Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan.
Primary and Secondary Healthcare Department, Govt of the Punjab, Lahore, Pakistan.
Eur J Med Res. 2024 Jun 8;29(1):313. doi: 10.1186/s40001-024-01915-3.
Alzheimer's disease (AD) is a diverse disease with a complex pathophysiology. The presence of extracellular β-amyloid deposition as neuritic plaques and intracellular accumulation of hyper-phosphorylated tau as neurofibrillary tangles remain the core neuropathologic criteria for diagnosing Alzheimer's disease. Nonetheless, several recent basic discoveries have revealed significant pathogenic roles for other essential cellular and molecular processes. Previously, there were not so many disease-modifying medications (DMT) available as drug distribution through the blood-brain barrier (BBB) is difficult due to its nature, especially drugs of polypeptides nature and proteins. Recently FDA has approved lecanemab as DMT for its proven efficacy. It is also complicated to deliver drugs for diseases like epilepsy or any brain tumor due to the limitations of the BBB. After the advancements in the drug delivery system, different techniques are used to transport the medication across the BBB. Other methods are used, like enhancement of brain blood vessel fluidity by liposomes, infusion of hyperosmotic solutions, and local intracerebral implants, but these are invasive approaches. Non-invasive approaches include the formulation of nanoparticles and their coating with polymers. This review article emphasizes all the above-mentioned techniques, procedures, and challenges to transporting medicines across the BBB. It summarizes the most recent literature dealing with drug delivery across the BBB.
阿尔茨海默病（AD）是一种具有复杂病理生理学的多样化疾病。细胞外β-淀粉样蛋白沉积形成神经纤维缠结，细胞内过度磷酸化的tau 积聚，这些仍然是诊断阿尔茨海默病的核心神经病理学标准。尽管如此，最近的一些基础发现揭示了其他重要细胞和分子过程的显著致病作用。以前，由于血脑屏障（BBB）的性质，能够通过血脑屏障（BBB）分布的疾病修饰药物（DMT）并不多，特别是多肽类药物和蛋白质类药物。最近，FDA 已批准 Lecanemab 作为治疗 AD 的 DMT，因其疗效已得到证实。由于 BBB 的限制，像癫痫或任何脑肿瘤等疾病的药物输送也很复杂。在药物输送系统取得进展后，人们使用不同的技术将药物输送到 BBB 中。其他方法，如通过脂质体增强脑血管流动性、输注高渗溶液和局部脑内植入，这些都是有创方法。非侵入性方法包括纳米颗粒的形成及其与聚合物的涂层。本文综述强调了所有上述技术、程序和在 BBB 中输送药物的挑战。它总结了最近涉及药物通过 BBB 输送的文献。
