Nanocarriers for Drug Delivery Systems

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Drug Delivery and Controlled Release".

Deadline for manuscript submissions: closed (30 July 2020) | Viewed by 47300

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Guest Editor
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
Interests: colloid systems; multifunctional nanoparticles; transdermal and topical delivery; polymeric nanoparticles; controlled release
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Special Issue Information

Dear Colleagues,

Drug delivery carriers have been successfully used in the previous years for the controlled release of therapeutic compounds for the treatment and cure as well as the diagnosis of many diseases. Drug carrier formulations are designed to connect a number of different possible actions depending on the needs of the future purposes for which they are processed. The use of nanomaterials has a lot of preferences and is becoming more pronounced in recent years. In fact, in recent years, nanotechnology, based on the manipulation of the matter in the nanoscale range, has produced a scientific revolution in different fields of application. Specially, this emerging technology is gaining prominence in the design of target drug delivery platforms. Research in this field has been focused on the use of nanostructures as drug carriers with unique size-dependent properties of biological and biomedical relevance that are able to improve the therapeutic efficacy of common drugs already used in clinical practice. The advantages of using nanostructures include increased drug bioavailability and stability, controlled release, and targeted delivery overcoming the main drawbacks of classical drug administration. The most prominent nano-devices that have been developed are liposomes, niosomes, solid lipid nanoparticles, polymeric nanoparticles, and inorganic nanoparticles.

Authors are invited to submit original and review articles describing basic science, preclinical, and clinical findings, that contribute to our understanding of the current and future potential applications of different nanocarriers, to be published in this Special Issue of Pharmaceutics.

Prof. Dr. Rita Muzzalupo
Guest Editor

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Keywords

  • nano-sized systems
  • polymeric micelles
  • vescicular systems
  • polymeric nanocarriers
  • drug targeting
  • controlled release
  • stimuli-responsive nanocarriers

Published Papers (10 papers)

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Research

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13 pages, 2387 KiB  
Article
New Nanomaterials with Intrinsic Antioxidant Activity by Surface Functionalization of Niosomes with Natural Phenolic Acids
by Elisabetta Mazzotta, Carla Orlando and Rita Muzzalupo
Pharmaceutics 2021, 13(6), 766; https://doi.org/10.3390/pharmaceutics13060766 - 21 May 2021
Cited by 14 | Viewed by 2481
Abstract
Nanoantioxidants have emerged as smart devices able to provide improved stability and biocompatibility and sustained and targeted release of conventional antioxidants. In the current research, a new family of nanoantioxidants has been developed by covalently grafting gallic (GA), caffeic (CF) and ferulic (FR) [...] Read more.
Nanoantioxidants have emerged as smart devices able to provide improved stability and biocompatibility and sustained and targeted release of conventional antioxidants. In the current research, a new family of nanoantioxidants has been developed by covalently grafting gallic (GA), caffeic (CF) and ferulic (FR) acid on the surfaces of Tween 80 niosomes. First, empty and curcumin (CUR)-loaded vesicles were prepared using a thin-layer evaporation technique and then functionalized with phenolic acids using carbodiimide chemistry. Nanoantioxidants obtained were characterized in terms of size, polydispersity index, zeta potential, and loading efficiency. Their antioxidant activity was studied by ABTS and DPPH assays. Surface functionalization of empty and CUR-loaded vesicles provided stable vesicles with intrinsic antioxidant properties. In vitro antioxidant assays highlighted that vesicles functionalized with FR or GA exhibited better antioxidant activity compared to CF-grafted niosomes. Furthermore, vesicles loaded with CUR and functionalized with GA and CF showed an enhanced scavenging ability of ABTS and DPPH radicals, compared to the single antioxidant-loaded formulations, highlighting an important synergic effect of CUR when used in combination with GA ad CF. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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24 pages, 4834 KiB  
Article
Biocompatible Catanionic Vesicles from Arginine-Based Surfactants: A New Strategy to Tune the Antimicrobial Activity and Cytotoxicity of Vesicular Systems
by Aurora Pinazo, Ramon Pons, Ana Marqués, Maribel Farfan, Anderson da Silva and Lourdes Perez
Pharmaceutics 2020, 12(9), 857; https://doi.org/10.3390/pharmaceutics12090857 - 09 Sep 2020
Cited by 19 | Viewed by 3386
Abstract
Their stability and low cost make catanionic vesicles suitable for application as drug delivery systems. In this work we prepared catanionic vesicles using biocompatible surfactants: two cationic arginine-based surfactants (the monocatenary Nα-lauroyl-arginine methyl ester—LAM and the gemini Nα,Nϖ-bis(N [...] Read more.
Their stability and low cost make catanionic vesicles suitable for application as drug delivery systems. In this work we prepared catanionic vesicles using biocompatible surfactants: two cationic arginine-based surfactants (the monocatenary Nα-lauroyl-arginine methyl ester—LAM and the gemini Nα,Nϖ-bis(Nα-lauroylarginine) α, ϖ-propylendiamide—C3(CA)2) and three anionic amphiphiles (the single chain sodium dodecanoate, sodium myristate, and the double chain 8-SH). The critical aggregation concentration, colloidal stability, size, and charge density of these systems were comprehensively studied for the first time. These catanionic vesicles, which form spontaneously after mixing two aqueous solutions of oppositely charged surfactants, exhibited a monodisperse population of medium-size aggregates and good stability. The antimicrobial and hemolytic activity of the vesicles can be modulated by changing the cationic/anionic surfactant ratio. Vesicles with a positive charge efficiently killed Gram-negative and Gram-positive bacteria as well as yeasts; the antibacterial activity declined with the decrease of the cationic charge density. The catanionic systems also effectively eradicated MRSA (Methicillin-resistant Staphylococcus Aureus) and Pseudomonas aeruginosa biofilms. Interestingly, the incorporation of cholesterol in the catanionic mixtures improved the stability of these colloidal systems and considerably reduced their cytotoxicity without affecting their antimicrobial activity. Additionally, these catanionic vesicles showed good DNA affinity. Their antimicrobial efficiency and low hemolytic activity render these catanionic vesicles very promising candidates for biomedical applications. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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17 pages, 4270 KiB  
Article
Combination Delivery of Alpha-Tocopheryl Succinate and Curcumin Using a GSH-Sensitive Micelle (PAH-SS-PLGA) to Treat Pancreatic Cancer
by Tilahun Ayane Debele, Hung-Chang Wu, Shang-Rung Wu, Yan-Shen Shan and Wen-Pin Su
Pharmaceutics 2020, 12(8), 778; https://doi.org/10.3390/pharmaceutics12080778 - 16 Aug 2020
Cited by 11 | Viewed by 3312
Abstract
Pancreatic cancer is one of the highest causes of mortality throughout the world; thus, it requires an effective treatment strategy. Some chemotherapeutic agents used in the clinics or under clinical trials are hydrophobic and have poor aqueous solubility; consequently, they also have minimal [...] Read more.
Pancreatic cancer is one of the highest causes of mortality throughout the world; thus, it requires an effective treatment strategy. Some chemotherapeutic agents used in the clinics or under clinical trials are hydrophobic and have poor aqueous solubility; consequently, they also have minimal systemic bioavailability. Nanoparticle-based drug delivery tactics have the potential for overcoming these limitations and enhancing their therapeutic efficacy. Herein, a glutathione (GSH)-sensitive micelle (PAH-SS-PLGA) was synthesized for the combined delivery of alpha-tocopheryl succinate (TOS) and curcumin to improve its therapeutic efficacy. The chemical structures of PAH-SS-PLGA were analyzed using Proton Nuclear Magnetic Resonance (1H-NMR) and Fourier Transform Infrared (FTIR) spectroscopy, whereas the particle size, zeta potential, and surface morphology were observed using dynamic light scattering (DLS) and transmission electron microscopy (TEM). In vitro drug release results revealed that more TOS and curcumin were released in the presence of GSH (5 mM) than the physiological pH value. Fluorescence microscopy images revealed that nanoformulated curcumin/rhodamine was uptaken by PAN02 pancreatic cancer cells. In vitro cytotoxicity assays showed higher cytotoxicity for nanoformulated TOS and/or curcumin than free TOS and/or curcumin. In addition, higher cytotoxicity was observed for combination drugs than free drugs alone. Most interestingly, at all tested concentrations of nanoformulated drugs (PAH-SS-PLGA, TOS, and curcumin), the calculated combination index (CI) value was less than one, which shows that TOS and curcumin have a synergistic effect on cellular proliferation inhibition. Overall, synthesized co-polymers are the best carriers for combination drugs, TOS, and curcumin, because they enhance the therapeutic efficacy and improve pancreatic cancer treatments. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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0 pages, 4630 KiB  
Article
RETRACTED: Thymoquinone-Loaded Soy-Phospholipid-Based Phytosomes Exhibit Anticancer Potential against Human Lung Cancer Cells
by Nabil A. Alhakamy, Shaimaa M. Badr-Eldin, Usama A. Fahmy, Nabil K. Alruwaili, Zuhier A. Awan, Giuseppe Caruso, Mohamed A. Alfaleh, Ahmed L. Alaofi, Faris O Arif, Osama A. A. Ahmed and Adel F. Alghaith
Pharmaceutics 2020, 12(8), 761; https://doi.org/10.3390/pharmaceutics12080761 - 12 Aug 2020
Cited by 50 | Viewed by 3902 | Retraction
Abstract
Thymoquinone (TQ), a natural polyphenol, has been associated with various pharmacological responses; however, low bioavailability of TQ limits its clinical application. Thus, a novel phytosomal delivery system of TQ-Phospholipon® 90H complex (TQ-phytosome) was developed by refluxing combined with anti-solvent precipitation. This TQ [...] Read more.
Thymoquinone (TQ), a natural polyphenol, has been associated with various pharmacological responses; however, low bioavailability of TQ limits its clinical application. Thus, a novel phytosomal delivery system of TQ-Phospholipon® 90H complex (TQ-phytosome) was developed by refluxing combined with anti-solvent precipitation. This TQ delivery system was optimized by a three-factor, three-level Box-Behnken design. The optimized TQ-phytosome size was (45.59 ± 1.82 nm) and the vesicle size was confirmed by transmission electron microscopy. The in vitro release pattern of the formulation indicated a biphasic release pattern, where an initial burst release was observed within 2 h, followed by a prolonged release. A remarkable increase in dose-dependent cytotoxicity was evident from the significant decrease in IC50 value of TQ-phytosomes (4.31 ± 2.21 µM) against the A549 cell line. The differential effect of TQ-phytosomes in cell cycle analysis was observed, where cancer cells were accumulated on G2-M and pre-G1 phases. Furthermore, increased apoptotic induction and cell necrosis of TQ-phytosomes were revealed with the annexin V staining technique via activation of caspase-3. In reactive oxygen species (ROS) analysis, TQ-phytosomes acted to significantly increase ROS generation in A549 cells. In conclusion, the sustained release profile with significantly-improved anticancer potential could be obtained with TQ by this phytosomal nanocarrier platform. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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22 pages, 4693 KiB  
Article
Fabrication of Core Crosslinked Polymeric Micelles as Nanocarriers for Doxorubicin Delivery: Self-Assembly, In Situ Diselenide Metathesis and Redox-Responsive Drug Release
by Yihenew Simegniew Birhan, Haile Fentahun Darge, Endiries Yibru Hanurry, Abegaz Tizazu Andrgie, Tefera Worku Mekonnen, Hsiao-Ying Chou, Juin-Yih Lai and Hsieh-Chih Tsai
Pharmaceutics 2020, 12(6), 580; https://doi.org/10.3390/pharmaceutics12060580 - 23 Jun 2020
Cited by 17 | Viewed by 3361
Abstract
Polymeric micelles (PMs) have been used to improve the poor aqueous solubility, slow absorption and non-selective biodistribution of chemotherapeutic agents (CAs), albeit, they suffer from disassembly and premature release of payloads in the bloodstream. To alleviate the thermodynamic instability of PMs, different core [...] Read more.
Polymeric micelles (PMs) have been used to improve the poor aqueous solubility, slow absorption and non-selective biodistribution of chemotherapeutic agents (CAs), albeit, they suffer from disassembly and premature release of payloads in the bloodstream. To alleviate the thermodynamic instability of PMs, different core crosslinking approaches were employed. Herein, we synthesized the poly(ethylene oxide)-b-poly((2-aminoethyl)diselanyl)ethyl l-aspartamide)-b-polycaprolactone (mPEG-P(LA-DSeDEA)-PCL) copolymer which self-assembled into monodispersed nanoscale, 156.57 ± 4.42 nm, core crosslinked micelles (CCMs) through visible light-induced diselenide metathesis reaction between the pendant selenocystamine moieties. The CCMs demonstrated desirable doxorubicin (DOX)-loading content (7.31%) and encapsulation efficiency (42.73%). Both blank and DOX-loaded CCMs (DOX@CCMs) established appreciable colloidal stability in the presence of bovine serum albumin (BSA). The DOX@CCMs showed redox-responsive drug releasing behavior when treated with 5 and 10 mM reduced glutathione (GSH) and 0.1% H2O2. Unlike the DOX-loaded non-crosslinked micelles (DOX@NCMs) which exhibited initial burst release, DOX@CCMs demonstrated a sustained release profile in vitro where 71.7% of the encapsulated DOX was released within 72 h. In addition, the in vitro fluorescent microscope images and flow cytometry analysis confirmed the efficient cellular internalization of DOX@CCMs. The in vitro cytotoxicity test on HaCaT, MDCK, and HeLa cell lines reiterated the cytocompatibility (≥82% cell viability) of the mPEG-P(LA-DSeDEA)-PCL copolymer and DOX@CCMs selectively inhibit the viabilities of 48.85% of HeLa cells as compared to 15.75% of HaCaT and 7.85% of MDCK cells at a maximum dose of 10 µg/mL. Overall, all these appealing attributes make CCMs desirable as nanocarriers for the delivery and controlled release of DOX in tumor cells. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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17 pages, 5291 KiB  
Article
Biotin-Decorated PAMAM G4.5 Dendrimer Nanoparticles to Enhance the Delivery, Anti-Proliferative, and Apoptotic Effects of Chemotherapeutic Drug in Cancer Cells
by Endiries Yibru Hanurry, Tefera Worku Mekonnen, Abegaz Tizazu Andrgie, Haile Fentahun Darge, Yihenew Simegniew Birhan, Wei-Hsin Hsu, Hsiao-Ying Chou, Chih-Chia Cheng, Juin-Yih Lai and Hsieh-Chih Tsai
Pharmaceutics 2020, 12(5), 443; https://doi.org/10.3390/pharmaceutics12050443 - 11 May 2020
Cited by 31 | Viewed by 3973
Abstract
Biotin receptors are overexpressed by various types of solid cancer cells and play a significant role in tumor metabolism, growth, and metastasis. Thus, targeting the biotin receptors on tumor cells may enhance the efficiency and reduce the side-effects of chemotherapy. The aim of [...] Read more.
Biotin receptors are overexpressed by various types of solid cancer cells and play a significant role in tumor metabolism, growth, and metastasis. Thus, targeting the biotin receptors on tumor cells may enhance the efficiency and reduce the side-effects of chemotherapy. The aim of this study was to develop a biotin-coupled poly(amido)amine (PAMAM) (PG4.5) dendrimer nanoparticle to enhance the tumor-specific delivery and intracellular uptake of anticancer drugs via receptor-mediated endocytosis. We modified PG4.5 with diethylenetriamine (DETA) followed by biotin via an amide bond and characterized the resulting PG4.5-DETA-biotin nanoparticles by 1H NMR, FTIR, and Raman spectroscopy. Loading and releasing of gemcitabine (GEM) from PG4.5-DETA-biotin were evaluated by UV–Visible spectrophotometry. Cell viability and cellular uptake were examined by MTT assay and flow cytometry to assess the biocompatibility, cellular internalization efficiency and antiproliferative activity of PG4.5-DETA-biotin/GEM. Gemcitabine-loaded PG4.5-DETA-biotin nanoparticles were spherical with a particle size of 81.6 ± 6.08 nm and zeta potential of 0.47 ± 1.25 mV. Maximum drug-loading content and encapsulation efficiency were 10.84 ± 0.16% and 47.01 ± 0.71%, respectively. Nearly 60.54 ± 1.99% and 73.96 ± 1.14% of gemcitabine was released from PG4.5-DETA-biotin/GEM nanoparticles after 48 h at the acidic pH values of 6.5 and 5, respectively. Flow cytometry and fluorescence microscopy of cellular uptake results revealed PG4.5-DETA-biotin/GEM nanoparticles selectively targeted cancer cells in vitro. Cytotoxicity assays demonstrated gemcitabine-loaded PG4.5-DETA-biotin significantly reduced cell viability and induced apoptosis in HeLa cells. Thus, biotin-coupled PG4.5-DETA nanocarrier could provide an effective, targeted drug delivery system and selectively convey gemcitabine into tumor cells. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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25 pages, 4335 KiB  
Article
Docetaxel-Loaded Disulfide Cross-Linked Nanoparticles Derived from Thiolated Sodium Alginate for Colon Cancer Drug Delivery
by Hock Ing Chiu, Asila Dinie Ayub, Siti Nur Aishah Mat Yusuf, Noorfatimah Yahaya, Erazuliana Abd Kadir and Vuanghao Lim
Pharmaceutics 2020, 12(1), 38; https://doi.org/10.3390/pharmaceutics12010038 - 02 Jan 2020
Cited by 40 | Viewed by 4304
Abstract
In this study, fluorescein-labelled wheat germ agglutinin (fWGA)-conjugated disulfide cross-linked sodium alginate nanoparticles were developed to specifically target docetaxel (DTX) to colon cancer cells. Different amounts of 3-mercaptopropionic acid (MPA) were covalently attached to sodium alginate to form thiolated sodium alginate (MPA1–5). These [...] Read more.
In this study, fluorescein-labelled wheat germ agglutinin (fWGA)-conjugated disulfide cross-linked sodium alginate nanoparticles were developed to specifically target docetaxel (DTX) to colon cancer cells. Different amounts of 3-mercaptopropionic acid (MPA) were covalently attached to sodium alginate to form thiolated sodium alginate (MPA1–5). These polymers were then self-assembled and air-oxidised to form disulfide cross-linked nanoparticles (MP1–5) under sonication. DTX was successfully loaded into the resulting MP1–5 to form DTX-loaded nanoparticles (DMP1–5). DMP2 had the highest loading efficiency (17.8%), thus was chosen for fWGA surface conjugation to form fWGA-conjugated nanoparticles (fDMP2) with a conjugation efficiency of 14.1%. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) analyses showed spherical nanoparticles, and an in vitro drug release study recorded a cumulative drug release of 48.6%. Dynamic light scattering (DLS) analysis revealed a mean diameter (MD) of 289 nm with a polydispersity index (PDI) of 0.3 and a zeta potential of −2.2 mV for fDMP2. HT-29 human colon cancer cells treated with fDMP2 showed lower viability than that of L929 mouse fibroblast cells. These results indicate that fDMP2 was efficiently taken up by HT-29 cells (29.9%). Fluorescence and confocal imaging analyses also showed possible internalisation of nanoparticles by HT-29 cells. In conclusion, fDMP2 shows promise as a DTX carrier for colon cancer drug delivery. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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15 pages, 3699 KiB  
Article
Actively Targeted and Redox Responsive Delivery of Anticancer Drug by Chitosan Nanoparticles
by Elisabetta Mazzotta, Selene De Benedittis, Antonio Qualtieri and Rita Muzzalupo
Pharmaceutics 2020, 12(1), 26; https://doi.org/10.3390/pharmaceutics12010026 - 26 Dec 2019
Cited by 49 | Viewed by 4313
Abstract
The clinical efficacy of methotrexate (MTX) is limited by its poor water solubility, its low bioavailability, and the development of resistance in cancer cells. Herein, we developed novel folate redox-responsive chitosan (FTC) nanoparticles for intracellular MTX delivery. l-Cysteine and folic acid molecules [...] Read more.
The clinical efficacy of methotrexate (MTX) is limited by its poor water solubility, its low bioavailability, and the development of resistance in cancer cells. Herein, we developed novel folate redox-responsive chitosan (FTC) nanoparticles for intracellular MTX delivery. l-Cysteine and folic acid molecules were selected to be covalently linked to chitosan in order to confer it redox responsiveness and active targeting of folate receptors (FRs). NPs based on these novel polymers could possess tumor specificity and a controlled drug release due to the overexpression of FRs and high concentration of reductive agents in the microenvironment of cancer cells. Nanoparticles (NPs) were prepared using an ionotropic gelation technique and characterized in terms of size, morphology, and loading capacity. In vitro drug release profiles exhibited a glutathione (GSH) dependence. In the normal physiological environment, NPs maintained good stability, whereas, in a reducing environment similar to tumor cells, the encapsulated MTX was promptly released. The anticancer activity of MTX-loaded FTC-NPs was also studied by incubating HeLa cells with formulations for various time and concentration intervals. A significant reduction in viability was observed in a dose- and time-dependent manner. In particular, FTC-NPs showed a better inhibition effect on HeLa cancer cell proliferation compared to non-target chitosan-based NPs used as control. The selective cellular uptake of FTC-NPs via FRs was evaluated and confirmed by fluorescence microscopy. Overall, the designed NPs provide an attractive strategy and potential platform for efficient intracellular anticancer drug delivery. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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Review

Jump to: Research

18 pages, 1785 KiB  
Review
Micro/Nanorobot: A Promising Targeted Drug Delivery System
by Mengyi Hu, Xuemei Ge, Xuan Chen, Wenwei Mao, Xiuping Qian and Wei-En Yuan
Pharmaceutics 2020, 12(7), 665; https://doi.org/10.3390/pharmaceutics12070665 - 15 Jul 2020
Cited by 74 | Viewed by 9613
Abstract
Micro/nanorobot, as a research field, has attracted interest in recent years. It has great potential in medical treatment, as it can be applied in targeted drug delivery, surgical operation, disease diagnosis, etc. Differently from traditional drug delivery, which relies on blood circulation to [...] Read more.
Micro/nanorobot, as a research field, has attracted interest in recent years. It has great potential in medical treatment, as it can be applied in targeted drug delivery, surgical operation, disease diagnosis, etc. Differently from traditional drug delivery, which relies on blood circulation to reach the target, the designed micro/nanorobots can move autonomously, which makes it possible to deliver drugs to the hard-to-reach areas. Micro/nanorobots were driven by exogenous power (magnetic fields, light energy, acoustic fields, electric fields, etc.) or endogenous power (chemical reaction energy). Cell-based micro/nanorobots and DNA origami without autonomous movement ability were also introduced in this article. Although micro/nanorobots have excellent prospects, the current research is mainly based on in vitro experiments; in vivo research is still in its infancy. Further biological experiments are required to verify in vivo drug delivery effects of micro/nanorobots. This paper mainly discusses the research status, challenges, and future development of micro/nanorobots. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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37 pages, 3171 KiB  
Review
Combination Therapy and Nanoparticulate Systems: Smart Approaches for the Effective Treatment of Breast Cancer
by Shivaprasad Gadag, Shristi Sinha, Yogendra Nayak, Sanjay Garg and Usha Y. Nayak
Pharmaceutics 2020, 12(6), 524; https://doi.org/10.3390/pharmaceutics12060524 - 08 Jun 2020
Cited by 23 | Viewed by 7835
Abstract
Breast cancer has become one of the biggest concerns for oncologists in the past few decades because of its unpredictable etiopathology and nonavailability of personalized translational medicine. The number of women getting affected by breast cancer has increased dramatically, owing to lifestyle and [...] Read more.
Breast cancer has become one of the biggest concerns for oncologists in the past few decades because of its unpredictable etiopathology and nonavailability of personalized translational medicine. The number of women getting affected by breast cancer has increased dramatically, owing to lifestyle and environmental changes. Besides, the development of multidrug resistance has become a challenge in the therapeutic management of breast cancer. Studies reveal that the use of monotherapy is not effective in the management of breast cancer due to high toxicity and the development of resistance. Combination therapies, such as radiation therapy with adjuvant therapy, endocrine therapy with chemotherapy, and targeted therapy with immunotherapy, are found to be effective. Thus, multimodal and combination treatments, along with nanomedicine, have emerged as a promising strategy with minimum side effects and drug resistance. In this review, we emphasize the multimodal approaches and recent advancements in breast cancer treatment modalities, giving importance to the current data on clinical trials. The novel treatment approach by targeted therapy, according to type, such as luminal, HER2 positive, and triple-negative breast cancer, are discussed. Further, passive and active targeting technologies, including nanoparticles, bioconjugate systems, stimuli-responsive, and nucleic acid delivery systems, including siRNA and aptamer, are explained. The recent research exploring the role of nanomedicine in combination therapy and the possible use of artificial intelligence in breast cancer therapy is also discussed herein. The complexity and dynamism of disease changes require the constant upgrading of knowledge, and innovation is essential for future drug development for treating breast cancer. Full article
(This article belongs to the Special Issue Nanocarriers for Drug Delivery Systems)
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