Transplantation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
School of Nephrology, University of Milan, Milan, Italy.
Nephrol Dial Transplant. 2023 May 31;38(6):1385-1396. doi: 10.1093/ndt/gfac233.
Kidney diseases represent a major public health problem, affecting millions of people worldwide. Moreover, the treatment of kidney diseases is burdened by the problematic effects of conventional drug delivery, such as systemic drug toxicity, rapid drug clearance, and the absence of precise targeting of the kidney. Although the use of nanotechnology in medicine is in its early stage and lacks robust translational studies, nanomedicines have already shown great promise as novel drug-delivery systems for the treatment of kidney disease. On the basis of our current knowledge of renal anatomy and physiology, pathophysiology of kidney diseases, and physicochemical characteristics of nanoparticles, an expansive repertoire and wide use of nanomedicines could be developed for kidney diseases in the near future. Some limitations have slowed the transition of these agents from preclinical studies to clinical trials, however. In this review, we summarize the current knowledge on renal drug-delivery systems and recent advances in renal cell targeting; we also demonstrate their important potential as future paradigm-shifting therapies for kidney diseases.
肾脏疾病是一个主要的公共卫生问题，影响着全球数百万人。此外，肾脏疾病的治疗受到常规药物输送的不良影响，如全身药物毒性、药物快速清除以及肾脏缺乏精确靶向。尽管纳米技术在医学中的应用还处于早期阶段，缺乏强有力的转化研究，但纳米药物已经显示出作为治疗肾脏疾病的新型药物输送系统的巨大潜力。基于我们目前对肾脏解剖和生理学、肾脏疾病的病理生理学以及纳米粒子的物理化学特性的了解，在不久的将来，可能会为肾脏疾病开发出广泛的纳米药物。然而，一些限制因素减缓了这些药物从临床前研究向临床试验的转化。在这篇综述中，我们总结了当前关于肾脏药物输送系统和肾脏细胞靶向的最新进展；我们还展示了它们作为治疗肾脏疾病的未来颠覆性疗法的重要潜力。
