Lim Yan Yik, Zaidi Ahmad Mujahid Ahmad, Miskon Azizi
Faculty of Defence Science and Technology, National Defence University of Malaysia, Sungai Besi Prime Camp, Kuala Lumpur 57000, Malaysia.
Faculty of Engineering, National Defence University of Malaysia, Sungai Besi Prime Camp, Kuala Lumpur 57000, Malaysia.
Pharmaceuticals (Basel). 2022 Oct 27;15(11):1330. doi: 10.3390/ph15111330.
Medication in arthritis therapies is complex because the inflammatory progression of rheumatoid arthritis (RA) and osteoarthritis (OA) is intertwined and influenced by one another. To address this problem, drug delivery systems (DDS) are composed of four independent exogenous triggers and four dependent endogenous stimuli that are controlled on program and induced on demand, respectively. However, the relationships between the mechanisms of endogenous stimuli and exogenous triggers with pathological alterations remain unclear, which results in a major obstacle in terms of clinical translation. Thus, the rationale for designing a guidance system for these mechanisms via their key irritant biosensors is in high demand. Many approaches have been applied, although successful clinical translations are still rare. Through this review, the status quo in historical development is highlighted in order to discuss the unsolved clinical difficulties such as infiltration, efficacy, drug clearance, and target localisation. Herein, we summarise and discuss the rational compositions of exogenous triggers and endogenous stimuli for programmable therapy. This advanced active pharmaceutical ingredient (API) implanted dose allows for several releases by remote controls for endogenous stimuli during lesion infections. This solves the multiple implantation and local toxic accumulation problems by using these flexible desired releases at the specified sites for arthritis therapies.
关节炎治疗中的药物治疗很复杂，因为类风湿性关节炎（RA）和骨关节炎（OA）的炎症进展相互交织且相互影响。为了解决这个问题，药物递送系统（DDS）由四个独立的外源性触发因素和四个依赖的内源性刺激因素组成，它们分别通过程序控制和按需诱导。然而，内源性刺激和外源性触发因素的机制与病理改变之间的关系仍不清楚，这在临床转化方面构成了主要障碍。因此，通过关键刺激生物传感器为这些机制设计指导系统的需求很高。尽管成功的临床转化仍然很少见，但已经应用了许多方法。通过这篇综述，突出了历史发展的现状，以便讨论诸如渗透、疗效、药物清除和靶点定位等未解决的临床难题。在此，我们总结并讨论用于可编程治疗的外源性触发因素和内源性刺激因素的合理组成。这种先进的活性药物成分（API）植入剂量允许在病变感染期间通过远程控制对内源性刺激进行多次释放。通过在关节炎治疗的特定部位使用这些灵活的期望释放，解决了多次植入和局部毒性积累的问题。
