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The blood–brain barrier is formed by the brain capillary endothelium and excludes from the brain 100% of large-molecule neurotherapeutics and more than 98% of all small-molecule drugs. [23] Overcoming the difficulty of delivering therapeutic agents to specific regions of the brain presents a major challenge to treatment of most brain disorders.
The blood–brain barrier is formed by special tight junctions between endothelial cells lining brain blood vessels. Blood vessels of all tissues contain this monolayer of endothelial cells, however only brain endothelial cells have tight junctions preventing passive diffusion of most substances into the brain tissue. [1]
Coating these polymeric nanoparticle devices with different surfactants can also aid BBB crossing and uptake in the brain. Surfactants such as polysorbate 80, 20, 40, 60, and poloxamer 188, demonstrated positive drug delivery through the blood–brain barrier, whereas other surfactants did not yield the same results. [2]
As is the case with most brain tumors, a major difficulty in treating DIPG is overcoming the blood–brain barrier. [20] [21] In the brain – unlike in other areas of the body, where substances can pass freely from the blood into the tissue – there is very little space between the cells lining the blood vessels.
The GLUT1 protein that transports glucose across the blood brain barrier is encoded by the SLC2A1 gene, located on chromosome 1. [8] In GLUT1 deficiency syndrome, one of the two genes is damaged by a mutation and an insufficient amount protein is made. As a result, insufficient glucose is passing the blood brain barrier.
Intracerebral (into the cerebrum) administration by direct injection into the brain. Used in experimental research of chemicals [17] and as a treatment for malignancies of the brain. [18] The intracerebral route can also interrupt the blood brain barrier from holding up against subsequent routes. [19]
Osmotic agents work by primarily affecting the blood brain barrier. [1] It's very important that the osmotic agents cannot cross the blood brain barrier because the main idea is to use osmotic agents to increase plasma osmolarity and cause an osmotic gradient to cause water from brain cells to flow into the plasma.
Hypoxic ischemic encephalopathy has many causes and is defined essentially as the reduction in the supply of blood or oxygen to a baby's brain before, during, or even after birth. It is a major cause of death and disability, occurring in approximately 2–3 per 1000 births and causing around 20% of all cases of cerebral palsy .