Improving the efficacy of inhaled drugs in cystic fibrosis: challenges and emerging drug delivery strategies

Adv Drug Deliv Rev. 2014 Aug:75:92-111. doi: 10.1016/j.addr.2014.05.008. Epub 2014 May 17.

Abstract

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.

Keywords: Biological barriers; Cystic fibrosis; Lipid particles; Polymeric particles; Pulmonary delivery.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Chemistry, Pharmaceutical
  • Cystic Fibrosis / drug therapy*
  • Drug Delivery Systems*
  • Humans
  • Lung / metabolism
  • Respiratory System Agents / administration & dosage
  • Respiratory System Agents / adverse effects
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Respiratory System Agents