Pharmacologic therapies of ARDS: From natural herb to nanomedicine
Javier Amador-Casta?eda, BHS, RRT, FCCM, PNAP
| Respiratory Care Practitioner | Author | Speaker | Veteran | ESICM Representative, North America
Meng L, Liao X, Wang Y, Chen L, Gao W, Wang M, Dai H, Yan N, Gao Y, Wu X, Wang K and Liu Q (2022) Pharmacologic therapies of ARDS: From natural herb to nanomedicine. Front. Pharmacol. 13:930593. doi: 10.3389/fphar.2022.930593
Summary of "Pharmacologic Therapies of ARDS: From Natural Herb to Nanomedicine"
Abstract
Acute respiratory distress syndrome (ARDS) is a critical illness with a high global mortality rate, despite advances in treatment and prevention. The syndrome arises from complex pathophysiological mechanisms that include lung inflammation, alveolar permeability dysfunction, and endothelial injury. Recent developments in pharmacologic therapies have led to various treatment approaches, including conventional drugs, natural medicine, and nanomedicine. Nanomedicine, in particular, offers promising potential due to its unique drug delivery properties. This article provides an overview of ARDS pharmacologic therapies, focusing on their mechanisms and application progress, highlighting the future role of nanotechnology in improving treatment outcomes.
Key Points
1. Pathophysiology of ARDS: ARDS results from alveolar endothelial and epithelial damage, leading to decreased lung compliance and impaired gas exchange.
2. Conventional Drug Therapies: Drugs targeting the renin-angiotensin system, neutrophil elastase inhibitors, and statins have shown limited success, with some promising outcomes in preclinical studies.
3. Natural Medicine: Herbal compounds like honokiol and isoforskolin exhibit anti-inflammatory and lung-protective effects, providing alternative therapeutic options for ARDS.
4. Nanomedicine: Nanoparticles, including liposomes and polymer-based nanocarriers, improve drug solubility and targeted delivery, offering a novel approach to ARDS treatment.
5. Liposomal Nanoparticles: Liposomes encapsulate drugs for better stability and targeted delivery, with early applications in surfactant therapy for ARDS.
6. Polymeric Nanoparticles: These can deliver both hydrophilic and hydrophobic drugs, improving bioavailability and reducing systemic toxicity.
7. Inorganic Nanoparticles: Inorganic nanomaterials like gold and silver have been explored, though concerns about toxicity limit their widespread use.
8. Exosomes and Cell-Based Therapy: Exosomes are promising nanocarriers for delivering genetic material and drugs, potentially enhancing ARDS treatment.
9. Inhalation Nanomedicine: Inhalation routes for nanomedicine improve drug delivery directly to the lungs, offering high local concentration and reduced systemic exposure.
10. Challenges: Despite the potential, there are concerns about nanoparticle toxicity, lung clearance mechanisms, and the risk of nanoparticle accumulation in the respiratory system.
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Conclusion
Pharmacologic therapies for ARDS continue to evolve, with nanomedicine showing great promise for targeted drug delivery and reducing mortality rates. While conventional drugs have shown limited success, advances in nanotechnology offer new hope for improving treatment outcomes. Future research should focus on overcoming current challenges related to nanoparticle safety, drug deposition, and long-term efficacy.
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Discussion Questions
1. How can nanomedicine improve the bioavailability and targeted delivery of ARDS treatments compared to conventional therapies?
2. What are the potential risks and challenges associated with nanoparticle accumulation in the respiratory system during ARDS treatment?
3. How can natural medicine therapies complement conventional and nanomedicine approaches in treating ARDS?
Copyright ? 2022 Meng, Liao, Wang, Chen, Gao, Wang, Dai, Yan, Gao, Wu, Wang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.