Nanotherapeutic platforms for osteoarticular tuberculosis

Osteoarticular tuberculosis is a fairly ordinary extrapulmonary tuberculosis with about 10%-20% of all diagnosed tuberculosis cases falling under this category. Conventional interventions have included chemotherapy as the primary line of treatment. However, over the years the development of multiple drug resistance in tuberculosis has posed a far greater challenge, rendering the conventional therapy ineffective. Moreover, the disease progression leads to kyphosis, which requires advanced surgical interventions that are not patient-compliant considering that the bones are located deep beneath tissues. Thus, in order to achieve more target specificity in drug delivery, bone-targeted nanotherapeutics with dose reduction and shorter treatment duration are being explored as an alternative strategy. In this chapter, we focus on the various nanoformulation-based therapeutics as well as combinatorial therapies based on surgical interventions with nanoformulations and scaffold technology. These are currently being tested for the successful clinical treatment of osteoarticular tuberculosis. Furthermore, we review the limitations and future perspectives of nanotherapeutics in the effective, patient-compliant management of osteoarticular tuberculosis and bone regeneration.