Neurotheranostics as Personalized Medicines
Open accessAbstract
The discipline of neurotheranostics was forged to improve diagnostic and therapeutic clinical outcomes for neurological disorders. Research was facilitated, in largest measure, by the creation of pharmacologically effective multimodal pharmaceutical formulations. Deployment of neurotheranostic agents could revolutionize staging and improve nervous system disease therapeutic outcomes. However, obstacles in formulation design, drug loading and payload delivery still remain. These will certainly be aided by multidisciplinary basic research and clinical teams with pharmacology, nanotechnology, neuroscience and pharmaceutic expertise. When successful the end results will provide "optimal" therapeutic delivery platforms. The current report reviews an extensive body of knowledge of the natural history, epidemiology, pathogenesis and therapeutics of neurologic disease with an eye on how, when and under what circumstances neurotheranostics will soon be used as personalized medicines for a broad range of neurodegenerative, neuroinflammatory and neuroinfectious diseases.
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The use of a diagnostic-therapeutic platform allows for real-time tracking of pharmacokinetics and biodistribution, as well as local action directly in the area of the pathological focus.
“The use of such a diagnostic–therapeutic platform allows for real-time tracking of pharmacokinetics and biodistribution, as well as local action directly in the area of the pathological focus [20].”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
The Bioimaging section (page unavailable) describes rapid assessment of pharmacokinetics and biodistribution, while the Blood brain barrier section describes real-time imaging to evaluate drug biodistribution and localization at target sites. The paper supports targeted local treatment, but it does not specifically say that pharmacokinetics can be tracked in real time. (LLM, conf=0.82)
Experimental — accuracy not yet measuredOptimal imaging windows span hours to days; Kevadiya et al. describe systems peaking at 4 days post-administration.
“Optimal imaging windows span hours to days; Kevadiya et al. [20] describe systems peaking at 4 days post-administration.”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
In “AD and theranostics” (page unavailable), the review describes an elevated MRI signal in mice imaged four days after injection. It does not say the signal peaked then or establish that optimal imaging windows span hours to days. (LLM, conf=0.87)
Experimental — accuracy not yet measuredTitanium oxide nanoparticles disrupt brain development in the fetus.
“titanium oxide disrupts brain development in the fetus”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
In “Therapeutics that facilitate neuroprotection and neuroregeneration” (page not provided), the review reports that maternal nanoparticle exposure may harm fetal development and that titanium oxide nanoparticles affected genes associated with mouse brain development. That supports concern about developmental effects, but it does not establish the unqualified claim that titanium oxide disrupts fetal brain development generally. (LLM, conf=0.83)
Experimental — accuracy not yet measuredIn AD, which requires long-term treatment, the risk of toxicity from nanoparticles is unacceptable, unlike in oncology where the risk of toxicity is often justified.
“Unlike oncology, where the risk of toxicity is often justified, in AD, which requires long-term treatment, this risk is unacceptable [20].”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
The section “Therapeutics that facilitate neuroprotection and neuroregeneration” (page unavailable) identifies a risk of nanoparticle toxicity. The AD section (page unavailable) says some AD drug candidates cause unacceptable toxicities. Neither passage says nanoparticle toxicity is unacceptable specifically because AD requires long-term treatment, or contrasts that risk with toxicity being justified in oncology. (LLM, conf=0.85)
Experimental — accuracy not yet measuredZinc oxide nanoparticles cause necrosis and apoptosis in macrophages.
“zinc oxide causes necrosis and apoptosis in macrophages”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
The section “Therapeutics that facilitate neuroprotection and neuroregeneration” reports that zinc oxide nanoparticles induced necrosis and apoptosis in murine macrophages. The citing sentence omits the nanoparticle form and murine qualification, making it broader than the reported finding. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Silver nanoparticles are toxic to neurons and astrocytes derived from human embryonic stem cells.
“silver Nps are toxic to neurons and astrocytes derived from human embryonic stem cells”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
Even 'neuroprotective' nanoparticles such as cerium oxide can cause hepatotoxicity in mice.
“As shown in the review by Kevadiya and co-authors [20], even “neuroprotective” Nps, such as cerium oxide, can cause hepatotoxicity in mice”
From Theranostic Nanoplatforms for Alzheimer's Disease: A Critical Analysis of Conceptual Contradictions (2026) · cites this paper as [20]
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References 746 · Cited by 124
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- Authors
- Kevadiya, B. D., Ottemann, B. M., Thomas, M. B., Mukadam, I., Nigam, S., McMillan, J., Gorantla, S., Bronich, T. K., Edagwa, B., & Gendelman, H. E.
- Affiliations
- University of Nebraska Medical Center (US)
- Corresponding author
- Gendelman, Howard E.
- ORCID
- Venue
- Advanced Drug Delivery Reviews
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 148
- Pages
- 252-289
- ISSN
- 0169-409X (ISSN-L)
- PMC
- PMC6486471
- OpenAlex
- W2898456731
- Cited by
- 124
- References
- 746
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 30 · 2023: 15 · 2022: 9 · 2021: 23 · 2020: 11 · 2019: 7 · 2018: 1
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Advanced Drug Delivery Reviews (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Foundation for the National Institutes of Health (2R01 NS034239, P01 MH64570, P01 NS31492, R01 NS36126, R01 AG043540, P01 DA028555, P30 MH062261, RO1 MH104147, P01 NS43985)
- University of Nebraska-Lincoln
- Topics
- Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- personalized medicine, neurological disorders, drug delivery, formulation design, drug loading, payload delivery, neurodegenerative diseases, neuroinflammatory diseases, central nervous system infection, therapeutics, nanotechnology
- MeSH terms
- Humans, Nervous System Diseases, Drug Delivery Systems, Neuroprotective Agents, Nanotechnology, Nanostructures, Precision Medicine
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