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442 G. Xiong and I. F. Uchegbu
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in clinical trials provide valuable information and insights for future research. As
concluded from this survey, most of the nanoplatforms used in the phase I to III
clinical trials were liposomes or polymer-based nanoparticles (He et al. 2019
efficacy of passively targeted and tumour cell-targeted nanom
edicines heavily relies
). The
on the EPR effect in cancer patients, which explains why many of these formulations
failed in large and randomized phase III clinical trials. It is recommended that the
therapeutic effect of the passively targeted nanomedicines might be improved by
combining the EPR enhancement measures listed in the ‘Strategies: EPR effect
enhancement’ section of this chapter. The near total
targe
ted
nanom
edicines
clin
in
ical
pha
se
III
also illustrates the need to increase
trials
annihilati
on of passively
the effective delivery of drugs to tumours by other means when designing nano
enabled cancer drugs.
The failures in clinical trials do not diminish the potential of nanomedicines.
These failures present opportunities for learning and further progress. While low
efficacy leading to the failure of phase III clinical trials is a challenge, it is not
insurmountable. With continued advancements and innovations, cancer nanotechnology still holds immense promise in realizing the vision of curing cancer. The
journey to harnessing the full potential of nanomedicines for cancer treatment
continues, and the field remains highly promising in the fight against cancer.
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Chapter 17
https://t.me/med1917
Anti-infective Drug Nanosystems
Claire Ginn, Matthew J. Burton, and Abeer H. A. Mohamed-Ahmed
17.1 Introduction
Infectious diseases are a major health problem worldwide. The cause of these
infections may be: (i) viral, e.g. hepatitis; (ii) parasitic, e.g. leishmaniasis; (iii)
fungal, e.g. systemic candidiasis and fungal keratitis or, (iv) bacterial,
e.g. tuberculosis and bacterial keratitis. Most of these diseases are caused by
intracellular pathogens. The great challenge in these types of infections is to deliver
an intracellular dose of the drug to kill the pathogen within the cell because the host
cell membrane may act as a barrier for drugs to reach the pathogen (Croft 2018;Qi
et al. 2021). Many antibiotics and antivirals require frequent administration and high
doses to reach therapeutic levels because of their short half-life. The frequent
administration and high doses of anti-infective drugs may result in toxic side effects
and low patient compliance. Poor patient adherence may result in the development of
resistance due to the exposure of pathogens to sub-therapeutic doses of drugs
(Almomani et al. 2022).
To treat intracellular pathogens, the anti-infective drugs should have the following properties: (i) an ability to cross the host cell membrane and reach the pathogen,
(ii) be non-toxic to host cells and (iii) sustained and site-specific release at a
therapeutic level (Sánchez et al. 2020). Many drug delivery strategies have been
investigated to address the challenges of delivering a drug intracellularly to selective
tissues and cells. Particulate drug delivery systems derived from colloidal-forming
C. Ginn
UCL School of Pharmacy, London, UK
M. J. Burton · A. H. A. Mohamed-Ahmed (*)
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine,
London, UK
e-mail: abeer.mohamed-ahmed1@lshtm.ac.uk
© The Editor(s) (if applicable) and The Author(s), under exclusive license to
Springer Nature Switzerland AG 2024
I. F. Uchegbu et al. (eds.), Fundamentals of Pharmaceutical Nanoscience,
https://doi.org/10.1007/978-3-031-59478-6_17
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