Musumeci Teresa, Bonaccorso Angela, Puglisi Giovanni
Department of Drug Sciences, University of Catania; V.le Andrea Doria, 6, 95125 Catania, Italy.
Pharmaceutics. 2019 Mar 13;11(3):118. doi: 10.3390/pharmaceutics11030118.
Epilepsy is the fourth most common global neurological problem, which can be considered a spectrum disorder because of its various causes, seizure types, its ability to vary in severity and the impact from person to person, as well as its range of co-existing conditions. The approaches to drug therapy of epilepsy are directed at the control of symptoms by chronic administration of antiepileptic drugs (AEDs). These AEDs are administered orally or intravenously but alternative routes of administration are needed to overcome some important limits. Intranasal (IN) administration represents an attractive route because it is possible to reach the brain bypassing the blood brain barrier while the drug avoids first-pass metabolism. It is possible to obtain an increase in patient compliance for the easy and non-invasive route of administration. This route, however, has some drawbacks such as mucociliary clearance and the small volume that can be administered, in fact, only drugs that are efficacious at low doses can be considered. The drug also needs excellent aqueous solubility or must be able to be formulated using solubilizing agents. The use of nanomedicine formulations able to encapsulate active molecules represents a good strategy to overcome several limitations of this route and of conventional drugs. The aim of this review is to discuss the innovative application of nanomedicine for epilepsy treatment using nose-to-brain delivery with particular attention focused on polymeric nanoparticles to load drugs.
癫痫是全球第四大常见的神经学问题,由于其病因多样、发作类型不同、严重程度因人而异、影响各不相同以及并存病症范围广泛,可被视为一种谱系障碍。癫痫的药物治疗方法旨在通过长期服用抗癫痫药物(AEDs)来控制症状。这些AEDs通过口服或静脉注射给药,但需要其他给药途径来克服一些重要限制。鼻内(IN)给药是一种有吸引力的途径,因为它可以绕过血脑屏障到达大脑,同时药物避免首过代谢。通过这种简单且无创的给药途径,可以提高患者的依从性。然而,这种途径有一些缺点,如黏液纤毛清除和可给药的体积小,实际上,只有低剂量有效药物才会被考虑。药物还需要具有出色的水溶性,或者必须能够使用增溶剂进行配制。使用能够包裹活性分子的纳米药物制剂是克服该途径和传统药物若干局限性的良好策略。本综述的目的是讨论纳米药物在癫痫治疗中的创新应用,采用鼻脑给药,特别关注用于载药的聚合物纳米颗粒。