been studied [229]. The use of antibiotic amphotericin B in the treatment of
systemic fungal infections is associ ated with extensive renal toxicity [229]. The
toxicity associated with this compound is probably the result of its interaction
with cholesterol in mammalian cells. Liposomal amphotericin B (Ambisome)
[230], the first liposomal preparation to be licensed for clinical use, is used for
the treatment of systemic fungal infections. Ambisome, by passively targeting
the liver and spleen, reduces the renal toxicity of the drug at normal doses,
although renal toxicity appears to remain unaffected when the formulation is
administered at elevated doses [231]. Ambisome may also be used to treat drug-
resistant leishmaniasis, a parasitic infec tion of the reticuloendothelial system
[232]. The ability of lipos omes to be taken up by macrophages and to
concentrate in the liver and spleen undoubtedly makes them ideal for the
treatment of diseases of the liver and spleen.
Liposomes have been established as immunoadjuvants (enhancers of the
immunological response), potentiating both cell-mediated and humoral
immunity [233]. Liposomal vaccines can be made by associating them with
cytokines [233], microbes [234], soluble antigens [235], or DNA [236]. Several
investigations have reported that liposomes encapsulating antigens ha ve been
found to stimulate an immune response for the antigen used in delivery.
Another advantage of liposomal vaccines is that they can be stored under dry
conditions at low tempe ratures for up to 12 months and still retain their
adjuvanticity [237]. Hence, liposomes hold promise for vaccine therapy as they
can be used for effective antigen/peptide delivery and are able to elicit immune
response against the antigen delivered.
The use of liposomes as carriers for DNA has also been explored [238, 239].
Such liposomes are prepared from phospholipids with an amine hyd rophilic
head group. The amine groups of liposomes interact with the phosphate group
of DNA molecules to form the gene carrier. Liposomes prepared in this way
are commonly referred to as cationic liposomes, because they possess a positive
surface charge at physiological pH. The use of cationic liposomes as gene
delivery systems was pioneered in the late 1980s when it was demonstrated that
the complexation of genes with liposomes promoted gene uptake by cells in
vitro [240]. Cationic liposomes have also been actively pursued as a potential
tool for gene delivery to specific cells in the body [241244]. Although the
experimental data indica te that cationic liposomes are able to facilitate the
transfer of DNA into live mammalian cells, there are still hurdles that need to
be overcome in order to achieve successful gene transfection. These include a
reduction in the rapid clearance of cationic liposomes, production of efficiently
targeted liposomes, ability to trans fer the gene to the nucleus of a cell, and the
ability to provide a sustained long-term expression of the genes. At the cellular
level, the problems may be overcome by improving receptor-mediated uptake
using appropriate ligands, the endowment of liposomes with endosomal escape
mechanisms, a more efficient translocation of DNA to the nucleus, and the
efficient dissociation of the liposome complex just before the entry of free DNA
into the nucleus [245].
160 BIOMEDICAL NANOSTRUCTURES