Brain-Targeted Exosomes-Based Drug Delivery System to Overcome the Treatment Bottleneck of Brainstem Glioma

Brain health is the humans’ primary goal in achieving health and longevity. Brainstem glioma (BSG) has a high disability and mortality rate, posing a serious threat to children's brain health. Delivery of drugs to the brainstem is limited by poor tumor targeting and low blood-brain barrier (BBB) permeability. Thus, it is a great challenge to construct intracranial drug delivery systems with strong biocompatibility, low immunogenicity, and high BBB permeability for the delivery of drugs targeting BSG. Exosomes, as the next generation of novel delivery systems, have been widely used to across the BBB due to their advantages of good biocompatibility, stability, and permeability of the BBB and have made corresponding breakthroughs in targeted drug delivery for CNS diseases. This review summarizes natural, polypeptide functionalized, and physical methods-assisted brain-targeted exosomes-based drug delivery systems, the drug treatment bottleneck of BSG, and highlights the potential of using a brain-targeted exosomes-based drug delivery system to overcome the drug treatment bottleneck of BSG. It provides new insights into using exosomes-based drug delivery for BSG treatment.