Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Department of Neurosurgery, Humanitas University, Milan, Italy.
Sci Rep. 2022 Feb 21;12(1):2906. doi: 10.1038/s41598-022-06791-7.
The blood-brain barrier (BBB) represents a major obstacle to the delivery of drugs to the central nervous system. The combined use of low-intensity pulsed ultrasound waves and intravascular microbubbles (MB) represents a promising solution to this issue, allowing reversible disruption of the barrier. In this study, we evaluate the feasibility of BBB opening through a biocompatible, polyolefin-based plate in an in vitro whole brain model. Twelve in vitro guinea pig brains were employed; brains were insonated using a planar transducer with or without interposing the polyolefin plate during arterial infusion of MB. Circulating MBs were visualized with an ultrasonographic device with a linear probe. BBB permeabilization was assessed by quantifying at confocal microscopy the extravasation of FITC-albumin perfused after each treatment. US-treated brains displayed BBB permeabilization exclusively in the volume under the US beam; no significant differences were observed between brains insonated with or without the polyolefin plate. Control brains not perfused with MB did not show signs of FITC-albumin extravasation. Our preclinical study suggests that polyolefin cranial plate could be implanted as a skull replacement to maintain craniotomic windows and perform post-surgical repeated BBB opening with ultrasound guidance to deliver therapeutic agents to the central nervous system.
血脑屏障(BBB)是将药物递送到中枢神经系统的主要障碍。低强度脉冲超声波与血管内微泡(MB)的联合使用为解决这一问题提供了一种有前途的方法,允许可逆地破坏屏障。在这项研究中,我们评估了在体外全脑模型中通过生物相容的聚烯烃板打开 BBB 的可行性。使用 12 个离体豚鼠脑进行研究;在动脉内输注 MB 期间,使用平面换能器进行脑超声,并在其间插入聚烯烃板。通过在每次处理后灌注 FITC-白蛋白后定量共聚焦显微镜评估 BBB 的通透性。US 处理的大脑仅在超声束下的体积中显示 BBB 通透性;在没有或有聚烯烃板的情况下进行超声处理的大脑之间没有观察到显著差异。没有用 MB 灌注的对照大脑没有显示 FITC-白蛋白外渗的迹象。我们的临床前研究表明,聚烯烃颅骨板可以作为颅骨替代品植入,以维持颅切开窗,并在超声引导下进行术后重复 BBB 开放,以将治疗剂递送到中枢神经系统。