Laboratory of Immunology of Reproduction, Faculty of Chemistry & Biology, Universidad de Santiago de Chile, 9170022 Santiago, Chile.
Department of Physiology, Faculty of Biological Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Nanomedicine (Lond). 2017 Jan;12(1):59-72. doi: 10.2217/nnm-2016-0307. Epub 2016 Nov 23.
Brain tumors display the highest mortality rates of all childhood cancers, and over the last decade its prevalence has steadily increased in elderly. To date, effective treatments for brain tumors and particularly for malignant gliomas remain a challenge mainly due to the low permeability and high selectivity of the blood-brain barrier (BBB) to conventional anticancer drugs. In recent years, the elucidation of the cellular mechanisms involved in the transport of substances into the brain has boosted the development of therapeutic-targeted nanoparticles (NPs) with the ability to cross the BBB. Here, we present a comprehensive overview of the available therapeutic strategies developed against malignant gliomas based on 'actively targeted' NPs, the challenges of crossing the BBB and blood-brain tumor barrier as well as its mechanisms and a critical assessment of clinical studies that have used targeted NPs for the treatment of malignant gliomas. Finally, we discuss the potential of actively targeted NP-based strategies in clinical settings, its possible side effects and future directions for therapeutic applications. First draft submitted: 4 October 2016; Accepted for publication: 14 October 2016; Published online: 23 November 2016.
脑肿瘤是儿童癌症中死亡率最高的肿瘤,在过去十年中,其在老年人中的发病率稳步上升。迄今为止,脑肿瘤,尤其是恶性神经胶质瘤的有效治疗仍然是一个挑战,主要是由于血脑屏障(BBB)对传统抗癌药物的低通透性和高选择性。近年来,对物质进入大脑的细胞机制的阐明促进了具有穿透 BBB 能力的治疗靶向纳米颗粒(NPs)的发展。在这里,我们全面概述了基于“主动靶向” NPs 的针对恶性神经胶质瘤的现有治疗策略、穿透 BBB 和血脑肿瘤屏障的挑战及其机制,以及使用靶向 NPs 治疗恶性神经胶质瘤的临床研究的批判性评估。最后,我们讨论了主动靶向 NP 为基础的策略在临床环境中的应用潜力、可能的副作用以及治疗应用的未来方向。首次提交日期:2016 年 10 月 4 日;接受出版日期:2016 年 10 月 14 日;在线出版日期:2016 年 11 月 23 日。