The role of anti-inflammatory drugs and nanoparticle-based drug delivery models in the management of ischemia-induced heart failure - 18/09/21
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Abstract |
Ongoing advancements in the treatment of acute myocardial infarction (MI) have significantly decreased MI related mortality. Consequently, the number of patients experiencing post-MI heart failure (HF) has continued to rise. Infarction size and the extent of left ventricular (LV) remodeling are largely determined by the extent of ischemia at the time of myocardial injury. In the setting of MI or acute phase of post-MI LV remodeling, anti-inflammatory drugs including intravenous immunoglobulin (IVIG) and Pentoxifylline have shown potential efficacy in preventing post-MI remodeling in-vitro and in some clinical trials. However, systemic administration of anti-inflammatory drugs are not without their off-target side effects. Herein, we explore the clinical feasibility of targeted myocardial delivery of anti-inflammatory drugs via biodegradable polymers, liposomes, hydrogels, and nano-particle based drug delivery models (NDDM) based on existing pre-clinical and clinical models. We summarize the barriers to clinical application of targeted anti-inflammatory delivery post-MI, including challenges in achieving sufficient retention and distribution, as well as the potential need for multiple dosing. Collectively, we suggest that localized delivery of anti-inflammatory agents to the myocardium using NDDM is a promising approach for successful treatment of ischemic HF. Future studies will be instrumental in determining the most effective target and delivery modalities for orchestrating NDDM-mediated treatment of HF.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Post-MI negative remodeling of LV may lead to heart failure. |
• | Anti-inflammatory drugs have shown potential efficacy in preventing post-MI LV remodeling. |
• | Systemic administration of anti-inflammatory drugs may have their off-target side effects. |
• | Localized delivery of anti-inflammatory drugs to the myocardium using NDDM may reduce off-target toxicity and improve clinical response. |
Keywords : Myocardial infarction, Heart failure, Left ventricular remodeling, Anti-inflammatory agents, Local anti-inflammatory drug delivery, Nanoparticle-based drug delivery, Multi-modal drug delivery
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Vol 142
Article 112014- octobre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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