An effective Nano Drug Delivery and combination therapy for the treatment of Tuberculosis

Abstract Background Drug-resistance in tuberculosis is exacerbating the threat this disease is posing for human beings. Antibiotics that were once effective against the causative agent, Mycobacterium tuberculosis (Mtb), are now no longer usable against multi- and extensively drug-resistant strains of this pathogen. To address this issue, new drug combinations and novel methods for targeted drug delivery could be of considerable value. In addition, studies have shown that the use of the antidepressant drug fluoxetine, a serotonin reuptake inhibitor, can be useful in the treatment of infectious diseases, including bacterial infections. Method In this study, an isoniazid and fluoxetine-conjugated multi-walled carbon nanotube nanofluid was designed to increase drug delivery efficiency alongside eliminating drug-resistance in vitro . The prepared nanofluid was tested against Mtb. Expression levels of inhA and katG mRNAs were detected by Real-time PCR. ELISA was applied to measure levels of cytokine secretion (TNF-α, and IL-6) from infected macrophages treated with the nano delivery system. Result The results showed that these nano-drug delivery systems are effective for fluoxetine at far lower doses than for free drug. Fluoxetine also has an additive effect on the effect of isoniazid, and their concomitant use in the delivery system can have significant effects in treating infection of all clinical strains of Mtb. In addition, it was found that the expression of isoniazid resistance genes, including inhA, katG , and the secretion of cytokines TNFα and IL6 under the influence of this drug delivery system is well regulated. Conclusion This nano-drug delivery method combined with host targeted molecules could be a game-changer in the development of a new generation of antibiotics that have high therapeutic efficiencies, low side effects and have the potential to overcome the problem of drug-resistance.