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Neoplasia ; 23(7): 676-691, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34139452

RESUMEN

The blood-brain barrier (BBB) is a major anatomical and physiological barrier limiting the passage of drugs into brain. Central nervous system tumors can impair the BBB by changing the tumor microenvironment leading to the formation of a leaky barrier, known as the blood-tumor barrier (BTB). Despite the change in integrity, the BTB remains effective in preventing delivery of chemotherapy into brain tumors. Focused ultrasound is a unique noninvasive technique that can transiently disrupt the BBB and increase accumulation of drugs within targeted areas of the brain. Herein, we summarize the current understanding of different types of targeted ultrasound mediated BBB/BTB disruption techniques. We also discuss influence of the tumor microenvironment on BBB opening, as well as the role of immunological response following disruption. Lastly, we highlight the gaps between evaluation of the parameters governing opening of the BBB/BTB. A deeper understanding of physical opening of the BBB/BTB and the biological effects following disruption can potentially enhance treatment strategies for patients with brain tumors.


Asunto(s)
Barrera Hematoencefálica/metabolismo , Barrera Hematoencefálica/efectos de la radiación , Neoplasias Encefálicas/metabolismo , Sistemas de Liberación de Medicamentos , Microambiente Tumoral/efectos de la radiación , Ondas Ultrasónicas , Animales , Transporte Biológico/efectos de la radiación , Variación Biológica Poblacional , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/etiología , Neoplasias Encefálicas/patología , Modelos Animales de Enfermedad , Ultrasonido Enfocado de Alta Intensidad de Ablación/efectos adversos , Ultrasonido Enfocado de Alta Intensidad de Ablación/métodos , Humanos , Metástasis de la Neoplasia , Permeabilidad/efectos de la radiación , Resultado del Tratamiento , Microambiente Tumoral/efectos de los fármacos , Microambiente Tumoral/inmunología , Terapia por Ultrasonido
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