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结构化聚合物能够在关节腔内持续释放糖皮质激素。

Structured Polymers Enable the Sustained Delivery of Glucocorticoids within the Intra-Articular Space.

作者信息

Crastin Ana, Martin Claire S, Suresh Sai, Davies Scott P, Kearns Daniel, Parlak Ahsen, Adcock Holly, Filer Andrew, Jones Simon W, Raza Karim, Moakes Richard Ja, Grover Liam M, Hardy Rowan S

机构信息

Dept of Biomedical Sciences. Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.

Dept of Metabolism and Systems Science, University of Birmingham, Birmingham, UK.

出版信息

Adv Healthc Mater. 2025 Feb;14(4):e2403000. doi: 10.1002/adhm.202403000. Epub 2024 Dec 23.

DOI:10.1002/adhm.202403000
PMID:39713898
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11804841/
Abstract

Intra-articular glucocorticoid injections are effective in controlling inflammation and pain in arthritides but restricted by short duration of action and risk of joint degeneration. Controlled drug release using biocompatible hydrogels offers a unique solution, but limitations of in situ gelation restrict their application. Gellan sheared hydrogels (GSHs) retain the advantages of hydrogels, however their unique microstructures lend themselves to intra-articular application - capable of shear thinning under force but restructuring at rest to enhance residence. This study examined GSHs for extended intra-articular glucocorticoid delivery of prednisolone (10 mg mL); demonstrating links between material mechanics, steroid release, and preclinical assessment of efficacy in synoviocyte culture and transgenic(TNF)197Gkl (TNFtg) murine model of arthritis. GSHs demonstrated sustained release, with typical Fickian profiles over 18 days. Moreover, systems showed good stability under extended culture, with inherent cell-compatibility and suppression of inflammatory synoviocyte activation. In TNFtg animals, GSHs suppressed synovitis (70.08%, p < 0.05), pannus formation (45.01%, p < 0.05), and increased articular cartilage (82.23%, p < 0.05) relative to vehicle controls. The extended profile of steroid release from injectable GSH formulations holds promise in the treatment and management of inflammatory arthritides such as rheumatoid and osteoarthritis, representing a step-change in intra-articular drug delivery to suppress long-term joint inflammation.

摘要

关节内注射糖皮质激素在控制关节炎的炎症和疼痛方面有效,但受作用时间短和关节退变风险的限制。使用生物相容性水凝胶的控释给药提供了一种独特的解决方案,但原位凝胶化的局限性限制了它们的应用。结冷胶剪切水凝胶(GSHs)保留了水凝胶的优点,然而其独特的微观结构使其适用于关节内应用——在受力时能够剪切变稀,但在静止时重新构建以增强滞留性。本研究考察了GSHs用于泼尼松龙(10mg/mL)的关节内长效糖皮质激素递送;证明了材料力学、类固醇释放以及在滑膜细胞培养和转基因(TNF)197Gkl(TNFtg)小鼠关节炎模型中的疗效临床前评估之间的联系。GSHs表现出持续释放,在18天内具有典型的菲克扩散特征。此外,该系统在长期培养下显示出良好的稳定性,具有内在的细胞相容性并抑制炎性滑膜细胞活化。在TNFtg动物中,相对于载体对照,GSHs抑制了滑膜炎(70.08%,p<0.05)、血管翳形成(45.01%,p<0.05),并增加了关节软骨(82.23%,p<0.05)。可注射GSH制剂中类固醇的延长释放特性在类风湿性关节炎和骨关节炎等炎性关节炎的治疗和管理中具有前景,代表了关节内药物递送在抑制长期关节炎症方面的重大变革。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/2b142aefb24d/ADHM-14-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/3b1b787ef869/ADHM-14-0-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/d8edd68ae0cc/ADHM-14-0-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/546334706235/ADHM-14-0-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/587972cba805/ADHM-14-0-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/2b142aefb24d/ADHM-14-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/3b1b787ef869/ADHM-14-0-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/d8edd68ae0cc/ADHM-14-0-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/546334706235/ADHM-14-0-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/587972cba805/ADHM-14-0-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e631/11804841/2b142aefb24d/ADHM-14-0-g001.jpg

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Longitudinal MRI-defined Cartilage Loss and Radiographic Joint Space Narrowing Following Intra-Articular Corticosteroid Injection for Knee Osteoarthritis: A Systematic Review and Meta-analysis.
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