1
|
Yuan T, Zhan W, Terzano M, Holzapfel GA, Dini D. A comprehensive review on modeling aspects of infusion-based drug delivery in the brain. Acta Biomater 2024:S1742-7061(24)00387-8. [PMID: 39032668 DOI: 10.1016/j.actbio.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Brain disorders represent an ever-increasing health challenge worldwide. While conventional drug therapies are less effective due to the presence of the blood-brain barrier, infusion-based methods of drug delivery to the brain represent a promising option. Since these methods are mechanically controlled and involve multiple physical phases ranging from the neural and molecular scales to the brain scale, highly efficient and precise delivery procedures can significantly benefit from a comprehensive understanding of drug-brain and device-brain interactions. Behind these interactions are principles of biophysics and biomechanics that can be described and captured using mathematical models. Although biomechanics and biophysics have received considerable attention, a comprehensive mechanistic model for modeling infusion-based drug delivery in the brain has yet to be developed. Therefore, this article reviews the state-of-the-art mechanistic studies that can support the development of next-generation models for infusion-based brain drug delivery from the perspective of fluid mechanics, solid mechanics, and mathematical modeling. The supporting techniques and database are also summarized to provide further insights. Finally, the challenges are highlighted and perspectives on future research directions are provided. STATEMENT OF SIGNIFICANCE: Despite the immense potential of infusion-based drug delivery methods for bypassing the blood-brain barrier and efficiently delivering drugs to the brain, achieving optimal drug distribution remains a significant challenge. This is primarily due to our limited understanding of the complex interactions between drugs and the brain that are governed by principles of biophysics and biomechanics, and can be described using mathematical models. This article provides a comprehensive review of state-of-the-art mechanistic studies that can help to unravel the mechanism of drug transport in the brain across the scales, which underpins the development of next-generation models for infusion-based brain drug delivery. More broadly, this review will serve as a starting point for developing more effective treatments for brain diseases and mechanistic models that can be used to study other soft tissue and biomaterials.
Collapse
Affiliation(s)
- Tian Yuan
- Department of Mechanical Engineering, Imperial College London, SW7 2AZ, UK.
| | - Wenbo Zhan
- School of Engineering, University of Aberdeen, Aberdeen, AB24 3UE, UK
| | - Michele Terzano
- Institute of Biomechanics, Graz University of Technology, Austria
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Austria; Department of Structural Engineering, NTNU, Trondheim, Norway
| | - Daniele Dini
- Department of Mechanical Engineering, Imperial College London, SW7 2AZ, UK.
| |
Collapse
|
2
|
Insights into Infusion-Based Targeted Drug Delivery in the Brain: Perspectives, Challenges and Opportunities. Int J Mol Sci 2022; 23:ijms23063139. [PMID: 35328558 PMCID: PMC8949870 DOI: 10.3390/ijms23063139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/31/2023] Open
Abstract
Targeted drug delivery in the brain is instrumental in the treatment of lethal brain diseases, such as glioblastoma multiforme, the most aggressive primary central nervous system tumour in adults. Infusion-based drug delivery techniques, which directly administer to the tissue for local treatment, as in convection-enhanced delivery (CED), provide an important opportunity; however, poor understanding of the pressure-driven drug transport mechanisms in the brain has hindered its ultimate success in clinical applications. In this review, we focus on the biomechanical and biochemical aspects of infusion-based targeted drug delivery in the brain and look into the underlying molecular level mechanisms. We discuss recent advances and challenges in the complementary field of medical robotics and its use in targeted drug delivery in the brain. A critical overview of current research in these areas and their clinical implications is provided. This review delivers new ideas and perspectives for further studies of targeted drug delivery in the brain.
Collapse
|
3
|
Pfister EL, DiNardo N, Mondo E, Borel F, Conroy F, Fraser C, Gernoux G, Han X, Hu D, Johnson E, Kennington L, Liu P, Reid SJ, Sapp E, Vodicka P, Kuchel T, Morton AJ, Howland D, Moser R, Sena-Esteves M, Gao G, Mueller C, DiFiglia M, Aronin N. Artificial miRNAs Reduce Human Mutant Huntingtin Throughout the Striatum in a Transgenic Sheep Model of Huntington's Disease. Hum Gene Ther 2018; 29:663-673. [PMID: 29207890 DOI: 10.1089/hum.2017.199] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Huntington's disease (HD) is a fatal neurodegenerative disease caused by a genetic expansion of the CAG repeat region in the huntingtin (HTT) gene. Studies in HD mouse models have shown that artificial miRNAs can reduce mutant HTT, but evidence for their effectiveness and safety in larger animals is lacking. HD transgenic sheep express the full-length human HTT with 73 CAG repeats. AAV9 was used to deliver unilaterally to HD sheep striatum an artificial miRNA targeting exon 48 of the human HTT mRNA under control of two alternative promoters: U6 or CβA. The treatment reduced human mutant (m) HTT mRNA and protein 50-80% in the striatum at 1 and 6 months post injection. Silencing was detectable in both the caudate and putamen. Levels of endogenous sheep HTT protein were not affected. There was no significant loss of neurons labeled by DARPP32 or NeuN at 6 months after treatment, and Iba1-positive microglia were detected at control levels. It is concluded that safe and effective silencing of human mHTT protein can be achieved and sustained in a large-animal brain by direct delivery of an AAV carrying an artificial miRNA.
Collapse
Affiliation(s)
- Edith L Pfister
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Natalie DiNardo
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Erica Mondo
- 2 Department of Neurobiology, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Florie Borel
- 3 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Faith Conroy
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Cara Fraser
- 4 Preclinical, Imaging, and Research Laboratories, South Australian Health and Medical Research Institute , Gilles Plains, South Australia
| | - Gwladys Gernoux
- 3 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Xin Han
- 5 West China School of Medicine, West China Hospital, Sichuan University. Chengdu , China
| | - Danjing Hu
- 5 West China School of Medicine, West China Hospital, Sichuan University. Chengdu , China
| | - Emily Johnson
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts.,6 Geisel School of Medicine, Dartmouth College , Hanover, New Hampshire
| | - Lori Kennington
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts
| | - PengPeng Liu
- 5 West China School of Medicine, West China Hospital, Sichuan University. Chengdu , China
| | - Suzanne J Reid
- 7 School of Biological Sciences, University of Auckland , Auckland, New Zealand
| | - Ellen Sapp
- 8 MassGeneral Institute for Neurodegenerative Disease , Charlestown, Massachusetts
| | - Petr Vodicka
- 8 MassGeneral Institute for Neurodegenerative Disease , Charlestown, Massachusetts.,9 Research Center PIGMOD, Institute of Animal Physiology and Genetics of the Czech Academy of Sciences , Libechov, Czech Republic
| | - Tim Kuchel
- 4 Preclinical, Imaging, and Research Laboratories, South Australian Health and Medical Research Institute , Gilles Plains, South Australia
| | - A Jennifer Morton
- 10 Department of Physiology, Development and Neuroscience, University of Cambridge , Cambridge, United Kingdom
| | - David Howland
- 11 CHDI Foundation/CHDI Management, Princeton, New Jersey
| | - Richard Moser
- 12 Department of Neurosurgery, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Miguel Sena-Esteves
- 3 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Guangping Gao
- 3 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Christian Mueller
- 3 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts.,13 Department of Pediatrics, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Marian DiFiglia
- 8 MassGeneral Institute for Neurodegenerative Disease , Charlestown, Massachusetts
| | - Neil Aronin
- 1 Department of Medicine, University of Massachusetts Medical School , Worcester, Massachusetts.,14 RNA Therapeutics Institute, University of Massachusetts Medical School , Worcester, Massachusetts
| |
Collapse
|
4
|
Wang W, Cho HY, Rosenstein-Sisson R, Marín Ramos NI, Price R, Hurth K, Schönthal AH, Hofman FM, Chen TC. Intratumoral delivery of bortezomib: impact on survival in an intracranial glioma tumor model. J Neurosurg 2017; 128:695-700. [PMID: 28409734 DOI: 10.3171/2016.11.jns161212] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Glioblastoma (GBM) is the most prevalent and the most aggressive of primary brain tumors. There is currently no effective treatment for this tumor. The proteasome inhibitor bortezomib is effective for a variety of tumors, but not for GBM. The authors' goal was to demonstrate that bortezomib can be effective in the orthotopic GBM murine model if the appropriate method of drug delivery is used. In this study the Alzet mini-osmotic pump was used to bring the drug directly to the tumor in the brain, circumventing the blood-brain barrier; thus making bortezomib an effective treatment for GBM. METHODS The 2 human glioma cell lines, U87 and U251, were labeled with luciferase and used in the subcutaneous and intracranial in vivo tumor models. Glioma cells were implanted subcutaneously into the right flank, or intracranially into the frontal cortex of athymic nude mice. Mice bearing intracranial glioma tumors were implanted with an Alzet mini-osmotic pump containing different doses of bortezomib. The Alzet pumps were introduced directly into the tumor bed in the brain. Survival was documented for mice with intracranial tumors. RESULTS Glioma cells were sensitive to bortezomib at nanomolar quantities in vitro. In the subcutaneous in vivo xenograft tumor model, bortezomib given intravenously was effective in reducing tumor progression. However, in the intracranial glioma model, bortezomib given systemically did not affect survival. By sharp contrast, animals treated with bortezomib intracranially at the tumor site exhibited significantly increased survival. CONCLUSIONS Bypassing the blood-brain barrier by using the osmotic pump resulted in an increase in the efficacy of bortezomib for the treatment of intracranial tumors. Thus, the intratumoral administration of bortezomib into the cranial cavity is an effective approach for glioma therapy.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Axel H Schönthal
- 3Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | |
Collapse
|
5
|
Golebiowski D, van der Bom IMJ, Kwon CS, Miller AD, Petrosky K, Bradbury AM, Maitland S, Kühn AL, Bishop N, Curran E, Silva N, GuhaSarkar D, Westmoreland SV, Martin DR, Gounis MJ, Asaad WF, Sena-Esteves M. Direct Intracranial Injection of AAVrh8 Encoding Monkey β-N-Acetylhexosaminidase Causes Neurotoxicity in the Primate Brain. Hum Gene Ther 2017; 28:510-522. [PMID: 28132521 DOI: 10.1089/hum.2016.109] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
GM2 gangliosidoses, including Tay-Sachs disease and Sandhoff disease, are lysosomal storage disorders caused by deficiencies in β-N-acetylhexosaminidase (Hex). Patients are afflicted primarily with progressive central nervous system (CNS) dysfunction. Studies in mice, cats, and sheep have indicated safety and widespread distribution of Hex in the CNS after intracranial vector infusion of AAVrh8 vectors encoding species-specific Hex α- or β-subunits at a 1:1 ratio. Here, a safety study was conducted in cynomolgus macaques (cm), modeling previous animal studies, with bilateral infusion in the thalamus as well as in left lateral ventricle of AAVrh8 vectors encoding cm Hex α- and β-subunits. Three doses (3.2 × 1012 vg [n = 3]; 3.2 × 1011 vg [n = 2]; or 1.1 × 1011 vg [n = 2]) were tested, with controls infused with vehicle (n = 1) or transgene empty AAVrh8 vector at the highest dose (n = 2). Most monkeys receiving AAVrh8-cmHexα/β developed dyskinesias, ataxia, and loss of dexterity, with higher dose animals eventually becoming apathetic. Time to onset of symptoms was dose dependent, with the highest-dose cohort producing symptoms within a month of infusion. One monkey in the lowest-dose cohort was behaviorally asymptomatic but had magnetic resonance imaging abnormalities in the thalami. Histopathology was similar in all monkeys injected with AAVrh8-cmHexα/β, showing severe white and gray matter necrosis along the injection track, reactive vasculature, and the presence of neurons with granular eosinophilic material. Lesions were minimal to absent in both control cohorts. Despite cellular loss, a dramatic increase in Hex activity was measured in the thalamus, and none of the animals presented with antibody titers against Hex. The high overexpression of Hex protein is likely to blame for this negative outcome, and this study demonstrates the variations in safety profiles of AAVrh8-Hexα/β intracranial injection among different species, despite encoding for self-proteins.
Collapse
Affiliation(s)
- Diane Golebiowski
- 1 Department of Neurology, University of Massachusetts Medical School , Worcester, Massachusetts.,2 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Imramsjah M J van der Bom
- 3 Department of Radiology, University of Massachusetts Medical School , Worcester, Massachusetts.,4 New England Center for Stroke Research, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Churl-Su Kwon
- 5 Department of Neurosurgery, Massachusetts General Hospital , Boston, Massachusetts
| | - Andrew D Miller
- 6 New England Primate Research Center, Harvard Medical School , Southborough, Massachusetts
| | - Keiko Petrosky
- 6 New England Primate Research Center, Harvard Medical School , Southborough, Massachusetts
| | - Allison M Bradbury
- 7 Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University , Alabama.,8 Department of Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University , Alabama
| | - Stacy Maitland
- 1 Department of Neurology, University of Massachusetts Medical School , Worcester, Massachusetts.,2 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Anna Luisa Kühn
- 3 Department of Radiology, University of Massachusetts Medical School , Worcester, Massachusetts.,4 New England Center for Stroke Research, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Nina Bishop
- 9 Department of Animal Medicine, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Elizabeth Curran
- 6 New England Primate Research Center, Harvard Medical School , Southborough, Massachusetts
| | - Nilsa Silva
- 6 New England Primate Research Center, Harvard Medical School , Southborough, Massachusetts
| | - Dwijit GuhaSarkar
- 1 Department of Neurology, University of Massachusetts Medical School , Worcester, Massachusetts.,2 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Susan V Westmoreland
- 6 New England Primate Research Center, Harvard Medical School , Southborough, Massachusetts
| | - Douglas R Martin
- 7 Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University , Alabama.,8 Department of Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University , Alabama
| | - Matthew J Gounis
- 3 Department of Radiology, University of Massachusetts Medical School , Worcester, Massachusetts.,4 New England Center for Stroke Research, University of Massachusetts Medical School , Worcester, Massachusetts
| | - Wael F Asaad
- 10 Department of Neurosurgery, Alpert Medical School, Brown University , Providence, Rhode Island.,11 Brown Institute for Brain Science, Brown University , Providence, Rhode Island.,12 Rhode Island Hospital , Providence, Rhode Island
| | - Miguel Sena-Esteves
- 1 Department of Neurology, University of Massachusetts Medical School , Worcester, Massachusetts.,2 Horae Gene Therapy Center, University of Massachusetts Medical School , Worcester, Massachusetts
| |
Collapse
|
6
|
van der Marel K, Gounis MJ, Weaver JP, de Korte AM, King RM, Arends JM, Brooks OW, Wakhloo AK, Puri AS. Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011843] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BackgroundPoor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation of deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images.MethodsVasoCT and OCT images were obtained after FD implant (n=8 aneurysms) in an experimental sidewall aneurysm model in canines. Surface models of the vessel wall and FD device were extracted, and the distance between them was presented on a two-dimensional flattened map. Maps and cross-sections at potential locations of malapposition detected on VasoCT-based maps were compared. The performance of OCT-based apposition detection was evaluated on manually labeled cross-sections using logistic regression against a thresholded (≥0.25 mm) apposition measure.ResultsVasoCT and OCT acquisitions yielded similar Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT) apposition maps. GRAFT maps from VasoCT highlighted 16 potential locations of malapposition, of which two were found to represent malapposed device struts. Logistic regression showed that OCT could detect malapposition with a sensitivity of 98% and a specificity of 81%.ConclusionsGRAFT delivered quantitative and visually convenient representations of potential FD malapposition and occasional acute thrombus formation. A powerful combination for future neuroendovascular applications is foreseen with the superior resolution delivered by intravascular OCT.
Collapse
|
7
|
Nitzsche B, Frey S, Collins LD, Seeger J, Lobsien D, Dreyer A, Kirsten H, Stoffel MH, Fonov VS, Boltze J. A stereotaxic, population-averaged T1w ovine brain atlas including cerebral morphology and tissue volumes. Front Neuroanat 2015; 9:69. [PMID: 26089780 PMCID: PMC4455244 DOI: 10.3389/fnana.2015.00069] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/12/2015] [Indexed: 01/18/2023] Open
Abstract
Standard stereotaxic reference systems play a key role in human brain studies. Stereotaxic coordinate systems have also been developed for experimental animals including non-human primates, dogs, and rodents. However, they are lacking for other species being relevant in experimental neuroscience including sheep. Here, we present a spatial, unbiased ovine brain template with tissue probability maps (TPM) that offer a detailed stereotaxic reference frame for anatomical features and localization of brain areas, thereby enabling inter-individual and cross-study comparability. Three-dimensional data sets from healthy adult Merino sheep (Ovis orientalis aries, 12 ewes and 26 neutered rams) were acquired on a 1.5 T Philips MRI using a T1w sequence. Data were averaged by linear and non-linear registration algorithms. Moreover, animals were subjected to detailed brain volume analysis including examinations with respect to body weight (BW), age, and sex. The created T1w brain template provides an appropriate population-averaged ovine brain anatomy in a spatial standard coordinate system. Additionally, TPM for gray (GM) and white (WM) matter as well as cerebrospinal fluid (CSF) classification enabled automatic prior-based tissue segmentation using statistical parametric mapping (SPM). Overall, a positive correlation of GM volume and BW explained about 15% of the variance of GM while a positive correlation between WM and age was found. Absolute tissue volume differences were not detected, indeed ewes showed significantly more GM per bodyweight as compared to neutered rams. The created framework including spatial brain template and TPM represent a useful tool for unbiased automatic image preprocessing and morphological characterization in sheep. Therefore, the reported results may serve as a starting point for further experimental and/or translational research aiming at in vivo analysis in this species.
Collapse
Affiliation(s)
- Björn Nitzsche
- Department of Cell Therapy, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, Germany ; Faculty of Veterinary Medicine, Institute of Anatomy, Histology and Embryology, University of Leipzig Leipzig, Germany
| | - Stephen Frey
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Louis D Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Johannes Seeger
- Faculty of Veterinary Medicine, Institute of Anatomy, Histology and Embryology, University of Leipzig Leipzig, Germany
| | - Donald Lobsien
- Department of Neuroradiology, University Hospital of Leipzig Leipzig, Germany
| | - Antje Dreyer
- Department of Cell Therapy, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, Germany ; Translational Centre for Regenerative Medicine, University of Leipzig Leipzig, Germany
| | - Holger Kirsten
- Department of Cell Therapy, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, Germany ; Faculty of Medicine, Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig Leipzig, Germany ; LIFE Center (Leipzig Interdisciplinary Research Cluster of Genetic Factors, Phenotypes and Environment), University of Leipzig Leipzig, Germany
| | - Michael H Stoffel
- Division of Veterinary Anatomy, Vetsuisse Faculty, University of Bern Bern, Switzerland
| | - Vladimir S Fonov
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Johannes Boltze
- Department of Cell Therapy, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, Germany ; Translational Centre for Regenerative Medicine, University of Leipzig Leipzig, Germany ; Neurovascular Regulation Laboratory at Neuroscience Center, Massachusetts General Hospital and Harvard Medical School Charlestown, MA, USA
| |
Collapse
|
8
|
Golebiowski D, Bradbury AM, Kwon CS, van der Bom IMJ, Stoica L, Johnson AK, Wilson DU, Gray-Edwards HL, Hudson JA, Johnson JA, Randle AN, Whitlock BK, Sartin JL, Kühn AL, Gounis M, Asaad W, Martin DR, Sena-Esteves M. AAV Gene Therapy Strategies for Lysosomal Storage Disorders with Central Nervous System Involvement. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/978-1-4939-2306-9_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
9
|
Ojala DS, Amara DP, Schaffer DV. Adeno-associated virus vectors and neurological gene therapy. Neuroscientist 2014; 21:84-98. [PMID: 24557878 DOI: 10.1177/1073858414521870] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gene therapy has strong potential for treating a variety of genetic disorders, as demonstrated in recent clinical trials. There is unfortunately no scarcity of disease targets, and the grand challenge in this field has instead been the development of safe and efficient gene delivery platforms. To date, approximately two thirds of the 1800 gene therapy clinical trials completed worldwide have used viral vectors. Among these, adeno-associated virus (AAV) has emerged as particularly promising because of its impressive safety profile and efficiency in transducing a wide range of cell types. Gene delivery to the CNS involves both considerable promise and unique challenges, and better AAV vectors are thus needed to translate CNS gene therapy approaches to the clinic. This review discusses strategies for vector design, potential routes of administration, immune responses, and clinical applications of AAV in the CNS.
Collapse
Affiliation(s)
- David S Ojala
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA
| | - Dominic P Amara
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, USA
| | - David V Schaffer
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA Department of Bioengineering, University of California, Berkeley, CA, USA The Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| |
Collapse
|
10
|
Flood TF, van der Bom IMJ, Strittmatter L, Puri AS, Hendricks GM, Wakhloo AK, Gounis MJ. Quantitative analysis of high-resolution, contrast-enhanced, cone-beam CT for the detection of intracranial in-stent hyperplasia. J Neurointerv Surg 2014; 7:118-25. [PMID: 24480728 PMCID: PMC4316917 DOI: 10.1136/neurintsurg-2013-010950] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Intracranial in-stent hyperplasia is a stroke-associated complication that requires routine surveillance. OBJECTIVE To compare the results of in vivo experiments to determine the accuracy and precision of in-stent hyperplasia measurements obtained with modified C-arm contrast-enhanced, cone-beam CT (CE-CBCT) imaging with those obtained by 'gold standard' histomorphometry. Additionally, to carry out clinical analyses comparing this CE-CBCT protocol with digital subtraction angiography (DSA). METHODS A non-binned CE-CBCT protocol (VasoCT) was used that acquires x-ray images with a small field-of-view and applies a full-scale reconstruction algorithm providing high-resolution three-dimensional (3D) imaging with 100 µm isotropic voxels. In an vivo porcine model, VasoCT cross-sectional area measurements were compared with gold standard vessel histology. VasoCT and DSA were used to calculate in-stent stenosis in 23 imaging studies. RESULTS Porcine VasoCT cross-sectional stent, lumen, and in-stent hyperplasia areas strongly correlated with histological measurements (r(2)=0.97, 0.93, 0.90; slope=1.14, 1.07, and 0.76, respectively; p<0.0001). Clinical VasoCT percentage stenosis correlated well with DSA percentage stenosis (r(2)=0.84; slope=0.76), and the two techniques were free of consistent bias (Bland-Altman, bias=3.29%; 95% CI -14.75% to 21.33%). An illustrative clinical case demonstrated the advantages of VasoCT, including 3D capability and non-invasive IV contrast administration, for detection of in-stent hyperplasia. CONCLUSIONS C-arm VasoCT is a high-resolution 3D capable imaging technique that has been validated in an animal model for measurement of in-stent tissue growth. Successful clinical implementation of the protocol was performed in a small case series.
Collapse
Affiliation(s)
- Thomas F Flood
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Imramsjah M J van der Bom
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Lara Strittmatter
- Department of Cell Biology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ajit S Puri
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gregory M Hendricks
- Department of Cell Biology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ajay K Wakhloo
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Matthew J Gounis
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
11
|
van der Bom IMJ, Gounis MJ, Ding L, Kühn AL, Goff D, Puri AS, Wakhloo AK. Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT. BMJ Case Rep 2013; 2013:bcr-2013-010763. [PMID: 23946527 DOI: 10.1136/bcr-2013-010763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Three years following endovascular embolization of a 3 mm ruptured arteriovenous malformation (AVM) of the left superior colliculus in a 42-year-old man, digital subtraction angiography showed continuous regrowth of the lesion. Thin-slice MRI acquired for treatment planning did not show the AVM nidus. The patient was brought back to the angiography suite for high-resolution contrast-enhanced cone beam CT (VasoCT) acquired using an angiographic c-arm system. The lesion and nidus were visualized with VasoCT. MRI, CT and VasoCT data were transferred to radiation planning software and mutually co-registered. The nidus was annotated for radiation on VasoCT data by an experienced neurointerventional radiologist and a dose/treatment plan was completed. Due to image registration, the treatment area could be directly adopted into the MRI and CT data. The AVM was completely obliterated 10 months following completion of the radiosurgery treatment.
Collapse
|