中枢神经系统脱髓鞘疾病是一类需长期干预的慢性自身免疫性疾病。传统的全身给药方式因受血
脑屏障限制，存在药物中枢递送效率低、系统暴露量高、个体药代动力学变异大等问题，影响治疗精准性与
患者依从性。经鼻脑给药途径（Nose-to-Brain，N2B）通过嗅觉与三叉神经通路绕过血脑屏障，实现药物直
达中枢，具有非侵入、靶向性强、全身副作用少等优势。本研究系统性综述了该途径的双通路递送机制，及
其在减少神经炎症、促进髓鞘再生与神经保护递送策略等方面的最新研究进展，并分析了目前存在的临床
转化挑战。
Central nervous system demyelinating diseases, represent a group of chronic autoimmune conditions
requiring long-term intervention. Traditional systemic administration methods face limitations due to the
blood-brain barrier, resulting in issues such as low central nervous system delivery efficiency, high systemic
exposure, and significant interindividual pharmacokinetic variability. These factors compromise treatment
precision and patient compliance. The Nose-to-Brain (N2B) route bypasses the blood-brain barrier via the
olfactory and trigeminal pathways, enabling direct central drug delivery with advantages including
non-invasiveness, high targeting specificity, and minimal systemic side effects. This study systematically
reviews the dual-pathway delivery mechanism of this route, along with recent advances in reducing
neuroinflammation, promoting myelin regeneration, and neuroprotective delivery strategies. It also analyzes
current challenges in clinical translation.
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