Evolving new-age strategies to transport therapeutics across the blood-brain-barrier

Int J Pharm. 2021 Apr 15:599:120351. doi: 10.1016/j.ijpharm.2021.120351. Epub 2021 Feb 2.

Abstract

A basic understanding of the blood-brain barrier (BBB) is essential for the novel advancements in targeting drugs specific to the brain. Neoplasm compromising the internal structure of BBB that results in impaired vasculature is called as blood tumor barrier (BTB). Besides, the BBB serves as a chief hindrance to the passage of a drug into the brain parenchyma. The small and hydrophilic drugs majorly display an absence of desired molecular characteristics required to cross the BBB. Furthermore, all classes of biologics have failed in the clinical trials of brain diseases over the past years since these biologics are large molecules that do not cross the BBB. Also, new strategies have been discovered that use the Trojan horse technology with the re-engineered biologics for BBB transport. Thus, this review delivers information about the different grades of tumors (I-IV) i.e. examples of BBB/BTB heterogenicity along with the different mechanisms for transporting the therapeutics into the brain tumors by crossing BBB. This review also provides insights into the emerging approaches of peptide delivery and the non-invasive and brain-specific molecular Trojan horse targeting technologies. Also, the several challenges in the clinical development of BBB penetrating IgG fusion protein have been discussed.

Keywords: Blood-brain barrier; Cerebrospinal fluid; Human insulin receptor; Molecular trojan horse; Monoclonal antibody; Peptide-based vector.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal* / metabolism
  • Biological Transport
  • Blood-Brain Barrier* / metabolism
  • Brain / metabolism
  • Drug Delivery Systems

Substances

  • Antibodies, Monoclonal