Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, 400056, Maharashtra, India.
AAPS PharmSciTech. 2024 Apr 8;25(4):78. doi: 10.1208/s12249-024-02793-y.
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive interstitial lung disease that has been well-reported in the medical literature. Its incidence has risen, particularly in light of the recent COVID-19 pandemic. Conventionally, IPF is treated with antifibrotic drugs-pirfenidone and nintedanib-along with other drugs for symptomatic treatments, including corticosteroids, immunosuppressants, and bronchodilators based on individual requirements. Several drugs and biologicals such as fluorofenidone, thymoquinone, amikacin, paclitaxel nifuroxazide, STAT3, and siRNA have recently been evaluated for IPF treatment that reduces collagen formation and cell proliferation in the lung. There has been a great deal of research into various treatment options for pulmonary fibrosis using advanced delivery systems such as liposomal-based nanocarriers, chitosan nanoparticles, PLGA nanoparticles, solid lipid nanocarriers, and other nanoformulations such as metal nanoparticles, nanocrystals, cubosomes, magnetic nanospheres, and polymeric micelles. Several clinical trials are also ongoing for advanced IPF treatments. This article elaborates on the pathophysiology of IPF, its risk factors, and different advanced drug delivery systems for treating IPF. Although extensive preclinical data is available for these delivery systems, the clinical performance and scale-up studies would decide their commercial translation.
特发性肺纤维化(IPF)是一种慢性进行性间质性肺疾病,在医学文献中有大量报道。随着最近 COVID-19 大流行的出现,其发病率有所上升。传统上,IPF 采用抗纤维化药物吡非尼酮和尼达尼布以及其他对症治疗药物(如皮质类固醇、免疫抑制剂和支气管扩张剂)进行治疗,具体取决于个体需求。最近,一些药物和生物制剂,如氟非尼酮、姜黄素、阿米卡星、紫杉醇硝呋太尔、STAT3 和 siRNA,已被评估用于治疗 IPF,可减少肺中胶原形成和细胞增殖。已经有大量研究使用先进的给药系统(如基于脂质体的纳米载体、壳聚糖纳米粒、PLGA 纳米粒、固体脂质纳米载体和其他纳米制剂如金属纳米粒、纳米晶体、立方纳米囊、磁性纳米球和聚合物胶束)来治疗肺纤维化的各种治疗方案。目前也有几项针对晚期 IPF 治疗的临床试验正在进行中。本文详细阐述了 IPF 的病理生理学、危险因素以及不同的先进药物输送系统治疗 IPF 的情况。尽管这些给药系统有广泛的临床前数据,但临床性能和扩大规模研究将决定它们的商业转化。