title: The long and winding road to inhaled TB therapy: not only the bug's fault.
abstract: Not all of the issues impacting the success of tuberculosis (TB) treatment arise from pathogen-related disease characteristics. Nowadays, there is an increasing awareness that antibiotic treatment is not the only answer to the TB problem, promoting the search for alternative administration strategies and host-directed therapies. Among all the administration routes, being the lungs the main TB focus, inhalation is conceptually a logical solution to enhance treatment effectiveness and compliance. Nevertheless, research efforts and funding are almost entirely conveyed to conventional approaches. This review will critically evaluate the reasons constraining research in this field, providing some future perspectives. The most recent advances in inhalation approaches for TB will be discussed, either at the preclinical or clinical phase, illustrating the risk of failure and chances of success.
authors.affiliation: a Department of Pharmaceutical Sciences , University of Perugia , Perugia , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giovagnoli
authors.affiliation: a Department of Pharmaceutical Sciences , University of Perugia , Perugia , Italy.
authors.forename: Aurelie
authors.initials: A
authors.lastname: Schoubben
authors.affiliation: a Department of Pharmaceutical Sciences , University of Perugia , Perugia , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ricci
mesh_terms: D000280:Administration, Inhalation; D000818:Animals; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000378:metabolism / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000378:metabolism; D014376:Tuberculosis / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D000995:Antitubercular Agents
keywords: Tuberculosis; host-directed therapies; inhalation; inhaled tuberculosis therapy; pulmonary route