抗幽门螺杆菌递药策略的研究进展

Advances in drug delivery strategies against Helicobacter pylori

幽门螺杆菌(Helicobacter pylori, H. pylori)可引发多种消化道疾病甚至胃癌。H. pylori全球感染率超过50%,其耐药性持续升高导致根除率不断下降,进而促使大量顽固性感染发生,严重威胁人类健康。目前临床上以增加抗生素联用种类或提高抗生素剂量为主的应对策略难以获得满意的疗效。本文总结了H. pylori的临床治疗方案,分析了H. pylori感染特点及其难根除的原因,重点介绍了提高H. pylori清除率的药物递送策略,如提高胃内药物浓度(胃酸稳定型)、提高药物在H. pylori定植部位的浓度(胃滞留型、H. pylori靶向型)、克服H. pylori耐药性(金属纳米粒、抗生物被膜制剂)及增强宿主免疫应答(疫苗制剂)等。细胞膜仿生和噬菌体等新型递药系统虽然报道较少,但展现了较好的应用前景。本综述为提高H. pylori根除率的治疗策略的开发和应用提供参考与借鉴。

Helicobacter pylori(H. pylori) can cause a variety of digestive tract diseases, the serious may develop into gastric cancer. Nowadays, H. pylori infection rate exceeds 50%, and its eradication rate is declining due to the continuous increase of drug resistance, leading to the occurrence of plenty of stubborn infections, which seriously threaten human health. At present, it is difficult to achieve satisfactory curative effect by increasing the types of antibiotics combination or increasing their dose. In this review, the clinical treatments of H. pylori were introduced.Proceed from the characteristics and pathological background of H. pylori infection that makes H. pylori difficult to eradicate, the research advances of drug delivery strategies for improving H. pylori eradication rate were reviewed, such as strategies that could increase drug concentration in stomach(e. g. drug delivery systems with gastric acid-stabilized ability), increase drug concentration in H. pylori colonization sites(e. g. drug delivery systems with gastric retention or H. pylori targeted abilities), overcome H. pylori resistance(metal nanoparticles,anti-biofilm delivery systems), enhance host immune response(vaccine preparation) and so on. Novel drug delivery systems, such as cell membrane coating technology and phage therapy, are comparatively rare in the field of antiH. pylori, but have broad application prospects. This review would provide reference for the development and application of therapeutic strategies to improve H. pylori eradication rate.