3. Nanomedicine in the treatment of cardiovascular disease
3.1 Intervention in cardiovascular disease with liposome
Delivery of therapeutics to targeted tissues is possible through the design and construction of nanoscale particles while reduced toxicity as well as higher efficiency is obtainable [67,68]. Liposomes have huge skillfulness with regard to physicochemical characteristics, permitting acclimatization of the tiny particle to dovetail to the exact biological application [69]. Building blocks of the bilayer structure, of liposome, are composed of natural lipids or/and synthetic polymers and cholesterol [70]. Liposomes circulatory half life has been extended through the emergence of polyethylene glycol (PEG) which assist in the evasion …show more content…
In an attempt to treat chronic myocardial ischemia, during angioplasty and stenting, Hedman et al [72] delivered vascular endothe¬lial growth factor encoding plasmid through liposomes, with the aim to prevent in-stent restenosis and postangioplasty but the treatment doomed to change the incidence of restenosis, while it was demonstrated that gene transfer using liposomes was a viable and well tolerated approach. In a different clinical trial paclitaxel nanoparticles fixed to albumin was used to prevent in-stent restenosis. Reports claimed that without major complication the treatment was well tolerated at 10 or 30 mg/m2 [73,74]. Zhang et al [75] described acquirement of the surface modified liposome with peptide which has an arginine-rich sequence (CRPPR) to coronary endothelia in myocardial infarction and ischemia models. In comparison to nontargeted liposomes, the CRPPR-conjugated nanostructure attains a 47-fold increase in accruement in the surrounding vasculature of injured tissue. It is worth mentioning that healthy tissue vasculature has accruement to a lesser extent. Modified liposomes can be used to minimize …show more content…
Narrowing of the blood vessel is termed as stenosis which hamper normal blood flow. In-stent restenosis is a decline in lumen diameter after stenting as a result of arterial damage. The mainstream challenges in using stents in an initiative to revascularize the narrowed arteries are, in-stent restenosis as the result of intimal hyperplasia [89] and activated platelets mediated thrombosis in the later stage [90]. Establishment of the stent as the drug delivery platform is the following degree of device sophistication. Johnson & Johnson, Guidant, Boston Scientific as well as Medtronic are the industry giants that started the production of drug eluting stents (DES) that released drugs such as sirolimus as well as paclitaxel to exploit their anti-proliferative benefits. DES have manifested lower occurings of restenosis six months post procedure in comparison to their bare metal counterparts, but recent longer term researches have raised major concern over the long term benefit of DES [91– 94]. The incorporation of stent within the vessel wall have resulted from the anti-proliferative feature of the eluted drugs that suppress the cell cycle hence inhibiting the remodeling of the normal vessel. The exposed structure of the stent as the result of incomplete neointimal coverage facilitates thrombus formation which leads to increased mortality
3.1 Intervention in cardiovascular disease with liposome
Delivery of therapeutics to targeted tissues is possible through the design and construction of nanoscale particles while reduced toxicity as well as higher efficiency is obtainable [67,68]. Liposomes have huge skillfulness with regard to physicochemical characteristics, permitting acclimatization of the tiny particle to dovetail to the exact biological application [69]. Building blocks of the bilayer structure, of liposome, are composed of natural lipids or/and synthetic polymers and cholesterol [70]. Liposomes circulatory half life has been extended through the emergence of polyethylene glycol (PEG) which assist in the evasion …show more content…
In an attempt to treat chronic myocardial ischemia, during angioplasty and stenting, Hedman et al [72] delivered vascular endothe¬lial growth factor encoding plasmid through liposomes, with the aim to prevent in-stent restenosis and postangioplasty but the treatment doomed to change the incidence of restenosis, while it was demonstrated that gene transfer using liposomes was a viable and well tolerated approach. In a different clinical trial paclitaxel nanoparticles fixed to albumin was used to prevent in-stent restenosis. Reports claimed that without major complication the treatment was well tolerated at 10 or 30 mg/m2 [73,74]. Zhang et al [75] described acquirement of the surface modified liposome with peptide which has an arginine-rich sequence (CRPPR) to coronary endothelia in myocardial infarction and ischemia models. In comparison to nontargeted liposomes, the CRPPR-conjugated nanostructure attains a 47-fold increase in accruement in the surrounding vasculature of injured tissue. It is worth mentioning that healthy tissue vasculature has accruement to a lesser extent. Modified liposomes can be used to minimize …show more content…
Narrowing of the blood vessel is termed as stenosis which hamper normal blood flow. In-stent restenosis is a decline in lumen diameter after stenting as a result of arterial damage. The mainstream challenges in using stents in an initiative to revascularize the narrowed arteries are, in-stent restenosis as the result of intimal hyperplasia [89] and activated platelets mediated thrombosis in the later stage [90]. Establishment of the stent as the drug delivery platform is the following degree of device sophistication. Johnson & Johnson, Guidant, Boston Scientific as well as Medtronic are the industry giants that started the production of drug eluting stents (DES) that released drugs such as sirolimus as well as paclitaxel to exploit their anti-proliferative benefits. DES have manifested lower occurings of restenosis six months post procedure in comparison to their bare metal counterparts, but recent longer term researches have raised major concern over the long term benefit of DES [91– 94]. The incorporation of stent within the vessel wall have resulted from the anti-proliferative feature of the eluted drugs that suppress the cell cycle hence inhibiting the remodeling of the normal vessel. The exposed structure of the stent as the result of incomplete neointimal coverage facilitates thrombus formation which leads to increased mortality