Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Gandhinagar, Gujarat, India.
J Liposome Res. 2024 Jun;34(2):349-367. doi: 10.1080/08982104.2023.2270060. Epub 2023 Oct 19.
Glioma is one of the most severe central nervous systems (CNS)-specific tumors, with rapidly growing malignant glial cells accounting for roughly half of all brain tumors and having a poor survival rate ranging from 12 to 15 months. Despite being the most often used technique for glioma therapy, conventional chemotherapy suffers from low permeability of the blood-brain barrier (BBB) and blood-brain tumor barrier (BBTB) to anticancer drugs. When it comes to nanocarriers, liposomes are thought of as one of the most promising nanocarrier systems for glioma treatment. However, owing to BBB tight junctions, non-targeted liposomes, which passively accumulate in most cancer cells primarily via the increased permeability and retention effect (EPR), would not be suitable for glioma treatment. The surface modification of liposomes with various active targeting ligands has shown encouraging outcomes in the recent times by allowing various chemotherapy drugs to pass across the BBB and BBTB and enter glioma cells. This review article introduces by briefly outlining the landscape of glioma, its classification, and some of the pathogenic causes. Further, it discusses major barriers for delivering drugs to glioma such as the BBB, BBTB, and tumor microenvironment. It further discusses modified liposomes such as long-acting circulating liposomes, actively targeted liposomes, stimuli responsive liposomes. Finally, it highlighted the limitations of liposomes in the treatment of glioma and the various actively targeted liposomes undergoing clinical trials for the treatment of glioma.
脑胶质瘤是中枢神经系统(CNS)中最严重的肿瘤之一,其恶性胶质细胞生长迅速,约占所有脑肿瘤的一半,生存率极差,为 12-15 个月。尽管传统化疗是脑胶质瘤治疗中最常用的方法,但由于血脑屏障(BBB)和血脑肿瘤屏障(BBTB)对抗癌药物的通透性低,其效果并不理想。说到纳米载体,脂质体被认为是治疗脑胶质瘤最有前途的纳米载体系统之一。然而,由于 BBB 紧密连接,非靶向脂质体主要通过增加通透性和滞留效应(EPR)被动地在大多数癌细胞中积累,因此不适合治疗脑胶质瘤。各种主动靶向配体对脂质体的表面修饰,使各种化疗药物能够穿过 BBB 和 BBTB 并进入脑胶质瘤细胞,在最近的研究中取得了令人鼓舞的结果。本文简要概述了脑胶质瘤的概况、分类以及一些发病原因。此外,还讨论了递送到脑胶质瘤的主要药物输送障碍,如 BBB、BBTB 和肿瘤微环境。进一步讨论了改良的脂质体,如长效循环脂质体、主动靶向脂质体、刺激响应脂质体。最后,强调了脂质体在治疗脑胶质瘤方面的局限性,以及各种正在进行临床试验的主动靶向脂质体用于治疗脑胶质瘤。