Nanomedicine in cerebral palsy

Bindu Balakrishnan,¹ Elizabeth Nance,¹ Michael V Johnston,² Rangaramanujam Kannan,³ Sujatha Kannan<sup>1

1</sup>Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; ²Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; ³Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA

Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed.

Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM