Do ginger-derived nanoparticles represent an attractive treatment strategy for inflammatory bowel diseases?
Do ginger-derived nanoparticles represent an attractive treatment strategy for inflammatory bowel diseases?
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DOI：
10.2217/nnm-2016-0353
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发表时间：
2016-11
期刊：
影响因子：
5.5
通讯作者：
Mingzhen Zhang;James F Collins;D. Merlin
中科院分区：
文献类型：
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作者：
Mingzhen Zhang;James F Collins;D. Merlin
炎症性肠病（IBD）是一个广义的术语，描述了慢性、复发性免疫反应和胃肠道炎症，导致严重的腹部绞痛和腹泻。IBD的两种最常见形式是溃疡性结肠炎（UC），其中炎症影响大肠，以及克罗恩病（CD），其中整个消化道都受到影响。IBD在发达国家最常见，影响北美约140万人和欧洲约220万人的生活质量[1]。虽然IBD的病因尚未完全了解，但已知遗传和环境因素都会增加风险[2]。UC患者中结肠炎相关癌症（CAC）的发生是肠道炎症与癌变之间相关性的最佳临床实例之一[3]。结肠直肠癌实际上是IBD患者发病率和死亡率的主要原因。IBD治疗的主要目标是首先减轻急性发作期间的症状，然后控制慢性炎症，以避免或延迟新的发作并降低结直肠癌的长期风险[4]。目前对治疗或预防IBD的新治疗方法的研究可分为三类：开发炎性细胞因子（例如，抗TNF-α抗体）诱导T淋巴细胞凋亡;识别和靶向下调T淋巴细胞增殖的抗炎细胞因子;以及合成抑制T淋巴细胞向肠上皮运输的选择性粘附分子（SAM）抑制剂。事实上，抗TNF-α药物是治疗IBD的最有效药物之一。然而，这些药物需要全身给药，其使用受到严重副作用的限制[5]。因此，对于能够将药物特异性地且排他地递送至发炎粘膜持续延长的时间段的载体系统存在未满足的需求。这种递送系统可以通过减少脱靶副作用来显著增加有效现有治疗的有用性。
Inflammatory bowel disease treatment challenges Inflammatory bowel disease (IBD) is a broad term that describes conditions with chronic, recurring immune responses and inflammation of the GI tract, which result in severe abdominal cramping and diarrhea. The two most common forms of IBD are ulcerative colitis (UC), in which inflammation affects the large intestine, and Crohn’s disease (CD), in which the entire digestive tract is affected. IBD is most common in developed countries, affecting the quality of life of roughly 1.4 million people in North America and 2.2 million people in Europe [1]. Although the etiology of IBD is not fully understood, both genetic and environmental factors are to known to increase contribute risk [2]. The development of colitis-associated cancer (CAC) in patients suffering from UC is one of the best-characterized clinical examples of an association between intestinal inflammation and carcinogenesis [3]. Colorectal cancer is in fact a major cause of morbidity and mortality in IBD patients. The mains goals of IBD treatment are to first reduce the symptoms during acute flares, and then to control chronic inflammation so as to avoid or delay new flares and decrease the long-term risk for colorectal cancer [4]. The current research into new therapeutic approaches to treat or prevent IBD can be divided into three categories: the development of inhibitors of inflammatory cytokines (e.g., anti-TNF-α antibodies) that induce T-lymphocyte apoptosis; the identification and targeting of anti-inflammatory cytokines that downregulate T-lymphocyte proliferation; and the synthesis of selective adhesion molecule (SAM) inhibitors that suppress the trafficking of T-lymphocytes into the gut epithelium. Indeed, anti-TNF-α agents are among the most potent drugs available for the treatment of IBD. These drugs, however, need to be administered systemically and their use is limited by serious side effects [5]. There is thus an unmet need for a carrier system capable of delivering drugs specifically, and exclusively, to the inflamed mucosa for a prolonged period of time. Such a delivery system could significantly increase the usefulness of the effective existing treatments by decreasing off-target side effects.