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Optimal timing for drug delivery into the hippocampus by focused ultrasound: A comparison of hydrophilic and lipophilic compounds.

Authors: Seo Y, Chang KW, Lee J, Kong C, Shin J, Chang JW, Na YC, Chang WS

Previous studies have reported that focused ultrasound (FUS) helps modulate the blood-brain barrier (BBB). These studies have generally used the paracellular pathway owing to tight junction proteins (TJPs) regulation. However, BBB transport pathways also include diffusion and transcytosis. Few studies have examined transcellular transport across endothelial cells. We supposed that increased BBB permeability caused by FUS may affect transcytosis. We investigated drug delivery through transcytosis and paracellular transport to the brain after BBB modulation using FUS. FUS and microbubbles were applied to the hippocampus of rats, and were euthanized at 1, 4, 24, and 48 h after sonication. To investigate paracellular transport, we analyzed TJPs, including zona occludens-1 (ZO-1) and occludin. We also investigated caveola-mediated transcytosis by analyzing caveola formation and major facilitator superfamily domain-containing 2a (Mfsd2a) levels, which inhibit caveola vesicle formation. One hour after FUS, ZO-1 and occludin expression was the lowest and gradually increased over time, returning to baseline 24 h after FUS treatment. Compared with that of TJPs, caveola formation started to increase 1 h after FUS treatment and peaked at 4 h after FUS treatment before returning to baseline by 48 h after FUS treatment. Decreased Mfsd2a levels were observed at 1 h and 4 h after FUS treatment, indicating increased caveola formation. FUS induces BBB permeability changes and regulates both paracellular transport and caveola-mediated transcytosis. However, a time difference was observed between these two mechanisms. Hence, when delivering drugs into the brain after FUS, the optimal drug administration timing should be determined by the mechanism by which each drug passes through the BBB.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To determine whether focused ultrasound with microbubbles modulates both paracellular tight-junction permeability and caveola-mediated transcytosis at the blood–brain barrier over time to guide optimal drug delivery timing.
Animal model / Human subject Rat (rats); strain: None; age: None; sex: None
Disease model Healthy
Targeted brain region(s) Hippocampus

Outcomes and Safety

Summary of Outcomes Focused ultrasound (FUS) with microbubbles transiently increased blood–brain barrier permeability by two mechanisms: early paracellular tight‑junction loosening peaking at 1 h (recovering by 24 h) and delayed caveolae‑mediated transcytosis peaking at 4 h (recovering by 48 h), permitting Evans blue and 500‑kDa dextran entry. The study did not vary sonication parameters beyond targeting the hippocampus and timepoints; the effective delivery windows identified were 1 h for paracellular transport and 4 h for transcellular (caveola‑mediated) transport.
Duration of biological effect 48 h
Safety-related matter Post-sonication MRI showed no edema and H&E staining revealed no red blood cell outflow (no cerebral hemorrhage); Evans blue leakage was localized and BBB closure occurred by 24 h. Tight junction and caveolae changes returned to baseline by 24–48 h, and no adverse effects were reported.

Brain Region

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None
Treatment frequency Single

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