Progress and problems in the application of focused ultrasound for blood-brain barrier disruption.
Advances in neuroscience have resulted in the development of new diagnostic and therapeutic agents for potential use in the central nervous system (CNS). However, the ability to deliver the majority of these agents to the brain is limited by the blood-brain barrier (BBB), a specialized structure of the blood vessel wall that hampers transport and diffusion from the blood to the brain. Many CNS disorders could be treated with drugs, enzymes, genes, or large-molecule biotechnological products such as recombinant proteins, if they could cross the BBB. This article reviews the problems of the BBB presence in treating the vast majority of CNS diseases and the efforts to circumvent the BBB through the design of new drugs and the development of more sophisticated delivery methods. Recent advances in the development of noninvasive, targeted drug delivery by MRI-guided ultrasound-induced BBB disruption are also summarized.
Department of Radiology, Focused Ultrasound Laboratory, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Room 515, 75 Francis Street, Boston, MA 02115, USA. natalia@bwh.harvard.edu
Natalia
N
Vykhodtseva
Nathan
N
McDannold
Kullervo
K
Hynynen
D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001812:Blood-Brain Barrier / Q000378:metabolism*; D003287:Contrast Media; D004058:Diffusion; D016503:Drug Delivery Systems / Q000295:instrumentation*; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D045423:Microbubbles; D014464:Ultrasonic Therapy / Q000379:methods*
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D003287:Contrast Media