Extracellular Vesicles as Drug Delivery Vehicles to the Central Nervous System
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INVITED REVIEW
Extracellular Vesicles as Drug Delivery Vehicles to the Central Nervous System Farah Shahjin 1
&
Subhash Chand 1
&
Sowmya V. Yelamanchili 1
Received: 6 March 2019 / Accepted: 15 August 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Effective drug delivery to the CNS to achieve the desired therapeutic response is a significant challenge in the field of drug delivery. In central nervous system (CNS), blood brain barrier (BBB) restricts the desired therapeutic responses due to inefficient targeting, release kinetics, and failure to reach therapeutic concentrations in the brain. Therefore, most potentially beneficial diagnostic and therapeutic agents are not able to reach to the brain upon systemic administration. Despite the existence of many invasive techniques to promote drug deliveries across BBB, novel strategies of drug delivery system which can cross BBB effectively are required, otherwise translation of novel neurotherapeutics from bench to bedside will be difficult to achieve. In this review, we briefly outline the existing and emerging strategies for CNS drug deliveries with a focus on potential and challenges of using extracellular vesicles (EVs) in CNS drug delivery system. EVs are emerging as a promising tool for therapeutic delivery owing to its favorable intrinsic features of biocompatibility, stability, stealth capacity, ability to overcome natural barriers and inherent homing capability. EVs are nanovesicles that allow cell-cell communication. The EVs-cargo reflects the physiological as well as the pathophysiological state of a cell. EVs are shown to play a role in human immunodeficiency virus (HIV) infection and dissemination, which contributes to acquired immune deficiency syndrome (AIDS). In the context of HIV-1 infection, this review also outlines the role of EVs in dissemination, challenges faced in EVs research in HIV-1 co-morbid conditions and potential of nanotechnologies, especially EVs in Neuro-AIDS. Keywords Extracellular vesicles . HIV . Nanocarriers . CNS drug delivery . Blood-brain barrier
Introduction Search for novel drug delivery systems and improvement of the existing ones for better pharmacokinetics and enhanced ability to carry drugs across the central nervous system (CNS) is a vital area of research for many researchers. Proteins, nucleic acids, and other macromolecules pose challenge of crossing the blood-brain barrier (BBB) when intended to be used as CNS therapeutics (Wong et al. 2012). In CNS, BBB restricts the desired therapeutic responses due to inefficient targeting, release kinetics, and failure to reach therapeutic concentrations in the brain (Druzhkova and Yakovlev 2018). Therefore, most potentially beneficial diagnostic and
* Sowmya V. Yelamanchili [email protected] 1
Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, 985800 Nebraska Medical Center, Omaha, NE 68198-5800, USA
therapeutic agents are not able to reach to the brain upon systemic administration (Al
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