Delivery of Neurotrophic Factors to the Central Nervous System: Pharmacokinetic Considerations

Thorne, Robert G.; Frey, William H.

doi:10.2165/00003088-200140120-00003

Cited by 487Barrier Structure and Function StudiesAdvanced Drug Delivery SystemsNerve injury and regeneration

Delivery of Neurotrophic Factors to the Central Nervous System: Pharmacokinetic Considerations

Thorne, Robert G., Frey, William H.·2001·Clinical Pharmacokinetics

DOI 10.2165/00003088-200140120-00003

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Abstract

Neurotrophic factors are proteins with considerable potential in the treatment of central nervous system (CNS) diseases and traumatic injuries. However, a significant challenge to their clinical use is the difficulty associated with delivering these proteins to the CNS. Neurotrophic factors are hydrophilic, typically basic, monomeric or dimeric proteins, mostly in the size range of 5 to 30 kDa. Neurotrophic factors potently support the development, growth and survival of neurons, eliciting biological effects at concentrations in the nanomolar to femtomolar range. They are not orally bioavailable and the blood-brain and blood-cerebrospinal fluid barriers severely limit their ability to enter into and act on sites in the CNS following parenteral systemic routes of administration. Most neurotrophic factors have short in vivo half-lives and poor pharmacokinetic profiles. Their access to the CNS is restricted by rapid enzymatic inactivation, multiple clearance processes, potential immunogenicity and sequestration by binding proteins and other components of the blood and peripheral tissues. The development of targeted drug delivery strategies for neurotrophic factors will probably determine their clinical effectiveness for CNS conditions. Achieving significant CNS target site concentrations while limiting systemic exposure and distribution to peripheral sites of action will lessen unwanted pleiotropic effects and toxicity. Local introduction of neurotrophic factors into the CNS intraparenchymally by direct injection/infusion or by implantation of delivery vectors such as polymer matrices or genetically modified cells yields the highest degree of targeting, but is limited by diffusion restrictions and invasiveness. Delivery of neurotrophic factors into the cerebrospinal fluid (CSF) following intracerebroventricular or intrathecal administration is less invasive and allows access to a much wider area of the CNS through CSF circulation pathways. However, diffusional and cellular barriers to penetration into surrounding CNS tissue and significant clearance of CSF into the venous and lymphatic circulation are also limiting. Unconventional delivery strategies such as intranasal administration may offer some degree of CNS targeting with minimal invasiveness. This review presents a summary of the neurotrophic factors and their indications for CNS disorders, their physicochemical characteristics and the different approaches that have been attempted or suggested for their delivery to the CNS. Future directions for further research such as the potential for CNS disease treatment utilising combinations of neurotrophic factors, displacement strategies, small molecule mimetics, chimaeric molecules and gene therapy are also discussed.

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Authors: Thorne, R. G., & Frey, W. H.
Affiliations: Regions Hospital (US)
ORCID: Thorne, Robert G.
Frey, William H.
Venue: Clinical Pharmacokinetics
Publisher: Springer Science and Business Media LLC
Published: 2001
Volume: 40
Issue: 12
Pages: 907-946
ISSN: 0312-5963 (ISSN-L)
DOI: 10.2165/00003088-200140120-00003
OpenAlex: W1973304468
Cited by: 487
References: 310
Citations by year: 2026: 10 · 2025: 15 · 2024: 19 · 2023: 20 · 2022: 21 · 2021: 24 · 2020: 31 · 2019: 17 · 2018: 24 · 2017: 17 · 2016: 26 · 2015: 26 · 2014: 26 · 2013: 28 · 2012: 20
FWCI: 1.14
Type: journal article
Language: en
Open access: closed
Locations: Clinical Pharmacokinetics (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Nerve injury and regeneration
Keywords: neurotrophic factors, brain drug delivery, blood-brain barrier, blood-CSF barrier, intrathecal administration, intracerebroventricular administration, intranasal drug delivery, intraparenchymal injection, gene therapy, small molecule mimetics, central nervous system disorders, traumatic brain injury, pharmacokinetics, immunogenicity
MeSH terms: Animals, Central Nervous System Diseases, Drug Combinations, Humans, Nerve Growth Factors

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Delivery of Neurotrophic Factors to the Central Nervous System: Pharmacokinetic Considerations

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