Strategies to improve nasal administration of antiretroviral therapeutics for the treatment of NeuroAIDS
Year: 2025
Type: article
Abstract: HIV-associated neurocognitive disorders (HAND) persist in a significant proportion of HIV patients, despite combination antiretroviral therapy (cART), due to limited drug penetration across the blood-brain barrier (BBB) and the establishment of viral reservoirs within the central nervous system (CNS). Intranasal drug delivery offers a promising, noninvasive route to bypass the BBB and directly target the brain through olfactory and trigeminal pathways. This review explores the pharmacology of antiretroviral drugs, the challenges they face in CNS delivery, and the advantages of intranasal administration for treating NeuroAIDS. We examine physicochemical properties influencing BBB penetration and the mechanisms of nose-to-brain transport, along with their benefits and challenges. The review further evaluates the use of polymeric and lipid-based nanocarrier systems that improve drug stability, nasal residence time, and neuronal transport. Key anatomical considerations for targeting the olfactory region and design parameters for specialized intranasal delivery devices are also discussed. Despite anatomical and physiological challenges, advancements in nanotechnology and device engineering are enhancing CNS drug delivery efficiency. Combining antiretroviral-loaded nanocarriers with targeted nasal delivery devices represents a compelling strategy to improve therapeutic outcomes for HAND. This integrative approach holds significant potential to overcome CNS viral reservoirs, reduce neurocognitive impairment, and advance the eradication of NeuroAIDS.
Source: Therapeutic Delivery
Institution: Virginia Commonwealth University
Language: English
Subfield: Pharmaceutical Science
Domain: Life Sciences
Open Access status: green
Funder: Virginia Commonwealth University
OpenAlex ID: W7120113572