Cationic lipid-based targeted nanocarriers for respiratory diseases in children: prospects and challenges

Pediatric respiratory diseases such as pneumonia, asthma, bronchiolitis, tuberculosis (TB), and cystic fibrosis (CF) are among the most important global health burdens and also main causes of mortality and morbidity in the pediatric population. The traditional therapeutic interventions are associated with considerable limitations, including systemic toxicity, inadequate lung targeting, rapid mucociliary clearance, and inadequate intracellular drug delivery, which limit their effectiveness. This review aims to provide an overview on cationic lipid-based nanocarriers (CLNCs), targeted pulmonary drug delivery, pediatric respiratory diseases, formulation strategies, therapeutic potential, safety considerations, and challenges for translation. The development in nanotechnology has indicated that cationic lipid-based drug carriers are promising drug delivery systems to target respiratory diseases. Solid lipid nanoparticles (SLNPs), cationic liposomes, lipid nanoparticles (LNPs), and nanostructured lipid carriers (NLCs) are examples of CLNCs. In addition, new advances in intelligent drug carriers and inhalable nanomedicines in nanoparticle development are improving the mechanisms of precision respiratory medicine. However, there are considerable limitations and challenges in immune activation, cationic lipid toxicity, lung barriers, stability, and scalability. The multidisciplinary research, especially designed for pediatric clinical trials, is important for converting these nanocarrier systems into safe and effective clinical treatments.