Liposomes are established drug carriers for inhalation owing to their safety and ability to provide controlled
drug release in the lung. These carriers can entrap a wide range of therapeutic molecules for delivery in
large volumes to the peripheral airways using medical nebulizers. Pressurized metered inhalers (pMDIs), soft mist
inhalers (SMIs) and dry powder inhalers (DPIs) can deliver relatively small quantities of medication to the lung
when compared to medical nebulizers which can deliver large volumes using simple liposome preparation techniques.
Unfortunately, the shearing provided during nebulization to convert the aqueous liposome dispersions into
“respirable” aerosol droplets may exert physical stress on liposome bilayers, causing losses of the originally entrapped
drug. The development of successful liposome carriers for inhalation depends on two main factors which
are formulation composition and nebulizer design, with the aim of reducing the detrimental effect of shearing on
liposome stability and maximizing the deposition of vesicles in the ‘deep lung’. A number of nebulizable
liposome formulations have reached clinical trials. For example, Arikace® (liposomal amikacin) and Pulmaquin®
(liposomal ciprofloxacin) are antibacterial formulations currently in advanced stages of development. In this
review, the role of liposome formulation and inhalation device design on the suitability of liposomes for eliciting
controlled drug release in the lung was evaluated. Moreover, the factors contributing to the success of Arikace® in
clinical trials were appraised.
Keywords: Device, inhalation, liposome, lung, nanocarrier, phosphatidylcholine, proliposome.
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