The nano-intervention in Huntington's disease: A theragnostic approach

Huntington's disease is a genetic autosomally dominant neurological disorder defined by chorea, uncontrollable movements, emotional instability, and cognitive decline. No disease-reversing therapy is available at present to treat disease. The blood brain barrier acts as a selectively permeable barrier eliminating the entry of therapeutic agents administered to provide relief rendering them ineffective in the management of the disease. Existing medicines which include tetrabenazine, deutetrabenazine, and off-label drugs offer only symptomatic treatment to improve the patient's quality of life and not to treat its root cause. One approach that has proven to be quite useful is the drug delivery via nose to the brain. These pathways bypass the blood brain barrier and transport API directly to the brain. Nanocarriers are also seen as a solution to the resistance offered by the blood brain barrier and have shown significant potential in enhancing the stability, bioavailability, and targeted delivery of drugs. These carriers are engineered to navigate the complex environment of the central nervous system, providing control release of therapeutic agents. For effective treatment there seems to be the need of Imaging and biofluid biomarkers for early diagnosis of the disease to prevent progression of the disease and offer early treatment. In the last ten years, many clinical trials have been conducted, but no disease-modifying therapy has yet been developed. Researchers across the globe are putting strenuous efforts to develop biomarker-driven strategies for diagnosis and drug delivery technology for treatment of Huntington's disease.