Burnham N L
Comprehensive Cancer Center, Mayo Clinic, Rochester, MN.
Am J Hosp Pharm. 1994 Jan 15;51(2):210-8; quiz 228-9.
The use of polymers for delivering peptide and protein drugs is described. Soluble-polymer technology attempts to bind a polymer to all sites on therapeutic protein molecules that cause the body to recognize the molecules as foreign. Goals include a stable linkage, water solubility, low immunogenicity, prolonged half-life, and intact biological activity. Polyethylene glycol (PEG)-adenosine deaminase (ADA), or pegademase bovine, has FDA-approved labeling as replacement therapy for ADA deficiency in patients with severe combined immunodeficiency disease who are not suitable candidates for bone marrow transplantation. Pegademase bovine reverses the toxic accumulation of adenosine and deoxyadenosine in adenosine deaminase-deficient cells, restoring the immune system. PEG-asparaginase (pegaspargase) has shown promise in patients with acute lymphocytic leukemia; allergic reactions have been minimal. Animal studies suggest that superoxide dismutase has potential use in conditions in which the body's ability to remove oxygen free radicals is reduced, such as burns and myocardial infarction; coupling with PEG may greatly increase the protein's half-life. Other PEG-conjugated proteins under investigation include PEG-catalase, PEG-uricase, PEG-honeybee venom, PEG-hemoglobin, and PEG-modified ragweed pollen extract. Dextran, albumin, DL-amino acids, and polyvinyl pyrrolidone have also been studied as protein carriers; most of the products created thus far have not shown much promise. The coupling of polymers to proteins has yielded protein drugs with intact biological activity and reduced immunogenicity, but much remains to be learned about this technology.
本文描述了聚合物在递送肽和蛋白质药物方面的应用。可溶性聚合物技术试图将聚合物与治疗性蛋白质分子上所有会使机体将这些分子识别为外来物的位点结合。目标包括稳定的连接、水溶性、低免疫原性、延长半衰期以及完整的生物活性。聚乙二醇(PEG)-腺苷脱氨酶(ADA),即培加酶,已获得美国食品药品监督管理局(FDA)批准的标签,可作为严重联合免疫缺陷病患者中ADA缺乏的替代疗法,这些患者不适合进行骨髓移植。培加酶可逆转腺苷脱氨酶缺陷细胞中腺苷和脱氧腺苷的毒性积累,恢复免疫系统。聚乙二醇天冬酰胺酶(培门冬酶)在急性淋巴细胞白血病患者中显示出前景;过敏反应极少。动物研究表明,超氧化物歧化酶在机体清除氧自由基能力降低的情况下(如烧伤和心肌梗死)可能有潜在用途;与PEG偶联可能会大大延长该蛋白质的半衰期。正在研究的其他PEG偶联蛋白质包括PEG-过氧化氢酶、PEG-尿酸酶、PEG-蜂毒、PEG-血红蛋白以及PEG修饰的豚草花粉提取物。葡聚糖、白蛋白、DL-氨基酸和聚乙烯吡咯烷酮也已作为蛋白质载体进行研究;迄今为止所制备的大多数产品都没有显示出太大前景。聚合物与蛋白质的偶联产生了具有完整生物活性和降低免疫原性的蛋白质药物,但关于这项技术仍有许多有待了解的地方。