Neuronopathic lysosomal storage disorders: Approaches to treat the central nervous system

Best Pract Res Clin Endocrinol Metab. 2015 Mar;29(2):159-71. doi: 10.1016/j.beem.2014.12.001. Epub 2015 Jan 5.

Abstract

Pharmacological research has always focused on developing new therapeutic strategies capable of modifying a disease's natural history and improving patients' quality of life. Despite recent advances within the fields of medicine and biology, some diseases still represent a major challenge for successful therapy. Neuronopathic lysosomal storage disorders, in particular, have high rates of morbidity and mortality and a devastating socio-economic effect. Many of the available therapies, such as enzyme replacement therapy, can reverse the natural history of the disease in peripheral organs but, unfortunately, are still unable to reach the central nervous system effectively because they cannot cross the blood-brain barrier that surrounds and protects the brain. Moreover, many lysosomal storage disorders are characterized by a number of blood-brain barrier dysfunctions, which may further contribute to disease neuropathology and accelerate neuronal cell death. These issues, and their context in the development of new therapeutic strategies, will be discussed in detail in this chapter.

Keywords: blood–brain barrier; central nervous system; drug delivery; lysosomal storage disorders; neurodegeneration.

Publication types

  • Review

MeSH terms

  • Blood-Brain Barrier / metabolism*
  • Drug Delivery Systems
  • Enzyme Replacement Therapy / methods*
  • Humans
  • Infusions, Intraventricular
  • Infusions, Spinal
  • Injections, Intraventricular
  • Injections, Spinal
  • Lysosomal Storage Diseases, Nervous System / drug therapy*
  • Lysosomal Storage Diseases, Nervous System / metabolism
  • Molecular Chaperones / therapeutic use
  • Nanoparticles / therapeutic use
  • Recombinant Proteins

Substances

  • Molecular Chaperones
  • Recombinant Proteins