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Emerging Insights into the Interstitial Distribution of Neuraxial Therapeutics via the Cerebrospinal Fluid Compartment

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Neuraxial Therapeutics

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Abstract

Accessing the central nervous system (CNS) therapeutically has historically been a significant hurdle and unfortunately remains a challenge. Recent research has brought to light physiological and pathological processes that regulate the movement of fluids and solutes between the cerebrospinal fluid (CSF) compartment and the CNS interstitium and may have important implications for neuraxial therapeutic delivery. Here, we review recent findings, suggesting that CSF–interstitial exchange is anatomically organized, rapid, physiologically regulated, and impaired in the setting of CNS pathology. We then discuss the implications that these recent findings may have on the delivery of small molecules, biologics, viral-, and cell-based therapeutics to the CNS.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Deidre J. Jansson & Jeffrey J. Iliff

  2. VISN 20 Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA

    Deidre J. Jansson & Jeffrey J. Iliff

  3. Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA

    Jeffrey J. Iliff

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  1. (CTF-312), UC San Diego-Anesthesia Res Lab 081 (CTF-312), La Jolla, CA, USA

    Tony Yaksh

  2. University Hospital, Case Western Reserve University, Cleveland, OH, USA

    Salim Hayek

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Jansson, D.J., Iliff, J.J. (2023). Emerging Insights into the Interstitial Distribution of Neuraxial Therapeutics via the Cerebrospinal Fluid Compartment. In: Yaksh, T., Hayek, S. (eds) Neuraxial Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-031-39558-1_8

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