Khademi Reyhane, Mohammadi Zahra, Khademi Rahele, Saghazadeh Amene, Rezaei Nima
Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN) Tehran Iran
Immunology Board for Transplantation and Cell-Based Therapeutics (Immuno_TACT), Universal Scientific Education and Research Network (USERN) Tehran Iran.
Nanoscale Adv. 2023 Jan 11;5(3):571-595. doi: 10.1039/d2na00483f. eCollection 2023 Jan 31.
: Leukemia is a malignant disease that threatens human health and life. Nano-delivery systems improve drug solubility, bioavailability, and blood circulation time, and release drugs selectively at desired sites using targeting or sensing strategies. As drug carriers, they could improve therapeutic outcomes while reducing systemic toxicity. They have also shown promise in improving leukemia detection and diagnosis. The study aimed to assess the potential of nanotechnology-based diagnostics and therapeutics in preclinical human acute lymphoblastic leukemia (h-ALL). : We performed a systematic search through April 2022. Articles written in English reporting the toxicity, efficacy, and safety of nanotechnology-based drugs (in the aspect of treatment) and specificity, limit of detection (LOD), or sensitivity (in the aspect of the detection field) in preclinical h-ALL were included. The study was performed according to PRISMA instructions. The methodological quality was assessed using the QualSyst tool. : A total of 63 original articles evaluating nanotechnology-based therapeutics and 35 original studies evaluating nanotechnology-based diagnostics were included in this review. As therapeutics in ALL, nanomaterials offer controlled release, targeting or sensing ligands, targeted gene therapy, photodynamic therapy and photothermic therapy, and reversal of multidrug-resistant ALL. A narrative synthesis of studies revealed that nanoparticles improve the ratio of efficacy to the toxicity of anti-leukemic drugs. They have also been developed as a vehicle for biomolecules (such as antibodies) that can help detect and monitor leukemic biomarkers. Therefore, nanomaterials can help with early diagnostics and personalized treatment of ALL. : This review discussed nanotechnology-based preclinical strategies to achieve ALL diagnosis and therapy advancement. This involves modern drug delivery apparatuses and detection devices for prompt and targeted disease diagnostics. Nonetheless, we are yet in the experimental phase and investigational stage in the field of nanomedicine, with many features remained to be discovered as well as numerous problems to be solved.
白血病是一种威胁人类健康和生命的恶性疾病。纳米递送系统可提高药物溶解度、生物利用度和血液循环时间，并通过靶向或传感策略在所需部位选择性释放药物。作为药物载体，它们可以在降低全身毒性的同时提高治疗效果。它们在改善白血病检测和诊断方面也显示出前景。本研究旨在评估基于纳米技术的诊断和治疗方法在临床前人类急性淋巴细胞白血病（h-ALL）中的潜力。
我们进行了截至2022年4月的系统检索。纳入了用英文撰写的、报告基于纳米技术的药物在临床前h-ALL中的毒性、疗效和安全性（治疗方面）以及特异性、检测限（LOD）或灵敏度（检测领域方面）的文章。该研究按照PRISMA指南进行。使用QualSyst工具评估方法学质量。
本综述共纳入63篇评估基于纳米技术的治疗方法的原始文章和35项评估基于纳米技术的诊断方法的原始研究。作为ALL的治疗方法，纳米材料提供控释、靶向或传感配体、靶向基因治疗、光动力疗法和光热疗法，以及逆转多药耐药ALL。对研究的叙述性综合分析表明，纳米颗粒提高了抗白血病药物的疗效与毒性之比。它们还被开发为生物分子（如抗体）的载体，有助于检测和监测白血病生物标志物。因此，纳米材料有助于ALL的早期诊断和个性化治疗。
本综述讨论了基于纳米技术的临床前策略，以实现ALL诊断和治疗的进展。这涉及用于快速和靶向疾病诊断的现代药物递送装置和检测设备。尽管如此，我们仍处于纳米医学领域的实验阶段和研究阶段，仍有许多特征有待发现以及众多问题有待解决。
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