REVISÃO DA LITERATURA: AVANÇOS E PERSPECTIVAS NO TRATAMENTO DE ALZHEIMER EM IDOSOS COM ÊNFASE NA BARREIRA HEMATOENCEFÁLICA

Abstract

Goals: The blood-brain barrier (BBB) ​​is a natural protector of the central nervous system (CNS), but it can also be a limiting factor for drugs due to its high selectivity. Greater permeability and lesser selectivity of the BBB did not prove to be the answer to improve drug treatments for patients with Alzheimer's disease (AD) and other dementias, as data found indicate that greater permeability may be a contributing factor to the advancement of dementias. The present work aims to bring the latest advances in AD treatment and encourage discussion of such treatments and advances, specifically addressing the BBB. We will address the physiological aspects of the BBB, relating them to the drugs used for treatment, also addressing the characteristics of drugs that make it difficult to cross the BBB. We sought to carry out a review mainly of foreign literature, bringing the latest advances for the treatment of AD, as there is a greater amount of material about the BBB in material in English than in Portuguese. Methods: A literature review was performed using the following databases: PubMed, Scielo, Google academic. The coverage period used in the surveys was between 2005 and 2020. We sought to review currently registered clinical trials, which seek to study BBB and AD, in the North American database clinicaltrials.gov. We also reviewed chapters addressing the BBB of three books, one book on physiology and two books on pharmacology. Conclusion: It is concluded that the BBB cannot be left out of research for AD and other dementias due to its extreme importance. It was observed that the permeability of the BBB can both benefit patients in the future if measured and controlled, and it can also harm and collaborate with the advancement of dementias if it is not fully understood. The perspective for the treatment of AD from this perspective of the BBB proved to be positive, due to an increase found in new approaches to treat, prevent and understand AD.