Pareek Anil, Alaseem Ali M, Alasiri Glowi, Kapoor Devesh U, Prajapati Bhupendra G
Department of Pharmaceutics, Lachoo Memorial College of Science and Technology (Autonomous), Jodhpur, Rajasthan 342003, India.
Department of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317, Saudi Arabia.
Int J Pharm. 2025 Nov 10;684:126169. doi: 10.1016/j.ijpharm.2025.126169. Epub 2025 Sep 18.
Leukemia, a heterogeneous group of hematologic malignancies, remains a therapeutic challenge due to drug resistance, systemic toxicity, and poor specificity of conventional treatments. In recent years, nanocarrier-based drug delivery systems particularly liposomes (phospholipid bilayers enabling hydrophilic/hydrophobic drug encapsulation) and niosomes (non-ionic surfactant vesicles offering stability and controlled release) have gained attention for their ability to overcome these limitations. This review comprehensively explores the design, formulation, and functionalization of these carriers tailored for leukemia therapy. Emphasis is placed on their roles in drug encapsulation (doxorubicin, cytarabine) and gene delivery (siRNA, plasmids). Mechanistically, these nanocarriers enable targeted delivery via ligand/receptor interactions, passive targeting through enhanced permeability and retention (EPR) effect, and stimuli-responsive release (pH, redox, enzyme-sensitive systems), thereby improving bioavailability and reducing off-target toxicity. Furthermore, co-delivery systems are discussed for their synergistic potential in combination therapies. Challenges including scalability, immunogenicity, and formulation stability are critically analyzed, alongside regulatory hurdles hindering clinical translation. The review also examines emerging trends, such as smart nanocarriers, personalized nanomedicine, and the integration of AI and biosensors for precision therapy. By highlighting both current advances and future directions, this article underscores the transformative role of liposomal and niosomal nanocarriers in reshaping leukemia treatment paradigms and moving toward safer, more effective, and patient-tailored therapeutic strategies. However, key challenges such as drug resistance, relapse, treatment-associated toxicity, and the high cost of novel therapies remain significant barriers. Future perspectives focus on integrating precision medicine, optimizing combination therapies, and advancing translational research to improve long-term survival and quality of life for patients with acute leukemia.
白血病是一组异质性血液系统恶性肿瘤，由于耐药性、全身毒性以及传统治疗的特异性差，仍然是一个治疗难题。近年来，基于纳米载体的药物递送系统，特别是脂质体（能够包封亲水性/疏水性药物的磷脂双层）和非离子表面活性剂囊泡（具有稳定性和控释功能的非离子表面活性剂囊泡）因其克服这些局限性的能力而受到关注。本综述全面探讨了这些针对白血病治疗量身定制的载体的设计、配方和功能化。重点介绍了它们在药物包封（阿霉素、阿糖胞苷）和基因递送（小干扰RNA、质粒）中的作用。从机制上讲，这些纳米载体能够通过配体/受体相互作用实现靶向递送，通过增强的通透性和滞留（EPR）效应实现被动靶向，以及通过刺激响应释放（pH、氧化还原、酶敏感系统），从而提高生物利用度并降低脱靶毒性。此外，还讨论了联合递送系统在联合治疗中的协同潜力。对包括可扩展性、免疫原性和配方稳定性在内的挑战进行了批判性分析，同时也分析了阻碍临床转化的监管障碍。本综述还研究了新兴趋势，如智能纳米载体、个性化纳米医学以及将人工智能和生物传感器整合用于精准治疗。通过强调当前的进展和未来的方向，本文强调了脂质体和非离子表面活性剂囊泡纳米载体在重塑白血病治疗模式以及迈向更安全、更有效和针对患者的治疗策略方面的变革性作用。然而，耐药性、复发、治疗相关毒性以及新型疗法的高成本等关键挑战仍然是重大障碍。未来的展望集中在整合精准医学、优化联合治疗以及推进转化研究，以提高急性白血病患者的长期生存率和生活质量。
