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在特发性干燥综合征特征性自身免疫性泪腺炎的小鼠模型中,局部持续递送雷帕霉素显示出治疗效果而无全身毒性。

Intralacrimal Sustained Delivery of Rapamycin Shows Therapeutic Effects without Systemic Toxicity in a Mouse Model of Autoimmune Dacryoadenitis Characteristic of Sjögren's Syndrome.

机构信息

Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, California 90033, United States.

Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, United States.

出版信息

Biomacromolecules. 2021 Mar 8;22(3):1102-1114. doi: 10.1021/acs.biomac.0c01468. Epub 2020 Dec 27.

Abstract

Sjögren's syndrome (SS) is an autoimmune disease associated with severe exocrinopathy, which is characterized by profound lymphocytic infiltration (dacryoadenitis) and loss of function of the tear-producing lacrimal glands (LGs). Systemic administration of Rapamycin (Rapa) significantly reduces LG inflammation in the male Nonobese Diabetic (NOD) model of SS-associated autoimmune dacryoadenitis. However, the systemic toxicity of this potent immunosuppressant limits its application. As an alternative, this paper reports an intra-LG delivery method using a depot formulation comprised of a thermoresponsive elastin-like polypeptide (ELP) and FKBP, the cognate receptor for Rapa (5FV). Depot formation was confirmed in excised whole LG using cleared tissue and observation by both laser-scanning confocal and lightsheet microscopy. The LG depot was evaluated for safety, efficacy, and intra-LG pharmacokinetics in the NOD mouse disease model. Intra-LG injection with the depot formulation (5FV) retained Rapa in the LG for a mean residence time (MRT) of 75.6 h compared to Rapa delivery complexed with a soluble carrier control (5FA), which had a MRT of 11.7 h in the LG. Compared to systemic delivery of Rapa every other day for 2 weeks (seven doses), a single intra-LG depot of Rapa representing 16-fold less total drug was sufficient to inhibit LG inflammation and improve tear production. This treatment modality further reduced markers of hyperglycemia and hyperlipidemia while showing no evidence of necrosis or fibrosis in the LG. This approach represents a potential new therapy for SS-related autoimmune dacryoadenitis, which may be adapted for local delivery at other sites of inflammation; furthermore, these findings reveal the utility of optical imaging for monitoring the disposition of locally administered therapeutics.

摘要

干燥综合征(SS)是一种自身免疫性疾病,与严重的外分泌疾病有关,其特征是淋巴细胞浸润(泪腺炎)和产生泪液的泪腺(LGs)功能丧失。雷帕霉素(Rapa)的全身给药可显著减轻 SS 相关自身免疫性泪腺炎的雄性非肥胖型糖尿病(NOD)模型中的 LG 炎症。然而,这种强效免疫抑制剂的全身毒性限制了其应用。作为替代方案,本文报道了一种通过使用包含热响应弹性蛋白样多肽(ELP)和 FKBP 的储库制剂(FKBP 是 Rapa 的同源受体)进行 LG 内递药的方法(5FV)。通过清除组织和激光扫描共聚焦以及光片显微镜观察,在切除的整个 LG 中证实了储库的形成。在 NOD 小鼠疾病模型中,评估了 LG 储库的安全性、疗效和 LG 内药代动力学。与与可溶性载体对照(5FA)复合的 Rapa 给药复合物(5FA)相比,LG 中的平均驻留时间(MRT)为 75.6 h,LG 中 5FV 的 Rapa 储库保留了 5FV 中的 Rapa。与每隔一天全身给予 Rapa 治疗 2 周(7 剂)相比,单次 LG 储库给予 Rapa(代表 16 倍的总药物)足以抑制 LG 炎症并改善泪液产生。这种治疗方式进一步降低了 LG 中高血糖和高血脂的标志物,同时没有 LG 坏死或纤维化的证据。这种方法代表了 SS 相关自身免疫性泪腺炎的一种潜在新疗法,该疗法可适用于其他炎症部位的局部给药;此外,这些发现揭示了光学成像在监测局部给予的治疗剂处置中的应用。

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