Theranostics in the vasculature: bioeffects of ultrasound and microbubbles to induce vascular shutdown.
antivascular therapy
cavitation
drug delivery
microbubbles
tumor therapy
ultrasound
Journal
Theranostics
ISSN: 1838-7640
Titre abrégé: Theranostics
Pays: Australia
ID NLM: 101552395
Informations de publication
Date de publication:
2023
2023
Historique:
received:
22
12
2021
accepted:
07
01
2023
medline:
10
8
2023
pubmed:
9
8
2023
entrez:
9
8
2023
Statut:
epublish
Résumé
Ultrasound-triggered microbubbles destruction leading to vascular shutdown have resulted in preclinical studies in tumor growth delay or inhibition, lesion formation, radio-sensitization and modulation of the immune micro-environment. Antivascular ultrasound aims to be developed as a focal, targeted, non-invasive, mechanical and non-thermal treatment, alone or in combination with other treatments, and this review positions these treatments among the wider therapeutic ultrasound domain. Antivascular effects have been reported for a wide range of ultrasound exposure conditions, and evidence points to a prominent role of cavitation as the main mechanism. At relatively low peak negative acoustic pressure, predominantly non-inertial cavitation is most likely induced, while higher peak negative pressures lead to inertial cavitation and bubbles collapse. Resulting bioeffects start with inflammation and/or loose opening of the endothelial lining of the vessel. The latter causes vascular access of tissue factor, leading to platelet aggregation, and consequent clotting. Alternatively, endothelium damage exposes subendothelial collagen layer, leading to rapid adhesion and aggregation of platelets and clotting. In a pilot clinical trial, a prevalence of tumor response was observed in patients receiving ultrasound-triggered microbubble destruction along with transarterial radioembolization. Two ongoing clinical trials are assessing the effectiveness of ultrasound-stimulated microbubble treatment to enhance radiation effects in cancer patients. Clinical translation of antivascular ultrasound/microbubble approach may thus be forthcoming.
Identifiants
pubmed: 37554276
doi: 10.7150/thno.70372
pii: thnov13p4079
pmc: PMC10405856
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4079-4101Informations de copyright
© The author(s).
Déclaration de conflit d'intérêts
Competing Interests: A. Klibanov declares that he is a co-founder and minority shareholder of Targeson Inc, a startup in the area of preclinical targeted contrast ultrasound microbubbles (now dissolved); his UVA lab is also a recipient of an NIH grant subcontract via SoundPipe Therapeutics (Charlottesville VA). Other authors have declared no competing interests.
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