Expert opinion on drug delivery最新文献

Introduction: Among the many ongoing difficulties, Candida infections present significant clinical hurdles due to the rapid development of resistance, recurrent episodes, and the limited effectiveness of conventional therapies. In recent decades, metallic nanoparticles (MNPs) and lipid nanoparticles (LNPs) have shown a specific impact (>84% Candida biofilm inhibition in preclinical models) by addressing the critical challenges of mitigating drug side effects and multidrug resistance (MDR).

Areas covered: This paper provides an in-depth overview of synthesis, fabrication, mechanistic insights, preclinical and clinical practices for MNPs and LNPs, discussing and highlighting their therapeutic efficacy against resistant Candida species over traditional methods. The literature was sourced from peer-reviewed journals and databases, including PubMed, Scopus, Web of Science, WIPO, and Clinical Trials up to May 2025.

Expert opinion: In this portion the potential of hybrid MNP-LNP systems with surface modification enables functionalization by targeting ligands and more specific binding toward fungal cells to enhance the therapeutic index. In addition, combining drug-loaded MNPs and LNPs with artificial intelligence (AI), photodynamic, gene, or immune therapies offers a comprehensive and innovative solution for MDR Candida. However, addressing regulatory complexity still needs to be considered toward optimizing the stability and scalability of MNPs and LNPs for clinically meaningful translation.

Introduction: There is growing evidence about the efficacy of natural compounds and peptides as central-acting anti-obesity drugs; on the other hand, their pharmacokinetic profile often hampers the clinical application. In this narrative review, the critical role of nanomedicine and peptide conjugation is reported as a promising strategy to overcome these limits.

Areas covered: The focus areas were centrally acting drugs for obesity, providing context about pathways involved and past and currently approved medications, pointing out their limits. The last 10 years research was analyzed to collect the progress in central-acting anti-obesity drugs and the new potential strategies (nanomedicine and conjugation), with attention on natural compounds and peptides.

Expert opinion: Based on literature review, nanocarriers and conjugation strategies can offer targeted delivery of both natural molecules and peptides, enhancing their therapeutics, improving cellular uptake, and regulating metabolism and inflammatory pathways. The choice of the proper administration route, along with a delivery strategy significantly impacts the pharmacokinetics and therapeutic outcomes of compounds delivered through nanomedicines and encourages their translation 'from bench to bedside.'

Introduction: Propolis is a gum-resinous compound produced by bees for hive protection. It displays complex chemical composition, dependent on the plant sources, and important biological activities, contributing to a wide range of pharmacological effects (e.g. antimicrobial, anti-inflammatory, healing and immunostimulant). Propolis shows poor aqueous solubility and low bioavailability. Thus, delivery systems have been proposed for the administration of propolis by different routes like oral, buccal, topical, local, vaginal, transmucosal, nasal, endodontics and intra-periodontal pocket.

Areas covered: From extracts and ointments, formulations for propolis delivery improved their physicochemical properties. The use of biocompatible, biodegradable, environmentally responsive materials, nanotechnology, and propolis by-product resulted in smart systems: films, micro/nanoparticles, lipid systems, carbon nanotubes, emulsion, and self-emulsifying systems, bioadhesive and environmentally responsive systems, microneedles, liquid crystals, sensors and electrospun fibers.

Expert opinion: Ensuring the efficacy and safety of propolis requires characterization, standardization, and quality control. Challenges like composition variability, limited bioavailability, and inconsistent extraction hinder its optimal use. Nanotechnology improves bioavailability and controlled release, while emerging strategies like microneedles and 3D/4D printing enhance precision and versatility. By integrating nanotechnology and additive manufacturing, researchers can develop safer, more effective delivery systems, expanding propolis applications and fostering innovation in pharmaceutical and biomedical fields.

Introduction: Hematopoietic stem cell transplantation (HSCT) is a promising treatment option for hematological malignancies. Despite its curative potential, it faces clinical challenges, including relapse and graft-versus-host disease (GVHD). Systemic toxicity due to chemotherapy is a significant problem in patients with hematological malignancies. Stem cell-based drug delivery can precisely deliver drugs to tumor sites, thereby increasing local drug toxicity, which may alleviate relapse and systemic toxicity.

Areas covered: This review integrates and critically examines the recent clinical advances in HSCT and its challenges. Autologous HSCT is constrained by the risk of relapse, whereas allogeneic HSCT is limited by donor availability and GVHD complications. Additionally, we highlight both the immunomodulation of mesenchymal stem cells (MSCs) in GVHD and the therapeutic potential of induced pluripotent stem cells (iPSCs). Furthermore, we explored stem cell-based drug delivery systems focusing on three primary strategies: (1) stem cells as intrinsic carriers, (2) stem cell-derived extracellular vesicles (EVs), and (3) stem cell membrane-derived biomimetic vesicles.

Expert opinion: While stem cell therapies hold promise, issues include the heterogeneity of stem cell sources, complexity of the cultivation process, and long-term safety issues. Future research should focus on large-scale technologies, stem cell engineering techniques, and combination therapies to facilitate clinical translation.

Introduction: Breast cancer, a malignancy characterized by high recurrence and mortality rates, faces critical bottlenecks in conventional therapies including systemic toxicity and insufficient drug concentration at lesion sites. Dissolving microneedles (DMNs) are micron-scale arrays fabricated from biodegradable materials. By leveraging their unique capability to penetrate the epidermal barrier and deliver drugs with precision, DMNs pioneer a novel therapeutic approach for breast cancer treatment.

Areas covered: This review provides new insights and directions for breast cancer research by systematically examining the latest advances in DMNs for breast cancer treatment. We comprehensively analyze DMNs mechanisms for localized delivery of chemotherapeutics, targeted degraders, immunomodulators, and gene editors, while assessing synergistic combinations with nanotechnology, physical therapies, and immunotherapy to overcome drug resistance and immunosuppression.

Expert opinion: Based on the literature review, DMNs demonstrate potential for breast cancer therapy through localized multi-agent delivery and combination strategies, significantly improving treatment efficacy for superficial tumors while minimizing systemic exposure.

Introduction: The heart is a highly dynamic organ with limited regenerative capacity and a unique microvascular environment, which restricts the accumulation and retention of systemically administered therapeutics. Despite notable progress in nanomedicine and targeted drug delivery technologies, achieving efficient and specific drug delivery to cardiac tissue remains a formidable challenge.

Areas covered: Extracellular vesicles (EVs) represent a novel therapeutic strategy for cardiovascular diseases, offering a versatile platform to integrate therapeutics, targeting moieties, and sensing elements for the detection, prevention, and treatment of cardiovascular diseases (CVD). This review highlights the recent progress in employing EVs as carriers for targeted myocardial drug delivery and explores their potential for clinical translation. A literature search was conducted using PubMed, focusing on studies categorized under EVs, cardiovascular diseases, and myocardium-targeted delivery. Current progress of EVs in clinical applications was evaluated based on the data from ClinicalTrials.gov.

Expert opinion: EVs offer significant promise for clinical myocardial drug delivery. Some key considerations for clinical application of EVs include modulating immune clearance, establishing scalable production with stringent quality control, and refining surface engineering strategies. Facilitating EV clinical translation requires focused strategies to overcome current barriers, especially by integrating bioengineering and biomaterial-based targeting to enhance myocardial delivery efficiency.

Introduction: Oral dopaminergic treatment is the cornerstone of Parkinson's disease (PD) management. However, progressive shortening of oral levodopa's effect, along with the limited efficacy of enzyme inhibitors and dopamine agonists, does not allow to adequately control motor and non-motor complications characterizing advanced PD. At this stage, device-aided therapies (DATs), including infusion treatments, are warranted to guarantee an adequate quality of life.

Areas covered: We review current and upcoming infusion therapies for PD, with a particular focus on their efficacy and safety data. Moreover, we provide an overview of current knowledge and open issues on patient selection and specific DAT choice.

Expert opinion: Recent EAN/MDS-ES guidelines suggest infusion therapies for advanced PD, yet several challenges remain, including limited access, delayed referrals, and patients' hesitancy. The '5-2-1' criteria and tools like MANAGE-PD aid early identification of eligible candidates, but treatment decisions often do not account for patients' preferences. Current trends favor early DATs implementation, as soon as motor fluctuations appear and before the disability onset. Emerging infusion therapies (e.g. foslevodopa-foscarbidopa) will boost this tendency. Enhancing DATs accessibility and inclusivity in clinical trials are key priorities. Finally, regenerative therapies including putaminal infusion of neurotrophic factors and dopaminergic neuron precursors may transform advanced PD care.

Introduction: Hollow microneedles (HMNs) offer a minimally invasive and highly efficient method for transdermal drug administration, overcoming the limitations of traditional delivery systems.

Areas covered: This review focuses on recent advancements in 3D-printed HMNs, highlighting their transformative potential in drug delivery applications. The integration of cutting-edge 3D printing technologies, such as stereolithography (SLA), digital light processing (DLP), and two-photon polymerization (2PP), has enabled the fabrication of complex, precise, and customizable microneedles (MNs). These innovations facilitate patient-specific applications, enhance drug bioavailability, and provide unparalleled control over dosage and delivery. Advances in biocompatible and biodegradable materials have further improved the safety and functionality of HMNs. Applications range from insulin delivery to biomarker sensing and theranostic systems, showcasing their versatility.

Expert opinion: 3D-printed HMNs are set to play an important role in improving personalized medicine and precision healthcare. By addressing fabrication and design issues, and using new materials, these devices are expected to change drug delivery systems and help develop new therapeutic and diagnostic platforms.