Li Chao, Sun Tao, Jiang Chen
Key Laboratory of Smart Drug Delivery, Ministry of Education, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Pharmaceutics, School of Pharmacy, Research Center on Aging and Medicine, Fudan University, Shanghai 201203, China.
Acta Pharm Sin B. 2021 Jul;11(7):1767-1788. doi: 10.1016/j.apsb.2020.11.019. Epub 2020 Nov 28.
Ischemic stroke is a cerebrovascular disease normally caused by interrupted blood supply to the brain. Ischemia would initiate the cascade reaction consisted of multiple biochemical events in the damaged areas of the brain, where the ischemic cascade eventually leads to cell death and brain infarction. Extensive researches focusing on different stages of the cascade reaction have been conducted with the aim of curing ischemic stroke. However, traditional treatment methods based on antithrombotic therapy and neuroprotective therapy are greatly limited for their poor safety and treatment efficacy. Nanomedicine provides new possibilities for treating stroke as they could improve the pharmacokinetic behavior of drugs , achieve effective drug accumulation at the target site, enhance the therapeutic effect and meanwhile reduce the side effect. In this review, we comprehensively describe the pathophysiology of stroke, traditional treatment strategies and emerging nanomedicines, summarize the barriers and methods for transporting nanomedicine to the lesions, and illustrate the latest progress of nanomedicine in treating ischemic stroke, with a view to providing a new feasible path for the treatment of cerebral ischemia.
缺血性中风是一种通常由大脑血液供应中断引起的脑血管疾病。缺血会引发由大脑受损区域中多个生化事件组成的级联反应,在该区域缺血级联反应最终会导致细胞死亡和脑梗死。为了治愈缺血性中风,人们针对级联反应的不同阶段进行了广泛研究。然而,基于抗血栓治疗和神经保护治疗的传统治疗方法因其安全性差和治疗效果有限而受到极大限制。纳米医学为治疗中风提供了新的可能性,因为它们可以改善药物的药代动力学行为,在靶位点实现有效的药物蓄积,增强治疗效果,同时减少副作用。在这篇综述中,我们全面描述了中风的病理生理学、传统治疗策略和新兴的纳米医学,总结了纳米医学向病变部位转运的障碍和方法,并阐述了纳米医学在治疗缺血性中风方面的最新进展,以期为脑缺血治疗提供一条新的可行途径。