Getting Drugs Across the Blood/Brain Barrier

Contributed by: Dennis Fortier, President, Medical Care Corporation
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As we have described in earlier posts, the blood-brain barrier is a key protective mechanism in many animals, including humans.  It effectively protects the central nervous system from contaminants in the blood stream while allowing necessary nutrients and oxygen into the brain.

While the blood/brain barrier is a marvel of protective design, it poses a major hurdle in delivering therapeutic drugs to the brain.  Despite decades of research on various novel approaches, scientists have yet to find an efficient method for crossing this barrier.  Several of these approaches were recently described in a Boston Globe article that we summarized here.

Earlier this week, scientists from the University of Oxford published a study in Nature Biotechnology detailing a new approach to this challenge.  They appear to have delivered specific proteins across the blood/brain barrier by fusing them with exosomes, part of the body's natural system for transporting particles between cells.

At the basic science level, this seems safer than other methods for compromising the barrier because it seems to allow only for specific and intended breach of the protective system.  Other approaches have had limited success in penetrating the barrier, but unfortunately, usually at the expense of letting unintended toxins pass into the brain as well.

Last week we described new evidence that Alzheimer's disease may begin outside of the brain.  That was an interesting story partly due to the difficulty of treating diseases on the other side of the blood/brain barrier, as Alzheimer's has always been considered.  If we can one day deliver drugs more effectively to the brain, then the location of origin for any particular brain disease, will be less important in terms of treatment.

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