Patil Pratiksha, Nene Shweta, Shah Saurabh, Singh Shashi Bala, Srivastava Saurabh
Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, Telangana, India.
Drug Deliv Transl Res. 2023 Feb;13(2):531-546. doi: 10.1007/s13346-022-01229-z. Epub 2022 Aug 28.
Osteoarthritis is one of the foremost disabling disorders in the world. There is no definitive treatment to prevent the progression of osteoarthritis. Hence, palliative treatment aims at minimizing pain, disability and improving function, performance and quality of life. Oral administration of nonsteroidal anti-inflammatory drug is associated with number of adverse effects and reduced therapeutic efficacy. Intra-articular injection has been the preferred route of drug administration. However, the clearance of drug from the arthritic site, risk of infections, cost and the pain associated with frequent injections make this route highly non-compliant to patients. Since osteoarthritis is a chronic condition which requires treatment for prolonged duration, there is an urgent need for another administration route which circumvents the hindrances linked with intra-articular route. Transdermal route across the skin locally at the osteoarthritis site could help in surpassing the disadvantages associated with intra-articular route. However, traversing skin barrier and reaching the chondrocytes with sufficient amount of the drug is extremely difficult. Nanocarrier-based approaches could hold an answer to the said shortcomings owing to their reduced size, targeting tunability and site specificity. In this article, we discuss the pathophysiology of osteoarthritis, molecular targets, and utilization of nanocarrier-based approaches to strategize the treatment of osteoarthritis in a new direction, i.e. topical delivery of nanocarriers in osteoarthritis.
骨关节炎是世界上最主要的致残性疾病之一。目前尚无预防骨关节炎进展的确定性治疗方法。因此，姑息治疗旨在将疼痛、残疾降至最低，并改善功能、表现和生活质量。口服非甾体抗炎药会产生多种不良反应，且治疗效果会降低。关节腔内注射一直是首选的给药途径。然而，药物从关节炎部位的清除、感染风险、成本以及与频繁注射相关的疼痛，使得这种给药途径患者的依从性极低。由于骨关节炎是一种需要长期治疗的慢性疾病，因此迫切需要另一种给药途径来规避与关节腔内给药途径相关的障碍。在骨关节炎部位经皮的透皮给药途径可能有助于克服与关节腔内给药途径相关的缺点。然而，穿越皮肤屏障并使足够量的药物到达软骨细胞极其困难。基于纳米载体的方法因其尺寸减小、靶向可调性和位点特异性，可能是解决上述缺点的答案。在本文中，我们讨论了骨关节炎的病理生理学、分子靶点，以及基于纳米载体的方法在将骨关节炎治疗策略转向新方向（即骨关节炎中纳米载体的局部递送）方面的应用。
