4.6 Review

New Drug Delivery Systems Developed for Brain Targeting

Journal

DRUGS
Volume 82, Issue 7, Pages 749-792

Publisher

ADIS INT LTD
DOI: 10.1007/s40265-022-01717-z

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This article discusses the importance and challenges of the blood-brain barrier and blood-cerebrospinal fluid barrier in drug delivery, as well as different strategies and methods for brain-targeted drugs, emphasizing the need for further research and prospects, especially in non-invasive approaches.
The blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (B-CSF) are two of the most complex and sophisticated concierges that defend the central nervous system (CNS) by numerous mechanisms. While they maintain the neuro-ecological homeostasis through the regulated entry of essential biomolecules, their conservative nature challenges the entry of most of the drugs intended for CNS delivery. Targeted delivery challenges for a diverse spectrum of therapeutic agents/drugs (non-small molecules, small molecules, gene-based therapeutics, protein and peptides, antibodies) are diverse and demand specialized delivery and disease-targeting strategies. This review aims to capture the trends that have shaped the current brain targeting research scenario. This review discusses the physiological, neuropharmacological, and etiological factors that participate in the transportation of various drug delivery cargoes across the BBB/B-CSF and influence their therapeutic intracranial concentrations. Recent research works spanning various invasive, minimally invasive, and non-invasive brain- targeting approaches are discussed. While the pre-clinical outcomes from many of these approaches seem promising, further research is warranted to overcome the translational glitches that prevent their clinical use. Non-invasive approaches like intranasal administration, P-glycoprotein (P-gp) inhibition, pro-drugs, and carrier/targeted nanocarrier-aided delivery systems (alone or often in combination) hold positive clinical prospects for brain targeting if explored further in the right direction.

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