Current Drug Metabolism - Volume 14, Issue 5, 2013

Inorganic nanoparticles (NPs) currently have immense potential as drug delivery vectors due to their unique physicochemical properties such as high surface area per unit volume, their optical and magnetic uniqueness and the ability to be functionalized with a large number of ligands to enhance their affinity towards target molecules. These features, together with the therapeutic activity of some drugs, render the combination of these two entities (NP-drug) as an attractive alternative in the area of drug delivery. One of the major advantages of these conjugates is the possibility to have a local delivery of the drug, thus reducing systemic side effects and enabling a higher efficiency of the therapeutic molecule. This review highlights the direct implications of nanoscale particles in the development of drug delivery systems. In more detail, it is also remarked the extensive use of inorganic NPs for targeted cancer therapies. As the range of nanoparticles and their applications continues to increase, human safety concerns are gaining importance, which makes it necessary to better understand the potential toxicity hazards of these materials.

With unique potentials for organ drug delivery and targeting, intravenous administration of drugs has represented a key tool in biomedicine. A major concern of this route is the rapid capture and destruction of foreign substances by circulating immune cells. Knowledge about the inter-relationships between drugs and blood cells is essential for a better control in drug stability and bioavailability. In this review, both classical pathways and novel insights into the immune mechanisms leading to drug clearance after systemic delivery are described. Drug surface chemistry and size have been identified as critical factors for the activation of host immune responses, and their modification has been extensively explored in order to evade immune surveillance. Common strategies to camouflage drug surfaces through polymer-grafting are presented, with special emphasis on Poly(Ethylene Glycol) (PEG) linkages, one of the most diverse strategies for modifying biomolecular surfaces. Finally, the use of “smart shields”, such as PEG attachments shed at particular intracellular conditions, is briefly overviewed as an interesting approach for balancing circulation half lives VS bioavailability in polymer-grafted formulations.

The microcirculation presents functional organic structures in the range of 1-100 micrometers, commensurate with the upper end of nanotechnology constructs. When devices are designed and deployed to deliver treatment via the circulation they ultimately contend with the smallest dimensions of both healthy and impaired microvessels, particularly the capillary system whose ability to sustain the tissue is assessed by measuring “functional capillary density” (FCD). FCD is directly determined by hydrostatic and osmotic pressures and indirectly by the effect of cardiovascular regulators, particularly the bioavailability of nitric oxide (NO) resulting from fluid mechanical effects and transport in the submicroscopic cell free plasma layer (CFL) located between blood and microvascular wall. Macromolecules using colloids as templates that are surface decorated with polyethylene glycol (PEG) become immuno-invisible and can be introduced into the circulation to manipulate the NO environment in blood and the endothelium. PEG-albumin is a class of molecules with novel plasma expansion properties that directly interacts with the microcirculation via CFL related effects. The principal application of this technology is in transfusion medicine and the plasma expanders used to treat blood losses and concomitant effects on microvascular function due to related acute inflammatory conditions and ischemia.

This review provides a brief overview of the variety of carriers employed for targeted drug delivery used in cancer therapy and summarizes advantages and disadvantages of each approach. Particularly, the attention was paid to polymeric nanocarriers, liposomes, micelles, polyethylene glycol, poly(lactic-co-glycolic acid), dendrimers, gold and magnetic nanoparticles, quantum dots, silica nanoparticles, and carbon nanotubes. Further, this paper briefly focuses on several anticancer agents (paclitaxel, docetaxel, camptothecin, doxorubicin, daunorubicin, cisplatin, curcumin, and geldanamycin) and on the influence of their combination with nanoparticulate transporters to their properties such as cytotoxicity, short life time and/or solubility.

Aptamer researches applied to the treatment of human cancers have increased since their discovery in 1990. This is due to different factors including: 1) the technical possibility to select, by SELEX-based procedures, specific aptamers targeting virtually any given molecule, 2) the aptamer favorable bio-activity in vivo, 3) the low production costs and 4) the ease synthesis and storage for the marketing. In the field of cancer treatments, aptamers have been studied as tumor-specific agents driving drugs into cancer cells; additionally they have been used as anti-neoplastic agents, able to inhibit tumor cell growth and dissemination when administered alone or in combination with conventional anti-neoplastic drugs. Aptamers are gaining an increased interest for pharmaceutical companies and some of them are under clinical evaluation trials. In this review we update the findings about the use of aptamers as “escort” molecules able to drive drugs into the cells and as antineoplastic drugs. Current anti-neoplastic treatments suffer from the intrinsic toxicity related to the un-specific targeting of both normal and tumorigenic proliferating cells. The aptamers could be useful to improve: 1) the selective targeting of molecules essential for the viability and expansion of tumor cells and/or the selective driving of chemotherapies into tumor cells, thus resulting in higher effectiveness and lower systemic side-effects compared to conventional anti-neoplastic drugs alone and 2) to improve the therapeutic index of currently used chemotherapies. Even if some problems related to the in vivo stability and pharmacokinetic/dynamics of aptamers remain to be improved, their potential use in the treatment of different human cancers is getting closer and closer to a practical therapeutic use.

The amount of drug remaining after previous doses, or drug accumulation, is closely related to drug efficacy and safety. An accurate calculation of the accumulation index or ratio (Rac) is crucial for dose finding. However, in drug accumulation studies little consensus exists with regard to experimental design or data analysis. We conducted a systematic review of the literature to produce a detailed profile of drug accumulation studies of the last 30 years (1980-2011). Ninety-six articles comprising 122 studies were analyzed. A typical drug accumulation study enrolled 10 to 20 subjects randomly assigned into treatment groups of 1 or 2 dose levels to observe pharmacokinetic behaviors. The median washout period between single and multiple dosing was 7 days, and the dose interval was 1-2 elimination half-lives in non- or one-compartmental models. Generally, the number of repeated times of administration for multiple dosing was 7-14, and the median number of sampling time points was 11. Eight different methods were used to calculate Rac. The most frequently used method, in 72.9% of the studies, was to set Rac equal to the ratio of the area under a plasma concentration-time curve (AUC) during a dosage interval at steady state to the AUC of a dosage interval after the first dose, i.e., Rac = AUC0-ι,ss / AUC0-ι,1. The values of Rac in the included studies ranged from 0.85 to 18.8, and 68.03% were <2. We suggest that sample size estimation for an accumulation study should be similar to that of a bioequivalence study, and in most studies, 18-24 subjects will be needed. Appropriate calculation methods for Rac should be selected based on the experimental design and data characteristics. The crucial values for non-, weak, moderate, and strong accumulation can be set at Rac <1.2, 1.2 ≤ Rac <2, 2 ≤ Rac <5, and Rac ≥ 5, respectively. Accumulations studies should also give more regard to drug metabolism and increased accumulation in kidney or liver damaged patients.

In Traditional Chinese Medicine (TCM), ginseng roots are taken orally as a pharmacological adaptogen and nourishing stimulants for thousands of years. Along with the rapid advancement of modern life technologies, ginseng's effects as a non-toxic non-organspecific cancer preventive agent have recently been elucidated both at molecular levels and on clinical aspects. Here we presented some techniques used for separating ginseng active ingredients, evidence of effects of ginseng and its ingredients on cancer and cancer metastasis obtained from in vitro and in vivo experiments and thousands of volunteers participated in various clinical trials. As a biological response modifier and an adaptogen to synergistically enhance efficacy of conventional therapy as a supplement, adequate ginseng consumption reduces the risk of development of all types of cancer and the recurrence of some types of cancer, improves host intrinsic response to cancer and quality of patients' life. We also briefly stated recent case reports on potential interaction between warfarin and ginseng products.