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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5918_Библиотеки_им_академика_М_И_Перельмана
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therapeutics, which will modify nanoparticle-based treatments to patient features.
Furthermore, ongoing research efforts are aimed at developing multifunctional NPs
capable of seamlessly combining diagnostic, therapeutic, and imaging characteristics into a single platform, demonstrating the expanding landscape of nanotechnology for improved theranostic. Navigating these hurdles and accepting novel
approaches will be critical to understanding the full potential of NP-based drug
delivery within biotechnological applications (Orive etal. 2003).
S. Yadav et al.
7.5.2 Polymeric Nanocarriers
Polymeric nanocarriers (PNCs) are important and versatile in biotechnology, especially in drug delivery. The short half-lives of many of these current treatments,
along with the non-specic distribution and cytotoxicity of previously reported
small-molecular drugs, have served as a main driving force in accelerating the
development of polymeric DDSs (Kamaly etal. 2016). To date, we have observed
the rst bench-to-bedside transformation of targeted and adaptable controlled
release polymeric NPs for small-molecular drugs, from initial proof-of-concept
invitro (Farokhzad etal. 2005) to successful invivo investigations (Gu etal. 2008),
laying the groundwork for humans being tested and ongoing clinical trials in phase
II for multiple cancer types (Hrkach et al. 2012). Because PNCs are typically
between 10nm to 200nm in size, their biodistribution throughout the human body
differs signicantly from that of tiny molecules. The drug’s distribution throughout
the human body will be determined by the PNCs, greatly increasing the therapeutic
impact. PNCs have an extremely large surface area to volume ratio, which favours
surface conjugation for functional moieties. In terms of stability, reducing carrier
size to the nanoscale can improve water penetration and consequently breakdown in
the circumstances of biodegradable carriers. NPs tend to stay in solution without
considerable sedimentation due to their low density and their unique combination of
the electrostatic and van der Waals forces on the surface that are relevant at this size
scale, prolonging their utility compared to bigger carriers (Kowalczuk etal. 2014).
These nanoscale carriers, which are primarily made of biocompatible and biodegradable polymers, provide several advantages that aid in therapeutic applications
and biomedical research (Table7.2).
Biocompatibility: PNCs are frequently made from materials that are well tolerated by the body, such as PLGA or PEG, minimising undesirable side effects.
Sustained Release: The controlled release characteristics of the PNCs allow for
the administration of therapeutic drugs to be prolonged and sustained. This characteristic is especially useful in persistent medical conditions during which continuous drug administration is benecial.
Payload Protection: PNCs can encapsulate a wide range of drugs, safeguarding
them from degradation, improving stability, and allowing for targeted distribution to
specic tissues or cells.

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Table 7.2 Types of polymeric nanocarriers
Type of PNC Description Example Reference
PLGA NPs Biodegradable polymer NPs
for controlled release of drug
Dendrimers Drug delivery using highly
branched macromolecules
Polymeric
micelles
Chitosan NPs Chitin-derived biocompatible
Polymeric
nanogels
Polymeric
nanocapsules
Polymeric
nanospheres
Polymeric
nanobers
Self-assembled structures for
the solubilisation of
hydrophobic therapeutic drugs
NPs
3-D networks enabling
stimuli-responsive drug
release
Hollow structures for drug
encapsulation
Spherical solid particles for
controlled release of drugs
Fibrous structures for
long-term delivery of drugs
PLGA NPs loaded with
doxorubicin
PAMAM dendrimers for the
purpose of gene delivery
Paclitaxel delivery using
Pluronic-based micelles
Chitosan NPs loaded with
insulin
pH-responsive nanogels for
doxorubicin and methotrexate
(anticancer) drug delivery
Polymeric nanocapsulesloaded with camptothecin
Polymeric nanospheresloaded with methotrexate
Silk broin electrospun
polymeric nanobers for
wound healing
Danhier etal.
(2012)
Kesharwani
etal. (2014)
Torchilin
(2007)
Wong etal.
(2020)
Salehi etal.
(2015)
Bzowska etal.
(2018)
Dhanaraj etal.
(2016)
Chouhan etal.
(2018)
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Tailored Release Proles: The structure and composition of PNCs can be nely
modied to achieve unique release proles, allowing for personalisation depending
on the therapeutic necessities of different drugs.
Reduced Side Effects: PNCs help to reduce side effects related to conventional
DDSs by minimising systemic exposure and offering tailored delivery.
Formulation Adaptability: PNCs can be developed into a variety of shapes and
sizes, such as NPs, microparticles, or hydrogels, providing adaptability for diverse
routes of administration and therapeutic applications.
Biodegradability: Many PNCs are biodegradable, facilitating for the slow disintegration of the carrier material over time, in accordance with environmentally and
patient-friendly principles (He etal. 2014).
Challenges andFuture Prospects
The problems in polymeric nanocarriers focus around gaining precise control
towards drug release kinetics and dealing with potential long-term toxicity issues,
emphasising the vital necessity for biocompatible materials. Incorporating stimuliresponsive components for on-demand drug release, designing multifunctional
nanocarriers for the theranostic applications, and enhancing personalised medicine
through customised nanocarrier formulations based on unique patient features are
the main prospects. Furthermore, improving targeted delivery systems, investigating new biocompatible materials, speeding clinical translation and scale-up operations, and investigating combination medicines are all important components of

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ongoing research. Addressing these issues and pursuing these future paths will be
critical to achieving the full potential of PNCs, revolutionising medication delivery,
and contributing to the advancement of personalised medicine. Interdisciplinary
collaborations and continual developments in nanotechnology, and biomedicine are
critical for determining the future landscape of PNC applications (Daglar etal. 2014).
S. Yadav et al.
7.6 Targeted Drug Delivery
7.6.1 Antibody-Drug Conjugates
Antibody-drug conjugates (ADCs) represent an important revolution in biotechnology’s approach to targeted drug delivery (TDD). These specialised molecules integrate the precision of monoclonal antibody (mAbs) with drug cytotoxicity, enabling
highly targeted therapeutic treatments (Beck etal. 2017). Here are some important
instances of ADCs and their biotechnological applications.
Ado-Trastuzumab Emtansine
Kadcyla, a commercialized version of ado-trastuzumab emtansine [2], is an exceptional illustration of targeted drug delivery (TDD) in the treatment of HER2-positive
metastatic breast tumors. The drug works by a precise process in which this trastuzumab antibody component binds precisely to HER2 receptors, which are found on
tumour cells. This selective binding causes the drug to be internalised by the cancer
cells, allowing its potent cytotoxic compound emtansine to be released. Kadcyla
specically delivers its lethal dose to HER2-positive tumour cells by utilising the
HER2 receptor pathway. This focused approach reduces damage caused to healthy
cells while increasing therapeutic impact. Kadcyla was approved for clinical use,
conrming its efcacy, and demonstrating the promise of TDD techniques in treating certain cancer subtypes like HER2-positive metastatic breast carcinoma
(Lambert and Chari 2014).
Brentuximab Vedotin
Brentuximab Vedotin, branded as Adcetris, is an effective lymphoma TDD approach.
This novel treatment aims to kill CD30-positive cells, which are frequent in anaplastic large cell lymphoma and Hodgkin’s lymphoma. The association of an anti CD30 antibody along with monomethyl auristatin-E (MMAE), a strong antimitotic
drug, is the mechanism of action. Brentuximab Vedotin increases drug internalisation by interacting with CD30 receptors on cancer cells, resulting in a release of the
cytotoxic MMAE payload. This targeted strategy assures that this potent cytotoxic

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drug reaches only CD30-positive cancer cells. Adcetris has been approved by the
FDA for the treatment of relapsing or refractory Hodgkin’s lymphoma and certain
kinds of non-Hodgkin’s lymphoma, demonstrating the effectiveness of TDD for the
treatment of lymphoma subtypes (Connors etal. 2018).
Trastuzumab Deruxtecan
Trastuzumab Deruxtecan, marketed as Enhertu, is a novel TDD approach for treatment in HER2-positive metastatic breast tumours. The drug is intended to specically target tumour cells that express HER2. The combined effect of the
HER2-targeting antibodies trastuzumab together with a topoisomerase-I inhibitor is
responsible for the mechanism of action. Trastuzumab Deruxtecan enhances drug
internalisation by connecting to HER2 receptors on cancer cells, resulting in the
delivery of a cytotoxic payload to the tumour cells. This focused approach reduces
damage done to healthy cells while increasing therapeutic impact. Enhertu has been
granted licences for clinical use, especially for the therapeutic treatment of HER2positive breast cancer with metastatic tumours, demonstrating the efcacy and precision of TDD techniques in treating specic disease subtypes (Shitara etal. 2020).
Polatuzumab Vedotin
119
Polivy, or polatuzumab vedotin, is an effective TDD approach for non-Hodgkin’s
lymphoma. This drug is especially developed for targeting CD79b-positive B cells,
which are characteristic of this kind of lymphoma. The combined effect of an antiCD79b antibody together with the microtubule-disrupting chemical vedotin is the
mechanism. Polatuzumab Vedotin effectively delivers the cytotoxic dose to tumour
cells expressing CD79b via this novel combination. This targeted approach reduces
collateral damage to normal cells, hence increasing therapeutic impact. Polivy has
received clinical approval for use, specically in combination therapies for certain
kinds of non-Hodgkin’s lymphoma. This achievement demonstrates the efcacy of
TDD systems in targeting certain cancer subtypes with more precision and enhanced
therapeutic effects (Palanca-Wessels etal. 2015).
7.6.2 Peptide-Based Targeting
Peptide-based targeting approaches in biotechnology employ the application of
peptides, short sequences of amino acids, to enable targeted and accurate drug
delivery. These tactics make use of the unique attributes of peptides, like their short
size, high degree of specicity, and capacity to be quickly manipulated (Chow etal.
2008). Here are some instances of how peptide-based strategies for targeting are
used in biotechnology.

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S. Yadav et al.
7.6.3 RGD Peptides
RGD peptides, particularly binding with integrins that are overexpressed on the outer
surfaces of tumour cells, constitute a TDD system in cancer therapies. The approach
involves RGD peptides specically attaching to integrins, a group of cell- adhering
receptors, allowing for TDD to cancer cells. Integrins have an important role in tumour
angiogenesis as well as metastasis, making them potential therapeutic targets. RGD
peptides are used in the enhancement of the specicity of antitumour drugs such as
paclitaxel. This tailored method attempts to reduce undesirable effects and improve
anticancer drug therapeutic efcacy. RGD peptide-based techniques demonstrate the
possibility of precision therapy in cancer treatment by utilising the specic properties of
tumour cell surfaces to obtain enhanced and targeted cancer treatment (Yin etal. 2017).
7.6.4 Cell-Penetrating Peptides
Cell-penetrating peptides (CPPs) are an important means of intracellular drug
administration because they target cell membranes. CPPs facilitate the internalisation of drugs into cells, boosting cellular absorption of different payloads such as
nucleic acids and smaller compounds. CPPs are important in gene delivery because
they help transport genetic material throughout cell membranes during gene therapy
applications. This adaptable strategy enables the efcient transport of therapeutic
payloads straight within the cytoplasm or nucleus of cells, eliminating obstacles that
may restrict the efcacy of traditional drug delivery systems. The widespread usage
of CPPs in gene delivery emphasises their importance in promoting focused and
precision therapeutic interventions for a variety of diseases, presenting them as
valuable tools in biotechnology and medicine (Lehto etal. 2012).
7.6.5 Tumour-Homing Peptides
Tumour-homing peptides (THP) are a promising method for TDD in cancer. These
peptides are intended to target specic components of the tumour microenvironment, such as tumour vasculature and extracellular matrix components. The peptides homing into these different traits facilitates TDD to the tumour region. This
targeted approach tries to improve drug delivery precision while minimising offtarget effects. THP are being studied for potential uses in tumour imaging and the
delivery of drugs to enhance therapeutic outcomes. These peptides provide a personalised and focused strategy to address the intricate nature of cancer by utilising
the properties of the tumour microenvironment, demonstrating their promise as signicant strategies in advancing cancer detection and treatment in the area of biotechnology (Kondo etal. 2021).

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7.6.6 Antimicrobial Peptides
Antimicrobial peptides (AMPs) are a powerful technique for developing innovative
antibiotics to combat drug-resistant microbial infections. These peptides work specically on microbial membranes. The method involves AMPs breaking the membranes of fungi and bacteria to demonstrate broad-spectrum antibacterial action.
This disruptive activity not just provides a diverse approach that is effective towards
a wide spectrum of infections, but it also possesses potential to ght against drugresistant bacteria. The use of AMPs in biotechnology is being intensively researched
as a valuable route for facilitating the development of novel antibiotics. AMPs’
distinct mode of action presents them as possible alternatives for tackling the global
issue of antibiotic resistance, highlighting their importance in infectious disease
therapies (Luo etal. 2018).
7.6.7 Somatostatin Analogues
Somatostatin analogues are emerging to be a targeted therapeutic approach to neuroendocrine tumour treatment. Certain analogues are intended to target overexpressed somatostatin receptors in certain tumours. Somatostatin peptide analogues
specically attach to receptors on tumour cells, depending on the mechanism. This
binding limits hormone secretion and triggers apoptosis, which helps to regulate
symptoms and slow tumour growth. Somatostatin analogues are used to treat neuroendocrine tumours, providing a targeted strategy for managing both physiological
signs and symptoms linked to hormone secretion and tumour growth. This comprehensive and targeted technique emphasises the great potential of somatostatin analogues in offering effective and personalised treatment interventions for
neuroendocrine tumours in biotechnology and medicine (Wolin 2012).
7.6.8 Biologics andGene Therapies
Biologics and gene treatments play critical roles in biotechnology, transforming
disease treatment and personalised medicine. Biologics, which include MAbs and
cytokines, use living organisms to provide targeted therapy in a variety of medical
sectors. Advances in biotechnology in delivery systems, such as antibody-drug conjugates, improve the accuracy of biologic treatments. Gene treatments, on the other
hand, include the introduction or alteration of genetic material to treat diseases at
their origin. Technologies such as CRISPR facilitate precise gene editing, perhaps
leading to the treatment of hereditary illnesses. The combination of biologics and
gene treatments with nanotechnology allows for targeted delivery, which improves
bioavailability and therapeutic effectiveness (Crommelin etal. 2020).

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S. Yadav et al.
7.6.9 Monoclonal Antibodies
In targeted therapy, MAbs are frequently utilised, and attempts are ongoing to
enhance their delivery systems. mAbs are a biotechnology cornerstone, providing
precise and focused therapy by utilising antibody specicity. These antibodies,
which have been engineered to preferentially attach to proteins on cell surfaces,
inuence immune responses or simply directly disrupt biological activities. They
are widely used in biotechnology throughout therapeutic elds, most notably oncology, infectious diseases, and autoimmune disorders. It involves the development of
ADCs, which allow therapeutic payloads to be delivered directly to the site of
action, as well as antibody engineering for enhanced tissue penetration. These
developments indicate the critical role of MAbs in biotechnology, paving the way
for more effective and customised treatment techniques (Reichert 2008). Here are a
few examples of commonly used MAbs (Table7.3).
Table 7.3 Some examples of monoclonal antibodies and their applications
Monoclonal
antibody Target Mechanism Application Reference
Ado-trastuzumab
emtansine
Rituximab CD20 protein
Bevacizumab Vascular
Nivolumab Programmed cell
Trastuzumab HER2/neu
Iniximab Tumour necrosis
Pembrolizumab PD-1 Inhibits the PD-1 pathway,
Adalimumab TNF-α TNF-α inhibition reduces
HER2/neu
receptor
present on B
cells
endothelial
growth factor
(VEGF)
death-protein 1
(PD-1)
receptor
factor alpha
(TNF-α)
Directly delivers a cytotoxic
chemical to HER2-positive
cancer cells
Causes B cells to undergo
apoptosis; useful in treating
autoimmune diseases and
B-cell lymphomas
Angiogenesis is inhibited,
causing tumour blood supply
to be disrupted
Like pembrolizumab, it
increases the immune
response towards cancer
cells
Inhibits the proliferation of
cancer cells that express the
HER2 protein
TNF-α is neutralised, which
reduces inammation and
immune reactions
allowing the immune system
to attack cancer cells more
effectively
inammation and tissue
damage
Breast cancer Corrigan
etal.
(2014)
Oncology Zhou etal.
(2008)
Cancer
therapy
Oncology Brahmer
Breast cancer Sun etal.
Autoimmune Billmeier
Oncology Billmeier
Autoimmune Cessak
Giantonio
(2009)
etal.
(2015)
(2013)
etal.
(2016)
etal.
(2016)
etal.
(2014)

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7.7 Gene Editing Tools
Gene editing techniques are game changers in biotechnology, providing unprecedented precision in modifying genetic material. Clustered Regularly Interspaced
Short Palindromic Repeats (CRISPR) has emerged as a transformational force
among these. CRISPR technology enables researchers to precisely alter DNA
sequences, allowing for targeted gene changes. CRISPR has a wide range of uses in
biotechnology, from generating genetically engineered creatures for research to
potentially treating hereditary problems in humans. CRISPR’s simplicity and versatility have accelerated advancements in functional genomics, discovering new
drugs, and the generation of genetically engineered crops. The capacity to modify
genes with remarkable precision expands our understanding of biological processes
and offers tremendous scope for treating previously incurable hereditary disorders.
As gene editing technologies advance, their incorporation into biotechnological
applications reshapes the scientic landscape.
7.7.1 CRISPR-Cas9
CRISPR and CRISPR-associated Protein 9 (Cas9) is an innovative gene editing
technique that allows for the exact altering of DNA sequences. This game-changing
technology has transformational applications in a wide range of elds. CRISPRCas9 provides therapeutic promise for addressing genetic diseases by targeted
genome editing. In research, it plays a crucial role in functional genomics, uncovering gene functions. Agriculture benets as well, because CRISPR-Cas9 allows to
produce genetically modied organisms (GMOs) with improved features.
Furthermore, the tool advances the development and discovery of drugs by allowing
researchers to comprehend more about gene functions and speed pharmaceutical
research. CRISPR-Cas9 is a precision lighthouse in the wide terrain of genetic alteration, establishing the future of biotechnology.
7.7.2 CRISPR-Cas12 andCRISPR-Cas13
CRISPR-Cas12 and CRISPR-Cas13 are evolutionary versions of the CRISPR system that offer characteristics beyond the well-known Cas9. CRISPR-Cas12 is
skilled in cleavage of DNA and editing, offering a unique toolkit for precise genomic
alterations. CRISPR-Cas13, on the other hand, specialises in RNA targeting, allowing for the editing and control of RNA molecules. These variants improve the platform’s adaptability by providing researchers with personalised solutions that
address DNA and RNA alterations. CRISPR-Cas12 and CRISPR-Cas13, with
applications spanning from genome engineering to RNA-level interventions,

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contribute greatly to the developing toolkit of molecular biology, signicantly
advancing our ability to accurately alter genetic material at various levels.
S. Yadav et al.
7.7.3 Prime Editing
Prime Editing, a recent achievement, is a versatile and extremely precise gene editing technology that inserts new genetic material directly into a specic DNA target.
This approach stands out for its ability to reduce off-target effects, which represents
a substantial improvement in genome editing. Prime Editing shows potential for
precise genome alterations to address genetic problems with increased accuracy.
The potential of technology to precisely modify individual DNA sequences brings
up new possibilities for modifying genetic information with unparalleled control,
demonstrating its potential to reshape the landscape of genetic modication for
therapeutic and scientic purposes (van der Oost and Patinios 2023).
7.7.4 TALENs
Transcription Activator-Like Effector Nucleases (TALENs) are synthetic proteins
that are designed to attach to specic DNA regions, allowing for targeted and precise gene editing. This approach has applications in a variety of elds, especially
therapeutic genome editing, that has the potential to address genetic problems by
customised alterations. TALENs serve a critical role in functional genomics
research, unravelling the complexities of gene functions with high sensitivity.
Furthermore, TALENs assist in the production of genetically edited cell lines, providing researchers with a vital tool for developing personalised cellular models.
TALENs, in essence, emerge as adaptable tools for the strategic alteration of genetic
material, allowing for advances concerning both research and clinical use.
7.7.5 ZFNs
Zinc Finger Nucleases (ZFNs) are designed proteins that have been precisely developed to bind to specic DNA sequences with accuracy and are paired with a nuclease allowing targeted DNA cleavage. This advanced technology has numerous uses,
especially for therapeutic genome editing, thereby offering a possible pathway for
precision therapies in hereditary diseases. ZFNs are also important in the production of genetically engineered organisms, allowing for specic genetic upgrades in
agriculture and other industries. Furthermore, ZFNs greatly contribute to genomic
research and engineering endeavours, allowing researchers to examine and change
the complexities of the genetic code using a high degree of specicity. Essentially,

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ZFNs emerge as potent instruments for the purposeful and precise alteration of
genetic material in a variety of applications (Adli 2018).
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7.8 Implantable Devices
7.8.1 Drug-Eluting Stents
Drug-eluting stents are novel medical devices that treat coronary artery disease.
These stents, which are commonly comprised of metal mesh, not only give mechanical support to coronary arteries but also gradually deliver medicinal drugs. The
drugs, which are frequently anti-proliferative or anti-inammatory in nature, help to
avoid restenosis by limiting excess tissue growth at the stent site. This dual functioning improves the intervention’s efcacy by promoting rapid healing and minimising the possibility of problems. Drug-eluting stents became an interventional
cardiology standard, considerably improving outcomes in individuals with coronary
artery disease.
7.8.2 Implantable Pumps forChronic Conditions
Implantable pumps are innovative medical devices that provide drugs in a continuous and controlled manner, particularly for chronic illnesses. These medical devices
are placed by surgery just below the layer of skin and are linked to specic locations
inside the body wherever drug is needed. They provide a focused and programmed
strategy for drug delivery, assuring consistent and accurate dosing throughout time.
Implantable pumps are employed to treat diseases such as chronic pain, spasms, and
some neurological abnormalities. Their capacity to give long-term therapeutic
effects while minimising adverse effects makes them useful in enhancing the quality of life of those living with chronic illnesses (Alcaraz etal. 2018).
7.9 Innovations inSmart DDSs
7.9.1 Use ofResponsive NPs
The use of responsive NPs is a game changer in drug delivery. These materials,
which are frequently triggered by environmental circumstances or stimuli, allow for
exact control of drug release. Nanocarriers that are pH-responsive, sensitive to temperature, or enzyme-triggered provide targeted drug delivery to specied areas,
improving therapeutic efcacy while minimising negative effects.
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