Fei Miaomiao, Liu Qidong, Zhang Hui, Du Yawei, Chen Liang, Wang Juan, Cui Wenguo, Li Cheng
Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, PR China.
Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China.
Bioact Mater. 2025 Jul 1;52:810-828. doi: 10.1016/j.bioactmat.2025.06.029. eCollection 2025 Oct.
Abnormal mitochondrial division in microglia significantly impacts central nervous system (CNS) diseases. However, treating CNS diseases through microglial mitochondria presents several challenges: intracerebral delivery of drugs, microglial targeting, and mitochondrial regulation. Herein, a novel three-stage sequential targeted nasal drops delivery system that achieves precise drug delivery to the core of brain lesions through noninvasive nasal delivery, targeting microglia, and regulating mitochondria were developed. Firstly, dehydroepiandrosterone (DHEA), identified from clinical data and transcriptomic analyses as a key neurosteroid regulating mitochondrial fission, was selected. Secondly, surface-positively charged hydrogel microspheres were prepared to adhere to the nasal mucosa, thereby avoiding rapid clearance and achieving the first stage of nasal mucosa targeting. Subsequently, targeted liposomes carrying cytotoxic T lymphocyte-associated protein-4 were constructed and modified into microspheres, which released liposomes through the nasal cavity to enter the brain and bound to the activated microglial surface receptors CD80/86 accomplishing the second stage of cell targeting. In the third stage, the system released DHEA in response to the microenvironment, precisely regulating dynamin-related protein 1 involved in mitochondrial membrane remodeling, which inhibited abnormal mitochondrial division, stabilized mitochondrial morphology and function, inhibited microglial activation. This study demonstrated that three-stage sequential nasal drops efficiently traversed the nose-to-brain pathway via nasal mucosa in both murine (n = 200) and porcine (n = 16) models, while significantly ameliorating anesthesia/surgery-induced cognitive dysfunction in mice. Therefore, the three-stage sequential nasal drip is a promising method for the treatment of central nervous system diseases.
小胶质细胞中异常的线粒体分裂对中枢神经系统(CNS)疾病有显著影响。然而,通过小胶质细胞线粒体治疗CNS疾病存在几个挑战:药物的脑内递送、小胶质细胞靶向以及线粒体调节。在此,开发了一种新型的三阶段顺序靶向滴鼻给药系统,该系统通过无创鼻腔给药实现向脑损伤核心的精确药物递送,靶向小胶质细胞并调节线粒体。首先,从临床数据和转录组分析中确定脱氢表雄酮(DHEA)为调节线粒体分裂的关键神经甾体,并将其选用。其次,制备表面带正电荷的水凝胶微球以粘附于鼻粘膜,从而避免快速清除并实现鼻粘膜靶向的第一阶段。随后,构建携带细胞毒性T淋巴细胞相关蛋白4的靶向脂质体并将其修饰成微球,微球通过鼻腔释放脂质体进入大脑并与活化的小胶质细胞表面受体CD80/86结合,完成细胞靶向的第二阶段。在第三阶段,该系统响应微环境释放DHEA,精确调节参与线粒体膜重塑的动力相关蛋白1,抑制异常的线粒体分裂,稳定线粒体形态和功能,抑制小胶质细胞活化。本研究表明,在小鼠(n = 200)和猪(n = 16)模型中,三阶段顺序滴鼻剂均能通过鼻粘膜有效穿过鼻脑通路,同时显著改善小鼠麻醉/手术诱导的认知功能障碍。因此,三阶段顺序滴鼻是一种有前景的中枢神经系统疾病治疗方法。
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