Agrahari Vivek
School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA.
Neural Regen Res. 2017 Feb;12(2):197-200. doi: 10.4103/1673-5374.200796.
Delivering therapeutics to the central nervous system (CNS) and brain-tumor has been a major challenge. The current standard treatment approaches for the brain-tumor comprise of surgical resection followed by immunotherapy, radiotherapy, and chemotherapy. However, the current treatments are limited in providing significant benefits to the patients and despite recent technological advancements; brain-tumor is still challenging to treat. Brain-tumor therapy is limited by the lack of effective and targeted strategies to deliver chemotherapeutic agents across the blood-brain barrier (BBB). The BBB is the main obstacle that must be overcome to allow compounds to reach their targets in the brain. Recent advances have boosted the nanotherapeutic approaches in providing an attractive strategy in improving the drug delivery across the BBB and into the CNS. Compared to conventional formulations, nanoformulations offer significant advantages in CNS drug delivery approaches. Considering the above facts, in this review, the physiological/anatomical features of the brain-tumor and the BBB are briefly discussed. The drug transport mechanisms at the BBB are outlined. The approaches to deliver chemotherapeutic drugs across the CNS into the brain-tumor using nanocarriers are summarized. In addition, the challenges that need to be addressed in nanotherapeutic approaches for their enhanced clinical application in brain-tumor therapy are discussed.
将治疗药物输送到中枢神经系统(CNS)和脑肿瘤一直是一项重大挑战。目前脑肿瘤的标准治疗方法包括手术切除,随后进行免疫治疗、放射治疗和化疗。然而,目前的治疗方法在为患者带来显著益处方面存在局限性,尽管最近技术有所进步,但脑肿瘤的治疗仍然具有挑战性。脑肿瘤治疗受到缺乏有效且有针对性的策略来使化疗药物穿过血脑屏障(BBB)的限制。血脑屏障是必须克服的主要障碍,以便化合物能够到达其在大脑中的靶点。最近的进展推动了纳米治疗方法的发展,为改善药物穿过血脑屏障并进入中枢神经系统提供了一种有吸引力的策略。与传统制剂相比,纳米制剂在中枢神经系统药物递送方法中具有显著优势。考虑到上述事实,在本综述中,简要讨论了脑肿瘤和血脑屏障的生理/解剖学特征。概述了血脑屏障处的药物转运机制。总结了使用纳米载体将化疗药物穿过中枢神经系统输送到脑肿瘤中的方法。此外,还讨论了纳米治疗方法在脑肿瘤治疗中增强临床应用需要解决的挑战。