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Localized Down-regulation of P-glycoprotein by Focused Ultrasound and Microbubbles induced Blood-Brain Barrier Disruption in Rat Brain.

Authors: Cho H, Lee HY, Han M, Choi JR, Ahn S, Lee T, Chang Y, Park J

Multi-drug resistant efflux transporters found in Blood-Brain Barrier (BBB) acts as a functional barrier, by pumping out most of the drugs into the blood. Previous studies showed focused ultrasound (FUS) induced microbubble oscillation can disrupt the BBB by loosening the tight junctions in the brain endothelial cells; however, no study was performed to investigate its impact on the functional barrier of the BBB. In this study, the BBB in rat brains were disrupted using the MRI guided FUS and microbubbles. The immunofluorescence study evaluated the expression of the P-glycoprotein (P-gp), the most dominant multi-drug resistant protein found in the BBB. Intensity of the P-gp expression at the BBB disruption (BBBD) regions was significantly reduced (63.2 ± 18.4%) compared to the control area. The magnitude of the BBBD and the level of the P-gp down-regulation were significantly correlated. Both the immunofluorescence and histologic analysis at the BBBD regions revealed no apparent damage in the brain endothelial cells. The results demonstrate that the FUS and microbubbles can induce a localized down-regulation of P-gp expression in rat brain. The study suggests a clinically translation of this method to treat neural diseases through targeted delivery of the wide ranges of brain disorder related drugs.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To determine whether MRI-guided focused ultrasound with microbubbles can locally down-regulate P-glycoprotein expression at the blood–brain barrier in rat brains.
Animal model / Human subject rat, Sprague-Dawley, none, male
Disease model healthy
MRI or image guidance method MRI guidance (MRgFUS): preclinical horizontal-bore 9.4T MRI used; T1-weighted MR images for treatment planning; MR images transferred to the MRgFUS system and coordinates synced to target sonications.
Cargo name and characteristics Evans Blue (small-molecule dye used to label BBB disruption); Gadolinium-based MRI contrast agent (Magnavist; small-molecule contrast agent); Mouse anti-P-glycoprotein (C219) and anti-RECA-1 primary antibodies (proteins for immunofluorescence); Alexa Fluor 488-conjugated goat anti-mouse secondary antibody (fluorophore-labeled protein)
Route of administration Intravenous (tail vein catheter) and intramuscular

Outcomes and Safety

Summary of Outcomes Focused ultrasound with microbubbles opened the BBB and reduced P-glycoprotein expression.
Duration of biological effect 24 h
Safety-related matter No tissue damage reported.

Brain Region

Visualization unavailable

Ultrasound Parameters

Ultrasound instrument RK-100
FUS Frequency 1 MHz
FUS Intensity not reported
FUS Pressure 0.6–0.65 MPa
FUS Mode pulsed
Pulse duration 10 ms
Duration of a single FUS session 120 seconds
Focal Characteristics focal length: 60 mm; aperture size: 75 mm
Treatment frequency Single

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