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Effect of Microbubble Size, Composition, and Multiple Sonication Points on Sterile Inflammatory Response in Focused Ultrasound-Mediated Blood-Brain Barrier Opening.

Authors: Martinez PJ, Song JJ, Castillo JI, DeSisto J, Song KH, Green AL, Borden M

Blood-brain barrier opening (BBBO) using focused ultrasound (FUS) and microbubbles (MBs) has emerged as a promising technique for delivering therapeutics to the brain. However, the influence of various FUS and MB parameters on BBBO and subsequent sterile inflammatory response (SIR) remains unclear. In this study, we investigated the effects of MB size and composition, as well as the number of FUS sonication points, on BBBO and SIR in an immunocompetent mouse model. Using MRI-guided MB + FUS, we targeted the striatum and assessed extravasation of an MRI contrast agent to assess BBBO and RNaseq to assess SIR. Our results revealed distinct effects of these parameters on BBBO and SIR. Specifically, at a matched microbubble volume dose (MVD), MB size did not affect the extent of BBBO, but smaller (1 μm diameter) MBs exhibited a lower classification of SIR than larger (3 or 5 μm diameter) MBs. Lipid-shelled microbubbles exhibited greater BBBO and a more pronounced SIR compared to albumin-shelled microbubbles, likely owing to the latter's poor <i>in vivo</i> stability. As expected, increasing the number of sonication points resulted in greater BBBO and SIR. Furthermore, correlation analysis revealed strong associations between passive cavitation detection measurements of harmonic and inertial MB echoes, BBBO, and the expression of SIR gene sets. Our findings highlight the critical role of MB and FUS parameters in modulating BBBO and subsequent SIR in the brain. These insights inform the development of targeted drug delivery strategies and the mitigation of adverse inflammatory reactions in neurological disorders.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To determine how microbubble size and composition and the number of focused ultrasound sonication points affect blood–brain barrier opening and the sterile inflammatory response in an immunocompetent mouse model.
Animal model / Human subject Mouse (immunocompetent), strain None, age None, sex None
Disease model healthy
MRI or image guidance method MRI-guided
Targeted brain region(s) Striatum
Cargo name and characteristics MRI contrast agent (small-molecule, gadolinium-based contrast agent used to assess BBB opening)

Outcomes and Safety

Summary of Outcomes FUS-mediated BBB opening increased with lipid-shelled microbubbles and with greater numbers of sonication points (harmonic and inertial cavitation measures correlated with BBBO), while smaller 1 μm microbubbles produced equivalent BBBO at matched microbubble volume dose but elicited reduced sterile inflammatory responses compared with 3–5 μm microbubbles.
Safety-related matter The study identifies sterile inflammatory responses (SIR) as a safety concern: larger (3–5 μm) and lipid-shelled microbubbles, and increasing the number of FUS sonication points, produced more pronounced SIR. The authors note these parameter-dependent inflammatory effects as adverse reactions that should be mitigated when developing BBBO-based therapeutic strategies.

Brain Region

Ultrasound Parameters

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

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