Precision medicine focus on the central nervous system: Non-invasive therapeutic agent delivery with focused ultrasound and microbubbles.

Advances in cancer research Pub Date : 2024-01-01 Epub Date: 2024-07-02 DOI:10.1016/bs.acr.2024.06.003
Padmanabhan Mannangatti, Praveen Bhoopathi, Amit Kumar, Swadesh K Das, Luni Emdad, Paul B Fisher
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Abstract

Focused ultrasound (FUS) combined with microbubble (MB) treatment is a promising strategy capable of accurately delivering molecular medicines and gene therapy to treat various disease states. The rapid progression and use of FUS technology, from its inception to applications in contemporary medicine, exemplifies the significance and expanding potential of this technology. FUS for drug delivery in the brain can overcome challenging obstacles posed by the blood-brain barrier (BBB) in treating central nervous system (CNS) disorders. Both FUS and magnetic resonance imaging-guided FUS are non-invasive techniques for effectively opening the BBB and enhancing the transportation of molecular medicines and imaging agents into the brain. By integrating MBs into this process, it is possible to disrupt the BBB, facilitating delivery of therapeutic compounds including neuropeptides, proteins, antibodies, chemotherapeutic drugs and recently viruses accurately into the CNS. The safety and versatility of ultrasound makes it an attractive approach for administering molecular medicines, with potential applications extending beyond neurological disorders to include cancer treatment and other medical fields. Preclinical and clinical studies confirm that FUS is safe and efficient in enhancing drug administration, particularly where delivery to a precise location in the CNS is required. Combination therapies that utilize FUS and MBs also provide synergistic responses in cancer therapy. Further refining FUS and MB approaches both from a mechanical and reagent perspective will be forthcoming in the future and prove valuable in precisely defining targets and broadening therapeutic applications. Continued development and applications of FUS and MB technologies will improve therapeutic outcomes and advance patient care in multiple diseases states. This will elevate FUS and MBs from infrequently used medical options to mainstream medical applications.

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聚焦中枢神经系统的精准医疗:利用聚焦超声波和微气泡进行非侵入性治疗剂输送。
聚焦超声(FUS)结合微气泡(MB)治疗是一种很有前途的策略,能够准确输送分子药物和基因疗法,治疗各种疾病。FUS 技术从诞生到在现代医学中的应用,其快速发展和应用体现了该技术的重要意义和不断扩大的潜力。在治疗中枢神经系统(CNS)疾病时,用于脑部给药的 FUS 可以克服血脑屏障(BBB)带来的挑战性障碍。FUS 和磁共振成像引导的 FUS 都是非侵入性技术,可有效打开 BBB,促进分子药物和成像剂进入大脑。通过将 MBs 纳入这一过程,可以破坏 BBB,促进治疗化合物(包括神经肽、蛋白质、抗体、化疗药物和最近的病毒)准确进入中枢神经系统。超声波的安全性和多功能性使其成为一种极具吸引力的分子药物给药方法,其潜在应用范围已超出神经系统疾病,包括癌症治疗和其他医学领域。临床前和临床研究证实,FUS 在加强给药方面安全高效,尤其是在需要向中枢神经系统的精确位置给药时。利用 FUS 和 MB 的组合疗法还能在癌症治疗中产生协同效应。未来将从机械和试剂的角度进一步完善 FUS 和 MB 方法,并证明其在精确定义靶点和扩大治疗应用方面的价值。FUS 和 MB 技术的不断发展和应用将改善治疗效果,促进多种疾病状态下的患者护理。这将把 FUS 和 MB 从不常出现的医疗选择提升为主流医疗应用。
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