Montelione Nunzio, Loreni Francesco, Nenna Antonio, Catanese Vincenzo, Scurto Lucia, Ferrisi Chiara, Jawabra Mohamad, Gabellini Teresa, Codispoti Francesco Alberto, Spinelli Francesco, Chello Massimo, Stilo Francesco
Unit of Vascular Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Unit of Cardiac Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Biomedicines. 2023 Mar 6;11(3):798. doi: 10.3390/biomedicines11030798.
Atherosclerosis-related coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. This requires effective primary and secondary prevention in reducing the complications related to CAD; the regression or stabilization of the pathology remains the mainstay of treatment. Statins have proved to be the most effective treatment in reducing adverse effects, but there are limitations related to the administration and achievement of effective doses as well as side effects due to the lack of target-related molecular specificity. The implemented technological steps are polymers and nanoparticles for the administration of statins, as it has been seen how the conjugation of drug delivery systems (DDSs) with statins increases bioavailability by circumventing the hepatic-renal filter and increases the related target specificity, enhancing their action and decreasing side effects. Reduction of endothelial dysfunction, reduced intimal hyperplasia, reduced ischemia-reperfusion injury, cardiac regeneration, positive remodeling in the extracellular matrix, reduced neointimal growth, and increased reendothelialization are all drug-related effects of statins enhanced by binding with DDSs. Recent preclinical studies demonstrate how the effect of statins stimulates the differentiation of endogenous cardiac stem cells. Poly-lactic-co-glycolic acid (PLGA) seems to be the most promising DDS as it succeeds more than the others in enhancing the effect of the bound drug. This review intends to summarize the current evidence on polymers and nanoparticles for statin delivery in the field of cardiovascular disease, trying to shed light on this topic and identify new avenues for future studies.
动脉粥样硬化相关的冠状动脉疾病(CAD)是全球范围内导致死亡和发病的主要原因。这就需要采取有效的一级和二级预防措施来减少与CAD相关的并发症;病变的消退或稳定仍然是治疗的主要手段。他汀类药物已被证明是减少不良反应最有效的治疗方法,但在给药和达到有效剂量方面存在局限性,并且由于缺乏与靶点相关的分子特异性而存在副作用。已实施的技术手段是使用聚合物和纳米颗粒来递送他汀类药物,因为已经观察到药物递送系统(DDS)与他汀类药物结合可通过绕过肝肾滤过增加生物利用度,并提高相关的靶点特异性,增强其作用并减少副作用。内皮功能障碍的减轻、内膜增生的减少、缺血再灌注损伤的减轻、心脏再生、细胞外基质的正向重塑、新生内膜生长的减少以及再内皮化的增加都是他汀类药物与DDS结合后增强的药物相关效应。最近的临床前研究表明他汀类药物的作用如何刺激内源性心脏干细胞的分化。聚乳酸-乙醇酸共聚物(PLGA)似乎是最有前途的DDS,因为它在增强结合药物的效果方面比其他材料更成功。本综述旨在总结心血管疾病领域中用于递送他汀类药物的聚合物和纳米颗粒的当前证据,试图阐明这一主题并确定未来研究的新途径。