Saito Ryuta, Tominaga Teiji
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Neurol Med Chir (Tokyo). 2012;52(8):531-8. doi: 10.2176/nmc.52.531.
The evolution of cancer chemotherapy has been a major advance in medical science in the late 20th century. However, patients with malignant gliomas have not benefitted much. The blood-brain barrier (BBB), which always hinders the entry of therapeutic agents into the central nervous system (CNS), may at least partly be responsible. Convection-enhanced delivery (CED), a method for distributing large and small molecular weight compounds bypassing the BBB, enables robust distribution of the infused molecules at the site of infusion. CED is promising as an effective treatment not only for malignant gliomas but also for multiple CNS disorders because this method can effectively distribute multiple molecules that are potentially effective against different diseases. Although the method is quite simple, several problems require solution in developing novel CED-based strategies, including what, where, when, and how to infuse. This review discusses basic considerations when developing CED-based strategies for CNS diseases, focusing mainly on brain tumors.
癌症化疗的发展是20世纪后期医学科学的一项重大进步。然而，恶性胶质瘤患者并未从中获益良多。血脑屏障（BBB）总是阻碍治疗药物进入中枢神经系统（CNS），这可能至少是部分原因。对流增强递送（CED）是一种绕过血脑屏障分布大、小分子化合物的方法，能使注入的分子在注入部位大量分布。CED不仅有望成为治疗恶性胶质瘤的有效方法，还可用于多种中枢神经系统疾病，因为该方法能有效分布多种可能对不同疾病有效的分子。尽管该方法相当简单，但在开发基于CED的新策略时仍有几个问题需要解决，包括注入什么、何处、何时以及如何注入。本文综述了开发基于CED的中枢神经系统疾病策略时的基本考虑因素，主要聚焦于脑肿瘤。
