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Focused ultrasound-mediated bbb disruption is associated with an increase in activation of AKT: experimental study in rats.

Authors: Jalali S, Huang Y, Dumont DJ, Hynynen K

The Blood Brain Barrier (BBB) maintains the homeostasis of central nervous system by preventing the free passage of macromolecules from the systemic circulation into the brain. This normal physiological function of the BBB presents a challenge for delivery of therapeutic compounds into the brain. Recent studies have shown that the application of focused ultrasound together with ultrasound contrast agent (microbubbles) temporarily increases the permeability of the BBB. This effect is associated with breakdown of tight junctions, the structures that regulate the paracellular permeability of the endothelial cell layer. The influence of this ultrasound effect on the activation of intracellular signaling proteins is currently not well understood. Therefore, the aim of this study was to investigate the activation of cell survival signaling molecules in response to ultrasound-mediated BBB opening; The BBB was disrupted in two four-spot lines (1-1.5 mm spacing) along the right hemisphere of rat brain with ultrasound beams (0.3 MPa, 120 s, 10 ms bursts, repetition frequency = 1 Hz) in the presence Definity microbubbles. Contrast-enhanced MRI images were acquired to assess the extent of BBB opening upon which the animals were sacrificed and the brains removed and processed for biochemical and immunohistochemical analyses; Immunoblotting of sonicated brain lysates resolved by SDS-PAGE demonstrated an increase in phosphorylation of Akt and its downstream signaling molecule, GSK3β, while the phosphorylation of MAPK remained unchanged. The elevated levels of pAkt and pGSK3β are still evident after 24 hours post-sonication, a time point where the integrity of the BBB is known to be re-established. Furthermore, immunofluoresence staining localized this increase in pAkt and pGSK3β levels to neuronal cells flanking the region of the disrupted BBB; Our data demonstrates that ultrasound-mediated BBB disruption causes an activation of the Akt signaling pathway in neuronal cells surrounding the disrupted BBB.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To investigate the activation of cell survival signaling molecules in response to ultrasound-mediated blood–brain barrier opening.
Animal model / Human subject Rat (Rattus norvegicus); strain: not reported; age: not reported; sex: not reported
Disease model Healthy
MRI or image guidance method Contrast-enhanced MRI
Targeted brain region(s) Hemisphere Of Rat Brain

Outcomes and Safety

Summary of Outcomes Focused ultrasound (0.3 MPa, 10 ms bursts at 1 Hz for 120 s applied as two four‑spot lines spaced 1–1.5 mm) with Definity microbubbles transiently opened the BBB (MRI contrast enhancement and IgG extravasation), reduced occludin–ZO‑1 interaction, and produced sustained activation (increased phosphorylation) of neuronal Akt and downstream GSK3β for ≥24 h while MAPK signaling remained unchanged.
Duration of biological effect 24 hours
Safety-related matter Focused ultrasound with microbubbles caused BBB disruption evidenced by MRI contrast enhancement, IgG extravasation, and reduced occludin–ZO-1 interaction; the authors did not report overt adverse effects or tissue damage, and instead observed increased neuronal Akt/GSK3β phosphorylation interpreted as activation of survival pathways.

Brain Region

Ultrasound Parameters

FUS Pressure 0.3 MPa
FUS Mode pulsed
Pulse duration 10 ms
Duration of a single FUS session 120 s
Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None
Treatment frequency Single

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