Most therapeutic agents are excluded from entering the central nervous system by the blood-brain barrier (BBB). Receptor mediated transcytosis (RMT) is a common mechanism used by proteins, including transferrin (Tf), to traverse the BBB. Here, we prepared Tf-containing, 80-nm gold nanoparticles with an acid-cleavable linkage between the Tf and the nanoparticle core to facilitate nanoparticle RMT across the BBB. These nanoparticles are designed to bind to Tf receptors (TfRs) with high avidity on the blood side of the BBB, but separate from their multidentate Tf-TfR interactions upon acidification during the transcytosis process to allow release of the nanoparticle into the brain. These targeted nanoparticles show increased ability to cross an in vitro model of the BBB and, most important, enter the brain parenchyma of mice in greater amounts in vivo after systemic administration compared with similar highavidity nanoparticles containing noncleavable Tf. In addition, we investigated this design with nanoparticles containing high-affinity antibodies (Abs) to TfR. With the Abs, the addition of the acid-cleavable linkage provided no improvement to in vivo brain uptake for Ab-containing nanoparticles, and overall brain uptake was decreased for all Ab-containing nanoparticles compared with Tf-containing ones. These results are consistent with recent reports of high-affinity anti-TfR Abs trafficking to the lysosome within BBB endothelium. In contrast, high-avidity, Tf-containing nanoparticles with the acid-cleavable linkage avoid major endothelium retention by shedding surface Tf during their transcytosis.blood-brain barrier | transcytosis | therapeutic delivery | systemic administration | in vivo T he inability of drugs to cross the blood-brain barrier (BBB) is one of the major impairments to developing treatments for neurological diseases. This highly restrictive, physiologic barrier excludes 98% of small-molecule drugs and ∼100% of large-molecule drugs from reaching the central nervous system (CNS) from blood circulation (1). Many methods to bypass the BBB have been investigated, such as transient disruption of the BBB, inhibition of efflux pumps, or transport using endogenous transcytosis systems, including receptor-mediated transcytosis (2-4).Transferrin receptor (TfR) has been one of the primary targets investigated for receptor-mediated transcytosis across the BBB because of its high expression on BBB endothelium (5). Anti-TfR antibody-drug conjugates have received the most attention because of their ability to bind TfR with high affinity without interfering with endogenous transferrin (Tf) (6-8). Despite the perceived potential of anti-TfR antibody-drug conjugates, a BBB-permeable drug using this approach has yet to reach the clinic. Yu et al. showed that anti-TfR Abs enter the brain in greater numbers when their affinity to TfR is reduced (9). Follow-up work from the same group showed that highaffinity, bispecific anti-TfR Abs preferentially trafficked to the lysosome within BBB endothelium, rather than transcy...