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Drug Delivery to the Brain by Blood-Brain Barrier Circumvention and Drug Modification

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Implications of the Blood-Brain Barrier and Its Manipulation

Abstract

Recent advances in the fields of pharmacology and molecular biology have spurred the development of several interesting and highly effective therapeutic agents for the treatment of a wide variety of malignant, infectious, and genetic diseases. While many chemotherapeutic agents exhibit excellent activity in vitro, their therapeutic efficacy is often significantly diminished when administered to appropriate animal models, since they are unable to gain access to the diseased site at a sufficient concentration for an appropriate time. This is particularly common when the disease is sequestered within the CNS. As described by Neuwelt (Chapter 17, Vol. 2, Parts A and B) and Greig (Chapter 16, Vol. 2), this problem is commonly encountered by neurooncologists in the treatment of both primary and metastatic brain tumors. As a consequence, the prognosis of such patients remains extremely poor.92 Possibly less extreme but of equal importance is the clinical observation that CNS drug-delivery problems are prevalent in the treatment of patients with acute cerebral bacterial and viral infections as well as with neurotransmitter and enzyme-deficiency diseases, such as Parkinson, Huntington, and Tay-Sachs disease.

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  1. Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, 20892, USA

    Nigel H. Greig

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    Edward A. Neuwelt M.D.

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Greig, N.H. (1989). Drug Delivery to the Brain by Blood-Brain Barrier Circumvention and Drug Modification. In: Neuwelt, E.A. (eds) Implications of the Blood-Brain Barrier and Its Manipulation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0701-3_12

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