Improving the efficacy of inhaled drugs in cystic fibrosis: challenges and emerging drug delivery strategies.
Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians associated with early death. Although the faulty gene is expressed in epithelia throughout the body, lung disease is still responsible for most of the morbidity and mortality of CF patients. As a local delivery route, pulmonary administration represents an ideal way to treat respiratory infections, excessive inflammation and other manifestations typical of CF lung disease. Nonetheless, important determinants of the clinical outcomes of inhaled drugs are the concentration/permanence at the lungs as well as the ability of the drug to overcome local extracellular and cellular barriers. This review focuses on emerging delivery strategies used for local treatment of CF pulmonary disease. After a brief description of the disease and formulation rules dictated by CF lung barriers, it describes current and future trends in inhaled drugs for CF. The most promising advanced formulations are discussed, highlighting the advantages along with the major challenges for researchers working in this field.
Di.S.T.A.B.i.F., Second University of Napoli, Via Vivaldi 43, 81100 Caserta, Italy.
Ivana
I
d'Angelo
Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
Claudia
C
Conte
Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
Maria Immacolata
MI
La Rotonda
Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
Agnese
A
Miro
Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy.
Fabiana
F
Quaglia
Laboratory of Drug Delivery, Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano 49, 80131 Napoli, Italy. Electronic address: ungaro@unina.it.
Francesca
F
Ungaro
D000280:Administration, Inhalation; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002626:Chemistry, Pharmaceutical; D003550:Cystic Fibrosis / Q000188:drug therapy*; D016503:Drug Delivery Systems; D006801:Humans; D008168:Lung / Q000378:metabolism; D019141:Respiratory System Agents / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D019141:Respiratory System Agents
Biological barriers; Cystic fibrosis; Lipid particles; Polymeric particles; Pulmonary delivery