Nanotechnology and pulmonary delivery to overcome resistance in infectious diseases

Adv Drug Deliv Rev. 2013 Nov;65(13-14):1816-27. doi: 10.1016/j.addr.2013.07.020. Epub 2013 Aug 7.

Abstract

Used since ancient times especially for the local treatment of pulmonary diseases, lungs and airways are a versatile target route for the administration of both local and systemic drugs. Despite the existence of different platforms and devices for the pulmonary administration of drugs, only a few formulations are marketed, partly due to physiological and technological limitations. Respiratory infections represent a significant burden to health systems worldwide mainly due to intrahospital infections that more easily affect immune-compromised patients. Moreover, tuberculosis (TB) is an endemic infectious disease in many developing nations and it has resurged in the developed world associated with the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Currently, medicine faces the specter of antibiotic resistance. Besides the development of new anti-infectious drugs, the development of innovative and more efficient delivery systems for drugs that went off patent appears as a promising strategy pursued by the pharmaceutical industry to improve the therapeutic outcomes and to prolong the utilities of their intellectual property portfolio. In this context, nanotechnology-based drug delivery systems (nano-DDS) emerged as a promising approach to circumvent the limitations of conventional formulations and to treat drug resistance, opening the hypothesis for new developments in this area.

Keywords: AmB; CDs; DDS; DPI; DSPC; Drug resistance; EDTA; GRAS; Inhalation; MAC; MBSA; MDR-TB; MIC; MRSA; Mycobacterium avium–Mycobacterium intracellulare complex; NPs; Nanoparticles; O-SAP; O-palmitoyl mannan; O-palmitoyl pullulan; O-steroyl amylopectin; OPM; OPP; PAM; PC; PC:Chol; PC:Chol:DCP; PC:Chol:P90; PLGA; Respiratory infections; SA-CSO; TB; Tuberculosis; XDR-TB; amphotericin B deoxycholate; cyclodextrins; distearoylphosphatidylcholine; drug delivery systems; dry powder inhalers; ethylenediaminetetraacetic acid; extensively drug-resistant TB; generally recognized as safe; mPEG–DSPE; maleylated bovine serum albumin; methicillin-resistant Staphylococcus aureus; minimum inhibitory concentration; multidrug resistant TB; nano-DDS; nanoparticles; nanotechnology-based drug delivery systems; p-aminophenyl-mannopyranoside; pMDI; phosphatidylcholine; phosphatidylcholine:cholesterol; phosphatidylcholine:cholesterol:P90; phosphatidylcholine:cholesterol:dicetylphosphate; poly(ethylene oxide)-b-distearoyl phosphatidyl-ethanolamin; poly(lactide-co-glycolide); pressurized metered-dose inhalers; stearic acid-grafted chitosan oligosaccharide; tuberculosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Animals
  • Anti-Infective Agents / administration & dosage*
  • Anti-Infective Agents / therapeutic use
  • Chemistry, Pharmaceutical
  • Drug Carriers / chemistry*
  • Drug Resistance, Microbial / drug effects*
  • Equipment Design
  • Humans
  • Nanoparticles / chemistry*
  • Nanotechnology / methods*
  • Nebulizers and Vaporizers
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / metabolism
  • Respiratory Tract Infections / microbiology

Substances

  • Anti-Infective Agents
  • Drug Carriers