Oral nanomedicine for modulating immunity, intestinal barrier functions, and gut microbiome

Adv Drug Deliv Rev. 2021 Dec:179:114021. doi: 10.1016/j.addr.2021.114021. Epub 2021 Oct 26.

Abstract

The gastrointestinal tract (GIT) affects not only local diseases in the GIT but also various systemic diseases. Factors that can affect the health and disease of both GIT and the human body include 1) the mucosal immune system composed of the gut-associated lymphoid tissues and the lamina propria, 2) the intestinal barrier composed of mucus and intestinal epithelium, and 3) the gut microbiota. Selective delivery of drugs, including antigens, immune-modulators, intestinal barrier enhancers, and gut-microbiome manipulators, has shown promising results for oral vaccines, immune tolerance, treatment of inflammatory bowel diseases, and other systemic diseases, including cancer. However, physicochemical and biological barriers of the GIT present significant challenges for successful translation. With the advances of novel nanomaterials, oral nanomedicine has emerged as an attractive option to not only overcome these barriers but also to selectively deliver drugs to the target sites in GIT. In this review, we discuss the GIT factors and physicochemical and biological barriers in the GIT. Furthermore, we present the recent progress of oral nanomedicine for oral vaccines, immune tolerance, and anti-inflammation therapies. We also discuss recent advances in oral nanomedicine designed to fortify the intestinal barrier functions and modulate the gut microbiota and microbial metabolites. Finally, we opine about the future directions of oral nano-immunotherapy.

Keywords: Gut microbiota; Intestinal barrier; Lamina propria; Mucosal Immunity; Nanomedicine; Oral immunotherapy; Peyer’s patches.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Oral
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / pharmacokinetics
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Immune Tolerance / physiology
  • Immunity, Mucosal / physiology*
  • Intestinal Mucosa / physiology*
  • Mucous Membrane / metabolism
  • Nanoparticle Drug Delivery System / pharmacokinetics*
  • Vaccines / administration & dosage

Substances

  • Anti-Inflammatory Agents
  • Nanoparticle Drug Delivery System
  • Vaccines