Drug transport into the central nervous system: using newer findings about the blood-brain barriers

The blood-brain barriers (BBBs) represent one of the biggest challenges for the effective delivery of drugs today. Discoveries made in the last 30 years offer new strategies for central nervous system (CNS) drug development, but have yet to be fully incorporated into the field. Here, we examine seven recently discovered aspects of the BBB and how they have been or could be developed for drug delivery. These areas are brain-to-blood (efflux) transporters, immune cell trafficking into the brain under physiologic conditions, mechanisms by which antibodies can access the CNS, Trojan horse delivery systems, blood-to-brain transport systems for biologicals, lectin interactions and ligand modifications that enhance BBB penetration, and secretory capacities of cells comprising the BBBs.