Allard Emilie, Passirani Catherine, Benoit Jean-Pierre
INSERM, U646, Université d'Angers, 10 rue André Boquel, Angers F-49100, France.
Biomaterials. 2009 Apr;30(12):2302-18. doi: 10.1016/j.biomaterials.2009.01.003. Epub 2009 Jan 24.
Primary brain tumors have a significant infiltrative capacity as their reappearance after resection usually occurs within 2cm of the tumor margin. Local delivery method such as Convection-Enhanced Delivery (CED) has been introduced to avoid this recurrence by delivering active molecules via positive-pressure methods. For an efficient infusion, the distribution volume of the drug has to be optimized while avoiding backflow, since this is responsible for side effects and a reduction of therapeutic efficacy. The encapsulation of the drug infused in nanosized structures can be considered, which would lead to a reduction of both toxicity of the treatment and infusion time during CED. In the present review, we will firstly discuss the technical approach of CED with regard to catheter design and brain characteristics; secondly, we will describe the 'ideal' nanocarrier in terms of size, surface properties, and interaction with the extracellular matrix for optimal diffusion in the brain parenchyma. We also discuss preclinical and clinical applications of this new method.
原发性脑肿瘤具有显著的浸润能力，因为其切除后复发通常发生在肿瘤边缘2厘米范围内。已引入诸如对流增强递送（CED）等局部递送方法，通过正压方法递送活性分子来避免这种复发。为了实现高效输注，必须优化药物的分布体积，同时避免回流，因为回流会导致副作用并降低治疗效果。可以考虑将注入的药物封装在纳米结构中，这将减少治疗的毒性并缩短CED期间的输注时间。在本综述中，我们将首先讨论CED在导管设计和脑特征方面的技术方法；其次，我们将根据尺寸、表面性质以及与细胞外基质的相互作用来描述“理想”的纳米载体，以实现其在脑实质中的最佳扩散。我们还将讨论这种新方法的临床前和临床应用。
