Department of Pharmaceutics, School of Pharmaceutical Sciences and Technology, Sardar Bhagwan Singh University, Balawala, Dehradun, Uttarakhand, 248161, India.
Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Premnagar, Dehradun, Uttarakhand, 248007, India.
Tuberculosis (Edinb). 2022 Jul;135:102228. doi: 10.1016/j.tube.2022.102228. Epub 2022 Jun 24.
Despite advancements in the medical and pharmaceutical fields, tuberculosis remains a major health problem globally. Patients do not widely accept the conventional approach to treating tuberculosis (TB) due to prolonged treatment periods with multiple high doses of drugs and associated side effects. A pulmonary route is a non-invasive approach to delivering drugs, hormones, nucleic acid, steroids, proteins, and peptides directly to the lungs, improving the efficacy of the treatment and consequently decreasing the adverse effect of the treatment. This route has been successfully developed for the treatment of various respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), tuberculosis (TB), lung cancer, and other pulmonary infections. The major approaches of inhalation delivery systems include nebulizers, metered-dose inhalers (MDIs), and dry powder inhalers (DPIs). However, dry powder inhalers (DPIs) are more advantageous due to their stability and ability to deliver a high dose of the drug to the lungs. The present review analyzes the modern therapeutic approach of inhaled dry powders, with a special focus on novel drug delivery system (NDDS) based DPIs for the treatment of TB. The article also discussed the challenges of preparing inhalable dry powder formulations for the treatment of TB. The clinical development of inhalable anti-TB drugs is also reviewed.
尽管在医学和制药领域取得了进步，但结核病仍然是全球的一个主要健康问题。由于治疗结核病（TB）的时间长，药物剂量高，且存在相关副作用，患者普遍不接受传统的治疗方法。肺部给药途径是一种将药物、激素、核酸、类固醇、蛋白质和肽直接递送到肺部的非侵入性方法，可提高治疗效果，从而降低治疗的不良反应。这种方法已成功用于治疗各种呼吸系统疾病，如哮喘、慢性阻塞性肺疾病（COPD）、结核病（TB）、肺癌和其他肺部感染。吸入给药系统的主要方法包括雾化器、定量吸入器（MDIs）和干粉吸入器（DPIs）。然而，干粉吸入器（DPIs）更具优势，因为它们更稳定，能够将高剂量的药物递送到肺部。本综述分析了吸入干粉的现代治疗方法，特别关注基于新型药物输送系统（NDDS）的 DPIs 治疗结核病。文章还讨论了为治疗结核病制备可吸入干粉制剂的挑战。还回顾了可吸入抗结核药物的临床开发。
