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Alzheimer's disease brain endothelial-like cells reveal differential drug transporter expression and modulation by potentially therapeutic focused ultrasound.

Authors: Chaves JCS, Wasielewska JM, Cuní-López C, Rantanen LM, Lee S, Koistinaho J, White AR, Oikari LE

The blood-brain barrier (BBB) has a key function in maintaining homeostasis in the brain, partly modulated by transporters, which are highly expressed in brain endothelial cells (BECs). Transporters mediate the uptake or efflux of compounds to and from the brain and they can also challenge the delivery of drugs for the treatment of Alzheimer's disease (AD). Currently there is a limited understanding of changes in BBB transporters in AD. To investigate this, we generated brain endothelial-like cells (iBECs) from induced pluripotent stem cells (iPSCs) with familial AD (FAD) Presenilin 1 (PSEN1) mutation and identified AD-specific differences in transporter expression compared to control (ctrl) iBECs. We first characterized the expression levels of 12 BBB transporters in AD-, Ctrl-, and isogenic (PSEN1 corrected) iBECs to identify any AD specific differences. We then exposed the cells to focused ultrasound (FUS) in the absence (FUS<sup>only</sup>) or presence of microbubbles (MB) (FUS<sup>+MB</sup>), which is a novel therapeutic method that can be used to transiently open the BBB to increase drug delivery into the brain, however its effects on BBB transporter expression are largely unknown. Following FUS<sup>only</sup> and FUS<sup>+MB</sup>, we investigated whether the expression or activity of key transporters could be modulated. Our findings demonstrate that PSEN1 mutant FAD (PSEN1<sup>AD</sup>) possess phenotypical differences compared to control iBECs in BBB transporter expression and function. Additionally, we show that FUS<sup>only</sup> and FUS<sup>+MB</sup> can modulate BBB transporter expression and functional activity in iBECs, having potential implications on drug penetration and amyloid clearance. These findings highlight the differential responses of patient cells to FUS treatment, with patient-derived models likely providing an important tool for modelling therapeutic effects of FUS.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To determine how blood–brain barrier transporter expression and function differ in PSEN1 familial Alzheimer's iPSC-derived brain endothelial-like cells versus controls and how focused ultrasound (with or without microbubbles) modulates these transporters and their efflux activity.
Animal model / Human subject Homo sapiens; patient-derived human induced pluripotent stem cells (hiPSCs) differentiated to brain endothelial-like cells (iBECs): 6 lines total (2 unrelated healthy control lines, 2 familial Alzheimer's disease lines harbouring PSEN1 exon 9 deletion, and 2 isogenic PSEN1 exon 9-corrected control lines); plus human immortalized cerebral microvascular endothelial cell line hCMEC/D3 (Merck Millipore, SCC066). Age: not reported. Sex: not reported.
Disease model Alzheimer's disease (familial Alzheimer's disease with PSEN1 mutation)
MRI or image guidance method None — in vitro setup; FUS was applied directly to cells in 24-well plates
Targeted brain region(s) Blood–Brain Barrier (Brain Endothelial Cells / In Vitro Ibecs)
Target coordinates not reported
Cargo name and characteristics Rhodamine 123 ; Calcein‑AM; FITC‑conjugated Aβ42; Cyclosporin‑A (CsA) ; MK‑571
Route of administration In vitro

Outcomes and Safety

Summary of Outcomes MRI
Duration of biological effect 24 h
Safety-related matter The paper states that FUS+MB can transiently and safely open the BBB to enhance drug delivery but warns of potential adverse effects—particularly increased or prolonged BBB permeability in aged/AD subjects that could exacerbate inflammation—so FUS parameters should be adjusted to mitigate risks.

Brain Region

Ultrasound Parameters

Ultrasound instrument Focused ultrasound system (Sonic Concepts); parameters reported: 286 kHz center frequency, 0.3 MPa peak rarefactional pressure, 50 cycles/burst, 20 ms burst period, 120 s sonication time. Transducer aperture/diameter: not specified.
FUS Frequency 286 kHz
FUS Intensity Not reported
FUS Pressure 0.3 MPa
FUS Mode pulsed
Pulse duration 0.175 ms
Duration of a single FUS session 120 s
Focal Characteristics Not reported
Treatment frequency single

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