Hyaluronic Acid Conjugates as Vectors for the Active Targeting of Drugs, Genes and Nanocomposites in Cancer Treatment
Hyaluronic acid is a high molecular weight (106 –107 Da) glycosaminoglycan polymer composed of repeating disaccharides: ?1,3 N-acetyl glucosaminyl-? 1,4 glucuronide. HA is ubiquitous, being the main component of extracellular matrix, and is essential for proper cell growth, structural stability of organs, and tissue organization. From the pharmaceutical standpoint, HA is a promising component, because it is biodegradable, biocompatible, nontoxic, hydrophilic, and nonimmunogenic. HA contains several chemical groups to which other components can be conjugated. The carboxylate on the glucuronic acid, the N-acetylglucosamine hydroxyl, and the reducing termination, have all been successfully utilized in conjugation reactions with drugs. The acetyl group may be enzymatically removed from the N-acetylglucosamine, and is thus also a potential site for drug conjugation. Low levels of the hyaluronic acid receptor CD44 are found on the surface of epithelial, hematopoietic, and neuronal cells; it is overexpressed in many cancer cells, and in particular in tumor-initiating cells. HA has recently attracted considerable interest in the field of developing drug delivery systems, having been used, as such or encapsulated in different types of nanoassembly, as ligand to prepare nano-platforms for actively targeting drugs, genes, and diagnostic agents. This review describes recent progress made with the several chemical strategies adopted to synthesize conjugates and prepare novel delivery systems with improved behaviors.
Cancer is a leading cause of death worldwide, accounting for 7.6 million deaths (around 13% of all deaths) in 2008. Deaths from cancer worldwide are projected to continue rising, with an estimated 13.1 million deaths in 2030. Lung, stomach, liver, colon and breast cancers cause the most cancer deaths each year.Conjugation of cytotoxic drugs with macromolecules improves their pharmacokinetic profile, prolonging the distribution and elimination phases. Furthermore, the slow release of active drug from the carrier may result in sustained high intratumoral drug levels and lower plasma concentrations of the active drug. In order to achieve this combined effect, a macromolecule-drug conjugate should preferentially release the active drug within the tumor tissue. The following components are essential to reach this goal: a biodegradable linkage, a suitable spacer, and a potent bioactive anticancer agent. Among the most widely studied macromolecules are N-(2-hydroxypropyl) methacrylamide (HPMA), polyglutamate, human serum albumin, dextrans, heparin, chitosan, dendrimers, multi-arm polyethylene glycol (PEG), and hyaluronic acid.The molecular weight of native HA has a wide range. In water, high molecular weight HA self-aggregates to form a viscous solution in which each molecule forms a sponge-like matrix with a radius of about 100 nanometers; this makes it a suitable candidate for passive tumor accumulation. In addition, HA plays an important physiological role in the tumorigenesis process, and consequently HA receptors are overexpressed on many types of tumor cells. This feature could be exploited in drug delivery, by using the receptor as an anchor to attach prodrugs or nanomedicine-based delivery systems, through a ligand, so as to increase the efficiency of anticancer drugs. (Molecules 2014, 19(3), 3193-3230.)