key: cord-287824-zg5akivn
authors: Chan, Yinghan; Ng, Sin Wi; Mehta, Meenu; Anand, Krishnan; Kumar Singh, Sachin; Gupta, Gaurav; Chellappan, Dinesh Kumar; Dua, Kamal
title: Advanced drug delivery systems can assist in managing influenza virus infection: A hypothesis
date: 2020-09-24
journal: Med Hypotheses
DOI: 10.1016/j.mehy.2020.110298
sha: 
doc_id: 287824
cord_uid: zg5akivn

Outbreaks of influenza infections in the past have severely impacted global health and socioeconomic growth. Antivirals and vaccines are remarkable medical innovations that have been successful in reducing the rates of morbidity and mortality from this disease. However, the relentless emergence of drug resistance has led to a worrisome increase in the trend of influenza outbreaks, characterized by worsened clinical outcomes as well as increased economic burden. This has prompted the need for breakthrough innovations that can effectively manage influenza outbreaks. This article provides an insight into a novel hypothesis that describes how the integration of nanomedicine, with the development of drugs and vaccines can potentially enhance body immune response and the efficacies of anti-viral therapeutics to combat influenza infections.

Apart from COVID-19, influenza is another infectious disease that ranks high as one of the 62 deadliest, characterized by a remarkably high rate of transmission that could cause a rapid 63 spread. It is estimated that influenza kills approximately 500 thousand people yearly [4, 8] . 64 Killed virus vaccine as an intramuscular injection and attenuated live vaccine as a nasal spray, 65 are the two most widely known vaccines for this deadly virus [9] . In the recent years, an 66 increasing trend of influenza outbreaks have been observed, prompting medical researchers to 67 design and develop suitable vaccines and novel therapeutic modalities [10] . Despite the 3 68 availability of vaccines that may protect individuals from well-matched strains, it is well-69 known that the influenza virus has high mutation rates, resulting in frequent mismatches due 70 to antigenic drift and shift, thereby, necessitating the development of a new vaccine every few 71 years [11] . However, the development of a new vaccine is time-consuming. In addition, 72 vaccine-development remains mostly applicable to developed countries, attributing to the cost 73 factor involved. Moreover, long term use of standalone anti-influenza drugs and vaccines are 74 often associated with adverse reactions and other shortcomings, that limit their effective 75 clinical applications [12] . For instance, although the neuraminidase inhibitor oseltamivir has 76 been widely employed as an anti-influenza drug, it was found that the drug does not offer 77 benefits in patients with pre-existing medical conditions [12, 13] predict possible chronic and other unforeseen in-vivo effects [61, 62] . Hence, it is hoped that 327 this hypothesis will trigger further exploration into nanomedicine-based approach to elucidate 328 the in-depth mechanisms involved, along with their safety, to pave way for a paradigm shift in 329 influenza management approaches. The authors declare that they have no known competing financial interests or personal 338 relationships that could have appeared to influence the work reported in this paper. 

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The authors declare no conflict of interest, financial or otherwise. 
