转铁蛋白受体及其在药物运输中的作用

血脑屏障的存在阻止了中枢神经系统疾病许多潜在治疗药物的通过.近年来主要利用脑毛细血管内皮细胞膜中的转运蛋白,如转铁蛋白受体、胰岛素受体等,将外源药物与这些受体的特异性抗体相连,通过受体介导的内吞作用将药物转运到脑组织中.转铁蛋白受体在抗癌药物定向运输及恶性肿瘤细胞基因治疗中的研究已经处于临床阶段.     

外泌体载体治疗在中枢神经系统疾病中的研究进展

中枢神经系统疾病包括脑血管疾病、神经退行性疾病和脑肿瘤等。血脑屏障(blood-brain barrier,BBB)阻碍了大多数通过血液循环系统输送到大脑来治疗和预防中枢神经系统疾病的药物。外泌体在细胞间物质运输和信号交流中发挥重要作用,由于其具有较小的体积、高递送效率、低免疫原性和良好的生物相容性等特点,可以通过正常的内吞作用和转胞吞作用进入脑内皮细胞,进而穿过血脑屏障转运内容物。为提高外泌体靶向性,对其膜进行工程改造,从而产生具有靶向能力的囊泡是今后外泌体载体研究的重要方向。该文就外泌体的生物学特征、工程化修饰及其作为治疗载体在中枢神经系统疾病中的研究进行综述。     

血脑屏障与脑药物转运

血脑屏障的存在使大分子药物难以进入脑中发挥疗效。成为中枢神经系统疾病治疗的瓶颈。本就血脑屏障的结构特点、大分子药物转运入脑的途径及药物与载体间的连接策略等问题进行了综述。     

神经药物通过血脑屏障的有关研究

随着世界人口老龄化的日趋加快 ,神经系统的疾病正日益成为威胁人类健康的主要问题。尽管新的神经药物已经能够治疗多种神经疾病 ,但是血脑屏障的存在使 95%的药物不能从血液进入脑部[1] 。未来神经疾病的治疗只有通过中枢神经系统 (ＣＮＳ)药物的发明和ＣＮＳ药物的传送两方面同时获得发展才能够取得突破。ＣＮＳ药物传送所面临的问题在于如何使药物有效的通过血脑屏障 (ｂｌｏｏｄｂｒａｉｎＢａｒｒｉ ｅｒ,ＢＢＢ)。1 .血脑屏障的结构与功能血脑屏障由脑毛细血管内皮细胞、基膜和神经胶质膜构成。脑部血循环的毛细血管内皮细胞相互接触…     

跨血脑屏障药物转运的研究进展

血脑屏障(Blood-brain barrier,BBB)的存在成为人们治疗中枢神经系统疾病(Central nervous system,CNS)所面临的一道难题,因为基本上100%的大分子药物及大于98%的小分子药物均无法穿过血脑屏障.因此,如何使CNS药物跨越血脑屏障从血液进入脑内且发挥药效成为解决难题的关键所在.如今一些借助内源性BBB运载体使药物转运入脑的技术发展起来.并处于实验研究和临床试验阶段,例如借助载体介导的转运系统、受体介导的转运系统的药物治疗策略,以及纳米技术的运用等,都有着良好的应用前景.这些新发现及新技术将为跨血脑屏障药物转运的研究提供新思路.并有望实现对CNS疾病患者的成功治疗.     

非侵入性基因治疗在中枢神经系统疾病中的应用

非侵入性地将具有治疗作用的基因通过血脑屏障输送至脑内,以治疗中枢神经系统疾病,是生物学领域研究的难点和热点,而应用适宜的转运载体是解决这一难题的有效途径。使用病毒载体或非病毒载体,已成功进行非侵入性基因治疗的中枢神经系统疾病有实验性运动神经疾病、脑部肿瘤和帕金森病等。随着对脑微血管内皮细胞上的受体的研究和新型载体的开发,应用非侵入性基因治疗中枢神经系统疾病将会更为广泛。     

血脑屏障与脑血管疾病的相关研究

血脑屏障（blood brain barrier,BBB）的主要结构包括：脑毛细血管内皮细胞及其间的紧密连接（tight junction,TJ）、基底膜、基 底膜下星型胶质细胞终足。血脑屏障是存在于血液和脑组织之间的一层屏障系统,在许多大脑疾患的病理过程中,BBB 的破坏导 致通透性增高都是不可避免的一个环节。BBB是保证中枢神经系统的正常生理功能的重要屏障系统。目前已有大量关于血脑屏 障通透性在脑血管疾病中的变化研究。本文分别从血脑屏障的结构和功能,药物通过血脑屏障的方法和功能,脑缺血损伤、阿尔 茨海默病、帕金森病和多发性硬化症等不同的脑病变与血脑屏障通透性的变化及中医药应用等方面做一综述。有针对性地对 BBB和大脑疾病进行进一步的研究与探索,将会为临床治疗相关疾病带来新的视角与机遇。     

转铁蛋白受体单链抗体与BDNF融合蛋白的表达及活性鉴定

脑源性神经营养因子（BDNF）对中枢神经系统的多种神经元具有营养,修复和保护功能,但因无法通过血脑屏障限制了其应用。本文利用抗转铁蛋白受体（TfR）的单链抗体（ox26-scFv）作为脑转运载体,分别扩增单链抗体和BDNF基因,插入pTIG-Trx载体,构建融合基因表达载体pTIG-Trx/scFv-BDNF,在大肠杆菌BL21（DE3）中实现了高效表达。经Ni-NTA金属鏊合层析柱纯化后,在41Kd处可见目的纯化条带。大鼠GH3细胞免疫酶染色显示,ScFv-BDNF融合蛋白能与转铁蛋白受体特异性结合。同时能够促进鸡胚背根节神经突起的生长,具备了BDNF的生物学活性。为使BDNF能够跨越血脑屏障成为中枢神经系统的治疗药物打下了实验基础。     

靶脑型载药纳米粒子

中枢神经系统(central nervous system,CNS)疾病严重影响人们的生活,给社会、家庭带来沉重负担。CNS疾病治疗的瓶颈是血脑屏障(blood brain barrier,BBB)的存在,严重限制了药物从血液转运到CNS。靶脑型纳米粒子的开发,是克服BBB的限制作用、发展治疗CNS疾病药物的一个有效途径。新近发展的修饰技术,使蛋白质或肽、表面活性剂、脂类等生物分子与纳米粒子相偶联,产生了多种类型的靶脑型纳米粒子。不同的纳米粒子尽管入脑机制不同,但均可以使药物在脑中聚集,达到治疗CNS疾病的目的。     

超声联合微泡介导血脑屏障开放及其在中枢神经系统疾病治疗中的作用

血脑屏障(blood-brain barrier, BBB)是一种介于外周循环系统与中枢神经系统之间的动态结构,起着守门员的作用,在维持机体内环境稳定的同时也阻碍了大多数治疗性药物进入大脑。聚焦超声联合微泡以非侵入的方式瞬时、局部可逆开放BBB,有利于药物分子的跨脑转运和中枢神经系统疾病的多功能诊疗。该文详细介绍了血脑屏障的结构、功能以及超声与微泡的发展历程,对聚焦超声联合微泡开放BBB的潜在机制、影响因素以及在脑部疾病中的最新研究进展进行了总结,并对其在临床实践中的应用前景进行了展望。     

Regulation of ABC transporters at the blood-brain barrier: new targets for CNS therapy

Worldwide, more than one billion people are affected by CNS disorders. Despite the huge demand for treatments, existing drugs have limited or no efficacy for some neurological diseases, including brain cancer and certain epilepsies. Furthermore, no effective therapies are available at all for some common disorders of the central nervous system (CNS) such as Alzheimer's disease. ATP-binding cassette (ABC) transporters at the blood-brain barrier (BBB) have become increasingly important in the treatment and pathogenesis of CNS disorders. Here we highlight a novel strategy--targeting signaling pathways that control ABC transporters at the BBB--to protect the brain, improve brain drug delivery, and reduce CNS pathology.     

Nanoparticles in cellular drug delivery

This review highlights the properties of nanoparticles used in targeted drug delivery, including delivery to cells as well as organelle targets, some of the known pharmacokinetic properties of nanoparticles, and their typical modifications to allow for therapeutic delivery. Nanoparticles exploit biological pathways to achieve payload delivery to cellular and intracellular targets, including transport past the blood-brain barrier. As illustrative examples of their utility, the evaluation of targeted nanoparticles in the treatment of cancers and diseases of the central nervous system, such as glioblastoma multiforme, neurovascular disorders, and neurodegenerative diseases, is discussed.     

Targeted delivery of antibodies through the blood-brain barrier by MRI-guided focused ultrasound

The blood-brain barrier (BBB) is a persistent obstacle for the local delivery of macromolecular therapeutic agents to the central nervous system (CNS). Many drugs that show potential for treating CNS diseases cannot cross the BBB and there is a need for a non-invasive targeted drug delivery method that allows local therapy of the CNS using larger molecules. We developed a non-invasive technique that allows the image-guided delivery of antibody across the BBB into the murine CNS. Here, we demonstrate that subsequent to MRI-targeted focused ultrasound induced disruption of BBB, intravenously administered dopamine D(4) receptor-targeting antibody crossed the BBB and recognized its antigens. Using MRI, we were able to monitor the extent of BBB disruption. This novel technology should be useful in delivering macromolecular therapeutic or diagnostic agents to the CNS for the treatment of various CNS disorders.     

Cationization, a process for the delivery of antibodies to the central nervous system. Problems encountered in its application for immunotherapy strategies such as those for clostridial poisoning

The central nervous system is separated from the rest of the body by the blood-brain barrier. This barrier prevents many substances, such as the antibodies, to penetrate into the brain making it difficult to use them for the treatment of brain diseases, such as tetanus and botulism. These two diseases are caused by the development of bacilli of the genus Clostridium which release neurotropic toxins. Specific antibodies can neutralize toxin activity when the toxin is in the blood but are ineffective when it is transported into nerve cells. Various invasive strategies have been used to deliver antibodies to the brain. However, they can induce seizures and transient neurologic deficits and may be applicable only for diseases restricted to the brain surface. Physiologically based strategies utilizing transport systems naturally present at the blood-brain barrier appear to be a more promising approach to brain delivery of antibodies. Cationization is a chemical treatment that causes the conversion of superficial carboxyl groups on a protein into extended primary amino groups. This is used to increase interactions of this protein with the negative charges at the luminal plasma membrane of the brain endothelial cells. The cationized protein can then undergo adsorptive mediated transcytosis through the blood-brain barrier. There are many problems yet to be solved in successfully carrying out in vivo applications of cationized antibodies. One of these problems is that cationization can cause damage to an antibody molecule and, thus, can compromise its binding affinity. Depending on the radiolabelling of the cationized antibodies, a serum inhibition phenomenon can possibly alter the pharmacokinetics and the organ distribution of these molecules. The antibodies can be cationized using various, synthetic (hexamethylenediamine) or naturally occuring (e.g., putrescine) polyamines. Hexamethylenediamine-induced and putrescine-induced brain uptakes of various antibodies and proteins have been shown, but the results obtained suggest that cationization with putrescine may be a more efficient approach to blood-brain barrier delivery. The development of animal or cellular models to check for therapeutic efficacy of cationized antibodies is necessary. In spite of the difficulties, the studies described in this paper indicate that cationization can be a realistic delivery strategy for carrying antibodies across the blood-brain barrier. The advances made in antibody technologies help generate more appropriate immunological structures for brain transfer with better effector functions and decreased immunogenicity or toxicity. Taken together, these two aspects can lead to further developments in treatment of intoxications caused by the clostridial neurotoxins.     

Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression

The clinical efficacy of a systemically administered drug acting on the central nervous system depends on its ability to pass the blood-brain barrier, which is regulated by transporter molecules such as ABCB1 (MDR1). Here we report that polymorphisms in the ABCB1 gene predict the response to antidepressant treatment in those depressed patients receiving drugs that have been identified as substrates of ABCB1 using abcb1ab double-knockout mice. Our results indicate that the combined consideration of both the medication's capacity to act as an ABCB1-transporter substrate and the patient's ABCB1 genotype are strong predictors for achieving a remission. This finding can be viewed as a further step into personalized antidepressant treatment.     

Bioactive analogs of neurotensin: focus on CNS effects

Neurotensin (NT) is a 13-amino acid neuropeptide found in the central nervous system and in the gastrointestinal tract. It is closely associated anatomically with dopaminergic and other neurotransmitter systems, and evidence supports a role for NT agonists in the treatment of various neuropsychiatric disorders. However, NT is readily degraded by peptidases, so there is much interest in the development of stable NT agonists, that can be injected systemically, cross the blood-brain barrier (BBB), yet retains the pharmacological characteristics of native NT for therapeutic use in the treatment of diseases such as schizophrenia, Parkinson's disease and addiction.     

A cell culture model of the blood-brain barrier

Endothelial cells that make up brain capillaries and constitute the blood-brain barrier become different from peripheral endothelial cells in response to inductive factors found in the nervous system. We have established a cell culture model of the blood-brain barrier by treating brain endothelial cells with a combination of astrocyte-conditioned medium and agents that elevate intracellular cAMP. These cells form high resistance tight junctions and exhibit low rates of paracellular leakage and fluid-phase endocytosis. They also undergo a dramatic structural reorganization as they form tight junctions. Results from these studies suggest modes of manipulating the permeability of the blood-brain barrier, potentially providing the basis for increasing the penetration of drugs into the central nervous system.     

Transependymal Cerebrospinal Fluid Flow: Opportunity for Drug Delivery?

Drug delivery to the central nervous system (CNS) is complicated by the blood-brain barrier. As a result, many agents that are found to be potentially effective at their site of action cannot be sufficiently or effectively delivered to the CNS and therefore have been discarded and not developed further for clinical use, leaving many CNS diseases untreated. One way to overcome this obstacle is intracerebroventricular (ICV) delivery of the therapeutics directly to cerebrospinal fluid (CSF). Recent experimental and clinical findings reveal that CSF flows from the ventricles throughout the parenchyma towards the subarachnoid space also named minor CSF pathway, while earlier, it was suggested that only in pathological conditions such as hydrocephalus this form of CSF flow occurs. This transependymal flow of CSF provides a route to distribute ICV-infused drugs throughout the brain. More insight on transependymal CSF flow will direct more rational to ICV drug delivery and broaden its clinical indications in managing CNS diseases.