Crossing the blood-brain barrier: The therapeutic potential of lncRNAs in neurosurgery.

The blood-brain barrier (BBB) is a critical structure that maintains central nervous system (CNS) homeostasis, but it also poses a significant challenge in the treatment of neurological disorders by limiting drug delivery to the brain. Long non-coding RNAs (lncRNAs) have emerged as key regulators of various physiological and pathological processes, including BBB permeability. These molecules influence tight junction (TJ) protein expression, modulate transport systems, and regulate inflammatory responses, offering a novel therapeutic approach for overcoming the restrictive nature of the BBB. This review explores the current understanding of lncRNAs in BBB modulation and their therapeutic implications in neurosurgery. We discuss the mechanisms through which lncRNAs impact BBB integrity, highlighting their potential to facilitate drug delivery and improve outcomes in neurological disorders and neurosurgery. Furthermore, we address the challenges associated with translating lncRNA-based therapies into clinical practice, including the need for efficient delivery systems, off-target effects, and safety concerns. Advances in lncRNA research, combined with innovative delivery technologies, hold the promise of transforming neurosurgical interventions from mechanical solutions to molecularly targeted therapies. This paradigm shift could lead to improved precision and efficacy in treating CNS disorders, offering new hope for patients.