Jiang Anan, Wang Zijie, Song Dan, Zhang Xinyu, Guan Mengtong, Li Xinhe, Tan Jindong, He Yi, Han Wang, Ding Xiaoqian, Han Xiaoyu, Li Faqi, Bai Dingqun
Department of Rehabilitation Medicine, Key Laboratory of Physical Medicine and Precision Rehabilitation of Chongqing Municipal Health Commission, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, P. R. China.
State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, P. R. China.
Small. 2025 Aug;21(31):e2502699. doi: 10.1002/smll.202502699. Epub 2025 Jun 16.
The blood-brain barrier (BBB) acts as a stringent biological filter situated between the circulatory system and the brain's tissue, shielding the brain by preventing the entry of detrimental neurotoxic substances into the central nervous system (CNS). Nevertheless, the BBB also restricts the entry of most therapeutic drugs, resulting in only a few medications currently available for the clinical treatment of neurological diseases. Consequently, it is imperative to discover a secure and potent technique to temporarily disrupt the BBB for the purpose of directed medication administration. The therapeutic approach of ultrasound-induced BBB opening combined with drug delivery offers advantages such as non-invasiveness, precise targeting, and deep tissue penetration. It overcomes the limitations of traditional therapies blocked by the BBB and shows significant potential for treating neurological disorders. This review includes an overview of the physical characteristics and transport mechanisms of the BBB, followed by an introduction to the mechanisms of ultrasound-mediated BBB opening. Additionally, it summarizes the neural and immune regulation following BBB opening by ultrasound, with a focus on its features and clinical applications in immunotherapy. These extensive insights aim to provide promising strategies for the clinical application of ultrasound-mediated BBB opening for targeted and personalized drug delivery.
血脑屏障(BBB)作为一种严格的生物过滤器,位于循环系统与脑组织之间,通过阻止有害神经毒性物质进入中枢神经系统(CNS)来保护大脑。然而,血脑屏障也限制了大多数治疗药物的进入,导致目前仅有少数药物可用于神经疾病的临床治疗。因此,必须找到一种安全有效的技术来暂时破坏血脑屏障,以便进行定向药物给药。超声诱导血脑屏障开放并结合药物递送的治疗方法具有非侵入性、精确靶向和深层组织穿透等优点。它克服了传统疗法被血脑屏障阻碍的局限性,在治疗神经疾病方面显示出巨大潜力。本综述包括对血脑屏障的物理特性和转运机制的概述,随后介绍超声介导血脑屏障开放的机制。此外,它总结了超声开放血脑屏障后的神经和免疫调节,重点关注其在免疫治疗中的特点和临床应用。这些广泛的见解旨在为超声介导血脑屏障开放用于靶向和个性化药物递送的临床应用提供有前景的策略。