Drug Delivery and Translational Research ( IF 5.7 ) Pub Date : 2022-07-11 , DOI: 10.1007/s13346-022-01191-w Myriam Bordone 1 , Ana Bettencourt 1
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The bone tissue can regenerate itself completely and continuously; however, large-scale bone defects may overpower this self-regenerative process. Furthermore, the aging population, the increment in obesity incidence, and the sedentary lifestyles are serious risk factors for bone diseases’ development which are associated with the self-regenerative process’s failure, high morbidity, and mortality rates. Thus, there is an ever-growing need for strategic approaches targeting bone replacement, its remodelling, and its regeneration. Bone scaffolds have successfully been used as synthetic bone grafts for many years, yet recent bone tissue engineering strategies attempt to explore their multifunctionality by investigating them as drug delivery systems. Bone diseases’ treatments can be substantially difficult due to the avascular nature of the surrounding cartilage; thus, targeted drug delivery to the bone can be advantageous: it provides local high drug concentrations and minimizes adverse effects while securing a space for new, healthy tissue growth. Despite the promising scientific progress, studies underlining bone scaffolds’ use as local drug delivery systems are not abundant. Hence, this work reviews bone scaffolds’ therapeutic interest for local drug delivery in five distinct bone disorders—osteomyelitis, osteoporosis, osteoarthritis, osteosarcoma, and cancer bone metastasis. Additionally, it presents the challenges of this possible therapeutic approach and its future perspectives. Albeit bone scaffolds present therapeutic benefits by acting as drug delivery systems, further pre-clinical and clinical assessments are needed to strengthen their understanding and enable research evidence translation into clinical practice. The mismatch between scientific evolution and regulatory frameworks remains one of the major future challenges.
Graphical abstract
中文翻译：
骨病管理：研究基于支架的药物输送策略
骨组织可以完全连续地自我再生；然而，大规模的骨缺损可能会压倒这种自我再生过程。此外，人口老龄化、肥胖发病率增加和久坐不动的生活方式是骨病发展的严重危险因素，与自我再生过程失败、高发病率和死亡率有关。因此，越来越需要针对骨置换、骨重塑和再生的战略方法。多年来，骨支架已成功用作合成骨移植物，但最近的骨组织工程策略试图通过研究它们作为药物输送系统来探索它们的多功能性。由于周围软骨的无血管特性，骨骼疾病的治疗可能非常困难；因此，靶向药物递送至骨骼可能是有利的：它提供局部高药物浓度并最大限度地减少副作用，同时确保新的健康组织生长的空间。尽管取得了令人鼓舞的科学进展，但强调骨支架用作局部药物输送系统的研究并不丰富。因此，这项工作回顾了骨支架在五种不同骨病（骨髓炎、骨质疏松症、骨关节炎、骨肉瘤和癌症骨转移）中局部给药的治疗意义。此外，它还介绍了这种可能的治疗方法的挑战及其未来前景。尽管骨支架通过充当药物输送系统呈现出治疗效果，需要进一步的临床前和临床评估来加强他们的理解并使研究证据转化为临床实践。科学发展与监管框架之间的不匹配仍然是未来的主要挑战之一。
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