Center for Nanomedicine, Department of Ophthalmology, Wilmer Eye Institute Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA.
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Adv Drug Deliv Rev. 2021 Oct;177:113950. doi: 10.1016/j.addr.2021.113950. Epub 2021 Aug 26.
Pre-existing conditions at reproductive age, and complications arising during pregnancy can be detrimental to maternal and fetal health. Current therapies to combat obstetric disorders are limited due to the inherent complexity of pregnancy, and can have harmful effects on developing fetus. Emerging research shows intricate signaling between the cells from mother and fetus at maternal-fetal interface, providing unique opportunities for interventions specifically targeted to the mother, fetus, or placenta. Advancements in nanotechnology, stem-cell biology and gene therapy have resulted in target-specific treatments with promising results in pre-clinical maternal and fetal disorder models. Comprehensive understanding of the effect of physicochemical properties of delivery systems on their uptake, retention and accumulation across placenta will help in the better diagnosis and treatment of perinatal disorders. This review describes the factors leading to obstetric complications along with their effect on pregnancy outcomes, and discusses key targeted therapeutic strategies for addressing conditions related to maternal and fetal health.
生殖年龄段的既有疾病以及妊娠期间出现的并发症可能会对母婴健康造成损害。由于妊娠的固有复杂性，目前对抗产科疾病的疗法受到限制，并且可能对发育中的胎儿产生有害影响。新兴研究表明，母体-胎儿界面处来自母亲和胎儿的细胞之间存在复杂的信号传递，为专门针对母亲、胎儿或胎盘的干预措施提供了独特的机会。纳米技术、干细胞生物学和基因治疗的进步带来了针对特定目标的治疗方法，在临床前的母婴疾病模型中取得了有前景的结果。全面了解传递系统的物理化学性质对其在胎盘内摄取、保留和积累的影响，将有助于更好地诊断和治疗围产期疾病。本综述描述了导致产科并发症的因素及其对妊娠结局的影响，并讨论了针对与母婴健康相关的疾病的关键靶向治疗策略。
