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Abstract(s)
A osteomielite Ă© uma doença inflamatĂłria, de apresentação clĂnica bastante heterogĂ©nea, geralmente de origem bacteriana. As bactĂ©rias, em particular as da espĂ©cie Staphylococcus aureus (principal agente etiolĂłgico desta infecção), tĂȘm a capacidade de formar biofilmes em superfĂcies biĂłticas ou abiĂłticas, fazendo desta uma infecção refractĂĄria ao tratamento convencional e de difĂcil erradicação. A recomendação geral para o tratamento da osteomielite crĂłnica Ă© de 4 a 6 semanas de terapia antibiĂłtica por via parentĂ©rica.
Na Ășltima dĂ©cada, a investigação tem procurado desenvolver estratĂ©gias terapĂȘuticas a fim melhorar a efectividade dos antibiĂłticos disponĂveis contra os biofilmes, encapsulando estes fĂĄrmacos em micro e nanopartĂculas. Estes sistemas de administração localizada de fĂĄrmacos permitem ultrapassar alguns problemas da terapĂȘutica actual. No entanto, apresentam vĂĄrios desafios do ponto de vista regulamentar, tecnolĂłgico, clĂnico e de segurança que dificultam a sua utilização clĂnica.
As principais vantagens sĂŁo: a possibilidade de libertação dirigida ou modificada de fĂĄrmacos, a veiculação de fĂĄrmacos lipofĂlicos ou hidrofĂlicos; a protecção do fĂĄrmaco encapsulado, a redução da toxicidade, a minimização das flutuaçÔes entre concentraçÔes tĂłxicas e subterapĂȘuticas nos tecidos-alvo; a melhoria a efectividade dos antibiĂłticos disponĂveis contra os biofilmes.
No Ăąmbito da nanomedicina utilizada no tratamento de infecçÔes Ăłsseas, os nanossistemas de maior relevo sĂŁo os seguintes: nanopartĂculas lipĂdicas, nanopartĂculas polimĂ©ricas, nanopartĂculas de cĂĄlcio e nanopartĂculas metĂĄlicas. As nanopartĂculas podem incorporar fĂĄrmacos de interesse ou exibir actividade bactericida intrĂnseca. Cada um destes nanosistemas tem as suas particularidades, benefĂcios e inconvenientes, naturalmente relacionadas com as suas caracterĂsticas fĂsico-quĂmicas.
Este trabalho analisa a bibliografia recente (foram consultados artigos cientĂficos publicados desde Janeiro 2011 atĂ© Agosto de 2017) relacionada com a etiologia, a patogenia, a epidemiologia, o diagnĂłstico e o tratamento da osteomielite, com especial ĂȘnfase nas nanopartĂculas como sistemas de veiculação de fĂĄrmacos, sublinhando o seu potencial como futuras ferramentas Ășteis no tratamento da osteomielite.
ConcluĂmos que as nanopartĂculas poderĂŁo ter um papel revolucionĂĄrio na terapĂȘutica da osteomielite, embora seja fundamental elaborar mais estudos, nomeadamente, no Ăąmbito da nanotoxicologia.
Osteomyelitis is an inflammatory disease, with a very heterogeneous clinical presentation, usually of bacterial origin. Bacteria, in particular Staphylococcus aureus (the main etiological agent of this infection), have the ability to form biofilms on biotic or abiotic surfaces, making it an infection resistant to conventional treatment and difficult to eradicate. The general recommendation for the treatment of chronic osteomyelitis is 4 to 6 weeks of parenteral antibiotic therapy. In the last decade, research has sought to improve the effectiveness of antibiotics available against biofilms by encapsulating these drugs in micro and nanoparticles. These local drug delivery systems allow to overcome some of the problems of the actual therapeutics, although they present many challenges from the regulatory, technological, clinical and safety point of views that hamper clinical use. The main advantages are: the possibility of making a targeted or modified release of drugs, delivery of lipophilic or hydrophilic drugs; protection of the encapsulated drug, reduction of the toxicity, minimization of the fluctuations between toxic and sub-therapeutic concentrations in target tissues; improve the effectiveness of antibiotics available against biofilms. In the field of nanomedicine applicable to the osteomyelitis treatment, the most relevant nanosystems are the following: lipid nanoparticles, polymer nanoparticles, calcium nanoparticles and metal nanoparticles. As nanoparticles may incorporate drugs of interest or exhibit intrinsic bactericidal activity. Each of these nanosystems have its peculiarities, benefits and drawbacks, naturally related to its physicochemical characteristics. This work analyses a recent bibliography (scientific articles published between january of 2011 and august of 2017 were consulted) related to the etiology, pathogenesis, epidemiology, diagnosis and treatment of osteomyelitis, with special emphasis on nanoparticles as drug delivery systems, underlining its potential as future useful tools without treatment of osteomyelitis. We concluded that nanoparticles can have a revolutionary role on osteomyelitis therapeutics, though It is fundamental to elaborate more studies, namely about nanotoxicology.
Osteomyelitis is an inflammatory disease, with a very heterogeneous clinical presentation, usually of bacterial origin. Bacteria, in particular Staphylococcus aureus (the main etiological agent of this infection), have the ability to form biofilms on biotic or abiotic surfaces, making it an infection resistant to conventional treatment and difficult to eradicate. The general recommendation for the treatment of chronic osteomyelitis is 4 to 6 weeks of parenteral antibiotic therapy. In the last decade, research has sought to improve the effectiveness of antibiotics available against biofilms by encapsulating these drugs in micro and nanoparticles. These local drug delivery systems allow to overcome some of the problems of the actual therapeutics, although they present many challenges from the regulatory, technological, clinical and safety point of views that hamper clinical use. The main advantages are: the possibility of making a targeted or modified release of drugs, delivery of lipophilic or hydrophilic drugs; protection of the encapsulated drug, reduction of the toxicity, minimization of the fluctuations between toxic and sub-therapeutic concentrations in target tissues; improve the effectiveness of antibiotics available against biofilms. In the field of nanomedicine applicable to the osteomyelitis treatment, the most relevant nanosystems are the following: lipid nanoparticles, polymer nanoparticles, calcium nanoparticles and metal nanoparticles. As nanoparticles may incorporate drugs of interest or exhibit intrinsic bactericidal activity. Each of these nanosystems have its peculiarities, benefits and drawbacks, naturally related to its physicochemical characteristics. This work analyses a recent bibliography (scientific articles published between january of 2011 and august of 2017 were consulted) related to the etiology, pathogenesis, epidemiology, diagnosis and treatment of osteomyelitis, with special emphasis on nanoparticles as drug delivery systems, underlining its potential as future useful tools without treatment of osteomyelitis. We concluded that nanoparticles can have a revolutionary role on osteomyelitis therapeutics, though It is fundamental to elaborate more studies, namely about nanotoxicology.
Description
Trabalho Final de Mestrado Integrado, CiĂȘncias FarmacĂȘuticas, Universidade de Lisboa, Faculdade de FarmĂĄcia, 2017
Keywords
Osteomielite AntibiĂłticos TerapĂȘutica NanopartĂculas BactĂ©rias Mestrado Integrado - 2017