Real-Time Intravital Imaging of Acoustic Cluster Therapy-Induced Vascular Effects in the Murine Brain.

Objective: The blood-brain barrier (BBB) is an obstacle for cerebral drug delivery. Controlled permeabilization of the barrier by external stimuli can facilitate the delivery of drugs to the brain. Acoustic Cluster Therapy (ACT (R)) is a promising strategy for transiently and locally increasing the permeability of the BBB to macromolecules and nanoparticles. However, the mechanism underlying the induced permeability change and subsequent enhanced accumulation of co-injected molecules requires further elucidation. Methods: In this study, the behavior of ACT (R) bubbles in microcapillaries in the murine brain was observed using real-time intravital multiphoton microscopy. For this purpose, cranial windows aligned with a ring transducer centered around an objective were mounted to the skull of mice. Dextrans labeled with 2 MDa fluorescein isothio-cyanate (FITC) were injected to delineate the blood vessels and to visualize extravasation.Discussion: Activated ACT (R) bubbles were observed to alter the blood flow, inducing transient and local increases in the fluorescence intensity of 2 MDa FITC-dextran and subsequent extravasation in the form of vascular out-pouchings. The observations indicate that ACT (R) induced a transient vascular leakage without causing substantial damage to the vessels in the brain.Conclusion: The study gave novel insights into the mechanism underlying ACT (R)-induced enhanced BBB permeability which will be important considering treatment optimization for a safe and efficient clinical translation of ACT (R).