Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
Graeme Clark Institute for Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
Fluids Barriers CNS. 2023 Nov 28;20(1):87. doi: 10.1186/s12987-023-00489-2.
The blood-brain barrier (BBB) is a selectively permeable membrane that separates the bloodstream from the brain. While useful for protecting neural tissue from harmful substances, brain-related diseases are difficult to treat due to this barrier, as it also limits the efficacy of drug delivery. To address this, promising new approaches for enhancing drug delivery are based on disrupting the BBB using physical means, including optical/photothermal therapy, electrical stimulation, and acoustic/mechanical stimulation. These physical mechanisms can temporarily and locally open the BBB, allowing drugs and other substances to enter. Focused ultrasound is particularly promising, with the ability to focus energies to targeted, deep-brain regions. In this review, we examine recent advances in physical approaches for temporary BBB disruption, describing their underlying mechanisms as well as evaluating the utility of these physical approaches with regard to their potential risks and limitations. While these methods have demonstrated efficacy in disrupting the BBB, their safety, comparative efficacy, and practicality for clinical use remain an ongoing topic of research.
血脑屏障（BBB）是一种具有选择性通透性的膜，将血液与大脑分隔开。虽然它对保护神经组织免受有害物质的侵害非常有用，但由于这种屏障的存在，与大脑相关的疾病很难治疗，因为它也限制了药物输送的效果。为了解决这个问题，有前途的新方法是使用物理手段来增强药物输送，包括光/光热疗法、电刺激和声/机械刺激。这些物理机制可以暂时和局部地打开 BBB，使药物和其他物质进入。聚焦超声尤其有前途，它能够将能量聚焦到靶向的深部脑区。在这篇综述中，我们检查了用于暂时破坏 BBB 的物理方法的最新进展，描述了它们的潜在机制，并评估了这些物理方法在潜在风险和局限性方面的效用。虽然这些方法已经证明在破坏 BBB 方面是有效的，但它们的安全性、比较效果和临床应用的实用性仍然是一个正在研究的课题。
