19 Active targeting via kidney-targeting peptides or antibodies that bind to specific receptors or ligands on specific kidney cells was performed previously. 16, 17, 18 Incorporating active targeting moieties to these nanoparticulate carriers can result in a successful and feasible strategy for more effective design of kidney specific nanoparticle.
Nanoparticle-based targeted delivery systems can offer enhanced targeting to the kidneys via passive targeting by modulating the nanoparticle properties, such as size, surface charge, aspect ratio etc. 3 Thus, targeted delivery of therapeutics toward kidneys would be ideal for treating renal diseases as the effects would be limited to the kidneys and reduce any systemic toxicity. An efficient gene delivery system should offer local transfer and expression of the therapeutic gene at the target tissue or organ. 6 Non-viral gene delivery systems based on liposomes, 7, 8 polyethyleneimine (PEI), 9 and gelatin-based 10, 11 nanoparticles 12 have been reported but have faced challenges relating to in vivo delivery and specific targeting to the kidneys. 4, 5 Both viral and non-viral gene delivery systems have been reported for the gene therapy of kidney diseases. However, this was associated with side effects and disadvantages, such as liver damage, kidney dysfunction, and invasiveness, limiting its clinical application. Hydrodynamic approach or local administration has been used for gene delivery to the kidneys. Although many developments have been made over the past few years in gene delivery approaches toward treating diseases, very little progress has been made in treating renal diseases. 2 Gene therapy, originally envisioned as an approach to treat genetic diseases, has been utilized as a strategy to cure acquired diseases by providing exogenous DNA via systemic or local delivery for expressing therapeutic proteins.
1 However, the strict and multilevel filtering mechanisms inherent to the kidneys play a crucial role in the success rate of the therapeutic systems. Chronic kidney disease (CKD) is an emerging health crisis, and it is possible to slow the progression by early diagnosis and treatment.
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