综述

新型纳米材料介导治疗念珠菌角膜炎研究进展

Research progress on novel nanomaterials mediated treatment of candidal keratitis

:348-354
 

真菌性角膜炎是我国常见的致盲性眼病,其中排前3位的致病病原菌分别为曲霉菌、镰刀菌以及念珠菌。念珠菌作为一种条件致病真菌,在宿主免疫功能低下或眼表微环境失衡时易引发机会性感染,其发病率因免疫抑制药物的滥用以及隐形眼镜佩戴的增加等因素逐年上升。在机会感染后,由于念珠菌本身以及生物膜形成的特殊作用,常导致其对现用系统性抗真菌药物,如伏立康唑、两性霉素B、伊曲康唑及氟康唑等耐药性增加。近年来,关于纳米材料介导的药物传递系统作用于治疗念珠菌角膜炎的研究日益增多,新型纳米材料通过作为抗真菌药物的载体,增加药物溶解度,延长眼表停留时间,加强生物膜、角膜穿透性,提高了抗真菌药物对念珠菌的抗菌作用,为解决念珠菌感染耐药性难题提供了新思路。文章综述了纳米聚合物、纳米颗粒、纳米凝胶、脂质体载体、纳米立方体、纳米微针和纳米胶束等新型纳米材料作为治疗念珠菌角膜炎的新型给药载体的研究现状与进展,突破传统疗法的局限,为改善目前临床存在抗真菌治疗药物有限的问题提供新的可行思路。

Fungal keratitis is a prevalent blinding ocular disease in China, with Aspergillus, Fusarium, and Candida ranking as the top three pathogenic fungi. As an opportunistic pathogenic fungus, Candida readily causes opportunistic infections when host immunity is compromised or the ocular surface microenvironment is imbalanced. The incidence of Candida keratitis has been rising annually due to factors such as the misuse of immunosuppressive drugs and increased contact lens wear. Following infection, Candida itself and the formation of biofilms contribute to enhanced resistance against currently used systemic antifungal agents, including voriconazole, amphotericin B, itraconazole, and fluconazole, posing significant challenges to clinical treatment.Recently, research on nanomaterials-mediated drug delivery systems for treating Candida keratitis has burgeoned. Novel nanomaterials, serving as carriers for antifungal drugs, enhance therapeutic efficacy by improving drug solubility, prolonging ocular surface retention time, penetrating biofilms, and enhancing corneal permeability. These advancements offer new strategies to address drug resistance in Candida infections. This article reviews the research status and progress of emerging nanomaterialssuch as nanopolymers, nanoparticles, nanogels, liposomal carriers, nanocubes, nanoneedles, and nanomicellesas innovative drug delivery vectors for Candida keratitis. By overcoming the limitations of conventional therapies, these nanomaterials provide feasible solutions to the clinical challenges of limited antifungal options and drug resistance. The integration of nanotechnology holds promise for revolutionizing the treatment of Candida keratitis and advancing precision medicine for ocular surface fungal infections.

综述

新型纳米材料在干眼中的应用进展

Progress in the application of new nanomaterials in dry eye

:233-239
 
局部点药是眼部用药最常见的方式,但一般药物通过角膜困难,药物生物利用度低。纳米载体药物于8 0年代开始用于眼部,脂质体和类脂质囊泡(niosomes)与眼表的黏蛋白相互作用,延长药物在眼表的停留时间。纳米乳剂(nanoemulsion)的表面活性剂可以松解角膜上皮细胞紧密连接,形成转运开口,抑制细胞表面糖蛋白酶P(glycoprotein P,Pgp)降解药物活性蛋白。纳米粒子(nanoparticles)通过角膜上皮和结膜上皮而不会引起毒性。纳米胶囊(nanocapsules)更深地内化到角膜上皮(50 μm处)。聚合物胶束(polymeric micelles)自组装成核-壳纳米载体增强药物渗透角膜的能力。阴离子高代聚酰氨基胺(poly-amidoamine,PAMAM)树枝状大分子增强药物通透性,中性和阳离子低代树枝状大分子通过网格蛋白途径介导药物更高的通透性。纳米晶体(nanocrystal),除增强药物溶解度和溶解速率之外,它的高黏附能力帮助药物保留和渗透到眼组织中。纳米结构材料与干眼关联密切,为干眼的治疗、诊断提供手段。
Topical administration is the most common method of ocular medication, but it is generally difficult for the drug to pass through the cornea, and the bioavailability of the drug is low. Nanocarrier drugs were used in eyes in the 1980s, and liposomes and lipoids vesicles (Niosomes) interacted with ocular surface mucins to prolong  the residence time of the drug on the ocular surface. Nanoemulsion surfactants can release the tight junctions of corneal epithelial cells, form transport openings, and inhibit the degradation of pharmaceutically active proteins by cell surface glycoprotein P (Pgp). Nanoparticles pass through the corneal and conjunctival epithelium without causing toxicity. Nanocapsules internalize deeper into the corneal epithelium (at 50 μm). Polymeric micelles self-assemble into core-shell nanocarriers to enhance the ability of drugs to penetrate the cornea. Anionic high-generation poly-amidoamine (PAMAM) dendrimers enhance drug permeability. Neutral and cationic low-generation dendrimers mediate higher drug permeability through clathrin pathway. Nanocrystal, in addition to enhancing drug solubility and dissolution rate, its high adhesion ability helps drug retention and penetration into ocular tissues. Nanostructured materials are closely related to dry eye and provide a choice for the treatment and diagnosis of dry eye.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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