Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
Division of ECD, Indian Council of Medical Research, New Delhi, India.
Drug Deliv Transl Res. 2022 Jan;12(1):27-48. doi: 10.1007/s13346-021-00907-8. Epub 2021 Jan 23.
Even though the dawn of highly active antiretroviral therapy (HAART) proved out to be a boon for acquired immunodeficiency syndrome (AIDS) patients, management of HIV infections persists to be a major global health curse. A reduced efficacy with existing conventional therapy for brain targeting has been largely credited to the inability of antiretroviral (ARV) drugs to transmigrate across the blood-brain barrier (BBB) in productive concentrations. The review consists of nano-based drug delivery strategies rendering superior outcomes to delivery of ARV drugs to the viral sanctuaries in the brain. Nano-ART for ARV drugs promotes the development of an optimized dosage regimen, thereby improving the penetration of drugs across the BBB in an attempt to target the central reservoirs hosting viral population. Numerous efforts have been undertaken for making the drug more bioavailable and therapeutically effective by moulding them into various nanostructures. Polymeric nanocarriers, solid lipid nanoparticles, nanostructured lipid carriers, nanoemulsions, nanodiamonds, vesicle-based drug carriers, metal-based nanoparticles, and nano vaccines have been reported for their advancing role as a smart alternative for drug delivery to central nervous system. The high drug loading capacity of nanocarriers and their small size effectuating increased surface to volume ratio is accountable for improved efficacy of ARV drugs when formulated as nanotherapeutics. This review highlights the advancing role of nanotherapeutics in mediating a successful delivery of ARV drugs to eradicate viral loads in treating NeuroAIDS.
尽管高效抗逆转录病毒疗法 (HAART) 的出现被证明是艾滋病 (AIDS) 患者的福音，但 HIV 感染的管理仍然是一个主要的全球健康难题。现有的常规脑部靶向治疗的疗效降低，在很大程度上归因于抗逆转录病毒 (ARV) 药物无法以有效的浓度穿越血脑屏障 (BBB)。本综述包括基于纳米的药物传递策略，为将 ARV 药物递送到大脑中的病毒避难所提供了更好的结果。纳米抗逆转录病毒疗法 (Nano-ART) 促进了优化剂量方案的发展，从而试图通过靶向宿主病毒种群的中央储库来提高药物穿过 BBB 的渗透。为了提高药物的生物利用度和治疗效果，人们已经做出了许多努力，将药物制成各种纳米结构。聚合物纳米载体、固体脂质纳米粒、纳米结构脂质载体、纳米乳剂、纳米金刚石、基于囊泡的药物载体、基于金属的纳米颗粒和纳米疫苗已被报道，它们作为向中枢神经系统输送药物的智能替代品发挥着推进作用。纳米载体的高载药能力和小尺寸效应导致表面积与体积比增加，这使得 ARV 药物在制成纳米药物时的疗效得到提高。本综述强调了纳米药物在介导成功递送至中枢神经系统的 ARV 药物以消除神经艾滋病中的病毒载量方面的推进作用。
