Bakker-Woudenberg I A, Lokerse A F
Department of Clinical Microbiology, Erasmus University Rotterdam, The Netherlands.
Scand J Infect Dis Suppl. 1990;74:34-41.
Since antibiotic treatment of severe infections is not always successful, intensification of the antibiotic treatment is needed. Targeting of antibiotics to infected tissues or cells by encapsulation in liposomes is under investigation and may be of importance in the treatment of infections that prove refractory to conventional forms of antibiotic therapy. In animal models of intracellular infections involving the mononuclear phagocyte system--parasitic, fungal, bacterial and viral infections--an improved therapeutic index and reduced toxicity resulting from encapsulation of the antibiotics in liposomes have been demonstrated. By varying the lipid composition of the liposomes it is possible to manipulate their intracellular degradation and thereby the intracellular release and therapeutic availability of the antibiotic. Efficacy of liposome-encapsulated antibiotics in the treatment of infectious diseases outside the mononuclear phagocyte system may be realized by manipulation of the liposome composition. Evidence for this is found in the treatment of systemic fungal infections, in which liposome appear to be very effective as a carrier of amphotericin B. The most advanced application of liposome-based therapy is in this field, and clinical studies with liposome-encapsulated amphotericin B have been in progress for several years.
由于严重感染的抗生素治疗并非总是成功，因此需要强化抗生素治疗。通过脂质体包封将抗生素靶向感染组织或细胞的研究正在进行中，这对于治疗那些对传统抗生素治疗无效的感染可能具有重要意义。在涉及单核吞噬细胞系统的细胞内感染的动物模型中（包括寄生虫、真菌、细菌和病毒感染），已证明将抗生素包封在脂质体中可提高治疗指数并降低毒性。通过改变脂质体的脂质组成，可以控制其细胞内降解，从而控制抗生素的细胞内释放和治疗效果。通过调整脂质体组成，有可能实现脂质体包封抗生素在单核吞噬细胞系统以外的传染病治疗中的有效性。在系统性真菌感染的治疗中可以找到这方面的证据，在该治疗中脂质体似乎是两性霉素B的非常有效的载体。基于脂质体的治疗的最先进应用就在这个领域，脂质体包封两性霉素B的临床研究已经进行了数年。
