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非酒精性脂肪性肝病的联合疗法和递送策略

Combination therapy and drug delivery strategies for treatment of non-alcoholic fatty liver disease

  • 摘要: 非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是与代谢功能障碍密切相关的一系列慢性肝病,其发病机制复杂,至今仅有一款PPAR-α/γ双重激动剂Saroglitazar上市,用于治疗非肝硬化非酒精性脂肪性肝炎。针对NAFLD发病机制中的相同或不同靶点和信号通路开发的联合治疗策略能有望实现药物与药物间的协同作用,小分子药物联用、RNAi联合疗法和化学基因疗法是目前极富前景的联合治疗策略。此外,设计安全、有效和特异性的药物递送系统能改善小分子药物与基因药物的成药性,并促进其临床转化和产业化。因此,本文介绍了小分子药物联用、基于RNAi的核酸药物联用和小分子与核酸药物联用的最新研发现状及其递送方式,以期为NAFLD的治疗提供新的思路与方法。

     

    Abstract: Non-alcoholic fatty liver disease (NAFLD) is a series of chronic liver diseases strongly associated with the metabolic disorder with an increasing rate of worldwide prevalence.Due to its complicated pathogenesis, only Saroglitazar has been approved by Indian Drug Controller General (DCGI) as a PPAR-α/γ dual agonist to treat non-cirrhotic non-alcoholic steatohepatitis.Combination therapy, which can target same or different signaling pathways of NAFLD pathogenesis, has been developed to achieve synergistic therapeutic efficacy.Currently, small-molecule drug combination, RNAi combination therapy, and chemogene therapy are proposed as promising strategies in NAFLD treatment.In addition, designing a smart, safe and effective drug delivery system is key to realizing the druggability, clinical translation and industrialization of small molecule drugs and gene drugs.This review summarizes the research status and delivery system of small-molecule drug combination, RNAi combination therapy, and chemogene therapy, in the hope of providing some novel insight for the treatment of NAFLD.

     

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