由于关节炎部位的淋巴管生成和淋巴液流动增加,发炎关节中纳米药物的清除已加速。为了最大限度地提高类风湿关节炎(RA)的治疗效果,有必要同时促进炎症滑膜中的靶向递送和延长药物保留。总的来说,纳米颗粒更有可能实现延长循环和靶向递送。而具有较大尺寸的药物载体可能更有利于延长药物保留。为了平衡冲突的需求,一种炎症反应型可变形的纳米颗粒,由淀粉样蛋白β衍生的KLVFF肽和聚唾液酸(PSA)组成,通过酸敏感接头与治疗剂地塞米松(Dex)偶联,被制造并称为Dex-KLVFF-PSA(DKPNP)。在生理条件下,DKPNP能保持稳定的纳米级形貌,PSA壳可以赋予DKPNP长循环和主动靶向关节炎部位。在发炎的关节中,酸性pH触发的Dex解离或巨噬细胞诱导的与PSA的特异性结合将诱导DKPNP从纳米颗粒到纳米纤维的重新组装。我们的结果表明,静脉注射DKPNP显示延长的体内循环和在发炎的关节中的优先分布,其中DKPNP经历形状转变为纤维结构,导致淋巴清除下降和疗效延长。总的来说,我们的双刺激反应可转化纳米颗粒提供了一种智能解决方案,可提高RA的治疗效果.
The clearance of nanomedicine in inflamed joints has been accelerated due to the increased lymph angiogenesis and lymph flow in arthritic sites. To maximize the therapeutic efficacy for rheumatoid arthritis (RA), it is necessary to facilitate targeted delivery and extended drug retention in inflamed synovium simultaneously. In general, nanosized particles are more likely to achieve prolonged circulation and targeted delivery. While drug carriers with larger dimension might be more beneficial for extending drug retention. To balance the conflicting requirements, an inflammation-responsive shape transformable nanoparticle, comprised of amyloid β-derived KLVFF peptide and polysialic acid (PSA), coupled with therapeutic agent dexamethasone (Dex) via an acid-sensitive linker, was fabricated and termed as Dex-KLVFF-PSA (DKPNPs). Under physiological condition, DKPNPs can keep stable nanosized morphology, and PSA shell could endow DKPNPs with long circulation and active targeting to arthritic sites. While in inflamed joints, acidic pH-triggered Dex dissociation or macrophages-induced specific binding with PSA would induce the re-assembly of DKPNPs from nanoparticles to nanofibers. Our results reveal that intravenously injected DKPNPs display prolonged in vivo circulation and preferential distribution in inflamed joints, where DKPNPs undergo shape transition to fibrous structures, leading to declined lymphatic clearance and prolonged efficacy. Overall, our dual-stimulus responsive transformable nanoparticle offers an intelligent solution to achieve enhanced therapeutic efficacy in RA.