biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/2413-9432-2026-15-2-27-36bioph-792Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSНаправленная доставка противотуберкулезных и фотосенсибилизирующих препаратов в опухоль-ассоциированные и M. tuberculosis-инфицированные макрофаги с использованием наноносителейTargeted delivery of anti-tuberculosis and photosensitizing agents to tumor-associated and M. tuberculosis-infected macrophages using nanocarriersКочетоваА. В.KochetovaA. V.

Новосибирск

Novosibirsk

Ksiomara47@gmail.comШварцЯ. Ш.SchwartzY. S.

Новосибирск

Novosibirsk

Федеральное государственное бюджетное учреждение «Новосибирский научно-исследовательский институт туберкулеза» Минздрава РоссииРоссияFederal state budgetary institution "Novosibirsk tuberculosis research institute" of the Ministry of Health of the Russian FederationRussian Federation2026240720261522736Copyright © Кочетова А.В., Шварц Я.Ш., 20262026Кочетова А.В., Шварц Я.Ш.Kochetova A.V., Schwartz Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/792

Туберкулёз остаётся одной из важнейших глобальных проблем общественного здравоохранения, входя в первую десятку основных причин, уносящих человеческие жизни и занимая первое место по смертности среди всех инфекционных заболеваний. При этом наиболее сложной проблемой туберкулеза, как и множества других инфекционных заболеваний, является лекарственная устойчивость возбудителя . Основным клеточным резервуаром M. tuberculosis (МБТ) являются макрофаги клетки врожденной иммунной системы, которые во взаимодействии с данным патогеном могут приобретать сложный фенотип с преимущественно антивоспалительными, иммуносупрессивными свойствами и формируют метаболически привилегированную среду, способствующую выживанию и внутриклеточной персистенции МБТ. В настоящем обзоре фенотип таких макрофагов обозначен как М2 (альтернативно активированные макрофаги). В обзоре систематизированы современные подходы к таргетной доставке противотуберкулезных препаратов в МБТ-инфицированные макрофаги с использованием высокомолекулярных и наноразмерных носителей. Рассмотрены стратегии пассивного и активного таргетирования, включая придание частицам векторных свойств лигандами к рецепторам М2-макрофагов, обсуждаются методы перепрограммирования функционального фенотипа макрофагов и использования наноразмерных биомиметиков; особое внимание уделяется направленной доставке в инфицированные клетки фотосенсибилизаторов для антимикробной фотодинамической терапии. Обобщенные данные свидетельствуют, что комбинированные нанотерапевтические подходы, сочетающие прямой антимикробный эффект с модуляцией локального иммунного ответа, открывают новые возможности для преодоления лекарственной устойчивости и эрадикации МБТ.

Tuberculosis remains a leading cause of mortality among infectious diseases, with drug resistance posing a major challenge to effective treatment. Macrophages serve as the primary cellular reservoir for M. tuberculosis (MTB), which upon interaction with this pathogen may acquire a complex phenotype with predominantly anti-inflammatory, immunosuppressive properties and establish a metabolically privileged niche that supports intracellular persistence and survival of MTB. In this review, the phenotype of such macrophages is referred to as M2 (alternatively activated macrophages). This review systematizes current strategies for targeted delivery of anti-tuberculosis agents to MTB-infected macrophages using macromolecular and nanoscale carriers. Passive and active targeting approaches are examined, including the engineering of vector properties through ligand conjugation to M2 macrophage receptors. Strategies for reprogramming macrophage functional phenotype and the development of nanoscale biomimetics are discussed. Special emphasis is placed on targeted delivery of photosensitizers to infected cells for antimicrobial photodynamic therapy. The summarized evidence indicates that combined nanotherapeutic approaches, integrating direct antimicrobial activity with modulation of local immune responses, offer promising strategies for overcoming drug resistance and achieving eradication of MTB.

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The authors declare that there are no conflicts of interest present.