Introduction

Human immunodeficiency virus (HIV) targets and modulates the immune system increasing the risk of other associated infections. Highly active antiretroviral therapy (HAART) has significantly improved AIDS-associated morbidity, but has limitations of adverse effects, frequent dosing regimen leading to medical non-adherence. Drug delivery systems that target HIV reservoirs could potentially reduce dose-dependent toxicity and the duration of treatment. The major cellular HIV reservoirs are macrophages and CD4⁺ T cells with macrophages being responsible for carrying and spreading the virus. The crucial involvement of macrophages in the pathogenesis of HIV infection has led to development of macrophage targeted nanocarrier delivery systems.

Areas covered

Eradication of viral reservoirs like HIV-infected macrophages has emerged to be a fundamental barrier and challenge for complete eradication of HIV from the immune system. Literature reports several macrophage targeted nanocarrier delivery systems developed as either functionalized or non-functionalized formulations such as liposomes, ethosomes, polymeric nanoparticles, dendrimers, and solid lipid nanoparticles showcasing superior efficacy over the conventional antiretroviral delivery systems.

Expert opinion

The development of fixed dose combination of antiretroviral drugs into macrophage targeted delivery systems should factor in the inherent plasticity and heterogeneity of macrophages that is dependent on their microenvironment. A rational selection of nanocarriers will facilitate selectivity and enhanced efficacy of antiretroviral drugs accompanied by reduced dosing and toxicity. Such macrophage targeted delivery systems would positively impact the therapeutic outcomes in the management of HIV infection.

中文翻译：

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HIV疗法中靶向巨噬细胞的纳米载体递送系统。

介绍

人类免疫缺陷病毒（HIV）靶向并调节免疫系统，增加了其他相关感染的风险。高效抗逆转录病毒疗法（HAART）可以显着改善与AIDS相关的发病率，但副作用有限，频繁的给药方案会导致药物不依从。针对艾滋病毒库的药物输送系统可能会降低剂量依赖性毒性和治疗时间。HIV的主要细胞库是巨噬细胞和CD4 ⁺ T细胞，巨噬细胞负责携带和传播病毒。巨噬细胞在HIV感染的发病机理中的关键参与导致巨噬细胞靶向的纳米载体递送系统的发展。

覆盖区域

消灭像艾滋病毒感染的巨噬细胞这样的病毒库已经成为从免疫系统彻底消灭艾滋病毒的根本障碍和挑战。文献报道了开发成功能化或非功能化制剂的几种巨噬细胞靶向纳米载体递送系统，例如脂质体，核糖体，聚合物纳米颗粒，树状聚合物和固体脂质纳米颗粒，显示出优于常规抗逆转录病毒递送系统的功效。

专家意见

将固定剂量的抗逆转录病毒药物组合开发到巨噬细胞靶向递送系统中，应考虑巨噬细胞固有的可塑性和异质性，这取决于它们的微环境。合理选择纳米载体将有利于抗逆转录病毒药物的选择性和增强功效，同时减少剂量和毒性。这样的巨噬细胞靶向递送系统将对HIV感染管理中的治疗结果产生积极影响。