1
|
Gao H, Ge XZ, Liu JW, Wang ST, Xu J, Fang WJ. Effect of Annealing on Visible-Bubble Formation and Stability Profiles of Freeze-Dried High Concentration Omalizumab Formulations. Mol Pharm 2024; 21:1691-1704. [PMID: 38430187 DOI: 10.1021/acs.molpharmaceut.3c00991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
In the clinical application of freeze-dried highly concentrated omalizumab formulations, extensive visible bubbles (VBs) can be generated and remain for a long period of time in the reconstitution process, which greatly reduces the clinical use efficiency. It is necessary to understand the forming and breaking mechanism of VBs in the reconstitution process, which is a key factor for efficient and safe administration of biopharmaceutical injection. The effects of different thermal treatments on the volume of VBs and stability of omalizumab, mAb-1, and mAb-2 were investigated. The internal microvoids of the cake were characterized by scanning electron microscopy and mercury intrusion porosimetry. Electron paramagnetic resonance was applied to obtain the molecular mobility of the protein during annealing. A large number of VBs were generated in the reconstitution process of unannealed omalizumab and remained for a long period of time. When annealing steps were added, the volume of VBs was dramatically reduced. When annealed at an aggressive temperature (i.e., -6 °C), although the volume of VBs decreased, the aggregation and acidic species increased significantly. Thus, our observations highlight the importance of setting an additional annealing step with a suitable temperature, which contributes to reducing the VBs while maintaining the stability of the high concentration freeze-dried protein formulation.
Collapse
Affiliation(s)
- Han Gao
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China
| | - Xin-Zhe Ge
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China
| | - Jia-Wei Liu
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China
| | - Si-Tao Wang
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Jie Xu
- Zhejiang Bioray Biopharmaceutical Co., Taizhou 317000, China
| | - Wei-Jie Fang
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China
- Innovation Center of Translational Pharmacy, Jinhua Institute of Zhejiang University, Jinhua 321000, China
- Taizhou Institute of Zhejiang University, Taizhou 317000, China
- Jinhua Hongyao Biotech Co., Ltd., Jinhua 321000, China
| |
Collapse
|
2
|
Ward RE, Martinez-Correa S, Tierradentro-García LO, Hwang M, Sehgal CM. Sonothrombolysis: State-of-the-Art and Potential Applications in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 11:57. [PMID: 38255371 PMCID: PMC10814591 DOI: 10.3390/children11010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
In recent years, advances in ultrasound therapeutics have been implemented into treatment algorithms for the adult population; however, the use of therapeutic ultrasound in the pediatric population still needs to be further elucidated. In order to better characterize the utilization and practicality of sonothrombolysis in the juvenile population, the authors conducted a literature review of current pediatric research in therapeutic ultrasound. The PubMed database was used to search for all clinical and preclinical studies detailing the use and applications of sonothrombolysis, with a focus on the pediatric population. As illustrated by various review articles, case studies, and original research, sonothrombolysis demonstrates efficacy and safety in clot dissolution in vitro and in animal studies, particularly when combined with microbubbles, with potential applications in conditions such as deep venous thrombosis, peripheral vascular disease, ischemic stroke, myocardial infarction, and pulmonary embolism. Although there is limited literature on the use of therapeutic ultrasound in children, mainly due to the lower prevalence of thrombotic events, sonothrombolysis shows potential as a noninvasive thrombolytic treatment. However, more pediatric sonothrombolysis research needs to be conducted to quantify the safety and ethical considerations specific to this vulnerable population.
Collapse
Affiliation(s)
- Rebecca E. Ward
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (R.E.W.); (S.M.-C.); (L.O.T.-G.); (M.H.)
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Santiago Martinez-Correa
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (R.E.W.); (S.M.-C.); (L.O.T.-G.); (M.H.)
| | - Luis Octavio Tierradentro-García
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (R.E.W.); (S.M.-C.); (L.O.T.-G.); (M.H.)
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Misun Hwang
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (R.E.W.); (S.M.-C.); (L.O.T.-G.); (M.H.)
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Chandra M. Sehgal
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
3
|
Fumadó Navarro J, Lomora M. Mechanoresponsive Drug Delivery Systems for Vascular Diseases. Macromol Biosci 2023; 23:e2200466. [PMID: 36670512 DOI: 10.1002/mabi.202200466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/16/2023] [Indexed: 01/22/2023]
Abstract
Mechanoresponsive drug delivery systems (DDS) have emerged as promising candidates to improve the current effectiveness and lower the side effects typically associated with direct drug administration in the context of vascular diseases. Despite tremendous research efforts to date, designing drug delivery systems able to respond to mechanical stimuli to potentially treat these diseases is still in its infancy. By understanding relevant biological forces emerging in healthy and pathological vascular endothelium, it is believed that better-informed design strategies can be deduced for the fabrication of simple-to-complex macromolecular assemblies capable of sensing mechanical forces. These responsive systems are discussed through insights into essential parameter design (composition, size, shape, and aggregation state) , as well as their functionalization with (macro)molecules that are intrinsically mechanoresponsive (e.g., mechanosensitive ion channels and mechanophores). Mechanical forces, including the pathological shear stress and exogenous stimuli (e.g., ultrasound, magnetic fields), used for the activation of mechanoresponsive DDS are also introduced, followed by in vitro and in vivo experimental models used to investigate and validate such novel therapies. Overall, this review aims to propose a fresh perspective through identified challenges and proposed solutions that could be of benefit for the further development of this exciting field.
Collapse
Affiliation(s)
- Josep Fumadó Navarro
- School of Biological and Chemical Sciences, University of Galway, University Road, Galway, H91 TK33, Ireland
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Upper Newcastle, Galway, H91 W2TY, Ireland
| | - Mihai Lomora
- School of Biological and Chemical Sciences, University of Galway, University Road, Galway, H91 TK33, Ireland
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Upper Newcastle, Galway, H91 W2TY, Ireland
| |
Collapse
|
4
|
Adzerikho IE, Kulak AI, Rachok SM, Minchenya VT. Kinetics of fibrin clots destruction under ultrasonic cavitation. DOKLADY OF THE NATIONAL ACADEMY OF SCIENCES OF BELARUS 2023. [DOI: 10.29235/1561-8323-2022-66-6-587-594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We studied the kinetic features of fibrin clot destruction in vitro under the action of ultrasonic cavitation generated by low-frequency (36 kHz) ultrasound (US) with the intensity I0 of 4.4–51.2 W/cm2, using a flexible waveguide concentrator. It was established that the rate of US destruction of clots immersed in saline at the initial stage of the process is proportional to I0 in the range of 12–51 W/cm2, corresponds to first-order kinetics, and is determined by the erosive processes without the formation of D-dimers and other fibrinolysis products at a minimum contribution of sonochemical reactions. The clot destruction rate is maximum at the initial time moment and decreases with increasing the US exposure duration (by 35 % in 1 min and by 72 % by the end of the second minute at I0 = 51.2 W/cm2). It was shown that in order to increase the completeness of clot destruction at a minimum administered US dose, it is advisable to minimize the US exposure time when using the highest values of the US intensity limited by the level of safe cavitation exposure to the vascular wall, hemostasis, and blood cells.
Collapse
Affiliation(s)
| | - A. I. Kulak
- Institute of General and Inorganic Chemistry of the National Academy of Sciences of Belarus
| | - S. M. Rachok
- Belarusian Medical Academy of Postgraduate Education
| | - V. T. Minchenya
- Belarus Scientific and Technological Park of the BNTU “Polytechnic”
| |
Collapse
|
5
|
Wang Z, Pan Y, Huang H, Zhang Y, Li Y, Zou C, Huang G, Chen Y, Li Y, Li J, Chen H. Enhanced thrombolysis by endovascular low-frequency ultrasound with bifunctional microbubbles in venous thrombosis: in vitro and in vivo study. Front Bioeng Biotechnol 2022; 10:965769. [PMID: 35942007 PMCID: PMC9356075 DOI: 10.3389/fbioe.2022.965769] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
There is a need to improve the efficacy and safety of endovascular techniques in venous thrombotic diseases, and microbubble enhanced sonothrombolysis is a promising approach. However, whether endovascular low-frequency ultrasound (LFUS) can be utilized in microbubble enhanced sonothrombolysis is unclear. Here, we present a catheter-based thrombolytic system that combines unfocused low-frequency low-intensity ultrasound with novel fibrin-targeted drug-loaded bifunctional microbubbles. We develop an in vitro flow model and an in vivo rabbit inferior vena cava (IVC) thrombosis model to evaluate the safety and efficacy of the thrombolytic system. The results indicate that microbubble enhanced sonothrombolysis with endovascular LFUS treatment for 30 min is equally effective compared to pure pharmacologic treatment. Furthermore, the thrombolytic efficacy of this system is safely and substantially improved by the introduction of a fibrin-targeted drug-loaded bifunctional microbubble with a reduction of the fibrinolytic agent dosage by 60%. The microbubble enhanced endovascular LFUS sonothrombolysis system with excellent thrombolytic efficacy may serve as a new therapeutic approach for venous thrombotic diseases.
Collapse
Affiliation(s)
- Zhaojian Wang
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunfan Pan
- State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Huaigu Huang
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Zhang
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yan Li
- State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Chenghong Zou
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, China
| | - Guanghua Huang
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuexin Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yuexin Chen, ; Yongjian Li,
| | - Yongjian Li
- State Key Laboratory of Tribology, Tsinghua University, Beijing, China
- *Correspondence: Yuexin Chen, ; Yongjian Li,
| | - Jiang Li
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, China
| | - Haosheng Chen
- State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| |
Collapse
|
6
|
Adzerikho I, Kulak A, Rachok S, Minchenya V. Dependence of the Rate and Completeness of Fibrin Clot Destruction on the Acoustic Dose and Ultrasound Intensity. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:846-855. [PMID: 35177275 DOI: 10.1016/j.ultrasmedbio.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
The kinetics of fibrin clot destruction under catheter-delivered 32- to 45-kHz ultrasound (US) has been studied at 36°C-38°C in isotonic saline solution. A pseudo-first-order rate constant increased linearly from 0.06/min to 0.57/min with increasing US intensity I0 from 21.6 to 51.2 W/cm2. At I0 = 4.4 and 11.4 W/cm2, the degree of clot destruction did not exceed 11%-15% regardless of the time of US exposure. Starting from I0 = 21.6 W/cm2, the maximum achievable level of clot destruction increased linearly with US intensity, reaching 68% at I0 = 51.2 W/cm2 after 3 min of US exposure. Thus, US intensity is a key parameter determining the maximum achievable level of clot destruction. However, an increase in US intensity above 30 W/cm2 is limited by the intensified negative sonochemical effect on the enzymatic system of hemostasis caused by an increase in inertial cavitation. The best effect can be achieved with ultrasound of a sufficiently high intensity that ensures a large contribution of stable cavitation, generating microstreaming flows, and a minimum contribution of inertial cavitation, generating microjets and shock waves.
Collapse
Affiliation(s)
- Igor Adzerikho
- State Higher Educational Establishment "Belarusian Medical Academy of Postgraduate Education", Minsk, Belarus
| | - Anatoly Kulak
- Institute of General and Inorganic Chemistry, National Academy of Sciences of Belarus, Minsk, Belarus.
| | - Svetlana Rachok
- State Higher Educational Establishment "Belarusian Medical Academy of Postgraduate Education", Minsk, Belarus
| | | |
Collapse
|
7
|
Namen AV, Jandhyala S, Jordan T, Luke GP. Repeated Acoustic Vaporization of Perfluorohexane Nanodroplets for Contrast-Enhanced Ultrasound Imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:3497-3506. [PMID: 34191726 PMCID: PMC8667194 DOI: 10.1109/tuffc.2021.3093828] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Superheated perfluorocarbon nanodroplets are emerging ultrasound imaging contrast agents that boast biocompatible components, unique phase-change dynamics, and therapeutic loading capabilities. Upon exposure to a sufficiently high-intensity pulse of acoustic energy, the nanodroplet's perfluorocarbon core undergoes a liquid-to-gas phase change and becomes an echogenic microbubble, providing ultrasound contrast. The controllable activation leads to high-contrast images, while the small size of the nanodroplets promotes longer circulation times and better in vivo stability. One drawback, however, is that the nanodroplets can only be vaporized a single time, limiting their versatility. Recently, we and others have addressed this issue by using a perfluorohexane core, which has a boiling point above body temperature. Thus after vaporization, the microbubbles recondense back into their stable nanodroplet form. Previous work with perfluorohexane nanodroplets relied on optical activation via pulsed laser absorption of an encapsulated dye. This strategy limits the imaging depth and temporal resolution of the method. In this study, we overcome these limitations by demonstrating acoustic droplet vaporization with 1.1-MHz high-intensity focused ultrasound (HIFU). A short-duration, high-amplitude pulse of focused ultrasound provides a sufficiently strong peak negative pressure to initiate vaporization. A custom imaging sequence was developed to enable the synchronization of a HIFU transducer and a linear array imaging transducer. We show a visualization of repeated acoustic activation of perfluorohexane nanodroplets in polyacrylamide tissue-mimicking phantoms. We further demonstrate the detection of hundreds of vaporization events from individual nanodroplets with activation thresholds well below the tissue cavitation limit. Overall, this approach has the potential to result in reliable and repeatable contrast-enhanced ultrasound imaging at clinically relevant depths.
Collapse
|
8
|
Mei L, Zhang Z. Advances in Biological Application of and Research on Low-Frequency Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2839-2852. [PMID: 34304908 DOI: 10.1016/j.ultrasmedbio.2021.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
In recent years, the in-depth study of low-frequency sonophoresis (LFS) has greatly elucidated its biological effects in various therapeutic applications, including drug delivery, enhanced healing, thrombolytic technology, anti-inflammatory effects and tumor treatment. Specifically, numerous studies have reported its use in drug delivery and synergistic antitumor activity, indicating a new treatment direction for cancer. However, there are significant gaps in the understanding of LFS in terms of frequency and sound intensity safety; these issues are becoming increasingly important in understanding the biological effects of LFS ultrasound. This article reviews the treatment mechanism and current applications of LFS technology and discusses and summarizes its safety and application prospects.
Collapse
Affiliation(s)
- Lixia Mei
- Department of Ultrasound, Qiqihar Hospital Affiliated to Southern Medical University, Qiqihar City, Heilongjiang Province, China.
| | - Zhen Zhang
- Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, China.
| |
Collapse
|
9
|
Sloand JN, Rokni E, Watson CT, Miller MA, Manning KB, Simon JC, Medina SH. Ultrasound-Responsive Nanopeptisomes Enable Synchronous Spatial Imaging and Inhibition of Clot Growth in Deep Vein Thrombosis. Adv Healthc Mater 2021; 10:e2100520. [PMID: 34137205 DOI: 10.1002/adhm.202100520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/25/2021] [Indexed: 01/22/2023]
Abstract
Deep vein thrombosis (DVT) is a life-threatening blood clotting condition that, if undetected, can cause deadly pulmonary embolisms. Critical to its clinical management is the ability to rapidly detect, monitor, and treat thrombosis. However, current diagnostic imaging modalities lack the resolution required to precisely localize vessel occlusions and enable clot monitoring in real time. Here, we rationally design fibrinogen-mimicking fluoropeptide nanoemulsions, or nanopeptisomes (NPeps), that allow contrast-enhanced ultrasound imaging of thrombi and synchronous inhibition of clot growth. The theranostic duality of NPeps is imparted via their intrinsic binding to integrins overexpressed on platelets activated during coagulation. The platelet-bound nanoemulsions can be vaporized and oscillate in an applied acoustic field to enable contrast-enhanced Doppler ultrasound detection of thrombi. Concurrently, nanoemulsions bound to platelets competitively inhibit secondary platelet-fibrinogen binding to disrupt further clot growth. Continued development of this synchronous theranostic platform may open new opportunities for image-guided, non-invasive, interventions for DVT and other vascular diseases.
Collapse
Affiliation(s)
- Janna N. Sloand
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Eric Rokni
- Graduate Program in Acoustics The Pennsylvania State University University Park PA 16802 USA
| | - Connor T. Watson
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Michael A. Miller
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Keefe B. Manning
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| | - Julianna C. Simon
- Graduate Program in Acoustics The Pennsylvania State University University Park PA 16802 USA
| | - Scott H. Medina
- Department of Biomedical Engineering The Pennsylvania State University University Park PA 16802 USA
| |
Collapse
|
10
|
Guan L, Wang C, Yan X, Liu L, Li Y, Mu Y. A thrombolytic therapy using diagnostic ultrasound combined with RGDS-targeted microbubbles and urokinase in a rabbit model. Sci Rep 2020; 10:12511. [PMID: 32719362 PMCID: PMC7385658 DOI: 10.1038/s41598-020-69202-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 04/10/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to explore thrombolysis therapy based on ultrasound combined with urokinase and Arg–Gly–Asp sequence (RGDS)-targeted microbubbles by evaluating the histological changes in a thrombotic rabbit model. Forty-two New Zealand rabbits featuring platelet-rich thrombi in the femoral artery were randomized to (n = 6/group): ultrasound alone (US); urokinase alone (UK); ultrasound plus non-targeted microbubbles (US + M); ultrasound plus RGDS-targeted microbubbles (US + R); RGDS-targeted microbubbles plus urokinase (R + UK); ultrasound, non-targeted microbubbles and urokinase (US + M + UK); and ultrasound, RGDS-targeted microbubbles and urokinase (US + R + UK) groups. Diagnostic ultrasound was used transcutaneously over the thrombus for 30 min. We evaluated the thrombolytic effect based on ultrasound thrombi detection, blood flow, and histological observations. Among all study groups, complete recanalization was achieved in the US + R + UK group. Hematoxylin and eosin staining showed that the thrombi were completely dissolved. Scanning electron microscopy examination demonstrated that the fiber network structure of the thrombi was damaged. Transmission electron microscopy showed that the thrombus was decomposed into high electron-dense particles. Histology for von Willebrand factor and tissue factor were both negative in the US + R + UK group. This study revealed that a thrombolytic therapy consisting of diagnostic ultrasound together with RGDS-targeted and urokinase coupled microbubbles.
Collapse
Affiliation(s)
- Lina Guan
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Chunmei Wang
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Xue Yan
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Liyun Liu
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Yanhong Li
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China
| | - Yuming Mu
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
| |
Collapse
|
11
|
Cui Z, Li D, Xu S, Xu T, Wu S, Bouakaz A, Wan M, Zhang S. Effect of scattered pressures from oscillating microbubbles on neuronal activity in mouse brain under transcranial focused ultrasound stimulation. ULTRASONICS SONOCHEMISTRY 2020; 63:104935. [PMID: 31945558 DOI: 10.1016/j.ultsonch.2019.104935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
Previous studies have indicated that the presence of microbubbles (MBs) during sonication has an impact on neuronal activity, while the underlying mechanisms remain to be revealed. In this study, a model for the scattered pressures produced by the pulsating lipid-encapsulated MBs in mouse brain was developed to numerically investigate the effect of MBs on neuronal activity during transcranial focused ultrasound stimulation. The additional summed scattered pressure (Psummed_scat) from the oscillating MBs was calculated from the model. The level of neuronal activity was experimentally verified using an immunofluorescence assay with antibodies against c-fos. The pressure difference (ΔP) between acoustic pressures at which the same level of neuronal activity is excited by ultrasound stimulation with and without MBs was obtained from the experiments. The results showed that Psummed_scat accounts for about half of the ΔP when the MBs experience a "compression-only" response. The Psummed_scat suddenly increased at a critical acoustic pressure, around which a rapid enhancement of ΔP obtained from experiment also occurred. This work suggested that the additional scattered pressures from pulsating MBs are probably a mechanism that affects neuronal activity under transcranial focused ultrasound stimulation.
Collapse
Affiliation(s)
- Zhiwei Cui
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Dapeng Li
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shanshan Xu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Tianqi Xu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shan Wu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | | | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Siyuan Zhang
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.
| |
Collapse
|
12
|
Brambila CJ, Lux J, Mattrey RF, Boyd D, Borden MA, de Gracia Lux C. Bubble Inflation Using Phase-Change Perfluorocarbon Nanodroplets as a Strategy for Enhanced Ultrasound Imaging and Therapy. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2020; 36:2954-2965. [PMID: 32090572 DOI: 10.1021/acs.langmuir.9b03647] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Phase-change perfluorocarbon microdroplets were introduced over 2 decades ago to occlude downstream vessels in vivo. Interest in perfluorocarbon nanodroplets has recently increased to enable extravascular targeting, to rescue the weak ultrasound signal of perfluorocarbon droplets by converting them to microbubbles and to improve ultrasound-based therapy. Despite great scientific interest and advances, applications of phase-change perfluorocarbon agents have not reached clinical testing because of efficacy and safety concerns, some of which remain unexplained. Here, we report that the coexistence of perfluorocarbon droplets and microbubbles in blood, which is inevitable when droplets spontaneously or intentionally vaporize to form microbubbles, is a major contributor to the observed side effects. We develop the theory to explain why the coexistence of droplets and microbubbles results in microbubble inflation induced by perfluorocarbon transfer from droplets to adjacent microbubbles. We also present the experimental data showing up to 6 orders of magnitude microbubble volume expansion, which occludes a 200 μm tubing in the presence of perfluorocarbon nanodroplets. More importantly, we demonstrate that the rate of microbubble inflation and ultimate size can be controlled by manipulating formulation parameters to tailor the agent's design for the potential theranostic application while minimizing the risk to benefit ratio.
Collapse
Affiliation(s)
- Carlos J Brambila
- Translational Research in Ultrasound Theranostics (TRUST) Program, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Biomedical Engineering Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Jacques Lux
- Translational Research in Ultrasound Theranostics (TRUST) Program, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Biomedical Engineering Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Organic Chemistry Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Robert F Mattrey
- Translational Research in Ultrasound Theranostics (TRUST) Program, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Biomedical Engineering Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Dustin Boyd
- Translational Research in Ultrasound Theranostics (TRUST) Program, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Mark A Borden
- Department of Mechanical Engineering, University of Colorado, Boulder, Colorado 80309, United States
| | - Caroline de Gracia Lux
- Translational Research in Ultrasound Theranostics (TRUST) Program, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Biomedical Engineering Graduate Program, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| |
Collapse
|
13
|
Goel L, Jiang X. Advances in Sonothrombolysis Techniques Using Piezoelectric Transducers. SENSORS 2020; 20:s20051288. [PMID: 32120902 PMCID: PMC7085655 DOI: 10.3390/s20051288] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Abstract
One of the great advancements in the applications of piezoelectric materials is the application for therapeutic medical ultrasound for sonothrombolysis. Sonothrombolysis is a promising ultrasound based technique to treat blood clots compared to conventional thrombolytic treatments or mechanical thrombectomy. Recent clinical trials using transcranial Doppler ultrasound, microbubble mediated sonothrombolysis, and catheter directed sonothrombolysis have shown promise. However, these conventional sonothrombolysis techniques still pose clinical safety limitations, preventing their application for standard of care. Recent advances in sonothrombolysis techniques including targeted and drug loaded microbubbles, phase change nanodroplets, high intensity focused ultrasound, histotripsy, and improved intravascular transducers, address some of the limitations of conventional sonothrombolysis treatments. Here, we review the strengths and limitations of these latest pre-clincial advancements for sonothrombolysis and their potential to improve clinical blood clot treatments.
Collapse
Affiliation(s)
- Leela Goel
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695-7910, USA;
- Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Raleigh, NC 27695-7910, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695-7910, USA;
- Correspondence: ; Tel.: +1-919-515-5240
| |
Collapse
|
14
|
Xu T, Zhao K, Guo X, Tu J, Zhang D, Sun W, Kong X. Low-intensity pulsed ultrasound inhibits adipogenic differentiation via HDAC1 signalling in rat visceral preadipocytes. Adipocyte 2019; 8:292-303. [PMID: 31322450 PMCID: PMC6768184 DOI: 10.1080/21623945.2019.1643188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Non-drug strategy targeting adipocyte differentiation is critical for alleviating visceral obesity and its related diseases. However, whether and how low intensity pulsed ultrasound (LIPUS) could be used for inhibiting visceral adipocyte differentiation is not fully understood. In this study, we aim to investigate the effect and associated mechanism of LIPUS on primary visceral preadipocyte differentiation and explore its potential role for clinical visceral obesity management. The preadipocytes were daily exposed to LIPUS (0.5 MHz, 1.2 MPa) for 10 min. Adipogenic differentiation was estimated by the formation of lipid droplets and the levels of adipogenic transcriptional factors and representative markers. Mitogen-activated protein kinase (MAPK) member proteins and histone acetylation-related molecules were measured by western blotting. LIPUS stimulation with an average acoustic pressure of 1.2 MPa led to a prominent inhibition of adipogenic differentiation and expression of adipogenic markers. As a mechanism, LIPUS treatment increased the nuclear levels of histone deacetylase 1 (HDAC1) and decreased the acetylation of histone 3 and histone 4. Meanwhile, the inhibition of the HDAC1 could block the inhibitory effect of LIPUS on adipogenic differentiation via increasing AcH3 and AcH4 levels. Our study may provide an ultrasound-based promising strategy for clinical visceral obesity control.
Collapse
Affiliation(s)
- Tianhua Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, China
| | - Juan Tu
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, China
| | - Dong Zhang
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, China
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
15
|
Cui Z, Li D, Feng Y, Xu T, Wu S, Li Y, Bouakaz A, Wan M, Zhang S. Enhanced neuronal activity in mouse motor cortex with microbubbles' oscillations by transcranial focused ultrasound stimulation. ULTRASONICS SONOCHEMISTRY 2019; 59:104745. [PMID: 31473423 DOI: 10.1016/j.ultsonch.2019.104745] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/29/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Microbubbles (MBs) are known to serve as an amplifier of the mechanical effects of ultrasound, which combined with ultrasound are widely used in brain. The goal of this study is to investigate the effect of oscillating MBs on the neuronal activity in the central nervous system (CNS) of mammals. The motor cortex of mice brain was subjected to ultrasound stimulation with and without MBs, and evoked electromyogram signals were recorded. A c-fos immunofluorescence assay was performed to evaluate the neuronal activation in the region of ultrasound stimulation. BBB integrity during ultrasound stimulation with MBs was assessed in this study. Moreover, the safety of ultrasound stimulation with MBs was examined. Using ultrasound at 620 kHz, the injection of MBs significantly increased the success rate of motor response from 0.065 ± 0.06 to 0.28 ± 0.10 when stimulation was applied at 0.12 MPa and from 0.38 ± 0.09 to 0.77 ± 0.18 at 0.25 MPa (p < 0.001). The results of the c-fos immunofluorescence assay showed that the mean densities of c-fos+ cells were significantly increased from 15.67 ± 3.51 to 53.01 ± 9.54 at 0.12 MPa acoustic pressure. At 0.25 MPa, the mean density of c-fos + cells was 81 ± 10.97 without MBs and it significantly increased to 124.12 ± 25.71 with MBs (p < 0.05). Enhanced neuronal activities were observed with 0.12 MPa ultrasound stimulation with MBs, while the integrity of BBB was not compromised, but 0.25 MPa ultrasound stimulation with MBs resulted in BBB disruption. These findings reveal that the oscillations of MBs can enhance neuronal activity in the CNS of mammals, and may provide an insight into the application of MBs combined with ultrasound in brain.
Collapse
Affiliation(s)
- Zhiwei Cui
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Dapeng Li
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yang Feng
- Xijing Hospital, Traditional Chinese Medicine, Xi'an 710032, China
| | - Tianqi Xu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shan Wu
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yibao Li
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an 710049, China
| | | | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Siyuan Zhang
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China.
| |
Collapse
|
16
|
Diagnostic Ultrasound and Microbubbles Treatment Improves Outcomes of Coronary No-Reflow in Canine Models by Sonothrombolysis. Crit Care Med 2019; 46:e912-e920. [PMID: 29965834 PMCID: PMC6110622 DOI: 10.1097/ccm.0000000000003255] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Supplemental Digital Content is available in the text. Objectives: Effective treatment for microvascular thrombosis-induced coronary no-reflow remains an unmet clinical need. This study sought to evaluate whether diagnostic ultrasound and microbubbles treatment could improve outcomes of coronary no-reflow by dissolving platelet- and erythrocyte-rich microthrombi. Design: Randomized controlled laboratory investigation. Setting: Research laboratory. Subjects: Mongrel dogs. Interventions: Coronary no-reflow models induced by platelet- or erythrocyte-rich microthrombi were established and randomly assigned to control, ultrasound, recombinant tissue-type plasminogen activator, ultrasound + microbubbles, or ultrasound + microbubbles + recombinant tissue-type plasminogen activator group. All treatments lasted for 30 minutes. Measurements and Main Results: Percentage of microemboli-obstructed coronary arterioles was lower in ultrasound + microbubbles group than that in control group for platelet- (> 50% obstruction: 10.20% ± 3.56% vs 31.80% ± 3.96%; < 50% obstruction: 14.80% ± 4.15% vs 28.20% ± 3.56%) and erythrocyte-rich microthrombi (> 50% obstruction: 8.20% ± 3.11% vs 30.60% ± 4.83%; < 50% obstruction: 12.80% ± 4.15% vs 25.80% ± 3.70%) (p < 0.001). Percentage change of myocardial blood flow in left anterior descending artery-dominated region, left ventricular ejection fraction, fractional shortening, and ST-segment resolution were higher, whereas infarcted area, troponin I, and creatine kinase MB isoenzyme were lower in ultrasound + microbubbles group than that in control group for both types of microthrombi (p < 0.001). Percentage change of myocardial blood flow, ejection fraction, fractional shortening, and ST-segment resolution were higher, whereas infarcted area, troponin I, and creatine kinase MB isoenzyme were lower in ultrasound + microbubbles and ultrasound + microbubbles + recombinant tissue-type plasminogen activator groups than that in recombinant tissue-type plasminogen activator group for platelet-rich microthrombi (p < 0.05). Conclusions: Ultrasound + microbubbles treatment could dissolve platelet- and erythrocyte-rich microthrombi, thereby improving outcomes of coronary no-reflow, making it a promising supplement to current reperfusion therapy for acute ST-segment elevation myocardial infarction.
Collapse
|
17
|
Bonnard T, Gauberti M, Martinez de Lizarrondo S, Campos F, Vivien D. Recent Advances in Nanomedicine for Ischemic and Hemorrhagic Stroke. Stroke 2019; 50:1318-1324. [DOI: 10.1161/strokeaha.118.022744] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas Bonnard
- From the Normandie University, UNICAEN, INSERM, INSERM UMR-S U1237, Physiopathology and Imaging of Neurological Disorders PhIND, Caen, France (T.B., M.G., S.M.d.L., D.V.)
| | - Maxime Gauberti
- From the Normandie University, UNICAEN, INSERM, INSERM UMR-S U1237, Physiopathology and Imaging of Neurological Disorders PhIND, Caen, France (T.B., M.G., S.M.d.L., D.V.)
| | - Sara Martinez de Lizarrondo
- From the Normandie University, UNICAEN, INSERM, INSERM UMR-S U1237, Physiopathology and Imaging of Neurological Disorders PhIND, Caen, France (T.B., M.G., S.M.d.L., D.V.)
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Department of Neurology, Clinical University Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain (F.C.)
| | - Denis Vivien
- From the Normandie University, UNICAEN, INSERM, INSERM UMR-S U1237, Physiopathology and Imaging of Neurological Disorders PhIND, Caen, France (T.B., M.G., S.M.d.L., D.V.)
- CHU Caen, Department of Clinical Research, CHU Caen Côte de Nacre, Caen, France (D.V.)
| |
Collapse
|
18
|
Su Z, Xu T, Wang Y, Guo X, Tu J, Zhang D, Kong X, Sheng Y, Sun W. Low‑intensity pulsed ultrasound promotes apoptosis and inhibits angiogenesis via p38 signaling‑mediated endoplasmic reticulum stress in human endothelial cells. Mol Med Rep 2019; 19:4645-4654. [PMID: 30957188 PMCID: PMC6522835 DOI: 10.3892/mmr.2019.10136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 03/26/2019] [Indexed: 12/20/2022] Open
Abstract
Aberrant increase in angiogenesis contributes to the progression of malignant solid tumors. An alternative anti-angiogenesis therapy is critical for cancer, since the current anti-angiogenesis drugs lack specificity for tumor cells. In the present study, the effects and mechanisms of low-intensity pulsed ultrasound (LIPUS) on human umbilical vein endothelial cells (HUVECs) and human microvascular endothelial cells (HMECs) were investigated, and the therapeutic potential of this technology was assessed. HUVECs and HMECs were treated with LIPUS (0.5 MHz; 210 mW/cm2) for 1 min and cultured for 24 h. Flow cytometry and Cell Counting Kit-8 assays demonstrated that LIPUS treatment at a dose of 210 mW/cm2 promoted apoptosis and decreased the viability in HUVECs and HMECs. Real-time cell analysis also revealed that LIPUS did not affect the proliferation or migration of HUVECs. An endothelial cell tube formation assay indicated that LIPUS treatment inhibited the angiogenic ability of HUVECs and HMECs. Furthermore, LIPUS increased the protein levels of the apoptosis-associated cleaved Caspase-3 and decreased the B-cell lymphoma-2 levels. LIPUS increased the phosphorylation of p38 mitogen-activated protein kinase (MAPK), and the levels of endoplasmic reticulum (ER) stress-associated markers, including activating transcription factor-4 (ATF-4) and phosphorylated eukaryotic initiation factor 2α (eIF2α). The p38 inhibitor SB203580 reversed the pro-apoptotic and anti-angiogenic effects of LIPUS in cells. Finally, inhibition of p38 decreased the LIPUS-induced elevation of p-eIF2α and ATF-4 levels. Taken together, these results suggested that LIPUS promoted apoptosis and inhibited angiogenesis in human endothelial cells via the activation of p38 MAPK-mediated ER stress signaling.
Collapse
Affiliation(s)
- Zhongping Su
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Tianhua Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yaqing Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
| | - Juan Tu
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
| | - Dong Zhang
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yanhui Sheng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| |
Collapse
|
19
|
Wilson CT, Hall TL, Johnsen E, Mancia L, Rodriguez M, Lundt JE, Colonius T, Henann DL, Franck C, Xu Z, Sukovich JR. Comparative study of the dynamics of laser and acoustically generated bubbles in viscoelastic media. Phys Rev E 2019; 99:043103. [PMID: 31108707 DOI: 10.1103/physreve.99.043103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Indexed: 04/30/2023]
Abstract
Experimental observations of the growth and collapse of acoustically and laser-nucleated single bubbles in water and agarose gels of varying stiffness are presented. The maximum radii of generated bubbles decreased as the stiffness of the media increased for both nucleation modalities, but the maximum radii of laser-nucleated bubbles decreased more rapidly than acoustically nucleated bubbles as the gel stiffness increased. For water and low stiffness gels, the collapse times were well predicted by a Rayleigh cavity, but bubbles collapsed faster than predicted in the higher stiffness gels. The growth and collapse phases occurred symmetrically (in time) about the maximum radius in water but not in gels, where the duration of the growth phase decreased more than the collapse phase as gel stiffness increased. Numerical simulations of the bubble dynamics in viscoelastic media showed varying degrees of success in accurately predicting the observations.
Collapse
Affiliation(s)
- Chad T Wilson
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Timothy L Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Eric Johnsen
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Lauren Mancia
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Mauro Rodriguez
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Jonathan E Lundt
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Tim Colonius
- Department of Mechanical Engineering, California Institute of Technology, Pasadena, California, 91125, USA
| | - David L Henann
- Department of Mechanical Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Christian Franck
- Department of Mechanical Engineering, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| | - Jonathan R Sukovich
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48105, USA
| |
Collapse
|
20
|
Zhong Y, Zhang Y, Xu J, Zhou J, Liu J, Ye M, Zhang L, Qiao B, Wang ZG, Ran HT, Guo D. Low-Intensity Focused Ultrasound-Responsive Phase-Transitional Nanoparticles for Thrombolysis without Vascular Damage: A Synergistic Nonpharmaceutical Strategy. ACS NANO 2019; 13:3387-3403. [PMID: 30855938 DOI: 10.1021/acsnano.8b09277] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Multimodal molecular imaging has shown promise as a complementary approach to thrombus detection. However, the simultaneous noninvasive detection and lysis of thrombi for cardiovascular diseases remain challenging. Herein, a perfluorohexane (PFH)-based biocompatible nanostructure was fabricated, namely, as-prepared Fe3O4-poly(lactic- co-glycolic acid)-PFH-CREKA nanoparticles (NPs), which combine phase transition (PT) thrombolysis capabilities with properties conducive to multimodal imaging. This well-developed PT agent responded effectively to low-intensity focused ultrasound (LIFU) by triggering the vaporization of liquid PFH to achieve thrombolysis. The presence of the CREKA peptide, which binds to the fibrin of the thrombus, allows targeted imaging and efficacious thrombolysis. Then, we found that, compared with thrombolysis using a non-phase-transition agent, PT thrombolysis can produce a robust decrease in the thrombus burden regardless of the acoustic power density of LIFU. In particular, the reduced energy for LIFU-responsive PT during the lysis process guarantees the superior safety of PT thrombolysis. After injecting the NPs intravenously, we demonstrated that this lysis process can be monitored with ultrasound and photoacoustic imaging in vivo to evaluate its efficacy. Therefore, this nonpharmaceutical strategy departs from routine methods and reveals the potential use of PT thrombolysis as an effective and noninvasive alternative to current thrombolytic therapy.
Collapse
Affiliation(s)
- Yixin Zhong
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Yu Zhang
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Jie Xu
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Jun Zhou
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Jia Liu
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Man Ye
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Liang Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Bin Qiao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Zhi-Gang Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Hai-Tao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| | - Dajing Guo
- Department of Radiology , Second Affiliated Hospital of Chongqing Medical University , No. 74 Linjiang Road , Yuzhong District, Chongqing , 400010 , People's Republic of China
| |
Collapse
|
21
|
Pretnar Oblak J, Sabovic M, Frol S. Intravenous Thrombolysis After Idarucizumab Application in Acute Stroke Patients—A Potentially Increased Sensitivity of Thrombi to Lysis? J Stroke Cerebrovasc Dis 2019; 28:768-773. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/08/2018] [Accepted: 11/14/2018] [Indexed: 12/21/2022] Open
|
22
|
Gerhardson T, Sukovich JR, Pandey AS, Hall TL, Cain CA, Xu Z. Catheter Hydrophone Aberration Correction for Transcranial Histotripsy Treatment of Intracerebral Hemorrhage: Proof-of-Concept. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:1684-1697. [PMID: 28880166 PMCID: PMC5681355 DOI: 10.1109/tuffc.2017.2748050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Histotripsy is a minimally invasive ultrasound therapy that has shown rapid liquefaction of blood clots through human skullcaps in an in vitro intracerebral hemorrhage model. However, the efficiency of these treatments can be compromised if the skull-induced aberrations are uncorrected. We have developed a catheter hydrophone which can perform aberration correction (AC) and drain the liquefied clot following histotripsy treatment. Histotripsy pulses were delivered through an excised human skullcap using a 256-element, 500-kHz hemisphere array transducer with a 15-cm focal distance. A custom hydrophone was fabricated using a mm PZT-5h crystal interfaced to a coaxial cable and integrated into a drainage catheter. An AC algorithm was developed to correct the aberrations introduced between histotripsy pulses from each array element. An increase in focal pressure of up to 60% was achieved at the geometric focus and 27%-62% across a range of electronic steering locations. The sagittal and axial -6-dB beam widths decreased from 4.6 to 2.2 mm in the sagittal direction and 8 to 4.4 mm in the axial direction, compared to 1.5 and 3 mm in the absence of aberration. After performing AC, lesions with diameters ranging from 0.24 to 1.35 mm were generated using electronic steering over a mm grid in a tissue-mimicking phantom. An average volume of 4.07 ± 0.91 mL was liquefied and drained after using electronic steering to treat a 4.2-mL spherical volume in in vitro bovine clots through the skullcap.
Collapse
|
23
|
Gerhardson T, Sukovich JR, Pandey AS, Hall TL, Cain CA, Xu Z. Effect of Frequency and Focal Spacing on Transcranial Histotripsy Clot Liquefaction, Using Electronic Focal Steering. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2302-2317. [PMID: 28716432 PMCID: PMC5580808 DOI: 10.1016/j.ultrasmedbio.2017.06.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 05/08/2023]
Abstract
This in vitro study investigated the effects of ultrasound frequency and focal spacing on blood clot liquefaction via transcranial histotripsy. Histotripsy pulses were delivered using two 256-element hemispherical transducers of different frequency (250 and 500 kHz) with 30-cm aperture diameters. A 4-cm diameter spherical volume of in vitro blood clot was treated through 3 excised human skullcaps by electronically steering the focus with frequency proportional focal spacing: λ/2, 2 λ/3 and λ with 50 pulses per location. The pulse repetition frequency across the volume was 200 Hz, corresponding to a duty cycle of 0.08% (250 kHz) and 0.04% (500 kHz) for each focal location. Skull heating during treatment was monitored. Liquefied clot was drained via catheter and syringe in the range of 6-59 mL in 0.9-42.4 min. The fastest rate was 16.6 mL/min. The best parameter combination was λ spacing at 500 kHz, which produced large liquefaction through 3 skullcaps (23.1 ± 4.0, 37.1 ± 16.9 and 25.4 ± 16.9 mL) with the fast rates (3.2 ± 0.6, 5.1 ± 2.3 and 3.5 ± 0.4 mL/min). The temperature rise through the 3 skullcaps remained below 4°C.
Collapse
Affiliation(s)
- Tyler Gerhardson
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Jonathan R Sukovich
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Aditya S Pandey
- Department of Neurologic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Timothy L Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Charles A Cain
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
24
|
Yan WC, Chua QW, Ong XJ, Sharma VK, Tong YW, Wang CH. Fabrication of ultrasound-responsive microbubbles via coaxial electrohydrodynamic atomization for triggered release of tPA. J Colloid Interface Sci 2017; 501:282-293. [PMID: 28460221 DOI: 10.1016/j.jcis.2017.04.073] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/21/2017] [Accepted: 04/23/2017] [Indexed: 01/16/2023]
Abstract
A single-step fabrication method, coaxial electrohydrodynamic atomization (CEHDA), was developed to synthesize drug-loaded microbubbles (MBs) for combination treatment of ischemic stroke. The bioactivity of therapeutic agent (tPA, tissue plasminogen activator) after preparation was evaluated, showing that CEHDA could be very promising method for producing MBs with therapeutic functions. The bubble performance and tPA release profiles were also examined by exposing the bubbles to 2MHz ultrasound of various intensities. The results showed that the mean diameter of tPA-loaded MBs was found to fluctuate about its original diameter when exposed to ultrasound and higher intensity ultrasound was more effective in triggering the burst of CEHDA MBs. High ultrasound-triggered bubble disintegration effectiveness in a short period (first 5min) fits well with the requirement of short ultrasound exposure time for human brain. Moreover, a numerical model was also applied to investigate the stability of the fabricated MBs in the bloodstream. It was found that MB dissolution time increased with initial radius, decreased with initial surface tension and increased with initial shell resistance but it was barely affected by the average excessive bloodstream pressure.
Collapse
Affiliation(s)
- Wei-Cheng Yan
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Qing Wei Chua
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Xiu Jing Ong
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Vijay Kumar Sharma
- Division of Neurology, Department of Medicine, National University Hospital, Tower Block Level 10, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Yen Wah Tong
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Chi-Hwa Wang
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore.
| |
Collapse
|
25
|
Suen WLL, Jiang J, Wong HS, Qu J, Chau Y. Examination of Effects of Low-Frequency Ultrasound on Scleral Permeability and Collagen Network. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2650-2661. [PMID: 27576194 DOI: 10.1016/j.ultrasmedbio.2016.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 06/23/2016] [Accepted: 07/13/2016] [Indexed: 06/06/2023]
Abstract
Delivery of therapeutics to the intraocular space or to targeted tissues in the posterior segment is challenging because of the structural and dynamic barriers surrounding the eye. Previously, we reported the feasibility of using ultrasound (US) irradiation to deliver macromolecules to the posterior segment of the eye via the transscleral route, which consists of sclera as the outermost anatomic barrier. In this study, we found that although ultrasound increases scleral permeability for macromolecules, the scleral collagen arrangement remains undisturbed. In an ex vivo experiment, protein permeation across the sclera was significantly enhanced by ultrasound in the stable cavitation regime. The scleral collagen network was further examined by second harmonic generation imaging. Quantitative image analysis techniques were adopted to examine the density, anisotropy and interlacing pattern of collagen fibers before and after ultrasound irradiation. Repeated ultrasound applications did not induce significant changes in the arrangement of collagen fibrils at 40 kHz with a spatial average temporal average intensity (ISATA) <1.8 W/cm2. These parameters correspond to a mechanical index (MI) below 0.8 in our setting. These data suggested that enhanced permeation of macromolecules across the sclera was achieved without disturbing the collagen network of the sclera. This evidence supports that low-frequency, low-intensity ultrasound is a tolerable approach to transscleral drug delivery.
Collapse
Affiliation(s)
- Wai-Leung Langston Suen
- Department of Chemical and Biomolecular Engineering, Hong Kong University of Science and Technology, Hong Kong, China
| | - Jun Jiang
- Department of Electronic and Computer Engineering, Hong Kong University of Science and Technology, Hong Kong, China
| | - Hoi Sang Wong
- Department of Chemical and Biomolecular Engineering, Hong Kong University of Science and Technology, Hong Kong, China
| | - Jianan Qu
- Department of Electronic and Computer Engineering, Hong Kong University of Science and Technology, Hong Kong, China
| | - Ying Chau
- Department of Chemical and Biomolecular Engineering, Hong Kong University of Science and Technology, Hong Kong, China; Division of Biomedical Engineering, Hong Kong University of Science and Technology, Hong Kong, China.
| |
Collapse
|
26
|
Kim HB, Swanberg KM, Han HS, Kim JC, Kim JW, Lee S, Lee CJ, Maeng S, Kim TS, Park JH. Prolonged stimulation with low-intensity ultrasound induces delayed increases in spontaneous hippocampal culture spiking activity. J Neurosci Res 2016; 95:885-896. [PMID: 27465511 DOI: 10.1002/jnr.23845] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 06/03/2016] [Accepted: 07/03/2016] [Indexed: 11/07/2022]
Abstract
Ultrasound is a promising neural stimulation modality, but an incomplete understanding of its range and mechanism of effect limits its therapeutic application. We investigated the modulation of spontaneous hippocampal spike activity by ultrasound at a lower acoustic intensity and longer time scale than has been previously attempted, hypothesizing that spiking would change conditionally upon the availability of glutamate receptors. Using a 60-channel multielectrode array (MEA), we measured spontaneous spiking across organotypic rat hippocampal slice cultures (N = 28) for 3 min each before, during, and after stimulation with low-intensity unfocused pulsed or sham ultrasound (spatial-peak pulse average intensity 780 μW/cm2 ) preperfused with artificial cerebrospinal fluid, 300 μM kynurenic acid (KA), or 0.5 μM tetrodotoxin (TTX) at 3 ml/min. Spike rates were normalized and compared across stimulation type and period, subregion, threshold level, and/or perfusion condition using repeated-measures ANOVA and generalized linear mixed models. Normalized 3-min spike counts for large but not midsized, small, or total spikes increased after but not during ultrasound relative to sham stimulation. This result was recapitulated in subregions CA1 and dentate gyrus and replicated in a separate experiment for all spike size groups in slices pretreated with aCSF but not KA or TTX. Increases in normalized 18-sec total, midsized, and large spike counts peaked predominantly 1.5 min following ultrasound stimulation. Our low-intensity ultrasound setup exerted delayed glutamate receptor-dependent, amplitude- and possibly region-specific influences on spontaneous spike rates across the hippocampus, expanding the range of known parameters at which ultrasound may be used for neural activity modulation. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Hyun-Bum Kim
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| | - Kelley M Swanberg
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| | - Hee-Sok Han
- Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Jung-Chae Kim
- Biometrics Team, CTO Future IT Laboratory, LG Electronics Umyeon R&D Campus, Seocho-gu, Republic of Korea
| | - Jun-Woo Kim
- Division of Polar Logistics, Korea Polar Research Institute, Incheon, Republic of Korea
| | - Sungon Lee
- School of Electrical Engineering, Hanyang University, Ansan, Republic of Korea
| | - C Justin Lee
- Center for Neuroscience and Functional Connectomics, Brain Science Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - Sungho Maeng
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| | - Tae-Seong Kim
- Department of Biomedical Engineering, Kyung Hee University, Yongin, Republic of Korea
| | - Ji-Ho Park
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| |
Collapse
|
27
|
Tsao NH, Hall EAH. Enzyme-Degradable Hybrid Polymer/Silica Microbubbles as Ultrasound Contrast Agents. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2016; 32:6534-6543. [PMID: 27245495 DOI: 10.1021/acs.langmuir.6b01075] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The fabrication of an enzyme-degradable polymer/silica hybrid microbubble is reported that produces an ultrasound contrast image. The polymer, a triethoxysilane end-capped polycaprolactone (SiPCL), is used to incorporate enzyme-degradable components into a silica microbubble synthesis, and to impart increased elasticity for enhanced acoustic responsiveness. Formulations of 75, 85, and 95 wt % SiPCL in the polymer feed produced quite similar ratios of SiPCL and silica in the final bubble but different surface properties. The data suggest that different regions of the microbubbles were SiPCL-rich: the inner layer next to the polystyrene template core and the outer surface layer, thereby creating a sandwiched silica-rich layer of the bubble shell. Overall, the thickness of the microbubble shell was dependent on the starting TEOS concentration and the reaction time. Despite the layered structure, the microbubble could be efficiently degraded by lipase enzyme, but was stable without enzyme. The ultrasound contrast showed a general trend of increase in image intensity with SiPCL feed ratio, although the 95 wt % SiPCL bubbles did not produce a contrast image, probably due to bubble collapse. At higher normalized peak negative acoustic pressure (mechanical index, MI), a nonlinear frequency response also emerges, characterized by the third harmonic at around 3f0, and increases with MI. The threshold MI transition from linear to nonlinear response increased with decrease in SiPCL.
Collapse
Affiliation(s)
- Nadia H Tsao
- Institute of Biotechnology, Department of Chemical Engineering and Biotechnology, University of Cambridge , Tennis Court Road, Cambridge CB2 1QT, United Kingdom
| | - Elizabeth A H Hall
- Institute of Biotechnology, Department of Chemical Engineering and Biotechnology, University of Cambridge , Tennis Court Road, Cambridge CB2 1QT, United Kingdom
| |
Collapse
|
28
|
Sukovich J, Xu Z, Kim Y, Cao H, Nguyen TS, Pandey A, Hall T, Cain C. Targeted Lesion Generation Through the Skull Without Aberration Correction Using Histotripsy. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:671-682. [PMID: 26890732 PMCID: PMC7371448 DOI: 10.1109/tuffc.2016.2531504] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study demonstrates the ability of histotripsy to generate targeted lesions through the skullcap without using aberration correction. Histotripsy therapy was delivered using a 500 kHz, 256-element hemispherical transducer with an aperture diameter of 30 cm and a focal distance of 15 cm fabricated in our lab. This transducer is theoretically capable of producing peak rarefactional pressures, based on linear estimation, (p-)LE, in the free field in excess of 200MPa with pulse durations 2 acoustic cycles. Three excised human skullcaps were used displaying attenuations of 73-81% of the acoustic pressure without aberration correction. Through all three skullcaps, compact lesions with radii less than 1mm were generated in red blood cell (RBC) agarose tissue phantoms without aberration correction, using estimated (p-)LE of 28-39MPa, a pulse repetition frequency of 1Hz, and a total number of 300 pulses. Lesion generation was consistently observed at the geometric focus of the transducer as the position of the skullcap with respect to the transducer was varied, and multiple patterned lesions were generated transcranially by mechanically adjusting the position of the skullcap with respect to the transducer to target different regions within. These results show that compact, targeted lesions with sharp boundaries can be generated through intact skullcaps using histotripsy with very short pulses without using aberration correction. Such capability has the potential to greatly simplify transcranial ultrasound therapy for non-invasive transcranial applications, as current ultrasound transcranial therapy techniques all require sophisticated aberration correction.
Collapse
|
29
|
Su H, Li Z, Dong Y, Jiang HX, Zheng HM, Du YH, Wu J, Wang ZB. Damage Effects on Bacille Calmette-Guérin by Low-Frequency, Low-Intensity Ultrasound: A Pilot Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:581-587. [PMID: 26887448 DOI: 10.7863/ultra.14.11056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/06/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To perform an in vitro experimental study of the possible damage effects on Bacille Calmette-Guérin (BCG) by low-frequency (42-kHz) ultrasound (US) irradiation at low spatially and temporally averaged intensities and different exposure times. METHODS A 2-mL BCG suspension was added to the wells of a 24-well cell culture plate. Then the samples were randomly divided into 4 groups, each group including 3 wells, with group 1 as a control group and groups 2, 3, and 4, as US treatment groups. The samples for groups 2, 3, and 4 were irradiated with US at 0.13 W/cm(2) for 5 minutes, 0.13 W/cm(2) for 15 minutes, and 1.53 W/cm(2) for 15 minutes, respectively. After irradiation, the temperature, ratio of damage, and structure of the bacteria were examined. The cavitation effect of the device was detected by the passive cavitation detection method. RESULTS After US irradiation at the different doses (intensity and exposure time), no significant temperature change was found in all sample suspensions. The ratio of bacterial damage tested by flow cytometry and the optical density of the suspensions as assayed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide colorimetric method showed that the US-irradiated groups were significantly different from the control group. The BCG damage ratio reached 28% at the intensity of 1.53 W/cm(2). Transmission electron microscopic results showed that the bacterial structure of BCG could be destroyed by low-frequency, low-intensity US. CONCLUSIONS Low-frequency, low-intensity US can cause acute injury to BCG, and the degree of injury is closely correlated with the US dose applied.
Collapse
Affiliation(s)
- Hang Su
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - Zhe Li
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - Yuan Dong
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - He-Xun Jiang
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - Hui-Min Zheng
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - Yong-Hong Du
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.).
| | - Junru Wu
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| | - Zhi-Biao Wang
- State Key Laboratory of Ultrasound Engineering in Medicine, Cofounded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (H.S., Z.L., Y.D., H.-Z.J., H.-M.Z, Y.-H.D., Z-.B.W.); and Department of Physics, University of Vermont, Burlington, Vermont USA (J.W.)
| |
Collapse
|
30
|
Liu Z, Shi C, Li Y, Song Y, Xu Q. Fluorescent genipin cross-linked REDV-conjugated polymeric microbubbles for human vascular endothelial cell (HVEC) targeting. RSC Adv 2016. [DOI: 10.1039/c6ra00992a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Fluorescent polymeric microbubbles conjugated with REDV peptides were fabricated to achieve HVECs active targeting. The degradation, cytotoxicity and targeting features endowed them potential candidates in early molecular diagnosis for cardiovascular diseases.
Collapse
Affiliation(s)
- Zhe Liu
- Wenzhou Institute of Biomaterials and Engineering
- Wenzhou Medical University
- Wenzhou 325011
- China
| | - Changcan Shi
- Wenzhou Institute of Biomaterials and Engineering
- Wenzhou Medical University
- Wenzhou 325011
- China
| | - Yihong Li
- Wenzhou Institute of Biomaterials and Engineering
- Wenzhou Medical University
- Wenzhou 325011
- China
| | - Yuanhui Song
- Wenzhou Institute of Biomaterials and Engineering
- Wenzhou Medical University
- Wenzhou 325011
- China
| | - Qien Xu
- Wenzhou Institute of Biomaterials and Engineering
- Wenzhou Medical University
- Wenzhou 325011
- China
| |
Collapse
|
31
|
Drug-Loaded Perfluorocarbon Nanodroplets for Ultrasound-Mediated Drug Delivery. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 880:221-41. [DOI: 10.1007/978-3-319-22536-4_13] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
32
|
Thrombolytic therapy with rt-PA and transcranial color Doppler ultrasound (TCCS) combined with microbubbles for embolic thrombus. Thromb Res 2015; 136:1027-32. [DOI: 10.1016/j.thromres.2015.08.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/29/2015] [Accepted: 08/29/2015] [Indexed: 11/22/2022]
|
33
|
Nacu A, Kvistad CE, Logallo N, Naess H, Waje-Andreassen U, Aamodt AH, Solhoff R, Lund C, Tobro H, Rønning OM, Salvesen R, Idicula TT, Thomassen L. A pragmatic approach to sonothrombolysis in acute ischaemic stroke: the Norwegian randomised controlled sonothrombolysis in acute stroke study (NOR-SASS). BMC Neurol 2015; 15:110. [PMID: 26162826 PMCID: PMC4499181 DOI: 10.1186/s12883-015-0359-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 06/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the absence of tPA also accelerates clot break-up (sonolysis). Adding intravenous gaseous microbubbles may potentiate the effect of ultrasound in both sonothrombolysis and sonolysis. The Norwegian Sonothrombolysis in Acute Stroke Study aims in a pragmatic approach to assess the effect and safety of contrast enhanced ultrasound treatment in unselected acute ischaemic stroke patients. METHODS/DESIGN Acute ischaemic stroke patients ≥ 18 years, with or without visible arterial occlusion on computed tomography angiography (CTA) and treatable ≤ 4(½) hours after symptom onset, are included in NOR-SASS. NOR-SASS is superimposed on a separate trial randomising patients with acute ischemic stroke to either tenecteplase or alteplase (The Norwegian Tenecteplase Stroke Trial NOR-TEST). The NOR-SASS trial has two arms: 1) the thrombolysis-arms (NOR-SASS A and B) includes patients given intravenous thrombolysis (tenecteplase or alteplase), and 2) the no-thrombolysis-arm (NOR-SASS C) includes patients with contraindications to thrombolysis. First step randomisation of NOR-SASS A is embedded in NOR-TEST as a 1:1 randomisation to either tenecteplase or alteplase. Second step NOR-SASS randomisation is 1:1 to either contrast enhanced sonothrombolysis (CEST) or sham CEST. Randomisation in NOR-SASS B (routine alteplase group) is 1:1 to either CEST or sham CEST. Randomisation of NOR-SASS C is 1:1 to either contrast enhanced sonolysis (CES) or sham CES. Ultrasound is given for one hour using a 2-MHz pulsed-wave diagnostic ultrasound probe. Microbubble contrast (SonoVue®) is given as a continuous infusion for ~30 min. Recanalisation is assessed at 60 min after start of CEST/CES. Magnetic resonance imaging and angiography is performed after 24 h of stroke onset. Primary study endpoints are 1) major neurological improvement measured with NIHSS score at 24 h and 2) favourable functional outcome defined as mRS 0-1 at 90 days. DISCUSSION NOR-SASS is the first randomised controlled trial designed to test the superiority of contrast enhanced ultrasound treatment given ≤ 4(½) hours after stroke onset in an unselected acute ischaemic stroke population eligible or not eligible for intravenous thrombolysis, with or without a defined arterial occlusion on CTA. If a positive effect and safety can be proven, contrast enhanced ultrasound treatment will be an option for all acute ischaemic stroke patients. EudraCT No 201200032341; www.clinicaltrials.gov NCT01949961.
Collapse
Affiliation(s)
- Aliona Nacu
- Department of Neurology, Haukeland University Hospital, N-5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Christopher E Kvistad
- Department of Neurology, Haukeland University Hospital, N-5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Nicola Logallo
- Department of Neurology, Haukeland University Hospital, N-5021, Bergen, Norway.
| | - Halvor Naess
- Department of Neurology, Haukeland University Hospital, N-5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Centre for age-related medicine, Stavanger University Hospital, Stavanger, Norway.
| | | | - Anne Hege Aamodt
- Department of Neurology, Oslo University Hospital, Oslo, Norway.
| | - Ragnar Solhoff
- Department of Neurology, Arendal Hospital, Arendal, Norway.
| | - Christian Lund
- Department of Neurology, Oslo University Hospital, Oslo, Norway.
| | - Håkon Tobro
- Department of Neurology, Skien Hospital, Skien, Norway.
| | - Ole Morten Rønning
- Department of Neuroly, Akershus University Hospital, Nordbyhagen, Norway.
| | - Rolf Salvesen
- Department of Neurology, Bodø Hospital, Bodo, Norway.
| | - Titto T Idicula
- Department of Neurology, St. Olavs Hospital, Trondheim, Norway.
| | - Lars Thomassen
- Department of Neurology, Haukeland University Hospital, N-5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| |
Collapse
|
34
|
Wu J, Xie F, Lof J, Sayyed S, Porter TR. Utilization of modified diagnostic ultrasound and microbubbles to reduce myocardial infarct size. Heart 2015; 101:1468-74. [DOI: 10.1136/heartjnl-2015-307625] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/25/2015] [Indexed: 01/10/2023] Open
|
35
|
Izamis ML, Efstathiades A, Keravnou C, Georgiadou S, Martins PN, Averkiou MA. Effects of air embolism size and location on porcine hepatic microcirculation in machine perfusion. Liver Transpl 2014; 20:601-11. [PMID: 24478135 DOI: 10.1002/lt.23838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 01/05/2014] [Indexed: 02/07/2023]
Abstract
The handling of donor organs frequently introduces air into the microvasculature, but little is known about the extent of the damage caused as a function of the embolism size and distribution. Here we introduced embolisms of different sizes into the portal vein, the hepatic artery, or both during the flushing stage of porcine liver procurement. The outcomes were evaluated during 3 hours of machine perfusion and were compared to the outcomes of livers with no embolisms. Dynamic contrast-enhanced ultrasound (DCEUS) was used to assess the perfusion quality, and it demonstrated that embolisms tended to flow mostly into the left lobe, occasionally into the right lobe, and rarely into the caudate lobe. Major embolisms could disrupt the flow entirely, whereas minor embolisms resulted in reduced or heterogeneous flow. Embolisms occasionally migrated to different regions of the same lobe and, regardless of their size, caused a general deterioration in the flow over time. Histological damage resulted primarily when both vessels of the liver were compromised, whereas bile production was diminished in livers that had arterial embolisms. Air embolisms produced a dose-dependent increase in vascular resistance and a decline in oxygen consumption. This is the first article to quantify the impact of air embolisms on microcirculation in an experimental model, and it demonstrates that air embolisms have the capacity to degrade the integrity of donor organs. The extent of organ damage is strongly dependent on the size and distribution of air embolisms. The diagnosis of embolism severity can be safely and easily made with DCEUS.
Collapse
Affiliation(s)
- Maria-Louisa Izamis
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | | | | | | | | | | |
Collapse
|
36
|
Chuang YH, Wang YH, Chang TK, Lin CJ, Li PC. Albumin acts like transforming growth factor β1 in microbubble-based drug delivery. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:765-774. [PMID: 24433746 DOI: 10.1016/j.ultrasmedbio.2013.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 07/24/2013] [Accepted: 10/22/2013] [Indexed: 06/03/2023]
Abstract
Unlike lipid-shelled microbubbles (MBs), albumin-shelled microbubbles (MBs) have not been reported to be actively targeted to cells without the assistance of antibodies. Recent studies indicate that the albumin molecule is similar to transforming growth factor β (TGF-β) both structurally and functionally. The TGF-β superfamily is important during early tumor outgrowth, with an elevated TGF-β being tumor suppressive; at later stages, this switches to malignant conversion and progression, including breast cancer. TGF-β receptors I and II play crucial roles in both the binding and endocytosis of albumin. However, until now, no specific albumin receptor has been found. On the basis of the above-mentioned information, we hypothesized that non-antibody-conjugated albumin-shelled MBs can be used to deliver drugs to breast cancer cells. We also studied the possible roles of TGF-β1 and radiation force in the behavior of cells and albumin-shelled MBs. The results indicate that albumin-shelled MBs loaded with paclitaxel (PTX) induce breast cancer cell apoptosis without the specific targeting produced by an antibody. Applying either an acoustic radiation force or cavitation alone to cells with PTX-loaded albumin MBs increased the apoptosis rate to 23.2% and 26.3% (p < 0.05), respectively. We also found that albumin-shelled MBs can enter MDA-MB-231 breast cancer cells and remain there for at least 24 h, even in the presence of PTX loading. Confocal micrographs revealed that 70.5% of the breast cancer cells took up albumin-shelled MBs spontaneously after 1 d of incubation. Applying an acoustic radiation force further increased the percentage to 91.9% in our experiments. However, this process could be blocked by TGF-β1, even with subsequent exposure to the radiation force. From these results, we conclude that TGF-β1 receptors are involved in the endocytotic process by which albumin-shelled MBs enter breast cancer cells. The acoustic radiation force increases the contact rate between albumin-shelled MBs and tumor cells. Combining a radiation force and cavitation yields an apoptosis rate of 31.3%. This in vitro study found that non-antibody-conjugated albumin-shelled MBs provide a useful method of drug delivery. Further in vivo studies of the roles of albumin MBs and TGF-β in different stages of cancer are necessary.
Collapse
Affiliation(s)
- Yueh-Hsun Chuang
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan; Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hsin Wang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Tien-Kuei Chang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Ching-Jung Lin
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Pai-Chi Li
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
37
|
Chen F, Qi Z, Luo Y, Hinchliffe T, Ding G, Xia Y, Ji X. Non-pharmaceutical therapies for stroke: mechanisms and clinical implications. Prog Neurobiol 2014; 115:246-69. [PMID: 24407111 PMCID: PMC3969942 DOI: 10.1016/j.pneurobio.2013.12.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/19/2013] [Accepted: 12/27/2013] [Indexed: 12/14/2022]
Abstract
Stroke is deemed a worldwide leading cause of neurological disability and death, however, there is currently no promising pharmacotherapy for acute ischemic stroke aside from intravenous or intra-arterial thrombolysis. Yet because of the narrow therapeutic time window involved, thrombolytic application is very restricted in clinical settings. Accumulating data suggest that non-pharmaceutical therapies for stroke might provide new opportunities for stroke treatment. Here we review recent research progress in the mechanisms and clinical implications of non-pharmaceutical therapies, mainly including neuroprotective approaches such as hypothermia, ischemic/hypoxic conditioning, acupuncture, medical gases and transcranial laser therapy. In addition, we briefly summarize mechanical endovascular recanalization devices and recovery devices for the treatment of the chronic phase of stroke and discuss the relative merits of these devices.
Collapse
Affiliation(s)
- Fan Chen
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Zhifeng Qi
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Yuming Luo
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Taylor Hinchliffe
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA
| | - Guanghong Ding
- Shanghai Research Center for Acupuncture and Meridian, Shanghai 201203, China
| | - Ying Xia
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA.
| | - Xunming Ji
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China.
| |
Collapse
|
38
|
Nederhoed JH, Slikkerveer J, Meyer KW, Wisselink W, Musters RJ, Yeung KK. Contrast-enhanced sonothrombolysis in a porcine model of acute peripheral arterial thrombosis and prevention of anaphylactic shock. Lab Anim (NY) 2014; 43:91-4. [DOI: 10.1038/laban.438] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/07/2013] [Indexed: 11/09/2022]
|
39
|
GAO XIUJU. A clinical study of transcranial ultrasound as an adjuvant therapy for progressive cerebral infarction. Exp Ther Med 2013; 5:1244-1246. [PMID: 23596496 PMCID: PMC3627469 DOI: 10.3892/etm.2013.965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/24/2013] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to investigate the clinical efficacy of transcranial ultrasound as an adjuvant therapy in combination with small doses of urokinase (UK) for the treatment of progressive cerebral infarction. Sixty-one eligible patients with progressive cerebral infarction were successively and randomly assigned into one of the following groups; 30 patients to the treatment group (transcranial ultrasound + small doses of UK) and 31 patients to the control group (single small doses of UK). Based on conventional therapy, patients in the treatment group received transcranial ultrasound. The neural function deficit scale and curative effect scores of the two groups were recorded before treatment and on the 7th and 14th days after treatment. No differences in the neural function deficit scale between the two groups was observed before treatment, however, on the 7th and 14th days after treatment, a significant decrease was evident in the treatment group (P<0.01). The overall response rate was 100% in the treatment group and 74.2% in the control group, with a significant difference (P<0.01). Transcranial ultrasound is able to contribute to the thrombolytic effects of UK and prevent the progression of thrombi, subsequently aiding the recovery of neural functions.
Collapse
Affiliation(s)
- XIUJU GAO
- Department of Neurology, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang 471003,
P.R. China
| |
Collapse
|
40
|
Park S, Maxwell AD, Owens GE, Gurm HS, Cain CA, Xu Z. Non-invasive embolus trap using histotripsy-an acoustic parameter study. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:611-9. [PMID: 23415285 PMCID: PMC3631564 DOI: 10.1016/j.ultrasmedbio.2012.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/17/2012] [Accepted: 11/28/2012] [Indexed: 05/06/2023]
Abstract
Free-flowing particles in a blood vessel were observed to be attracted, trapped and eroded by a histotripsy bubble cloud. This phenomenon may be used to develop a non-invasive embolus trap (NET) to prevent embolization. This study investigates the effect of acoustic parameters on the trapping ability of the NET generated by a focused 1.063 MHz transducer. The maximum trapping velocity, defined by the maximum mean fluid velocity at which a 3-4 mm particle trapped in a 6 mm diameter vessel phantom, increased linearly with peak negative pressure (P-) and increased as the square root of pulse length and pulse repetition frequency (PRF). At 19.9 MPa P-, 1000 Hz PRF and 10 cycle pulse length, a 3 mm clot-mimicking particle could remain trapped under a background velocity of 9.7 cm/s. Clot fragments treated by NET resulted in debris particles <75 μm. These results will guide the appropriate selection of NET parameters.
Collapse
Affiliation(s)
- Simone Park
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Adam D. Maxwell
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Gabe E. Owens
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109
| | - Hitinder S. Gurm
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109
| | - Charles A. Cain
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109
| |
Collapse
|
41
|
Abstract
OPINION STATEMENT Acute ischemic stroke remains one of the most devastating diseases when it comes to morbidity and mortality, not to mention the personal and economic burden that occurs in long-term. Intravenous thrombolysis with tissue plasminogen activator (tPA) is the only effective acute stroke therapy that improves outcome if given up to 4.5 hours from symptom onset. However, recanalization rates are meager and the majority of treated patients still have residual disability after stroke, emphasizing the need for further treatment options that may facilitate or even rival the only approved therapy. Sonothrombolysis, the adjuvant continuous ultrasound sonication of an intra-arterial occlusive thrombus during thrombolysis, enhances the clot-dissolving capabilities of intravenous tPA presumably by delivering acoustic pressure to the target brain vessel. Higher recanalization rates produce a trend towards better functional outcomes that could be safely achieved with the combination of high-frequency ultrasound and intravenous tPA. However, data on ultrasound targeting of intracranial proximal occlusive lesions other than those in the middle cerebral arteries are sparse. Moreover, recent sonothrombolysis trials were exclusively conducted with operator-dependent hand-held technology hindering its further testing in clinical sonothrombolysis trials. An operator-independent 2-MHz transcranial Doppler device has been developed allowing health care professionals not formally trained in ultrasound apparatus to provide therapeutic ultrasound as needed. Currently, this operator-independent device covering 12 proximal intracranial segments that most commonly contain thrombo-embolic occlusions enters testing in a pivotal multicenter sonothrombolysis efficacy trial. If this trial demonstrates safety and efficacy, adjuvants, such as gaseous microbubbles that further potentiate the thrombolytic effect of intravenous tPA, could be tested along with this device.
Collapse
|
42
|
Wang C, Yang F, Xu Z, Shi D, Chen D, Dai J, Gu N, Jiang Q. Intravenous release of NO from lipidic microbubbles accelerates deep vein thrombosis resolution in a rat model. Thromb Res 2013. [DOI: 10.1016/j.thromres.2012.11.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
43
|
Kaya M, Toma C, Wang J, Grata M, Fu H, Villanueva FS, Chen X. Acoustic radiation force for vascular cell therapy: in vitro validation. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1989-97. [PMID: 22975034 PMCID: PMC3471247 DOI: 10.1016/j.ultrasmedbio.2012.07.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 07/23/2012] [Accepted: 07/25/2012] [Indexed: 05/21/2023]
Abstract
Cell-based therapeutic approaches are attractive for the restoration of the protective endothelial layer in arteries affected by atherosclerosis or following angioplasty and stenting. We have recently demonstrated a novel technique for the delivery of mesenchymal stem cells (MSCs) that are surface-coated with cationic lipid microbubbles (MBs) and displaced by acoustic radiation force (ARF) to a site of arterial injury. The objective of this study was to characterize ultrasound parameters for effective acoustic-based delivery of cell therapy. In vitro experiments were performed in a vascular flow phantom where MB-tagged MSCs were delivered toward the phantom wall using ARF generated with an intravascular ultrasound catheter. The translation motion velocity and adhesion of the MB-cell complexes were analyzed. Experimental data indicated that MSC radial velocity and adhesion to the vessel phantom increased with the time-averaged ultrasound intensity up to 1.65 W/cm², after which no further significant adhesion was observed. Temperature increase from baseline near the catheter was 5.5 ± 0.8°C with this setting. Using higher time-averaged ultrasound intensities may not significantly benefit the adhesion of MB-cell complexes to the target vessel wall (p = NS), but could cause undesirable biologic effects such as heating to the MB-cell complexes and surrounding tissue. For the highest time-averaged ultrasound intensity of 6.60 W/cm², the temperature increase was 11.6 ± 1.3°C.
Collapse
Affiliation(s)
- Mehmet Kaya
- Center for Ultrasound Molecular Imaging and Therapeutics, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | | | | | | | | |
Collapse
|
44
|
Alexandrov AV, Barlinn K. Taboos and opportunities in sonothrombolysis for stroke. Int J Hyperthermia 2012; 28:397-404. [PMID: 22621740 DOI: 10.3109/02656736.2012.674621] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Systemic thrombolysis with tissue plasminogen activator (tPA) is the only approved treatment for acute ischaemic stroke that improves functional outcome if given up to 4.5 h from symptom onset. At least half of treated patients have unfavourable outcomes long-term though, emphasising the need to amplify the only approved acute stroke therapy. Ultrasound targeting of an intra-arterial occlusive clot and delivering mechanical pressure to its surrounding fluids (referred to as sonothrombolysis) accelerates the thrombolytic effect of tPA. Higher recanalisation rates produce a trend towards better functional outcomes that could be safely achieved with the combination of 2 MHz frequency ultrasound and systemic tPA. To further accelerate the clot-dissolving effect of ultrasound, a variety of frequencies and intensities as well as other adjuvant treatment elements are being studied. However, literature reports argue efficacy and safety of these novel approaches doubting promptly translation into the clinical practice. This review will summarise our current knowledge about potentially harmful (taboos) directions and what we think are promising avenues for these future stroke therapies. We also give a prospect for novel technologies such as operator-independent devices that aim to further spread the use of sonothrombolysis for stroke.
Collapse
Affiliation(s)
- Andrei V Alexandrov
- Comprehensive Stroke Center, University of Alabama Hospital, Birmingham, Alabama, USA.
| | | |
Collapse
|
45
|
Sheeran PS, Dayton PA. Phase-change contrast agents for imaging and therapy. Curr Pharm Des 2012; 18:2152-65. [PMID: 22352770 DOI: 10.2174/138161212800099883] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 12/29/2011] [Indexed: 01/24/2023]
Abstract
Phase-change contrast agents (PCCAs) for ultrasound-based applications have resulted in novel ways of approaching diagnostic and therapeutic techniques beyond what is possible with microbubble contrast agents and liquid emulsions. When subjected to sufficient pressures delivered by an ultrasound transducer, stabilized droplets undergo a phase-transition to the gaseous state and a volumetric expansion occurs. This phenomenon, termed acoustic droplet vaporization, has been proposed as a means to address a number of in vivo applications at the microscale and nanoscale. In this review, the history of PCCAs, physical mechanisms involved, and proposed applications are discussed with a summary of studies demonstrated in vivo. Factors that influence the design of PCCAs are discussed, as well as the need for future studies to characterize potential bioeffects for administration in humans and optimization of ultrasound parameters.
Collapse
Affiliation(s)
- Paul S Sheeran
- Joint Department of Biomedical Engineering, The University of North Carolina, Chapel Hill, 27599, USA
| | | |
Collapse
|
46
|
Petit B, Gaud E, Colevret D, Arditi M, Yan F, Tranquart F, Allémann E. In vitro sonothrombolysis of human blood clots with BR38 microbubbles. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1222-1233. [PMID: 22542261 DOI: 10.1016/j.ultrasmedbio.2012.02.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 05/31/2023]
Abstract
Microbubble-mediated sonothrombolysis is a promising approach for ischemic stroke treatment. The aim of this in vitro study was to evaluate a new microbubble (MB) formulation (BR38) for sonothrombolysis and to investigate the involved mechanisms. Human whole-blood clots were exposed to different combinations of recombinant tissue plasminogen activator (rtPA), ultrasound (US) and MB. Ultrasound at 1.6 MHz was used at 150, 300, 600 and 1000 kPa (peak-negative pressure). Thrombolysis efficacy was assessed by measuring clot diameter changes during 60-min US exposure. The rate of clot diameter loss (RDL) in μm/min was determined and clot lysis profiles were analyzed. The most efficient clot lysis (5.9 μm/min) was obtained at acoustic pressures of 600 and 1000 kPa in combination with MB and a low concentration of rtPA (0.3 μg/mL). This is comparable with the rate obtained with rtPA at 3 μg/mL alone (6.6 μm/min, p > 0.05). Clot lysis profiles were shown to be related to US beam profiles and microbubble cavitation.
Collapse
Affiliation(s)
- Bénédicte Petit
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
47
|
Smith BW, Simpson DG, Sarwate S, Miller RJ, Blue JP, Haak A, O'Brien WD, Erdman JW. Contrast ultrasound imaging of the aorta alters vascular morphology and circulating von Willebrand factor in hypercholesterolemic rabbits. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:711-20. [PMID: 22535718 PMCID: PMC3428799 DOI: 10.7863/jum.2012.31.5.711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Ultrasound contrast agents (UCAs) are intravenously infused microbubbles that add definition to ultrasonic images. Ultrasound contrast agents continue to show clinical promise in cardiovascular imaging, but their biological effects are not known with confidence. We used a cholesterol-fed rabbit model to evaluate these effects when used in conjunction with ultrasound (US) to image the descending aorta. METHODS Male New Zealand White rabbits (n = 41) were weaned onto an atherogenic diet containing 1% cholesterol, 10% fat, and 0.11% magnesium. At 21 days, rabbits were exposed to contrast US at 1 of 4 pressure levels using either the UCA Definity (Lantheus Medical Imaging, Inc, North Billerica, MA) or a saline control (n = 5 per group). Blood samples were collected and analyzed for lipids and von Willebrand factor (vWF), a marker of endothelial function. Animals were euthanized at 42 days, and tissues were collected for histologic analysis. RESULTS After adjustment for pre-exposure vWF, high-level US (in situ [at the aorta] peak rarefactional pressure of 1.4 or 2.1 MPa) resulted in significantly lower vWF 1 hour post exposure (P = .0127; P(adj) < .0762). This difference disappeared within 24 hours. Atheroma thickness in the descending aorta was lower in animals receiving the UCA compared to animals receiving saline. CONCLUSIONS Contrast US affected the descending aorta, as evidenced by two separate outcome measures. These results may be a first step in elucidating a previously unknown biological effect of UCAs. Further research is warranted to characterize the effects of this procedure.
Collapse
Affiliation(s)
- Brendon W Smith
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Miller DL, Smith NB, Bailey MR, Czarnota GJ, Hynynen K, Makin IRS. Overview of therapeutic ultrasound applications and safety considerations. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:623-34. [PMID: 22441920 PMCID: PMC3810427 DOI: 10.7863/jum.2012.31.4.623] [Citation(s) in RCA: 331] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Applications of ultrasound in medicine for therapeutic purposes have been accepted and beneficial uses of ultrasonic biological effects for many years. Low-power ultrasound of about 1 MHz has been widely applied since the 1950s for physical therapy in conditions such as tendinitis and bursitis. In the 1980s, high-pressure-amplitude shock waves came into use for mechanically resolving kidney stones, and "lithotripsy" rapidly replaced surgery as the most frequent treatment choice. The use of ultrasonic energy for therapy continues to expand, and approved applications now include uterine fibroid ablation, cataract removal (phacoemulsification), surgical tissue cutting and hemostasis, transdermal drug delivery, and bone fracture healing, among others. Undesirable bioeffects can occur, including burns from thermal-based therapies and severe hemorrhage from mechanical-based therapies (eg, lithotripsy). In all of these therapeutic applications of ultrasound bioeffects, standardization, ultrasound dosimetry, benefits assurance, and side-effect risk minimization must be carefully considered to ensure an optimal benefit to risk ratio for the patient. Therapeutic ultrasound typically has well-defined benefits and risks and therefore presents a manageable safety problem to the clinician. However, safety information can be scattered, confusing, or subject to commercial conflicts of interest. Of paramount importance for managing this problem is the communication of practical safety information by authoritative groups, such as the American Institute of Ultrasound in Medicine, to the medical ultrasound community. In this overview, the Bioeffects Committee of the American Institute of Ultrasound in Medicine outlines the wide range of therapeutic ultrasound methods, which are in clinical use or under study, and provides general guidance for ensuring therapeutic ultrasound safety.
Collapse
Affiliation(s)
- Douglas L Miller
- Department of Radiology, University of Michigan, 3240A Medical Science Building I, 1301 Catherine St, Ann Arbor, MI 48109-5667, USA.
| | | | | | | | | | | |
Collapse
|
49
|
Kenis AM, Grinfeld J, Zadicario E, Vitek S. Impact of propagating and standing waves on cavitation appearance. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:99-108. [PMID: 22104538 DOI: 10.1016/j.ultrasmedbio.2011.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/20/2011] [Accepted: 08/02/2011] [Indexed: 05/31/2023]
Abstract
Standing waves play a significant role in the appearance of cavitation phenomena. The goal of this study was to investigate the effect that the relation between standing and propagating waves in a focused field has on acoustic bubble cloud formation. Measurements of the cavitation signals were performed on five different configurations of a hemispheric phased array transducer (230 kHz) representing a wide range of relations between propagating and standing waves. The results show that configurations with a larger propagating component induce bubble clouds at lower pressures than configurations with a larger standing component.
Collapse
|
50
|
Petit B, Yan F, Tranquart F, Allémann E. Microbubbles and ultrasound-mediated thrombolysis: a review of recent in vitro studies. J Drug Deliv Sci Technol 2012. [DOI: 10.1016/s1773-2247(12)50065-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|