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Nanomedicines, an emerging therapeutic regimen for treatment of ischemic cerebral stroke: A review
Journal of Controlled Release ( IF 10.8 ) Pub Date : 2021-10-23 , DOI: 10.1016/j.jconrel.2021.10.020
Wei Chen 1 , Lingfei Jiang 2 , Yueqiang Hu 3 , Gang Fang 4 , Bilin Yang 2 , Junhong Li 5 , Ni Liang 5 , Lin Wu 3 , Zahid Hussain 6
Affiliation  

Owing to its intricate pathophysiology, cerebral stroke is a serious medical condition caused by interruption or obstruction of blood supply (blockage of vasculature) to the brain tissues which results in diminished supply of essential nutrients and oxygen (hypoxia) and ultimate necrosis of neuronal tissues. A prompt risks assessment and immediate rational therapeutic plan with proficient neuroprotection play critically important role in the effective management of this neuronal emergency. Various conventional medications are being used for treatment of acute ischemic cerebral stroke but fibrinolytic agents, alone or in combination with other agents are considered the mainstay. These clot-busting agents effectively restore blood supply (reperfusion) to ischemic regions of the brain; however, their clinical significance is hampered due to various factors such as short plasma half-life, limited distribution to brain tissues due to the presence of highly efficient physiological barrier, blood brain barrier (BBB), and lacking of target-specific delivery to the ischemic brain regions. To alleviate these issues, various types of nanomedicines such as polymeric nanoparticles (NPs), liposomes, nanoemulsion, micelles and dendrimers have been designed and evaluated. The implication of these newer therapies (nanomedicines) have revolutionized the therapeutic outcomes by improving the plasma half-life, permeation across BBB, efficient distribution to ischemic cerebral tissues and neuroprotection. Furthermore, the adaptation of some diverse techniques including PEGylation, tethering of targeting ligands on the surfaces of nanomedicines, and pH responsive features have also been pondered. The implication of these emerging adaptations have shown remarkable potential in maximizing the targeting efficiency of drugs to ischemic brain tissues, simultaneous delivery of drugs and imaging agents (for early prognosis as well as monitoring of therapy), and therapeutic outcomes such as long-term neuroprotection.



中文翻译:

纳米药物,一种治疗缺血性脑卒中的新兴治疗方案:综述

由于其复杂的病理生理学,脑卒中是一种严重的疾病,由脑组织的血液供应中断或阻塞(脉管系统阻塞)导致必需营养素和氧气供应减少(缺氧)和神经元组织最终坏死。及时的风险评估和立即合理的治疗计划以及熟练的神经保护在有效管理这种神经元紧急情况中起着至关重要的作用。各种常规药物被用于治疗急性缺血性脑卒中,但单独或与其他药物联合使用的纤溶药物被认为是主要药物。这些血栓破坏剂有效地恢复了大脑缺血区域的血液供应(再灌注);然而,由于各种因素,例如血浆半衰期短、由于存在高效生理屏障、血脑屏障 (BBB) 而在脑组织中的分布有限,以及缺乏对缺血脑的靶向特异性递送,它们的临床意义受到阻碍地区。为了缓解这些问题,已经设计和评估了各种类型的纳米药物,例如聚合物纳米颗粒 (NPs)、脂质体、纳米乳液、胶束和树枝状聚合物。这些新疗法(纳米药物)的意义通过改善血浆半衰期、血脑屏障渗透、缺血脑组织的有效分布和神经保护,彻底改变了治疗结果。此外,一些不同技术的适应,包括聚乙二醇化,纳米药物表面靶向配体的束缚,还考虑了 pH 响应特性。这些新兴适应的意义在最大限度地提高药物对缺血脑组织的靶向效率、同时递送药物和显像剂(用于早期预后和治疗监测)以及治疗结果(例如长期神经保护)方面具有显着的潜力.

更新日期:2021-11-17
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