Peritoneal fibrosis (PF) is a common complication of long-term
peritoneal dialysis (PD). It is considered as the main reason for dialysis inadequacy and PD withdrawal.
Transforming growth factor beta (TGF-β) regulates the expression of
stromal cell-derived factor 1 (SDF-1α) and its receptor
C-X-C chemokine receptor type 4 (CXCR4) on human peritoneal mesothelial cells (HPMCs), resulting in an increased migratory potential of HPMCs and extracellular matrix (ECM) deposition in the
scar tissue and eventually
fibrosis. Because SDF-1α/CXCR4 activation has a vital role in the pathogenesis of PF, codelivery of a CXCR4-receptor targeting agent with an antifibrotic agent in a single nanocarrier can be a promising strategy for treating PF. Here, for the first time,
AMD3100 (AMD), a CXCR4-receptor antagonist, was coformulated with sulfotanshinone IIA
sodium (STS IIA) into a
liposome (STS-AMD-Lips) to develop a
CXCR4 receptor targeting form of combination
therapy for PF. CXCR4 targeting increased the ability of
liposomes to target fibrotic peritoneal mesothelial cells overexpressing CXCR4 and facilitated the ability of STS IIA treatment at the fibrotic site. The
liposome had an average diameter of 103 nm with encapsulated efficiencies of above 50%. The in vivo studies confirmed the reversal of PD
solution-induced epithelial-to-mesenchymal transition by STS-AMD-Lips in HPMCs. The in vivo studies also revealed the precise biodistribution of the
liposomes to peritoneum. Significant reduction of the morphological lesions and decreased level of ECM
proteins were observed in rats treated with STS-AMD-Lips, proving that the liposomal nanocarrier has excellent ability to reverse PF. It has been concluded that the STS-AMD-Lips exhibit specific peritoneal targeting ability and could be used to improve STS-AMD combination delivery for the treatment of PF.