Nontuberculous mycobacterial (NTM) pulmonary disease is a chronic respiratory infection associated with declining lung function, radiological deterioration and significantly increased morbidity and mortality. Patients often have underlying lung conditions, particularly bronchiectasis and COPD. NTM pulmonary disease is difficult to treat because mycobacteria can evade host defences and antimicrobial therapy through extracellular persistence in biofilms and sequestration into macrophages. Management of NTM pulmonary disease remains challenging and outcomes are often poor, partly due to limited penetration of antibiotics into intracellular spaces and biofilms. Efficient drug delivery to the site of infection is therefore a key objective of treatment, but there is high variability in lung penetration by antibiotics. Inhalation is the most direct route of delivery and has demonstrated increased efficacy of antibiotics like amikacin compared with systemic administration. Liposomes are small, artificial, enclosed spherical vesicles, in which drug molecules can be encapsulated to provide controlled release, with potentially improved pharmacokinetics and reduced toxicity. They are especially useful for drugs where penetration of cell membranes is essential. Inhaled delivery of liposomal drug solutions can therefore facilitate direct access to macrophages in the lung where the infecting NTM may reside. A range of liposomal drugs are currently being evaluated in respiratory diseases.

非结核分枝杆菌 (NTM) 肺病是一种慢性呼吸道感染，与肺功能下降、放射学恶化以及发病率和死亡率显着增加有关。患者通常有潜在的肺部疾病，尤其是支气管扩张和慢性阻塞性肺病。NTM 肺部疾病难以治疗，因为分枝杆菌可以通过生物膜中的细胞外持久性和隔离到巨噬细胞中来逃避宿主防御和抗微生物治疗。NTM 肺部疾病的管理仍然具有挑战性，结果往往很差，部分原因是抗生素对细胞内空间和生物膜的渗透有限。因此，将药物有效输送到感染部位是治疗的一个关键目标，但抗生素在肺部的渗透性存在很大差异。吸入是最直接的给药途径，与全身给药相比，已证明阿米卡星等抗生素的疗效更高。脂质体是小的、人造的、封闭的球形囊泡，药物分子可以封装在其中以提供控制释放，具有潜在改善的药代动力学和降低的毒性。它们特别适用于需要穿透细胞膜的药物。因此，脂质体药物溶液的吸入递送可以促进直接进入感染性 NTM 可能存在的肺部巨噬细胞。目前正在评估一系列脂质体药物在呼吸系统疾病中的作用。其中可以封装药物分子以提供控制释放，并可能改善药代动力学并降低毒性。它们特别适用于需要穿透细胞膜的药物。因此，脂质体药物溶液的吸入递送可以促进直接进入感染性 NTM 可能存在的肺部巨噬细胞。目前正在评估一系列脂质体药物在呼吸系统疾病中的作用。其中可以封装药物分子以提供控制释放，并可能改善药代动力学并降低毒性。它们特别适用于需要穿透细胞膜的药物。因此，脂质体药物溶液的吸入递送可以促进直接进入感染性 NTM 可能存在的肺部巨噬细胞。目前正在评估一系列脂质体药物在呼吸系统疾病中的作用。