Chen M Y, Lonser R R, Morrison P F, Governale L S, Oldfield E H
Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA.
J Neurosurg. 1999 Feb;90(2):315-20. doi: 10.3171/jns.1999.90.2.0315.
Although recent studies have shown that convection can be used to distribute macromolecules within the central nervous system (CNS) in a homogeneous, targeted fashion over clinically significant volumes and that the volume of infusion and target location (gray as opposed to white matter) influence distribution, little is known about other factors that may influence optimum use of convection-enhanced distribution. To understand the variables that affect convective delivery more fully, we examined the rate of infusion, delivery cannula size, concentration of infusate, and preinfusion sealing time.
The authors used convection to deliver 4 microl of 14C-albumin to the striatum of 40 rats. The effect of the rate of infusion (0.1, 0.5, 1, and 5 microl/minute), cannula size (32, 28, and 22 gauge), concentration of infusate (100%, 50%, and 25%), and preinfusion sealing time (0 and 70 minutes) on convective delivery was examined using quantitative autoradiography, National Institutes of Health image analysis software, scintillation analysis, and histological analysis. Higher rates of infusion (1 and 5 microl/minute) caused significantly (p < 0.05) more leakback of infusate (22.7+/-11.7% and 30.3+/-7.8% [mean+/-standard deviation], respectively) compared with lower rates (0.1 microl/minute [4+/-3.6%] and 0.5 microl/minute [5.2+/-3.6%]). Recovery of infusate was significantly (p < 0.05) higher at the infusion rate of 0.1 microl/minute (95.1+/-2.8%) compared with higher rates (85.2+/-4%). The use of large cannulae (28 and 22 gauge) produced significantly (p < 0.05) more leakback (35.7+/-8.1% and 21.1+/-7.5%, respectively) than the smaller cannula (32 gauge [5.2+/-3.6%]). Varying the concentration of the infusate and the preinfusion sealing time did not alter the volume of distribution, regional distribution, or infusate recovery.
Rate of infusion and cannula size can significantly affect convective distribution of molecules, whereas preinfusion sealing time and variations in infusate concentration have no effect in this small animal model. Understanding the parameters that influence convective delivery within the CNS can be used to enhance delivery of potentially therapeutic agents in an experimental setting and to indicate the variables that will need to be considered for optimum use of this approach for drug delivery in the clinical setting.
尽管最近的研究表明,对流可用于将大分子以均匀、靶向的方式在中枢神经系统(CNS)内分布至具有临床意义的体积,且输注量和靶点位置(灰质而非白质)会影响分布,但对于可能影响对流增强分布最佳应用的其他因素知之甚少。为了更全面地了解影响对流输送的变量,我们研究了输注速率、输送套管尺寸、输注液浓度和输注前封闭时间。
作者使用对流将4微升的14C - 白蛋白输送至40只大鼠的纹状体。使用定量放射自显影、美国国立卫生研究院图像分析软件、闪烁分析和组织学分析,研究输注速率(0.1、0.5、1和5微升/分钟)、套管尺寸(32、28和22号)、输注液浓度(100%、50%和25%)以及输注前封闭时间(0和70分钟)对对流输送的影响。与较低速率(0.1微升/分钟[4±3.6%]和0.5微升/分钟[5.2±3.6%])相比,较高的输注速率(1和5微升/分钟)导致输注液的漏回显著增加(分别为22.7±11.7%和30.3±7.8%[平均值±标准差])。在输注速率为0.1微升/分钟时,输注液的回收率(95.1±2.8%)显著高于较高速率(85.2±4%)(p < 0.05)。使用大尺寸套管(28和22号)产生的漏回显著多于小尺寸套管(32号[5.2±3.6%])(分别为35.7±8.1%和21.1±7.5%)(p < 0.05)。改变输注液浓度和输注前封闭时间并未改变分布体积、区域分布或输注液回收率。
输注速率和套管尺寸可显著影响分子的对流分布,而在这个小动物模型中,输注前封闭时间和输注液浓度的变化没有影响。了解影响中枢神经系统内对流输送的参数,可用于在实验环境中增强潜在治疗药物的输送,并指出在临床环境中优化使用这种药物输送方法时需要考虑的变量。