Department of Mechanical Engineering, Imperial College London, London SW7 2AZ, UK.
Vita-Salute San Raffaele University, 20132 Milan, Italy.
Int J Mol Sci. 2022 Mar 15;23(6):3139. doi: 10.3390/ijms23063139.
Targeted drug delivery in the brain is instrumental in the treatment of lethal brain diseases, such as glioblastoma multiforme, the most aggressive primary central nervous system tumour in adults. Infusion-based drug delivery techniques, which directly administer to the tissue for local treatment, as in convection-enhanced delivery (CED), provide an important opportunity; however, poor understanding of the pressure-driven drug transport mechanisms in the brain has hindered its ultimate success in clinical applications. In this review, we focus on the biomechanical and biochemical aspects of infusion-based targeted drug delivery in the brain and look into the underlying molecular level mechanisms. We discuss recent advances and challenges in the complementary field of medical robotics and its use in targeted drug delivery in the brain. A critical overview of current research in these areas and their clinical implications is provided. This review delivers new ideas and perspectives for further studies of targeted drug delivery in the brain.
脑内靶向药物输送对于治疗致命性脑部疾病(如多形性胶质母细胞瘤)至关重要,这种疾病是成人中枢神经系统中最具侵袭性的原发性肿瘤。基于输注的药物输送技术可直接将药物输送到组织中进行局部治疗,例如在对流增强输送(CED)中;然而,由于人们对脑内压力驱动的药物输送机制的理解不足,限制了其在临床应用中的最终成功。在这篇综述中,我们专注于脑内基于输注的靶向药物输送的生物力学和生化方面,并探讨了潜在的分子水平机制。我们讨论了医学机器人这一互补领域的最新进展及其在脑内靶向药物输送中的应用,并对这些领域的当前研究及其临床意义进行了批判性的综述。本文为脑内靶向药物输送的进一步研究提供了新的思路和观点。