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Drug delivery in overcoming the blood–brain barrier: role of nasal mucosal grafting

Authors Marianecci C, Rinaldi F, Hanieh PN, Di Marzio L, Paolino D, Carafa M

Received 29 September 2016

Accepted for publication 7 December 2016

Published 27 January 2017 Volume 2017:11 Pages 325—335

DOI https://doi.org/10.2147/DDDT.S100075

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Junhua Mai

Peer reviewer comments 3

Editor who approved publication: Dr James Janetka

Carlotta Marianecci,1 Federica Rinaldi,2 Patrizia Nadia Hanieh,1 Luisa Di Marzio,3 Donatella Paolino,4,5 Maria Carafa1

1Department of Drug Chemistry and Technology, University of Rome “Sapienza”, Rome, Italy; 2Center for Life Nano Science@Sapienza, Fondazione Istituto Italiano di Tecnologia, Rome, Italy; 3Department of Pharmacy, University “G. d’Annunzio”, Chieti, Italy; 4IRC FSH-Interregional Research Center for Food Safety & Health, Campus Universitario “S. Venuta”, University of Catanzaro “Magna Græcia”, Catanzaro, Italy; 5Department of Health Sciences, Campus Universitario “S. Venuta”, University of Catanzaro “Magna Græcia”, Catanzaro, Italy

Abstract: The blood–brain barrier (BBB) plays a fundamental role in protecting and maintaining the homeostasis of the brain. For this reason, drug delivery to the brain is much more difficult than that to other compartments of the body. In order to bypass or cross the BBB, many strategies have been developed: invasive techniques, such as temporary disruption of the BBB or direct intraventricular and intracerebral administration of the drug, as well as noninvasive techniques. Preliminary results, reported in the large number of studies on the potential strategies for brain delivery, are encouraging, but it is far too early to draw any conclusion about the actual use of these therapeutic approaches. Among the most recent, but still pioneering, approaches related to the nasal mucosa properties, the permeabilization of the BBB via nasal mucosal engrafting can offer new potential opportunities. It should be emphasized that this surgical procedure is quite invasive, but the implication for patient outcome needs to be compared to the gold standard of direct intracranial injection, and evaluated whilst keeping in mind that central nervous system diseases and lysosomal storage diseases are chronic and severely debilitating and that up to now no therapy seems to be completely successful.

Keywords: CNS, BBB, nasal mucosa, grafting, lysosomal storage diseases, enzyme replacement therapies

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