Shrewsbury Stephen B
Formerly of Impel Pharmaceuticals, 201 Elliott Ave West, Seattle, WA 98119, USA.
Pharmaceutics. 2023 Jun 13;15(6):1720. doi: 10.3390/pharmaceutics15061720.
Sino-nasal disease is appropriately treated with topical treatment, where the nasal mucosa acts as a barrier to systemic absorption. Non-invasive nasal delivery of drugs has produced some small molecule products with good bioavailability. With the recent COVID pandemic and the need for nasal mucosal immunity becoming more appreciated, more interest has become focused on the nasal cavity for vaccine delivery. In parallel, it has been recognized that drug delivery to different parts of the nose can have different results and for "nose-to-brain" delivery, deposition on the olfactory epithelium of the upper nasal space is desirable. Here the non-motile cilia and reduced mucociliary clearance lead to longer residence time that permits enhanced absorption, either into the systemic circulation or directly into the CNS. Many of the developments in nasal delivery have been to add bioadhesives and absorption/permeation enhancers, creating more complicated formulations and development pathways, but other projects have shown that the delivery device itself may allow more differential targeting of the upper nasal space without these additions and that could allow faster and more efficient programs to bring a wider range of drugs-and vaccines-to market.
鼻病采用局部治疗是合适的,因为鼻黏膜可作为全身吸收的屏障。药物的非侵入性鼻腔给药已产生了一些具有良好生物利用度的小分子产品。随着近期新冠疫情的爆发以及对鼻黏膜免疫需求的日益受到重视,人们对鼻腔用于疫苗递送的兴趣愈发浓厚。与此同时,人们已经认识到,药物递送至鼻腔的不同部位可能会产生不同的结果,对于“鼻至脑”递送而言,药物沉积于上鼻道的嗅上皮是理想的。此处,不动纤毛以及黏液纤毛清除功能减弱会导致药物停留时间延长,从而使药物吸收增强,既可以进入体循环,也可以直接进入中枢神经系统。鼻腔给药的许多进展在于添加生物黏附剂和吸收/渗透促进剂,这导致制剂和研发途径更加复杂,但其他项目表明,递送装置本身可能无需添加这些物质就能实现对上鼻道更具差异性的靶向递送,这可以使更快、更高效的项目将更多种类的药物和疫苗推向市场。