Qu Zhichuang, Luo Juan, Li Zheng, Yang Rong, Zhao Jiaxi, Chen Xin, Yu Sixun, Shu Haifeng
Department of Neurosurgery, Meishan City People's Hospital, Meishan, China.
Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China.
Front Aging Neurosci. 2024 Aug 26;16:1353003. doi: 10.3389/fnagi.2024.1353003. eCollection 2024.
The blood-brain barrier is known to consist of a variety of cells and complex inter-cellular junctions that protect the vulnerable brain from neurotoxic compounds; however, it also complicates the pharmacological treatment of central nervous system disorders as most drugs are unable to penetrate the blood-brain barrier on the basis of their own structural properties. This dramatically diminished the therapeutic effect of the drug and compromised its biosafety. In response, a number of drugs are often delivered to brain lesions in invasive ways that bypass the obstruction of the blood-brain barrier, such as subdural administration, intrathecal administration, and convection-enhanced delivery. Nevertheless, these intrusive strategies introduce the risk of brain injury, limiting their clinical application. In recent years, the intensive development of nanomaterials science and the interdisciplinary convergence of medical engineering have brought light to the penetration of the blood-brain barrier for brain-targeted drugs. In this paper, we extensively discuss the limitations of the blood-brain barrier on drug delivery and non-invasive brain-targeted strategies such as nanomedicine and blood-brain barrier disruption. In the meantime, we analyze their strengths and limitations and provide outlooks on the further development of brain-targeted drug delivery systems.
血脑屏障由多种细胞和复杂的细胞间连接组成,可保护脆弱的大脑免受神经毒性化合物的侵害;然而,这也使中枢神经系统疾病的药物治疗变得复杂,因为大多数药物基于自身的结构特性无法穿透血脑屏障。这极大地降低了药物的治疗效果并损害了其生物安全性。作为回应,许多药物常通过侵入性方式输送到脑损伤部位,以绕过血脑屏障的阻碍,如硬膜下给药、鞘内给药和对流增强给药。然而,这些侵入性策略会带来脑损伤的风险,限制了它们的临床应用。近年来,纳米材料科学的蓬勃发展以及医学工程的跨学科融合为脑靶向药物穿透血脑屏障带来了曙光。在本文中,我们广泛讨论了血脑屏障对药物递送的限制以及纳米医学和血脑屏障破坏等非侵入性脑靶向策略。同时,我们分析了它们的优势和局限性,并对脑靶向药物递送系统的进一步发展进行了展望。