Permeation Challenges of Drugs for Treatment of Neurological Tuberculosis and HIV and the Application of Magneto-Electric Nanoparticle Drug Delivery Systems.

Sinaye Mhambi,Moise B Tchoula Tchokonte,David Fisher,Admire Dube

doi:10.3390/pharmaceutics13091479

Sinaye Mhambi, Moise B Tchoula Tchokonte + Show 2 more

Open Access

https://doi.org/10.3390/pharmaceutics13091479

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Journal: Pharmaceutics	Publication Date: Sep 15, 2021
Citations: 6	License type: CC BY 4.0

Affiliation: University of the Western Cape

Abstract

The anatomical structure of the brain at the blood–brain barrier (BBB) creates a limitation for the movement of drugs into the central nervous system (CNS). Drug delivery facilitated by magneto-electric nanoparticles (MENs) is a relatively new non-invasive approach for the delivery of drugs into the CNS. These nanoparticles (NPs) can create localized transient changes in the permeability of the cells of the BBB by inducing electroporation. MENs can be applied to deliver antiretrovirals and antibiotics towards the treatment of human immunodeficiency virus (HIV) and tuberculosis (TB) infections in the CNS. This review focuses on the drug permeation challenges and reviews the application of MENs for drug delivery for these diseases. We conclude that MENs are promising systems for effective CNS drug delivery and treatment for these diseases, however, further pre-clinical and clinical studies are required to achieve translation of this approach to the clinic.

Highlights

central nervous system (CNS) TB is differentiated from TB meningitis (TBM) in that CNS TB begins as small tuberculous foci (Rich foci) in the brain, spinal cord or meninges [2], whereas TBM is a form of meningitis characterized by
CNS human immunodeficiency virus (HIV) is associated with acute neurological symptoms similar to viral meningoencephalitis and leads to a high cerebrospinal fluid (CSF) viral load, local immune activation, changes in magnetic resonance imaging (MRI), and partially reversible neurocognitive impairment in some patients [17,18,19]
In this manuscript we have discussed the challenges faced by drugs for CNS TB

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. CNS HIV is associated with acute neurological symptoms similar to viral meningoencephalitis (the inflammation of the brain and its surrounding protective membranes) and leads to a high CSF viral load, local immune activation, changes in magnetic resonance imaging (MRI), and partially reversible neurocognitive impairment in some patients [17,18,19]. Similar to other magnetic NPs, MENs have a nonzero saturation magnetization that could enable them to be guided throughout the body by the application of magnetic field gradients [29,30] These NPs could be localized using traditional imageguided magnetic processes such as MRI and magnetic particle imaging [29] to facilitate drug delivery across the CNS.

Drug Permeation Challenges in CNS TB Treatment

Drug Permeation Challenges in CNS HIV

Drug Delivery across the BBB

Application of MENs to Deliver Drugs across the BBB for CNS TB and HIV

NPs targeting

Findings

Conclusions and Future Directions