Bourguignon Tom, Godinez-Leon Jesus Alfredo, Gref Ruxandra
Institut des Sciences Moléculaires d'Orsay, Université Paris-Saclay, CNRS, 91405 Orsay, France.
Pharmaceutics. 2023 Jan 24;15(2):393. doi: 10.3390/pharmaceutics15020393.
Tuberculosis (TB) is currently the second deadliest infectious disease. Existing antitubercular therapies are long, complex, and have severe side effects that result in low patient compliance. In this context, nanosized drug delivery systems (DDSs) have the potential to optimize the treatment's efficiency while reducing its toxicity. Hundreds of publications illustrate the growing interest in this field. In this review, the main challenges related to the use of drug nanocarriers to fight TB are overviewed. Relevant publications regarding DDSs for the treatment of TB are classified according to the encapsulated drugs, from first-line to second-line drugs. The physicochemical and biological properties of the investigated formulations are listed. DDSs could simultaneously (i) optimize the therapy's antibacterial effects; (ii) reduce the doses; (iii) reduce the posology; (iv) diminish the toxicity; and as a global result, (v) mitigate the emergence of resistant strains. Moreover, we highlight that host-directed therapy using nanoparticles (NPs) is a recent promising trend. Although the research on nanosized DDSs for TB treatment is expanding, clinical applications have yet to be developed. Most studies are only dedicated to the development of new formulations, without the in vivo proof of concept. In the near future, it is expected that NPs prepared by "green" scalable methods, with intrinsic antibacterial properties and capable of co-encapsulating synergistic drugs, may find applications to fight TB.
结核病（TB）目前是第二大致命性传染病。现有的抗结核疗法疗程长、复杂，且有严重的副作用，导致患者依从性低。在这种背景下，纳米药物递送系统（DDSs）有潜力在降低毒性的同时优化治疗效果。数百篇出版物表明了该领域日益增长的关注度。在这篇综述中，概述了与使用药物纳米载体对抗结核病相关的主要挑战。关于用于治疗结核病的DDSs的相关出版物根据包封药物进行分类，从一线药物到二线药物。列出了所研究制剂的物理化学和生物学性质。DDSs可以同时（i）优化治疗的抗菌效果；（ii）减少剂量；（iii）减少用药剂量；（iv）降低毒性；总体而言，（v）减少耐药菌株的出现。此外，我们强调使用纳米颗粒（NPs）的宿主导向疗法是一个近期有前景的趋势。尽管用于结核病治疗的纳米DDSs的研究正在扩展，但临床应用尚未得到开发。大多数研究仅致力于新制剂的开发，而没有体内概念验证。在不久的将来，预计通过“绿色”可扩展方法制备的、具有内在抗菌特性且能够共包封协同药物的NPs可能会在对抗结核病中找到应用。
