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Abstract
<p class="first" id="d3109150e188">Despite optimal therapeutic regimen with currently
available antiepileptic drugs (AEDs),
approximately a third of epilepsy patients remain drug refractory. Region-specific
overexpression of multidrug efflux transporters at the blood-brain barrier, such as
P-glycoprotein (P-gp), might contribute to multidrug resistance (MDR) by reducing
target concentrations of AEDs. Therefore, development of nanomedicine that can modulate
P-gp function as well as facilitate targeted AEDs delivery represents a promising
strategy for epilepsy intervention. To achieve this, we sought to exploit the possibility
of combination of active targeting function of tryptophan by transporter-mediated
endocytosis and overcoming MDR by Pluronic block copolymers. Herein, a tryptophan
derivate (TD) functionalized Pluronic P123/F127 mixed micelles encapsulating LTG (TD-PF/LTG)
was developed to promote AEDs delivery to epileptogenic focus. TD-PF/LTG was about
20 nm in diameter with a spherical shape and high encapsulation efficiency. A rat
epilepsy model with pilocarpine was established to evaluate the brain penetration
efficiency of the LTG-incorporated polymeric micellar formulation, compared with free
LTG formulations. Studies showed that TD-PF/LTG was more efficient than PF/LTG as
well as free LTG in delivering the drug to the brain, especially the hippocampus.
The enhanced targeted delivery could be ascribed to the increased tryptophan uptake
at epileptogenic focus as well as P-gp modulation property of the nanomaterial. Taken
together, TD-conjugated Pluronic micelles showed promising potential as a nanoplatform
for the delivery of AEDs in refractory epilepsy.
</p>