Exosomal delivery of therapeutic modulators through the blood-brain barrier; promise and pitfalls

Nowadays, a large population around the world, especially the elderly, suffers from neurological inflammatory and degenerative disorders/diseases. Current drug delivery strategies are facing different challenges because of the presence of the BBB, which limits the transport of various substances and cells to brain parenchyma. Additionally, the low rate of successful cell transplantation to the brain injury sites leads to efforts to find alternative therapies. Stem cell byproducts such as exosomes are touted as natural nano-drug carriers with 50-100 nm in diameter. These nano-sized particles could harbor and transfer a plethora of therapeutic agents and biological cargos to the brain. These nanoparticles would offer a solution to maintain paracrine cell-to-cell communications under healthy and inflammatory conditions. The main question is that the existence of the intact BBB could limit exosomal trafficking. Does BBB possess some molecular mechanisms that facilitate the exosomal delivery compared to the circulating cell? Although preliminary studies have shown that exosomes could cross the BBB, the exact molecular mechanism(s) beyond this phenomenon remains unclear. In this review, we tried to compile some facts about exosome delivery through the BBB and propose some mechanisms that regulate exosomal cross in pathological and physiological conditions.

Automated summary

Current drug delivery strategies for neurological disorders face challenges due to the blood-brain barrier (BBB) limiting transport to the brain parenchyma. Stem cell byproducts such as exosomes are proposed as natural nano-drug carriers, but the intact BBB may hinder their delivery. Understanding the molecular mechanisms behind exosomal trafficking through the BBB remains unclear despite some preliminary studies showing potential.