Targeted Drug Delivery to The Brain for Treatment of Nipah Encephalitis

Abstract

Nipah virus (NiV), which is a henipavirus, is a contagious and lethal illness with substantial morbidity as a result of its association with severe acute respiratory disease and encephalitis, and a high fatality rate. There are currently no antiviral agents available for treating the neurological disease produced by Nipah virus infection despite the potential for outbreaks throughout the world. One of the main reasons for this lack of treatment for central nervous system infections is the presence of the blood-brain barrier (BBB). Because the BBB restricts drug movement from circulation into the brain, it limits the availability of drugs for treating CNS infections.There have been several advances in developing targeted drug delivery for CNS infections and these new methods of delivering drugs have demonstrated the ability to overcome this barrier. There has been active research into developing nanocarrier systems to carry drugs across the BBB that will improve the efficacy of the treatment of infections in the CNS, including various types of liposomes, polymeric nanoparticles, solid lipid nanoparticles, dendrimers, and nanogels. There has also been research into intranasal (nasal) delivery methods and receptor-mediated strategies as potential methods of delivering drugs directly to the site of infective agents in the brain through the nasal mucosa. The use of these strategies may improve the effectiveness of delivering antivirals, monoclonal antibodies, and nucleic acid based therapeutics to infected tissues in the brain while reducing the potential for adverse effects in other parts of the body. This review article discusses the pathophysiology of Nipah Encephalitis, the challenges to traditional methods for treating the viral infection, as well as more recent advances in systems designed for targeted delivery of drugs directly to the site of infection of the CNS. The review will also provide a summary of common themes in current research on development of new delivery SYSTEMS for developing new antivirals. Issues of limitations and potential areas of future research development will also be addressed within the context of this review article.