Gao Qiang, Song Dengpan, Xu Dingkang, Chai Xinyi, Ge Ming
Department of Neurosurgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Pediatr. 2025 Aug 29;13:1646641. doi: 10.3389/fped.2025.1646641. eCollection 2025.
The blood-brain barrier (BBB) plays a vital role in maintaining central nervous system homeostasis but poses a major obstacle to effective drug delivery in pediatric brain tumors. BBB integrity varies significantly in pediatric brain tumors compared to adult ones, and is influenced by the tumor type, molecular subtype, and anatomical location. This review discusses the heterogeneous nature of the BBB across various pediatric brain tumors, including low-grade gliomas, diffuse midline gliomas, medulloblastomas, ependymomas and craniopharyngiomas. We review histological, molecular, and imaging evidence to highlight differences in BBB permeability and their implications for therapeutic delivery and treatment resistance. Special consideration is given to advanced drug delivery strategies, such as focused ultrasound and BBB-disrupting agents, which have been tailored to the unique barrier properties of each tumor subtype. A deeper understanding of tumor-specific BBB architecture is essential for tailoring treatment strategies and improving outcomes in pediatric brain cancer.
血脑屏障（BBB）在维持中枢神经系统稳态方面发挥着至关重要的作用，但在小儿脑肿瘤的有效药物递送中却是一个主要障碍。与成人脑肿瘤相比，小儿脑肿瘤中的血脑屏障完整性差异显著，且受肿瘤类型、分子亚型和解剖位置的影响。本综述讨论了各种小儿脑肿瘤（包括低级别胶质瘤、弥漫性中线胶质瘤、髓母细胞瘤、室管膜瘤和颅咽管瘤）中血脑屏障的异质性。我们回顾了组织学、分子和影像学证据，以突出血脑屏障通透性的差异及其对治疗递送和治疗耐药性的影响。特别关注了先进的药物递送策略，如聚焦超声和血脑屏障破坏剂，这些策略是根据每种肿瘤亚型独特的屏障特性量身定制的。深入了解肿瘤特异性血脑屏障结构对于制定小儿脑癌的治疗策略和改善治疗效果至关重要。
