Drug efficacy depends on timely delivery to the site of action. Recogn
ition of this fact is particularly important in the design of macromol
ecular drugs, whose size may slow delivery. This review describes four
major biological barriers to the delivery of macromolecules: 1) epith
elial and endothelial cell layers, 2) the basement membrane, 3) tissue
s and 4) in vivo degradation or inactivation. Current research related
to each barrier is presented, and the implications for macromolecular
drug design are discussed.