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Suarez Escudero D, Haworth KJ, Genstler C, Holland CK. Quantifying the Effect of Acoustic Parameters on Temporal and Spatial Cavitation Activity: Gauging Cavitation Dose. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2388-2397. [PMID: 37648590 PMCID: PMC10581030 DOI: 10.1016/j.ultrasmedbio.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Cavitation-enhanced delivery of therapeutic agents is under development for the treatment of cancer and neurodegenerative and cardiovascular diseases, including sonothrombolysis for deep vein thrombosis. The objective of this study was to quantify the spatial and temporal distribution of cavitation activity nucleated by Definity infused through the EKOS catheter over a range of acoustic parameters controlled by the EKOS endovascular system. METHODS Three insonation protocols were compared in an in vitro phantom mimicking venous flow to measure the effect of peak rarefactional pressure, pulse duration and pulse repetition frequency on cavitation activity energy, location and duration. Inertial and stable cavitation activity was quantified using passive cavitation imaging, and a metric of cavitation dose based on energy density was defined. RESULTS For all three insonation protocols, cavitation was sustained for the entire 30 min Definity infusion. The evolution of cavitation energy during each pulse duration was similar for all three protocols. For insonation protocols with higher peak rarefactional acoustic pressures, inertial and stable cavitation doses also increased. A complex relationship between the temporal behavior of cavitation energy within each pulse and the pulse repetition frequency affected the cavitation dose for the three insonation protocols. The relative predominance of stable or inertial cavitation dose varied according to insonation schemes. Passive cavitation images revealed the spatial distribution of cavitation activity. CONCLUSION Our cavitation dose metric based on energy density enabled the impact of different acoustic parameters on cavitation activity to be measured. Depending on the type of cavitation to be promoted or suppressed, particular pulsing schemes could be employed in future studies, for example, to correlate cavitation dose with sonothrombolytic efficacy.
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Affiliation(s)
- Daniel Suarez Escudero
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, USA
| | - Kevin J Haworth
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | | | - Christy K Holland
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
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Klegerman ME, Peng T, Huang SL, Frierson B, Moody MR, Kim H, McPherson DD. Storage Stability of Atheroglitatide, an Echogenic Liposomal Formulation of Pioglitazone Targeted to Advanced Atheroma with a Fibrin-Binding Peptide. Pharmaceutics 2023; 15:2288. [PMID: 37765257 PMCID: PMC10536356 DOI: 10.3390/pharmaceutics15092288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
We have conducted a stability study of a complex liposomal pharmaceutical product, Atheroglitatide (AGT), stored at three temperatures, 4, 24, and 37 °C, for up to six months. The six parameters measured were functions of liposomal integrity (size and number), drug payload (loading efficiency), targeting peptide integrity (conjugation efficiency and specific avidity), and echogenicity (ultrasound-dependent controlled drug release), which were considered most relevant to the product's intended use. At 4 °C, liposome diameter trended upward, indicative of aggregation, while liposome number per mg lipid and echogenicity trended downward. At 24 °C, peptide conjugation efficiency (CE) and targeting efficiency (TE, specific avidity) trended downward. At 37 °C, CE and drug (pioglitazone) loading efficiency trended downward. At 4 °C, the intended storage temperature, echogenicity, and liposome size reached their practical tolerance limits at 6 months, fixing the product expiration at that point. Arrhenius analysis of targeting peptide CE and drug loading efficiency decay at the higher temperatures indicated complete stability of these characteristics at 4 °C. The results of this study underscore the storage stability challenges presented by complex nanopharmaceutical formulations.
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Affiliation(s)
- Melvin E. Klegerman
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
| | - Tao Peng
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
| | - Shao-Ling Huang
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
| | - Brion Frierson
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
| | - Melanie R. Moody
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
| | - Hyunggun Kim
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
- Department of Biomechatronic Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - David D. McPherson
- Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (T.P.); (S.-L.H.); (B.F.); (M.R.M.); (D.D.M.)
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Kennedy SR, Lafond M, Haworth KJ, Escudero DS, Ionascu D, Frierson B, Huang S, Klegerman ME, Peng T, McPherson DD, Genstler C, Holland CK. Initiating and imaging cavitation from infused echo contrast agents through the EkoSonic catheter. Sci Rep 2023; 13:6191. [PMID: 37062767 PMCID: PMC10106464 DOI: 10.1038/s41598-023-33164-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Ultrasound-enhanced delivery of therapeutic-loaded echogenic liposomes is under development for vascular applications using the EkoSonic Endovascular System. In this study, fibrin-targeted echogenic liposomes loaded with an anti-inflammatory agent were characterized before and after infusion through an EkoSonic catheter. Cavitation activity was nucleated by Definity or fibrin-targeted, drug-loaded echogenic liposomes infused and insonified with EkoSonic catheters. Passive cavitation imaging was used to quantify and map bubble activity in a flow phantom mimicking porcine arterial flow. Cavitation was sustained during 3-min infusions of Definity or echogenic liposomes along the distal 6 cm treatment zone of the catheter. Though the EkoSonic catheter was not designed specifically for cavitation nucleation, infusion of drug-loaded echogenic liposomes can be employed to trigger and sustain bubble activity for enhanced intravascular drug delivery.
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Affiliation(s)
- Sonya R Kennedy
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cardiovascular Center 3935, 231 Albert Sabin Way, Cincinnati, OH, 45267-0586, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Maxime Lafond
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cardiovascular Center 3935, 231 Albert Sabin Way, Cincinnati, OH, 45267-0586, USA
- LabTAU, Inserm, Université Lyon 1, Lyon, France
| | - Kevin J Haworth
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cardiovascular Center 3935, 231 Albert Sabin Way, Cincinnati, OH, 45267-0586, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Daniel Suarez Escudero
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cardiovascular Center 3935, 231 Albert Sabin Way, Cincinnati, OH, 45267-0586, USA
| | - Dan Ionascu
- Department of Radiation Oncology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Brion Frierson
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shaoling Huang
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Melvin E Klegerman
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tao Peng
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - David D McPherson
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Christy K Holland
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cardiovascular Center 3935, 231 Albert Sabin Way, Cincinnati, OH, 45267-0586, USA.
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
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Automatic Evaluation for Bioengineering of Human Artificial Ovary: A Model for Fertility Preservation for Prepubertal Female Patients with a Malignant Tumor. Int J Mol Sci 2022; 23:ijms232012419. [PMID: 36293273 PMCID: PMC9604043 DOI: 10.3390/ijms232012419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: The in vitro culture of primordial follicles is the only available option for preserving fertility in prepubertal girls with malignant tumors. The cultivation of primordial follicles in scaffolds as artificial ovaries is a promising approach for this. Methods: Dissociated follicles were placed into an artificial ovarian scaffold composed of fibrinogen and thrombin. The follicles were cultured in a dish dedicated to live cell imaging and observed for growth using immunofluorescence and development via optical microscopy. The morphology of the follicles in the scaffold was three-dimensionally reconstructed using the Imaris software. Growth and development were also quantified. Results: The morphology of artificial ovaries began to degrade over time. Within approximately 7 days, primordial follicles were activated and grew into secondary follicles. A comparison of optical and confocal microscopy results revealed the superior detection of live cells using confocal microscopy. The three-dimensional reconstruction of the confocal microscopy data enabled the automatic enumeration and evaluation of the overall morphology of many follicles. Conclusions: The novel artificial ovary-enabled primordial follicles to enter the growth cycle after activation and grow into secondary follicles. The use of a fibrin scaffold as a carrier preserves the developmental potential of primordial germ cells and is a potentially effective method for preserving fertility in prepubertal girls.
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