Recent advances in novel functionalized oral administration therapy for inflammatory bowel diseases
<p indent="0mm">Inflammatory bowel disease (IBD) is a non-specific, chronic and easily relapsing inflammatory bowel disease, consisting of Crohn’s disease and ulcerative colitis. IBD is not limited to intestinal lesions, but also involves organs and tissues throughout the body. In recent years, the global incidence of IBD has been rising rapidly and become a common and frequently-occurring disease in China. The pathogenesis of IBD may be related to interactions between immunity, genetics, environment and microorganisms. Since oral administration has good compliance with patients, high safety, convenience, ease of operation, and can directly act on intestinal mucosa, it is suitable for the long-term administration of chronic intestinal diseases, and is the most ideal administration route for IBD therapy. However, due to the poor water solubility and stability of oral drugs, the gastrointestinal physiological environment, systemic toxicity and side effects and single therapeutic function, the bioavailability is low and the therapeutic efficacy is poor. Therefore, it is urgent to develop novel functionalized oral administration therapy methods for IBD, improve the solubility and bioavailability of drugs, and realize colon targeting and multifunctional diagnosis and treatment, so as to provide new ideas and approaches for the precision treatment of IBD. Polymer drug delivery systems can effectively improve the solubility and stability of drugs and significantly improve the efficacy of drugs. Excessive reactive oxygen species (ROS) can cause intestinal mucosal layer damage, stimulate immune response, and accelerate the occurrence and development of IBD. Nanoparticles with colonic and inflammatory targeted ROS clearance can effectively alleviate IBD symptoms while reducing systemic side effects of the drug. In addition, nano-enzymes play unique biological functions while have a variety of enzyme activities, such as cascade reaction, antioxidant, fluorescence imaging, and photothermal effect, becoming an important means of adjuvant therapy for IBD. By imitating the special structure and function of organisms through biomimetic methods such as morphological bionics, living-organism biomimetics, microecological bionics and biomimetic mineralization, a range of bionic drug delivery systems with strong gastrointestinal adhesion, efficient intestinal targeted delivery, collaborative therapy and resistance to harsh gastrointestinal environments have been developed for functional treatment of IBD. The use of synthetic biology to design engineered probiotics with specific gene products to reduce oxidative stress, repair the intestinal barrier, and regulate the immune response while regulating the intestinal flora. Currently, patients with IBD are usually diagnosed via endoscopy, an invasive test that is extremely painful for patients and difficult to achieve early diagnosis. Non-invasive biomarker detection provides an important basis for early diagnosis and subsequent stratified treatment of IBD. Nanodiagnostic probes integrate diagnostic and therapeutic functions, realizing multi-functional diagnosis of enteritis, targeted therapy and efficacy evaluation. The use of synthetic biology to construct intelligent engineered bacteria for the integration of diagnosis, recording and treatment is a promising approach. In this paper, we first review polymer drug delivery systems, which can improve drug solubility and achieve targeted therapy for colon and inflammation. We then introduced nanozyme preparations for the treatment of IBD through antioxidant cascades, CT imaging, photothermal effects, and colon targeting. Thirdly, the design of new biomimetic delivery systems based on biomimetic materials such as morphological biomimetic, living-organism, microecological biomimetic and biomimetic mineralization is reviewed to achieve functional treatment of IBD. In addition, the construction of genetically engineered probiotics not only regulates the intestinal flora, but also eliminates ROS, repairs the intestinal barrier and regulates the immune response. Furthermore, the application of biomarker detection, nanodiagnostic probes and intelligent engineered bacteria in the integration of diagnosis and treatment of IBD is introduced, which is expected to realize the multifunctional integration of detection, personalized treatment and remote guidance. Although these new functionalized treatment strategies offer new directions and new possibilities for the precision treatment of IBD, several challenges remain. Firstly, there is a need to evaluate the safety and efficacy of treatment strategies. Secondly, there is a lack of development and research on delivery systems based on drugs that promote mucosal repair. Thirdly, the pathogenesis of IBD needs to be further elucidated. Fourthly, multiple approaches should be used to increase the screening of novel biomarkers in the early diagnosis and treatment of IBD, so as to guide the development of new drugs for IBD and achieve precise treatment.
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