Anti-tuberculosis drug delivery for tuberculous bone defects

ABSTRACT

Introduction

Traditional therapy methods for treating tuberculous bone defects have several limitations. Furthermore, systemic toxicity and disease recurrence in tuberculosis (TB) have not been effectively addressed.

Areas covered

This review is based on references from September 1998 to September 2021 and summarizes the classification and drug-loading methods of anti-TB drugs. The application of different types of biological scaffolds loaded with anti-TB drugs as a novel drug delivery strategy for tuberculous bone defects has been deeply analyzed. Furthermore, the limitations of the existing studies are summarized.

Expert opinion

Loading anti-TB drugs into the scaffold through various drug-loading techniques can effectively improve the efficiency of anti-TB treatment and provide an effective means of treating tuberculous bone defects. This methodology also has good application prospects and provides directions for future research.

KEYWORDS:

• Anti-tuberculosis
• drug delivery
• osteogenesis
• target therapy
• tuberculous bone defect

Abbreviations

TB: Tuberculosis INH: Isoniazide RFP: RifampicinPZA: PyrazinamideEMBH: Ethambutol RIF: Rifapentine; PHA: PolyhydroxyalkanoatesPHBV: Polyhydroxyvalonate GG: Gellan gumCS: Chitosan ALG: Alginate PLA: Polylactic acid PLGA: Poly(lactic co-glycolic acid)PVA: Polyvinyl alcohol PCL: PolycaprolactoneHA: Hydroxyapatite BHA: Bone-like hydroxyapatite PAA: Poly amino acid MBG: Mesoporous bioactive glass MSN: Mesoporous silicon nanoparticlesGP: Glucan particle NLC: Nanostructured lipid carriers MA: Mycolic acidsHOBs: Human osteoblasts

Article highlights

• 1. Tuberculous bone defect, which is difficult to treat and prone to recurrence, is a challenge for orthopedic surgeons.

• 2. As a new treatment method, drug delivery technology has been widely used in the study of tuberculous bone defects.

• 3. Drug loading can be achieved by physical methods such as dip coating, hydrogel encapsulation, or chemical methods to obtain excellent drug-loading performance.

• 4. A wide variety of drug-loaded scaffolds combined with multiple preparation technologies can meet the clinical need.

• 5. The method of drug loading, selection of scaffold materials, and preparation technology need to be further optimized.

Additional information

Funding

This study was supported by the Natural Science Foundation of China [Grant No. 81873988]. Clinical research fund of National Clinical Research Center for Geriatric Disorders [Xiangya Hospital, Grant No. 2020LNJJ15].