Review

Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA

Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA

Department of Otorhinolaryngology – Head & Neck Surgery, Sengkang General Hospital, 110 Sengkang E Way, 544886, Singapore

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Valentina Di Francesco

https://orcid.org/0000-0003-4216-724X

Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA

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Di Huang

https://orcid.org/0000-0002-6809-6470

Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA

Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA

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Anisha D’Souza

https://orcid.org/0000-0003-2457-671X

Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA

Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA

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Benjamin S Bleier

https://orcid.org/0000-0003-0783-8861

Department of Otolaryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA

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Mansoor M Amiji

*Author for correspondence: Tel.: +1 617 373 3137;

E-mail Address: m.amiji@northeastern.edu

https://orcid.org/0000-0001-6170-881X

Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, Northeastern University, 360 Huntington Avenue, Boston, 140 The Fenway Building, MA 02115, USA

Department of Chemical Engineering, College of Engineering, Northeastern University, 360 Huntington Avenue, 140 The Fenway Building, Boston, MA 02115, USA

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Published Online:6 Oct 2023https://doi.org/10.2217/nnm-2023-0072

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Abstract

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the paranasal sinuses which represents a significant health burden due to its widespread prevalence and impact on patients’ quality of life. As the molecular pathways driving and sustaining inflammation in CRS become better elucidated, the diversity of treatment options is likely to widen significantly. Nanotechnology offers several tools to enhance the effectiveness of topical therapies, which has been limited by factors such as poor drug retention, mucosal permeation and adhesion, removal by epithelial efflux pumps and the inability to effectively penetrate biofilms. In this review, we highlight the successful application of nanomedicine in the field of CRS therapeutics, discuss current limitations and propose opportunities for future work.

Plain language summary

Chronic sinusitis is a common inflammatory condition of the sinuses, which affects patients’ quality of life and consumes significant healthcare resources. It is primarily treated with corticosteroids, a type of medication that reduces inflammation, as a nasal spray or taken orally. Nasal sprays are preferred, to minimize side effects elsewhere in the body. Recently, another class of drugs – ‘biologic agents’ – has been approved for a subtype of chronic sinusitis that causes polyps (grape-like swellings of the sinus lining). However, a lasting cure is elusive, because inflammation frequently returns once these medications are stopped. As our understanding of what causes chronic sinusitis improves, researchers are seeking therapies that more accurately target the cause of inflammation, rather than broadly suppressing all types of inflammation using corticosteroids. The use of nanotechnology allows the design of drugs to overcome various challenges in treating chronic sinusitis, potentially enabling more accurate delivery of drugs into the sinuses, improving drugs’ ability to remain on the sinus lining and penetrate it, reducing the amount of drug lost due to the action of outflow pumps and overcoming additional defenses built up by bacteria when they form thick films. Here, we describe how nanomedicine has been used to develop drugs for chronic sinusitis, discuss current limitations and propose opportunities for future work.

Graphical abstract

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 18, No. 20

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History

Received 13 March 2023

Accepted 15 August 2023

Published online 6 October 2023

Published in print August 2023

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Keywords

Author contributions

A Chua: conceptualized article, drafted and revised manuscript. V Di Francesco: conceptualized article, drafted and revised manuscript. D Huang: conceptualized article, drafted and revised manuscript. A D’Souza: conceptualized article, drafted and revised manuscript. B Bleier: conceptualized article, revised manuscript critically for important intellectual content. M Amiji: conceptualized article, revised manuscript critically for important intellectual content. All authors approved the final version and agree to be accountable for all aspects of the article.

Financial & competing interests disclosure

A Chua received salary support from the National Medical Research Council of Singapore. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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Nanotechnology-enabled topical delivery of therapeutics in chronic rhinosinusitis

Abstract

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Graphical abstract

References