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Keum H, Albadawi H, Zhang Z, Graf E, Santos PRD, Gunduz S, Oklu R. Bioengineered Ionic Liquid for Catheter-Directed Tissue Ablation, Drug Delivery, and Embolization. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2309412. [PMID: 38305472 PMCID: PMC11161330 DOI: 10.1002/adma.202309412] [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: 09/12/2023] [Revised: 12/03/2023] [Indexed: 02/03/2024]
Abstract
Delivery of therapeutics to solid tumors with high bioavailability remains a challenge and is likely the main contributor to the ineffectiveness of immunotherapy and chemotherapy. Here, a catheter-directed ionic liquid embolic (ILE) is bioengineered to achieve durable vascular embolization, uniform tissue ablation, and drug delivery in non-survival and survival porcine models of embolization, outperforming the clinically used embolic agents. To simulate the clinical scenario, rabbit VX2 orthotopic liver tumors are treated showing successful trans-arterial delivery of Nivolumab and effective tumor ablation. Furthermore, similar results are also observed in human ex vivo tumor tissue as well as significant susceptibility of highly resistant patient-derived bacteria is seen to ILE, suggesting that ILE can prevent abscess formation in embolized tissue. ILE represents a new class of liquid embolic agents that can treat tumors, improve the delivery of therapeutics, prevent infectious complications, and potentially increase chemo- and immunotherapy response in solid tumors.
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Affiliation(s)
- Hyeongseop Keum
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Hassan Albadawi
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
- Division of Vascular & Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, Arizona 85054, USA
| | - Zefu Zhang
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Erin Graf
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, Arizona 85054, USA
| | - Pedro Reck Dos Santos
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
- Department of Cardiothoracic Surgery, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, Arizona 85054, USA
| | - Seyda Gunduz
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
- Department of Medical Oncology, Istinye University Bahcesehir Liv Hospital, Istanbul 34517, Turkey
| | - Rahmi Oklu
- The Laboratory for Patient-Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
- Division of Vascular & Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, Arizona 85054, USA
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Parvez MA, Yashiro K, Tsunoi Y, Saitoh D, Sato S, Nishidate I. In vivo monitoring of hemoglobin derivatives in a rat thermal injury model using spectral diffuse reflectance imaging. Burns 2024; 50:167-177. [PMID: 37821274 DOI: 10.1016/j.burns.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION To demonstrate the feasibility of our previously proposed Diffuse reflectance spectral imaging (DRSI) method for in vivo monitoring of oxygenated hemoglobin, deoxygenated hemoglobin, methemoglobin, tissue oxygen saturation, and methemoglobin saturation in a rat scald burn wound model and assess whether the method could be used for differentiating the burn depth groups in rats based on the hemoglobin parameters. METHODOLOGY Superficial dermal burns (SDBs), deep dermal burns (DDBs), and deep burns (DBs) were induced in rat dorsal skin using a Walker-Mason method. An approach based on multiple regression analysis for spectral diffuse reflectance images aided by Monte Carlo simulations for light transport was used to quantify the hemoglobin parameters. Canonical discriminant analysis (CDA) was performed to discriminate SDB, DDB, and DB. RESULTS CDA using the total hemoglobin concentration, tissue oxygen saturation, and methemoglobin saturation as the independent variables showed good performance for discriminating the SDB, DDB, and DB groups immediately after burn injury and the SDB group from the DDB and DB groups 24-72 h after burn injury. CONCLUSIONS The DRSI method with multiple regression analysis for quantification of oxygenated hemoglobin, deoxygenated hemoglobin, and methemoglobin proved to be reliable for monitoring these hemoglobin derivatives in the rat experimental burn injury model. The parameters of tissue oxygen saturation, methemoglobin saturation, and total hemoglobin concentration are promising for the differentiating the degree of burn injury using CDA.
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Affiliation(s)
- Md Anowar Parvez
- Graduate School of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei-shi, Tokyo 1848588 Japan
| | - Kazuhiro Yashiro
- Graduate School of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei-shi, Tokyo 1848588 Japan
| | - Yasuyuki Tsunoi
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, 3-2, Namiki, Tokorozawa-shi, Saitama 3598513 Japan
| | - Daizoh Saitoh
- Division of Basic Traumatology, National Defense Medical College Research Institute, 3-2, Namiki, Tokorozawa-shi, Saitama 3598513 Japan
| | - Shunichi Sato
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, 3-2, Namiki, Tokorozawa-shi, Saitama 3598513 Japan
| | - Izumi Nishidate
- Graduate School of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei-shi, Tokyo 1848588 Japan.
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Kim SE, McNally JS, Alexander MD, Zabriskie MS, Parker DL, Day RW. Evaluation of methemoglobin as an intravascular contrast agent: T1 relaxation time effect in a rabbit model. Magn Reson Imaging 2023; 103:1-7. [PMID: 37392804 PMCID: PMC10530177 DOI: 10.1016/j.mri.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE Alternative contrast agents for MRI are needed for individuals who may respond adversely to gadolinium, and need an intravascular agent for specific indications. One potential contrast agent is intracellular methemoglobin, a paramagnetic molecule that is normally present in small amounts in red blood cells. An animal model was used to determine whether methemoglobin modulation with intravenous sodium nitrite transiently changes the T1 relaxation of blood. METHODS Four adult New Zealand white rabbits were treated with 30 mg intravenous sodium nitrite. 3D TOF and 3D MPRAGE images were acquired before (baseline) and after methemoglobin modulation. T1 of blood was measured with 2D ss EPl acquisitions with inversion recovery preparation performed at two-minute intervals up to 30 min. T1 maps were calculated by fitting the signal recovery curve within major blood vessels. RESULTS Baseline T1 was 1758 ± 53 ms in carotid arteries and 1716 ± 41 ms in jugular veins. Sodium nitrite significantly changed intravascular T1 relaxation. The mean minimum value of T1 was 1126 ± 28 ms in carotid arteries 8 to 10 min after the injection of sodium nitrite. The mean minimum value of T1 was 1171 ± 52 ms in jugular veins 10 to 14 min after the injection of sodium nitrite. Arterial and venous T1 recovered to baseline after a period of 30 min. CONCLUSION Methemoglobin modulation produces intravascular contrast on T1-weighted MRI in vivo. Additional studies are needed to safely optimize methemoglobin modulation and sequence parameters for maximal tissue contrast.
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Affiliation(s)
- Seong-Eun Kim
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA.
| | - J Scott McNally
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Matthew D Alexander
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Matthew S Zabriskie
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Dennis L Parker
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Ronald W Day
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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Glyoxylate protects against cyanide toxicity through metabolic modulation. Sci Rep 2022; 12:4982. [PMID: 35322094 PMCID: PMC8943054 DOI: 10.1038/s41598-022-08803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/04/2022] [Indexed: 11/09/2022] Open
Abstract
Although cyanide's biological effects are pleiotropic, its most obvious effects are as a metabolic poison. Cyanide potently inhibits cytochrome c oxidase and potentially other metabolic enzymes, thereby unleashing a cascade of metabolic perturbations that are believed to cause lethality. From systematic screens of human metabolites using a zebrafish model of cyanide toxicity, we have identified the TCA-derived small molecule glyoxylate as a potential cyanide countermeasure. Following cyanide exposure, treatment with glyoxylate in both mammalian and non-mammalian animal models confers resistance to cyanide toxicity with greater efficacy and faster kinetics than known cyanide scavengers. Glyoxylate-mediated cyanide resistance is accompanied by rapid pyruvate consumption without an accompanying increase in lactate concentration. Lactate dehydrogenase is required for this effect which distinguishes the mechanism of glyoxylate rescue as distinct from countermeasures based solely on chemical cyanide scavenging. Our metabolic data together support the hypothesis that glyoxylate confers survival at least in part by reversing the cyanide-induced redox imbalances in the cytosol and mitochondria. The data presented herein represent the identification of a potential cyanide countermeasure operating through a novel mechanism of metabolic modulation.
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In Vivo Transcutaneous Monitoring of Hemoglobin Derivatives Using a Red-Green-Blue Camera-Based Spectral Imaging Technique. Int J Mol Sci 2021; 22:ijms22041528. [PMID: 33546389 PMCID: PMC7913506 DOI: 10.3390/ijms22041528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022] Open
Abstract
Cyanosis is a pathological condition that is characterized by a bluish discoloration of the skin or mucous membranes. It may result from a number of medical conditions, including disorders of the respiratory system and central nervous system, cardiovascular diseases, peripheral vascular diseases, deep vein thrombosis, and regional ischemia. Cyanosis can also be elicited from methemoglobin. Therefore, a simple, rapid, and simultaneous monitoring of changes in oxygenated hemoglobin and deoxygenated hemoglobin is useful for protective strategies against organ ischemic injury. We previously developed a red-green-blue camera-based spectral imaging method for the measurements of melanin concentration, oxygenated hemoglobin concentration (CHbO), deoxygenated hemoglobin concentration (CHbR), total hemoglobin concentration (CHbT) and tissue oxygen saturation (StO2) in skin tissues. We leveraged this approach in this study and extended it to the simultaneous quantifications of methemoglobin concentration (CmetHb), CHbO, CHbR, and StO2. The aim of the study was to confirm the feasibility of the method to monitor CmetHb, CHbO, CHbR, CHbT, and StO2. We performed in vivo experiments using rat dorsal skin during methemoglobinemia induced by the administration of sodium nitrite (NaNO2) and changing the fraction of inspired oxygen (FiO2), including normoxia, hypoxia, and anoxia. Spectral diffuse reflectance images were estimated from an RGB image by the Wiener estimation method. Multiple regression analysis based on Monte Carlo simulations of light transport was used to estimate CHbO, CHbR, CmetHb, CHbT, and StO2. CmetHb rapidly increased with a half-maximum time of less than 30 min and reached maximal values nearly 60 min after the administration of NaNO2, whereas StO2 dramatically dropped after the administration of NaNO2, indicating the temporary production of methemoglobin and severe hypoxemia during methemoglobinemia. Time courses of CHbT and StO2, while changing the FiO2, coincided with well-known physiological responses to hyperoxia, normoxia, and hypoxia. The results indicated the potential of this method to evaluate changes in skin hemodynamics due to loss of tissue viability and vitality.
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Khatun F, Aizu Y, Nishidate I. Transcutaneous monitoring of hemoglobin derivatives during methemoglobinemia in rats using spectral diffuse reflectance. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-200279SSRR. [PMID: 33583153 PMCID: PMC7881097 DOI: 10.1117/1.jbo.26.3.033708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
SIGNIFICANCE Untreated methemoglobinemia may cause severe hypoxemia and even death when methemoglobin levels in the blood stream exceed 70%. Although CO-oximetry can be used to monitor the response to treatment for methemoglobinemia, it is costly and requires an invasive procedure for collecting blood samples from patients. A pulse CO-oximeter with a contact probe can be used to continuously and non-invasively measure the percentage of methemoglobin, as well as the percutaneous oxygen saturation. In terms of the prevention of infectious diseases, however, it is desirable to monitor methemoglobin and oxygen saturation levels in a non-contact manner. Diffuse reflectance spectral imaging is promising as a non-contact, non-invasive, and cost-effective clinical diagnostic tool for methemoglobinemia. AIM To demonstrate the feasibility of visible spectral diffuse reflectance for in vivo monitoring of hemoglobin derivatives and evaluating methemoglobin production and reduction as well as hypoxemia during methemoglobinemia in rats. APPROACH A new imaging approach based on the multiple regression analysis aided by Monte Carlo simulations for light transport was developed to quantify methemoglobin, oxygenated hemoglobin, and deoxygenated hemoglobin using a hyperspectral imaging system. An in vivo experiment with rats exposed to sodium nitrite (NaNO2) at different doses was performed to confirm the feasibility of the method for evaluating the dynamics of methemoglobin, oxygenated hemoglobin, and deoxygenated hemoglobin during methemoglobinemia. Systemic physiological parameters, including the percutaneous arterial oxygen saturation, heart rate (HR), and pulse distention, were measured by a commercially available pulse oximeter, and the results were compared to those obtained by the proposed method. RESULTS Both the methemoglobin concentration and methemoglobin saturation rapidly increased with a half-maximum time of <20 min. They reached their maximal values nearly 60 min after the administration of NaNO2. Tissue oxygen saturation dramatically dropped to a minimum of 33.7 % ± 0.4 % , 23.1 % ± 5.6 % , 8.8 % ± 1.7 % , and 9.7 % ± 5.1 % on average for NaNO2 doses of 25, 37.5, 50, and 75 mg/kg, respectively. Changes in methemoglobin concentration and tissue oxygen saturation are indicative of the temporary production of methemoglobin and severe hypoxemia during methemoglobinemia. Profound increases in the HR and pulse distention implied an elevated cardiac output caused by tachycardia and the resultant increase in peripheral blood volume to compensate for the hypoxia and hypoxemia during methemoglobinemia. This was in agreement with the time course of the peripheral hemoglobin volume concentration obtained by the proposed method. CONCLUSIONS The proposed method is capable of the in vivo non-contact simultaneous evaluation of methemoglobin levels and hypoxemia during methemoglobinemia, and that it has potential as a tool for the diagnosis and management of methemoglobinemia.
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Affiliation(s)
- Fahima Khatun
- Tokyo University of Agriculture and Technology, Graduate School of Bio-Applications and Systems Engineering, Tokyo, Japan
- Bangabandhu Sheikh Mujibur Rahman Agricultural University, Faculty of Veterinary Medicine and Animal Science, Department of Pathobiology, Gazipur, Dhaka, Bangladesh
| | - Yoshihisa Aizu
- Muroran Institute of Technology, College of Design and Manufacturing Technology, Hokkaido, Japan
| | - Izumi Nishidate
- Tokyo University of Agriculture and Technology, Graduate School of Bio-Applications and Systems Engineering, Tokyo, Japan
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Lee J, Rockwood G, Logue B, Manandhar E, Petrikovics I, Han C, Bebarta V, Mahon SB, Burney T, Brenner M. Monitoring Dose Response of Cyanide Antidote Dimethyl Trisulfide in Rabbits Using Diffuse Optical Spectroscopy. J Med Toxicol 2018; 14:295-305. [PMID: 30094773 DOI: 10.1007/s13181-018-0680-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Cyanide (CN) poisoning is a serious chemical threat from accidental or intentional exposures. Current CN exposure treatments, including direct binding agents, methemoglobin donors, and sulfur donors, have several limitations. Dimethyl trisulfide (DMTS) is capable of reacting with CN to form the less toxic thiocyanate with high efficiency, even without the sulfurtransferase rhodanese. We investigated a soluble DMTS formulation with the potential to provide a continuous supply of substrate for CN detoxification which could be delivered via intramuscular (IM) injection in a mass casualty situation. We also used non-invasive technology, diffuse optical spectroscopy (DOS), to monitor physiologic changes associated with CN exposure and reversal. METHODS Thirty-six New Zealand white rabbits were infused with a lethal dose of sodium cyanide solution (20 mg/60 ml normal saline). Animals were divided into three groups and treated with saline, low dose (20 mg), or high dose (150 mg) of DMTS intramuscularly. DOS continuously assessed changes in tissue hemoglobin concentrations and cytochrome c oxidase redox state status throughout the experiment. RESULTS IM injection of DMTS increased the survival in lethal CN poisoning. DOS demonstrated that high-dose DMTS (150 mg) reversed the effects of CN exposure on cytochrome c oxidase, while low dose (20 mg) did not fully reverse effects, even in surviving animals. CONCLUSIONS This study demonstrated potential efficacy for the novel approach of supplying substrate for non-rhodanese mediated sulfur transferase pathways for CN detoxification via intramuscular injection in a moderate size animal model and showed that DOS was useful for optimizing the DMTS treatment.
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Affiliation(s)
- Jangwoen Lee
- Beckman Laser Institute, University of California, 1002 Health Sciences Rd. East, Irvine, CA, 92612, USA.
| | - Gary Rockwood
- Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, 2900 Rickets Point Road, Aberdeen Proving Ground, Aberdeen, MD, 21010, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota University, Brookings, SD, 57007, USA
| | - Erica Manandhar
- Department of Chemistry and Biochemistry, South Dakota University, Brookings, SD, 57007, USA
| | - Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, TX, 77341, USA
| | - Changhoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Geonggi-do, 10444, South Korea
| | - Vik Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, 1002 Health Sciences Rd. East, Irvine, CA, 92612, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, 1002 Health Sciences Rd. East, Irvine, CA, 92612, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, 1002 Health Sciences Rd. East, Irvine, CA, 92612, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA, 92868, USA
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Van Leeuwen SR, Baranoski GVG, Kimmel BW. Three-wavelength method for the optical differentiation of methemoglobin and sulfhemoglobin in oxygenated blood. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2017:4570-4573. [PMID: 29060914 DOI: 10.1109/embc.2017.8037873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Methemoglobinemia and sulfhemoglobinemia are rare, but potentially life threatening, diseases that refer to an abnormal amount of methemoglobin or sulfhemoglobin in the blood, respectively. Unfortunately, blood samples containing abnormal quantities of methemoglobin or sulfhemoglobin have similar spectral characteristics. This makes it difficult to optically differentiate them and, hence, difficult to diagnose a patient with either disease. However, performing treatments for one of the diseases without a correct diagnosis can introduce increased risk to the patient. In this paper, we propose a method for differentiating the presence of methemoglobin and sulfhemoglobin in blood, under several conditions, using reflectance values measured at three wavelengths. In order to validate our method, we perform in silico experiments considering various levels of methemoglobin and sulfhemoglobin. These experiments employ a cell-based light interaction model, known as CLBlood, which accounts for the orientation and distribution of red blood cells. We then discuss the reflectance curves produced by the experiments and evaluate the efficacy of our method. In particular, we consider various experimental conditions by modifying the flow rate, hemolysis level and incident light direction.
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Ghijsen M, Lentsch GR, Gioux S, Brenner M, Durkin AJ, Choi B, Tromberg BJ. Quantitative real-time optical imaging of the tissue metabolic rate of oxygen consumption. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-12. [PMID: 29575830 PMCID: PMC5866507 DOI: 10.1117/1.jbo.23.3.036013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 02/28/2018] [Indexed: 05/06/2023]
Abstract
The tissue metabolic rate of oxygen consumption (tMRO2) is a clinically relevant marker for a number of pathologies including cancer and arterial occlusive disease. We present and validate a noncontact method for quantitatively mapping tMRO2 over a wide, scalable field of view at 16 frames / s. We achieve this by developing a dual-wavelength, near-infrared coherent spatial frequency-domain imaging (cSFDI) system to calculate tissue optical properties (i.e., absorption, μa, and reduced scattering, μs', parameters) as well as the speckle flow index (SFI) at every pixel. Images of tissue oxy- and deoxyhemoglobin concentration ( [ HbO2 ] and [HHb]) are calculated from optical properties and combined with SFI to calculate tMRO2. We validate the system using a series of yeast-hemoglobin tissue-simulating phantoms and conduct in vivo tests in humans using arterial occlusions that demonstrate sensitivity to tissue metabolic oxygen debt and its repayment. Finally, we image the impact of cyanide exposure and toxicity reversal in an in vivo rabbit model showing clear instances of mitochondrial uncoupling and significantly diminished tMRO2. We conclude that dual-wavelength cSFDI provides rapid, quantitative, wide-field mapping of tMRO2 that can reveal unique spatial and temporal dynamics relevant to tissue pathology and viability.
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Affiliation(s)
- Michael Ghijsen
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Department of Biomedical Engineering, Irvine, California, United States
| | - Griffin R. Lentsch
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Department of Biomedical Engineering, Irvine, California, United States
| | - Sylvain Gioux
- University of Strasbourgh, ICube Laboratory, Illkirch, France
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Irvine Medical Center, Department of Medicine, Division of Pulmonology, Orange, California, United States
| | - Anthony J. Durkin
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Department of Biomedical Engineering, Irvine, California, United States
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Department of Biomedical Engineering, Irvine, California, United States
| | - Bruce J. Tromberg
- Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, Irvine, California, United States
- University of California, Department of Biomedical Engineering, Irvine, California, United States
- University of California, Irvine Medical Center, Department of Surgery, Orange, California, United States
- Address all correspondence to: Bruce J. Tromberg, E-mail:
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McLachlan PJ, Kishimoto J, Diop M, Milej D, Lee DSC, de Ribaupierre S, St Lawrence K. Investigating the effects of cerebrospinal fluid removal on cerebral blood flow and oxidative metabolism in infants with post-hemorrhagic ventricular dilatation. Pediatr Res 2017; 82:634-641. [PMID: 28553990 DOI: 10.1038/pr.2017.131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/28/2017] [Indexed: 11/09/2022]
Abstract
BackgroundPost-hemorrhagic ventricular dilatation (PHVD) is predictive of mortality and morbidity among very-low-birth-weight preterm infants. Impaired cerebral blood flow (CBF) due to elevated intracranial pressure (ICP) is believed to be a contributing factor.MethodsA hyperspectral near-infrared spectroscopy (NIRS) method of measuring CBF and the cerebral metabolic rate of oxygen (CMRO2) was used to investigate perfusion and metabolism changes in patients receiving a ventricular tap (VT) based on clinical management. To improve measurement accuracy, the spectral analysis was modified to account for compression of the cortical mantle caused by PHVD and the possible presence of blood breakdown products.ResultsFrom nine patients (27 VTs), a significant CBF increase was measured (15.6%) following VT (14.6±4.2 to 16.9±6.6 ml/100 g/min), but with no corresponding change in CMRO2 (1.02±0.41 ml O2/100 g/min). Post-VT CBF was in good agreement with a control group of 13 patients with patent ductus arteriosus but no major cerebral pathology (16.5±7.7 ml/100 g/min), whereas tissue oxygen saturation (StO2) was significantly lower (58.9±12.1% vs. 70.5±9.1% for controls).ConclusionCBF was impeded in PHVD infants requiring a clinical intervention, but the effect is not large enough to alter CMRO2.
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Affiliation(s)
- Peter J McLachlan
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jessica Kishimoto
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Mamadou Diop
- Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - Daniel Milej
- Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
| | - David S C Lee
- Department of Pediatrics, Western University, London, Ontario, Canada
| | | | - Keith St Lawrence
- Imaging Division, Lawson Health Research Institute, London, Ontario, Canada
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Brenner M, Azer SM, Oh KJ, Han CH, Lee J, Mahon SB, Du X, Mukai D, Burney T, Saidian M, Chan A, Straker DI, Bebarta VS, Boss GR. Oral Glycine and Sodium Thiosulfate for Lethal Cyanide Ingestion. ACTA ACUST UNITED AC 2017; 7. [PMID: 28868209 PMCID: PMC5578424 DOI: 10.4172/2167-7972.1000355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objective Accidental or intentional cyanide ingestion is an-ever present danger. Rapidly acting, safe, inexpensive oral cyanide antidotes are needed that can neutralize large gastrointestinal cyanide reservoirs. Since humans cannot be exposed to cyanide experimentally, we studied oral cyanide poisoning in rabbits, testing oral sodium thiosulfate with and without gastric alkalization. Setting University research laboratory. Subjects New Zealand white rabbits. Interventions Seven animal groups studied; Groups 1–5 received high dose oral NaCN (50 mg, >LD100) and were treated immediately with oral (via nasogastric tube): 1) saline, 2) glycine, 3) sodium thiosulfate or 4) sodium thiosulfate and glycine, or 5) after 2 min with intramuscular injection of sodium nitrite and sodium thiosulfate plus oral sodium thiosulfate and glycine. Groups 6–7 received moderate dose oral NaCN (25 mg, LD70) and delayed intramuscular 6) saline or 7) sodium nitrite-sodium thiosulfate. Measurements and Main Results All animals in the high dose NaCN group receiving oral saline or glycine died very rapidly, with a trend towards delayed death in glycine-treated animals; saline versus glycine-treated animals died at 10.3+3.9 and 14.6+5.9 min, respectively (p=0.13). In contrast, all sodium thiosulfate-treated high dose cyanide animals survived (p<0.01), with more rapid recovery in animals receiving both thiosulfate and glycine, compared to thiosulfate alone (p<0.03). Delayed intramuscular treatment alone in the moderate cyanide dose animals increased survival over control animals from 30% to 71%. Delayed treatment in high dose cyanide animals was not as effective as immediate treatment, but did increase survival time and rescued 29% of animals (p<0.01 versus cyanide alone). Conclusions Oral sodium thiosulfate with gastric alkalization rescued animals from lethal doses of ingested cyanide. The combination of oral glycine and sodium thiosulfate may have potential for treating high dose acute cyanide ingestion and merits further investigation. The combination of systemic and oral therapy may provide further options.
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Affiliation(s)
- Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, California, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, California, USA
| | - Sarah M Azer
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Kyung-Jin Oh
- Department of Urology, Chonnam National University Medical School, South Korea
| | - Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Geonggi-do, South Korea
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Xiaohua Du
- Pulmonary Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - David Mukai
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Mayer Saidian
- Beckman Laser Institute, University of California, Irvine, California, USA.,The Institute for Drug Research, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem Israel
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Derek I Straker
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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12
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The Vitamin B 12 Analog Cobinamide Is an Effective Antidote for Oral Cyanide Poisoning. J Med Toxicol 2016; 12:370-379. [PMID: 27631586 DOI: 10.1007/s13181-016-0566-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/31/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Cyanide is a major chemical threat, and cyanide ingestion carries a higher risk for a supra-lethal dose exposure compared to inhalation but provides an opportunity for effective treatment due to a longer treatment window and a gastrointestinal cyanide reservoir that could be neutralized prior to systemic absorption. We hypothesized that orally administered cobinamide may function as a high-binding affinity scavenger and that gastric alkalinization would reduce cyanide absorption and concurrently increase cobinamide binding, further enhancing antidote effectiveness. METHODS Thirty New Zealand white rabbits were divided into five groups and were given a lethal dose of oral cyanide poisoning (50 mg). The survival time of animals was monitored with oral cyanide alone, oral cyanide with gastric alkalinization with oral sodium bicarbonate buffer (500 mg), and in combination with either aquohydroxocobinamide or dinitrocobinamide (250 mM). Red blood cell cyanide concentration, plasma cobinamide, and thiocyanate concentrations were measured from blood samples. RESULTS In cyanide ingested animals, oral sodium bicarbonate alone significantly prolonged survival time to 20.3 ± 8.6 min compared to 10.5 ± 4.3 min in saline-treated controls, but did not lead to overall survival. Aquohydroxocobinamide and dinitrocobinamide increased survival time to 64 ± 41 (p < 0.05) and 75 ± 16.4 min (p < 0.001), respectively. Compared to aquohydroxocobinamide, dinitrocobinamide showed greater systemic absorption and reduced blood pressure. Dinitrocobinamide also markedly increased the red blood cell cyanide concentration. Under all conditions, the plasma thiocyanate concentration gradually increased with time. CONCLUSION This study demonstrates a promising new approach to treat high-dose cyanide ingestion, with gastric alkalinization alone and in combination with oral cobinamide for treating a supra-lethal dose of orally administered cyanide in rabbits.
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13
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Iwabuchi T, Yoshimoto C, Shigetomi H, Kobayashi H. Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology. Oncol Lett 2016; 11:3384-3388. [PMID: 27123121 DOI: 10.3892/ol.2016.4383] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 03/04/2016] [Indexed: 01/14/2023] Open
Abstract
The aim of the present study was to assess the relative concentrations of hemoglobin (Hb) species in endometriosis as a possible indicator of malignancy. Electronic absorption spectroscopy was employed to quantify the Hb species present in the cyst fluid collected from 8 patients with endometriosis-associated ovarian cancer (EAOC), and compared with those present in the cyst fluid of 35 patients with benign endometriotic cysts. The 620/580 nm ratio in the electronic absorption spectrum, which was used as a surrogate indicator of the methemoglobin (metHb)/(oxyhemoglobin+metHb) ratio, was measured in each cyst fluid by ultraviolet/visible grating spectrophotometric microplate reader. The optimal cutoff value was defined according to the analysis of receiver operating characteristic (ROC) curve. The sensitivity and specificity of detection were calculated on the basis of the cutoff value to differentiate EAOC from endometriosis. The 620/580 nm ratio of cyst fluid in EAOC patients was much lower than that measured in women with benign cysts (0.389±0.266 vs. 0.666±0.188, P=0.021). ROC curve analysis performed using 0.35 as the optimal cutoff value indicated that the 620/580 nm ratio had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value of 62.5, 100.0, 100.0 and 92.1%, respectively, in the diagnosis of EAOC. In conclusion, metHb is one of the most abundant Hb species in benign cysts, and the absorption 620/580 nm ratio of cyst fluid exhibits high specificity and PPV as a surveillance test for the early detection of malignant transformation of endometriosis. Thus, metallobiology highlights diverse features involved in Hb homeostasis and the pathogenesis of malignant transformation of endometriosis.
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Affiliation(s)
- Takuya Iwabuchi
- Department of Research and Development, Metallogenics Co., Ltd., Chiba 260-0856, Japan
| | - Chiharu Yoshimoto
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Shigetomi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
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14
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Murphy K, Ryan C, Dempsey EM, O'Toole PW, Ross RP, Stanton C, Ryan CA. Neonatal Sulfhemoglobinemia and Hemolytic Anemia Associated With Intestinal Morganella morganii. Pediatrics 2015; 136:e1641-5. [PMID: 26553186 DOI: 10.1542/peds.2015-0996] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/24/2022] Open
Abstract
Sulfhemoglobinemia is a rare disorder characterized by the presence of sulfhemoglobin in the blood. It is typically drug-induced and may cause hypoxia, end-organ damage, and death through oxygen deprivation. We present here a case of non-drug-induced sulfhemoglobinemia in a 7-day-old preterm infant complicated by hemolytic anemia. Microbiota compositional analysis of fecal samples to investigate the origin of hydrogen sulphide revealed the presence of Morganella morganii at a relative abundance of 38% of the total fecal microbiota at the time of diagnosis. M morganii was not detected in the fecal samples of 40 age-matched control preterm infants. M morganii is an opportunistic pathogen that can cause serious infection, particularly in immunocompromised hosts such as neonates. Strains of M morganii are capable of producing hydrogen sulphide, and virulence factors include the production of a diffusible α-hemolysin. The infant in this case survived intact through empirical oral and intravenous antibiotic therapy, probiotic administration, and red blood cell transfusions. This coincided with a reduction in the relative abundance of M morganii to 3%. Neonatologists should have a high index of suspicion for intestinal pathogens in cases of non-drug-induced sulfhemoglobinemia and consider empirical treatment of the intestinal microbiota in this potentially lethal condition.
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Affiliation(s)
- Kiera Murphy
- Food Biosciences Department, Teagasc Food Research Centre, Moorepark, Co Cork, Ireland; School of Microbiology, APC Microbiome Institute
| | - Clodagh Ryan
- Department of Haematology, Mercy University Hospital, Cork, Ireland; and
| | - Eugene M Dempsey
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland INFANT Centre, and
| | | | - R Paul Ross
- APC Microbiome Institute, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland
| | - Catherine Stanton
- Food Biosciences Department, Teagasc Food Research Centre, Moorepark, Co Cork, Ireland; APC Microbiome Institute
| | - C Anthony Ryan
- APC Microbiome Institute, Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
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15
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Nanoparticles of perfluorocarbon emulsion contribute to the reduction of methemoglobin to oxyhemoglobin. Int J Pharm 2015; 497:88-95. [PMID: 26626224 DOI: 10.1016/j.ijpharm.2015.11.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 11/15/2015] [Accepted: 11/20/2015] [Indexed: 01/17/2023]
Abstract
Here we show that methemoglobin is converted to oxyhemoglobin in the presence of perfluorocarbon (PFС) emulsion. Methemoglobin in blood at the level of above 30% can cause severe complications and lethal outcome. Some pharm chemicals in blood in vivo and in vitro can lead to oxidation of iron, Fe(2+)→Fe(3+), and to increased level of methemoglobin. The oxidized heme is not able to carry oxygen, hypoxia arises and irreversible changes are developing in vital organs. We added NaNO2 solution in different concentrations to blood in vitro in order to yield methemoglobin. Then the suspension of PFC nanoparticles was added. As methemoglobin interacted with PFC nanoparticles the optical density of peaks typical for oxyhemoglobin increased and spectral peak of methemoglobin decreased. The greater the concentration of PFC and the more was the incubation time, the more efficient was the process of reduction of methemoglobin to oxyhemoglobin. We proved experimentally that with an initial concentration of methemoglobin in average 95% the addition of nanoparticles of PFC decreases its concentration to 9% in average. At the same time the concentration of oxyhemoglobin increased in average from 5% to 81%.
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16
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Tang M, Zhou Y, Zhang R, Wang LV. Noninvasive photoacoustic microscopy of methemoglobin in vivo. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:036007. [PMID: 25760655 PMCID: PMC4356553 DOI: 10.1117/1.jbo.20.3.036007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/20/2015] [Indexed: 05/29/2023]
Abstract
Due to the various causes of methemoglobinemia and its potential to be confused with other diseases, in vivo measurements of methemoglobin have significant applications in the clinic. Using photoacoustic microscopy (PAM), we quantified the average and the distributed percentage of methemoglobin both in vitro and in vivo. Based on the absorption spectra of methemoglobin, oxyhemoglobin, and deoxyhemoglobin, three wavelengths were chosen to differentiate methemoglobin from the others. The methemoglobin concentrations calculated from the photoacoustic signals agreed well with the preset concentrations. Then we imaged the methemoglobin percentage in microtubes that mimicked blood vessels. Average percentages calculated for five samples with different methemoglobin concentrations also agreed well with the preset values. Finally, we demonstrated the ability of PAM to detect methemoglobin in vivo in a mouse ear. Our results show that PAM can quantitatively image methemoglobin distribution in vivo.
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Affiliation(s)
- Min Tang
- Washington University in St. Louis, Department of Biomedical Engineering, Optical Imaging Laboratory, One Brookings Drive, St. Louis, Missouri 63130, United States
| | - Yong Zhou
- Washington University in St. Louis, Department of Biomedical Engineering, Optical Imaging Laboratory, One Brookings Drive, St. Louis, Missouri 63130, United States
| | - Ruiying Zhang
- Washington University in St. Louis, Department of Biomedical Engineering, Optical Imaging Laboratory, One Brookings Drive, St. Louis, Missouri 63130, United States
| | - Lihong V. Wang
- Washington University in St. Louis, Department of Biomedical Engineering, Optical Imaging Laboratory, One Brookings Drive, St. Louis, Missouri 63130, United States
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17
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Chan A, Jiang J, Fridman A, Guo LT, Shelton GD, Liu MT, Green C, Haushalter KJ, Patel HH, Lee J, Yoon D, Burney T, Mukai D, Mahon SB, Brenner M, Pilz RB, Boss GR. Nitrocobinamide, a new cyanide antidote that can be administered by intramuscular injection. J Med Chem 2015; 58:1750-9. [PMID: 25650735 DOI: 10.1021/jm501565k] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Currently available cyanide antidotes must be given by intravenous injection over 5-10 min, making them ill-suited for treating many people in the field, as could occur in a major fire, an industrial accident, or a terrorist attack. These scenarios call for a drug that can be given quickly, e.g., by intramuscular injection. We have shown that aquohydroxocobinamide is a potent cyanide antidote in animal models of cyanide poisoning, but it is unstable in solution and poorly absorbed after intramuscular injection. Here we show that adding sodium nitrite to cobinamide yields a stable derivative (referred to as nitrocobinamide) that rescues cyanide-poisoned mice and rabbits when given by intramuscular injection. We also show that the efficacy of nitrocobinamide is markedly enhanced by coadministering sodium thiosulfate (reducing the total injected volume), and we calculate that ∼1.4 mL each of nitrocobinamide and sodium thiosulfate should rescue a human from a lethal cyanide exposure.
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Affiliation(s)
- Adriano Chan
- Departments of †Medicine, ‡Pathology, §Chemistry and Biochemistry, and ∥Anesthesiology, University of California-San Diego , La Jolla, California 92093-0652, United States
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18
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Zhu MF, Ye XP, Huang YY, Guo ZY, Zhuang ZF, Liu SH. Detection of methemoglobin in whole blood based on confocal micro-Raman spectroscopy and multivariate statistical techniques. SCANNING 2014; 36:471-478. [PMID: 24729434 DOI: 10.1002/sca.21143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/04/2014] [Indexed: 06/03/2023]
Abstract
Raman spectroscopy has been shown to have the potential for revealing oxygenated and spin ability of hemoglobin. In this study, confocal micro-Raman spectroscopy is developed to monitor the effect of sodium nitrite on oxyhemoglobin (HbO2 ) in whole blood. We observe that the band at 1,638 cm(-1) which is sensitive to the oxidation state decreases dramatically, while the 1,586 cm(-1) (low-spin state band) reduces both in methemoglobin (MetHb) and poisoning blood. Our results show that adding in sodium nitrite lead to the transition from HbO2 (Fe(2+) ) to MetHb (Fe(3+) ) in whole blood, and the iron atom converts from the low spin state to the high spin state with a delocalization from porphyrin plane. Moreover, multivariate statistical techniques, including principal components analysis (PCA) and linear discriminant analysis (LDA) are employed to develop effective diagnostic algorithms for classification of spectra between pure blood and poisoning blood. The diagnostic algorithms based on PCA-LDA yield a diagnostic sensitivity of 100% and specificity of 100% for separating poisoning blood from normal blood. Receiver operating characteristic (ROC) curve further confirms the effectiveness of the diagnostic algorithm based on PCA-LDA technique. The results from this study demonstrate that Raman spectroscopy combined with PCA-LDA algorithms has tremendous potential for the non-invasive detection of nitrite poisoning blood.
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Affiliation(s)
- M F Zhu
- MOE Key Laboratory of Laser Life Science & Laboratory of Photonic Chinese Medicine, College of Biophotonics, South China Normal University, Guangzhou, P.R. China
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19
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Spliethoff JW, Tanis E, Evers DJ, Hendriks BHW, Prevoo W, Ruers TJM. Monitoring of tumor radio frequency ablation using derivative spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:97004. [PMID: 25239499 DOI: 10.1117/1.jbo.19.9.097004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 08/22/2014] [Indexed: 05/15/2023]
Abstract
Despite the widespread use of radio frequency (RF) ablation, an effective way to assess thermal tissue damage during and after the procedure is still lacking. We present a method for monitoring RF ablation efficacy based on thermally induced methemoglobin as a marker for full tissue ablation. Diffuse reflectance (DR) spectra were measured from human blood samples during gradual heating of the samples from 37 to 60, 70, and 85°C. Additionally, reflectance spectra were recorded real-time during RF ablation of human liver tissue ex vivo and in vivo. Specific spectral characteristics of methemoglobin were extracted from the spectral slopes using a custom optical ablation ratio. Thermal coagulation of blood caused significant changes in the spectral slopes, which is thought to be caused by the formation of methemoglobin. The time course of these changes was clearly dependent on the heating temperature. RF ablation of liver tissue essentially led to similar spectral alterations. In vivo DR measurements confirmed that the method could be used to assess the degree of thermal damage during RF ablation and long after the tissue cooled.
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Affiliation(s)
- Jarich W Spliethoff
- The Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
| | - Erik Tanis
- The Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
| | - Daniel J Evers
- The Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
| | - Benno H W Hendriks
- Minimally Invasive Healthcare, Philips Research, High Tech Campus 34, Eindhoven 5656 AE, The Netherlands
| | - Warner Prevoo
- The Netherlands Cancer Institute, Department of Radiology, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
| | - Theo J M Ruers
- The Netherlands Cancer Institute, Department of Surgery, Plesmanlaan 121, Amsterdam 1066CX, The NetherlandsdUniversity of Twente, MIRA Institute, Building Zuidhorst P.O. Box 217, Enschede 7500 AE, The Netherlands
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20
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Lee J, Kim JG, Mahon SB, Mukai D, Yoon D, Boss GR, Patterson SE, Rockwood G, Isom G, Brenner M. Noninvasive optical cytochrome c oxidase redox state measurements using diffuse optical spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:055001. [PMID: 24788369 PMCID: PMC4006145 DOI: 10.1117/1.jbo.19.5.055001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 03/01/2014] [Accepted: 03/07/2014] [Indexed: 05/28/2023]
Abstract
A major need exists for methods to assess organ oxidative metabolic states in vivo. By contrasting the responses to cyanide (CN) poisoning versus hemorrhage in animal models, we demonstrate that diffuse optical spectroscopy (DOS) can detect cytochrome c oxidase (CcO) redox states. Intermittent decreases in inspired O2 from 100% to 21% were applied before, during, and after CN poisoning, hemorrhage, and resuscitation in rabbits. Continuous DOS measurements of total hemoglobin, oxyhemoglobin, deoxyhemoglobin, and oxidized and reduced CcO from muscle were obtained. Rabbit hemorrhage was accomplished with stepwise removal of blood, followed by blood resuscitation. CN treated rabbits received 0.166 mg/min NaCN infusion. During hemorrhage, CcO redox state became reduced concurrently with decreases in oxyhemoglobin, resulting from reduced tissue oxygen delivery and hypoxia. In contrast, during CN infusion, CcO redox state decreased while oxyhemoglobin concentration increased due to CN binding and reduction of CcO with resultant inhibition of the electron transport chain. Spectral absorption similarities between hemoglobin and CcO make noninvasive spectroscopic distinction of CcO redox states difficult. By contrasting physiological perturbations of CN poisoning versus hemorrhage, we demonstrate that DOS measured CcO redox state changes are decoupled from hemoglobin concentration measurement changes.
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Affiliation(s)
- Jangwoen Lee
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
| | - Jae G. Kim
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
- Gwangju Institute of Science and Technology, School of Information and Communications, Department of Medical System Engineering, 123 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712, Republic of Korea
| | - Sari B. Mahon
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
| | - David Mukai
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
| | - David Yoon
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
| | - Gerry R. Boss
- University of California San Diego, Department of Medicine, 9500 Gilman Dr., La Jolla, California 92093
| | - Steven E. Patterson
- University of Minnesota, Department of Pharmacology, 516 Delaware Street SE, Minneapolis, Minnesota 55455
| | - Gary Rockwood
- US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland 21010
| | - Gary Isom
- Purdue University, Department of Medicinal Chemistry and Molecular Pharmacology, 575 Stadium Mall Drive, West Lafayette, Indiana 47907
| | - Matthew Brenner
- University of California Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612
- University of California Irvine Medical Center, Department of Pulmonary and Critical Care, 333 West City Boulevard, Suite 400, Orange, California 92868
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21
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Affiliation(s)
- Irene Shu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston TX
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22
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Takeuchi S, Kawauchi S, Sato S, Nawashiro H, Nagatani K, Kobayashi H, Otani N, Osada H, Wada K, Shima K. Evaluation of the stage of hemorrhage using optical diffuse reflectance spectroscopy: an in vivo study. ACTA NEUROCHIRURGICA. SUPPLEMENT 2013; 118:45-48. [PMID: 23564102 DOI: 10.1007/978-3-7091-1434-6_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Intracerebral hemorrhage (ICH) is a common and often fatal subtype of stroke. Estimation of the stage of hemorrhage allows clinicians to know when the hemorrhage occurred, even in unconscious patients, enabling decisions to be made about the optimal management and treatment strategy. After ICH, oxidative denaturation of the hemoglobin progresses, and deoxyhemoglobin is gradually converted to methemoglobin. MRI has been used to estimate the stage of hemorrhage by evaluating the status of hemoglobin. However, there is currently no bedside device that can be used for the measurement of hemoglobin derivatives in patients with hematomas. The aim of the present study was to investigate the validity of using optical diffuse reflectance spectroscopy (ODRS) for bedside evaluation of the stage of hemorrhage. An ICH model was generated in adult Sprague-Dawley male rats by stereotactically injecting 50 μl of autologous blood into the right caudate nucleus. To analyze the hemoglobin derivatives in the hematomas, ODRS measurement was performed for the rats in vivo. In all rats, we found increased absorption at around 630 nm, which indicated the formation of methemoglobin. In conclusion, the results of the present study suggest that ODRS allows clinicians to more easily evaluate the stage of hemorrhage at the patient's bedside.
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Affiliation(s)
- Satoru Takeuchi
- Department of Neurosurgery, National Defense Medical College, Saitama, Japan.
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23
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Nikitin SM, Khokhlova TD, Pelivanov IM. Temperature dependence of the optoacoustic transformation efficiency in ex vivo tissues for application in monitoring thermal therapies. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:061214. [PMID: 22734744 DOI: 10.1117/1.jbo.17.6.061214] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The calibration dependencies of the optoacoustic (OA) transformation efficiency on tissue temperature are obtained for the application in OA temperature monitoring during thermal therapies. Accurate measurement of the OA signal amplitude versus temperature is performed in different ex vivo tissues in the temperature range 25°C to 80°C. The investigated tissues were selected to represent different structural components: chicken breast (skeletal muscle), porcine lard (fatty tissue), and porcine liver (richly perfused tissue). Backward mode of the OA signal detection and a narrow probe laser beam were used in the experiments to avoid the influence of changes in light scattering with tissue coagulation on the OA signal amplitude. Measurements were performed in heating and cooling regimes. Characteristic behavior of the OA signal amplitude temperature dependences in different temperature ranges were described in terms of changes in different structural components of the tissue samples. The accuracy of temperature reconstruction from the obtained calibration dependencies for the investigated tissue types is evaluated.
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Affiliation(s)
- Sergey M Nikitin
- International Laser Center, M.V. Lomonosov Moscow State University, Moscow, Russia
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24
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Rubin IK, Farinelli WA, Doukas A, Anderson RR. Optimal wavelengths for vein-selective photothermolysis. Lasers Surg Med 2012; 44:152-7. [DOI: 10.1002/lsm.21161] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2011] [Indexed: 11/07/2022]
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25
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Sarioğlan Ş. A Comparison Study on Conductive Poly(3,4-ethylenedioxythiophene) Nanocomposites Synthesized with Clay Type Montmorillonite and Organophilic Montmorillonite. PARTICULATE SCIENCE AND TECHNOLOGY 2012. [DOI: 10.1080/02726351.2010.544378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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26
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Kuleš J, Mayer I, Rafaj RB, Matijatko V, Kiš I, Kučer N, Brkljačić M, Mrljak V. Co-oximetry in clinically healthy dogs and effects of time of post sampling on measurements. J Small Anim Pract 2011; 52:628-31. [DOI: 10.1111/j.1748-5827.2011.01129.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Lindbergh T, Häggblad E, Ahn H, Göran Salerud E, Larsson M, Strömberg T. Improved model for myocardial diffuse reflectance spectra by including mitochondrial cytochrome aa3, methemoglobin, and inhomogenously distributed RBC. JOURNAL OF BIOPHOTONICS 2011; 4:268-76. [PMID: 20661995 DOI: 10.1002/jbio.201000048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The aim of this study was to compare a previously used light transport model (I) comprising the chromophores hemo- and myoglobin, fat, and water, with two extended models, where the chromophores of cytochrome aa3, methemo- and metmyoglobin are added (model II), and in addition, accounting for an inhomogenous hemoglobin distribution (model III). The models were evaluated using calibrated diffuse reflectance spectroscopy measurements on the human myocardium. Model II proved a significantly better spectral fitting, especially in the wavelength ranges corresponding to prominent absorption characteristics for the added chromophores. Model III was significantly better than model II and displayed a markedly higher tissue fraction and saturation of hemo- and myoglobin. The estimated tissue chromophore fractions, saturation and oxidation levels, were in agreement with other studies, demonstrating the potential of diffuse reflectance spectroscopy measurements for evaluating open heart surgery. However, the choice of chromophores and vessel packaging effects in the light transport model has a major effect on the results.
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Affiliation(s)
- Tobias Lindbergh
- Department of Biomedical Engineering, Linköping Biomedical Optics Group, Linköping University, 58185 Linköping, Sweden.
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28
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Lee J, Keuter KA, Kim J, Tran A, Uppal A, Mukai D, Mahon SB, Cancio LC, Batchinsky A, Tromberg BJ, Brenner M. Noninvasive in vivo monitoring of cyanide toxicity and treatment using diffuse optical spectroscopy in a rabbit model. Mil Med 2010; 174:615-21. [PMID: 19585775 DOI: 10.7205/milmed-d-02-7408] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Currently, no reliable noninvasive methods exist for monitoring the severity of in vivo cyanide (CN) toxicity, treatment, and resulting physiological changes. We developed a broadband diffuse optical spectroscopy (DOS) system to measure bulk tissue absorption and scattering. DOS was used to optically monitor CN toxicity and treatment with sodium nitrite (NaNO2). To perform experiments, the DOS probe was placed on the hind leg of rabbits. A sodium CN solution was infused intravenously. DOS and concurrent physiologic measurements were obtained. After completion of CN infusion, NaNO2 was infused to induce methemoglobinemia (MetHb). During infusion of CN, blood gas measurements showed an increase in venous partial pressure of oxygen (pO2), and following reversal, venous pO2 values decreased. DOS measurements demonstrated corresponding changes in hemoglobin oxygenation states and redox states of cytochrome-c oxidase (CcO) during CN infusion and NaNO2 treatment. Therefore, DOS enables detection and monitoring of CN toxicity and treatment with NaNO2.
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Affiliation(s)
- Jangwoen Lee
- Laser Microbeam and Medical Program, Beckman Laser Institute, University of California, 1002 Health Sciences Road East, Irvine, CA 92612-1475, USA
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Blanco E, Bey EA, Khemtong C, Yang SG, Setti-Guthi J, Chen H, Kessinger CW, Carnevale KA, Bornmann WG, Boothman DA, Gao J. Beta-lapachone micellar nanotherapeutics for non-small cell lung cancer therapy. Cancer Res 2010; 70:3896-904. [PMID: 20460521 DOI: 10.1158/0008-5472.can-09-3995] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Lung cancer is the leading cause of cancer-related deaths with current chemotherapies lacking adequate specificity and efficacy. Beta-lapachone (beta-lap) is a novel anticancer drug that is bioactivated by NAD(P)H:quinone oxidoreductase 1, an enzyme found specifically overexpressed in non-small cell lung cancer (NSCLC). Herein, we report a nanotherapeutic strategy that targets NSCLC tumors in two ways: (a) pharmacodynamically through the use of a bioactivatable agent, beta-lap, and (b) pharmacokinetically by using a biocompatible nanocarrier, polymeric micelles, to achieve drug stability, bioavailability, and targeted delivery. Beta-lap micelles produced by a film sonication technique were small ( approximately 30 nm), displayed core-shell architecture, and possessed favorable release kinetics. Pharmacokinetic analyses in mice bearing subcutaneous A549 lung tumors showed prolonged blood circulation (t(1/2), approximately 28 h) and increased accumulation in tumors. Antitumor efficacy analyses in mice bearing subcutaneous A549 lung tumors and orthotopic Lewis lung carcinoma models showed significant tumor growth delay and increased survival. In summary, we have established a clinically viable beta-lap nanomedicine platform with enhanced safety, pharmacokinetics, and antitumor efficacy for the specific treatment of NSCLC tumors.
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Affiliation(s)
- Elvin Blanco
- Departments of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center at Dallas, Texas 75390-8807, USA
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Lindbergh T, Larsson M, Szabó Z, Casimir-Ahn H, Strömberg T. Intramyocardial oxygen transport by quantitative diffuse reflectance spectroscopy in calves. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:027009. [PMID: 20459283 DOI: 10.1117/1.3374050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Intramyocardial oxygen transport was assessed during open-chest surgery in calves by diffuse reflectance spectroscopy using a small intramuscular fiber-optic probe. The sum of hemo- and myoglobin tissue fraction and oxygen saturation, the tissue fraction and oxidation of cytochrome aa3, and the tissue fraction of methemoglobin were estimated using a calibrated empirical light transport model. Increasing the oxygen content in the inhaled gas, 21%-50%-100%, in five calves (group A) gave an increasing oxygen saturation of 19+/-4%, 24+/-5%, and 28+/-8% (p<0.001, ANOVA repeated measures design) and mean tissue fractions of 1.6% (cytochrome aa3) and 1.1% (hemo- and myoglobin). Cardiac arrest in two calves gave an oxygen saturation lower than 5%. In two calves (group B), a left ventricular assistive device (LVAD pump) was implanted. Oxygen saturation in group B animals increased with LVAD pump speed (p<0.001, ANOVA) and with oxygen content in inhaled gas (p<0.001, ANOVA). The cytochrome aa3 oxidation level was above 96% in both group A and group B calves, including the two cases involving cardiac arrest. In conclusion, the estimated tissue fractions and oxygenation/oxidation levels of the myocardial chromophores during respiratory and hemodynamic provocations were in agreement with previously presented results, demonstrating the potential of the method.
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Affiliation(s)
- Tobias Lindbergh
- Linkoping University, Department of Biomedical Engineering, Division of Biomedical Instrumentation, Linkoping, 58185 Sweden.
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Intramuscular cobinamide sulfite in a rabbit model of sublethal cyanide toxicity. Ann Emerg Med 2010; 55:352-63. [PMID: 20045579 DOI: 10.1016/j.annemergmed.2009.12.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 11/19/2009] [Accepted: 12/02/2009] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVE Exposure to cyanide in fires and industrial exposures and intentional cyanide poisoning by terrorists leading to mass casualties is an ongoing threat. Current treatments for cyanide poisoning must be administered intravenously, and no rapid treatment methods are available for mass casualty cyanide exposures. Cobinamide is a cobalamin (vitamin B(12)) analog with an extraordinarily high affinity for cyanide that is more water-soluble than cobalamin. We investigate the use of intramuscular cobinamide sulfite to reverse cyanide toxicity-induced physiologic changes in a sublethal cyanide exposure animal model and determine the ability of an intramuscular cobinamide sulfite injection to rapidly reverse the physiologic effects of cyanide toxicity. METHODS New Zealand white rabbits were given 10 mg sodium cyanide intravenously over 60 minutes. Quantitative diffuse optical spectroscopy and continuous-wave near-infrared spectroscopy monitoring of tissue oxyhemoglobin and deoxyhemoglobin concentrations were performed concurrently with blood cyanide level measurements and cobinamide levels. Immediately after completion of the cyanide infusion, the rabbits were injected intramuscularly with cobinamide sulfite (n=6) or inactive vehicle (controls, n=5). RESULTS Intramuscular administration led to rapid mobilization of cobinamide and was extremely effective at reversing the physiologic effects of cyanide on oxyhemoglobin and within deoxyhemoglobin extraction. Recovery time to 63% of their baseline values in the central nervous system occurred within a mean of 1,032 minutes in the control group and 9 minutes in the cobinamide group, with a difference of 1,023 minutes (95% confidence interval 116 to 1,874 minutes). In muscle tissue, recovery times were 76 and 24 minutes, with a difference of 52 minutes (95% confidence interval 7 to 98 minutes). RBC cyanide levels returned toward normal significantly faster in cobinamide sulfite-treated animals than in control animals. CONCLUSION Intramuscular cobinamide sulfite rapidly and effectively reverses the physiologic effects of cyanide poisoning, suggesting that a compact cyanide antidote kit can be developed for mass casualty cyanide exposures.
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Brenner M, Mahon SB, Lee J, Kim J, Mukai D, Goodman S, Kreuter KA, Ahdout R, Mohammad O, Sharma VS, Blackledge W, Boss GR. Comparison of cobinamide to hydroxocobalamin in reversing cyanide physiologic effects in rabbits using diffuse optical spectroscopy monitoring. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:017001. [PMID: 20210475 PMCID: PMC2816993 DOI: 10.1117/1.3290816] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Our purpose is to compare cobinamide to hydroxocobalamin in reversing cyanide (CN)-induced physiologic effects in an animal model using diffuse optical spectroscopy (DOS). Cyanide poisoning is a major threat worldwide. Cobinamide is a novel molecule that can bind two molecules of cyanide, has a much higher binding affinity than hydroxocobalamin, and is more water soluble. We investigated the ability of equimolar doses of cobinamide and hydroxocobalamin to reverse the effects of cyanide exposure in an animal model monitored continuously by DOS. Cyanide toxicity was induced in 16 New Zealand white rabbits by intravenous infusion. Animals were divided into three groups: controls (n=5) received saline following cyanide, hydroxocobalamin (N=6) following cyanide, and cobinamide (N=5) following cyanide. Cobinamide caused significantly faster and more complete recovery of oxy- and deoxyhemoglobin concentrations in cyanide-exposed animals than hydroxocobalamin- or saline-treated animals, with a recovery time constant of 13.8+/-7.1 min compared to 75.4+/-25.1 and 76.4+/-42.7 min, for hydroxocobalamin- and saline-treated animals, respectively (p<0.0001). This study indicates that cobinamide more rapidly and completely reverses the physiologic effects of cyanide than equimolar doses of cobalamin at the dose used in this study, and CN effects and response can be followed noninvasively using DOS.
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Affiliation(s)
- Matthew Brenner
- University of California, Beckman Laser Institute, Irvine, California 92612-1475, USA.
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Lee J, Kim JG, Mahon S, Tromberg BJ, Mukai D, Kreuter K, Saltzman D, Patino R, Goldberg R, Brenner M. Broadband diffuse optical spectroscopy assessment of hemorrhage- and hemoglobin-based blood substitute resuscitation. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:044027. [PMID: 19725738 PMCID: PMC2868523 DOI: 10.1117/1.3200932] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hemoglobin-based oxygen carriers (HBOCs) are solutions of cell-free hemoglobin (Hb) that have been developed for replacement or augmentation of blood transfusion. It is important to monitor in vivo tissue hemoglobin content, total tissue hemoglobin [THb], oxy- and deoxy-hemoglobin concentrations ([OHb], [RHb]), and tissue oxygen saturation (S(t)O(2)=[OHb][THb]x100%) to evaluate effectiveness of HBOC transfusion. We designed and constructed a broadband diffuse optical spectroscopy (DOS) prototype system to measure bulk tissue absorption and scattering spectra between 650 and 1000 nm capable of accurately determining these tissue hemoglobin component concentrations in vivo. Our purpose was to assess the feasibility of using DOS to optically monitor tissue [OHb], [RHb], S(t)O(2), and total tissue hemoglobin concentration ([THb]=[OHb]+[RHb]) during HBOC infusion using a rabbit hypovolemic shock model. The DOS prototype probe was placed on the shaved inner thigh muscle of the hind leg to assess concentrations of [OHb], [RHb], [THb], as well as S(t)O(2). Hemorrhagic shock was induced in intubated New Zealand white rabbits (N=6) by withdrawing blood via a femoral arterial line to 20% blood loss (10-15 cckg). Hemoglobin glutamer-200 (Hb-200) 1:1 volume resuscitation was administered following the hemorrhage. These values were compared against traditional invasive measurements, serum hemoglobin concentration (sHGB), systemic blood pressure, heart rate, and blood gases. DOS revealed increases of [THb], [OHb], and tissue hemoglobin oxygen saturation after Hb-200 infusion, while blood total hemoglobin values continued did not increase; we speculate, due to hyperosmolality induced hemodilution. DOS enables noninvasive in vivo monitoring of tissue hemoglobin and oxygenation parameters during shock and volume expansion with HBOC and potentially enables the assessment of efficacy of resuscitation efforts using artificial blood substitutes.
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Affiliation(s)
- Jangwoen Lee
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612, USA.
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Lee J, Kim JG, Mahon S, Tromberg BJ, Ryan KL, Convertino VA, Rickards CA, Osann K, Brenner M. Tissue hemoglobin monitoring of progressive central hypovolemia in humans using broadband diffuse optical spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2008; 13:064027. [PMID: 19123673 PMCID: PMC4079508 DOI: 10.1117/1.3041712] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We demonstrate noninvasive near-infrared diffuse optical spectroscopy (DOS) measurements of tissue hemoglobin contents that can track progressive reductions in central blood volume in human volunteers. Measurements of mean arterial blood pressure (MAP), heart rate (HR), stroke volume (SV), and cardiac output (Q) are obtained in ten healthy human subjects during baseline supine rest and exposure to progressive reductions of central blood volume produced by application of lower body negative pressure (LBNP). Simultaneous quantitative noninvasive measurements of tissue oxyhemoglobin (OHb), deoxyhemoglobin (RHb), total hemoglobin concentration (THb), and tissue hemoglobin oxygen saturation (S(t)O(2)) are performed throughout LBNP application using broadband DOS. As progressively increasing amounts of LBNP are applied, HR increases, and MAP, SV, and Q decrease (p<0.001). OHb, S(t)O(2), and THb decrease (p<0.001) in correlation with progressive increases in LBNP, while tissue RHb remained relatively constant (p=0.378). The average fractional changes from baseline values in DOS OHb (fOHb) correlate closely with independently measured changes in SV (r(2)=0.95) and Q (r(2)=0.98) during LBNP. Quantitative noninvasive broadband DOS measurements of tissue hemoglobin parameters of peripheral perfusion are capable of detecting progressive reductions in central blood volume, and appear to be sensitive markers of early hypoperfusion associated with hemorrhage as simulated by LBNP.
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Affiliation(s)
- Jangwoen Lee
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612, USA.
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Lee J, Armstrong J, Kreuter K, Tromberg BJ, Brenner M. Non-invasive in vivo diffuse optical spectroscopy monitoring of cyanide poisoning in a rabbit model. Physiol Meas 2007; 28:1057-66. [PMID: 17827653 DOI: 10.1088/0967-3334/28/9/007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study is to establish a cyanide toxicity animal model and to investigate the ability of broadband diffuse optical spectroscopy (DOS) to non-invasively monitor physiological changes that occur during the development of cyanide toxicity in a rabbit model. Broadband DOS combines multi-frequency frequency-domain photon migration (FDPM) with time-independent near-infrared spectroscopy (NIRS) to quantitatively measure bulk tissue absorption and scattering spectra between 600 nm and 1000 nm. Serum cyanide concentration and arterial and venous blood gas analysis at pre- and post-cyanide infusion were presented. To investigate the ability of DOS to non-invasively monitor physiologic changes occurring during development of CN toxicity, tissue concentrations of deoxyhemoglobin [Hb-R], oxyhemoglobin [Hb-O2], cytochrome c oxidase oxidized state [CcO_Ox] and reduced state [CcO_Re] were determined from absorption spectra acquired in 'real time' during cyanide infusions (NaCN 6 mg/60 ml normal saline) in six pathogen-free New Zealand white rabbits. During cyanide infusion, in vivo tissue oxygen saturation increased ( approximately 10%). In addition, broadband DOS was able to detect a concurrent increase in [CcO_Re] and decrease in [CcO_Ox]. Changes in tissue scattering properties in all six animals were detected during these events, confirming the need for DOS-based methods over traditional NIR spectroscopy to obtain accurate results.
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Affiliation(s)
- Jangwoen Lee
- Laser Microbeam and Medical Program, Beckman Laser Institute, University of California, Irvine, CA 92612-1475, USA.
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