Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Semin Cancer Biol. 2022 Nov;86(Pt 2):929-942. doi: 10.1016/j.semcancer.2021.08.003. Epub 2021 Aug 8.
Advances in the development of anti-tumour drugs and related technologies have resulted in a significant increase in the number of cancer survivors. However, the incidence of chemotherapy-induced cardiotoxicity (CIC) has been rising continuously, threatening their long-term survival. The integration of nanotechnology and biomedicine has brought about an unprecedented technological revolution and has promoted the progress of anti-tumour therapy. In this review, we summarised the possible mechanisms of CIC, evaluated the role of nanoparticles (including liposomes, polymeric micelles, dendrimers, and hydrogels) as drug carriers in preventing cardiotoxicity and proposed five advantages of nanotechnology in reducing cardiotoxicity: Liposomes cannot easily penetrate the heart's endothelial barrier; optimized delivery strategies reduce distribution in important organs, such as the heart; targeting the tumour microenvironment and niche; stimulus-responsive polymer nano-drug carriers rapidly iterate; better economic benefits were obtained. Nanoparticles can effectively deliver chemotherapeutic drugs to tumour tissues, while reducing the toxicity to heart tissues, and break through the dilemma of existing chemotherapy to a certain extent. It is important to explore the interactions between the physicochemical properties of nanoparticles and optimize the highly specific tumour targeting strategy in the future.
抗肿瘤药物及相关技术的发展进步使癌症幸存者的人数显著增加。然而,化疗引起的心脏毒性(CIC)的发生率却在持续不断地上升,这对他们的长期生存构成了威胁。纳米技术和生物医学的融合带来了前所未有的技术革命,促进了抗肿瘤治疗的进展。在这篇综述中,我们总结了 CIC 的可能机制,评估了纳米颗粒(包括脂质体、聚合物胶束、树枝状大分子和水凝胶)作为药物载体在预防心脏毒性方面的作用,并提出了纳米技术在降低心脏毒性方面的五个优势:脂质体不易穿透心脏的内皮屏障;优化的递药策略减少了在心脏等重要器官中的分布;靶向肿瘤微环境和龛位;刺激响应型聚合物纳米药物载体快速迭代;获得更好的经济效益。纳米颗粒可以将化疗药物有效地递送到肿瘤组织,同时降低对心脏组织的毒性,在一定程度上突破了现有化疗的困境。未来需要探索纳米颗粒的理化性质与高度特异性肿瘤靶向策略之间的相互作用。