Progress in drug delivery to the central nervous system by the prodrug approach

Molecules. 2008 May 1;13(5):1035-65. doi: 10.3390/molecules13051035.

Abstract

This review describes specific strategies for targeting to the central nervous system (CNS). Systemically administered drugs can reach the brain by crossing one of two physiological barriers resistant to free diffusion of most molecules from blood to CNS: the endothelial blood-brain barrier or the epithelial blood-cerebrospinal fluid barrier. These tissues constitute both transport and enzymatic barriers. The most common strategy for designing effective prodrugs relies on the increase of parent drug lipophilicity. However, increasing lipophilicity without a concomitant increase in rate and selectivity of prodrug bioconversion in the brain will result in failure. In these regards, consideration of the enzymes present in brain tissue and in the barriers is essential for a successful approach. Nasal administration of lipophilic prodrugs can be a promising alternative non-invasive route to improve brain targeting of the parent drugs due to fast absorption and rapid onset of drug action. The carrier-mediated absorption of drugs and prodrugs across epithelial and endothelial barriers is emerging as another novel trend in biotherapeutics. Several specific transporters have been identified in boundary tissues between blood and CNS compartments. Some of them are involved in the active supply of nutrients and have been used to explore prodrug approaches with improved brain delivery. The feasibility of CNS uptake of appropriately designed prodrugs via these transporters is described in detail.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biological Transport / drug effects
  • Central Nervous System / drug effects
  • Central Nervous System / metabolism*
  • Drug Delivery Systems*
  • Humans
  • Oxidation-Reduction / drug effects
  • Prodrugs / administration & dosage*
  • Prodrugs / chemistry
  • Prodrugs / pharmacokinetics*
  • Prodrugs / pharmacology
  • Solubility / drug effects

Substances

  • Prodrugs