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Begley D, Gabathuler R, Pastores G, Garcia-Cazorla A, Ardigò D, Scarpa M, Tomanin R, Tosi G. Challenges and opportunities in neurometabolic disease treatment with enzyme delivery. Expert Opin Drug Deliv 2024; 21:817-828. [PMID: 38963225 DOI: 10.1080/17425247.2024.2375388] [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: 12/30/2023] [Accepted: 06/28/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Neurometabolic disorders remain challenging to treat, largely due to the limited availability of drugs that can cross the blood-brain barrier (BBB) and effectively target brain impairment. Key reasons for inadequate treatment include a lack of coordinated knowledge, few studies on BBB status in these diseases, and poorly designed therapies. AREAS COVERED This paper provides an overview of current research on neurometabolic disorders and therapeutic options, focusing on the treatment of neurological involvement. It highlights the limitations of existing therapies, describes innovative protocols recently developed, and explores new opportunities for therapy design and testing, some of which are already under investigation. The goal is to guide researchers toward innovative and potentially more effective treatments. EXPERT OPINION Advancing research on neurometabolic diseases is crucial for designing effective treatment strategies. The field suffers from a lack of collaboration, and a strong collective effort is needed to enhance synergy, increase knowledge, and develop a new therapeutic paradigm for neurometabolic disorders.
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Affiliation(s)
- David Begley
- Blood-Brain Barrier Group, King's College London, Strand, London, UK
| | | | | | - Angeles Garcia-Cazorla
- Neurometabolic Unit. Department of Neurology, Hospital Sant Joan de Déu, CIBERER and MetabERN, Barcelona, Spain
| | | | - Maurizio Scarpa
- Regional Coordinating Center for Rare Diseases, Udine University Hospital, Udine, Italy
| | - Rosella Tomanin
- Laboratory of Diagnosis and Therapy of Lysosomal Disorders, Dept. of Women's and Children's Health, University of Padova, Padova, Italy
- Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Giovanni Tosi
- Nanotech Lab, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Gu Z, Chen H, Zhao H, Yang W, Song Y, Li X, Wang Y, Du D, Liao H, Pan W, Li X, Gao Y, Han H, Tong Z. New insight into brain disease therapy: nanomedicines-crossing blood-brain barrier and extracellular space for drug delivery. Expert Opin Drug Deliv 2022; 19:1618-1635. [PMID: 36285632 DOI: 10.1080/17425247.2022.2139369] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Brain diseases including brain tumor, Alzheimer's disease, Parkinson's disease, etc. are difficult to treat. The blood-brain barrier (BBB) is a major obstacle for drug delivery into the brain. Although nano-package and receptor-mediated delivery of nanomedicine markedly increases BBB penetration, it yet did not extensively improve clinical cure rate. Recently, brain extracellular space (ECS) and interstitial fluid (ISF) drainage in ECS have been found to determine whether a drug dissolved in ISF can reach its target cells. Notably, an increase in tortuosity of ECS associated with slower ISF drainage induced by the accumulated harmful substances, such as: amyloid-beta (Aβ), α-synuclein, and metabolic wastes, causes drug delivery failure. AREAS COVERED The methods of nano-package and receptor-mediated drug delivery and the penetration efficacy of nanomedicines across BBB and ECS are assessed. EXPERT OPINION Invasive delivering drug via ECS and noninvasive near-infrared photo-sensitive nanomedicines may provide a promising benefit to patients with brain disease.
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Affiliation(s)
- Ziqi Gu
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Haishu Chen
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Han Zhao
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wanting Yang
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yilan Song
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiang Li
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yang Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.,Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Dan Du
- Department of Radiology, Peking University Third Hospital, Beijing, China.,Department of Magnetic Resonance Imaging, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, China.,Beijing Key Laboratory of Magnetic Resonance Imaging Devices and Technology, Peking University Third Hospital, Beijing, China
| | - Haikang Liao
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wenhao Pan
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xi Li
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yajuan Gao
- Department of Radiology, Peking University Third Hospital, Beijing, China.,NMPA key Laboratory for Evaluation of Medical Imaging Equipment and Technique, Beijing, China
| | - Hongbin Han
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.,Department of Radiology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging Devices and Technology, Peking University Third Hospital, Beijing, China.,Peking University Shenzhen Graduate School, Shenzhen, China
| | - Zhiqian Tong
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory, School of Mental Health, Wenzhou Medical University, Wenzhou, China.,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
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