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 furt...

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Bibliographic Details
Published in:Molecular neurobiology 2018-04, Vol.55 (4), p.2780-2788
Main Authors: Casaca-Carreira, João, Temel, Yasin, Hescham, Sarah-Anna, Jahanshahi, Ali
Format: Article
Language:English
Subjects:
Animals
Biomedical and Life Sciences
Biomedicine
Blood-brain barrier
Cell Biology
Central nervous system
Cerebrospinal fluid
Cerebrospinal Fluid - physiology
Drug delivery
Drug Delivery Systems
Ependyma - physiology
Fluid flow
Humans
Hydrocephalus
Neurobiology
Neurology
Neurosciences
Parenchyma
Rheology
Subarachnoid space
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Summary: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.
ISSN:0893-7648
1559-1182
DOI:10.1007/s12035-017-0501-y