Abstract
Development of nanoparticle-based drug delivery systems has been attempted for the treatment of cancer over the past decade. The enhanced permeability and retention (EPR) effect is the major mechanism to passively deliver nanodrugs to tumor tissue. However, a recent systematic review demonstrated limited success of these studies, with the clearance of nanoparticles by the mononuclear phagocytic system (MPS) being a major hurdle. Herein, we propose that nanotechnologists should reconsider their research focuses, aiming for therapeutic targets other than cancer. Treatments for diseases that do not (or less) rely on EPR should be considered, such as active targeting or MPS evasion systems. For example, systemic delivery of drugs through intravenous injection can be used to treat sepsis, multi-organ failure, metabolic disorders, blood diseases, immune and autoimmune diseases, etc. Local delivery of nanodrugs to organs such as the lung, rectum, or bladder may enhance the local drug concentration with less clearance via MPS. In transplant settings, ex vivo organ perfusion provides a new route to repair injury of isolated organs in the absence of MPS. Based on a similar concept, chemotherapy with in vivo lung perfusion techniques and other isolated organ perfusion provides opportunities for cancer therapy.
Highlights
Over the past decade, the explosion of nanoparticle-related drug delivery research has outpaced that of gene therapy and human embryonic stem cell-based therapy research
As with gene therapy and embryonic stem cell research, the main focus of nanoparticle research is a cure for cancer and optimism for other diseases
The enhanced permeability and retention (EPR) effect is considered the major mechanism for nanoparticle-related therapy in cancer [1]
Summary
The explosion of nanoparticle-related drug delivery research has outpaced that of gene therapy and human embryonic stem cell-based therapy research. The enhanced permeability and retention (EPR) effect is considered the major mechanism for nanoparticle-related therapy in cancer [1]. In addition to long-term plans aimed at systematically exploring the mechanisms and methodologies that may improve foundational nanotechnology understanding, for example, active targeting strategies with peptides, antibodies, or other types of ligands that target to certain types of cancer cells, new avenues to translate potential nanoparticle-related therapies to clinical practice are required.
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