Invited Commentary: Treatment of Diseases of the Central Nervous System Using Encapsulated Cells, by A. F. Hottinger and P. Aebischer (Advances and Technical Standards in Neurosurgery Vol. 25)

Abstract

The treatment of neurological disorders with conventional drug therapies, such as L-dopa for Parkinson’s disease, has traditionally been achieved by the administration of the drugs through peripheral routes. However, this approach is hampered by the problem of drug penetration across the blood brain barrier, as well as being relatively non-specific with respect to site of action within the CNS. The discovery of high molecular weight proteins which can affect the development of the CNS and protect against various types of neuronal cell death, has stimulated efforts to explore their use as neuroprotective agents in a variety of pathological conditions [3]. The direct delivery of these large peptides to the CNS can be achieved either by injection through an intracerebral cannula, which then communicates to the outside world, or by implantation of a closed system which has the capacity to continuously release the neuroactive substance. The advantages of an implantable system over pump injection are outlined by the authors and relate largely to practical issues such as the risk of infection associated with an indwelling cannula. Two main approaches have been employed in the development of implantable devices.