A review of chitosan-based nanocarriers as drug delivery systems for brain diseases: Critical challenges, outlooks and promises

The administration of medicinal drugs orally or systemically limits the treatment of specific central nervous system (CNS) illnesses, such as certain types of brain cancers. These methods can lead to severe adverse reactions and inadequate transport of drugs to the brain, resulting in limited effectiveness. The CNS homeostasis is maintained by various barriers within the brain, such as the endothelial, epithelial, mesothelial, and glial barriers, which strictly control the movement of chemicals, solutes, and immune cells. Brain capillaries consist of endothelial cells (ECs) and perivascular pericytes, with pericytes playing a crucial role in maintaining the blood-brain barrier (BBB), influencing new blood vessel formation, and exhibiting secretory capabilities. This article summarizes the structural components and anatomical characteristics of the BBB. Intranasal administration, a non-invasive method, allows drugs to reach the brain by bypassing the BBB, while direct cerebral administration targets specific brain regions with high concentrations of therapeutic drugs. Technical and mechanical tools now exist to bypass the BBB, enabling the development of more potent and safer medications for neurological disorders. This review also covers clinical trials, formulations, challenges, and patents for a comprehensive perspective.