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糖尿病性视网膜病变眼科药物递送的新兴创新:转化医学视角

Emerging innovations in ophthalmic drug delivery for diabetic retinopathy: a translational perspective.

作者信息

Adak Souvik, Jadhav Vaishnavi Suresh, Khatri Dharmendra Kumar

机构信息

Department of Pharmacology, NIMS Institute of Pharmacy, NIMS University, Rajasthan, Jaipur, 303121, India.

出版信息

Drug Deliv Transl Res. 2025 Jul 20. doi: 10.1007/s13346-025-01925-6.

Abstract

Diabetic retinopathy (DR) is a progressive microvascular complication of diabetes and a leading cause of vision impairment worldwide. Despite advancements in pharmacotherapy, challenges such as poor intraocular bioavailability, rapid drug clearance, and the restrictive blood-retinal barrier hinder effective treatment. Recent innovations in ophthalmic drug delivery systems offer promising solutions to these limitations. This review explores advanced drug delivery strategies, including biodegradable intravitreal implants, nanoparticle-based carriers, and gene therapy approaches, which enhance targeted drug delivery, prolong therapeutic effects, and reduce adverse systemic exposure. Sustained-release formulations of corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated improved clinical outcomes in DR management. Additionally, novel biomaterial-based hydrogels, microneedle arrays, and cell-based therapies are emerging as potential game-changers in retinal drug delivery. Cutting-edge approaches such as CRISPR Cas9 gene editing, stem cell-derived exosome therapies, and artificial intelligence (AI) -driven precision medicine are further expanding the therapeutic landscape. While these advancements show significant potential, challenges such as drug stability, biocompatibility, and patient adherence must be addressed to ensure translational success. Future research should focus on optimizing pharmacokinetic properties, integrating nanotechnology with personalized medicine, and developing minimally invasive delivery platforms. A multidisciplinary approach combining biomedical engineering, molecular biology, and computational modelling will be essential for advancing DR therapeutics. This review provides a comprehensive analysis of the evolving landscape of ophthalmic drug delivery, highlighting the potential of next-generation technologies to transform DR treatment and improve patient outcomes.

摘要

糖尿病视网膜病变(DR)是糖尿病的一种进行性微血管并发症,也是全球视力损害的主要原因。尽管药物治疗取得了进展,但诸如眼内生物利用度差、药物清除迅速以及血视网膜屏障的限制等挑战阻碍了有效治疗。眼科药物递送系统的最新创新为这些局限性提供了有前景的解决方案。本综述探讨了先进的药物递送策略,包括可生物降解的玻璃体内植入物、基于纳米颗粒的载体和基因治疗方法,这些策略可增强靶向药物递送、延长治疗效果并减少全身不良暴露。皮质类固醇和抗血管内皮生长因子(抗VEGF)药物的缓释制剂在DR管理中已显示出改善的临床结果。此外,基于新型生物材料的水凝胶、微针阵列和细胞疗法正在成为视网膜药物递送中潜在的变革者。诸如CRISPR Cas9基因编辑、干细胞衍生的外泌体疗法和人工智能(AI)驱动的精准医学等前沿方法正在进一步拓展治疗前景。虽然这些进展显示出巨大潜力,但必须解决药物稳定性、生物相容性和患者依从性等挑战,以确保转化成功。未来的研究应专注于优化药代动力学特性、将纳米技术与个性化医学相结合以及开发微创递送平台。结合生物医学工程、分子生物学和计算建模的多学科方法对于推进DR治疗至关重要。本综述对眼科药物递送不断演变的格局进行了全面分析,突出了下一代技术在改变DR治疗和改善患者预后方面的潜力。

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