Pandey Manisha, Choudhury Hira, Abdul-Aziz Azila, Bhattamisra Subrat Kumar, Gorain Bapi, Su Jocelyn Sziou Ting, Tan Choo Leey, Chin Woon Yee, Yip Khar Yee
Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia.
Centre for Bioactive Molecules and Drug Delivery, Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur 57000, Malaysia.
Pharmaceutics. 2020 Dec 22;13(1):1. doi: 10.3390/pharmaceutics13010001.
The eyes are the window to the world and the key to communication, but they are vulnerable to multitudes of ailments. More serious than is thought, corneal infection by herpes simplex viruses (HSVs) is a prevalent yet silent cause of blindness in both the paediatric and adult population, especially if immunodeficient. Globally, there are 1.5 million new cases and forty thousand visual impairment cases reported yearly. The Herpetic Eye Disease Study recommends topical antiviral as the front-line therapy for HSV keratitis. Ironically, topical eye solutions undergo rapid nasolacrimal clearance, which necessitates oral drugs but there is a catch of systemic toxicity. The hurdle of antiviral penetration to reach an effective concentration is further complicated by drugs' poor permeability and complex layers of ocular barriers. In this current review, novel delivery approaches for ocular herpetic infection, including nanocarriers, prodrugs, and peptides are widely investigated, with special focus on advantages, challenges, and recent updates on in situ gelling systems of ocular HSV infections. In general congruence, the novel drug delivery systems play a vital role in prolonging the ocular drug residence time to achieve controlled release of therapeutic agents at the application site, thus allowing superior ocular bioavailability yet fewer systemic side effects. Moreover, in situ gel functions synergistically with nanocarriers, prodrugs, and peptides. The findings support that novel drug delivery systems have potential in ophthalmic drug delivery of antiviral agents, and improve patient convenience when prolonged and chronic topical ocular deliveries are intended.
眼睛是心灵的窗户和沟通的关键,但它们容易受到多种疾病的影响。单纯疱疹病毒(HSV)引起的角膜感染比人们想象的更为严重,是儿童和成人失明的常见且隐匿原因,免疫功能低下者尤其如此。全球范围内,每年报告有150万新病例和4万例视力损害病例。疱疹性眼病研究推荐局部使用抗病毒药物作为HSV角膜炎的一线治疗方法。具有讽刺意味的是,局部眼药水会通过鼻泪管迅速清除,这就需要口服药物,但存在全身毒性的问题。药物渗透性差以及眼部屏障层复杂,进一步增加了抗病毒药物渗透到有效浓度的难度。在本综述中,对眼部疱疹感染的新型给药方法进行了广泛研究,包括纳米载体、前药和肽类,特别关注其优势、挑战以及眼部HSV感染原位凝胶系统的最新进展。总体而言,新型药物递送系统在延长眼部药物停留时间以在应用部位实现治疗剂的控释方面发挥着至关重要的作用,从而实现更高的眼部生物利用度,同时减少全身副作用。此外,原位凝胶与纳米载体、前药和肽类具有协同作用。这些研究结果表明,新型药物递送系统在抗病毒药物的眼部给药方面具有潜力,并且在需要长期和慢性局部眼部给药时,可提高患者的便利性。
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