Tuberculosis Therapy Uses Targeted Drug Delivery With Nanoparticles, Providing a New Approach in Fighting Antibiotic Resistance

Tuberculosis remains one of the infectious diseases with the highest death rate worldwide. The World Health Organization (WHO) confirms that antibiotic-resistant tuberculosis is increasing and continue to be a public health crisis, bringing challenges in treating dangerous infectious disease.

New Insight in Tuberculosis Therapy

Tuberculosis presents two challenges in medical treatment. First, the bacteria thriving in the lungs are enclosed in tissue and remain inactive for years, causing symptoms after the onset of the primary infection. Second, the bacteria that trigger this disease usually resist two or more common antibiotics used in conventional treatments.

As a response to this concern, researchers from the Karlsruhe Institute of Technology (KIT) developed a nanoparticle that can deliver new antibiotics directly to the target area of the lungs. Headed by Professor Claus Feldmann, the team produced nanoparticles containing high concentrations of antibiotics.

The nanoparticles will be used in carrying the new antibiotics directly to the source of infection and infected cells, increasing the drug concentration in the local areas of the lungs. However, the newly developed antibiotics are usually lipophilic and fat-soluble, making them difficult to be administered in water and absorb in the stomach, blood, or cell fluid. To address this issue, the researchers added surfactants to the nanoparticles to make sure that the highly fat-soluble drugs would be dispersed very finely in water and could also be inhaled.

Until now, the concentration of antibiotics for tuberculosis is only up to 10% of the total weight of the particles. Feldmann and his colleagues successfully made their version up to 99%. The nanocarriers made by KIT scientists can also be dispersed in water and inhaled as an aerosol.

When it was first tested at the Research Center Borstel, Leibniz Lung Center, it was found that the developed nanoparticles demonstrate high effectiveness and good compatibility with the ideal nanocarriers of antibiotics.

The new approach has already been tested in mice, but the researchers plan to apply its formulation in humans. Feldmann and his team are confident that the nanocarriers they developed can overcome biological barriers commonly encountered during tuberculosis therapy. They are convinced that it is possible to carry high doses of antibiotics directly to the site of infection in the lungs without causing damage to the other organs.

What is a Multidrug-resistant Tuberculosis?

According to the Centers for Disease Control and Prevention (CDC), multidrug-resistant tuberculosis (MDR TB) is an infection caused by bacteria that can resist at least isoniazid and rifampin. These are the two most potent drugs used in treating all persons with tuberculosis.

Resistance to drugs happens when the medicines are inappropriately used for various reasons, such as incorrect prescriptions, poor drug quality, and prematuretreatment stoppingt. Fortunately, MDR TB can be treated and cured using second-line drugs. However, the second-line treatment options usually require extensive toxic and expensive therapy. It is estimated that about 1 in every three people with drug-resistant tuberculosis have access to treatment as of 2021.