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Acute Effects of Focused Ultrasound-Induced Blood-Brain Barrier Opening on Anti-Pyroglu3 Abeta Antibody Delivery and Immune Responses.

Authors: Bathini P, Sun T, Schenk M, Schilling S, McDannold NJ, Lemere CA

Alzheimer's Disease (AD) is a neurodegenerative disorder characterized by the accumulation of amyloid plaques and hyperphosphorylated tau in the brain. Currently, therapeutic agents targeting amyloid appear promising for AD, however, delivery to the CNS is limited due to the blood-brain-barrier (BBB). Focused ultrasound (FUS) is a method to induce a temporary opening of the BBB to enhance the delivery of therapeutic agents to the CNS. In this study, we evaluated the acute effects of FUS and whether the use of FUS-induced BBB opening enhances the delivery of 07/2a mAb, an anti-pyroglutamate-3 Aβ antibody, in aged 24 mo-old APP/PS1dE9 transgenic mice. FUS was performed either unilaterally or bilaterally with mAb infusion and the short-term effect was analyzed 4 h and 72 h post-treatment. Quantitative analysis by ELISA showed a 5-6-fold increase in 07/2a mAb levels in the brain at both time points and an increased brain-to-blood ratio of the antibody. Immunohistochemistry demonstrated an increase in IgG2a mAb detection particularly in the cortex, enhanced immunoreactivity of resident Iba1+ and phagocytic CD68+ microglial cells, and a transient increase in the infiltration of Ly6G+ immune cells. Cerebral microbleeds were not altered in the unilaterally or bilaterally sonicated hemispheres. Overall, this study shows the potential of FUS therapy for the enhanced delivery of CNS therapeutics.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To evaluate whether focused ultrasound-induced blood-brain barrier opening enhances delivery of the anti-pyroglutamate-3 Aβ antibody 07/2a to the brains of aged APP/PS1dE9 transgenic mice and to assess acute local immune and vascular effects.
Animal model / Human subject Mouse (Mus musculus), APP/PS1dE9 transgenic, 24 months old, sex not specified
Disease model Alzheimer's disease (APP/PS1dE9 transgenic mouse model)
Targeted brain region(s) Cortex
Cargo name and characteristics 07/2a monoclonal antibody (protein): anti-pyroglutamate-3 amyloid-β (pGlu3 Aβ) IgG2a mAb

Outcomes and Safety

Summary of Outcomes Unilateral and bilateral focused ultrasound–induced BBB opening increased delivery of the 07/2a anti‑pGlu3 Aβ antibody to aged APP/PS1 mouse brains 5–6-fold (at 4 h and 72 h), raised brain-to-blood antibody ratios, enhanced Iba1+/CD68+ microglial phagocytic activation and caused transient Ly6G+ immune cell infiltration without increasing cerebral microbleeds.
Duration of biological effect 72 h
Safety-related matter Acute FUS-induced BBB opening produced transient infiltration of Ly6G+ immune cells and increased activation/phagocytic markers in Iba1+/CD68+ microglia, but did not alter cerebral microbleeds in unilaterally or bilaterally sonicated hemispheres (assessed at 4 h and 72 h).

Brain Region

Ultrasound Parameters

Focal Characteristics focal depth: None; focal length: None; aperture size: None
Treatment frequency single session

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