A single pathogen, mycobacterium tuberculosis, causes tuberculosis (TB), which primarily impacts the lungs but can also affect the central nervous system (CNS).
New research reveals novel nanotech approaches to treat and manage TB. Today, the bacterial infection is recognised as one of the worst infectious and contagious illnesses in the world after HIV/AIDS.
In a 2022 World Health Organization (WHO) report analysing key changes to treating drug-resistant TB, 10 million people were estimated to have developed the disease in 2020, with 1.5 million people losing their lives to TB. In response to the impact of the Covid-19 pandemic, the incidence of TB may increase in 2022 and 2023, the Global tuberculosis report 2021 reported.
Every year, approximately 500,000 new cases of multidrug or rifampicin-resistant TB are estimated to emerge, prompting new developments in the treatment of TB.
Problems preventing progression
Researchers highlight the emerging problem of antimicrobial resistance in TB, which need“urgent treatment and management”.
Several factors have blighted TB treatment progression by extensively drug-resistant (XDR) and multidrug-resistant (MDR) treatment approaches. TB treatment is complicated by its long-term therapy, a high medication burden, insufficient compliance, strict management routines and serious side effects.
In light of its prevalence, severity and the broader healthcare context impacting TB treatment, the scientific team explored the applicability and validity of innovation in intervention tools. The researchers sought to better understand the potential of these tools for early diagnosis and therapeutics.
Nanotech application for tuberculosis treatment
Various nanotherapeutic agents have been developed for MTB diagnostics, anti-TB drugs and vaccines.
The use of nanoparticles (NPs) to treat TB has strong potential, the researchers stated in their study, suggesting their successful outcomes when applied in treatment pathways. Scientists designed nanocarriers with different types of NPs for drug delivery applications via various administration methods.
Opting for a drug with NPs to treat TB rather than traditional drug selections may enable clinicians to control and maintain the release of medications to help treat and manage the condition more effectively. NP-based drugs can also reduce the dosage burden and overcome issues with a lack of compliance.
While NPs have been developed for TB over the past decade, the therapeutic systems have become prominent using diagnostic and therapeutic methods (theranostic). Theranostic approaches to TB management were designed to conduct nuclear imaging, optical imaging, ultrasound, imaging with magnetic resonance, and computed tomography.
Problems with resistance to conventional TB drugs mean therapeutic methods require high doses of numerous medications over a longer time. Issues with the practical capabilities of traditional drugs for TB also exist. Solubility, stability, and penetration impact the drugs’ effectiveness. Traditional drugs may also create resistance over time, a relapse, and extend to other body parts, leading to secondary TB.
Enhancing TB treatment with nanotech
Using nanomaterials to deliver drugs to treat TB and infectious lung diseases can provide numerous advantages over traditional drug delivery methods. In the review, the researchers conclude that pulmonary nano drug delivery systems as a therapeutic agent for treating TB “has become extremely useful”.
Benefits of nanomaterial-based treatment include targeted drug delivery, improved drug solubility, reduced toxicity, lowered side effects compared to conventional drug routines that cause XDR and MDR, and synergistic therapeutic effects.
The marketability of nanocarriers can be enhanced by conjugating these with ligands, the receptor. In recent years, ligand-anchored nanocarrier systems have been explored to ascertain their relevance for pulmonary TB. Lectin, mycolic acid, ligand-anchored pH-sensitive liposomes and nano-embedded microparticles are areas relevant to TB drug delivery.
However, despite the potential of nanomaterials in treating TB, the ability to accurately ascertain the pros and cons of a particular drug delivery system may be challenging as variations can occur based on the treatment procedures and targets defined.
Research gathers pace
Despite the nascent development of nanotech development in TB treatment, a body of research is growing. A 2023 study into the potential of nanomedicine for anti-TB therapy says that nanomedicine ispromising. . It offers the possibility of effective drug delivery using nanoparticles and reducing drug doses and side effects to improve patient compliance with TB treatment and enhance their recovery.
In a 2021 study, researchers found nanotherapeutics help to overcome the toxicity and poor solubility issues of several drugs used to manage TB. Due to their diameter and surface chemistry, nanocarriers encapsulated with antimicrobial medications are absorbed by macrophages. These macrophages act as target sites for active and passive nanocarrier targeting. As nanocarriers’ surface has ligand-specific receptors, this further improves drug concentration locally and suggests nanocarriers’ therapeutic potential.
In a 2020 study, researchers explored nanotechnology-based targeted drug delivery, calling it “an emerging tool to overcome tuberculosis”.Pulmonary administration is vital and its progression is a priority. Passive and active targeting strategies toward bacteria reservoirs are also crucial to overcome TB treatment challenges.
Queen’s University Belfast has a PhD programme to develop magneto-electric nanoparticles for advanced drug delivery of therapeutic agents to treat neurological TB and HIV. The University states “there is an urgent need” to develop innovative drug delivery strategies that effectively deliver drugs across the Blood Brain Barrier (BBB) as most anti-TB drugs such as isoniazid, pyrazinamide and rifampicin are unable to penetrate the BBB to remove TB effectively.
The University considers magneto-electric NPs a novel class of nanoparticles, exhibiting significant and beneficial magnetic and electric properties that can be controlled using magnetic and electric fields. Additionally, they can significantly enhance the transient permeability of the BBB through cell nano-electroporation. Therefore, NPs could carry drugs for TB for improved and targeted CNS delivery.
Emerging yet experimental
Nanotech solutions in treating TB “remains an experimental approach and bears some promise in TB diagnostics, therapeutics, vaccines”, a spokesperson for WHO told Medical Technology.“We are keenly watching the space for more data and evidence to emerge, but it is too early for us to start working on them meaningfully,” adds the WHO spokesperson.
“Although nanomedicines have great potential, they are currently in the middle of their development,” the researchers of the newly-released innovative approaches study said. Today, research is ongoing regarding concerns relating to physicochemical analysis, pharmacological activity, and pharmacodynamic applications. Based on current trends in clinical trial stages, the researchers predict new drugs will emerge as a nanomedicine therapy, particularly in the respiratory system, in the next several years.
“The overall future for nanoparticle drug delivery systems is promising since they are being developed not just for diagnosing and treating respiratory diseases but also for a wide range of other diseases,” the researchers conclude.