、凝血因子和干扰素。本综述的重点是评估迄今为止在延长循环半衰期和提高蛋白质治疗效果方面取得的技术进展。

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