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What are the new findings?
Drugs can be delivered in a controlled manner into the brain and into the posterior compartment of the eye from the oral and maxillofacial region.
There may be a central control of peripheral dopamine.
How might it impact on healthcare in the future?
The device can be useful for treating neurodegenerative diseases of the brain like Parkinson’s and Alzheimer’s disease, rare diseases of the brain, brain cancer, pain management, psychiatric conditions etc.
The device can be useful for treating retinal diseases and conditions.
Introduction
It is more than 100 years since the blood–brain barrier was discovered.1 The blood–brain barrier protects the brain from external agents. But this natural protection also prevents 98% of the small drugs and 100% of the large drugs available today from entering the brain in concentrations that can produce the required therapeutic effects.2
In Parkinson’s disease, focus is currently on techniques to effect continuous tonic firing of diseased dopamine neurons as in normal physiologic conditions. But dopamine does not cross the blood–brain barrier normally.
In Alzheimer’s disease, focus is currently on immunotherapy. But, the entry of the peripherally administered antibodies into the brain has been limited to around 0.1%–0.2% by the blood–brain barrier.
In tumours involving the brainstem, the prognosis has been poor because drug delivery is restricted by the blood–brain barrier.
In the eye, retinal drug delivery is a challenge till date because of the blood retinal barrier.
This study assesses the efficacy of a novel oral and maxillofacial device and technique for delivering drugs into the brain. This technique also provides access to the optic nerve and vessels and therefore can deliver drugs into the retina and the vitreous.
The device is implanted in the oral or maxillofacial region and the drugs are delivered directly into the connective tissue of the respiratory mucosa of the maxillary sinus, from where the drugs get …
Footnotes
Contributors Both the authors have contributed equally to this study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests The authors, AUR and KV are stated as the inventors and applicants in the published patent applications US15/177,347 and PCT/IB2016/053899 with National Phase Entry into European Patent Office, Canada and India. The technique and device are also patented in Australia.
Provenance and peer review Not commissioned; externally peer reviewed.