Drug delivery against leishmaniasis? Still an open question

EDER L. ROMERO AND MARIA JOSE MORILLA

EXPERT OPINION ON DRUG DELIVERY

Año: 2008 vol. 5 p. 805 - 823

1742-5247

Background: Leishmania amastigotes live inside resident macrophages in different anatomic sites; their hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed. hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed. hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed. hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed. hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed. Leishmania amastigotes live inside resident macrophages in different anatomic sites; their hidden location is responsible for impairing the accession of therapeutic drugs. Drug delivery systems (dds) should allow surpassing the impairments caused by problematic routes of administration as well as enhancing the anti-leishmanial activity and reducing toxicity of medication. However, after thirty years of research in the field, and being leishmaniasis mostly a disease affecting the poorest population, currently AmBisome is the only dds employed against the visceral form, whereas most of the experimental development admits only parenteral administration. Objective: In this work we will critically review the main dds designed against the different clinical forms. Methods: A literature search on drug delivery systems applied to each clinical presentation of leishmaniasis that followed the development of experimental approaches that ended up or not in clinical use, was done on Pub Med and through Google. Conclusions: Upon reviewing the experimental and clinical therapeutic performance of former and current drug delivery systems and on the bases of the three main barriers to be surpassed to ensure compliance and improving therapeutic window, we discuss how nanomedicine can contribute with new and more efficient strategies for those barriers to be surpassed.