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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 etal. 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-specic distribution and cytotoxicity of previously reported small-molecular drugs, have served as a main driving force in accelerating the development of polymeric DDSs (Kamaly etal. 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 invitro (Farokhzad etal. 2005) to successful invivo investigations (Gu etal. 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 10nm to 200nm in size, their biodistribution throughout the human body differs signicantly 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 etal. 2014). These nanoscale carriers, which are primarily made of biocompatible and biode­gradable polymers, provide several advantages that aid in therapeutic applications and biomedical research (Table7.2).
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 benecial.
Payload Protection: PNCs can encapsulate a wide range of drugs, safeguarding them from degradation, improving stability, and allowing for targeted distribution to specic 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 nanobers
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 nanobers for wound healing
Danhier etal. (2012)
Kesharwani etal. (2014)
Torchilin (2007)
Wong etal. (2020)
Salehi etal. (2015)
Bzowska etal. (2018)
Dhanaraj etal. (2016)
Chouhan etal. (2018)
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Tailored Release Proles: The structure and composition of PNCs can be nely modied to achieve unique release proles, 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 etal. 2014).
Challenges andFuture 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 etal. 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 etal. 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 specically 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, conrming its efcacy, 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 etal. 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 speci­cally 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 efcacy and pre­cision of TDD techniques in treating specic disease subtypes (Shitara etal. 2020).
Polatuzumab Vedotin
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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, specically in combination therapies for certain kinds of non-Hodgkin’s lymphoma. This achievement demonstrates the efcacy of TDD systems in targeting certain cancer subtypes with more precision and enhanced therapeutic effects (Palanca-Wessels etal. 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 specicity, and capacity to be quickly manipulated (Chow etal.
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 specically 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 specicity of antitumour drugs such as paclitaxel. This tailored method attempts to reduce undesirable effects and improve anticancer drug therapeutic efcacy. RGD peptide-based techniques demonstrate the possibility of precision therapy in cancer treatment by utilising the specic properties of tumour cell surfaces to obtain enhanced and targeted cancer treatment (Yin etal. 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 efcient transport of therapeutic payloads straight within the cytoplasm or nucleus of cells, eliminating obstacles that may restrict the efcacy 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 etal. 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 specic 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 sig­nicant strategies in advancing cancer detection and treatment in the area of bio­technology (Kondo etal. 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 spe­cically 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 etal. 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 specically 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 andGene 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 etal. 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 specicity. These antibodies, which have been engineered to preferentially attach to proteins on cell surfaces, inuence 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 (Table7.3).
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
Iniximab 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 inammation and immune reactions
allowing the immune system to attack cancer cells more effectively
inammation and tissue damage
Breast cancer Corrigan
etal. (2014)
Oncology Zhou etal.
(2008)
Cancer therapy
Oncology Brahmer
Breast cancer Sun etal.
Autoimmune Billmeier
Oncology Billmeier
Autoimmune Cessak
Giantonio (2009)
etal. (2015)
(2013)
etal. (2016)
etal. (2016)
etal. (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 scientic 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 benets as well, because CRISPR-Cas9 allows to produce genetically modied 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 andCRISPR-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, signicantly 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 specic 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 modication for therapeutic and scientic 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 specic 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 specic 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 specic 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 specicity. 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-inammatory in nature, help to avoid restenosis by limiting excess tissue growth at the stent site. This dual func­tioning improves the intervention’s efcacy 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 forChronic 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 specic 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 etal. 2018).
7.9 Innovations inSmart DDSs
7.9.1 Use ofResponsive 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 specied areas, improving therapeutic efcacy while minimising negative effects.