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ο‚ž The chemotherapy of infections caused by bacteria that
inhabit intracellular presents a number of uncommon
challenges.
ο‚ž Many bacteria have found the way to produce a β€œsilent”
infection inside the cells and to avoid from their bactericidal
mechanisms.
ο‚ž Many methods for diagnosing and treating these and other
bacterial infections presently exist, there is an essential need
for new and improved approaches for bacterial destruction.
3
ο‚ž It is now clear that a nanotechnology-driven approach using
nanoparticles to selectively target and destroy pathogenic
bacteria can be successfully implemented.
ο‚ž Localized diseases such as infection and inflammation not
only have perforated vasculature but also over express some
epitopes or receptors that can be used as targets. Thus,
nanomedicines can also be actively targeted to these
locations.
4
ο‚ž Various types of nanoparticulate systems have been tried as
potential drug delivery systems:
biodegradable polymeric nanoparticles
Polymer micelles
Nanocapsules
Nanogels
Fullerenes
Solid lipid nanoparticles (SLN)
Nanoliposomes
Dendrimers
5
Metal nanoparticles
Quantum dots
ο‚ž In recent years, encapsulation of antimicrobial drugs in
nanoparticle systems has emerged as an innovative and
promising alternative that enhances therapeutic effectiveness
and minimizes the undesirable side effects of drugs.
ο‚ž The major goals in designing nanoparticles as delivery
systems are to control particle size, surface properties and
release of pharmacologically active agents in order to achieve
the site-specific action at the therapeutically optimal rate and
dose regimen.
6
ο‚ž Infectious diseases can be caused by either virus, bacterium,
fungus or parasite.
ο‚ž Communicable diseases ( malaria, tuberculosis, flu,
influenza)
ο‚ž Classification of infections :
1. Known disease: which are insistently there e.g.., dengue,
malaria, tuberculosis.
2. New, previously unknown diseases: e.g., severe acute
respiratory syndrome.
3. Diseases which threaten to enhance in near future e.g.,
avian influenza.
7
ο‚ž Bacteria classified here are on the basis of their
pathogenicity i.e.
ο‚ž Extra-cellular bacteria
ο‚ž Intra-Cellular bacteria
8
9
ο‚ž To produce disease, extracellular bacteria utilize any portal
of entry provided a satisfactory fluid medium be recognized
at the site of lesion. Extracellular pathogens utilize virulence
mechanisms to avoid the antimicrobial capabilities of humoral
immunity and phagocytosis thus advancing extracellular
reproduction.
ο‚ž Examples of such bacteria include, Staphylococcus aureus,
Streptococcus pyogenes, Pseudomonas aeruginosa,
Escherichia coli which have been considered extracellular
pathogens, and lesion infections, osteomyelitis, scarlet fever,
specified forms of pneumonia, urinary tract infections
10
ο‚ž To establish an infection, these pathogens have to make
contact with the appropriated type of host cell that provides
suitable intracellular conditions for growth. Bacteria such as
Mycobacterium, Legionella, Brucella or Listeria have
extended the ability to resist and replicate inside various
mammalian cells including the aggressive phagocytic cells,
which establish the first-line defense against invading
pathogens
11
ο‚ž As we know that some antibiotics suffer to reach their intra-
cellular tagets due to their hydrophillic nature
ο‚ž Secondly emergence of resistance from bacteria is problem in
therapy, which results by modification of tagets, drug
destruction by enzymes and by efflux of drug from cell.
12
ο‚ž As with nanoparticles targeting intracellular bacteria,
nanoparticles targeting the site of infection can release high
concentrations of antimicrobial drugs at the site of infection.
ο‚ž Nanopaticles can be used actively or passively.
ο‚ž Actively targeted nanoparticles contain ligands (e.g.
antibodies) that bind receptors (e.g. antigens) at sites of
infection
13
ο‚ž There some barriers while passive targeting with
nanoparticles which are:
ο‚ž Mucosal barriers
ο‚ž nonspecific uptake of the particle and non-specific delivery of
the drug (as a result of uncontrolled release
ο‚ž Targeting infections in RES (reticuloendothelial sites),
because It comprise of monocyte/like cells which are sites for
rapid clearance of drug
14
ο‚ž Hence nanoparticles are still the best approach for targeting
intra-cellular micro-organisms
ο‚ž Antibiotics loaded NPs can enter host cells through
endocytosis, followed by releasing the payloads to delete
intracellular microbes. The need to target drugs to specific
sites is increasing day by day as a result of therapeutic and
economic factors
15
ο‚ž Antimicrobial NPs propose several clinical advantages which
are:
ο‚ž First, the surface properties of nanoparticles can be changed
for targeted drug delivery for e.g. small molecules, proteins,
peptides, and nucleic acids loaded nanoparticles are not
known by immune system and efficiently targeted to special
tissue types
16
ο‚ž Second, nanocarriers may overcome solubility or stability
issues of the drug and minimize drug-induced side effects.
ο‚ž Third, using nanotechnology, it may be possible to achieve
co-delivery of two or more drugs or therapeutic modality for
combination therapy.
ο‚ž Fourth, NP-based antimicrobial drug delivery is promising in
overcoming resistance to common antibiotics developed by
many pathogenic bacteria
17
ο‚ž Five, administration of antimicrobial agents using NPs can
progress therapeutic index, extend drug circulation (i.e.,
extended half-life), and achieve controlled drug release,
increasing the overall pharmacokinetics.
ο‚ž Six, the system can be used for several routes of
administration including oral, nasal, parenteral, intra-ocular
etc
18
ο‚ž Although nanoantibiotics promises significant benefits, there
are foreseeable challenges in translating this exciting
technology for clinical application which are as follows:
ο‚ž The toxic effects of antimicrobial NPs on central nervous
system (CNS) are still unknown, and the interactions of NPs
with the cells and tissues in CNS are poorly understood.
19
ο‚ž Furthermore, NPs represent size-specific properties that limit
the use of currently available in vitro experiments in a general
way, and there is no standardized definition for NP dose in
mass, number, surface area, and biological samples (e.g.,
blood, urine, and inside organs)
ο‚ž NPs usually have short circulation half-life due to natural
defense mechanism of human body for eliminating them after
opsonization by the mononuclear phagocytic system.
Therefore, the particles surfaces need to be changed to be
hidden to opsonization
20
ο‚ž There are many types of nanoparticles which are given
in next slides with their brief information.
21
ο‚ž Polymer-based nanoparticles are submicron-sized polymeric
colloidal particles in which a therapeutic agent of interest can
be embedded or encapsulated within their polymeric matrix or
adsorbed or conjugated onto the surface.
ο‚ž The drugs may also be sensitive to gastroin‐ testinal
degradation by digestive enzymes
22
ο‚ž The advantage of using polymeric nanoparticles is to permit
encapsulation of bioactive molecules and protect them against
enzymatic and hydrolytic degradation.
ο‚ž Therapeutically used polymeric nanoparticles are composed
of biodegradable or biocompatible materials, such as poly (Ξ΅-
caprolactone) (PCL), poly(lactic acid) (PLA), poly(lactic-co-
glycolic acid) (PLGA), alginic acid, gelatin and chitosan
23
ο‚ž Polymeric nanoparticles possess several unique
characteristics for antimicrobial drug delivery.
ο‚ž Firstly, polymeric nanoparticles are structurally stable and can
be synthesized with a sharper size distribution
ο‚ž Secondly, particle properties such as size, zeta potentials, and
drug release profiles can be accurately tuned by selecting
different polymer lengths, surfactants, and organic solvents
during the synthesis.
24
ο‚ž Thirdly, the surface of polymeric nanoparticles typically
contains functional groups that can be chemically changed with
either drug moieties or targeting ligands
25
ο‚ž A hydrogel is a network of hydrophilic polymers that can
swell in water and hold a large amount of water while
maintaining the structure. Drugs can be loaded into the
polymer matrix of these materials and controlled release is
dependent on the diffusion coefficient of the drug across the
hydrogel network
ο‚ž Hydrogels are biocompatible hydrophilic networks that can
be constructed from both synthetic and natural materials
26
ο‚ž Hydrogels can be classified based on a variety of
characteristics, containing the nature of side groups (neutral
or ionic), mechanical and structural features (affine or
phantom), method of preparation (homo-or co-polymer),
physical structure (amorphous, semicrystalline, hydrogen
bonded, supermolecular, and hydrocollodial), and
responsiveness to physiologic environment stimuli (pH, ionic
strength, temperature, electromagnetic radiation, etc.)
27
ο‚ž Hydrogel/glass composite (Nitric oxide-releasing
nanoparticles) NO NPs have also been shown to have a high
degree of effectiveness against (Methicillin-resistant
Staphylococcus aureus) MRSA infection in several different
mouse models
ο‚ž A variety of strategies for introducing hydrophobic domains
directly into otherwise hydrophilic hydrogel networks have
permitted significant improvements in the loading of
hydrophobic drugs
28
ο‚ž Despite these many advantageous properties, hydrogels also
have several limitations. The low elastic force of many
hydrogels limits their use in load-bearing applications and can
result in the precocious decomposition or flow away of the
hydrogel from a targeted local site
ο‚ž But It can be covered in typical drug delivery applications
such as sub-cutaneous injections.
29
ο‚ž Consequently, the use of metallic nanoparticles for drug
delivery is a concern
ο‚ž Different types of Nanoparticles are discussed briefly as
follows
30
ο‚ž Gold nanoparticles (GNPs) have found many applications in
many fields such as cancer diagnosis and therapy, drug and
gene delivery, DNA and ptotein determination, etc
ο‚ž GNPs are suitable for the delivery of drugs to cellular
destinations due to their ease of synthesis, functionalization
and biocompatibility.
31
ο‚ž Conjugates of gold nanoparticles with antibiotics and
antibodies also have been used for selective photothermal
killing of protozoa and bacteria
ο‚ž GNPs conjugates has been ascribed to their ability to bind to
and/or penetrate the cell wall and, in doing so they are able to
deliver a large number of antibiotic molecules into a highly
localized volume
32
ο‚ž Silver nanoparticles of size smaller than 100 nm contain
about 10000–15000 silver atoms. They are prepared by
engineering the metallic silver into ultrafine particles by
numerous physical methods, including spark discharging and
cryochemical synthesis
ο‚ž The most widely used and known application of silver
nanoparticles is in the medical sciences include topical
ointments and creams containing silver to prevent infection of
burns and open wound.
33
ο‚ž Iron oxide nanoparticles (IONPs) are magnetic Fe3O4 or
Fe2O3 nanocrystals which can interact with external
magnetic fields, offering different opportunities in
nanomedicine, e.g., as contrast agents in MRI, for magnetic
hyperthermal therapies, or as magnetically triggerable drug
delivery systems.
ο‚ž However, in most of the cases where magnetic nanocarriers
have been used, difficulties in achieving these objectives
appeared
34
ο‚ž The vancomycin conjugated iron oxide nanoparticles were
utilized as probes to selectively entrap S. saprophyticus
ο‚ž Among the nanoparticles, Fe3O4 showed maximum activity
against pseudomonas aeruginosa. The reactive oxygen species
(ROS) generated by Fe3O4 nanoparticles could kill bacteria
without harming nonbacterial cells
35
ο‚ž Silica materials have been proved to be efficient carriers for
the local release of antibiotics, which could be of interest in
the context of biofilm associated infections, which are a real
challenge for the modern medicine. Moreover, mesoporous
silica has been found to be relatively β€œnon-toxic” and
biocompatible, however of course depending on dose and
administration route
ο‚ž Nanoporous silica materials possess large pore volumes and
high surface areas, allowing the absorption of large amounts
of drugs, thus providing sufficient concentrations for local
treatment
36
ο‚ž The surface of silica materials is reactive due to the presence
of silanol groups. This allows for facile modification by
silanization reactions and thus opens possibilities for
enhancing the drug loading and for controlling the drug
release
ο‚ž Till present there are only few reports concerning the
application of silica materials, crystalline or amorphous, in
the antimicrobial therapy
37
ο‚ž Micelles are submicroscopic aggregates of surfactant
molecules assembly of amphiphillic block copolymers or
polymer-lipid conjugates or other surface-active molecules
that selfassemble in aqueous media to form structures with a
hydrophobic core.
ο‚ž Their small size (1-50 nm) makes them ideal for intravenous
delivery. In addition they are also more stable, when
compared to liposomes due to be ability to design them to be
chemically stable and biocompatible
ο‚ž One specific feature of micelles is that the amount of drug
released can be controlled by an external stimulus like pH,
temperature, ultrasound or certain enzymes 38
ο‚ž Other unique properties of polymeric micelles are that they
are easily altered with small functional groups that enhance
their targeting potential
ο‚ž The disadvantage for the polymeric micelle systems is the
immature technology for drug incorporation in a physical
manner
ο‚ž The another disadvantage is much slower extravasations of
polymeric carrier systems than that of low molecular weight
drugs
39
ο‚ž Liposomes are small spherical vesicles in which one or more
aqueous parts are completely surrounded by molecules that
have hydrophilic and hydrophobic functionality. Liposomes
change with composition, size, surface charge and method of
preparation. They can be single or in multiple bilayers. Those
including one bilayer membrane are called small unilamellar
vesicles or large unilamellar vesicles based on their sizes
ο‚ž Liposomes are also the most broadly used antimicrobial drug
delivery vehicles because their lipid bilayer structure imitators
the cell membrane and can readily fuse with infectious
microbes
40
ο‚ž One of the disadvantages of liposomal antibiotics is the short
shelf lives of lipid vesicles, which limits drug stability. Short
shelf lives can be conditioned by both physical and chemical
processes.
ο‚ž There are many advantages of liposomes as antibiotic
carriers: improved pharmacokinetics and biodistribution;
decreased toxicity; enhanced activity against intracellular
pathogens; target selectivity; enhanced activity against
extracellular pathogens, in particular to overcome bacterial
drug resistance
ο‚ž The ability of liposomes to alter drug distribution depends
mostly on their size and surface properties
41
ο‚ž Thus, liposomal encapsulation of antibiotics helps to increase
their therapeutic index with mode of action related to
increasing the drug concentration at the site of infection
and/or reducing its toxicity
ο‚ž Encapsulation of vancomycin and teicoplanin in liposomes
resulted in significantly improved elimination of intracellular
methicillin resistant S. aureus (MRSA) infection.
ο‚ž Netilmicin liposomes showed an increase in pharmacological
activity in a peritonitis model of mice infected with E. coli, in
terms of survival both prophy‐ lactically and therapeutically
42
ο‚ž SLNs are sub-micron colloidal carriers, ranging from 50 nm
to 1 ΞΌm, that are composed of physiological lipid dispersed in
water or in aqueous surfactant solution. In the last decade
SLNs have gained considerable interest as novel particulate
drug delivery systems.
ο‚ž SLNs are suitable for the incorporation of lipophilic and
hydrophilic drugs within the lipid matrix in considerable
amount
43
ο‚ž Some advantages of SLNs are possibility of controlling drug
release and drug targeting, increased drug stability, high drug
payload, possibility of the incorporation of lipophilic and
hydrophilic drugs, lack of biotoxicity of the carrier, no
problems with respect to large-scale production, sterilization
possibility, and good tolerability
ο‚ž SLNs are considered good drug carriers to obtain sustained
release of antibiotics .
ο‚ž SLNs can act as promising carriers for sustained ciprofloxacin
release in infections or to enhance the bioavailability of
tobramycin from antibiotic-loaded SLN in the aqueous humor
for topical ocular delivery
44
ο‚ž Common disadvantages of SLN are their particle growing,
their unpredictable gelation tendency, their unexpected
dynamics of polymorphic transitions and their inherent low
incorporation rate due to the crystalline structure of the solid
lipid.
ο‚ž Even though the development history of SLN-based
antimicrobial drug delivery systems is relatively shorter than
other nanoparticle systems such as liposomes and polymeric
nanoparticles, SLNs have shown great therapeutic potentials
45
ο‚ž Fullerenes are a new form of carbon, other forms being
diamond, graphite, and coal. They can take three forms of a
hollow sphere, ellipsoid, or tube. Their small size, spherical
shape, and hollow interior all provide therapeutic
opportunities
ο‚ž The most abundant form of fullerenes is buckminsterfullerene
(C60) with 60 carbon atoms arranged in a spherical structure
46
ο‚ž Since fullerenes possess unique geometrical shapes, as well as
novel photophysical properties, in addition to being efficient
radical scavengers, a wide variety of biological applications
have been considered
47
ο‚ž Dendrimers are globular repeatedly branched macromolecules
that exhibit controlled patterns of branching with multiple
arms extending from a central core
ο‚ž Asymmetric dendrimers are synthesized by coupling
dendrons of different generations (G1-G4) to a linear core,
which yields a branched dendrimer with a nonuniform
orthogonal architecture
48
ο‚ž Dendrimers also possess many unique properties that make
them a good nanoparticle platform for antimicrobial drug
delivery
ο‚ž Dendrimers can be made from a wide variety of
biocompatible materials, the most frequently used are
polyamidoamine (PAMAM), polyethylene oxide (PEO),
polypropylene imine (PPI), polyethyleneimine (PEI),
polyethylene glycol (PEG) etc
49
ο‚ž Sulfamethoxazole (SMZ)-encapsulating PAMAM dendrimers
led to sustained release of the drug in vitro and 4–8 folds
increased antibacterial activity against E. coli, compared to
free Sulphamethoxazole.
50
ο‚ž Zeolites are solid hydrated crystalline materials with frame-
works comprising silicon, aluminum and oxygen and
featuring nano-channels and cages of regular dimensions.
Silica is a neutral regular tetrahedron in which positive charge
of silicon ion is balanced by oxygen. Zeolites are minerals
with selective pores that can be used to sieve molecules
having certain dimensions
ο‚ž Generally, zeolits with a low silica/alumina (Si/Al) ratio have
higher ion exchange capacity
51
ο‚ž According Si/Al ratio, there are several types of natural and
synthetic zeolites including zeolite-Ξ², zeolite A, zeolite X and
zeolite Y, which are the most common commercial
adsorbents.
ο‚ž Coating or impregnating zeolite with metallic silver
nanoparticles to prepare zeolite composites can enhance the
antibacterial ability of materials, and these materials can
inhibit bacterial growth effectively.
ο‚ž It has been reported that silver embedded zeolite A was found
to be antibactrerial against E. coli, Bacillus subtilis and
staphy‐ lococcus aureus
52
ο‚ž Several in vivo and in vitro studies have reported the potential
applications of various nanoparticle based carrier systems to
enhance the selectivity of antibiotics for phagocytic cells and
sustain therapeutic efficiency in the treatment of intracellular
infections, Such as ,infections due to mycobacteria,
Brucellocis, salmonellosis, lysteriosis etc
53
ο‚ž Tuberculosis, caused by Mycobacterium tuberculosis, is a
lung infection.
ο‚ž Mycobacterium avium complex (MAC) is the main cause of
hardships in immunocompromised patients.
ο‚ž The treatment for the disease is extended and increasing the
risk of side effects.
54
ο‚ž Main issue with this is the patient non-compliance which is
the main cause of treatment failure & drug resistance.
ο‚ž The encapsulation of antitubercular drugs in polymeric
particles is another strategy to improve the current therapeutic
regimen of tuberculosis.
ο‚ž Fawaz, et al. encapsulated the drug ciprofloxacin in
polyisobutylcyanoacrylate (PIBCA) nanoparticles. These
nanoparticles were tested against M.avium ifection in human
macrophage culture and concluded that nanoparticles bound
ciprofloxacin was more effective than unbound drug.
55
ο‚ž Brucellosis is infectious disease caused by Brucella spp.
ο‚ž Four species are known to be pathogenic i.e. Brucella abortis,
Brucella melitensis, Brucella suis & Brucella canis.
ο‚ž Because of its intracellular location, long treatment with
several antibiotics is required. Replases are frequent due to
low efficacy & patient non compliance.
56
ο‚ž So, alternative methods such as DDS should be considered.
ο‚ž Gentamicin, encapsulated in different types of liposomes, has
been evaluated against murine monocytes infected with B.
abortus. All such liposomes reduced the number of bacteria,
the most effective being SPLVs (stable plurilamellar vesicles).
ο‚ž Thus, alternative methods such as DDS to achieve high
intracellular bactericidal activity see promising. The possible
use of drug delivery systems containing aminoglycosides may
be one of the most appropriate therapeutic advances in human
brucellosis treatment in the recent years
57
ο‚ž Salmonellosis is serious food-borne disease affecting humans.
The bacteria is intracellular parasite.
ο‚ž Antibiotics effective against this type of bacteria have
limitations owing to the problems of formulation, low
penetration, or the appearance of side effects; these can be
solved using carrier systems
58
ο‚ž Several studies using antibiotic-loade nanoparticles have been
performed in order to recognize the suitability and efficacy of
these carriers in experimental models of salmonellosis
ο‚ž Page-clisson et al. compared the effect of carrier
polyalkylcyanoacrylate nanopartilcels in Salmonella
typhemurium infection and free ciprofloxacin components.
ο‚ž Compared with free ciprofloxacin, it extends survival and
reduces the number of bacteria in the liver and spleen.
59
ο‚ž Lysteria monocytogenes is intracellular parasite that causes
meningitis & septicemia.
ο‚ž The encapsulation of ampicillin in liposomes decreases the
survival of L. monocytogenes in mouse peritoneal
macrophages to different extents, depending on the
composition of the liposomes.
60
ο‚ž Chitosan-coated plastic films, alone or loaded with
antimicrobial agents, were evaluated for their effect against L.
monocytogenes.
ο‚ž These chitosan-coated films inhibited this pathogen growth in
a concentration-dependent manner whereas chitosancoated
films impregnated with antibiotics were significantly more
effective against L. monocytogenes.
61
ο‚ž Attractive features, such as increased dissolution velocity,
increased saturation solubility, improved bioadhesivity,
versatility in surface modification and ease of post-production
processing, have widened the applications of nanosuspensions
for various routes
ο‚ž The applications of nanosuspensions in parenteral and oral
routes have been very well investigated and applications in
pulmonary and ocular delivery have been discovered.
However, their applications in buccal, nasal and topical
delivery are still awaiting exploration
62
ο‚ž Nanoparticles have a significant drug delivery role in
following routes.
ο‚ž Oral delivery
ο‚ž Pulmonary delivery(inhalers etc)
ο‚ž Ocular delivery
ο‚ž Brain delivery( their lipophillicity and small particle size
plays a vital role by crossing blood brain barrier)
63
ο‚ž Oral delivery of drugs using nanoparticles is far superior to
the delivery of free drugs in terms of bioavailability, residence
time and biodistribution.
ο‚ž Oral drug delivery is the choicest route for drug
administration because of its non invasive nature.
ο‚ž The advantage of using polymeric nanoparticles is to permit
encapsulation of bioactive molecules and maintain them
against enzymatic and hydrolytic degradation.
64
ο‚ž The efficacy & proficiency of the orally administered drug
commonly depends on its solubility & absorption through
gastrointestinal tract.
ο‚ž Therefore, a drug candidate that represents poor aqueous
solubility or decomposition rate, limited absorption is
believed to possess low 0r highly variable oral bioavailability.
65
ο‚ž Fattel et al. achieved the protection of mice against S.
typhimurium following oral administration of S. typhimurium
phosphorylcholine antigen encapsulated in PLGA particles.
ο‚ž Pinto and Muller (1999) incorporated SLN into spherical
pellets and investigated SLN release for oral administration.
ο‚ž Orally administered antibiotics such as atovaquone and
bupravaquone replicate this problem very well. Nanosizing of
such drugs can lead to a dramatic increase in their oral
absorption and consequently bioavailability
66
ο‚ž Besides its non-invasive nature, pulmonary drug delivery has
many other advantages compared to alternative drug delivery
strategies, containing a large surface area for solute transport,
rapid drug uptake, and improved drug bioavailability.
ο‚ž It was reported that intratracheally administered antibiotics
loaded NPs were able to penetrate through the alveolar-
capillary barrier into the systemic circulation and accumulate
in extrapulmonary organ containing liver, spleen, bone, and
kidney
67
ο‚ž Micronization of drugs plays an important role in improving
the drug dosage form and therapeutic efficiency today. If a
drug is micronized into microspheres with suitable particle
size, it can be addressed directly to the lung by the
mechanical prevention of capillary bed in the lungs.
ο‚ž Nanosuspensions may demonstrate to be an ideal approach
for delivering drugs that display poor solubility in pulmonary
secretions
68
ο‚ž Furthermore, because of the nanoparticulate nature and
uniform size distribution of nanosuspensions, it is very likely
that in each aerosol droplet at least one drug nanoparticles is
contained, leading to even distribution of the drug in the lungs
as compared to the micro particulate form of the drug.
ο‚ž In regular suspension aerosols many droplets are drug free
and others are highly filled with the drug, directing to uneven
delivery and circulating of the drug in the lungs.
Nanosuspensions could be utilized in all available types of
nebulizer
69
ο‚ž In a recent study, antitubercular drugs (rifampicin, isoniazid
and pyrazinamide) were incorporated into various
formulations of solid lipid particles ranged from 1.1–2.1 ΞΌm
and formulations were nebulized to guinea pigs by mouth for
direct pulmonary delivery.
ο‚ž Conditions such as pulmonary aspergillosis can easily be
targeted by using suitable drug candidates, such as
amphotericin B, in the form of pulmonary nanosuspensions
instead of using stealth liposome.
70
ο‚ž Nanosuspensions can assay to be a advantage for drugs that
show poor solubility in lachrymal fluids. For delivery of such
drugs, approaches such as suspensions and ointments have
been proposed.
ο‚ž Although suspensions present advantages such as extended
residence time in a cul-de-sac (which is desirable for most
ocular diseases for effective treatment) and avoidance of the
high tonicity produced by water-soluble drugs, their actual
performance depends on the native solubility of the drug in
lachrymal fluids.
71
ο‚ž Thus, the intrinsic decomposition rate of the drug in
lachrymal fluid governs its release and ocular bioavailability.
ο‚ž An approach that has recently been investigated to achieve
the desired duration of action of the drug is the formulation of
polymeric nanosuspensions loaded with the drug.
ο‚ž Cavalli et al (2002) evaluated SLN as carriers for ocular
delivery of tobramycin in rabbit eyes. As a result SLN
significantly enhanced the drug bioavalability in the aqueous
humor within 6 hours.
72
ο‚ž In addition, poly-cationic polymers may be useful penetration
enhancers for ocular drug delivery. De Salamanaca et al. have
reported that chitosan nanoparticles readily penetrate
conjunctival epithelial cells and are well suffered at the ocular
surface of rabbits.
ο‚ž De Campos et al. discovered the potential of cyclosporin-A
loaded nanoparticles for the management of extraocular
disorders, i.e. keratoconjunctivitis sicca or dry eye disease.
ο‚ž They reported that the advantages of these systems in ocular
drug delivery contain their ability to contact intimately with
the corneal and conjunctival surface, thereby increasing
delivery to external ocular tissues without compromising
inner ocular structures and systemic drug exposure, and to
provide these target tissues with long term drug level
73
ο‚ž One of the most challenging barriers in the body is the blood–
brain barrier (BBB).
ο‚ž Endothelial cells of the BBB limit the solute movement into
the brain by regulating transport mechanisms at the cell
surface. These transport mechanisms help to keep the harmful
substances out of the brain in order to maintain homeostasis
74
ο‚ž Emerging approach to circumvent the BBB is the use of
liposomes, polymeric nanoparticles or solid lipid
nanoparticles, in which the therapeutic drugs can be adsorbed
or entrapped.
ο‚ž A drug can passively spread through the BBB in a more
efficient manner after it is transformed into a more lipophilic
prodrug.
ο‚ž Fenart et al demonstrated that when polysaccharide
nanoparticles were coated with a lipid bilayer, a 3 to 4-fold
improvement in brain uptake without disruption of the BBB
integrity was observed.
75
ο‚ž Industrial applications of the nanosphere technology would
have several benefits:
1. Nanoparticles deliver drugs to the brain that normally do
not cross the blood-brain barrier.
2. They reduce peripheral side effects of (approved) drugs that
cross the BBB by increasing the relative dose of drugs
reaching the brain.
3. Nanoparticles can also be used as a screening tool.
Delivering drug candidates to the brain by nanosphere
technology for initial screening of CNS activity obviates
direct CNS injections.
76
ο‚ž Recently dendrimers have been evaluated for CNS delivery of
antiretrovira (ARVs) too. Polyamidoamine dendrimers loaded
with lamivudine, a nucleoside/nucleotide reverse transcriptase
inhibitor (NRTI) commonly utilized in HIV treatment.
ο‚ž When loaded on dendrimeric nanocarriers, a 21-fold increase
in cellular lamivudine uptake and 2.6-fold reduction in the
viral load were observed when compared to the group treated
with free drug solution.
77
ο‚ž Compared with other colloidal carriers, polymeric particles,
mainly nanoparticles, have appeared more recently as
attractive carriers for the delivery of drugs to infected cells.
Synthetic biodegradable and biocompatible polymers have
been shown to be effective for encapsulating a great variety of
antibiotics.
ο‚ž Today the application of nanotechnology in drug delivery is
widely expected to change the scenery of pharmaceutical and
biotechnology industries for the foreseeable future
78
ο‚ž Tallury P, Malhotra A, Byrne L, Santra S. Nanobioimaging and sensing of infectious
diseases. Advanced Drug Delivery Reviews 2010; 62: 424–437.
ο‚ž Baldoni D. Innovative Methods for the Diagnosis and Treatment of Implant-associated
Infections. PhD thesis. University of Basel; 2009.
ο‚ž Yildiz F H. Processes control-ling the transmission of bacterial pathogens in the
environment. Res. Microbiol 2007; 158:195–202.
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Nanoparticles based drug delivery systems for treatment of

  • 1. 1
  • 2. 2
  • 3. ο‚ž The chemotherapy of infections caused by bacteria that inhabit intracellular presents a number of uncommon challenges. ο‚ž Many bacteria have found the way to produce a β€œsilent” infection inside the cells and to avoid from their bactericidal mechanisms. ο‚ž Many methods for diagnosing and treating these and other bacterial infections presently exist, there is an essential need for new and improved approaches for bacterial destruction. 3
  • 4. ο‚ž It is now clear that a nanotechnology-driven approach using nanoparticles to selectively target and destroy pathogenic bacteria can be successfully implemented. ο‚ž Localized diseases such as infection and inflammation not only have perforated vasculature but also over express some epitopes or receptors that can be used as targets. Thus, nanomedicines can also be actively targeted to these locations. 4
  • 5. ο‚ž Various types of nanoparticulate systems have been tried as potential drug delivery systems: biodegradable polymeric nanoparticles Polymer micelles Nanocapsules Nanogels Fullerenes Solid lipid nanoparticles (SLN) Nanoliposomes Dendrimers 5
  • 6. Metal nanoparticles Quantum dots ο‚ž In recent years, encapsulation of antimicrobial drugs in nanoparticle systems has emerged as an innovative and promising alternative that enhances therapeutic effectiveness and minimizes the undesirable side effects of drugs. ο‚ž The major goals in designing nanoparticles as delivery systems are to control particle size, surface properties and release of pharmacologically active agents in order to achieve the site-specific action at the therapeutically optimal rate and dose regimen. 6
  • 7. ο‚ž Infectious diseases can be caused by either virus, bacterium, fungus or parasite. ο‚ž Communicable diseases ( malaria, tuberculosis, flu, influenza) ο‚ž Classification of infections : 1. Known disease: which are insistently there e.g.., dengue, malaria, tuberculosis. 2. New, previously unknown diseases: e.g., severe acute respiratory syndrome. 3. Diseases which threaten to enhance in near future e.g., avian influenza. 7
  • 8. ο‚ž Bacteria classified here are on the basis of their pathogenicity i.e. ο‚ž Extra-cellular bacteria ο‚ž Intra-Cellular bacteria 8
  • 9. 9
  • 10. ο‚ž To produce disease, extracellular bacteria utilize any portal of entry provided a satisfactory fluid medium be recognized at the site of lesion. Extracellular pathogens utilize virulence mechanisms to avoid the antimicrobial capabilities of humoral immunity and phagocytosis thus advancing extracellular reproduction. ο‚ž Examples of such bacteria include, Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Escherichia coli which have been considered extracellular pathogens, and lesion infections, osteomyelitis, scarlet fever, specified forms of pneumonia, urinary tract infections 10
  • 11. ο‚ž To establish an infection, these pathogens have to make contact with the appropriated type of host cell that provides suitable intracellular conditions for growth. Bacteria such as Mycobacterium, Legionella, Brucella or Listeria have extended the ability to resist and replicate inside various mammalian cells including the aggressive phagocytic cells, which establish the first-line defense against invading pathogens 11
  • 12. ο‚ž As we know that some antibiotics suffer to reach their intra- cellular tagets due to their hydrophillic nature ο‚ž Secondly emergence of resistance from bacteria is problem in therapy, which results by modification of tagets, drug destruction by enzymes and by efflux of drug from cell. 12
  • 13. ο‚ž As with nanoparticles targeting intracellular bacteria, nanoparticles targeting the site of infection can release high concentrations of antimicrobial drugs at the site of infection. ο‚ž Nanopaticles can be used actively or passively. ο‚ž Actively targeted nanoparticles contain ligands (e.g. antibodies) that bind receptors (e.g. antigens) at sites of infection 13
  • 14. ο‚ž There some barriers while passive targeting with nanoparticles which are: ο‚ž Mucosal barriers ο‚ž nonspecific uptake of the particle and non-specific delivery of the drug (as a result of uncontrolled release ο‚ž Targeting infections in RES (reticuloendothelial sites), because It comprise of monocyte/like cells which are sites for rapid clearance of drug 14
  • 15. ο‚ž Hence nanoparticles are still the best approach for targeting intra-cellular micro-organisms ο‚ž Antibiotics loaded NPs can enter host cells through endocytosis, followed by releasing the payloads to delete intracellular microbes. The need to target drugs to specific sites is increasing day by day as a result of therapeutic and economic factors 15
  • 16. ο‚ž Antimicrobial NPs propose several clinical advantages which are: ο‚ž First, the surface properties of nanoparticles can be changed for targeted drug delivery for e.g. small molecules, proteins, peptides, and nucleic acids loaded nanoparticles are not known by immune system and efficiently targeted to special tissue types 16
  • 17. ο‚ž Second, nanocarriers may overcome solubility or stability issues of the drug and minimize drug-induced side effects. ο‚ž Third, using nanotechnology, it may be possible to achieve co-delivery of two or more drugs or therapeutic modality for combination therapy. ο‚ž Fourth, NP-based antimicrobial drug delivery is promising in overcoming resistance to common antibiotics developed by many pathogenic bacteria 17
  • 18. ο‚ž Five, administration of antimicrobial agents using NPs can progress therapeutic index, extend drug circulation (i.e., extended half-life), and achieve controlled drug release, increasing the overall pharmacokinetics. ο‚ž Six, the system can be used for several routes of administration including oral, nasal, parenteral, intra-ocular etc 18
  • 19. ο‚ž Although nanoantibiotics promises significant benefits, there are foreseeable challenges in translating this exciting technology for clinical application which are as follows: ο‚ž The toxic effects of antimicrobial NPs on central nervous system (CNS) are still unknown, and the interactions of NPs with the cells and tissues in CNS are poorly understood. 19
  • 20. ο‚ž Furthermore, NPs represent size-specific properties that limit the use of currently available in vitro experiments in a general way, and there is no standardized definition for NP dose in mass, number, surface area, and biological samples (e.g., blood, urine, and inside organs) ο‚ž NPs usually have short circulation half-life due to natural defense mechanism of human body for eliminating them after opsonization by the mononuclear phagocytic system. Therefore, the particles surfaces need to be changed to be hidden to opsonization 20
  • 21. ο‚ž There are many types of nanoparticles which are given in next slides with their brief information. 21
  • 22. ο‚ž Polymer-based nanoparticles are submicron-sized polymeric colloidal particles in which a therapeutic agent of interest can be embedded or encapsulated within their polymeric matrix or adsorbed or conjugated onto the surface. ο‚ž The drugs may also be sensitive to gastroin‐ testinal degradation by digestive enzymes 22
  • 23. ο‚ž The advantage of using polymeric nanoparticles is to permit encapsulation of bioactive molecules and protect them against enzymatic and hydrolytic degradation. ο‚ž Therapeutically used polymeric nanoparticles are composed of biodegradable or biocompatible materials, such as poly (Ξ΅- caprolactone) (PCL), poly(lactic acid) (PLA), poly(lactic-co- glycolic acid) (PLGA), alginic acid, gelatin and chitosan 23
  • 24. ο‚ž Polymeric nanoparticles possess several unique characteristics for antimicrobial drug delivery. ο‚ž Firstly, polymeric nanoparticles are structurally stable and can be synthesized with a sharper size distribution ο‚ž Secondly, particle properties such as size, zeta potentials, and drug release profiles can be accurately tuned by selecting different polymer lengths, surfactants, and organic solvents during the synthesis. 24
  • 25. ο‚ž Thirdly, the surface of polymeric nanoparticles typically contains functional groups that can be chemically changed with either drug moieties or targeting ligands 25
  • 26. ο‚ž A hydrogel is a network of hydrophilic polymers that can swell in water and hold a large amount of water while maintaining the structure. Drugs can be loaded into the polymer matrix of these materials and controlled release is dependent on the diffusion coefficient of the drug across the hydrogel network ο‚ž Hydrogels are biocompatible hydrophilic networks that can be constructed from both synthetic and natural materials 26
  • 27. ο‚ž Hydrogels can be classified based on a variety of characteristics, containing the nature of side groups (neutral or ionic), mechanical and structural features (affine or phantom), method of preparation (homo-or co-polymer), physical structure (amorphous, semicrystalline, hydrogen bonded, supermolecular, and hydrocollodial), and responsiveness to physiologic environment stimuli (pH, ionic strength, temperature, electromagnetic radiation, etc.) 27
  • 28. ο‚ž Hydrogel/glass composite (Nitric oxide-releasing nanoparticles) NO NPs have also been shown to have a high degree of effectiveness against (Methicillin-resistant Staphylococcus aureus) MRSA infection in several different mouse models ο‚ž A variety of strategies for introducing hydrophobic domains directly into otherwise hydrophilic hydrogel networks have permitted significant improvements in the loading of hydrophobic drugs 28
  • 29. ο‚ž Despite these many advantageous properties, hydrogels also have several limitations. The low elastic force of many hydrogels limits their use in load-bearing applications and can result in the precocious decomposition or flow away of the hydrogel from a targeted local site ο‚ž But It can be covered in typical drug delivery applications such as sub-cutaneous injections. 29
  • 30. ο‚ž Consequently, the use of metallic nanoparticles for drug delivery is a concern ο‚ž Different types of Nanoparticles are discussed briefly as follows 30
  • 31. ο‚ž Gold nanoparticles (GNPs) have found many applications in many fields such as cancer diagnosis and therapy, drug and gene delivery, DNA and ptotein determination, etc ο‚ž GNPs are suitable for the delivery of drugs to cellular destinations due to their ease of synthesis, functionalization and biocompatibility. 31
  • 32. ο‚ž Conjugates of gold nanoparticles with antibiotics and antibodies also have been used for selective photothermal killing of protozoa and bacteria ο‚ž GNPs conjugates has been ascribed to their ability to bind to and/or penetrate the cell wall and, in doing so they are able to deliver a large number of antibiotic molecules into a highly localized volume 32
  • 33. ο‚ž Silver nanoparticles of size smaller than 100 nm contain about 10000–15000 silver atoms. They are prepared by engineering the metallic silver into ultrafine particles by numerous physical methods, including spark discharging and cryochemical synthesis ο‚ž The most widely used and known application of silver nanoparticles is in the medical sciences include topical ointments and creams containing silver to prevent infection of burns and open wound. 33
  • 34. ο‚ž Iron oxide nanoparticles (IONPs) are magnetic Fe3O4 or Fe2O3 nanocrystals which can interact with external magnetic fields, offering different opportunities in nanomedicine, e.g., as contrast agents in MRI, for magnetic hyperthermal therapies, or as magnetically triggerable drug delivery systems. ο‚ž However, in most of the cases where magnetic nanocarriers have been used, difficulties in achieving these objectives appeared 34
  • 35. ο‚ž The vancomycin conjugated iron oxide nanoparticles were utilized as probes to selectively entrap S. saprophyticus ο‚ž Among the nanoparticles, Fe3O4 showed maximum activity against pseudomonas aeruginosa. The reactive oxygen species (ROS) generated by Fe3O4 nanoparticles could kill bacteria without harming nonbacterial cells 35
  • 36. ο‚ž Silica materials have been proved to be efficient carriers for the local release of antibiotics, which could be of interest in the context of biofilm associated infections, which are a real challenge for the modern medicine. Moreover, mesoporous silica has been found to be relatively β€œnon-toxic” and biocompatible, however of course depending on dose and administration route ο‚ž Nanoporous silica materials possess large pore volumes and high surface areas, allowing the absorption of large amounts of drugs, thus providing sufficient concentrations for local treatment 36
  • 37. ο‚ž The surface of silica materials is reactive due to the presence of silanol groups. This allows for facile modification by silanization reactions and thus opens possibilities for enhancing the drug loading and for controlling the drug release ο‚ž Till present there are only few reports concerning the application of silica materials, crystalline or amorphous, in the antimicrobial therapy 37
  • 38. ο‚ž Micelles are submicroscopic aggregates of surfactant molecules assembly of amphiphillic block copolymers or polymer-lipid conjugates or other surface-active molecules that selfassemble in aqueous media to form structures with a hydrophobic core. ο‚ž Their small size (1-50 nm) makes them ideal for intravenous delivery. In addition they are also more stable, when compared to liposomes due to be ability to design them to be chemically stable and biocompatible ο‚ž One specific feature of micelles is that the amount of drug released can be controlled by an external stimulus like pH, temperature, ultrasound or certain enzymes 38
  • 39. ο‚ž Other unique properties of polymeric micelles are that they are easily altered with small functional groups that enhance their targeting potential ο‚ž The disadvantage for the polymeric micelle systems is the immature technology for drug incorporation in a physical manner ο‚ž The another disadvantage is much slower extravasations of polymeric carrier systems than that of low molecular weight drugs 39
  • 40. ο‚ž Liposomes are small spherical vesicles in which one or more aqueous parts are completely surrounded by molecules that have hydrophilic and hydrophobic functionality. Liposomes change with composition, size, surface charge and method of preparation. They can be single or in multiple bilayers. Those including one bilayer membrane are called small unilamellar vesicles or large unilamellar vesicles based on their sizes ο‚ž Liposomes are also the most broadly used antimicrobial drug delivery vehicles because their lipid bilayer structure imitators the cell membrane and can readily fuse with infectious microbes 40
  • 41. ο‚ž One of the disadvantages of liposomal antibiotics is the short shelf lives of lipid vesicles, which limits drug stability. Short shelf lives can be conditioned by both physical and chemical processes. ο‚ž There are many advantages of liposomes as antibiotic carriers: improved pharmacokinetics and biodistribution; decreased toxicity; enhanced activity against intracellular pathogens; target selectivity; enhanced activity against extracellular pathogens, in particular to overcome bacterial drug resistance ο‚ž The ability of liposomes to alter drug distribution depends mostly on their size and surface properties 41
  • 42. ο‚ž Thus, liposomal encapsulation of antibiotics helps to increase their therapeutic index with mode of action related to increasing the drug concentration at the site of infection and/or reducing its toxicity ο‚ž Encapsulation of vancomycin and teicoplanin in liposomes resulted in significantly improved elimination of intracellular methicillin resistant S. aureus (MRSA) infection. ο‚ž Netilmicin liposomes showed an increase in pharmacological activity in a peritonitis model of mice infected with E. coli, in terms of survival both prophy‐ lactically and therapeutically 42
  • 43. ο‚ž SLNs are sub-micron colloidal carriers, ranging from 50 nm to 1 ΞΌm, that are composed of physiological lipid dispersed in water or in aqueous surfactant solution. In the last decade SLNs have gained considerable interest as novel particulate drug delivery systems. ο‚ž SLNs are suitable for the incorporation of lipophilic and hydrophilic drugs within the lipid matrix in considerable amount 43
  • 44. ο‚ž Some advantages of SLNs are possibility of controlling drug release and drug targeting, increased drug stability, high drug payload, possibility of the incorporation of lipophilic and hydrophilic drugs, lack of biotoxicity of the carrier, no problems with respect to large-scale production, sterilization possibility, and good tolerability ο‚ž SLNs are considered good drug carriers to obtain sustained release of antibiotics . ο‚ž SLNs can act as promising carriers for sustained ciprofloxacin release in infections or to enhance the bioavailability of tobramycin from antibiotic-loaded SLN in the aqueous humor for topical ocular delivery 44
  • 45. ο‚ž Common disadvantages of SLN are their particle growing, their unpredictable gelation tendency, their unexpected dynamics of polymorphic transitions and their inherent low incorporation rate due to the crystalline structure of the solid lipid. ο‚ž Even though the development history of SLN-based antimicrobial drug delivery systems is relatively shorter than other nanoparticle systems such as liposomes and polymeric nanoparticles, SLNs have shown great therapeutic potentials 45
  • 46. ο‚ž Fullerenes are a new form of carbon, other forms being diamond, graphite, and coal. They can take three forms of a hollow sphere, ellipsoid, or tube. Their small size, spherical shape, and hollow interior all provide therapeutic opportunities ο‚ž The most abundant form of fullerenes is buckminsterfullerene (C60) with 60 carbon atoms arranged in a spherical structure 46
  • 47. ο‚ž Since fullerenes possess unique geometrical shapes, as well as novel photophysical properties, in addition to being efficient radical scavengers, a wide variety of biological applications have been considered 47
  • 48. ο‚ž Dendrimers are globular repeatedly branched macromolecules that exhibit controlled patterns of branching with multiple arms extending from a central core ο‚ž Asymmetric dendrimers are synthesized by coupling dendrons of different generations (G1-G4) to a linear core, which yields a branched dendrimer with a nonuniform orthogonal architecture 48
  • 49. ο‚ž Dendrimers also possess many unique properties that make them a good nanoparticle platform for antimicrobial drug delivery ο‚ž Dendrimers can be made from a wide variety of biocompatible materials, the most frequently used are polyamidoamine (PAMAM), polyethylene oxide (PEO), polypropylene imine (PPI), polyethyleneimine (PEI), polyethylene glycol (PEG) etc 49
  • 50. ο‚ž Sulfamethoxazole (SMZ)-encapsulating PAMAM dendrimers led to sustained release of the drug in vitro and 4–8 folds increased antibacterial activity against E. coli, compared to free Sulphamethoxazole. 50
  • 51. ο‚ž Zeolites are solid hydrated crystalline materials with frame- works comprising silicon, aluminum and oxygen and featuring nano-channels and cages of regular dimensions. Silica is a neutral regular tetrahedron in which positive charge of silicon ion is balanced by oxygen. Zeolites are minerals with selective pores that can be used to sieve molecules having certain dimensions ο‚ž Generally, zeolits with a low silica/alumina (Si/Al) ratio have higher ion exchange capacity 51
  • 52. ο‚ž According Si/Al ratio, there are several types of natural and synthetic zeolites including zeolite-Ξ², zeolite A, zeolite X and zeolite Y, which are the most common commercial adsorbents. ο‚ž Coating or impregnating zeolite with metallic silver nanoparticles to prepare zeolite composites can enhance the antibacterial ability of materials, and these materials can inhibit bacterial growth effectively. ο‚ž It has been reported that silver embedded zeolite A was found to be antibactrerial against E. coli, Bacillus subtilis and staphy‐ lococcus aureus 52
  • 53. ο‚ž Several in vivo and in vitro studies have reported the potential applications of various nanoparticle based carrier systems to enhance the selectivity of antibiotics for phagocytic cells and sustain therapeutic efficiency in the treatment of intracellular infections, Such as ,infections due to mycobacteria, Brucellocis, salmonellosis, lysteriosis etc 53
  • 54. ο‚ž Tuberculosis, caused by Mycobacterium tuberculosis, is a lung infection. ο‚ž Mycobacterium avium complex (MAC) is the main cause of hardships in immunocompromised patients. ο‚ž The treatment for the disease is extended and increasing the risk of side effects. 54
  • 55. ο‚ž Main issue with this is the patient non-compliance which is the main cause of treatment failure & drug resistance. ο‚ž The encapsulation of antitubercular drugs in polymeric particles is another strategy to improve the current therapeutic regimen of tuberculosis. ο‚ž Fawaz, et al. encapsulated the drug ciprofloxacin in polyisobutylcyanoacrylate (PIBCA) nanoparticles. These nanoparticles were tested against M.avium ifection in human macrophage culture and concluded that nanoparticles bound ciprofloxacin was more effective than unbound drug. 55
  • 56. ο‚ž Brucellosis is infectious disease caused by Brucella spp. ο‚ž Four species are known to be pathogenic i.e. Brucella abortis, Brucella melitensis, Brucella suis & Brucella canis. ο‚ž Because of its intracellular location, long treatment with several antibiotics is required. Replases are frequent due to low efficacy & patient non compliance. 56
  • 57. ο‚ž So, alternative methods such as DDS should be considered. ο‚ž Gentamicin, encapsulated in different types of liposomes, has been evaluated against murine monocytes infected with B. abortus. All such liposomes reduced the number of bacteria, the most effective being SPLVs (stable plurilamellar vesicles). ο‚ž Thus, alternative methods such as DDS to achieve high intracellular bactericidal activity see promising. The possible use of drug delivery systems containing aminoglycosides may be one of the most appropriate therapeutic advances in human brucellosis treatment in the recent years 57
  • 58. ο‚ž Salmonellosis is serious food-borne disease affecting humans. The bacteria is intracellular parasite. ο‚ž Antibiotics effective against this type of bacteria have limitations owing to the problems of formulation, low penetration, or the appearance of side effects; these can be solved using carrier systems 58
  • 59. ο‚ž Several studies using antibiotic-loade nanoparticles have been performed in order to recognize the suitability and efficacy of these carriers in experimental models of salmonellosis ο‚ž Page-clisson et al. compared the effect of carrier polyalkylcyanoacrylate nanopartilcels in Salmonella typhemurium infection and free ciprofloxacin components. ο‚ž Compared with free ciprofloxacin, it extends survival and reduces the number of bacteria in the liver and spleen. 59
  • 60. ο‚ž Lysteria monocytogenes is intracellular parasite that causes meningitis & septicemia. ο‚ž The encapsulation of ampicillin in liposomes decreases the survival of L. monocytogenes in mouse peritoneal macrophages to different extents, depending on the composition of the liposomes. 60
  • 61. ο‚ž Chitosan-coated plastic films, alone or loaded with antimicrobial agents, were evaluated for their effect against L. monocytogenes. ο‚ž These chitosan-coated films inhibited this pathogen growth in a concentration-dependent manner whereas chitosancoated films impregnated with antibiotics were significantly more effective against L. monocytogenes. 61
  • 62. ο‚ž Attractive features, such as increased dissolution velocity, increased saturation solubility, improved bioadhesivity, versatility in surface modification and ease of post-production processing, have widened the applications of nanosuspensions for various routes ο‚ž The applications of nanosuspensions in parenteral and oral routes have been very well investigated and applications in pulmonary and ocular delivery have been discovered. However, their applications in buccal, nasal and topical delivery are still awaiting exploration 62
  • 63. ο‚ž Nanoparticles have a significant drug delivery role in following routes. ο‚ž Oral delivery ο‚ž Pulmonary delivery(inhalers etc) ο‚ž Ocular delivery ο‚ž Brain delivery( their lipophillicity and small particle size plays a vital role by crossing blood brain barrier) 63
  • 64. ο‚ž Oral delivery of drugs using nanoparticles is far superior to the delivery of free drugs in terms of bioavailability, residence time and biodistribution. ο‚ž Oral drug delivery is the choicest route for drug administration because of its non invasive nature. ο‚ž The advantage of using polymeric nanoparticles is to permit encapsulation of bioactive molecules and maintain them against enzymatic and hydrolytic degradation. 64
  • 65. ο‚ž The efficacy & proficiency of the orally administered drug commonly depends on its solubility & absorption through gastrointestinal tract. ο‚ž Therefore, a drug candidate that represents poor aqueous solubility or decomposition rate, limited absorption is believed to possess low 0r highly variable oral bioavailability. 65
  • 66. ο‚ž Fattel et al. achieved the protection of mice against S. typhimurium following oral administration of S. typhimurium phosphorylcholine antigen encapsulated in PLGA particles. ο‚ž Pinto and Muller (1999) incorporated SLN into spherical pellets and investigated SLN release for oral administration. ο‚ž Orally administered antibiotics such as atovaquone and bupravaquone replicate this problem very well. Nanosizing of such drugs can lead to a dramatic increase in their oral absorption and consequently bioavailability 66
  • 67. ο‚ž Besides its non-invasive nature, pulmonary drug delivery has many other advantages compared to alternative drug delivery strategies, containing a large surface area for solute transport, rapid drug uptake, and improved drug bioavailability. ο‚ž It was reported that intratracheally administered antibiotics loaded NPs were able to penetrate through the alveolar- capillary barrier into the systemic circulation and accumulate in extrapulmonary organ containing liver, spleen, bone, and kidney 67
  • 68. ο‚ž Micronization of drugs plays an important role in improving the drug dosage form and therapeutic efficiency today. If a drug is micronized into microspheres with suitable particle size, it can be addressed directly to the lung by the mechanical prevention of capillary bed in the lungs. ο‚ž Nanosuspensions may demonstrate to be an ideal approach for delivering drugs that display poor solubility in pulmonary secretions 68
  • 69. ο‚ž Furthermore, because of the nanoparticulate nature and uniform size distribution of nanosuspensions, it is very likely that in each aerosol droplet at least one drug nanoparticles is contained, leading to even distribution of the drug in the lungs as compared to the micro particulate form of the drug. ο‚ž In regular suspension aerosols many droplets are drug free and others are highly filled with the drug, directing to uneven delivery and circulating of the drug in the lungs. Nanosuspensions could be utilized in all available types of nebulizer 69
  • 70. ο‚ž In a recent study, antitubercular drugs (rifampicin, isoniazid and pyrazinamide) were incorporated into various formulations of solid lipid particles ranged from 1.1–2.1 ΞΌm and formulations were nebulized to guinea pigs by mouth for direct pulmonary delivery. ο‚ž Conditions such as pulmonary aspergillosis can easily be targeted by using suitable drug candidates, such as amphotericin B, in the form of pulmonary nanosuspensions instead of using stealth liposome. 70
  • 71. ο‚ž Nanosuspensions can assay to be a advantage for drugs that show poor solubility in lachrymal fluids. For delivery of such drugs, approaches such as suspensions and ointments have been proposed. ο‚ž Although suspensions present advantages such as extended residence time in a cul-de-sac (which is desirable for most ocular diseases for effective treatment) and avoidance of the high tonicity produced by water-soluble drugs, their actual performance depends on the native solubility of the drug in lachrymal fluids. 71
  • 72. ο‚ž Thus, the intrinsic decomposition rate of the drug in lachrymal fluid governs its release and ocular bioavailability. ο‚ž An approach that has recently been investigated to achieve the desired duration of action of the drug is the formulation of polymeric nanosuspensions loaded with the drug. ο‚ž Cavalli et al (2002) evaluated SLN as carriers for ocular delivery of tobramycin in rabbit eyes. As a result SLN significantly enhanced the drug bioavalability in the aqueous humor within 6 hours. 72
  • 73. ο‚ž In addition, poly-cationic polymers may be useful penetration enhancers for ocular drug delivery. De Salamanaca et al. have reported that chitosan nanoparticles readily penetrate conjunctival epithelial cells and are well suffered at the ocular surface of rabbits. ο‚ž De Campos et al. discovered the potential of cyclosporin-A loaded nanoparticles for the management of extraocular disorders, i.e. keratoconjunctivitis sicca or dry eye disease. ο‚ž They reported that the advantages of these systems in ocular drug delivery contain their ability to contact intimately with the corneal and conjunctival surface, thereby increasing delivery to external ocular tissues without compromising inner ocular structures and systemic drug exposure, and to provide these target tissues with long term drug level 73
  • 74. ο‚ž One of the most challenging barriers in the body is the blood– brain barrier (BBB). ο‚ž Endothelial cells of the BBB limit the solute movement into the brain by regulating transport mechanisms at the cell surface. These transport mechanisms help to keep the harmful substances out of the brain in order to maintain homeostasis 74
  • 75. ο‚ž Emerging approach to circumvent the BBB is the use of liposomes, polymeric nanoparticles or solid lipid nanoparticles, in which the therapeutic drugs can be adsorbed or entrapped. ο‚ž A drug can passively spread through the BBB in a more efficient manner after it is transformed into a more lipophilic prodrug. ο‚ž Fenart et al demonstrated that when polysaccharide nanoparticles were coated with a lipid bilayer, a 3 to 4-fold improvement in brain uptake without disruption of the BBB integrity was observed. 75
  • 76. ο‚ž Industrial applications of the nanosphere technology would have several benefits: 1. Nanoparticles deliver drugs to the brain that normally do not cross the blood-brain barrier. 2. They reduce peripheral side effects of (approved) drugs that cross the BBB by increasing the relative dose of drugs reaching the brain. 3. Nanoparticles can also be used as a screening tool. Delivering drug candidates to the brain by nanosphere technology for initial screening of CNS activity obviates direct CNS injections. 76
  • 77. ο‚ž Recently dendrimers have been evaluated for CNS delivery of antiretrovira (ARVs) too. Polyamidoamine dendrimers loaded with lamivudine, a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) commonly utilized in HIV treatment. ο‚ž When loaded on dendrimeric nanocarriers, a 21-fold increase in cellular lamivudine uptake and 2.6-fold reduction in the viral load were observed when compared to the group treated with free drug solution. 77
  • 78. ο‚ž Compared with other colloidal carriers, polymeric particles, mainly nanoparticles, have appeared more recently as attractive carriers for the delivery of drugs to infected cells. Synthetic biodegradable and biocompatible polymers have been shown to be effective for encapsulating a great variety of antibiotics. ο‚ž Today the application of nanotechnology in drug delivery is widely expected to change the scenery of pharmaceutical and biotechnology industries for the foreseeable future 78
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  • 80. ο‚ž Jaracz S, Chen J, Kuznetsova L V, Ojima I. Recent advances in tumortargeting anticancer drug conjugates. Bioorg. Med. Chem 2005; 13: 5043-54. ο‚ž Torchilin V P. Targeted polymeric micelles for delivery of poorly soluble drugs. Cell Mol. Life Sci 2004; 61: 2549-59. ο‚ž Gabizon A, Shmeeda H, Horowitz A T, Zalipsky S. Tumor cell targeting of liposomeentrapped drugs with phospholipid-anchored folic acid-PEG conjugates. Adv. Drug Delivery Rev 2004; 56: 1177-92. 80