Targeting pulmonary tuberculosis using nanocarrier-based dry powder inhalation: current status and futuristic need

Abstract

Tuberculosis (TB) is a disease caused by the pathogen Mycobacterium tuberculosis. Prolonged administration of high dose antibiotics using oral and injectable routes and their associated side effects show limitations to successful treatment outcome of TB. Nanocarrier-based dry powder inhalers (DPIs) may provide a breakthrough as an alternative therapeutic approach because of their stable, non-invasive nature and ability to target the drug at the site of infection. The current review focuses on the roadmap of the respiratory system, drug deposition and targeting at the site of infection via the pulmonary route. This review will provide readers with an overview of the existing literature of nanocarrier-based DPIs of anti-TB drugs. Among different nanocarriers, results of most of the proliposomes and polymeric particles-based DPIs with respect to their characterisation parameters like encapsulation efficiency, drug loading, storage stability and aerodynamic properties are not encouraging, whereas surface engineered, nanostructured lipid carriers (NLCs), i.e. ligand attached-NLCs-based dry powder inhalers (NLCs-DPI) show promising results. But still, there is a need to investigate them for in vitro, ex vivo, in vivo and toxicity studies to achieve a market approval.

Spray-dried lactose-leucine microparticles for pulmonary delivery of antimycobacterial nanopharmaceuticals

“…API-loaded nanocarriers embedded in dry powder microparticle (MP) formulations with suitable aerodynamic properties represent an approach to overcome this obstacle. Dry powder aerosol delivery of plain antimycobacterial drugs has already been successfully demonstrated in animal models [13][14][15]. However, it is not trivial to generate aerosol powders of accepted pharmaceutical excipients where nanoparticle (NP) integrity and aerodynamic properties are both maintained after spray drying.…”

Recent Advances in Polymeric Nanoparticle-Encapsulated Drugs against Intracellular Infections

“…It used PNs functionalized with the Fc fragment of IgG to target neonatal Fc receptor (FcRn) through an FcRn-mediated transcytosis mechanism so the PNs can finally overstep the intestinal epithelium. Valuable information that may be of interest to the reader have also been reviewed elsewhere regarding nanotherapeutics of leishmaniasis [ 120 , 236 , 237 ], tuberculosis [ 238 , 239 , 240 , 241 , 242 ], viral infections [ 243 , 244 ], HIV [ 245 , 246 , 247 , 248 , 249 ], malaria [ 118 , 250 , 251 , 252 ], infectious diseases [ 4 , 45 , 66 , 253 ], intracellular delivery [ 59 , 60 , 64 , 83 , 254 , 255 ], bacterial pathogens [ 46 , 192 , 256 , 257 , 258 , 259 ] and stimuli-responsive systems [ 15 , 58 , 260 , 261 , 262 ].…”

Efficacy of Combined Rifampicin Formulations Delivered by the Pulmonary Route to Treat Tuberculosis in the Guinea Pig Model

“…To avoid these limitations of the treatment with RMs, future studies should employ microparticles manufactured by spray drying that would have smaller sizes and less aggregation or they should be delivered as dry powders. Several research groups have developed dry powder formulations of liposomes [ 17 , 18 , 32 , 33 ], which may enhance the efficiency of the aerosol delivery of anti-TB drugs.…”

“…Liposomes have been employed to enhance drug absorption of drugs with poor water solubility including amphotericin B [ 11 ], doxorubicin [ 12 ] and docetaxel [ 13 ]. They have also been considered for the pulmonary delivery of anti-cancer drugs [ 14 , 15 ] and anti-TB drugs [ 16 , 17 , 18 , 19 ] as well as for biopharmaceutical compounds such salmon calcitonin [ 20 ]. Notably, in September 2018, the FDA approved the use of Arikayce (an amikacin liposome inhalation suspension) for the treatment of lung infections by the Mycobacterium avium complex [ 21 ].…”