Bypassing the blood-brian barrier using established skull base reconstruction techniques

作     者：Marcel M.Miyake Benjamin S.Bleier 

作者机构：Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA USASanta Casa de Sao Paulo School of Medical Sciences Sao Paulo BrazilCAPES-Brazil Scholarship Brazil Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA USA 

出 版 物：《World Journal of Otorhinolaryngology-Head and Neck Surgery》 (世界耳鼻咽喉头颈外科杂志（英文）)

年 卷 期：2015年第1卷第1期

页      面：-页

学科分类：1003[医学-口腔医学] 1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Michael J. Fox Foundation for Parkinson’s Research 

主　　题：Blood-brain barrier Transnasal drug delivery Skull base reconstruction Mucosal flap 

摘      要：Background: Neurological disorders represent a profound healthcare problem accounting for 6.3％ of the global disease *** s disease alone is expected to impact over 115 million people worldwide by 2050 with a cost of over $1 trillion per year to the *** considerable advances in our understanding of the pathogenesis and natural history of neurological disorders, the development of disease modifying therapies have failed to keep *** lack of effective treatments is directly attributable to the presence of the blood-brain and blood-cerebrospinal fluid barriers (BBB and BCSFB) which prevent up to 98％ of all potential neuropharmaceutical agents from reaching the central nervous system (CNS).These obstacles have thereby severely limited research and development into novel therapeutic strategies for neurological *** experimental methods to bypass the BBB, including pharmacologic modification and direct transcranial catheter implantation, are expensive, are associated with significant complications, and cannot be feasibly scaled up to meet the chronic needs of a large, aging patient *** drug delivery: An innovative method of direct CNS drug delivery using heterotopic mucosal grafts was *** method is based on established endoscopic skull base nasoseptal flap reconstruction *** model has successfully demonstrated CNS delivery of chromophore-tagged molecules 1000 times larger than those typically permitted by the ***: This innovative technique represents the first described method of permanently bypassing the blood-brain barrier using purely autologous *** has the potential to dramatically improve the current treatment of neurological disease by providing a safe and chronic transnasaldelivery pathway for high molecular weight neuropharmaceuticals.