4.6 Review Book Chapter

Therapeutic Agent Delivery Across the Blood-Brain Barrier Using Focused Ultrasound

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DOI: 10.1146/annurev-bioeng-062117-121238

关键词

ultrasound; brain; therapy; drug delivery; blood-brain barrier; image-guided therapy

资金

  1. National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health [RO1-EB003268]
  2. Canadian Institutes of Health Research [FDN 154272]
  3. Temerty Chair in Focused Ultrasound Research at Sunnybrook Health Sciences Centre

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This article discusses the application of using focused ultrasound and microbubbles to increase cerebrovascular permeability for drug delivery, includes technical and biological considerations, summarizes results from clinical trials, and discusses the future direction of the field.
Specialized features of vasculature in the central nervous system greatly limit therapeutic treatment options for many neuropathologies. Focused ultrasound, in combination with circulating microbubbles, can be used to transiently and noninvasively increase cerebrovascular permeability with a high level of spatial precision. For minutes to hours following sonication, drugs can be administered systemically to extravasate in the targeted brain regions and exert a therapeutic effect, after which permeability returns to baseline levels. With the wide range of therapeutic agents that can be delivered using this approach and the growing clinical need, focused ultrasound and microbubble (FUS+MB) exposure in the brain has entered human testing to assess safety. This review outlines the use of FUS+MB-mediated cerebrovascular permeability enhancement as a drug delivery technique, details several technical and biological considerations of this approach, summarizes results from the clinical trials conducted to date, and discusses the future direction of the field.

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