Key Laboratory of Drug Targeting and Drug Delivery Systems, West China School of Pharmacy, Mental Health Center and National Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Sichuan University, Chengdu 610064, China.
Department of Public Health, Chengdu Medical College, 783 Xindu Avenue, Xindu, Chengdu, Sichuan 610500, China.
J Control Release. 2024 Feb;366:519-534. doi: 10.1016/j.jconrel.2023.12.054. Epub 2024 Jan 11.
Despite the increasing global incidence of brain disorders, achieving sufficient delivery towards the central nervous system (CNS) remains a formidable challenge in terms of translating into improved clinical outcomes. The brain is highly safeguarded by physiological barriers, primarily the blood-brain barrier (BBB), which routinely excludes most therapeutics from entering the brain following systemic administration. Among various strategies investigated to circumvent this challenge, intranasal administration, a noninvasive method that bypasses the BBB to allow direct access of drugs to the CNS, has been showing promising results. Nanotechnology-based drug delivery systems, in particular, have demonstrated remarkable capacities in overcoming the challenges posed by nose-to-brain drug delivery and facilitating targeted drug accumulation within the brain while minimizing side effects of systemic distribution. This review comprehensively summarizes the barriers of nose-to-brain drug delivery, aiming to enhance our understanding of potential physiological obstacles and improve the efficacy of nasal delivery in future trials. We then highlight cutting-edge nanotechnology-based studies that enhance nose-to-brain drug delivery in three key aspects, demonstrating substantial potential for improved treatment of brain diseases. Furthermore, the attention towards clinical studies will ease the regulatory approval process for nasal administration of nanomedicines targeting brain disease.
尽管全球范围内脑疾病的发病率不断上升,但要将其转化为改善临床疗效,实现向中枢神经系统(CNS)的充分递送仍然是一个巨大的挑战。大脑受到生理屏障的高度保护,主要是血脑屏障(BBB),这通常会阻止大多数治疗药物在全身给药后进入大脑。为了克服这一挑战,研究人员探索了各种策略,其中鼻内给药是一种非侵入性方法,可绕过 BBB,使药物直接进入 CNS。基于纳米技术的药物递送系统在克服鼻内递药面临的挑战方面表现出了显著的能力,可促进药物在脑内的靶向积累,同时最大限度地减少全身分布的副作用。本综述全面总结了鼻内递药的障碍,旨在提高我们对潜在生理障碍的认识,并提高未来试验中鼻腔给药的疗效。然后,我们重点介绍了基于纳米技术的最新研究,这些研究在三个关键方面增强了鼻内递药,为改善脑部疾病的治疗提供了巨大的潜力。此外,对临床研究的关注将简化针对脑部疾病的纳米药物鼻内给药的监管审批流程。