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.

Keywords:

• Tuberculosis
• inhalation
• inhaled tuberculosis therapy
• host-directed therapies
• pulmonary route

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.