On-Demand Drug Delivery: Recent Advances in Cardiovascular Applications

H. Genç, E. Efthimiadou, I. Cicha
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Abstract

Cardiovascular diseases (CVD), including life-threatening atherosclerosis and arterial thrombosis, account for almost 50% of all deaths in Europe and around 30% of all deaths worldwide. Despite the ongoing improvement and accessibility of invasive cardiovascular interventions and pharmacological therapies, pathological processes often progress asymptomatically, before manifesting themselves as unstable angina pectoris, myocardial infarction, sudden cardiac death or stroke. Since atherosclerosis and thrombosis represent localized disease processes, insufficient response to systemically-administered drugs is a common problem. The available pharmacological therapies are often burdened by poor tolerability, limited efficacy and/or bioavailability. Although encapsulating drugs in a nanoscale shell increases their circulation time and availability, it does not guarantee disease-specific targeting, or the proper control of the drug release. In contrast, on-demand drug delivery has the advantage of localized treatment and allows reducing off-target effects by a stimuli-controlled drug release in the affected region. Such “smart” systems are expected to have a great therapeutic potential in CVD. This mini-review article highlights recent advances in stimuli-responsive drug delivery approaches to CVD, with specific drug release triggered either internally or externally.
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按需给药:心血管应用的最新进展
心血管疾病(CVD),包括危及生命的动脉粥样硬化和动脉血栓形成,几乎占欧洲所有死亡人数的50%,约占全球死亡人数的30%。尽管有创性心血管干预和药物治疗的不断改善和可及性,但病理过程通常无症状进展,然后表现为不稳定型心绞痛、心肌梗死、心源性猝死或中风。由于动脉粥样硬化和血栓形成代表局部疾病过程,对系统给药反应不足是一个常见问题。现有的药物治疗通常具有耐受性差、疗效和/或生物利用度有限的特点。尽管将药物封装在纳米级外壳中可以增加其循环时间和可用性,但这并不能保证疾病特异性靶向或药物释放的适当控制。相反,按需给药具有局部治疗的优势,并允许通过刺激控制药物在受影响区域的释放来减少脱靶效应。这种“智能”系统有望在CVD中具有巨大的治疗潜力。这篇小型综述文章强调了CVD刺激反应性药物递送方法的最新进展,该方法可从内部或外部触发特定的药物释放。
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