Recent approaches for targeted drug delivery in rheumatoid arthritis diagnosis and treatment

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease with complex pathology characterized by inflammation of joints, devastation of the synovium, pannus formation, bones and cartilage destruction and often is associated with persistent arthritic pain, swelling, stiffness and work disability. In conventional RA therapy, because of short biological half-life, poor bioavailability, high and frequent dosing is required. Thereby, these anti-RA medications, which unable to selectively target affected zone, may cause severe side effects in extra-articular tissues. Today, nanotechnology has emerged as promising tool in the development of novel drug delivery systems for the treatment and diagnosis of intractable diseases such as RA. Active targeting in RA nanomedicine has also been introduced a successful way for facilitating specific uptake of therapeutic agents by the disease cells. In this review, it is attempted to describe various targeted drug delivery systems (localized and receptor-based) used for RA diagnosis and therapy. Then, we highlight recent developments related to various non-viral gene delivery systems for RA gene therapy.

Leveraging Electrostatic Interactions for Drug Delivery to the Joint

“…41,42 Synovial fibroblasts stimulate the production of vascular endothelial growth factor leading to angiogenesis, which further perpetuates the inflammatory process by recruiting more inflammatory leukocytes. 43 In addition, the increased levels of TNF-a in the joint stimulate the maturation of osteoclasts, which results in erosion of the subchondral bone. The persistent inflammation that occurs in RA leads to systemic complications and comorbidities, which finally result in handicap and social dysfunction.…”

“…60 Liposomes have improved the stability and prolonged the biological half-life of drugs when delivering therapies to inflamed joints. 4,43,61 However, they have proven to be sensitive to mechanical loading, which can be problematic in orthopedic applications. 62 Liposomes are attractive drug delivery systems for encapsulation of hydrophobic corticosteroids.…”

Recent Advances in Nanotheranostics for Treat‐to‐Target of Rheumatoid Arthritis

“…Great progress had been made in the identification of genetic regions tagged by structural variation, showing that more than 30 genetic regions were associated with RA 172. These genes blocked the production of some inflammatory agents involved in RA pathogenesis or expressed proteins that played roles in blocking the production of inflammatory agents 45. The MAPK p38 signaling pathway which positively regulated the expression of many inflammatory mediators is thought to be the most important contributor to the pathogenesis of RA 173.…”

“…Despite recent significant advances, most of the current relevant reviews are either out of date or focused on a narrow topic such as a specific RA treatment mechanism 45,46. Therefore, a detailed review focusing on powerful theranostic at different pathogenesis and the subsequent development trends is highly desirable.…”

Formulation and characterization of lornoxicam-loaded cellulosic-microsponge gel for possible applications in arthritis

“…Rheumatoid arthritis is a sever autoimmune disease-causing inflammation of the synovial joints and may involves individual joint to several joints at the same time ( Joshi et al, 2018 , Bullock et al, 2018 ). It is associated with severe pain due to joint inflammation, synovial hyperplasia and destruction of bones and cartilage, thereby limiting the range of motion, promoting stiffness especially in the early hours of the morning and may progress into permanent disability ( Pirmardvand Chegini et al, 2018 , Buttgereit et al, 2008 , Zhang et al, 2020 ). Females are more prone to develop inflammatory arthritis than males and the disease is usually more prevalent in the elderly ( van Vollenhoven, 2009 , Byun et al, 2020 ).…”