Targeted delivery of self-complementary adeno-associated virus serotype 9 to the brain, using magnetic resonance imaging-guided focused ultrasound.
Authors: Thévenot E, Jordão JF, O'Reilly MA, Markham K, Weng YQ, Foust KD, Kaspar BK, Hynynen K, Aubert I
Noninvasive drug delivery to the brain remains a major challenge for the treatment of neurological disorders. Transcranial focused ultrasound combined with lipid-coated gas microspheres injected into the bloodstream has been shown to increase the permeability of the blood-brain barrier locally and transiently. Coupled with magnetic resonance imaging, ultrasound can be guided to allow therapeutics administered in the blood to reach brain regions of interest. Using this approach, we perform gene transfer from the blood to specific regions of the mouse brain. Focused ultrasound was targeted to the right hemisphere, at multiple foci, or restricted to one focal point of the hippocampus or the striatum. Doses from 5 × 10(8) to 1.25 × 10(10) vector genomes per gram (VG/g) of self-complementary adeno-associated virus serotype 9 carrying the green fluorescent protein were injected into the tail vein. A dose of 2.5 × 10(9) VG/g was optimal to express the transgene, 12 days later, in neurons, astrocytes, and oligodendrocytes in brain regions targeted with ultrasound, while minimizing the infection of peripheral organs. In the hippocampus and striatum, predominantly neurons and astrocytes were infected, respectively. Transcranial focused ultrasound applications could fulfill a long-term goal of gene therapy: delivering vectors to diseased brain areas directly from the circulation, in a noninvasive manner.
Introduction
Purpose
Drug delivery with BBB opening
Study Objective
To determine whether MRI-guided transcranial focused ultrasound combined with intravenously injected lipid-coated microbubbles can noninvasively deliver self-complementary AAV9 vectors from the bloodstream to specific mouse brain regions to achieve localized gene expression in target cell types.
Animal model / Human subject
Male and female C57BL/6 mice (12 weeks old)
Disease model
healthy
MRI or image guidance method
Magnetic resonance imaging (MRI)-guided focused ultrasound (FUS) 1.5 T MRI guidance
Targeted brain region(s)
Striatum
Target coordinates
Not reported
Cargo name and characteristics
Self-complementary adeno-associated virus serotype 9 (scAAV9) encoding green fluorescent protein (GFP); systemic IV delivery at doses 5×10^8 to 1.25×10^10 vector genomes per gram (VG/g), optimal 2.5×10^9 VG/g; delivered with MRI-guided focused ultrasound and lipid-coated gas microspheres to transiently open the blood–brain barrier for targeted brain transduction.
Route of administration
Intravenous (tail vein injection)
Outcomes and Safety
Summary of Outcomes
MRI-guided transcranial focused ultrasound (FUS) with intravenously injected lipid-coated microbubbles produced localized, transient blood–brain barrier opening that enabled delivery of systemically administered scAAV9-GFP into targeted mouse brain regions. An optimal systemic dose of 2.5×10^9 vector genomes per gram yielded robust GFP expression 12 days after treatment in FUS-targeted areas while minimizing peripheral organ transduction. Cell-type transduction depended on target: hippocampal FUS produced predominantly neuronal expression, striatal FUS produced predominantly astrocytic expression, and targeted regions overall showed transduction of neurons, astrocytes, and oligodendrocytes. The approach achieved noninvasive, region-specific gene transfer from the circulation with expression lasting at least 12 days. FUS + microbubbles enabled transient, localized BBB opening
Duration of biological effect
minimum of 12 days
Safety-related matter
Mentions 'noninvasive' delivery; transcranial focused ultrasound with lipid-coated gas microspheres 'increases the permeability of the blood–brain barrier locally and transiently'; reports an optimal dose (2.5×10^9 VG/g) that expressed transgene while 'minimizing the infection of peripheral organs'. No explicit mention of tissue damage or other adverse effects. No tissue damage
Brain Region
Ultrasound Parameters
Ultrasound instrument
MRIg FUS integrated in a 1.5T MRI
FUS Frequency
0.558 MHz for 4 spot RH, 1.18 MHz for striatum
FUS Intensity
Not specified in provided text
FUS Pressure
0.3 Mpa for 4 spot, 0.53-0.6 Mpa for single spot striatum
FUS Mode
pulsed
Pulse duration
10 ms
Duration of a single FUS session
120 seconds (2 minutes)
Focal Characteristics
Transducer: diameter: 10cm, focal length 8cm, targeted through intact skull, with 1.5 mm spacing between 4 spot array in hemisphere group
Treatment frequency
single session
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