Nanomedicine strategies to improve therapeutic agents for the prevention and treatment of preterm birth and future directions



Taylor, Jessica, Sharp, Andrew ORCID: 0000-0003-3396-7464, Rannard, Steve P ORCID: 0000-0002-6946-1097, Arrowsmith, Sarah and McDonald, Tom O ORCID: 0000-0002-9273-9173
(2023) Nanomedicine strategies to improve therapeutic agents for the prevention and treatment of preterm birth and future directions. NANOSCALE ADVANCES, 5 (7). pp. 1870-1889.

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Abstract

The World Health Organisation (WHO) estimates 15 million babies worldwide are born preterm each year, with 1 million infant mortalities and long-term morbidity in survivors. Whilst the past 40 years have provided some understanding in the causes of preterm birth, along with development of a range of therapeutic options, notably prophylactic use of progesterone or uterine contraction suppressants (tocolytics), the number of preterm births continues to rise. Existing therapeutics used to control uterine contractions are restricted in their clinical use due to pharmacological drawbacks such as poor potency, transfer of drugs to the fetus across the placenta and maternal side effects from activity in other maternal systems. This review focuses on addressing the urgent need for the development of alternative therapeutic systems with improved efficacy and safety for the treatment of preterm birth. We discuss the application of nanomedicine as a viable opportunity to engineer pre-existing tocolytic agents and progestogens into nanoformulations, to improve their efficacy and address current drawbacks to their use. We review different nanomedicines including liposomes, lipid-based carriers, polymers and nanosuspensions highlighting where possible, where these technologies have already been exploited <i>e.g.</i> liposomes, and their significance in improving the properties of pre-existing therapeutic agents within the field of obstetrics. We also highlight where active pharmaceutical agents (APIs) with tocolytic properties have been used for other clinical indications and how these could inform the design of future therapeutics or be repurposed to diversify their application such as for use in preterm birth. Finally we outline and discuss the future challenges.

Item Type: Article
Uncontrolled Keywords: Contraception/Reproduction, Bioengineering, Pediatric, Perinatal Period - Conditions Originating in Perinatal Period, Prevention, Infant Mortality, Preterm, Low Birth Weight and Health of the Newborn, 5.1 Pharmaceuticals, 5 Development of treatments and therapeutic interventions, Reproductive health and childbirth, 3 Good Health and Well Being
Divisions: Faculty of Health and Life Sciences
Faculty of Science and Engineering > School of Physical Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 31 Mar 2023 11:12
Last Modified: 14 Mar 2024 19:17
DOI: 10.1039/d2na00834c
Open Access URL: https://doi.org/10.1039/D2NA00834C
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3169391