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Cited by 187Nanoparticle-Based Drug DeliveryAdvanced Drug Delivery SystemsCerebrospinal fluid and hydrocephalus

Intrathecal drug delivery in the era of nanomedicine

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Fowler, M.J., Cotter, J.D., Knight, B.E., Sevick-Muraca, E.M., Sandberg, D.I., Sirianni, R.W.·2020·Advanced Drug Delivery Reviews
DOI 10.1016/j.addr.2020.02.006PMC PMC8182643
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Abstract

Administration of substances directly into the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord is one approach that can circumvent the blood-brain barrier to enable drug delivery to the central nervous system (CNS). However, molecules that have been administered by intrathecal injection, which includes intraventricular, intracisternal, or lumbar locations, encounter new barriers within the subarachnoid space. These barriers include relatively high rates of turnover as CSF clears and potentially inadequate delivery to tissue or cellular targets. Nanomedicine could offer a solution. In contrast to the fate of freely administered drugs, nanomedicine systems can navigate the subarachnoid space to sustain delivery of therapeutic molecules, genes, and imaging agents within the CNS. Some evidence suggests that certain nanomedicine agents can reach the parenchyma following intrathecal administration. Here, we will address the preclinical and clinical use of intrathecal nanomedicine, including nanoparticles, microparticles, dendrimers, micelles, liposomes, polyplexes, and other colloidalal materials that function to alter the distribution of molecules in tissue. Our review forms a foundational understanding of drug delivery to the CSF that can be built upon to better engineer nanomedicine for intrathecal treatment of disease.

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  • Intrathecal drug administration is a typical method for drug delivery into the entire ventricular system without passing through the blood-brain barrier.

    “For instance, intrathecal drug administration is a typical method for drug delivery into the entire ventricular system without passing through the BBB.134,135”

    From The blood–brain barrier: Structure, regulation and drug delivery (2023) · cites this paper as [135]

    The “Possible routes of IT administration” section says intrathecal injection bypasses the BBB and can include injection into a ventricle. But the Introduction says drug distribution after intrathecal administration remains to be optimized, with some agents restricted near the injection site; it does not support delivery throughout the entire ventricular system. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Authors
Fowler, M. J., Cotter, J. D., Knight, B. E., Sevick-Muraca, E. M., Sandberg, D. I., & Sirianni, R. W.
Affiliations
  • The University of Texas Health Science Center at Houston (US)
  • The University of Texas MD Anderson Cancer Center (US)
Corresponding author
Sirianni, R.W.
ORCID
Venue
Advanced Drug Delivery Reviews
Publisher
Elsevier BV
Published
2020
Volume
165-166
Pages
77-95
ISSN
0169-409X (ISSN-L)
DOI
10.1016/j.addr.2020.02.006
PMC
PMC8182643
OpenAlex
W3009270825
Cited by
187
References
13
Citations by year
2026: 27 · 2025: 39 · 2024: 41 · 2023: 29 · 2022: 26 · 2021: 17 · 2020: 8
FWCI
1.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Advanced Drug Delivery Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Ian's Friends Foundation
  • National Institutes of Health
Topics
  • Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
Keywords
intrathecal drug delivery, nanomedicine, cerebrospinal fluid, blood-brain barrier, brain drug delivery, nanoparticles, microparticles, dendrimers, micelles, liposomes, polyplexes, colloidal drug carriers, subarachnoid space, intraventricular administration, intracisternal administration, gene delivery, imaging agents
MeSH terms
Animals, Biological Transport, Blood-Brain Barrier, Cerebral Ventricles, Cerebrospinal Fluid, Humans, Injections, Spinal, Liposomes, Micelles, Subarachnoid Space, Drug Delivery Systems, Nanoparticles

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