Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, Guizhou, 550000, China.
Translational Tissue Engineering Center, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
Adv Healthc Mater. 2021 Jun;10(11):e2001732. doi: 10.1002/adhm.202001732. Epub 2021 Apr 18.
Noninfectious arthritis (NIA) comprises a class of chronic and progressive inflammatory disorders that require early-stage management to prevent disease progression. The most common forms include osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis. Current treatments involve nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs and glucocorticoids to alleviate clinical symptoms, although regular use of these can result in a high risk of chronic kidney disease and heart failure, as well as severe adverse gastrointestinal effects. Nanomedicine offers unique opportunities to address these challenges and improve therapeutic efficacy due to its ability to deliver therapeutics locally in a sustained manner, thus extending the half-life, improving bioavailability, and reducing the side effects of these agents. This review includes a comprehensive analysis of the mechanisms of various treatment options for NIA and highlights recent progress and emerging strategies in treating NIA with nanomedicine platforms, particularly related to long-term biosafety and nonspecific targeting in designing nanomedicine delivery systems.
非传染性关节炎(NIA)包括一类慢性和进行性炎症性疾病,需要早期管理以防止疾病进展。最常见的形式包括骨关节炎、类风湿关节炎、强直性脊柱炎和痛风性关节炎。目前的治疗方法包括非甾体抗炎药、改善病情的抗风湿药和糖皮质激素来缓解临床症状,尽管这些药物的常规使用会导致慢性肾脏病和心力衰竭的风险增加,以及严重的胃肠道不良反应。由于纳米医学能够以持续的方式局部递送治疗剂,从而延长半衰期、提高生物利用度并降低这些药物的副作用,因此为解决这些挑战和提高治疗效果提供了独特的机会。本综述包括对 NIA 各种治疗选择的机制的全面分析,并重点介绍了纳米医学平台治疗 NIA 的最新进展和新兴策略,特别是在设计纳米医学递送系统时与长期生物安全性和非特异性靶向相关的进展和新兴策略。