Abstract
<p>Tuberculosis (TB) had been a leading chronic bacterial infection since decades. Current therapeutic management of Mycobacterium tuberculosis (MTB) is inadequate due to the lengthy course of treatment, drug-related side effects and ill-planned therapy, and these factors can lead to therapeutic failure and the emergence of drug-resistant TB. The Multi-drug-resistant (MDR) TB needs a lengthy course of treatment with second-line antitubercular drugs (ATDs) having higher side effects and cost. The misuse of second-line ATDs may result in extremely drug-resistant (XDR) strain which is very difficult to treat and require high doses of drugs resulting in more toxicity and side effects. This review highlights the need for novel drug delivery for the treatment of drug-susceptible and resistant TB. The characteristics of the nanoparticulate system in ATDs delivery and its approach in the MDR and XDR TB are discussed. The lung is the site of infection in pulmonary TB and the targeted drug delivery to the site of infection helps in achieving increased efficacy with less dose further reducing the side effects and toxicity. The symbiotic association of nanotechnology and pulmonary drug delivery give rise to an efficient inhalable polymer based nanoparticulate system containing ATDs for the better management of drug-susceptible and resistant TB. Various ATDs loaded polymer based nanocarrier systems like Alginate, PLGA, Chitosan and Gelatin nanocarriers are discussed in detail. Thus, this review highlights the current research in pulmonary drug delivery of polymer based ATDs nanomedicine and their importance in control of drug-resistant TB.</p>
Highlights
Tuberculosis (TB) is a chronic infectious disease, and the latent TB infection has affected over one-third of the people on this planet
The drawbacks like inefficient efficacy, poor tolerability of second line antitubercular drugs (ATDs) leads to withdrawal from treatment cause further resistance like extremely drug-resistant tuberculosis (XDR-TB) which results in the increase in high death rate due to the TB infection [5]
The conventional chemotherapy of TB has suffered from limitations like a lengthy course of treatment and drugs induce side effects
Summary
Tuberculosis (TB) is a chronic infectious disease, and the latent TB infection has affected over one-third of the people on this planet. The drawbacks like inefficient efficacy, poor tolerability of second line ATDs leads to withdrawal from treatment cause further resistance like extremely drug-resistant tuberculosis (XDR-TB) which results in the increase in high death rate due to the TB infection [5] This indicates the need for new drug delivery technology such as the use of novel controlled release nanoparticulate system like polymeric nanocarrier systems containing existing Anti-tubercular drugs (ATDs). The PLGA nanocarriers containing Streptomycin was given by oral route and, they possess various merits such as the increase in therapeutic efficacy, bioavailability and absence of nephrotoxicity as opposed to the free form of the drug [41] These studies showed that the polymeric nanocarriers possess significant characteristics to be used as a carrier system for second line ATDs. But the variability of drug-resistant with respect to the individual treatment is responsible for the limited data on nanotechnological approach in drug-resistant TB.
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