Indian scientists have made an important breakthrough in the fight against tuberculosis (TB), particularly a severe form known as Central Nervous System Tuberculosis (CNS TB).
Researchers at the Institute of Nano Science and Technology (INST) in Mohali have developed a novel method to deliver TB medications directly to the brain using a nasal drug delivery system. This innovative approach is expected to improve the treatment of CNS TB, one of the most dangerous forms of the disease.
What is Central Nervous System Tuberculosis (CNS TB)?
CNS TB is a serious type of tuberculosis that affects the brain and spinal cord. It usually develops as tuberculous meningitis, where the protective membranes surrounding the brain become inflamed. This leads to symptoms like severe headaches, fever, stiffness in the neck, and other neurological issues such as confusion or difficulty in movement. In more advanced cases, CNS TB can also result in the formation of tuberculomas—masses in the brain that can cause seizures or specific neurological problems, like weakness in certain areas of the body.
If left untreated, CNS TB can cause long-lasting health problems, including paralysis, memory loss, or even death. Early diagnosis through tests such as cerebrospinal fluid analysis (a test of the fluid around the brain and spinal cord) and imaging scans like MRI or CT scans is crucial for managing this disease. However, one of the major challenges in treating CNS TB is getting the necessary drugs to the brain.
The Challenge: The Blood-Brain Barrier
Treating CNS TB is particularly difficult because of a natural defense mechanism in the body called the blood-brain barrier (BBB). This barrier protects the brain from harmful substances in the blood, but it also makes it difficult for many medications, including TB drugs, to reach the brain. As a result, even when patients take the right medications, these drugs often don’t reach the brain in high enough amounts to effectively treat CNS TB.
A New Solution: Nose-to-Brain Drug Delivery
To overcome this challenge, the team of scientists led by Dr. Rahul Kumar Verma, along with colleagues Krishna Jadhav, Agrim Jhilta, Raghuraj Singh, Eupa Ray, Vimal Kumar, Awadh Yadav, and Amit Kumar Singh, developed a novel way to deliver TB drugs directly to the brain. Instead of relying on the traditional method of oral or intravenous delivery, which often fails to get past the blood-brain barrier, they created a system that delivers the drugs through the nose.
This new method involves the use of nanoparticles—tiny particles that are much smaller than a grain of sand. The team used chitosan, a natural material that is both biocompatible (safe for use in the human body) and biodegradable (can break down harmlessly over time), to create these nanoparticles. They then formed these nanoparticles into slightly larger clusters called nano-aggregates, which can hold TB medications like isoniazid (INH) and rifampicin (RIF).
How Does It Work?
The key advantage of this new drug delivery system is that the medications are given through the nasal route, allowing them to bypass the blood-brain barrier entirely. When the patient inhales the nano-aggregates, they travel through the nasal passage and reach the brain directly. This ensures that a higher concentration of the drugs reaches the brain, improving the chances of effectively treating the infection.
The researchers also designed the chitosan nano-aggregates to be “mucoadhesive,” meaning they stick to the nasal lining. This helps the nano-aggregates stay in place for a longer period, gradually releasing the drug over time. This extended release not only improves the effectiveness of the treatment but also means that patients may need fewer doses of medication, reducing the burden of treatment.
Why is This Important?
CNS TB is a life-threatening condition that is difficult to treat because of the blood-brain barrier. Current treatments for TB often struggle to deliver the drugs where they are needed most—in the brain. This new nose-to-brain delivery system could change that by significantly increasing the amount of medicine that reaches the brain, offering hope for better outcomes in patients suffering from this dangerous form of TB.
Moreover, the scientists believe that this technology could have applications beyond CNS TB. The method could potentially be used to treat other brain-related conditions such as brain infections, neurodegenerative diseases like Alzheimer’s and Parkinson’s, brain tumors, and epilepsy. Since these conditions also suffer from the challenge of delivering drugs to the brain, this nasal delivery system might open up new avenues for treatment.
Published Research and Future Prospects
The team’s groundbreaking work has been published in the journal Nanoscale by the Royal Society of Chemistry. The findings highlight not only the success of their research in tackling CNS TB but also the potential for broader medical applications in the future.
This innovative treatment method developed by Indian scientists represents a significant step forward in the fight against CNS TB. By delivering drugs directly to the brain through the nasal route, it addresses the long-standing problem posed by the blood-brain barrier.
As research continues, this method might offer a promising solution not only for CNS TB but also for other brain diseases that have proven difficult to treat with traditional methods.
