谷胱甘肽响应性甲氨蝶呤聚合物囊泡用于异位妊娠的潜在管理。

Glutathione-Responsive Methotrexate Polymersomes for Potential Management of Ectopic Pregnancy.

机构信息

Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, 2730 S Moody Avenue, Portland, Oregon, 97201, USA.

Department of Pathology and Laboratory Medicine, and the Center for Developmental Health, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.

出版信息

Small. 2024 Oct;20(41):e2302969. doi: 10.1002/smll.202302969. Epub 2023 Jul 14.

Abstract

The first-line treatment for ectopic pregnancy (EP), the chemotherapeutic methotrexate (MTX), has a failure rate of more than 10%, which can lead to severe complications or death. Inadequate accumulation of administered MTX at the ectopic implantation site significantly contributes to therapeutic failure. This study reports the first glutathione-responsive polymersomes for efficient delivery of MTX to the implantation site and its triggered release in placental cells. Fluorescence and photoacoustic imaging have confirmed that the developed polymersomes preferentially accumulate after systemic administration in the implantation site of pregnant mice at early gestational stages. The high concentrations of intracellular glutathione (GSH) reduce an incorporated disulfide bond within polymersomes upon internalization into placental cells, resulting in their disintegration and efficient drug release. Consequently, MTX delivered by polymersomes induces pregnancy demise in mice, as opposed to free MTX at the same dose regimen. To achieve the same therapeutic efficacy with free MTX, a sixfold increase in dosage is required. In addition, mice successfully conceive and birth healthy pups following a prior complete pregnancy demise induced by methotrexate polymersomes. Therefore, the developed MTX nanomedicine can potentially improve EP management and reduce associated mortality rates and related cost.

摘要

宫外孕(EP)的一线治疗药物是化疗药物甲氨蝶呤(MTX),但其治疗失败率超过 10%,可导致严重并发症甚至死亡。在异位妊娠部位,给予的 MTX 不能充分蓄积,这也是导致治疗失败的主要原因。本研究报告了首例谷胱甘肽响应聚合物囊泡,用于将 MTX 高效递送至着床部位并触发其在胎盘细胞中的释放。荧光和光声成像已证实,在妊娠早期,开发的聚合物囊泡在全身给药后可优先在怀孕小鼠的着床部位蓄积。进入胎盘细胞后,细胞内高浓度的谷胱甘肽(GSH)还原聚合物囊泡内的二硫键,导致其崩解和药物的有效释放。因此,与相同剂量方案的游离 MTX 相比,聚合物囊泡递送的 MTX 可导致小鼠妊娠终止。为了达到与游离 MTX 相同的治疗效果,需要将剂量增加六倍。此外,在用 MTX 聚合物囊泡诱导完全妊娠终止后,小鼠成功受孕并产下健康幼崽。因此,这种新型 MTX 纳米药物有望改善宫外孕的治疗效果,降低相关死亡率和相关成本。

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