Towards NanoMedicine Interventions for HIV/AIDS

近年来，纳米药物已被证明极具价值，许多纳米药物每天用于治疗各种疾病或需求的患者-从治疗癌症和更年期症状到预防器官排斥或营养不良/体重减轻。一系列未满足的临床需求可能会从新的纳米颗粒合成技术的研究和应用中受益，而开发适当的纳米药物和提供可扩展的、商业上可行的、可以影响患者结果的技术是纳米医学研究的一个关键目标。通过优化产品性能来验证新技术，展示与制药相关的生产和人体药代动力学研究对于进展至关重要，纳米毒理学研究也是建立安全评估以支持未来投资的关键。迄今为止，利物浦大学与英国一家专业初创公司IOTA NanoSolutions Ltd合作，在RCUK的资助下，已经产生了一系列用于艾滋病毒/艾滋病治疗的候选纳米药物。IOTA正在商业化一种新型纳米颗粒合成技术（最初由UoL在EPSRC的资助下开发），该技术可与最成功的商业化自上而下的纳米医学技术——纳米研磨技术相媲美。艾滋病毒/艾滋病纳米药物候选药物已经申请了3项专利，并且正在寻求资金来优化其生产并利用临床研究技术确定其行为。此外，该项目将寻求通过基础机制研究大幅增加对纳米医学的理解，从而对未来纳米药物的作用方式和安全性产生新的见解。如果成功，该项目将产生第一个用于治疗艾滋病毒/艾滋病的纳米药物选择，它对患者护理的好处可能包括更低的剂量、更少的副作用、更好的患者间一致性和减少片剂大小。无国界医生组织内部产生了极大的兴趣，他们热衷于利用产出为发展中国家提供慈善药品，用更好的产品治疗感染艾滋病毒的儿童，并预防新生儿感染艾滋病毒。目前，为了防止艾滋病毒从受感染的母亲传染给孩子，世界卫生组织建议从出生后3周开始服用抗逆转录病毒药物。唯一可用的儿童药物包括高浓度酒精，以溶解水溶性差的药物。该计划中的纳米药物可在水中分散，并在儿科治疗方面向前迈进了一步。成功建立支持新型纳米药物的基础研究将为英国在这一新兴领域的全球地位提供明显的进步，目前价值750亿美元，并迅速增长，预计在3年内达到1000亿美元。

Nanomedicines have proven extremely valuable in recent years and many are used daily to treat patients with a range of conditions or needs - from the treatment of cancer and menopausal symptoms to the prevention of organ rejection or malnutrition/weight loss. A range of unmet clinical needs may benefit considerably from the research and application of new nanoparticle synthesis techniques and the development of appropriate nanomedicines and provision of scale-able, commercially viable technologies that can impact patient outcomes is a key goal of nanomedicine research.Validation of new technologies through optimisation of product performance, demonstration of pharmaceutically relevant manufacturing and in-man pharmacokinetic studies is critical for progression as is the study of nanotoxicology to establish a safety assessment that supports future investment.To date, a series of candidate nanomedicines for HIV/AIDS treatment have been generated at the University of Liverpool in collaboration with IOTA NanoSolutions Ltd, a specialist start-up company in the UK, and supported by RCUK funding. IOTA is commercialising a novel nanoparticle synthesis technology (initially developed at UoL with EPSRC funding support) that rivals the most successful commercial top-down nanomedicine technology - nanomilling. The HIV/AIDS nanomedicine candidates have been the subject of 3 patent filings and funds are sought to optimise their production and establish their behaviour using clinical research techniques. Additionally the project will seek to dramatically increase the understanding of nanomedicine through fundamental mechanistic studies, thereby producing new insight into the mode of action and the safety of future nanomedicines.If successful, the programme will produce the first nanomedicine options for HIV/AIDS therapy with benefits for patient care potentially including lower dosing, reduced side effects, better patient-to-patient consistency and a reduction of tablet size. Significant interest has been generated within Medecins Sans Frontiere who are keen to utilise the outputs for charitable medicines in the developing world, treating children with HIV infection with better products and prevent HIV infection in newborns. Currently, to prevent transmission of HIV to children from infected mothers, the World Heath Organisation has recommended dosing from 3 weeks after birth with antiretrovirals. The only children's medicines available include high levels of alcohol to dissolve the poorly water-soluble drugs. The nanomedcines within this programme are dispersible in water and offer a step-forward in paediatric therapy. The successful establishment of the fundamental research underpinning new nanomedicines will provide a clear advance in the UK's global standing in this emerging area, currently valued at >US$75bn and growing rapidly, with expectations to reach >US$100bn within 3 years.