Title:
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Antimicrobial nanotherapies for respiratory infection in cystic fibrosis
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This thesis presents the design, development and efficacy of antimicrobial nanotherapies, to overcome
the challenges faced by conventional antimicrobial delivery for the treatment of Pseudomonas
aeruginosa respiratory infections in cystic fibrosis (CF). In the CF lungs, mucus and biofilms pre.sent
complex barriers to the optimal delivery of antimicrobial therapy, leading to low antimicrobial exposure
to resident bacteria and inadequate eradication. Respiratory disease, associated with chronic
respiratory infection, is ultimately the main cause of morbidity and mortality in CF patients. There is a
need to develop improved antimicrobial and anti-biofilm therapies in this patient group.
Firstly, alginate/chitosan polymeric nanoparticle (NP) delivery vehicles for the antimicrobial tobramycin
were formulated. Tobramycin NPs demonstrated antimicrobial efficacy against laboratory and clinically
isolated strains of P. aeruginosa in vitro and in vivo against infected Galleria mellonella. Next,
functionalisation of the mucolytic DNase to tobramycin NPs was investigated with the aim to improve
penetration of the mucus and biofilm barriers, to increase the accessibility of tobramycin to the
difficult-to-reach sites of infection. Functional activity of both drugs was established against DNA, P.
aeruginosa strains and in CF sputum. DNase functionalisation was found to improve the sputum
penetration of NPs and these DNase tobramycin NPs possessed anti microbia! activity in sputum
samples from CF patients. Finally, the antimicrobial activity of the developed nanotherapies against P.
aeruginosa biofilms was studied. DNase tobramycin NPs have the potential to target both the biofilm
matrix and bacterial cells through the combined DNA degradation and bactericidal actions of DNase
and tobramycin. Against established P. aeruginosa biofilms, both tobramycin NPs and DNase
tobramycin NPs were found to be effective antimicrobial agents. The developed antimicrobial
nanotherapies represent a promising therapeutic strategy for improving tobramycin delivery to
mucus-embedded, biofilm-associated respiratory infections in CF.
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