Current Status of Nanoparticles Loaded Medication in the Management of Diabetic Retinopathy.

ABSTRACT

Diabetes Mellitus (DM) is a chronic metabolic disorder affecting a vast majority of the human population causing marked morbidity and mortality. Diabetic retinopathy (DR) is a complication of diabetes that affects the eyes and vision. It is a leading cause of visual impairment and blindness in people. In this review, various nano-delivery systems to effectively deliver antidiabetic compounds in treating angiopathy and retinopathy in diabetes mellitus are discussed. This has been used to overcome many complications in traditional treatment of bioactive compounds with a lower potential antidiabetic effect due to the lower stability of those compounds in gastrointestinal systems and during absorption. Several bioactive compounds loaded into nanodelivery systems are currently in clinical trials, and once these compounds are commercially marketed, nano bioactive compounds will be available as novel medicines to treat many chronic diseases, including diabetes mellitus. DR is driven by prolonged hyperglycaemic episodes arising from suboptimal glycaemic control in patients with either Type I or II diabetes mellitus. Elevated blood glucose levels alter the regulation of a number of biochemical pathways leading to superoxide production and oxidative stress in retina. Mitochondrial dysfunction, inflammation, and hypoxia-driven Vascular Endothelial Growth Factor (VEGF) secretion giving rise to vascular and neuronal apoptosis, neovascularization and elevated vasopermeability, respectively. Several medicines loaded with nanoparticles have been developed to enhance the target effectiveness and bioavailability of medicinal compounds with antidiabetic effects in various animal and human models. Bioactive compounds have been loaded into nanoparticles for oral delivery in various antidiabetic animal models, and the results have shown improved stability, bioavailability, and sustained antidiabetic effects. Nanocarriers used in the delivery of drugs are very precise and ensure targeted drug delivery at the disease site. The antidiabetic activity of triamcinolone acetonide-loaded lipid nanocapsules, humanin peptide with elastin like polypeptide nanoassembly, loaded poly lactic-co-glycolic acid nanoparticles, anti-VEGF-aptamer modified C-Dots as hybrid nano-composite, axitinib, apatinib loaded poly lactic-co-glycolic acid nanoparticles, mulberry leaf extract mediated silver nanoparticles, resveratrol coated gold nanoparticles, fenofibrate-loaded biodegradable nanoparticles, nano-delivery of doxorubicin, insulin-loaded chitosan nanoparticles, silk fibroin nanoparticles, fluorescent silicon nanoparticles-based theranostic probes, topical curcumin nanocarriers, nanoparticles loaded-palmitoyl ethanolamide, hyaluronic acid coated albumin nanoparticles, nilvadipine loaded nanoparticles, cilostazol ophthalmic nanodispersions, naringenin-loaded sulphobutylether-β-cyclodextrin/chitosan nanoparticles, emodin-loaded magnesium silicate hollow nanocarriers, yttrium oxide nanoparticles are discussed in this review.