Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu 610064, P. R. China.
Acc Chem Res. 2021 Dec 7;54(23):4262-4271. doi: 10.1021/acs.accounts.1c00493. Epub 2021 Nov 10.
Over the past two decades, research on mRNA-based therapies has exploded, mainly because of the inherent advantages of mRNA, including a low integration probability, transient expression, and simple and rapid in vitro transcription production approaches. In addition, thanks to improved stability and reduced immunogenicity by advanced strategies, the application of mRNA has expanded from protein replacement therapy to vaccination, gene editing and other fields, showing great promise for clinical application. Recently, with the successive launch of two mRNA-based COVID-19 vaccines, mRNA technology has attracted an enormous amount of attention from scientific researchers as well as pharmaceutical companies. Because of the large molecular weight, hydrophilicity, and highly negative charge densities of mRNA, it is difficult to overcome the intracellular delivery barriers. Therefore, various delivery vehicles have been developed to achieve more effective mRNA delivery. In general, conventional mRNA administration methods are based on injection strategies, including intravenous, intramuscular, intradermal, and subcutaneous injections. Although these routes circumvent the absorption barriers to some extent, they bring about injection-related concerns such as safety issues, pain, low compliance, and difficulty in repeated dosing, increasing the need to explore alternative strategies for noninvasive delivery. The ideal noninvasive delivery systems are featured with easy to use, low risks of infection, and good patient compliance. At the same time, they allow patients to self-administer, reducing reliance on professional healthcare workers and interference with bodily functions and daily life. In particular, the noninvasive mucosal delivery of mRNA vaccines can induce mucosal immune responses, which are important for resisting pathogens infected through mucosal routes.Because of the potential clinical benefits mentioned above, we detailed the existing strategies for the noninvasive delivery of mRNA in this review, including delivery via the nasal, pulmonary, vaginal, and transdermal routes. First, we discussed the unique strengths and biological hindrances of each route on the basis of physiology. Next, we comprehensively summarized the research progress reported so far and analyzed the technologies and delivery vehicles used, hoping to provide some references for further explorations. Among these noninvasive routes, nasal and pulmonary delivery are the earliest and most intensively studied areas, mostly owing to their favorable physiological structures: the nasal or pulmonary mucosa is easily accessible, highly permeable and highly vascularized. In contrast, the development of vaginal mRNA delivery is relatively less reported, and the current research mainly focused on some local applications. In addition, microneedles have also been investigated to overcome skin barriers for mRNA delivery in recent years, making microneedle-based delivery an emerging alternative pathway. In summary, a variety of mRNA formulations and delivery strategies have been developed for noninvasive mRNA delivery, skillfully combining appropriate vehicles or physical technologies to enhance effectiveness. We surmise that continuous advances and technological innovations in the development of mRNA noninvasive delivery will accelerate the translation from experimental research to clinical application.
在过去的二十年中,mRNA 疗法的研究呈爆炸式增长,这主要归因于 mRNA 的固有优势,包括低整合概率、瞬时表达以及简单、快速的体外转录生产方法。此外,通过先进的策略提高稳定性和降低免疫原性,mRNA 的应用已从蛋白替代疗法扩展到疫苗接种、基因编辑等领域,在临床应用中显示出巨大的潜力。最近,随着两款基于 mRNA 的 COVID-19 疫苗的相继推出,mRNA 技术引起了科研人员和制药公司的极大关注。由于 mRNA 分子量较大、亲水性和高度负电荷密度,因此难以克服细胞内传递障碍。因此,已经开发了各种输送载体以实现更有效的 mRNA 传递。一般来说,传统的 mRNA 给药方法基于注射策略,包括静脉内、肌肉内、皮内和皮下注射。尽管这些途径在一定程度上克服了吸收障碍,但它们带来了与注射相关的问题,如安全性问题、疼痛、低顺应性和难以重复给药,这增加了对非侵入性递送替代策略的探索需求。理想的非侵入性递送系统具有易用性、低感染风险和良好的患者依从性。同时,它们允许患者自行给药,减少对专业医疗保健工作者的依赖以及对身体功能和日常生活的干扰。特别是,mRNA 疫苗的非侵入性黏膜递送可以诱导黏膜免疫反应,这对于抵抗通过黏膜途径感染的病原体很重要。鉴于上述潜在的临床益处,我们在本文中详细介绍了非侵入性递送 mRNA 的现有策略,包括通过鼻、肺、阴道和透皮途径进行递送。首先,我们根据生理学讨论了每种途径的独特优势和生物学障碍。接下来,我们全面总结了迄今为止报道的研究进展,并分析了所使用的技术和输送载体,希望为进一步的探索提供一些参考。在这些非侵入性途径中,鼻内和肺内给药是最早和研究最多的领域,这主要是因为它们具有有利的生理结构:鼻或肺黏膜容易接近、高度渗透和高度血管化。相比之下,阴道 mRNA 递送的发展相对较少报道,目前的研究主要集中在一些局部应用上。此外,近年来,人们还研究了微针以克服用于 mRNA 递送至皮肤的屏障,使得基于微针的递送成为一种新兴的替代途径。总之,已经开发了多种用于非侵入性 mRNA 递送的 mRNA 制剂和递送策略,巧妙地结合了合适的载体或物理技术以增强效果。我们推测,在 mRNA 非侵入性递送的开发方面,不断的进步和技术创新将加速从实验研究到临床应用的转化。