Keller Sara B, Suo Dingjie, Wang Yak-Nam, Kenerson Heidi, Yeung Raymond S, Averkiou Michalakis A
Department of Bioengineering, University of Washington, Seattle, WA, United States.
Applied Physics Laboratory, University of Washington, Seattle, WA, United States.
Front Pharmacol. 2020 Sep 30;11:584344. doi: 10.3389/fphar.2020.584344. eCollection 2020.
Despite advances in interventional procedures and chemotherapeutic drug development, hepatocellular carcinoma (HCC) is still the fourth leading cause of cancer-related deaths worldwide with a <30% 5-year survival rate. This poor prognosis can be attributed to the fact that HCC most commonly occurs in patients with pre-existing liver conditions, rendering many treatment options too aggressive. Patient survival rates could be improved by a more targeted approach. Ultrasound-induced cavitation can provide a means for overcoming traditional barriers defining drug uptake. The goal of this work was to evaluate preclinical efficacy of image-guided, cavitation-enabled drug delivery with a clinical ultrasound scanner. To this end, ultrasound conditions (unique from those used in imaging) were designed and implemented on a Philips EPIQ and S5-1 phased array probe to produced focused ultrasound for cavitation treatment. Sonovue microbubbles which are clinically approved as an ultrasound contrast agent were used for both imaging and cavitation treatment. A genetically engineered mouse model was bred and used as a physiologically relevant preclinical analog to human HCC. It was observed that image-guided and targeted microbubble cavitation resulted in selective disruption of the tumor blood flow and enhanced doxorubicin uptake and penetration. Histology results indicate that no gross morphological damage occurred as a result of this process. The combination of these effects may be exploited to treat HCC and other challenging malignancies and could be implemented with currently available ultrasound scanners and reagents.
尽管介入手术和化疗药物研发取得了进展,但肝细胞癌(HCC)仍是全球癌症相关死亡的第四大主要原因,其5年生存率低于30%。这种不良预后可归因于HCC最常发生在已有肝脏疾病的患者中,这使得许多治疗方案过于激进。采用更具针对性的方法可以提高患者生存率。超声诱导空化可以提供一种克服传统药物摄取障碍的手段。这项工作的目的是评估使用临床超声扫描仪进行图像引导、空化辅助药物递送的临床前疗效。为此,在飞利浦EPIQ和S5-1相控阵探头上设计并实施了超声条件(与成像所用条件不同),以产生用于空化治疗的聚焦超声。临床批准作为超声造影剂的声诺维微泡用于成像和空化治疗。培育了一种基因工程小鼠模型,并将其用作与人类HCC生理相关的临床前类似物。观察到图像引导和靶向微泡空化导致肿瘤血流的选择性破坏,并增强了阿霉素的摄取和渗透。组织学结果表明,该过程未导致明显的形态学损伤。这些效应的组合可用于治疗HCC和其他具有挑战性的恶性肿瘤,并且可以使用现有的超声扫描仪和试剂来实现。
Ultrasound Med Biol. 2021-11
J Control Release. 2018-5-24
Proc Natl Acad Sci U S A. 2017-11-13
IEEE Trans Ultrason Ferroelectr Freq Control. 2021-4
J Control Release. 2016-9-28
J Control Release. 2015-4-10
IEEE Trans Ultrason Ferroelectr Freq Control. 2025-3
Pharmaceutics. 2023-4-11
Ultrasound Med Biol. 2020-3
Nanotheranostics. 2019-10-1
JACC Cardiovasc Imaging. 2019-8-14
Ultrasound Med Biol. 2019-1-9
ACS Appl Mater Interfaces. 2018-5-15