About the book
The effectiveness of central nervous system pharmacotherapy is a major scientific challenge for the third millennium, being considered and called as "the final frontier of pharmacotherapy." This is mainly due to the inability of many drugs to cross the blood-brain barrier (BBB) and to reach concentrations that are sufficiently high in certain target areas of the brain. This barrier is at the level of microvascular cerebral capillary endothelium, and a defining characteristic of the cerebral capillary phenotype is the ATP-dependent expression of ATP-binding cassettes (ABC transporters) found on the endothelial cell luminal plasma membrane. These transporters restrict the absorption of lipophilic xenobiotics which, based on the structure, should easily diffuse through endothelial cell membranes. The most studied in terms of action and regulation mechanisms, is P-glycoprotein (P-gp) which modulates the transport of a very large number of therapeutic substances (it is expressed predominantly in cerebral capillary endothelium).
This book intends to provide the reader with a comprehensive overview of the scientific mechanisms that enhance the multidrug resistance impressed by the activity of the P-gp at the hematoencephalic barrier level: the cerebral oxidative status and the dynamics of the main neurotransmitters.