高会乐, 蒋新国. 肿瘤靶向递药新策略的研究进展J. 药学学报, 2016,51(2): 272-280. doi: 10.16438/j.0513-4870.2015-0992
引用本文: 高会乐, 蒋新国. 肿瘤靶向递药新策略的研究进展J. 药学学报, 2016,51(2): 272-280. doi: 10.16438/j.0513-4870.2015-0992
GAO Hui-le, JIANG Xin-guo. The development of novel tumor targeting delivery strategyJ. Acta Pharmaceutica Sinica, 2016,51(2): 272-280. doi: 10.16438/j.0513-4870.2015-0992
Citation: GAO Hui-le, JIANG Xin-guo. The development of novel tumor targeting delivery strategyJ. Acta Pharmaceutica Sinica, 2016,51(2): 272-280. doi: 10.16438/j.0513-4870.2015-0992

肿瘤靶向递药新策略的研究进展

The development of novel tumor targeting delivery strategy

  • 摘要: 肿瘤已成为危害人类健康和生命的第二大疾病。尽管已有多种抗肿瘤药物上市,但是由于肿瘤靶向性不佳,肿瘤内蓄积能力较差,使得抗肿瘤效果不尽如人意。如何高效地将抗肿瘤药物递送入肿瘤,提高药物在肿瘤部位的浓度,降低其在正常组织中的浓度,成为制药领域研究的热点。为达到此目的,研究者设计了多种纳米靶向递药系统,并取得了一定的效果。本文将对目前已有的肿瘤靶向递药策略进行综述,对其中存在的问题进行讨论。

     

    Abstract: Tumor is one of the most serious threats for human being. Although many anti-tumor drugs are approved for clinical use, the treatment outcome is still modest because of the poor tumor targeting efficiency and low accumulation in tumor. Therefore, it is important to deliver anti-tumor drug into tumor efficiently, elevate drug concentration in tumor tissues and reduce the drug distribution in normal tissues. And it has been one of the most attractive directions of pharmaceutical academy and industry. Many kinds of strategies, especially various nanoparticulated drug delivery systems, have been developed to address the critical points of complex tumor microenvironment, which are partially or mostly satisfied for tumor treatment. In this paper, we carefully reviewed the novel targeting delivery strategies developed in recent years. The most powerful method is passive targeting delivery based on the enhanced permeability and retention (EPR) effect, and most commercial nanomedicines are based on the EPR effect. However, the high permeability and retention require different particle sizes, thus several kinds of size-changeable nanoparticles are developed, such as size reducible particles and assemble particles, to satisfy the controversial requirement for particle size and enhance both tumor retention and penetration. Surface charge reversible nanoparticles also shows a high efficiency because the anionic charge in blood circulation and normal organs decrease the unintended internalization. The charge can change into positive in tumor microenvironment, facilitating drug uptake by tumor cells. Additionally, tumor microenvironment responsive drug release is important to decrease drug side effect, and many strategies are developed, such as pH sensitive release and enzyme sensitive release. Except the responsive nanoparticles, shaping tumor microenvironment could attenuate the barriers in drug delivery, for example, decreasing tumor collagen intensity and normalizing tumor microvessels to decrease the internal fluid pressure. All these strategies could enhance the accumulation and penetration of nanoparticles into tumor, leading to a homogenous distribution of drugs in tumor. To enhance the internalization by specific cells, active targeting delivery strategies are developed. There were many surface markers, receptors or carriers overexpressed on specific kinds of cells, thus the corresponding ligands were utilized to mediate active tar-geting to certain cells, including tumor cells, cancer stem cells, tumor neovasculatures, tumor associated macrophages and other tumor stroma cells. Targeting more than one cell type may provide an improved antitumor effect. Although these passive and active targeting strategies all have promising outcome in the treatment of tumor, some shortages are still unaddressed, such as the specificity of responsive is not good enough, and the active targeting may be diminished by the protein corona. Thus more research is required to promote the drug delivery study.

     

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