US
Funds Development of an Inhaled Form of Gentamicin
In the event of a bioterrorist attack, the Centers for
Disease Control and Prevention considers six Category A biological agents as
the most likely culprits. These agents include botulinum toxin, anthrax, viral
hemorrhagic fevers, plague, smallpox, and tularemia. The high morbidity and
mortality give these biohazardous threat agents a particular potential for
public health impact.
On
NanoGENTTM, an inhaled formulation of the
broad-spectrum antibiotic, gentamicin, provides a potential treatment for
bioterrorist threat agents, such as those that cause tularemia and plague.
Gentamicin is a bactericidal aminoglycoside antibiotic that binds to the 30S
ribosome of gram-negative bacteria and thereby inhibits protein synthesis.
According to the manufacturer, NanoGENTTM
provides several potential advantages over traditional delivery mechanisms such
as intravenous administration. These include: 1) higher shelf-life stability,
2) better control of particle size and deposition efficiency, 3) control of
cell uptake and targeting, 4) controlled release-rates, and 5) increased
systemic bioavailability. Descriptions of these advantages may be found on the
Nanotherapeutics, Inc. website at: http://www.nanotherapeutics.com/
nanotechnology.php.
Perhaps the most beneficial advantage of inhalational
gentamicin might occur during situations requiring mass post-exposure
prophylaxis, such as large-scale biological agent release. This advantage is in
the relative ease of administration and non-invasive nature of the drug
delivery system. Further “advantages of inhaled therapy include direct drug
delivery to the diseased organ, targeting to alveolar macrophages harboring the
bacteria, reduced risk of systemic toxicity, and improved patient compliance.” More detailed information regarding these
advantages may be found in the following publication: Pandey, R., and Khuller,
G.K. “Antitubercular inhaled therapy:
opportunities, progress, and challenges.”
J Antimicrob Chemo. (2005) 55: 430-435. Potential disadvantages that occurred with
older versions of inhaled antibiotics several decades ago, including
aminoglycosides, must be anticipated and monitored for closely.
The lack of FDA-licensed vaccines or immunoglobulin for
either tularemia or plague, as well as the potential for person-to-person
transmission of plague pneumonia, leave antibiotics as the only presently
available therapeutic countermeasure.
Therefore, novel forms of antibiotics, such as NanoGENTTM,
may contribute to the advancement of our current biodefense countermeasures.
Megan
Hofmeister, Christine SooHoo, Courtney Tauscher, Ray Webber, and Wade Greening
Graduate Students in the Master of Science (M.S.) Program in
Biohazardous Threat Agents and Emerging Infectious Diseases, Department of Microbiology
and Immunology, Georgetown University Medical Center. MICB-523 Course: “
Biodefense Public Health Countermeasures” taught by Daniel R. Lucey, MD, MPH,
Director of the Center Biological Counterterrorism and Emerging Diseases, EROne
Institutes,
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