Solving the blood-brain barrier challenge for the effective treatment of HIV replication in the central nervous system

Luc Bertrand, Madhavan Nair, Michal J Toborek

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Recent decades mark a great progress in the treatment of HIV infection. What was once a deadly disease is now a chronic infection. However, HIV-infected patients are prone to develop comorbidities, which severely affect their daily functions. For example, a large population of patients develop a variety of neurological and cognitive complications, called HIV associated neurological disorders (HAND). Despite efficient repression of viral replication in the periphery, evidence shows that the virus can remain active in the central nervous system (CNS). This low level of replication is believed to result in a progression of neurocognitive dysfunction in infected individuals. Insufficient viral inhibition in the brain results from the inability of several treatment drugs in crossing the blood-brain barrier (BBB) and reaching therapeutic concentrations in the CNS. The current manuscript discusses several strategies that are being developed to enable therapeutics to cross the BBB, including bypassing BBB, inhibition of efflux transporters, the use of active transporters present at the BBB, and nanotechnology. The increased concentration of therapeutics in the CNS is desirable to prevent viral replication; however, potential side effects of anti-retroviral drugs need also to be taken into consideration.

Original languageEnglish (US)
Pages (from-to)5477-5486
Number of pages10
JournalCurrent Pharmaceutical Design
Volume22
Issue number35
DOIs
StatePublished - Oct 1 2016

Fingerprint

Blood-Brain Barrier
Central Nervous System
HIV
Therapeutics
Nanotechnology
Manuscripts
Nervous System Diseases
Pharmaceutical Preparations
HIV Infections
Comorbidity
Viruses
Brain
Infection
Population

Keywords

  • Anti-retroviral drugs
  • Blood brain barrier
  • Central nervous system
  • HIV
  • Nanoparticles
  • Viral reservoir

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery

Cite this

Solving the blood-brain barrier challenge for the effective treatment of HIV replication in the central nervous system. / Bertrand, Luc; Nair, Madhavan; Toborek, Michal J.

In: Current Pharmaceutical Design, Vol. 22, No. 35, 01.10.2016, p. 5477-5486.

Research output: Contribution to journalReview article

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