Convection-Enhanced Drug Delivery to the Brain: Therapeutic Potential and Neuropathological Considerations

被引：90

作者：

Barua, Neil U. ^{[1
]}

Gill, Steven S. ^{[1
]}

Love, Seth ^{[2
]}

机构：

[1] Univ Bristol, Frenchay Hosp, Dept Neurosurg, Inst Clin Neurosci,Sch Clin Sci, Bristol BS16 1LE, Avon, England

[2] Univ Bristol, Frenchay Hosp, Dept Neuropathol, Inst Clin Neurosci,Sch Clin Sci, Bristol BS16 1LE, Avon, England

来源：

BRAIN PATHOLOGY | 2014年 / 24卷 / 02期

基金：

英国工程与自然科学研究理事会;

关键词：

Alzheimer's disease; blood-brain barrier; convection-enhanced delivery; drug delivery; glioma; Parkinson's disease; perivascular spaces; NEPRILYSIN GENE-TRANSFER; AMYLOID-BETA PEPTIDE; NERVE GROWTH-FACTOR; NEUROTROPHIC FACTOR; PIA MATER; A-BETA; RECURRENT GLIOBLASTOMA; PERIVASCULAR SPACES; INTERSTITIAL FLUID; MALIGNANT GLIOMA;

D O I：

10.1111/bpa.12082

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Convection-enhanced delivery (CED) describes a direct method of drug delivery to the brain through intraparenchymal microcatheters. By establishing a pressure gradient at the tip of the infusion catheter in order to exploit bulk flow through the interstitial spaces of the brain, CED offers a number of advantages over conventional drug delivery methodsbypass of the blood-brain barrier, targeted distribution through large brain volumes and minimization of systemic side effects. Despite showing early promise, CED is yet to fulfill its potential as a mainstream strategy for the treatment of neurological disease. Substantial research effort has been dedicated to optimize the technology for CED and identify the parameters, which govern successful drug distribution. It seems likely that successful clinical translation of CED will depend on suitable catheter technology being used in combination with drugs with optimal physicochemical characteristics, and on neuropathological analysis in appropriate preclinical models. In this review, we consider the factors most likely to influence the success or failure of CED, and review its application to the treatment of high-grade glioma, Parkinson's disease (PD) and Alzheimer's disease (AD).

引用

页码：117 / 127

页数：11

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