Nanoparticle theranostics for respiratory diseases: advances and challenges in asthma, lung cancer, and tuberculosis

Abstract Respiratory diseases including asthma, lung cancer, and tuberculosis continue to impose significant health challenges worldwide, affecting hundreds of millions and causing millions of deaths annually. Conventional therapies often fall short due to issues like drug resistance, limited targeting, and systemic side effects, necessitating novel approaches. Nanoparticle-based theranostics offer a promising avenue by integrating targeted treatment with precise diagnostics, overcoming biological barriers, and enhancing drug delivery efficiency. In asthma, nanoparticles facilitate focused delivery to inflamed airways and enable breath-based biomarker detection, improving disease monitoring and management. For lung cancer, nanocarriers assist in early tumor biomarker identification and provide selective chemotherapy that minimizes damage to healthy tissue. Tuberculosis treatment benefits from nanoparticle systems that enhance intracellular drug delivery to infected macrophages, addressing multidrug resistance. This review uniquely combines therapeutic and diagnostic advances while emphasizing challenges such as complex manufacturing, safety concerns, regulatory hurdles, and disparities in access, particularly in resource-limited settings. Overcoming these obstacles through scalable production methods, rigorous clinical evaluation, and international collaboration holds the potential to transform respiratory disease care by enabling earlier diagnosis and personalized treatment on a global scale. Graphical abstract