Inspiration of Nanoengineered Antimicrobial Therapeutics Against Nontuberculous Mycobacterial Infection.
4 affiliations
- 1Guangdong Provincial Key Laboratory of Medical Immunology and Molecular Diagnostics, The First Dongguan Affiliated Hospital, School of Medical Technology, Guangdong Medical University, Dongguan, People's Republic of China.
- 2Dongguan Key Laboratory of Pathogenesis and Experimental Diagnosis of Infectious Diseases, The First Dongguan Affiliated Hospital, School of Medical Technology, Guangdong Medical University, Dongguan, People's Republic of China.
- 3International Center for Interdisciplinary Research in Sciences (ICIRS), The University of Lahore, Lahore, Pakistan.
- 4Department of Tuberculosis, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, People's Republic of China.
Abstract
Non-tuberculous mycobacteria (NTM), a diverse collection of environmentally ubiquitous pathogens, are emerging as a significant global public health concern with rising incidence and prevalence. NTM infections occur predominantly in immunocompromised populations and present as pulmonary, disseminated, and skin/soft tissue infections. Clinically prevalent NTM species are exhibiting inherent and acquired multidrug resistance, which is mediated by biofilm formation, efflux pump expression and target-site mutations, rendering conventional therapies increasingly ineffective. Current clinical management relies on prolonged, multi-drug antibiotic regimens, but are limited by poor efficacy, severe adverse effects and high rates of recurrence. This therapeutic impasse underscores an urgent need for novel intervention strategies. Engineered nanocarriers, including liposomes, polymeric, lipid-based and inorganic nanoparticles, encapsulate conventional antimicrobials to enhance bioavailability, prolong systemic circulation, improve penetration into infected tissues and biofilms, and facilitate uptake by infected macrophages for intracellular delivery. In addition, nanoplatforms can be engineered for targeted delivery, co-delivery of synergistic antimicrobials or host-directed agents, immune modulation, and stimulus-responsive release triggered by infection-related cues including acidic pH, reactive oxygen species (ROS), and enzymes. These multifunctional systems can help overcome physiological and cellular barriers while minimizing off-target toxicity. This review summarizes key clinical NTM species, their pathogenic traits, and molecular mechanisms of drug resistance. It assesses limitations of current regimens and highlights advances in nanotechnology-based antimicrobial delivery strategies, with emphasis on targeted delivery, intracellular trafficking, biofilm disruption, immunomodulation and key translational challenges. These strategies primarily target pulmonary NTM infection (the most common clinical manifestation), while this review briefly covers their applications in disseminated, cutaneous and lymph node NTM infections. The integration of nanomedicine holds the potential to revolutionize the therapeutic landscape, facilitating the development of more effective and targeted interventions against these challenging infections.
Related
- Asymptomatic Tattoo-Associated Cutaneous Nontuberculous Mycobacterial Infection: Case Report.
- Pulmonary pharmacokinetics and lesion penetration of antimicrobials in patients with nontuberculous mycobacterial disease
- Falling short: Inadequate target attainment in guideline-based therapy of nontuberculous mycobacterial disease
- Antimicrobial Therapy, Disinfection, Resistance Mechanisms, and Microbiota Interactions in Nontuberculous Mycobacteria: Current Evidence and Emerging Perspectives.
- Species distribution and antimicrobial susceptibility profiles of nontuberculous mycobacteria, with an exploratory 12-month completer outcome analysis: a single-center retrospective study from Shandong Province, China
BibTeX
@article{chen2026inspiration,
title = {{Inspiration of Nanoengineered Antimicrobial Therapeutics Against Nontuberculous Mycobacterial Infection.}},
author = {Yixian Chen and Yuhe Huang and Jiaxiang Li and Yongjie Ge and Yating Zhang and Faquan Wu and Meirong Zhu and Muhammad Tahir Khan and Haiyan Gong and Yi Zhao and Wenjuan Nie and Jiang Pi},
journal = {International journal of nanomedicine},
year = {2026},
month = nov,
doi = {10.2147/ijn.s644904},
url = {https://europepmc.org/article/MED/42999645},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Inspiration of Nanoengineered Antimicrobial Therapeutics Against Nontuberculous Mycobacterial Infection.
AU - Yixian Chen
AU - Yuhe Huang
AU - Jiaxiang Li
AU - Yongjie Ge
AU - Yating Zhang
AU - Faquan Wu
AU - Meirong Zhu
AU - Muhammad Tahir Khan
AU - Haiyan Gong
AU - Yi Zhao
AU - Wenjuan Nie
AU - Jiang Pi
PY - 2026
DA - 2026/11/03
JO - International journal of nanomedicine
DO - 10.2147/ijn.s644904
UR - https://europepmc.org/article/MED/42999645
AB - Non-tuberculous mycobacteria (NTM), a diverse collection of environmentally ubiquitous pathogens, are emerging as a significant global public health concern with rising incidence and prevalence. NTM infections occur predominantly in immunocompromised populations and present as pulmonary, disseminated, and skin/soft tissue infections. Clinically prevalent NTM species are exhibiting inherent and acquired multidrug resistance, which is mediated by biofilm formation, efflux pump expression and target-site mutations, rendering conventional therapies increasingly ineffective. Current clinical management relies on prolonged, multi-drug antibiotic regimens, but are limited by poor efficacy, severe adverse effects and high rates of recurrence. This therapeutic impasse underscores an urgent need for novel intervention strategies. Engineered nanocarriers, including liposomes, polymeric, lipid-based and inorganic nanoparticles, encapsulate conventional antimicrobials to enhance bioavailability, prolong systemic circulation, improve penetration into infected tissues and biofilms, and facilitate uptake by infected macrophages for intracellular delivery. In addition, nanoplatforms can be engineered for targeted delivery, co-delivery of synergistic antimicrobials or host-directed agents, immune modulation, and stimulus-responsive release triggered by infection-related cues including acidic pH, reactive oxygen species (ROS), and enzymes. These multifunctional systems can help overcome physiological and cellular barriers while minimizing off-target toxicity. This review summarizes key clinical NTM species, their pathogenic traits, and molecular mechanisms of drug resistance. It assesses limitations of current regimens and highlights advances in nanotechnology-based antimicrobial delivery strategies, with emphasis on targeted delivery, intracellular trafficking, biofilm disruption, immunomodulation and key translational challenges. These strategies primarily target pulmonary NTM infection (the most common clinical manifestation), while this review briefly covers their applications in disseminated, cutaneous and lymph node NTM infections. The integration of nanomedicine holds the potential to revolutionize the therapeutic landscape, facilitating the development of more effective and targeted interventions against these challenging infections.
SN - 1176-9114
SN - 1178-2013
ER -