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Adv Drug Deliv Rev. 2013 Nov;65(13-14):1816-27. doi: 10.1016/j.addr.2013.07.020. Epub 2013 Aug 7.

Nanotechnology and pulmonary delivery to overcome resistance in infectious diseases.

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Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal. Electronic address:


Used since ancient times especially for the local treatment of pulmonary diseases, lungs and airways are a versatile target route for the administration of both local and systemic drugs. Despite the existence of different platforms and devices for the pulmonary administration of drugs, only a few formulations are marketed, partly due to physiological and technological limitations. Respiratory infections represent a significant burden to health systems worldwide mainly due to intrahospital infections that more easily affect immune-compromised patients. Moreover, tuberculosis (TB) is an endemic infectious disease in many developing nations and it has resurged in the developed world associated with the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Currently, medicine faces the specter of antibiotic resistance. Besides the development of new anti-infectious drugs, the development of innovative and more efficient delivery systems for drugs that went off patent appears as a promising strategy pursued by the pharmaceutical industry to improve the therapeutic outcomes and to prolong the utilities of their intellectual property portfolio. In this context, nanotechnology-based drug delivery systems (nano-DDS) emerged as a promising approach to circumvent the limitations of conventional formulations and to treat drug resistance, opening the hypothesis for new developments in this area.


AmB; CDs; DDS; DPI; DSPC; Drug resistance; EDTA; GRAS; Inhalation; MAC; MBSA; MDR-TB; MIC; MRSA; Mycobacterium avium–Mycobacterium intracellulare complex; NPs; Nanoparticles; O-SAP; O-palmitoyl mannan; O-palmitoyl pullulan; O-steroyl amylopectin; OPM; OPP; PAM; PC; PC:Chol; PC:Chol:DCP; PC:Chol:P90; PLGA; Respiratory infections; SA-CSO; TB; Tuberculosis; XDR-TB; amphotericin B deoxycholate; cyclodextrins; distearoylphosphatidylcholine; drug delivery systems; dry powder inhalers; ethylenediaminetetraacetic acid; extensively drug-resistant TB; generally recognized as safe; mPEG–DSPE; maleylated bovine serum albumin; methicillin-resistant Staphylococcus aureus; minimum inhibitory concentration; multidrug resistant TB; nano-DDS; nanoparticles; nanotechnology-based drug delivery systems; p-aminophenyl-mannopyranoside; pMDI; phosphatidylcholine; phosphatidylcholine:cholesterol; phosphatidylcholine:cholesterol:P90; phosphatidylcholine:cholesterol:dicetylphosphate; poly(ethylene oxide)-b-distearoyl phosphatidyl-ethanolamin; poly(lactide-co-glycolide); pressurized metered-dose inhalers; stearic acid-grafted chitosan oligosaccharide; tuberculosis

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