Drug-Delivery-Strategien zur gezielten Behandlung von chronisch-entzündlichen Darmerkrankungen

Zusammenfassung

Chronisch-entzündliche Darmerkrankungen (CED) sind häufig auftretende Erkrankungen bei jungen Erwachsenen, die mit rezidivierender oder chronisch-entzündlicher Krankheitsaktivität einhergehen. Die Therapie ist bislang geprägt durch die Gabe von antiinflammatorischen oder immunsuppressiven Wirkstoffen, die die intestinale Entzündung begrenzen und entsprechend Krankheitssymptome lindern. Derzeitige CED-Behandlungsstrategien zeichnen sich aber durch eine begrenzte therapeutische Effizienz und dem potenziellen Auftreten schwerer unerwünschter Nebenwirkungen aus. Dieser Übersichtsartikel fasst sog. „Drug-Delivery-Strategien“ zur Behandlung von CED zusammen. Dazu werden etablierte „Intestine-Targeting-Strategien“ vorgestellt, die gezielt Wirkstoffe in den entsprechenden Darmabschnitt an den Ort der Entzündung liefern, wie z. B. Prodrugs und Formulierungen mit pH-/zeitkontrollierter Wirkstofffreisetzung. Zusätzlich werden auch zukunftsorientierte „Disease-Targeting-Strategien“ diskutiert, die selektiv Wirkstoffe im Bereich der intestinalen Entzündung freisetzen, wie z. B. mikro-/nanoskalige synthetische und biologische Wirkstoffträger. Dadurch kann die therapeutische Effizienz in der Behandlung von CED erhöht und das Risiko von unerwünschter Arzneimittelnebenwirkung minimiert werden.

Abstract

Inflammatory bowel disease (IBD) is a frequently occurring disease in young people, which is characterized by chronic inflammation of the gastrointestinal tract. The therapy of IBD is dominated by the administration of anti-inflammatory and immunosuppressive agents, which suppress the intestinal inflammatory burden and improve the disease-related symptoms. Present treatment strategies are characterized by a limited therapeutical efficacy and the occurrence of adverse drug reactions. The development of novel disease-targeted drug delivery strategies is preferable for a more effective therapy and thus demonstrates the potential to address unmet medical needs. This review gives an overview about drug delivery strategies for the treatment of IBD. Therefore, established intestine-targeting strategies for a selective drug release into the diseased part of the gastrointestinal tract will be presented, including prodrugs, and dosage forms with pH-/time-dependent drug release. Furthermore future-oriented disease-targeting strategies for a selective drug release into the intestinal inflammation will be described, including micro-/nanosized synthetic and biologic drug carriers. This novel therapeutic approach may enable a more effective anti-inflammatory treatment of IBD with reduced risks of adverse reactions.

Schlüsselwörter

chronisch-entzündliche Darmerkrankung - Morbus Crohn - Colitis ulcerosa

Key words

chronic inflammatory bowel disease - Crohn's disease - ulcerative colitis

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