Department of Rheumatology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China.
The Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Br J Hosp Med (Lond). 2024 Aug 30;85(8):1-41. doi: 10.12968/hmed.2024.0347.
Osteoarthritis and rheumatoid arthritis, though etiologically distinct, are both inflammatory joint diseases that cause progressive joint injury, chronic pain, and loss of function. Therefore, long-term treatment with a focus on relieving symptoms is needed. At present, the primary treatment for arthritis is drug therapy, both oral and intravenous. Although significant progress has been achieved for these treatment methods in alleviating symptoms, certain prominent drawbacks such as the substantial side effects and limited absorption of medications call for an urgent need for improved drug delivery methods. Injected hydrogels can be used as a delivery system to deliver drugs to the joint cavity in a controlled manner and continuously release them, thereby enhancing drug retention in the joint cavity to improve therapeutic effectiveness, which is attributed to the desirable attributes of the delivery system such as low immunogenicity, good biodegradability and biocompatibility. This review summarizes the types of injectable hydrogels and analyzes their applications as delivery systems in arthritis treatment. We also explored how hydrogels counteract inflammation, bone and cartilage degradation, and oxidative stress, while promoting joint cartilage regeneration in the treatment of osteoarthritis (OA) and rheumatoid arthritis (RA). This review also highlights new approaches to developing injectable hydrogels as delivery systems for OA and RA.
骨关节炎和类风湿关节炎虽然病因不同，但都是炎症性关节疾病，可导致进行性关节损伤、慢性疼痛和功能丧失。因此，需要长期以缓解症状为重点进行治疗。目前，关节炎的主要治疗方法是药物治疗，包括口服和静脉注射。尽管这些治疗方法在缓解症状方面取得了显著进展，但药物的大量副作用和吸收有限等突出缺点需要迫切改进药物输送方法。注射水凝胶可用作药物输送系统，以受控方式将药物递送到关节腔中并持续释放，从而提高关节腔中药物的保留率，以提高治疗效果，这归因于输送系统的理想特性，如低免疫原性、良好的生物降解性和生物相容性。本文综述了可注射水凝胶的类型，并分析了它们作为关节炎治疗中药物输送系统的应用。我们还探讨了水凝胶如何在治疗骨关节炎 (OA) 和类风湿关节炎 (RA) 中对抗炎症、骨和软骨降解以及氧化应激，同时促进关节软骨再生。本文还强调了开发用于 OA 和 RA 的可注射水凝胶作为药物输送系统的新方法。
