Intravenous and Intravascular Drug Delivery

The blood-brain barrier (BBB) is a unique entity within the central nervous system (CNS) that consists of both passive and active mechanisms to regulate access to the brain. This structure maintains the ionic and volumetric environments of the brain, and serves as a selective barrier to protect the CNS from pathogens, toxins, and other xenobiotic compounds. However, the protective function of the BBB is a double-edged sword, as it also limits the ability of systemic drug treatments for various neurological diseases to reach the brain. There is a critical need to safely and selectively bypass the BBB to treat patients with brain tumors, inborn errors of metabolism, CNS infection, or neurodegenerative disease. This chapter explores the physiology of the BBB and three methods of enhancing penetration of systemically administered pharmacologic agents into the CNS.

Duke Scholars

Author Gerald Arthur Grant Neurosurgery