Application of Liposomes in Treatment of Rheumatoid Arthritis: Quo Vadis

Abstract

The most common treatments for rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease modifying antirheumatic drugs (DMARDs), and some biological agents. However, none of the treatments available is able to achieve the ultimate goal of treatment, that is, drug-free remission. This limitation has shifted the focus of treatment to delivery strategies with an ability to deliver the drugs into the synovial cavity in the proper dosage while mitigating side effects to other tissues. A number of approaches like microemulsions, microspheres, liposomes, microballoons, cocrystals, nanoemulsions, dendrimers, microsponges, and so forth, have been used for intrasynovial delivery of these drugs. Amongst these, liposomes have proven to be very effective for retaining the drug in the synovial cavity by virtue of their size and chemical composition. The fast clearance of intra-synovially administered drugs can be overcome by use of liposomes leading to increased uptake of drugs by the target synovial cells, which in turn reduces the exposure of nontarget sites and eliminates most of the undesirable effects associated with therapy. This review focuses on the use of liposomes in treatment of rheumatoid arthritis and summarizes data relating to the liposome formulations of various drugs. It also discusses emerging trends of this promising technology.

Liposome-Based Immunotherapy Against Autoimmune Diseases: Therapeutic Effect on Multiple Sclerosis

“…Liposomes provide an effective tolerogenic-signal induction with additional advantages. They are biocompatible, completely biodegradable, nontoxic, nonimmunogenic, suitable for encapsulation of peptides with varying solubility and low cost [31]. Moreover, they protect the encapsulated drug from the external environment and exhibit flexibility to be coupled with site-specific ligands (e.g., PS and its receptor in DCs).…”

Prolongation of Anti-Inflammatory Activity of Glucocorticosteroids Encapsulated in Large Oligolamellar Liposomes in Treatment of Arthritis in Rabbits

“…These include microemulsions, microspheres, liposomes and others, of which liposomes have been shown to retain the drug in the synovial cavity effectively due to their chemical composition and size. (2,3) In our previous work we have demonstrated prolongation of the anti-inflammatory effect produced by HA encapsulated into the membrane of multilamellar TSL composed of DPPC and cholesterol in rabbits with aseptic arthritis. (4) However, this prolongation was limited to only about 5 days compared to 1 day in the case of intra-articular administration of free hydrocortisone acetate or 2 days for its liposomal form composed of egg lecithin and cholesterol.…”

Lipid bilayer nanoparticle-based drug delivery systems in the treatment of rheumatoid arthritis: a glance at liposomes and exosomes

“…cytokine targeting biological agents) [3]. High systemic drug doses are usually required for RA treatment due to their relatively low bioavailability and/or poor selectivity, which entail side effects and toxicity, especially at repeated administrations that are required for the chronic disease [2,4]. Thus, to improve the therapy outcome of RA, appropriate drug delivery systems capable of enhancing treatment efficacy, reducing off-target toxicity and providing sustained release are on demand, for instance, nanodelivery systems.…”

“…Lipid bilayer nanoparticles as zero-dimensional materials are widely explored as delivery systems for therapeutics, due to their membrane-like structure, low toxicity, passive targeting, good biocompatibility and sustained release to name a few [8]. In particular, liposomes and exosomes representing artificial and natural lipid bilayer nanoparticle-based drug delivery systems, respectively, have sparked great interest in their applications for the treatment of RA, especially when considering the characteristics of RA and the shortcomings of conventional drug administration techniques [4].…”

“…All these characteristics have resulted in a substantial body of data on liposomes as superior drug delivery systems for RA management. Accordingly, liposomes are credited for enhancing therapeutic efficacy, reducing systemic toxicity and prolonging release time [4,12,17]. However, it is worth noting that the current marketed liposomal drug formulations mainly concentrate on cancer therapy, and liposomal preparations still face the problems like drug leakage [9,10].…”