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Ultrasound enhanced delivery of molecular imaging and therapeutic agents in Alzheimer's disease mouse models.

Authors: Raymond SB, Treat LH, Dewey JD, McDannold NJ, Hynynen K, Bacskai BJ

Alzheimer's disease is a neurodegenerative disorder typified by the accumulation of a small protein, beta-amyloid, which aggregates and is the primary component of amyloid plaques. Many new therapeutic and diagnostic agents for reducing amyloid plaques have limited efficacy in vivo because of poor transport across the blood-brain barrier. Here we demonstrate that low-intensity focused ultrasound with a microbubble contrast agent may be used to transiently disrupt the blood-brain barrier, allowing non-invasive, localized delivery of imaging fluorophores and immunotherapeutics directly to amyloid plaques. We administered intravenous Trypan blue, an amyloid staining red fluorophore, and anti-amyloid antibodies, concurrently with focused ultrasound therapy in plaque-bearing, transgenic mouse models of Alzheimer's disease with amyloid pathology. MRI guidance permitted selective treatment and monitoring of plaque-heavy anatomical regions, such as the hippocampus. Treated brain regions exhibited 16.5+/-5.4-fold increase in Trypan blue fluorescence and 2.7+/-1.2-fold increase in anti-amyloid antibodies that localized to amyloid plaques. Ultrasound-enhanced delivery was consistently reproduced in two different transgenic strains (APPswe:PSEN1dE9, PDAPP), across a large age range (9-26 months), with and without MR guidance, and with little or no tissue damage. Ultrasound-mediated, transient blood-brain barrier disruption allows the delivery of both therapeutic and molecular imaging agents in Alzheimer's mouse models, which should aid pre-clinical drug screening and imaging probe development. Furthermore, this technique may be used to deliver a wide variety of small and large molecules to the brain for imaging and therapy in other neurodegenerative diseases.

Introduction

Purpose Drug delivery with BBB opening
Study Objective To test whether low-intensity focused ultrasound with microbubbles can transiently open the blood–brain barrier to enable localized delivery of imaging fluorophores and anti-amyloid antibodies to amyloid plaques in transgenic Alzheimer's mouse models.
Animal model / Human subject Mouse (transgenic): APPswe:PSEN1dE9 and PDAPP; age 9–26 months; sex not specified
Disease model Alzheimer's disease
MRI or image guidance method MRI guidance
Targeted brain region(s) Thalamus
Cargo name and characteristics Trypan blue (small-molecule red fluorescent amyloid-staining dye) and anti-amyloid antibodies (protein immunotherapeutics targeting amyloid-beta plaques)
Route of administration intravenous

Outcomes and Safety

Summary of Outcomes Low-intensity focused ultrasound with microbubbles transiently opened BBB and significantly increased delivery of imaging dyes and anti-amyloid antibodies to plaque-rich brain regions, with mild tissue damage except at higher pressures
Safety-related matter Minor petechial hemmorhages ocured in a subset of animals, mainly at higher pressures (0.8 Mpa), while sonications at 0.67 Mpa produces mostly no detectable tissue damage.

Brain Region

Ultrasound Parameters

Ultrasound instrument MR-compatible sonication system consisting of an ultrasound transducer in water tank
FUS Frequency 0.69 MHz
FUS Pressure 0.67-0.8 Mpa
FUS Mode pulsed
Pulse duration 10 ms
Duration of a single FUS session 40-45 s
Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None
Treatment frequency single

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