Abstract
The blood-brain barrier (BBB) continues to interest neuroscientists, and is studied widely in a number of animal models and disease states. The breakdown of the BBB as a consequence of disease or injury is also studied extensively in animals and humans. However, the idea of transiently opening the BBB in a controlled fashion for the purpose of achieving increased drug permeability across the barrier is a relatively new concept. To adapt these techniques to the clinical setting has been considered desirable for improved treatment of central nervous system (CNS) disease, and recent progress has made this possible.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Abbreviations
- ACNU:
-
3-[(4-Amino-2-methyl-5-pyrimidinyl)methyl]-1-(2-chloroethyl)-1-nitrosourea
- BBB:
-
Blood-brain barrier
- BCNU:
-
1,3-bis(2-chloroethyl)-1-nitrosourea
- CNS:
-
Central nervous system
- CT:
-
Computerized tomography
- DTPA:
-
Diethylenetriaminepentaacetic acid
- FDA:
-
Federal Drug Agency
- ICP:
-
Intracranial pressure
- Ig:
-
Immunoglobulin
- MAb:
-
Monoclonal antibody
- MRI:
-
Magnetic resonance imaging
- PET:
-
Positron emission tomography
- PFI:
-
Progression-free interval
- SPECT:
-
Single photon emission computerized tomography
- VER:
-
Visual evoked response
References
Beaumier PL, Neuzil D, Yang HM et al. (1986) Immunoreactivity assay for labeled antimelanoma monclonal antibodies. J Nucl Med 27:824–828
Blasberg RG, Patlak C, Fenstermacher JD (1985) Intrathecal chemotherapy: brain tissue profiles after ventriculocisternal perfusion. J Pharmacol Exp Ther 195: 73–83
Bonstelle CT, Kori SH, Rekate H (1983) Intracarotid chemotherapy of glioblastoma after induced blood-brain barrier disruption. AJNR 4:810–812
Chamberlain MC, Murovic JA, Levin VA (1988) Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 28:1371–1374
Chiras J, Dormont D, Fauchon F, Debussche C, Bories J (1988) Intra-arterial chemotherapy of malignant gliomas. J Neuroradiol 15:31–48
Ervin T, C’anellos GP (1980) Successful treatment of recurrent primary central nervous system lymphoma with high-dose methotrexate. Cancer 45:1556–1557
Fauchon F, Chiras J, Poisson M, Rose M, Terrier L, Bories J, Guerin RA (1986) Intra-arterial chemotherapy by cisplatin and cytarabine after temporary disruption of the blood-brain barrier for the treatment of malignant gliomas in adults. J Neuroradiol 13:151–162
Groothuis DR, Molnar P, Blasberg RG (1984) Regional blood flow and blood-to-tissue transport in five brain tumor models. Prog Exp Tumor Res 27:132–153
Gumerlock MK, Neuwelt EA (1987) Principles of chemotherapy in brain neoplasia. In: Jellinger K (ed) Therapy of malignant brain tumors. Springer, Berlin Heidelberg New York, pp 277–348
Gumerlock MK, Belshe BD, Madsen R, Watts C (1992) Osmotic blood-brain barrier disruption and chemotherapy in the treatment of high grade malignant glioma: patient series and literature review. J Neurooncol 12:33–46
Heimberger K, Samec P, Podreka I, Binder H, Suess E, Reisner T, Deecke L, Steger G, Hiesmayr M, Dittrich C, Horaczek A, Zimpfer M (1987) Reversible opening of the blood-brain barrier in the chemotherapy of malignant gliomas (in German) Wien Klin Wochenschr 99:385–388
Hiesmayr M, Dirnberger H, Aloy A, Heimberger K, Horaczek A, Brandstatter B, Zimpfer M (1987) Hemodynamic effects of an osmotic bolus for the reversible opening of the blood-brain barrier (in German). Schweiz Med Wochenschr 117:450–454
Hildebrand J (1986) Radiotherapy and chemotherapy of malignant brain gliomas. Drugs Clin Res 12:167–175
Houghton AN, Mintzer D, Cordon-Cardo C et al. (1985) Mouse monoclonal I3 antibody detecting GD3 ganglioside: a phase I trial in patients with malignant melanoma. Proc Natl Acad Sci USA 82:1242–1246
Johnson DW, Parkinson D, Wolpert SM, Kasdon D, Kwan ES, Laucella M, Anderson ML (1987) Intracarotid chemotherapy with 1,3-Bis-(2-chloroethyl)-1- nitrosourea (BCNU) in 5% dextrose in water in the treatment of malignant glioma. Neurosurgery 20:577–583
Li V, Levin AB, Turski P (1988) Intra-arterial chemotherapy following blood-brain barrier disruption in patients with recurrent high grade astrocytomas (abstract). Proc Am Ass Neurol Surg 274:404
Markowsky SJ, Zimmerman CL, Tholl D, Soria I, Castillo R (1991) Methotrexate disposition following disruption of the blood-brain barrier. Ther Drug Monit 13:24–31
Millay RH, Klein ML, Shults WT, Dahlborg SA, Neuwelt EA (1986) Maculopathy associated with combination chemotherapy and osmotic opening of the blood- brain barrier. Am J Ophthmol 102:626–632
Miller DF, Bay JW, Lederman RJ, Purvis JD, Rogers LR, Tomsak RL (1985) Ocular and orbital toxicity following intracarotid injection of BCNU (carmustine) and cisplatinum for malignant gliomas. Ophthalmology 92:402–406
Miyagami M, Kagawa Y, Tusbokawa T (1985) ACNU delivery to malignant glioma tissue by osmotic blood brain barrier modification with intracarotid infusion of hyperosmolar mannitol. No Shinkei Geka 13:955–963
Miyagami M, Tsubokawa T, Tazoe M, Kagawa Y (1990) Intra-arterial ACNU chemotherapy employing 20% mannitol osmotic blood-brain barrier disruption for malignant brain tumors. Neurol Med Chir (Tokyo) 30:582–590
Neuwelt EA, Dahlborg SA (1987) Chemotherapy administered in conjunction with osmotic blood-brain barrier modification in patients with brain metastases. J Neurooncol 4:195–207
Neuwelt EA, Dahlborg SA (1989) Blood-brain barrier disruption in the treatment of brain tumors: Clinical implications. In: Neuwelt EA (ed) Implications of the blood-brain barrier and its manipulation, vol 2. Plenum, New York, pp 195–261
Neuwelt EA, Frenkel EP, Diehl JT et al (1980) Reversible osmotic blood-brain barrier disruption in humans: implications for chemotherapy of malignant brain tumors. Neurosurgery 7:44–52
Neuwelt EA, Glasberg M, Diehl J, Frenkel EP, Barnett P (1981) Osmotic blood- brain barrier disruption the posterior fossa of the dog. J Neurosurg 55:742–748
Neuwelt EA, Specht HD, Howieson J (1983) Osmotic blood-brain barrier modification: clinical documentation by enhanced CT scanning and/or radionuclide brain scanning. AJNR 4:907–913
Neuwelt EA, Barnett PA, Frenkel EP (1984) Chemotherapeutic agent permeability to normal brain and delivery to avian sarcoma virus-induced brain tumors in the rodent: observations on problems of drug delivery. Neurosurgery 14:154–159
Neuwelt EA, Frenkel E, d’Agostino AN (1985) Growth of human lung tumor in the brain of the nude rat as a model to evaluate antitumor agent delivery across the blood-brain barrier. Cancer Res 45:2827–2833
Neuwelt EA, Frenkel EP, Gumerlock MK, Braziel R, Dana B, Hill SA (1986a) Developments in the diagnosis and treatment of primary CNS lymphoma: a prospective series. Cancer 58:1609–1620
Neuwelt EA, Howieson J, Frenkel EP, Specht HD, Weigel R, Buchan CG, Hill SA (1986b) Therapeutic efficacy of multiagent chemotherapy with drug delivery enhancement by blood-brain barrier modification in glioblastoma. Neurosurgery 19:573–582
Neuwelt EA, Specht HD, Larson S et al. (1987) Increased delivery of tumor-specific monoclonal antibodies to brain after osmotic blood-brain barrier modification in patients with melanomaa metastatic to the central nervous system. Neurosurgery 20:885–895
Neuwelt EA, Enzmann DR, Pagel MA, Miller G (1989) Bacterial and fungal brain abscess and the blood-brain barrier. In: Neuwelt EA (ed) Implications of the blood-brain barrier and its manipulation, vol 2. Plenum, New York, pp 263–305
Neuwelt EA, Goldman DL, Dahlborg SA, Crossen J, Ramsey F, Roman-Goldstein S, Braziel R, Dana B (1991) Primary central nervous system lymphoma treated with osmotic blood-brain barrier disruption: prolonged survival and preservation of cognitive function. J Clin Oncol 9:1580–1590
Phillips JP, Alderson T, Sikora K et al. (1983) Localization of malignant glioma by a radiolabeled human monoclonal antibody. J Neurosurg 46:388–392
Roman-Goldstein SM, Barnett PA, Mormick CI, Ball MJ, Ramsey F, Neuwelt EA (1991) Imaging and toxicity of gadopentate dimeglumine administered after osmotic blood-brain barrier disruption. AJNR 12:885–890
Runge VM, Price AC, Wehr CJ, Atkinson JB, Tweedle MF (1985) Contrast enhanced MRI evaluation of a canine model of osmotic blood-brain barrier disruption. Invest Radiol 20:830–844
Sato S, Toya S, Otani M (1985a) Barrier opening microcirculation in human brain tumor. No To Shinkei 37:109–113
Sato S, Yoshinori A, Kodama R, Fujioka M, Otani M, Inoue H, Toya S (1985b) Blood-brain barrier opening CT. Prog Comput Tomogr 7:43–48
Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2:187–193
Stewart DJ, Grahovak Z, Maroun J et al. (1985) Intraarterial chemotherapy for brain tumors. Proc Am Soc Clin Oncol 4:C513
Suda K, Nakasu S, Saito A (1985) Ocular complication of combined intracarotid chemotherapy and osmotic blood-brain barrier disruption. Nippon Geka Hokan 54:359–363
Williams WT, Lowry RL, Eggers GWN (1986) Anesthetic management during therapeutic disruption of the blood-brain barrier. Anesth Analg 65:188–190
Yamada K, Takahama H, Nakai O, Takanashi T, Hosoya T (1989) Intra-arterial chemotherapy for malignant glioma after osmotic blood-brain barrier disruption. Gan To Kagaku Ryoho 16:2692–2696
York D, Legan M, Benner S, Watts C (1984) Further studies with a noninvasive method of intracranial pressure estimation. Neurosurgery 14:456–461
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Gumerlock, M.K., Neuwelt, E.A. (1992). Therapeutic Opening of the Blood-Brain Barrier in Man. In: Bradbury, M.W.B. (eds) Physiology and Pharmacology of the Blood-Brain Barrier. Handbook of Experimental Pharmacology, vol 103. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76894-1_21
Download citation
DOI: https://doi.org/10.1007/978-3-642-76894-1_21
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-76896-5
Online ISBN: 978-3-642-76894-1
eBook Packages: Springer Book Archive