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Drug Targeting Organ-Specific Strategies

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XVIII Contents<br />

4.3 Hepatic Inflammation and Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . 96<br />

4.4 Liver Cirrhosis: Causes and Therapy . . . . . . . . . . . . . . . . . . . . . . . 98<br />

4.5 <strong>Drug</strong> <strong>Targeting</strong> to the Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99<br />

4.5.1 Carriers Directed at SECs and KCs . . . . . . . . . . . . . . . . . . . 100<br />

4.5.1.1 Albumins . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100<br />

4.5.1.2 Liposomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101<br />

4.5.1.3 Carriers with Intrinsic Anti-inflammatory Activity . . . . . 102<br />

4.5.2 <strong>Targeting</strong> to other Hepatic Cells . . . . . . . . . . . . . . . . . . . . . 103<br />

4.6 Anti-inflammatory <strong>Drug</strong>s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103<br />

4.6.1 Nonsteroidal Anti-inflammatory <strong>Drug</strong>s (NSAIDs) . . . . . . . . . . 103<br />

4.6.2 Glucocorticosteroids . . . . . . . . . . . . . . . . . . . . . . . . . . . 104<br />

4.6.3 Other Anti-inflammatory <strong>Drug</strong>s . . . . . . . . . . . . . . . . . . . . . 105<br />

4.7 Anti-fibrotic <strong>Drug</strong>s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105<br />

4.8 Testing Liver <strong>Targeting</strong> Preparations . . . . . . . . . . . . . . . . . . . . . . . 106<br />

4.8.1 Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106<br />

4.8.2 Cellular Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108<br />

4.8.3 Efficacy and Toxicity . . . . . . . . . . . . . . . . . . . . . . . . . . . 108<br />

4.9 <strong>Targeting</strong> of Anti-inflammatory <strong>Drug</strong>s for the Treatment of Liver Fibrosis . . 110<br />

4.9.1 <strong>Targeting</strong> of NSAIDs . . . . . . . . . . . . . . . . . . . . . . . . . . . 111<br />

4.9.2 <strong>Targeting</strong> of Glucocorticosteroids . . . . . . . . . . . . . . . . . . . . 112<br />

4.10 Selective <strong>Drug</strong> Delivery for the Treatment of Other Hepatic Disorders . . . 114<br />

4.11 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115<br />

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115<br />

5 Delivery of <strong>Drug</strong>s and Antisense Oligonucleotides to the Proximal Tubular<br />

Cell of the Kidney Using Macromolecular and Pro-drug Approaches<br />

Marijke Haas, Yukio Kato, R. Folgert G. Haverdings, Frits Moolenaar,<br />

Kokichi Suzuki, Dick de Zeeuw, Yuichi Sugiyama, Dirk K. F. Meijer . . . . . . 121<br />

5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121<br />

5.1.1 Kidneys and their Functions . . . . . . . . . . . . . . . . . . . . . . . 121<br />

5.1.2 Proximal Tubular Cells and their Functions . . . . . . . . . . . . . . . 123<br />

5.1.3 Cellular Targets for <strong>Drug</strong> Delivery in the Kidney . . . . . . . . . . . 124<br />

5.1.4 Renal Pathology and the Proximal Tubular Cell for Therapeutic<br />

Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124<br />

5.1.5 <strong>Targeting</strong> to the Proximal Tubular Cell . . . . . . . . . . . . . . . . . 125<br />

5.2 Renal Delivery Using Pro-<strong>Drug</strong>s . . . . . . . . . . . . . . . . . . . . . . . . . 126<br />

5.2.1 The Alkylglycoside Approach . . . . . . . . . . . . . . . . . . . . . . 126<br />

5.2.1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 126<br />

5.2.1.2 Concept of the Alkylglycoside Approach . . . . . . . . . . 126<br />

5.2.1.3 Distribution of Alkylglycoside-derivatized AVP In Vivo . . 126<br />

5.2.1.4 <strong>Specific</strong> Binding of Alkylglycoside-derivatized AVP<br />

in Kidney Plasma Membranes . . . . . . . . . . . . . . . . . 129<br />

5.2.1.5 Structure–Kinetic Relationship Studies . . . . . . . . . . . 129

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