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Advancing drug delivery to articular cartilage:From single to multiple strategies

Acta Pharmaceutica Sinica B 2023年第10期13卷 4127-4148页

作者： Tianyuan Zhao Xu Li Hao Li Haoyuan Deng Jianwei Li Zhen Yang Songlin He Shuangpeng Jiang Xiang Sui Quanyi Guo Shuyun Liu Institute of Orthopedics The First Medical CenterChinese PLA General HospitalBeijing Key Lab of Regenerative Medicine in OrthopedicsKey Laboratory of Musculoskeletal Trauma&War Injuries PLABeijing 100853China School of Medicine Nankai UniversityTianjin 300071China Musculoskeletal Research Laboratory Department of Orthopedics&TraumatologyThe Chinese University of Hong Kong999077Hong KongChina Arthritis Clinic&Research Center Peking University People’s HospitalPeking UniversityBeijing 100044China Department of Joint Surgery Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

Articular cartilage(AC) injuries often lead to cartilage degeneration and may ultimately result in osteoarthritis(OA) due to the limited self-repair ability. To date, numerous intra-articular delivery systems carrying various therapeutic agents have been developed to improve therapeutic localization and retention, optimize controlled drug release profiles and target different pathological processes. Due to the complex and multifactorial characteristics of cartilage injury pathology and heterogeneity of the cartilage structure deposited within a dense matrix, delivery systems loaded with a single therapeutic agent are hindered from reaching multiple targets in a spatiotemporal matched manner and thus fail to mimic the natural processes of biosynthesis, compromising the goal of full cartilage regeneration. Emerging evidence highlights the importance of sequential delivery strategies targeting multiple pathological processes. In this review, we first summarize the current status and progress achieved in single-drug delivery strategies for the treatment of AC diseases. Subsequently, we focus mainly on advances in multiple drug delivery applications, including sequential release formulations targeting various pathological processes, synergistic targeting of the same pathological process, the spatial distribution in multiple tissues, and heterogeneous regeneration. We hope that this review will inspire the rational design of intraarticular drug delivery systems(DDSs) in the future.

关键词： Drug delivery systems Articular cartilage Cartilage injury Osteoarthritis Cartilage regeneration Multiple drug delivery strategy Biomaterials therapeutic factors

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Analysis of factors Associated with the Abandonment of Nutritional Recovery among Parents of Severely Malnourished Children Aged 6 to 59 Months in the Health District of Titao, Burkina Faso

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Open Journal of Nursing 2024年第9期14卷 477-490页

作者： Aminata Gansore Patrice Ngangue Birama Apho Ly Ludovic K. N’Tcha Douglas Mbang Massom Gbètogo Maxime Kiki Josiane Seu Nestor Bationo Noufou Gustave Nana Fla Koueta Institute for Interdisciplinary Training and Research in Health and Education Sciences Ouagadougou Burkina Faso Faculty of Nursing Laval University Quebec Canada Faculty of Medicine and Odonto Stomatology University of Sciences Techniques and Technology of Bamako Bamako Mali Centre de Recherche Entomologique de Cotonou Cotonou Benin Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Centre for Interdisciplinary Research in Rehabilittaion and Social Integration (CIRRIS) Laval University Quebec Canada Faculty of Health Sciences Joseph Ki-Zerbo University Ouagadougou Burkina Faso

Introduction: In Burkina Faso, undernutrition is a public health problem associated with more than 40% of infant and child mortality. Undernutrition management is complex, and there is often a risk of treatment abandonment. Studies on this topic have not explored the influence of environmental and therapeutic factors on parental compliance. This study proposes an analysis of factors influencing the abandonment of nutritional recovery by parents of malnourished children aged 6 to 59 months in ambulatory care. Methods: This was a descriptive and exploratory qualitative study. Data collection took place in February 2020. Data were collected from seventeen (17) participants via in-depth interviews (IDI) and direct observation. The IDIs were transcribed verbatim and thematically analyzed using Nvivo software. Results: The results revealed that factors related to the physical environment, such as geographical inaccessibility, pastoral occupation, displacement at auriferous sites, and insecurity, are important causes of nutritional recovery abandonment. They also prove that factors related to the social environment, such as lack of family and social support, feelings of shame, stigmatization, occupation of the mother, and social events, lead to this abandonment. In addition, therapeutic factors such as interruptions of supplies of Ready to Use therapeutic Food (RUTF), feeling of improvement or worsening of the state of health, recourse to traditional medicine, and ignorance of undernutrition are also associated with this issue. Conclusion: This study highlighted barriers to the abandonment of nutritional recovery among parents of severely malnourished children aged 6 to 59 months in the health district of Titao, Burkina Faso. It is more important to consider these different factors when evaluating care protocols so that policies to reduce child undernutrition can considerably impact the targets.

关键词： Nutritional Recovery Severe Acute Malnutrition Environmental factors therapeutic factors Abandonment Burkina Faso

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