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Zheng X, Yang J, Hou Y, Fang Y, Wu K, Song Y, Liu K, Zhu J. Current non-invasive strategies for brain drug delivery: overcoming blood-brain barrier transport. Mol Biol Rep 2023; 51:25. [PMID: 38127178 DOI: 10.1007/s11033-023-08968-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/23/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The blood-brain barrier (BBB) is a complex and dynamic structure that serves as a gatekeeper, restricting the migrations of most compounds and molecules from blood into the central nervous system (CNS). The BBB plays a crucial role in maintaining CNS physiological function and brain homeostasis. It can protect the CNS from the entrance of toxic and infectious agents, however, it also restricts the drug permeation into brain to play a therapeutic role. The BBB has been the biggest limiting hurdle to medications entering the brain excluding from the brain about 100% of large-molecule and more than 98% of all small-molecule neurotherapeutics. As a result, it is of inability for drug molecule to reach requisite concentrations within the brain. OBJECTIVE With the aim of enhancing drug permeability and efficacy, a variety of strategies have been developed: invasive approaches, such as intraarterial delivery, intrathecal delivery, or administrating directly the drug intraventricularly and intracerebrally; non-invasive approaches that take advantage of innate BBB functions, using prodrugs, focused ultrasound, intranasal administration or nanotechnology. CONCLUSIONS Here we mainly review recent developments and challenges related to non-invasive BBB-crossing techniques, whose benefits include higher efficacy, easier application, less treatment burden, better patient acceptability, and adherence. Additionally, we also analyze the potential of non-invasive methods in the treatment of CNS disorders and render them as a most suitable platform for the management of neurological diseases.
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Affiliation(s)
- Xiaoxiao Zheng
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China
| | - Jingyao Yang
- School of Basic Medical Sciences, Institute of Physiology, Shanxi Medical University, Taiyuan, China
| | - Yiwei Hou
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China
| | - Yong Fang
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China
| | - Kaiyu Wu
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China
| | - Yanna Song
- Department of Neurology, Neuroscience Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Kangding Liu
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China.
| | - Jie Zhu
- Department of Neurology, Neuroscience Center, First Hospital of Jilin University, Xinmin Street 1#, Changchun, 130021, China.
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Karolinska University Hospital, Solna, Stockholm, Sweden.
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Roberts JW, Powlovich L, Sheybani N, LeBlang S. Focused ultrasound for the treatment of glioblastoma. J Neurooncol 2022; 157:237-247. [PMID: 35267132 PMCID: PMC9021052 DOI: 10.1007/s11060-022-03974-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/21/2022] [Indexed: 12/05/2022]
Abstract
Purpose Six years ago, in 2015, the Focused Ultrasound Foundation sponsored a workshop to discuss, and subsequently transition the landscape, of focused ultrasound as a new therapy for treating glioblastoma. Methods This year, in 2021, a second workshop was held to review progress made in the field. Discussion topics included blood–brain barrier opening, thermal and nonthermal tumor ablation, immunotherapy, sonodynamic therapy, and desired focused ultrasound device improvements. Results The outcome of the 2021 workshop was the creation of a new roadmap to address knowledge gaps and reduce the time it takes for focused ultrasound to become part of the treatment armamentarium and reach clinical adoption for the treatment of patients with glioblastoma. Priority projects identified in the roadmap include determining a well-defined algorithm to confirm and quantify drug delivery following blood–brain barrier opening, identifying a focused ultrasound-specific microbubble, exploring the role of focused ultrasound for liquid biopsy in glioblastoma, and making device modifications that better support clinical needs. Conclusion This article reviews the key preclinical and clinical updates from the workshop, outlines next steps to research, and provides relevant references for focused ultrasound in the treatment of glioblastoma.
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Affiliation(s)
- Jill W Roberts
- Focused Ultrasound Foundation, 1230 Cedars Court, Suite 206, Charlottesville, VA, 22903, USA.
| | - Lauren Powlovich
- Focused Ultrasound Foundation, 1230 Cedars Court, Suite 206, Charlottesville, VA, 22903, USA
| | - Natasha Sheybani
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, 22908, USA
| | - Suzanne LeBlang
- Focused Ultrasound Foundation, 1230 Cedars Court, Suite 206, Charlottesville, VA, 22903, USA
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