School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China.
Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, 410013, PR China.
Signal Transduct Target Ther. 2024 Jan 1;9(1):1. doi: 10.1038/s41392-023-01668-1.
Combining existing drug therapy is essential in developing new therapeutic agents in disease prevention and treatment. In preclinical investigations, combined effect of certain known drugs has been well established in treating extensive human diseases. Attributed to synergistic effects by targeting various disease pathways and advantages, such as reduced administration dose, decreased toxicity, and alleviated drug resistance, combinatorial treatment is now being pursued by delivering therapeutic agents to combat major clinical illnesses, such as cancer, atherosclerosis, pulmonary hypertension, myocarditis, rheumatoid arthritis, inflammatory bowel disease, metabolic disorders and neurodegenerative diseases. Combinatorial therapy involves combining or co-delivering two or more drugs for treating a specific disease. Nanoparticle (NP)-mediated drug delivery systems, i.e., liposomal NPs, polymeric NPs and nanocrystals, are of great interest in combinatorial therapy for a wide range of disorders due to targeted drug delivery, extended drug release, and higher drug stability to avoid rapid clearance at infected areas. This review summarizes various targets of diseases, preclinical or clinically approved drug combinations and the development of multifunctional NPs for combining therapy and emphasizes combinatorial therapeutic strategies based on drug delivery for treating severe clinical diseases. Ultimately, we discuss the challenging of developing NP-codelivery and translation and provide potential approaches to address the limitations. This review offers a comprehensive overview for recent cutting-edge and challenging in developing NP-mediated combination therapy for human diseases.
在疾病的预防和治疗中,结合现有药物疗法对于开发新的治疗药物至关重要。在临床前研究中,某些已知药物的联合使用已被证实可有效治疗广泛的人类疾病。联合治疗通过靶向各种疾病途径发挥协同作用,具有减少给药剂量、降低毒性和减轻耐药性等优势,目前正在通过将治疗药物递送至对抗主要临床疾病(如癌症、动脉粥样硬化、肺动脉高压、心肌炎、类风湿性关节炎、炎症性肠病、代谢紊乱和神经退行性疾病)来实现。联合治疗涉及联合或共同递送两种或多种药物来治疗特定疾病。由于具有靶向药物递送、延长药物释放和提高药物稳定性以避免在感染部位快速清除等优势,纳米颗粒(NP)介导的药物递送系统,即脂质体 NPs、聚合物 NPs 和纳米晶体,在广泛的疾病的联合治疗中引起了极大的兴趣。本文总结了各种疾病靶点、临床前或临床批准的药物组合以及用于联合治疗的多功能 NPs 的开发,并强调了基于药物递送的联合治疗策略在治疗严重临床疾病中的应用。最后,我们讨论了开发 NP 共递药的挑战性和转化问题,并提供了潜在的解决方法。本文综述了 NP 介导的组合疗法在人类疾病中的最新研究进展和面临的挑战,为相关研究提供了全面的参考。