Liposome and Polysaccharide Based Nanomedicines: An Emerging Hope to Improve the Peritoneal Dialysis Technique Guleria A and Kumar D * Centre of Biomedical Research (CBMR), Lucknow-226014, Uttar Pradesh, India * Corresponding author: Kumar D, Centre of Biomedical Research (CBMR), SGPGIMS Campus, Raibareli Road, Lucknow-226014, Uttar Pradesh, India, Tel: +91-8953261506, 8005409932; E-mail: dineshcbmr@gmail.com Received date: November 03, 2016; Accepted date: December 08, 2016; Published date: December 12, 2016 Copyright: © 2016 Guleria A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Polysaccharide based Nanoparticles; Antimicrobial nanomaterials; Biological synthesis; Peritoneal dialysis; Renal replacement therapy; Health care infections; Infectious peristonitis Introduction Peritoneal Dialysis (PD) is the simple and cost-efective renal replacement modality used for treating patients with End-Stage Renal Failure (ESRF) [1-3]. It ofers several clear advantages over Hemodialysis (HD) like cost-efectiveness, fexibility and autonomy to the patients, however, it is ofen associated with a high risk of infection of the peritoneal cavity, subcutaneous tunnel and catheter exit site as well as the subsequently formed microbial bioflms. In current practice, the episodes of PD associated infections-if diagnosed timely-are cured through the empirical use of antibiotics. However, the fungal infections or infections caused by drug resistant bacteria remains critical and ofen lead to infammation of the peritoneum. Te complication- generally known as infectious peritonitis-is not only the major cause of technique failure and patient transferring to HD, it is also the leading cause of mortality and morbidity in ESRF patients continuing on PD. As the number of ESRF patients continuing on PD is increasing continuously every year, the PD associated infections are also becoming more and more evident posing extra burden on dialysis- centers/nephrology-wards to resolve such life-threatening and critical conditions. Te situation is even more pathetic and worse in developing countries-having limited healthcare centers and poor socioeconomic status of patients-where majority of ESRF patients continuing on PD die because of intraperitoneal (IP) infections [1,3-5]. As ESRF patients are generally manifested with sabotaged immune system, therefore, high antibiotic dose is ofen used to achieve complete eradication of Intraperitoneal (IP) infections. However, the frequent intraperitoneal administration of higher anti-biotic doses may cause serious side-efects including peritoneal malfunctioning and hepatotoxicity. Tus, there has been an urgent need to improve the PD technique in terms of reducing the frequency of IP infections and improving its efciency to remove drugs/endotoxins from the patient body. Nanomedicines Tere are several reports in the literature now where nanotechnology products including nanomedicines have been implicated in the diagnosis and treatment of kidney diseases [6]. Tere is also an increasing cohort of nanomaterials which has been envisaged to improve the PD technique either through the use of (a) anti- microbial spray for preventing Catheter Exit-Site Infection [7], (b) liposomes for detoxifcation of drugs and endogenous metabolites to enhance the efciency of peritoneal dialysis [8,9], (c) nano-carriers for TNF-β1-SiRNA to inhibit the peritoneal fbrosis [10], (d) silica- containing redox nanoparticles (siRNPs) for high-performance peritoneal dialysis through suppressing oxidative stress by scavenging Reactive Oxygen Species [11], and (e) antimicrobial nanomaterials synthesized biologically–which confer several advantages like biocompatibility, low cellular toxicity and activity against variety of drug-resistant bacteria- to impart infection resistant properties to the PD fuid and thus reducing the frequency of PD associated infections [12]. An alternative, but more relevant and promising approach to improve the existing PD therapy-in terms of its dialysis efciency and limiting microbial infections- can be envisaged based on the use of liposomal antibiotic formulations [13,14]. Liposomes-generally referred as nanometric size vesicles formed by phospholipid bilayer membrane-exhibit remarkable physicochemical properties like biocompatibility, biodegradability, and low cytotoxicity. On top of this, these (a) may increase the solubility of hydrophilic, hydrophobic and amphiphilic molecules of therapeutic potential, (b) may protect them from degradation in the body and (c) may enhance their retention time within the peritoneal cavity [13-16]. All these features are highly desirable for increasing dialysis efciency and treatment against of formidable intraperitoneal infections in PD patients. Terefore, we strongly believe that liposomal formulations will soon enter into the peritoneal dialysis therapy: (a) to reduce the in vivo toxicity of anti- biotics for their safe intraperitoneal use and/or (b) to improve the therapeutic efcacy of poorly water soluble antibiotics [13,16]. Similarly, the nanometric drug-delivery systems derived from natural polysaccharides -such as heparin, cellulose, chitin, chitosan, cyclodextrin, dextrose, etc. can also be envisaged for efective and complete eradication of IP infections [17-22]. Natural polysaccharides represent a novel class of permeative biopolymers and because of their stability, availability, renewability, low toxicity and low cost are gaining tremendous popularity in the development of nano-sized drug delivery systems [23]. Various functional groups such as hydroxyl, amine etc. which are present in these polysaccharides allows chemical derivatization by which their properties can be modulated and adjusted to the aimed application [23-25]. Tese are the reasons that polysaccharides based biomaterials have undergone rapid development in the past few decades for their use in a variety of biomedical and pharmaceutical applications such as drug delivery (or co-delivery of synergistic drug combinations), gene therapy, vascular grafs, and scafolds for tissue engineering, wound dressings, medical implants and medical imaging [17,22]. In the context of improving PD technique, we foresee a great potential of low molecular weight heparin based nano-sized drug delivery systems. Heparin-most commonly known as an anticoagulant-is commonly administered intraperitoneally whenever fbrin is detected in the dialysate efuent (a clinical manifestation of peritonitis) [26]. A variety of recent research studies have shown that heparin improves the biocompatibility of Guleria and Kumar, Pharm Anal Acta 2016, 7:12 DOI: 10.4172/2153-2435.1000524 Commentry Open Access Pharm Anal Acta, an open access journal ISSN: 2153-2435 Volume 7 • Issue 12 • 1000524 P h a r m a c e u t i c a A n a l y t i c a A c t a ISSN: 2153-2435 Pharmaceutica Analytica Acta