Novel Approaches for the Treatment of Pulmonary Tuberculosis

Abstract

Tuberculosis (TB) is a contagious airborne disease caused by Mycobacterium tuberculosis, which primarily affects human lungs. The progression of drug-susceptible TB to drug-resistant strains, MDR-TB and XDR-TB, has become worldwide challenge in eliminating TB. The limitations of conventional TB treatment including frequent dosing and prolonged treatment, which results in patient’s noncompliance to the treatment because of treatment-related adverse effects. The non-invasive pulmonary drug administration provides the advantages of targeted-site delivery and avoids first-pass metabolism, which reduced the dose requirement and systemic adverse effects of the therapeutics. With the modification of the drugs with advanced carriers, the formulations may possess sustained released property, which helps in reducing the dosing frequency and enhanced patients’ compliances. The dry powder inhaler formulation is easy to handle and storage as it is relatively stable compared to liquids and suspension. This review mainly highlights the aerosolization properties of dry powder inhalable formulations with different anti-TB agents to understand and estimate the deposition manner of the drug in the lungs. Moreover, the safety profile of the novel dry powder inhaler formulations has been discussed. The results of the studies demonstrated that dry powder inhaler formulation has the potential in enhancing treatment efficacy.

Lung Targeted Lipopolymeric Microspheres of Dexamethasone for the Treatment of ARDS

“…It generates vitamin E in vivo, which also participates in lung surfactant biosynthesis. PLGA microspheres have been proved suitable for passive lung targeting and pulmonary therapy [44][45][46] Polydispersity index was found to be 0.31 indicating narrow size distribution. The same is also revealed from the SEM and TEM images (Figure 1B,C) showing multiple microspheres of uniform size that were round in shape with smooth surface and absence of particle aggregation.…”

“…It generates vitamin E in vivo, which also participates in lung surfactant biosynthesis. PLGA microspheres have been proved suitable for passive lung targeting and pulmonary therapy [ 44 , 45 , 46 ].…”

“…The in vitro release studies showed the release of 20% dexamethasone in the initial 1 h, followed by sustained release continued up to 24 h ( Figure 2 ). Microsphere particle size greatly affects the surface area to volume ratio, the polymer degradation rate, microsphere erosion rate and thus impacts the drug release rate from the encapsulating microsphere [ 45 ]. The size of microspheres plays a crucial role in regulating the drug release rate; increasing microsphere size results in a decreasing drug release rate and vice versa.…”

Strategies to Get Drugs across Bladder Penetrating Barriers for Improving Bladder Cancer Therapy

“…Bacillus Calmette–Guérin (BCG) is the live attenuated vaccine form of Mycobacterium bovis , which is primarily used against tuberculosis [ 14 , 15 ]. Intravesical BCG to treat bladder cancer is since 1976, BCG can induce immune responses in the bladder mucosa to treat residual tumors after TURBT and prevent the recurrence/progression of bladder cancer, which is the currently recommended therapy [ 16 ].…”

Systematic Evolution of Ligands by Exponential Enrichment Technologies and Aptamer-Based Applications: Recent Progress and Challenges in Precision Medicine of Infectious Diseases

“…Existing pathogen detection methods are difficult to achieve a balance between timeliness, accuracy and cost to meet the requirements of large-scale population screening. In addition, the existence of antibiotic-resistant microbes such as multidrug-resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) and methicillin-and aminoglycoside-resistant Staphylococcus aureus (MARSA) brings greater challenges to the prevention and treatment of infectious diseases ( Fauci et al, 2005 ; Tan Z. M. et al, 2020 ; Nang et al, 2021 ). Therefore, there is an urgent demand to develop rapid, economic, and sensitive early diagnostic assays for pathogens, and also adequate therapeutics of precision medicine for infectious diseases.…”