1313.1 366 13 Solid Lipid Nanoparticles to Improve Brain Drug Delivery
The General Problem of Brain Drug Delivery
Basic Brain PhysiologyThe CNS consists of the encephalon or brain, and the medulla spinalis or spinal cord (Figure 13.1 ). Both regions are well protected against trauma, the brain by the skull bones and the spinal cord by the vertebra, while three membranes -the meninges -are positioned in between the brain and the skull bones (Figure 13.1 ). The brain and spinal cord are continuous with one another at the level of the upper border of the atlas vertebra.The dura mater lies directly under the skull, the pia mater lies over the brain, while the arachnoid resides in between the former two. The brain is surrounded by the subarachnoid space , positioned between the pia mater and arachnoid, in which the cerebrospinal fl uid ( CSF ) runs. The CSF, which is produced mainly by the choroid plexus ( CP ), fi lls the ventricles and the subarachnoid space, and is in direct relationship with the brain interstitial fl uid [14] .The brain is one of the most -if not the most -well -protected organs in the human body, with both anatomic and physiological barriers providing protection against the external environment. Indeed, specifi c interfaces tightly regulate the exchanges between the peripheral circulation and the CSF circulatory system. These interfaces include: (i) the CP epithelium (blood/ventricular CSF); (ii) the arachnoid epithelium (blood/subarachnoid CSF); and (iii) the BBB formed by the cerebrovascular endothelium (blood/interstitial fl uid of the brain). By tightly regulating both the entrance and clearance of endogenous and exogenous molecules, these barriers provide an excellent homeostasis of the CNS. Figure 13.1 Schematic representation of the human brain within the skull bones. Meninges Skull Cerebrum Cerebellum Central Sulcus Corpus Callosum Striatum Thalamus Hypothalamus Brain Stem Midbrain Pons Medulla Oblongata Spinal Cord Olfactory Sensors Transverse Fissure 13.2 The General Problem of Brain Drug Delivery 367The BBB, which represents the main obstacle against achieving effective CNS pharmacological treatments [4, 12, 13] , is constituted by the brain microvasculature that, due to its anatomic and physiologic features, greatly restricts the number of drugs that can enter the brain after systemic administration. The volume occupied by the capillary and endothelial cells respectively is about 1% and 0.1% of the brain volume; however, the brain microvasculature develops a total surface area of ∼ 20 m 2 and a total length of ∼ 600 km (Figure 13.2 ) [13] .The brain capillaries present no fenestrae , a small amount of pinocytosis vesicles and particular tight junction s ( TJ s) that are also known as the zonula occludens [15, 16] . The TJs are structures that form a narrow and continuous seal surrounding each endothelial and epithelial cell at the apical border, the aim being to strictly regulate the movement of molecules through the paracellular pathway. The brain microvasculature TJs show some d...