NOVEL DRUG DELIVERY SYSTEMS IN MANAGEMENT OF CARDIOVASCULAR DISEASES

SHYAMOSHREE BASUABOUT AUTHOR
SHYAMOSHREE BASU
Advanced Cardiac Center,
B.R. Singh Hospital & Centre for Medical Education & Research
Sealdah, Kolkata – 700014 West Bengal

shyamoshree@gmail.com

ABSTRACT
Cardiovascular (CV) diseases like atherosclerosis, angina pectoris, acute myocardial infarction, are a major cause of mortality in the whole world owing to the present day hectic lifestyle. In this review we will concentrate on the various novel drug delivery systems (DDS) like transdermal DDS, micelles, liposomes, nanoparticles (NPs), dendrimers, drug eluting stents (DES) and drug eluting balloons (DEB) that are being used over the years and in present day for the treatment of these diseases.

Reference Id: PHARMATUTOR-ART-2589

INTRODUCTION
Cardiovascular diseases pose a major threat to the lives of people in today’s hectic world. Not only adults but children are also getting affected by such diseases.  Many medications are commercially available for their treatment but the conventional tablets and capsules are unable to cope up with these situations. This augments the use of novel drug delivery systems providing targeted drug delivery and prolonged drug residence to the affected areas of the cardiovascular system. Novel drug delivery systems started with platform technology involving the introduction of transdermal patches, containing drug particles, were applied on skin. But with the necessity of targeted drug delivery, several nanoscale formulations like micelles, liposomes, nanoparticles, dendrimers, were developed and their applications in treatment of CV diseases were investigated.

The main advantage of nanoscale DDs is that they remain in the circulation for a long time avoiding renal excretion and hepatic first pass metabolism. They also exhibit enhanced permeability and retention effects. In this review we are going to discuss the various novel formulations and their application in controlling the CV diseases.

Novel drug delivery systems
Transdermal patch is a polymeric layered structure where the drug particles are dispersed uniformly and the patch is placed over the skin through which the drug diffuses into the bloodstream. Abrams (1989) studied the effect of transdermal patches of nitroglycerin in angina pectoris. Xingyan et al developed ethosome patches of Ligustrazine (4-methyl-pyrazine [tetramethylpyrazine, which is a traditional Chinese medicine for angina pectoris. These patches were found to decrease hemorheological indices of myocardial ischemia in rats, as well as protect acute ischemic myocardium and ischemia-reperfusion injured myocardium.

Transdermal patch

Figure1. Transdermal patch

Micelles are composed of lipids and other ampiphilic artificial molecules. They self assemble in aqueous environment and can encompass hydrophobic drug particles to overcome solubility problems.

Micelle

Figure 2. Micelle

Liposomes comprise phospholipids and cholesterol to form bilayered structures, capable of incorporating both hydrophobic and hydrophilic drugs according to need. Liposomal drug delivery systems have many advantages in the formulations containing potent drugs to improve therapeutic efficacy which include biocompatibility, flexibility, controlled hydration, various administration routes and stabilization of the entrapped drug from hostile environments. However, liposomal drug delivery suffers from rapid clearance by the reticuloendothelial system if administered by parenteral injection into the bloodstream. The conjugation of polyethyleneglycol (PEG) and distearoyl phosphatidylethanolamine (DSPE) to the liposomes can reduce their recognition by the reticuloendothelial system. Recently, liposomes were modified by targeted ligands to decrease toxicity and improve deposition in the desired tissues. Takahoma et al (2009) studied the influence of liposomes on distribution and activity of ischemic/ reperfused myocardium and showed that PEGylated liposomal adenosine increased cardioprotective effects of adenosine against I/R injury and reduced unfavorable hemodynamic effcts.     Paulis et al (2012) studied the comparision between micellar and liposomal distribution in infarcted heart in mice. They concluded that liposomes could be used as proangiogenic drug delivery systems and micelles could be used for targeted delivery of cardioprotective therapeutics.   Tang et al. (2014) developed VEGF-encapsulated immunoliposomes targeting MI. By injecting the VEGF-immunoliposomes together with mesenchymal stem cells (MSCs) into a rat immediately following MI, the authors observed a significantly high reduction of cardiac function loss, together with an 80% increase in blood vessel density

Liposome

Figure 3. Liposome

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