Chaurasiya Birendra, Zhao You-Yang
Program for Lung and Vascular Biology, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
Department of Pediatrics, Division of Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Pharmaceutics. 2020 Dec 28;13(1):31. doi: 10.3390/pharmaceutics13010031.
The pulmonary route has long been used for drug administration for both local and systemic treatment. It possesses several advantages, which can be categorized into physiological, i.e., large surface area, thin epithelial membrane, highly vascularized, limited enzymatic activity, and patient convenience, i.e., non-invasive, self-administration over oral and systemic routes of drug administration. However, the formulation of dry powder for pulmonary delivery is often challenging due to restrictions on aerodynamic size and the lung's lower tolerance capacity in comparison with an oral route of drug administration. Various physicochemical properties of dry powder play a major role in the aerosolization, deposition, and clearance along the respiratory tract. To prepare suitable particles with optimal physicochemical properties for inhalation, various manufacturing methods have been established. The most frequently used industrial methods are milling and spray-drying, while several other alternative methods such as spray-freeze-drying, supercritical fluid, non-wetting templates, inkjet-printing, thin-film freezing, and hot-melt extrusion methods are also utilized. The aim of this review is to provide an overview of the respiratory tract structure, particle deposition patterns, and possible drug-clearance mechanisms from the lungs. This review also includes the physicochemical properties of dry powder, various techniques used for the preparation of dry powders, and factors affecting the clinical efficacy, as well as various challenges that need to be addressed in the future.
肺部给药途径长期以来一直用于局部和全身治疗的药物给药。它具有几个优点,可分为生理学方面的优点,即表面积大、上皮膜薄、血管高度丰富、酶活性有限,以及患者便利性方面的优点,即非侵入性、与口服和全身给药途径相比可自行给药。然而,与口服给药途径相比,由于对空气动力学尺寸的限制以及肺部较低的耐受能力,用于肺部给药的干粉制剂通常具有挑战性。干粉的各种物理化学性质在呼吸道的雾化、沉积和清除中起主要作用。为了制备具有最佳物理化学性质的合适吸入颗粒,已经建立了各种制造方法。最常用的工业方法是研磨和喷雾干燥,同时也使用其他几种替代方法,如喷雾冷冻干燥、超临界流体、非润湿模板、喷墨打印、薄膜冷冻和热熔挤出方法。本综述的目的是概述呼吸道结构、颗粒沉积模式以及肺部可能的药物清除机制。本综述还包括干粉的物理化学性质、用于制备干粉的各种技术、影响临床疗效的因素以及未来需要解决的各种挑战。