Department of Pharmacy, National University of Singapore, Singapore.
Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
Curr Pharm Des. 2020;26(42):5488-5502. doi: 10.2174/1381612826666200523174108.
Autoimmune diseases are collectively addressed as chronic conditions initiated by the loss of one's immunological tolerance, where the body treats its own cells as foreigners or self-antigens. These hay-wired antibodies or immunologically capable cells lead to a variety of disorders like rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, multiple sclerosis and recently included neurodegenerative diseases like Alzheimer's, Parkinsonism and testicular cancer triggered T-cells induced autoimmune response in testes and brain. Conventional treatments for autoimmune diseases possess several downsides due to unfavourable pharmacokinetic behaviour of drug, reflected by low bioavailability, rapid clearance, offsite toxicity, restricted targeting ability and poor therapeutic outcomes. Novel nanovesicular drug delivery systems including liposomes, niosomes, proniosomes, ethosomes, transferosomes, pharmacosomes, ufasomes and biologically originated exosomes have proved to possess alluring prospects in supporting the combat against autoimmune diseases. These nanovesicles have revitalized available treatment modalities as they are biocompatible, biodegradable, less immunogenic and capable of carrying high drug payloads to deliver both hydrophilic as well as lipophilic drugs to specific sites via passive or active targeting. Due to their unique surface chemistry, they can be decorated with physiological or synthetic ligands to target specific receptors overexpressed in different autoimmune diseases and can even cross the blood-brain barrier. This review presents exhaustive yet concise information on the potential of various nanovesicular systems as drug carriers in improving the overall therapeutic efficiency of the dosage regimen for various autoimmune diseases. The role of endogenous exosomes as biomarkers in the diagnosis and prognosis of autoimmune diseases along with monitoring progress of treatment will also be highlighted.
自身免疫性疾病通常被认为是由免疫耐受丧失引起的慢性疾病，在这种情况下，身体会将自身细胞视为外来物或自身抗原。这些错乱的抗体或免疫细胞会导致多种疾病，如类风湿性关节炎、银屑病关节炎、系统性红斑狼疮、多发性硬化症，最近还包括阿尔茨海默病、帕金森病和睾丸癌等神经退行性疾病，这些疾病的自身免疫反应是由睾丸和大脑中的 T 细胞引发的。由于药物药代动力学行为不理想，如生物利用度低、清除速度快、异位毒性、靶向能力有限和治疗效果不佳，自身免疫性疾病的传统治疗方法存在诸多缺点。新型纳米囊泡药物递送系统，包括脂质体、非离子型脂质体、前体脂质体、醇质体、转胞体、药质体、超滤体和生物起源的外泌体，已被证明在支持对抗自身免疫性疾病方面具有诱人的前景。这些纳米囊泡具有生物相容性、可生物降解、免疫原性低且能够携带高药物载量，通过被动或主动靶向将亲水性和疏水性药物递送到特定部位，从而使现有的治疗方式得以复兴。由于其独特的表面化学性质，它们可以用生理或合成配体进行修饰，以针对不同自身免疫性疾病中过度表达的特定受体进行靶向，甚至可以穿透血脑屏障。本综述全面而简洁地介绍了各种纳米囊泡系统作为药物载体在提高各种自身免疫性疾病治疗方案总体疗效方面的潜力。内源性外泌体作为自身免疫性疾病诊断和预后以及监测治疗进展的生物标志物的作用也将得到强调。
