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Targeting cerebral diseases with enhanced delivery of therapeutic proteins across the blood-brain barrier

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EXPERT OPINION ON DRUG DELIVERY
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TAYLOR & FRANCIS LTD
DOI: 10.1080/17425247.2023.2193390

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AAV; BBB; Exosomes; Focused ultrasound; Liposomes; Nanoparticles; Recombinant antibodies; Therapeutic protein delivery

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In recent years, cerebral diseases have posed a threat to public health. However, the blood-brain barrier makes it difficult for therapeutic proteins to enter the central nervous system. Fortunately, there have been emerging strategies to overcome this barrier and deliver macromolecular therapeutic proteins.
IntroductionCerebral diseases have been threatening public physical and psychological health in the recent years. With the existence of the blood-brain barrier (BBB), it is particularly hard for therapeutic proteins like peptides, enzymes, antibodies, etc. to enter the central nervous system (CNS) and function in diagnosis and treatment in cerebral diseases. Fortunately, the past decade has witnessed some emerging strategies of delivering macromolecular therapeutic proteins across the BBB.Areas coveredBased on the structure, functions, and substances transport mechanisms, various enhanced delivery strategies of therapeutic proteins were reviewed, categorized by molecule-mediated delivery strategies, carrier-mediated delivery strategies, and other delivery strategies.Expert opinionAs for molecule-mediated delivery strategies, development of genetic engineering technology, optimization of protein expression and purification techniques, and mature of quality control systems all help to realize large-scale production of recombinant antibodies, making it possible to apply to the clinical practice. In terms of carrier-mediated delivery strategies and others, although nano-carriers/adeno-associated virus (AAV) are also promising candidates for delivering therapeutic proteins or genes across the BBB, some issues still remain to be further investigated, including safety concerns related to applied materials, large-scale production costs, quality control standards, combination therapies with auxiliary delivery strategies like focused ultrasound, etc.

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