Nano‐Based Drug Delivery in Eliminating Tuberculosis

Tuberculosis, commonly called as TB is a fatal infectious disease caused by the bacteria, Mycobacterium tuberculosis . The presence of multidrug resistant and extensively drug-resistant M. tuberculosis in India shows the true state of affairs in our country, despite there being well-established treatment regimens for tuberculosis over the last 50 years. The pitfalls of the drug regimens existent in India are the rigid and prolonged drug schedules with its frequent dosing, side effects, and poor patient compliance. Nanotechnology with its improved and novel drug delivery system is the light at the end of this dark tunnel. Nanotechnology offers promising approaches to curb the menace of drug resistance, drug interactions with antiretroviral drugs and improves patient compliance. The unique feature of nanoparticles is its small size, high stability, high bioavailability, capability to deliver both hydrophilic and hydrophobic drugs, slow, and persistent drug release, delivery of drugs to the target sites and variable routes of drug administration. It does not cause toxicity and facilitates adherence to drug therapy by reducing the dosing frequency. The possibility to diminish latent tuberculosis using nanotechnology needs to be explored. Liposomes, dendrimers, nanocapsules, inorganic nanocarriers, polymeric nanoparticles, micelles are few of the nanocarriers that can be used for drug delivery. Physical encapsulation, chemical conjugation, and adsorption are used for incorporating the chemotherapeutic agents in the nanocarriers. Nanocarriers achieve drug delivery through passive targeting, active targeting, mannose receptor targeting, folate receptor targeting, hyaluronic acid receptor targeting, tuftsin receptor targeting, targeting of formyl peptide receptors, and others. Respiratory route of administration of nanoparticles is a promising area for tuberculosis pharmacotherapy. The lack of specific regulatory guidelines for the characterization, study design, and statistical analysis hinders the application of nanoformulations to clinical medicine. This chapter outlines the various therapeutic approaches based on nanotechnology against tuberculosis and the challenges in its implementation.