Strategies for delivering therapeutics across the blood-brain barrier

Nat Rev Drug Discov. 2021 May;20(5):362-383. doi: 10.1038/s41573-021-00139-y. Epub 2021 Mar 1.

Abstract

Achieving sufficient delivery across the blood-brain barrier is a key challenge in the development of drugs to treat central nervous system (CNS) disorders. This is particularly the case for biopharmaceuticals such as monoclonal antibodies and enzyme replacement therapies, which are largely excluded from the brain following systemic administration. In recent years, increasing research efforts by pharmaceutical and biotechnology companies, academic institutions and public-private consortia have resulted in the evaluation of various technologies developed to deliver therapeutics to the CNS, some of which have entered clinical testing. Here we review recent developments and challenges related to selected blood-brain barrier-crossing strategies - with a focus on non-invasive approaches such as receptor-mediated transcytosis and the use of neurotropic viruses, nanoparticles and exosomes - and analyse their potential in the treatment of CNS disorders.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood-Brain Barrier / metabolism*
  • Central Nervous System Agents / pharmacokinetics*
  • Central Nervous System Agents / therapeutic use*
  • Central Nervous System Diseases / drug therapy*
  • Drug Delivery Systems*
  • Humans

Substances

  • Central Nervous System Agents