Implantable systems for neurological chronotherapy

IF 15.2 1区医学 Q1 PHARMACOLOGY & PHARMACY

Advanced drug delivery reviews Pub Date : 2025-04-03 DOI:10.1016/j.addr.2025.115574

Seung Ho Lee , Roemer Pott Hofstede , Adrián Noriega de la Colina , John H. Gunton , Joshua D. Bernstock , Giovanni Traverso

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Abstract

Implantable systems for neurological chronotherapy are poised to revolutionize the treatment of central nervous system diseases and disorders. These devices enable precise, time-controlled drug delivery aligned with the body’s circadian rhythms, optimizing therapeutic outcomes. By bypassing the blood–brain barrier, they achieve high local drug concentrations while minimizing systemic side effects, offering significant advantages for conditions where traditional therapies often fall short.

Platforms like SynchroMed II and CraniUS showcase this innovation, providing programmable delivery for conditions such as epilepsy and glioblastoma, with customizable profiles ranging from continuous infusion to timed bolus administration. Preclinical and clinical studies underscore the efficacy of aligning drug delivery with circadian rhythms, enhancing outcomes in chrono-chemotherapy and anti-epileptic treatments.

Despite their promise, challenges remain, including the invasiveness of implantation within the brain, device longevity, synchronization complexities, and cost(s). Accordingly, this review explores the current state of implantable neurological systems that may be leveraged for chronotherapy, their applications, limitations, and potential to transform neurological disease/disorder management.

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用于神经系统慢性病治疗的植入式系统

用于神经时钟治疗的植入式系统有望彻底改变中枢神经系统疾病和紊乱的治疗。这些设备能够根据人体昼夜节律精确、定时地给药，从而优化治疗效果。通过绕过血脑屏障，它们可以达到较高的局部药物浓度，同时最大限度地减少全身副作用，为传统疗法往往达不到的条件提供了显著的优势。SynchroMed II和CraniUS等平台展示了这一创新，为癫痫和胶质母细胞瘤等疾病提供可编程的输送，具有从连续输注到定时丸给药的可定制配置。临床前和临床研究强调了使药物递送与昼夜节律一致的有效性，提高了慢性化疗和抗癫痫治疗的疗效。尽管前景看好，但挑战依然存在，包括植入大脑的侵入性、设备寿命、同步复杂性和成本。因此，本综述探讨了可用于时间治疗的植入式神经系统的现状，它们的应用、局限性以及改变神经疾病/障碍管理的潜力。

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来源期刊

Advanced drug delivery reviews 医学-药学

CiteScore

28.10

自引率

5.00%

发文量

294

审稿时长

15.1 weeks

期刊介绍： The aim of the Journal is to provide a forum for the critical analysis of advanced drug and gene delivery systems and their applications in human and veterinary medicine. The Journal has a broad scope, covering the key issues for effective drug and gene delivery, from administration to site-specific delivery. In general, the Journal publishes review articles in a Theme Issue format. Each Theme Issue provides a comprehensive and critical examination of current and emerging research on the design and development of advanced drug and gene delivery systems and their application to experimental and clinical therapeutics. The goal is to illustrate the pivotal role of a multidisciplinary approach to modern drug delivery, encompassing the application of sound biological and physicochemical principles to the engineering of drug delivery systems to meet the therapeutic need at hand. Importantly the Editorial Team of ADDR asks that the authors effectively window the extensive volume of literature, pick the important contributions and explain their importance, produce a forward looking identification of the challenges facing the field and produce a Conclusions section with expert recommendations to address the issues.