Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
Pharm Res. 2009 Nov;26(11):2401-16. doi: 10.1007/s11095-009-9957-4.
One third of the world population is infected with tuberculosis (TB), and new infections occur at a rate of one per second. The recent increase in the emergence of drug-resistant strains of Mycobacterium tuberculosis and the dearth of anti-TB drugs is threatening the future containment of TB. New drugs or delivery systems that will stop the spread of TB and slow down or prevent the development of drug-resistant strains are urgently required. One of the reasons for the emergence of drug-resistant strains is the exposure of mycobacteria to sub-therapeutic levels of one or more antibiotics. Lung lesions containing large numbers of bacteria are poorly vascularized and are fortified with thick fibrous tissue; conventional therapy by the oral and parenteral routes may provide sub-therapeutic levels of anti-TB drugs to these highly sequestered organisms. Administering drugs by the pulmonary route to the lungs allows higher drug concentrations in the vicinity of these lesions. Supplementing conventional therapy with inhaled anti-TB therapy may allow therapeutic concentrations of drug to penetrate effectively into lung lesions and treat the resident mycobacteria.
全球有三分之一的人口感染了结核病（TB），新的感染率为每秒一人。最近，结核分枝杆菌耐药菌株的出现和抗结核药物的缺乏，正在威胁着结核病的未来控制。迫切需要新的药物或输送系统来阻止结核病的传播，并减缓或预防耐药菌株的出现。耐药菌株出现的原因之一是结核分枝杆菌暴露于一种或多种抗生素的亚治疗水平。含有大量细菌的肺部病变血管供应不足，并有厚厚的纤维组织加固；口服和静脉途径的常规治疗可能会为这些高度隔离的生物提供亚治疗水平的抗结核药物。通过肺部途径向肺部给药可以使这些病变附近的药物浓度更高。用吸入性抗结核治疗来补充常规治疗可能会使治疗浓度的药物有效地渗透到肺部病变中，并治疗潜伏的分枝杆菌。
