Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea.
Molecules. 2024 Aug 23;29(17):3994. doi: 10.3390/molecules29173994.
Drug resistance remains a critical barrier in cancer therapy, diminishing the effectiveness of chemotherapeutic, targeted, and immunotherapeutic agents. Overexpression of proteins such as B-cell lymphoma 2 (Bcl-2), inhibitor of apoptosis proteins (IAPs), protein kinase B (Akt), and P-glycoprotein (P-gp) in various cancers leads to resistance by inhibiting apoptosis, enhancing cell survival, and expelling drugs. Although several inhibitors targeting these proteins have been developed, their clinical use is often hampered by systemic toxicity, poor bioavailability, and resistance development. Nanoparticle-based drug delivery systems present a promising solution by improving drug solubility, stability, and targeted delivery. These systems leverage the Enhanced Permeation and Retention (EPR) effect to accumulate in tumor tissues, reducing off-target toxicity and increasing therapeutic efficacy. Co-encapsulation strategies involving anticancer drugs and resistance inhibitors within nanoparticles have shown potential in achieving coordinated pharmacokinetic and pharmacodynamic profiles. This review discusses the mechanisms of drug resistance, the limitations of current inhibitors, and the advantages of nanoparticle delivery systems in overcoming these challenges. By advancing these technologies, we can enhance treatment outcomes and move towards more effective cancer therapies.
耐药性仍然是癌症治疗中的一个关键障碍,降低了化疗、靶向和免疫治疗药物的疗效。在各种癌症中,B 细胞淋巴瘤 2(Bcl-2)、凋亡抑制蛋白(IAPs)、蛋白激酶 B(Akt)和 P 糖蛋白(P-gp)等蛋白的过度表达会通过抑制细胞凋亡、增强细胞存活和排出药物来导致耐药性。尽管已经开发了几种针对这些蛋白的抑制剂,但由于全身毒性、生物利用度差和耐药性的发展,它们的临床应用常常受到阻碍。基于纳米粒子的药物递送系统通过提高药物的溶解度、稳定性和靶向递送提供了有前途的解决方案。这些系统利用增强的渗透性和保留(EPR)效应在肿瘤组织中积累,减少脱靶毒性并提高治疗效果。将抗癌药物和耐药抑制剂共同包封在纳米粒子内的共包封策略已显示出在实现协调的药代动力学和药效学特征方面的潜力。这篇综述讨论了耐药性的机制、当前抑制剂的局限性以及纳米粒子递送系统在克服这些挑战方面的优势。通过推进这些技术,我们可以提高治疗效果,迈向更有效的癌症治疗方法。
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