Physical Examination Center, China-Japan Union Hospital of Jilin University, Changchun 130033, PR China.
State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, PR China.
Adv Drug Deliv Rev. 2021 Jul;174:114-126. doi: 10.1016/j.addr.2021.04.009. Epub 2021 Apr 20.
Cervical cancer or cervical intraepithelial neoplasia (CIN) remain a major public health problem among women globally. Traditional methods such as surgery are often associated with possible complications which may impact future pregnancies and childbirth especially for young female patients. Vagina with a high contact surface is a suitable route for the local and systemic delivery of drugs but its abundant mucus in continuous exchange presents a barrier for the popularization of conventional vaginal formulations including suppositories, gel, patch, creams and so on. So the development of new pharmaceutical forms based on nanotechnology became appealing owing to its several advantages such as mucosa penetration, bioadhesion, controlled drug release, and decreased adverse effects. This review provided an overview of the development of topical treatment of cervical cancer or CIN through vaginal drug delivery ranging from conventional vaginal formulations to new nanocarriers to the newly developed phototherapy and gene therapy, analyzing the problems faced by current methods used, and advising the developing trend in future. The methods of establishing preclinical animal model are also discussed.
宫颈癌或宫颈上皮内瘤变(CIN)仍然是全球女性的一个主要公共卫生问题。传统方法,如手术,常伴有可能的并发症,这可能会影响未来的怀孕和分娩,尤其是对年轻的女性患者。阴道具有较高的接触表面,是局部和全身给药的合适途径,但丰富的粘液不断交换,这对包括栓剂、凝胶、贴片、乳膏等在内的传统阴道制剂的推广构成了障碍。因此,基于纳米技术的新药物制剂的发展具有黏膜穿透性、生物黏附性、药物控释和减少不良反应等优势,引起了人们的关注。本文综述了通过阴道给药治疗宫颈癌或 CIN 的局部治疗的新进展,从传统的阴道制剂到新的纳米载体,再到新发展的光疗和基因治疗,分析了当前方法所面临的问题,并对未来的发展趋势提出了建议。还讨论了建立临床前动物模型的方法。