1
|
Shao X, Saito R, Sato A, Okuno S, Saigusa D, Saito R, Uruno A, Osada Y, Kanamori M, Tominaga T. Local Delivery of Nimustine Hydrochloride against Brain Tumors: Basic Characterization Study. TOHOKU J EXP MED 2023; 261:187-194. [PMID: 37635063 DOI: 10.1620/tjem.2023.j069] [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: 08/29/2023]
Abstract
Convection-enhanced delivery (CED) delivers agents directly into tumors and the surrounding parenchyma. Although a promising concept, clinical applications are often hampered by insufficient treatment efficacy. Toward developing an effective CED-based strategy for delivering drugs with proven clinical efficacy, we performed a basic characterization study to explore the locally delivered characteristics of the water soluble nitrosourea nimustine hydrochloride (ACNU). First, ACNU distribution after CED in rodent brain was studied using mass spectrometry imaging. Clearance of 14C-labeled ACNU after CED in striatum was also studied. ACNU was robustly distributed in rodent brain similar to the distribution of the hydrophilic dye Evans blue after CED, and locally delivered ACNU was observed for over 24 h at the delivery site. Subsequently, to investigate the potential of ACNU to induce an immunostimulative microenvironment, Fas and transforming growth factor-β1 (TGF-β1) was assessed in vitro. We found that ACNU significantly inhibited TGF-β1 secretion and reduced Fas expression. Further, after CED of ACNU in 9L-derived intracranial tumors, the infiltration of CD4/CD8 lymphocytes in tumors was evaluated by immunofluorescence.CED of ACNU in xenografted intracranial tumors induced tumor infiltration of CD4/CD8 lymphocytes. ACNU has a robust distribution in rodent brain by CED, and delayed clearance of the drug was observed at the local infusion site. Further, local delivery of ACNU affects the tumor microenvironment and induces immune cell migration in tumor. These characteristics make ACNU a promising agent for CED.
Collapse
Affiliation(s)
- Xiaodong Shao
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Ryuta Saito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
- Department of Neurosurgery, Nagoya University Graduate School of Medicine
| | - Aya Sato
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Saori Okuno
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Daisuke Saigusa
- Faculty of Pharma-Science, Teikyo University
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University
| | - Ritsumi Saito
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University
| | - Akira Uruno
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University
| | - Yoshinari Osada
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masayuki Kanamori
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| |
Collapse
|
2
|
Tosi U, Kommidi H, Adeuyan O, Guo H, Maachani UB, Chen N, Su T, Zhang G, Pisapia DJ, Dahmane N, Ting R, Souweidane MM. PET, image-guided HDAC inhibition of pediatric diffuse midline glioma improves survival in murine models. SCIENCE ADVANCES 2020; 6:eabb4105. [PMID: 32832670 PMCID: PMC7439439 DOI: 10.1126/sciadv.abb4105] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/05/2020] [Indexed: 05/24/2023]
Abstract
Efforts at altering the dismal prognosis of pediatric midline gliomas focus on direct delivery strategies like convection-enhanced delivery (CED), where a cannula is implanted into tumor. Successful CED treatments require confirmation of tumor coverage, dosimetry, and longitudinal in vivo pharmacokinetic monitoring. These properties would be best determined clinically with image-guided dosimetry using theranostic agents. In this study, we combine CED with novel, molecular-grade positron emission tomography (PET) imaging and show how PETobinostat, a novel PET-imageable HDAC inhibitor, is effective against DIPG models. PET data reveal that CED has significant mouse-to-mouse variability; imaging is used to modulate CED infusions to maximize tumor saturation. The use of PET-guided CED results in survival prolongation in mouse models; imaging shows the need of CED to achieve high brain concentrations. This work demonstrates how personalized image-guided drug delivery may be useful in potentiating CED-based treatment algorithms and supports a foundation for clinical translation of PETobinostat.
Collapse
Affiliation(s)
- Umberto Tosi
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Harikrishna Kommidi
- Department of Radiology, Molecular Imaging Innovations Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Oluwaseyi Adeuyan
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Hua Guo
- Department of Radiology, Molecular Imaging Innovations Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Uday Bhanu Maachani
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Nandi Chen
- Department of Radiology, Molecular Imaging Innovations Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Taojunfeng Su
- Proteomics and Metabolomics Core Facility, Weill Cornell Medicine, New York, NY 10021, USA
| | - Guoan Zhang
- Proteomics and Metabolomics Core Facility, Weill Cornell Medicine, New York, NY 10021, USA
| | - David J. Pisapia
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Nadia Dahmane
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Richard Ting
- Department of Radiology, Molecular Imaging Innovations Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Mark M. Souweidane
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| |
Collapse
|
3
|
Saito R, Kanamori M, Sonoda Y, Yamashita Y, Nagamatsu K, Murata T, Mugikura S, Kumabe T, Wembacher-Schröder E, Thomson R, Tominaga T. Phase I trial of convection-enhanced delivery of nimustine hydrochloride (ACNU) for brainstem recurrent glioma. Neurooncol Adv 2020; 2:vdaa033. [PMID: 32642691 PMCID: PMC7212853 DOI: 10.1093/noajnl/vdaa033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Treatment options for patients suffering brainstem gliomas are quite limited as surgery is not an option against intrinsic tumors at brainstem and chemotherapy generally failed to demonstrate its efficacy. Intracerebral convection-enhanced delivery (CED) is a novel approach for administering chemotherapy to patients with brain tumors. We present the results of phase I trial of CED of nimustine hydrochloride (ACNU), designed to determine the maximum tolerable concentration of ACNU, for patients with recurrent brainstem gliomas. Methods Sixteen patients, aged 3–81 years old, suffering from recurrent brainstem gliomas, including diffuse intrinsic pontine glioma patients as well as patients with recurrent gliomas that originated from non‐brainstem sites, were enrolled in this trial between February 2011 and April 2016. The dose/concentration escalation trial included 3 dose/concentration groups (0.25, 0.5, and 0.75 mg/mL, all at 7 mL) to determine the safety and tolerability of CED of ACNU. Real-time monitoring of drug distribution was performed by mixing gadolinium-tetraazacyclododecanetetraacetic acid (Gd-DOTA) in the infusion solution. CED of ACNU was given in combination with oral or intravenous temozolomide chemotherapy. Results CED of ACNU demonstrated antitumor activity, as assessed by radiographic changes and prolonged overall survival. The recommended dosage was 0.75 mg/mL. Drug-associated toxicity was minimal. Conclusions Intracerebral CED of ACNU under real-time monitoring of drug distribution, in combination with systemic temozolomide, was well tolerated among patients with recurrent brainstem gliomas. The safety and efficacy observed suggest the clinical benefits of this strategy against this devastating disease. Based on this phase I study, further clinical development of ACNU is warranted.
Collapse
Affiliation(s)
- Ryuta Saito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Kanamori
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukihiko Sonoda
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoji Yamashita
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenichi Nagamatsu
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaki Murata
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shunji Mugikura
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
4
|
Tosi U, Souweidane MM. Longitudinal Monitoring of Gd-DTPA Following Convection Enhanced Delivery in the Brainstem. World Neurosurg 2020; 137:38-42. [PMID: 32028001 DOI: 10.1016/j.wneu.2020.01.199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Convection-enhanced delivery (CED) has been introduced into contemporary therapeutic strategies for incurable brain neoplasms as diffuse intrinsic pontine glioma. Therapeutic benefit in part is predictably dependent on drug distribution within tumors. However, therapeutics can rarely be detected through conventional imaging techniques. Coinfusion of the tracer gadolinium-diethylenetriaminepentacetate (Gd-DTPA) has been advocated to monitor drug distributive features including volume, tumor coverage, and efflux during and after administration. The kinetics of Gd-DTPA are unclear as longitudinal magnetic resonance imaging is rarely performed. Understanding these changes would have important implications related to the timing of diagnostic imaging and reliance on tracers as surrogates of pharmacokinetic drug monitoring. CASE DESCRIPTION The behavior of Gd-DTPA as a surrogate is presented in a time-dependent fashion as measured by repeated magnetic resonance imaging based on the case of a child with recurrent diffuse intrinsic pontine glioma treated with an oncolytic virus (ICOVIR-5) delivered by CED with coinfused Gd-DTPA (1 mM, for a volume of 2000 μL). Initial Vd/Vi was 1.46. Gd-DTPA was observed up to 18 hours post CED but not thereafter. CONCLUSIONS This longitudinal imaging assessment provides a rare opportunity to better characterize the kinetics of surrogate tracers delivered by CED to the brainstem, highlighting the importance of immediate and longitudinal monitoring.
Collapse
Affiliation(s)
- Umberto Tosi
- Department of Neurosurgery, Weill Cornell Medicine, New York, New York, USA
| | - Mark M Souweidane
- Department of Neurosurgery, Weill Cornell Medicine, New York, New York, USA; Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
| |
Collapse
|
5
|
Chen PY, Yeh CK, Hsu PH, Lin CY, Huang CY, Wei KC, Liu HL. Drug-carrying microbubbles as a theranostic tool in convection-enhanced delivery for brain tumor therapy. Oncotarget 2018; 8:42359-42371. [PMID: 28418846 PMCID: PMC5522072 DOI: 10.18632/oncotarget.16218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/22/2017] [Indexed: 11/25/2022] Open
Abstract
Convection-enhanced delivery (CED) is a promising technique for infusing a therapeutic agent through a catheter with a pressure gradient to create bulk flow for improving drug spread into the brain. So far, gadopentetate dimeglumine (Gd-DTPA) is the most commonly applied surrogate agent for predicting drug distribution through magnetic resonance imaging (MRI). However, Gd-DTPA provides only a short observation duration, and concurrent infusion provides an indirect measure of the exact drug distribution. In this study, we propose using microbubbles as a contrast agent for MRI monitoring, and evaluate their use as a drug-carrying vehicle to directly monitor the infused drug. Results show that microbubbles can provide excellent detectability through MRI relaxometry and accurately represent drug distribution during CED infusion. Compared with the short half-life of Gd-DTPA (1-2 hours), microbubbles allow an extended observation period of up to 12 hours. Moreover, microbubbles provide a sufficiently high drug payload, and glioma mice that underwent a CED infusion of microbubbles carrying doxorubicin presented considerable tumor growth suppression and a significantly improved survival rate. This study recommends microbubbles as a new theranostic tool for CED procedures.
Collapse
Affiliation(s)
- Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center and School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.,Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Chih-Kuang Yeh
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - Po-Hung Hsu
- Department of Electrical Engineering, Chang Gung University, Taoyuan 333, Taiwan
| | - Chung-Yin Lin
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Chiung-Yin Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center and School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center and School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hao-Li Liu
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center and School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.,Department of Electrical Engineering, Chang Gung University, Taoyuan 333, Taiwan.,Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| |
Collapse
|
6
|
Convection-enhanced delivery of a hydrophilic nitrosourea ameliorates deficits and suppresses tumor growth in experimental spinal cord glioma models. Acta Neurochir (Wien) 2017; 159:939-946. [PMID: 28247160 DOI: 10.1007/s00701-017-3123-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Convection-enhanced delivery (CED) is a technique allowing local infusion of therapeutic agents into the central nervous system, circumventing the blood-brain or spinal cord barrier. OBJECTIVE To evaluate the utility of nimustine hydrochloride (ACNU) CED in controlling tumor progression in an experimental spinal cord glioma model. METHODS Toxicity studies were performed in 42 rats following the administration of 4 μl of ACNU CED into the mid-thoracic spinal cord at concentrations ranging from 0.1 to 10 mg/ml. Behavioral analyses and histological evaluations were performed to assess ACNU toxicity in the spinal cord. A survival study was performed in 32 rats following the implantation of 9 L cells into the T8 spinal cord. Seven days after the implantation, rats were assigned to four groups: ACNU CED (0.25 mg/ml; n = 8); ACNU intravenous (i.v.) (0.4 mg; n = 8); saline CED (n = 8); saline i.v. (n = 8). Hind limb movements were evaluated daily in all rats for 21 days. Tumor sizes were measured histologically. RESULTS The maximum tolerated ACNU concentration was 0.25 mg/ml. Preservation of hind limb motor function and tumor growth suppression was observed in the ACNU CED (0.25 mg/ml) and ACNU i.v. groups. Antitumor effects were more prominent in the ACNU CED group especially in behavioral analyses (P < 0.05; log-rank test). CONCLUSIONS ACNU CED had efficacy in controlling tumor growth and preserving neurological function in an experimental spinal cord tumor model. ACNU CED can be a viable treatment option for spinal cord high-grade glioma.
Collapse
|
7
|
Concepts, technologies, and practices for drug delivery past the blood–brain barrier to the central nervous system. J Control Release 2016; 240:251-266. [DOI: 10.1016/j.jconrel.2015.12.041] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 12/29/2022]
|
8
|
Mano Y, Saito R, Haga Y, Matsunaga T, Zhang R, Chonan M, Haryu S, Shoji T, Sato A, Sonoda Y, Tsuruoka N, Nishiyachi K, Sumiyoshi A, Nonaka H, Kawashima R, Tominaga T. Intraparenchymal ultrasound application and improved distribution of infusate with convection-enhanced delivery in rodent and nonhuman primate brain. J Neurosurg 2016; 124:1490-500. [DOI: 10.3171/2015.3.jns142152] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECT
Convection-enhanced delivery (CED) is an effective drug delivery method that delivers high concentrations of drugs directly into the targeted lesion beyond the blood-brain barrier. However, the drug distribution attained using CED has not satisfactorily covered the entire targeted lesion in tumors such as glioma. Recently, the efficacy of ultrasound assistance was reported for various drug delivery applications. The authors developed a new ultrasound-facilitated drug delivery (UFD) system that enables the application of ultrasound at the infusion site. The purpose of this study was to demonstrate the efficacy of the UFD system and to examine effective ultrasound profiles.
METHODS
The authors fabricated a steel bar-based device that generates ultrasound and enables infusion of the aqueous drug from one end of the bar. The volume of distribution (Vd) after infusion of 10 ml of 2% Evans blue dye (EBD) into rodent brain was tested with different frequencies and applied voltages: 252 kHz/30 V; 252 kHz/60 V; 524 kHz/13 V; 524 kHz/30 V; and 524 kHz/60 V. In addition, infusion of 5 mM gadopentetate dimeglumine (Gd-DTPA) was tested with 260 kHz/60 V, the distribution of which was evaluated using a 7-T MRI unit. In a nonhuman primate (Macaca fascicularis) study, 300 μl of 1 mM Gd-DTPA/EBD was infused. The final distribution was evaluated using MRI. Two-sample comparisons were made by Student t-test, and 1-way ANOVA was used for multiple comparisons. Significance was set at p < 0.05.
RESULTS
After infusion of 10 μl of EBD into the rat brain using the UFD system, the Vds of EBD in the UFD groups were significantly larger than those of the control group. When a frequency of 252 kHz was applied, the Vd of the group in which 60 V was applied was significantly larger than that of the group in which 30 V was used. When a frequency of 524 kHz was applied, the Vd tended to increase with application of a higher voltage; however, the differences were not significant (1-way ANOVA). The Vd of Gd-DTPA was also significantly larger in the UFD group than in the control group (p < 0.05, Student t-test). The volume of Gd-DTPA in the nonhuman primate used in this study was 1209.8 ± 193.6 mm3. This volume was much larger than that achieved by conventional CED (568.6 ± 141.0 mm3).
CONCLUSIONS
The UFD system facilitated the distribution of EBD and Gd-DTPA more effectively than conventional CED. Lower frequency and higher applied voltage using resonance frequencies might be more effective to enlarge the Vd. The UFD system may provide a new treatment approach for CNS disorders.
Collapse
Affiliation(s)
- Yui Mano
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Ryuta Saito
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yoichi Haga
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Tadao Matsunaga
- 3Tohoku University Micro System Integration Center (μSIC); and
| | - Rong Zhang
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masashi Chonan
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Shinya Haryu
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Takuhiro Shoji
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Aya Sato
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Yukihiko Sonoda
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Noriko Tsuruoka
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Keisuke Nishiyachi
- 2Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering
| | - Akira Sumiyoshi
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Hiroi Nonaka
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Ryuta Kawashima
- 4Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Teiji Tominaga
- 1Department of Neurosurgery, Tohoku University Graduate School of Medicine
| |
Collapse
|
9
|
Fan X, Nelson BD, Ai Y, Stiles DK, Gash DM, Hardy PA, Zhang Z. Continuous intraputamenal convection-enhanced delivery in adult rhesus macaques. J Neurosurg 2015; 123:1569-77. [DOI: 10.3171/2015.1.jns132345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Assessing the safety and feasibility of chronic delivery of compounds to the brain using convection-enhanced delivery (CED) is important for the further development of this important therapeutic technology. The objective of this study was to follow and model the distribution of a compound delivered by CED into the putamen of rhesus monkeys.
METHODS
The authors sequentially implanted catheters into 4 sites spanning the left and right putamen in each of 6 rhesus monkeys. The catheters were connected to implanted pumps, which were programmed to deliver a 5-mM solution of the MRI contrast agent Gd-DTPA at 0.1 μl/minute for 7 days and 0.3 μl/minute for an additional 7 days. The animals were followed for 28 days per implant cycle during which they were periodically examined with MRI.
RESULTS
All animals survived the 4 surgeries with no deficits in behavior. Compared with acute infusion, the volume of distribution (Vd) increased 2-fold with 7 days of chronic infusion. Increasing the flow rate 3-fold over the next week increased the Vd an additional 3-fold. Following withdrawal of the compound, the half-life of Gd-DTPA in the brain was estimated as 3.1 days based on first-order pharmacokinetics. Histological assessment of the brain showed minimal tissue damage limited to the insertion site.
CONCLUSIONS
These results demonstrate several important features in the development of a chronically implanted pump and catheter system: 1) the ability to place catheters accurately in a predetermined target; 2) the ability to deliver compounds in a chronic fashion to the putamen; and 3) the use of MRI and MR visible tracers to follow the evolution of the infusion volume over time.
Collapse
Affiliation(s)
- Xiaotong Fan
- 1Department of Neurosurgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
- 2Department of Anatomy & Neurobiology, College of Medicine,
| | | | - Yi Ai
- 2Department of Anatomy & Neurobiology, College of Medicine,
| | | | - Don M. Gash
- 2Department of Anatomy & Neurobiology, College of Medicine,
| | - Peter A. Hardy
- 3Magnetic Resonance Imaging and Spectroscopy Center, and
- 5Department of Radiology, Chandler Medical Center, University of Kentucky, Lexington, Kentucky; and
| | - Zhiming Zhang
- 2Department of Anatomy & Neurobiology, College of Medicine,
| |
Collapse
|
10
|
Endo T, Fujii Y, Sugiyama SI, Zhang R, Ogita S, Funamoto K, Saito R, Tominaga T. Properties of convective delivery in spinal cord gray matter: laboratory investigation and computational simulations. J Neurosurg Spine 2015; 24:359-366. [PMID: 26516661 DOI: 10.3171/2015.5.spine141148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Convection-enhanced delivery (CED) is a method for distributing small and large molecules locally into the interstitial space of the spinal cord. Delivering these molecules to the spinal cord is otherwise difficult due to the blood-spinal cord barrier. Previous research has proven the efficacy of CED for delivering molecules over long distances along the white matter tracts in the spinal cord. Conversely, the characteristics of CED for delivering molecules to the gray matter of the spinal cord remain unknown. The purpose of this study was to reveal regional distribution of macromolecules in the gray and white matter of the spinal cord with special attention to the differences between the gray and white matter. METHODS Sixteen rats (F344) underwent Evans blue dye CED to either the white matter (dorsal column, 8 rats) or the gray matter (ventral horn, 8 rats) of the spinal cord. The rates and total volumes of infusion were 0.2 μl/min and 2.0 μl, respectively. The infused volume of distribution was visualized and quantified histologically. Computational models of the rat spinal cord were also obtained to perform CED simulations in the white and gray matter. RESULTS The ratio of the volume of distribution to the volume of infusion in the gray matter of the spinal cord was 3.60 ± 0.69, which was comparable to that of the white matter (3.05 ± 0.88). When molecules were injected into the white matter, drugs remained in the white matter tract and rarely infused into the adjacent gray matter. Conversely, when drugs were injected into the gray matter, they infiltrated laterally into the white matter tract and traveled longitudinally and preferably along the white matter. In the infusion center, the areas were larger in the gray matter CED than in the white matter (Mann-Whitney U-test, p < 0.01). In computational simulations, the aforementioned characteristics of CED to the gray and white matter were reaffirmed. CONCLUSIONS In the spinal cord, the gray and white matter have distinct characteristics of drug distribution by CED. These differences between the gray and white matter should be taken into account when considering drug delivery to the spinal cord. Computational simulation is a useful tool for predicting drug distributions in the normal spinal cord.
Collapse
Affiliation(s)
- Toshiki Endo
- Department of Neurosurgery, Graduate School of Medicine, and
| | - Yushi Fujii
- Department of Neurosurgery, Graduate School of Medicine, and
| | | | - Rong Zhang
- Department of Neurosurgery, Graduate School of Medicine, and
| | - Shogo Ogita
- Department of Neurosurgery, Graduate School of Medicine, and
| | - Kenichi Funamoto
- Creative Flow Research Division, Institute of Fluid Science, Tohoku University, Sendai, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Graduate School of Medicine, and
| | - Teiji Tominaga
- Department of Neurosurgery, Graduate School of Medicine, and
| |
Collapse
|
11
|
Li YQ, Tang Y, Fu R, Meng QH, Zhou X, Ling ZM, Cheng X, Tian SW, Wang GJ, Liu XG, Zhou LH. Efficient labeling in vitro with non-ionic gadolinium magnetic resonance imaging contrast agent and fluorescent transfection agent in bone marrow stromal cells of neonatal rats. Mol Med Rep 2015; 12:913-20. [PMID: 25816076 PMCID: PMC4438951 DOI: 10.3892/mmr.2015.3532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 02/26/2015] [Indexed: 12/15/2022] Open
Abstract
Although studies have been undertaken on gadolinium labeling-based molecular imaging in magnetic resonance imaging (MRI), the use of non-ionic gadolinium in the tracking of stem cells remains uncommon. To investigate the efficiency in tracking of stem cells with non-ionic gadolinium as an MRI contrast agent, a rhodamine-conjugated fluorescent reagent was used to label bone marrow stromal cells (BMSCs) of neonatal rats in vitro, and MRI scanning was undertaken. The fluorescent-conjugated cell uptake reagents were able to deliver gadodiamide into BMSCs, and cell uptake was verified using flow cytometry. In addition, the labeled stem cells with paramagnetic contrast medium remained detectable by an MRI monitor for a minimum of 28 days. The present study suggested that this method can be applied efficiently and safely for the labeling and tracking of bone marrow stromal cells in neonatal rats.
Collapse
Affiliation(s)
- Ying-Qin Li
- Department of Anatomy, Zhong Shan School of Medicine, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Ying Tang
- Department of Anatomy, Zhong Shan School of Medicine, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Rao Fu
- Department of Anatomy, Zhong Shan School of Medicine, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Qiu-Hua Meng
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Xue Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Ze-Min Ling
- Department of Anatomy, Zhong Shan School of Medicine, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Xiao Cheng
- Department of Encephalopathy Center, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Su-Wei Tian
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat‑sen University, Zhuhai, Guangdong 519000, P.R. China
| | - Guo-Jie Wang
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat‑sen University, Zhuhai, Guangdong 519000, P.R. China
| | - Xue-Guo Liu
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat‑sen University, Zhuhai, Guangdong 519000, P.R. China
| | - Li-Hua Zhou
- Department of Anatomy, Zhong Shan School of Medicine, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
| |
Collapse
|
12
|
Zhang R, Saito R, Mano Y, Kanamori M, Sonoda Y, Kumabe T, Tominaga T. Concentration rather than dose defines the local brain toxicity of agents that are effectively distributed by convection-enhanced delivery. J Neurosci Methods 2014; 222:131-7. [DOI: 10.1016/j.jneumeth.2013.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 11/05/2013] [Indexed: 10/26/2022]
|
13
|
Sugiyama SI, Saito R, Funamoto K, Nakayama T, Sonoda Y, Yamashita Y, Inoue T, Kumabe T, Hayase T, Tominaga T. Computational simulation of convection-enhanced drug delivery in the non-human primate brainstem: a simple model predicting the drug distribution. Neurol Res 2013; 35:773-81. [DOI: 10.1179/1743132813y.0000000215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Shin-ichiro Sugiyama
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryuta Saito
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Toshio Nakayama
- Graduate School of Biomedical EngineeringTohoku University, Sendai, Japan
| | - Yukihiko Sonoda
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoji Yamashita
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoo Inoue
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshihiro Kumabe
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Teiji Tominaga
- Department of NeurosurgeryTohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
14
|
Siegal T. Which drug or drug delivery system can change clinical practice for brain tumor therapy? Neuro Oncol 2013; 15:656-69. [PMID: 23502426 DOI: 10.1093/neuonc/not016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The prognosis and treatment outcome for primary brain tumors have remained unchanged despite advances in anticancer drug discovery and development. In clinical trials, the majority of promising experimental agents for brain tumors have had limited impact on survival or time to recurrence. These disappointing results are partially explained by the inadequacy of effective drug delivery to the CNS. The impediments posed by the various specialized physiological barriers and active efflux mechanisms lead to drug failure because of inability to reach the desired target at a sufficient concentration. This perspective reviews the leading strategies that aim to improve drug delivery to brain tumors and their likelihood to change clinical practice. The English literature was searched for defined search items. Strategies that use systemic delivery and those that use local delivery are critically reviewed. In addition, challenges posed for drug delivery by combined treatment with anti-angiogenic therapy are outlined. To impact clinical practice and to achieve more than just a limited local control, new drugs and delivery systems must adhere to basic clinical expectations. These include, in addition to an antitumor effect, a verified favorable adverse effects profile, easy introduction into clinical practice, feasibility of repeated or continuous administration, and compatibility of the drug or delivery system with any tumor size and brain location.
Collapse
Affiliation(s)
- Tali Siegal
- Gaffin Center for Neuro-Oncology, Hadassah Hebrew-University Medical Center, Ein Kerem, P.O. Box 12000, Jerusalem 91120, Israel.
| |
Collapse
|