[关键词]
[摘要]
眼部精细的解剖结构与复杂的动态生理屏障严重制约了眼科药物的眼内生物利用度,传统滴眼液不足5%的吸收率及玻璃体腔注射的高侵入性风险,构成了眼科治疗领域的长期瓶颈。随着材料科学与生物医学工程的交叉融合,基于刺激响应机制的智能药物递送系统凭借其对病理微环境或外源物理场的特异性识别与响应能力,为实现药物的时空可控释放及突破生理屏障提供了革新性策略。文章系统综述了该领域的最新进展,从高分子相变热力学与化学键断裂动力学视角,深入剖析了不同刺激响应载体的物理化学机制。结合青光眼、年龄相关性黄斑变性及眼内感染等重大眼病的临床前与临床研究数据,论证了智能系统在延长眼表滞留时间、实现生物标志物触发的按需释放及降低全身系统性毒性方面的显著优势。最后,文章分析了此类复杂制剂在无菌规模化制备、监管审批路径及临床转化中面临的挑战,并展望发展前景。
[Key word]
[Abstract]
The intricate anatomical architecture and complex dynamic physiological barriers of the eye severely restrict the intraocular bioavailability of ophthalmic drugs. The limited absorption efficiency of conventional eye drops(<5%)and the highly invasive nature of intravitreal injections remain persistent bottlenecks in ophthalmic therapeutics. Driven by the convergence of materials science and biomedical engineering, intelligent stimuli-responsive drug delivery systems offer revolutionary strategies to overcome these physiological barriers and achieve spatiotemporally controlled drug release. These systems leverage specific recognition and response capabilities targeted at pathological microenvironments or exogenous physical fields. This article systematically reviews recent advances in this domain, providing an in-depth analysis of the physicochemical mechanisms underlying various stimuli-responsive carriers from the perspectives of polymer phase transition thermodynamics and chemical bond cleavage kinetics. By synthesizing preclinical and clinical research data on major ocular diseases, including glaucoma, age-related macular degeneration, and intraocular infections, the significant advantages of these intelligent systems were demonstrated. Highlighted benefits include prolonged ocular surface retention, biomarker-triggered on-demand release, and minimized systemic toxicity. Finally, this review critically analyzes the challenges of translating these complex formulations to the clinic, specifically regarding sterile scale-up manufacturing and regulatory approval pathways, while providing perspectives on future development.
[中图分类号]
[基金项目]
南京市卫生科技发展专项资金项目计划(No.YKK22263)