Neuronopathic LSDs: Quest for Treatments Drives Research in Nanomedicine and Nanotechnology
Pp. 128-155 (28)
Cinzia M. Bellettato, David J. Begley, Christina Lampe and Maurizio Scarpa
Lysosomal storage diseases (LSDs) are due to mutations in genes coding for
high molecular weight lysosomal enzymes, which result in a deficiency or complete
loss of enzyme activity and the consequent storage of undegraded substrate within
lysosomes. Therapeutic approaches capable of modifying the natural history of the
disease are available today and many have already entered into clinical practice.
Among these, enzyme replacement therapy (ERT) represents an approved key
treatment for a number of LSDs. Unfortunately, none of the used therapeutic
replacement enzymes have, so far, proved to be effectively able to reach the central
nervous system (CNS) in significant amounts and arrest neurodegeneration. Thus,
currently, only the peripheral disease can be treated with ERT while storage product
continues to accumulate in the CNS, resulting in severe neurodegeneration and
premature death in childhood for all neurologically affected patients. In recent years,
scientific advances in nanotechnology have led to development of revolutionary
approaches potentially capable to provide a solution to the still unmet problem of
increasing drug delivery across the Blood Brain Barrier. In particular, the growing
interest in the medical applications of nanotechnology has contributed to the advent of
a new field of applied science named nanomedicine that offers promising strategies to
overcome several of the current impediments and disadvantages of ERT. The
combination of existing nanotechnology with already available enzymes can, in fact,
significantly improve the enzyme delivery opening a promising new era in the
treatment of LSDs. This chapter aims to review the most recent advancement in
nanomedicine and nanotechnology presenting novel therapeutic approaches designed to
address neuronopathic LSDs.
Blood-brain barrier, Enzyme replacement, Lysosomal storage
diseases, Neurodegeneration, Nanomedicine, Nanotechnology.
University of Padova, Department of Women and Children Health, Via Giustiniani 3, 35128 Padova, Italy.