Sonoporation of cultured cells in the rotating tube exposure system

Induction of apoptosis in sonoporation and ultrasonic gene transfer

The role of apoptosis in sonoporation and ultrasound-enhanced gene transfection of cell suspensions was examined in vitro. Suspensions of HL-60 and of CHO-K1 cells were exposed to 2.25-MHz continuous ultrasound for 1 min in a 60-rpm rotating-tube exposure system, with ultrasound contrast media added to ensure nucleation of cavitation. Cell necrosis was measured by trypan blue dye exclusion (using a hemacytometer) and by propidium iodide nuclear staining (using flow cytometry). Apoptosis was detected by the annexin V method with Alexa Fluor 350 as the fluorescent label, and confirmed by Hoechst 33342 nuclear staining. Sonoporation cell loading was assessed by uptake of large fluorescent-dextran molecules from the medium. Transfection was demonstrated by expression of green fluorescent protein (GFP) from plasmids transferred into the cells by the treatment. Cell scoring was performed by flow cytometry, with necrotic cell events excluded. For HL-60 cells at 0.4 MPa, cell loading and transfection was significantly increased relative to shams at 2, 6 and 24 h post exposure, peaking at 19.0 +/- 5.5% and 9.6 +/- 4.2% of non-necrotic cells, respectively, at 6 h. However, about one third of the treatment-positive cells were identified as apoptotic. The cell loading and gene transfer effects increased for increasing peak rarefactional pressure amplitude, reaching 24.4 +/- 7.7% and 12.7 +/- 5.1% of non-necrotic cells, respectively, for 0.6-MPa exposure. However, the lethal cellular injury caused by cavitation in the rotating tube system reduced the overall apparent efficacy of cell loading and gene transfer to 5.1 +/- 2.1% and 2.1 +/- 0.9%, respectively, after accounting for necrosis and apoptosis. Similar tests with CHO cells showed increased sonoporation but mostly cell death by necrosis, rather than apoptosis. The induction of apoptosis by cavitation treatments should be considered as a possible confounding factor, in addition to necrosis, in sonoporation and ultrasonic gene transfer research.

Experimental study on cell self-sealing during sonoporation

Reparable sonoporation of human breast cancer cells was achieved during exposure to moderate ultrasound (spatial peak acoustic pressure, p(sp)=0.25 MPa, 1 MHz tone-bursts, 20 cycles per tone-burst at pulse repetition frequency of 10 kHz) up to 40 s assisted by the presence of encapsulated microbubbles (EMBs). It was demonstrated that shear stress generated by oscillating EMBs at the cell membranes introduced small transient pores in cell membranes by which cells were able to uptake some extracellular fluid and meanwhile triggered the repairing process through self-sealing during sonoporation. It was also indicated by post-sonoporation analysis using the fluorescent microscopy, scanning electron microscopy, and the Bradford assay which determined the protein content in cell supernatant that the self-sealing might be established by lysosomal-associated membrane protein, LAMP-1, fusing with the plasma membrane under the stressful condition in sonoporation.

Ultrasound, cavitation bubbles and their interaction with cells

This article reviews the basic physics of ultrasound generation, acoustic field, and both inertial and non-inertial acoustic cavitation in the context of localized gene and drug delivery as well as non-linear oscillation of an encapsulated microbubble and its associated microstreaming and radiation force generated by ultrasound. The ultrasound thermal and mechanical bioeffects and relevant safety issues for in vivo applications are also discussed.

Phospholipids-based microbubbles sonoporation pore size and reseal of cell membrane cultured in vitro

OBJECTIVE

To investigate phospholipids-based microbubbles induced sonoporation and cell membrane reseal in vitro under various conditions.

METHODS

A breast cancer cell line SK-BR-3 was used to investigate ultrasonic sonoporation under various conditions. Atomic force microscopy (AFM) scanning techniques were employed to observe the change of membrane pores.

RESULTS

Normal SK-BR-3 cells membrane pores were evenly distributed and less than 1 microm. After ultrasound exposure, membrane pores were enlarged at different degree depending on ultrasound exposure durations, filling gas species and microbubble suspension concentration. With microbubble suspension concentration being increased to 5% or ultrasound exposure reached 30 s, membrane pores in fluorocarbon (C(3)F(8) or SF(6))-filled microbubble groups exceeded 1 microm, which were significantly larger than that of air-filled microbubble group. Membrane pores were about 2-3 microm under ultrasound 60 s with 5% fluorocarbon-filled microbubble suspension. After 24 h of incubation, most of the enlarged membrane pores could reseal to normal size, which corresponded to cell viability.

CONCLUSIONS

Membrane pores can be obviously enlarged by ultrasonic sonoporation of fluorocarbon-filled microbubbles, whose reseal time depended on ultrasound exposure duration and microbubble suspension concentration.

Application of ultrasound in preparing pathological sections to reduce processing time

It has been found experimentally that application of sub-mega and low megahertz ultrasound (US) of spatial and temporal averaged intensity /(sata) up to 10 W/cm(2) during the process of preparing pathological sections of the mouse tissue has shortened the processing time from 12h (without US) to less than half an hour (with US). The experiment has also showed that the processing time reached the shortest for ultrasound f=200 kHz among the frequencies of 200 kHz, 400 kHz, 600 kHz, 800 kHz and 1 MHz used in this study. It has been proposed that ultrasound inducing non-inertial cavitation enhanced the permeability of cell membrane to liquid. Thus tissue fixation and dehydration were speeded up by application of US.

Ultrasound-induced cavitation: applications in drug and gene delivery

Ultrasound, which has been conventionally used for diagnostics until recently, is now being extensively used for drug and gene delivery. This transformation has come about primarily due to ultrasound-mediated acoustic cavitation - particularly transient cavitation. Acoustic cavitation has been used to facilitate the delivery of small molecules, as well as macromolecules, including proteins and DNA. Controlled generation of cavitation has also been used for targeting drugs to diseased tissues, including skin, brain, eyes and endothelium. Ultrasound has also been employed for the treatment of several diseases, including thromboembolism, arteriosclerosis and cancer. This review provides a detailed account of mechanisms, current status and future prospects of ultrasonic cavitation in drug and gene delivery applications.

Ultrasound, contrast agents and biological cells; a simplified model for their interaction during in vitro experiments

A model based on simplifying assumptions is described for the time course of an in vitro experiment in which a beam of ultrasound passes through a suspension of biological cells and gaseous contrast agents (UCAs). It is assumed that cavitation-related activation events (AEs) occur, during each of which a UCA is destroyed or becomes nonfunctional and, at the same time, nearby cells are lysed or otherwise altered. If the UCAs are highly concentrated, the ultrasound attenuation is high and may significantly affect the action. The number of cells affected by each AE depends on the concentrations of cells and UCAs as well as the concentration ratio.

Effect of 5-fluorouracil, Optison and ultrasound on MCF-7 cell viability

The aim of this study was to analyze cell viability and expression of apoptotic-related signaling proteins in MCF-7 breast cancer cells induced by combinations of ultrasound, the anticancer drug 5-fluorouracil (5-FU) and the ultrasound contrast agent Optison. MCF-7 cells were treated with 5-FU and sonicated at the frequency of 3.0 MHz and intensity of 3.0 W/cm2 for 1 min in the presence of Optison. The cells were analyzed for lactate dehydrogenase (LDH) release (a measure of cytotoxicity) and cell proliferation (by MTT assays). The LDH/MTT ratio was used for assessment of cell death. Expression of the apoptotic-related proteins, Bax and p27kip1, as well as phosphorylated forms of ERK and Akt proteins was assessed by Western blot analysis. We demonstrate that, immediately after treatment, cell death was most dependent on Optison; however, 24 h after treatment, cell death was more dependent on 5-FU. Ultrasound duty cycle increased cell death associated with either Optison or 5-FU. Furthermore, we show that treatment with 5-FU and ultrasound increased the levels of the Bax and p27kip1 proteins, but the addition of Optison appears to suppress apoptotic protein expression.

Application of liposomes to sonoporation

A method to prepare liposomes is presented. Liposomes made in our laboratory were characterized acoustically and optically. The phase velocity and attenuation of liposomes in suspension (concentration = 10(9)/mL) were measured, ranging from 2 to 14 MHz, using ultrasound spectroscopy. Anti-rabbit IgG conjugated with Alexafluor 647 was delivered into Jurkat cells in suspension, using the liposomes, by 10 % duty cycle ultrasound tonebursts of 2.2 MHz (the in situ spatial peak-pressure amplitude = 80 W/cm2) with an efficiency of 13 %. It has been experimentally shown that liposomes may be an alternative stable agent to Optison for delivering macromolecules into cells.

Fluorescein isothiocynate-dextran uptake by chinese hamster ovary cells in a 1.5 MHz ultrasonic standing wave in the presence of contrast agent

Uptake of fluorescein isothiocynate-dextran (FITC-dextran) by Chinese hamster ovary cells was studied after exposure to ultrasonic standing wave (USW) in presence of Optison, an ultrasound contrast agent. Confluent Chinese hamster ovary cells were harvested and suspended in phosphate-buffered saline + 0.1% bovine serum albumin containing FITC-dextran (10, 40, and 500 kDa) at 10 microM final concentration. The suspension was seeded with contrast agent (75 microL/mL) and exposed to a 1.5 MHz USW system at acoustic pressures ranging from 0.98 to 4.2 MPa. Macromolecular uptake was assessed by fluorescent microscopy and quantified by flow cytometry 10 min after exposure. FITC-dextran positive cells, as assessed by flow cytometry, were 1 +/- 0.05% and 2.58 +/- 0.27% for acoustic pressures of 1.96 and 4.2 MPa, respectively (p = 0.006). Fluorescent microscopy indicated a degree of macromolecular loading at 0.98 MPa with 46% of peripherally FITC-dextran- and/or propidium iodide-stained cells coincident with the appearance of significant frequency (f0/2 and 2 f0) emission signals. At higher pressures, high macromolecular loading with 6% peripherally stained cells at 1.96 MPa was associated with lower order emission signals and white noise. The study conclusively demonstrates macromolecular loading in an USW, a significantly higher macromolecular loading at higher pressures and indicates potential of emission signals for a feedback loop to control the acoustic power outputs and fine-tune the biologic effects associated with sonoporation.

Ultrasound-enhanced transfection activity of HPMA-stabilized DNA polyplexes with prolonged plasma circulation

Cancer gene therapy would greatly benefit from the possibility to deliver therapeutic genes via tumor-targeted systemic intravenous delivery. The main objective of this study was to determine biophysical, transfection, and pharmacokinetic properties of DNA complexes with reducible polycations that are reversibly stabilized by surface coating with multivalent HPMA copolymers. The specific goals were to evaluate compatibility of these polyplexes with extended plasma circulation, molecular targeting, and ultrasound-enhanced transfection activity. It was demonstrated that using polyplexes based on reducible polycations allows increasing transfection activity and preserving extended plasma circulation half-life observed for control polyplexes based on non-reducible polycations. In addition, the reversibly stabilized polyplexes were compatible with both molecular targeting using protein ligands as well as physical targeting using ultrasound-directed cavitation in vitro. As such, the described gene delivery vectors have the potential to permit efficient systemic delivery of therapeutic genes targeted by a local focused ultrasound treatment.

Microfluidic sonicator for real-time disruption of eukaryotic cells and bacterial spores for DNA analysis

Biologic agent screening is a three-step process: lysis of host cell membranes or walls to release their DNA, polymerase chain reaction to amplify the genetic material and screening for distinguishing genetic signatures. Macrofluidic devices commonly use sonication as a lysis method. Here, we present a piezoelectric microfluidic minisonicator and test its performance. Eukaryotic human leukemia HL-60 cells and Bacillus subtilis bacterial spores were lysed as they passed through a microfluidic channel at 50 microL/min and 5 microL/min, respectively, in the absence of any chemical denaturants, enzymes or microparticles. We used fluorescence-activated cell sorting and hematocytometry to measure 80% lysis of HL-60 cells after 3 s of sonication. Real-time polymerase chain reaction indicated 50% lysis of B. subtilis spores with 30 s of sonication. Advantages of the minisonicator over macrofluidic implementations include a small sample volume (2.5 microL), reduced energy consumption and compatibility with other microfluidic blocks. These features make this device an attractive option for "lab-on-a-chip" and portable applications.

Increase in capillary perfusion following low-intensity ultrasound and microbubbles during postischemic reperfusion

OBJECTIVES

We postulated that the increase in shear stress caused by microbubbles in the presence of low-intensity ultrasound increases vasodilation in ischemia/reperfusion.

DESIGN

Prospective, randomized, and blinded experimental study.

SETTING

Research laboratory.

SUBJECTS

Forty hamsters were subjected to ischemia/reperfusion and observed by intravital microscopy.

INTERVENTIONS

Ultrasound (2.5 MHz, 1.3 mechanical index, 2.0 peak pressure) was applied to the hamster cheek pouch in ischemia/reperfusion with and without microbubbles (Levovist or Sono Vue) at baseline (15 mins) and at the beginning (15 mins) of reperfusion after ischemia (30 mins).

MEASUREMENTS AND MAIN RESULTS

Arterial diameter (A2-A3, 38.5 +/- 5.3 microm; A4,15.0 +/- 7.0 microm), red blood cell velocity, wall shear stress, permeability, perfused capillary length, and adherent leukocytes in venules were evaluated. Lipid peroxides were also determined in the systemic blood. Ultrasound and microbubbles in reperfusion significantly increased the diameter (A2-A3 Sono Vue, 33%; Levovist, 53% vs. ischemia/reperfusion, p < .05; A4, Sono Vue, 93%; Levovist, 104% vs. ischemia/reperfusion, p < .05), red blood cell velocity, flow, and shear stress in both A4 and A2-A3 arterioles. Shear stress was significantly higher with Levovist (A2-A3, 105%; A4, 185%) and Sono Vue (A2, 108%; A4, 140% vs. ischemia/reperfusion, p < .05) than ultrasound alone in arterioles. With ischemia/reperfusion, perfused capillary length was reduced significantly, whereas it increased with Levovist and Sono Vue (43%, 41% vs. ischemia/reperfusion p < .05). Lipid peroxides increased early during reperfusion and remained at increased levels throughout reperfusion. Lipid peroxides were unchanged after ultrasound alone or ultrasound with Sono Vue or Levovist during ischemia/reperfusion. With ultrasound there was a significant increase in vascular permeability vs. ischemia/reperfusion. Treatment with Sono Vue (-36%) and Levovist (-57%) decreased permeability vs. ischemia/reperfusion in reperfusion (p < .001). Ischemia/reperfusion had significantly increased leukocyte adhesion. Ultrasound alone (-39%) or with Sono Vue (-64%) and Levovist (-57%) caused smaller increases in leukocyte adhesion than ischemia/reperfusion (p < .05).

CONCLUSIONS

Ultrasound and microbubbles equilibrate microvascular shear stress, thus avoiding the failure of capillary perfusion in postischemic reperfusion.

Vascular effects induced by combined 1-MHz ultrasound and microbubble contrast agent treatments in vivo

Previous in vivo studies have demonstrated that microvessel hemorrhages and alterations of endothelial permeability can be produced in tissues containing microbubble-based ultrasound contrast agents when those tissues are exposed to MHz-frequency pulsed ultrasound of sufficient pressure amplitudes. The general hypothesis guiding this research was that acoustic (viz., inertial) cavitation, rather than thermal insult, is the dominant mechanism by which such effects arise. We report the results of testing five specific hypotheses in an in vivo rabbit auricular blood vessel model: (1) acoustic cavitation nucleated by microbubble contrast agent can damage the endothelia of veins at relatively low spatial-peak temporal-average intensities, (2) such damage will be proportional to the peak negative pressure amplitude of the insonifying pulses, (3) damage will be confined largely to the intimal surface, with sparing of perivascular tissues, (4) greater damage will occur to the endothelial cells on the side of the vessel distal to the source transducer than on the proximal side and (5) ultrasound/contrast agent-induced endothelial damage can be inherently thrombogenic, or can aid sclerotherapeutic thrombogenesis through the application of otherwise subtherapeutic doses of thrombogenic drugs. Auricular vessels were exposed to 1-MHz focused ultrasound of variable peak pressure amplitude using low duty factor, fixed pulse parameters, with or without infusion of a shelled microbubble contrast agent. Extravasation of Evans blue dye and erythrocytes was assessed at the macroscopic level. Endothelial damage was assessed via scanning electron microscopy (SEM) image analysis. The hypotheses were supported by the data. We discuss potential therapeutic applications of vessel occlusion, e.g., occlusion of at-risk gastric varices.

Plasma membrane poration induced by ultrasound exposure: implication for drug delivery

Sonoporation, in the presence of ultrasound contrast agents (UCA), is a technique that permits the transfer of drugs, including genes, into cells. In this study, the size of the pores created by ultrasound application, and the duration of pore opening, have been characterized via indirect molecular probing and microscopic observation. Internalization of molecules with diameters up to 37 nm was efficient and generally well-tolerated; on the other hand, confocal microscopy revealed that 75 nm particles entered only a few cells when sonoporation was applied. In general, the larger the species to internalize, the poorer the transfer. Direct visualization of pores following insonification, using scanning electron microscopy, was hampered by the presence of numerous villi on the surface of the cells employed (MAT B III), and by the short duration of pore opening. Clearer observations of porated regions were possible using red blood cells. This research (i) confirms that sonoporation is a means with which to achieve macromolecule delivery into cells, and (ii) characterizes in some detail the phenomenon of ultrasound induction of transient pores in the cell membrane.

Ultrasound-mediated gene delivery: kinetics of plasmid internalization and gene expression

Sonoporation is an approach that can be used to transfer DNA or drugs into cells. However, very little is known about the mechanism of ultrasound-mediated membrane permeabilization. In this investigation, DNA transport post-sonoporation and the subsequent plasmid internalization and protein expression kinetics have been studied. Using a plasmid encoding for the green fluorescent protein (GFP), labelled or not with an intercalating agent (YOYO-1), it was found that, as compared to lipofection that requires endocytosis, sonoporation allowed a rapid and direct transfer of naked DNA into the cell cytoplasm probably via ultrasound-induced pores in the membrane. The kinetics of protein expression were significantly faster for sonoporation than for lipofection, the mechanism of which requires endocytosis. However, unprotected DNA in the cytoplasm could be degraded by resident cytosolic DNases, thereby decreasing ultrasound-mediated gene delivery efficiency.

Optimisation of ultrasound-mediated gene transfer (sonoporation) in skeletal muscle cells

Ultrasound (US) is a promising tool for facilitating direct gene transfer to skeletal muscle, but no systematic optimisation study has been performed. We exposed H2K myoblast cells to US with varying intensity of exposure and duration to evaluate its effect on cell viability and transfection efficiency using as endpoints transfection rate, average fluorescence intensity (fluorescence normalised by the number of transfected cells) and overall expression (the product of transfection rate and average fluorescence intensity) as indices. Cell viability decreased with exposure time and intensity, consistent with previous findings. Optimal setting of US was observed at the range of 0.5 to 1 W cm(-2) with duration of 20 s, producing maximum efficiency (transfection = 4.5%) in gene transfection with minimum cell toxicity (cell viability = 83%). Higher intensity alone or in combination with low intensity and long duration did not improve cell viability and transfection. The increase of eGFP (enhanced green fluorescence protein) plasmid concentration up to 200 microg per mL was related to an increase in average fluorescence intensity and overall expression. However, transfection rate saturated when DNA concentration reached 50 microg per mL despite initial increase with DNA concentration. The average fluorescence intensity was linearly proportional to the logarithm of DNA concentration, suggesting a diffusion-based model for DNA uptake under sonoporation. We conclude that low-intensity US irradiation provides a safe and effective alternative for gene delivery.

Targeted tissue transfection with ultrasound destruction of plasmid-bearing cationic microbubbles

The aim of this study was to assess the relative efficacy and mechanism of gene transfection by ultrasound (US) destruction of plasmid-bearing microbubbles. Luciferase reporter plasmid was charge-coupled to cationic lipid microbubbles. Rat hindlimb skeletal muscle was exposed to intermittent high-power US during dose-adjusted intra-arterial (IA) or IV administration of plasmid-bearing microbubbles via the carotid artery or jugular vein, respectively. At 4 days, luciferase activity in US-exposed skeletal muscle was 200-fold greater with IA than with IV administration of plasmid-bearing microbubbles, and was similar to transfection achieved by IM injection of plasmid (positive control). No transfection occurred with US and IA injection of plasmid alone. Intravital microscopy of the cremaster muscle in mice following administration of microbubbles and US exposure demonstrated perivascular deposition of fluorescent plasmid, the extent of which was twofold greater for IA compared to IV injection. Electron microscopy demonstrated a greater extent of myocellular microporations in US-exposed muscle after IA injection of microbubbles. We conclude that muscle transfection by US destruction of plasmid-bearing cationic microbubbles is amplified by IA, rather than IV, injection of microbubbles due to greater extravascular deposition of plasmid and to greater extent of myocellular microporation.

The role of ultrasound in molecular imaging

Ultrasound has received less attention than other imaging modalities for molecular imaging, but has a number of potential advantages. It is cheap, widely available and portable. Using Doppler methods, flow information can be obtained easily and non-invasively. It is arguably the most physiological modality, able to image structure and function with less sedation than other modalities. This means that function is minimally disturbed, and multiple repeat studies or the effect of interventions can easily be assessed. High frame rates of over 200 frames a second are achievable on current commercial systems, allowing for convenient cardiac studies in small animals. It can be used to guide interventional or invasive studies, such as needle placement. Ultrasound is also unique in being both an imaging and therapeutic tool and its value in gene therapy has received much recent interest. Ultrasound biomicroscopy has been used for in utero imaging and can guide injection of virus and cells. Ultrahigh frequency ultrasound can be used to determine cell mechanical properties. The development of microbubble contrast agents has opened many new opportunities, including new functional imaging methods, the ability to image capillary flow and the possibility of molecular targeting using labelled microbubbles.

Ultrasound-enhanced transgene expression in vascular cells is not dependent upon cavitation-induced free radicals

Although acoustic cavitation is clearly important in ultrasound (US)-enhanced gene delivery (UEGD), the relative importance of mechanical and sonochemical (free radical) bioeffects remains unclear, as does the mechanism of gene delivery at the cellular level. Porcine vascular smooth muscle cells (VSMC) were transfected with luciferase or green fluorescent protein (GFP) plasmid +/- pulsed 956 kHz US (2.0 mechanical index (MI), 128 W cm(-2) spatial peak pulse average intensity, ISPPA) for 60 s, in the presence or absence of 20 mM cysteamine or N-acetyl-L-cysteine. Both compounds effectively scavenged free radical production following US, leaving unaffected the 50- to 100-fold enhancements in luciferase expression seen in US-treated VSMC. US exposure enhanced plasmid uptake (25 +/- 4.6 vs. 3 +/- 1.9 cells/field, n=4, p<0.05), most likely directly into the cytoplasm, and increased both the total number (>sevenfold) and average fluorescence intensity (>sixfold) of GFP-transfected cells. UEGD is not dependent upon cavitation-induced free radical generation and has potential for use with a wide range of therapeutic transgenes.

Bioeffects caused by changes in acoustic cavitation bubble density and cell concentration: a unified explanation based on cell-to-bubble ratio and blast radius

Acoustic cavitation has been shown to load drugs, proteins and DNA into viable cells as a complex function of acoustic and nonacoustic parameters. To better understand and quantify this functionality, DU145 prostate cancer cell suspensions at different cell concentrations (2.5 x 10(5) to 4.0 x 10(7) cells/mL) were exposed to 500 kHz ultrasound (US) over a range of acoustic energy exposures (2 to 817 J/cm(2); peak negative pressures of 0.64 to 2.96 MPa; exposure times of 120 to 2000 ms) in the presence of different initial concentrations of Optison contrast agent bubbles (3.6 x 10(4) to 9.3 x 10(7) bubbles/mL). As determined by flow cytometry, molecular uptake of calcein and cell viability both increased with increasing cell density; viability decreased and uptake was unaffected by increasing initial contrast agent concentration. When normalized relative to the initial contrast agent concentration (e.g., cells killed per bubble), bioeffects increased with increasing cell density and decreased with increasing bubble concentration. These varying effects of contrast agent concentration and cell density were unified through an overall correlation with cell-to-bubble ratio. Additional analysis led to estimation of "blast radii" over which bubbles killed or permeabilized cells; these radii were as much as 3 to 90 times the bubble radius. Combined, these results suggest that extensive molecular uptake into cells at high viability occurs for low-energy exposure US applied at a high cell-to-bubble ratio.

Nonlinear behaviors of contrast agents relevant to diagnostic and therapeutic applications

The nonlinear properties of an encapsulated microbubble of a contrast agent were studied theoretically and experimentally. A modified nonlinear differential equation (Herring equation) was used to describe the radial oscillation of the microbubble and solved numerically. It was found that the nonlinear resonance frequency, at which the peak radial oscillation amplitude occurs, was a decreasing function of the acoustic amplitude of a driving ultrasonic pulse. Optical images of the contrast agent microbubbles under various ultrasonic exposure conditions: 1. sham exposure; 2. 2-MHz spatial peak acoustic pressure = 200 kPa, I(SATA) = 260 mW/cm(2), duty cycle = 7.5%, repetition period = 0.0266 ms; 3. 0.5-MHz spatial peak acoustic pressure = 200 kPa, I(SATA) = 130 mW/cm(2), duty cycle = 7.5%, repetition period = 0.1067 ms; have also shown that the lower-frequency ultrasound (US) excitation (0.5 MHz) is more effective in disruption of the microbubbles due to acoustic inertial cavitation than the higher frequency US (2 MHz).

Transdermal delivery of poly-l-lysine by sonomacroporation

A feasibility study of using high-amplitude ultrasound (US) to deliver large molecules transdermally was undertaken. US (20 kHz) of intensity in the range between 2 to 50 W/cm(2) was used to increase the permeability of skin in vitro to large size molecules. For example, when 20-kHz, 5% duty cycle US at the spatial average and pulse-average intensity I(SAPA) = 19 W/cm(2) was applied for 10 min and the distance between the US source and the surface of a skin specimen was 2 mm, the skin permeability was calculated to be 0.5 +/- 0.2 cm/h and 8.5 +/- 4.2 cm/h, respectively, for poly l-lysine-fluorescein isothiocyanate (FITC) (51 kDa) and octa-1-lysine-FITC (2.5 kDa). Without application of US, the skin permeability of the above-mentioned molecules would be essentially zero. A transdermal flux enhancement occurring during the process reported here was much higher than that due to sonophoresis (I(SAPA) < 2 W/cm(2)) as reported in the literature. For comparison, for example, the skin permeability for delivering erythropoeitin (48 kDa) and insulin (6 kDa) reached 9.8 x 10(-6) and 3.3 x10(-3) cm/h, respectively, by using sonophoresis for 1 h US exposure. Experimental results from transdermal flux kinetics, and confocal microscopic cross-sectional and optical images, suggested that the formation of pores in the stratum corneum, whose size varies with skin samples, may be in the range of 1 to 100 microm. The confocal images also suggest the formation of microm-size pathways in epidermis during US exposure.

Effects of dissolved gases and an echo contrast agent on ultrasound mediated in vitro gene transfection

The effects of acoustic cavitation on in vitro transfection by ultrasound were investigated. HeLa cells were exposed to 1.0 MHz continuous ultrasound in culture media containing the luciferase gene. Transfection efficiency was elevated when an echo contrast agent, Levovist was added or air was dissolved in the medium. When cells were sonicated in medium saturated with Ar, N2 or N2O which have different gamma values (Cp/Cv), or were saturated with He, Ar or Ne with different thermal conductivities, the effectiveness for the dissolved gases in the ultrasound mediated transfection was Ar > N2 > N2O or Ar > Ne > He, respectively. When free radical formation in water by ultrasound was monitored as a measure of inertial cavitation, it was similarly affected by dissolved gases. These results indicate that the efficiency of ultrasound mediated transfection was significantly affected either by occurrence of or by modification of inertial cavitation due to various gases.

Equilibrium loading of cells with macromolecules by ultrasound: effects of molecular size and acoustic energy

Ultrasound has been shown to deliver small compounds, macromolecules, and DNA into cells, which suggests potential applications in drug and gene delivery. However, the effect of molecular size on intracellular uptake has not been quantified. This study measured the effect of molecule size (calcein, 623 Da; bovine serum albumin, 66 kDa; and two dextrans, 42 and 464 kDa) on molecular uptake and cell viability in DU145 prostate cancer cells exposed to 500 kHz ultrasound. Molecular uptake in viable cells was shown to be very similar for small molecules and macromolecules and found to correlate with acoustic energy exposure. Molecular uptake was seen to be heterogeneous among viable cells exposed to the same ultrasound conditions; this heterogeneity also correlated with acoustic energy exposure. In a fraction of these cells, molecular uptake reached thermodynamic equilibrium with the extracellular solution for the small molecule and all three macromolecules. The results demonstrate that ultrasound provides a means to load viable cells with large numbers of macromolecules, which may be of use for laboratory and possible clinical drug delivery applications.

Theoretical study on shear stress generated by microstreaming surrounding contrast agents attached to living cells

Numerical calculations have shown that shear stress associated with microstreaming surrounding encapsulated stable bubbles of contrast agents, near living cells driven by 0.12-MPa acoustic pressure amplitude ultrasound (US) at 1 MHz or 2 MHz, may be large enough to generate reparable sonoporation of the cells. Some encapsulated bubbles that have mechanically weak shells may break into free bubbles under the above-mentioned sound field. When that happens, the shear stress caused by microstreaming surrounding the free bubble increases dramatically and may play an important role in lethal sonoporation and fragmentation of cells during the early stage of US exposure.

Lysis and sonoporation of epidermoid and phagocytic monolayer cells by diagnostic ultrasound activation of contrast agent gas bodies

Epidermoid A431 (human carcinoma) and phagocytic RAW-264.7 cells were grown as monolayers on 5-microm thick Mylar sheets by standard culture methods. The sheets formed one window of disk-shaped ultrasound (US) exposure chambers. A diagnostic US machine in spectral Doppler mode was used for exposure with a 3.5-MHz scanhead aimed upward at the chamber in a 37 degrees C water bath. Sonoporation and cell lysis were evaluated for assessment of cell membrane damage. For both epidermoid and RAW cells on the upper window with 1% Optison contrast agent, cell lysis was detectable in addition to sonoporation. The phagocytic cells tended to retain the gas bodies when incubated with contrast agent, and membrane damage occurred even for exposure on the bottom window. The effects were also seen for RAW cells incubated with 5% contrast agent for 15 min and then rinsed before exposure. Above a threshold range for lysis and sonoporation of 0.09 to 0.23 MPa, the counts of affected cells increased for both cell lines to about 20% at 0.83 MPa. These results indicate relatively low thresholds for membrane damage induced by diagnostic US activation of contrast agent gas bodies, with a potential for targeting of these effects to phagocytic cells.

Ultrasound-mediated disruption of cell membranes. II. Heterogeneous effects on cells

Ultrasound has been shown to reversibly and irreversibly disrupt membranes of viable cells through a mechanism believed to involve cavitation. Because cavitation is both temporally and spatially heterogeneous, flow cytometry was used to identify and quantify heterogeneity in the effects of ultrasound on molecular uptake and cell viability on a cell-by-cell basis for suspensions of DU145 prostate cancer and aortic smooth muscle cells exposed to varying peak negative acoustic pressures (0.6-3.0 MPa). exposure times (120-2,000 ms), and pulse lengths (0.02-60 ms) in the presence of Optison (1.7% v/v) contrast agent. Cell-to-cell heterogeneity was observed at all conditions studied and was classified into three subpopulations: nominal uptake (NUP), low uptake (LUP), and high uptake (HUP) populations. The average number of molecules within each subpopulation was generally constant: 10(4)-10(5) molecules/cell in NUP, approximately 10(6) molecules/cell in LUP, and approximately 10(7) molecules/cell in HUP. However, the fraction of cells within each subpopulation showed a strong dependence on both acoustic pressure and exposure time. Varying pulse length produced no significant effect. The distribution of cells among the three subpopulations correlated with acoustic energy exposure, which suggests that energy exposure may govern the ability of ultrasound to induce bioeffects by a nonthermal mechanism.

Ultrasound-mediated disruption of cell membranes. I. Quantification of molecular uptake and cell viability

Ultrasound-mediated drug delivery is a nonchemical, nonviral, and noninvasive method for targeted transport of drugs and genes into cells. Molecules can be delivered into cells when ultrasound disrupts the cell membrane by a mechanism believed to involve cavitation. This study examined molecular uptake and cell viability in cell suspensions (DU145 prostate cancer and aortic smooth muscle cells) exposed to varying peak negative acoustic pressures (0.6-3.0 MPa), exposure times (120-2000 ms), and pulse lengths (0.02-60 ms) in the presence of Optison (1.7% v/v) contrast agent. With increasing pressure and exposure time, molecular uptake of a marker compound, a calcein, increased and approached equilibrium with the extra cellular solution, while cell viability decreased. Varying pulse length produced no significant effect. All viability and molecular uptake measurements collected over the broad range of ultrasound conditions studied correlated with acoustic energy exposure. This suggests that acoustic energy exposure may be predictive of ultrasound's nonthermal bioeffects.

Microbubble-enhanced ultrasound for vascular gene delivery

Progress in cardiovascular gene therapy has been hampered by concerns over the safety and practicality of viral vectors and the inefficiency of current nonviral transfection techniques. We have previously reported that ultrasound exposure (USE) enhances transgene expression in vascular cells by up to 10-fold after naked DNA transfection, and enhances lipofection by up to three-fold. We report here that performing USE in the presence of microbubble echocontrast agents enhances acoustic cavitation and is associated with approximately 300-fold increments in transgene expression after naked DNA transfections. This approach also enhances by four-fold the efficiency of polyplex transfection, yielding transgene expression levels approximately 3000-fold higher than after naked DNA alone. These data indicate an important role for acoustic cavitation in the effects of USE. Ultrasound can be focused upon almost any organ and hence this approach holds promise as a means to deliver targeted gene therapy in cardiovascular conditions such as such angioplasty restenosis and in many other clinical situations.

Cytoplasmic molecular delivery with shock waves: importance of impulse

Cell permeabilization using shock waves may be a way of introducing macromolecules and small polar molecules into the cytoplasm, and may have applications in gene therapy and anticancer drug delivery. The pressure profile of a shock wave indicates its energy content, and shock-wave propagation in tissue is associated with cellular displacement, leading to the development of cell deformation. In the present study, three different shock-wave sources were investigated; argon fluoride excimer laser, ruby laser, and shock tube. The duration of the pressure pulse of the shock tube was 100 times longer than the lasers. The uptake of two fluorophores, calcein (molecular weight: 622) and fluorescein isothiocyanate-dextran (molecular weight: 71,600), into HL-60 human promyelocytic leukemia cells was investigated. The intracellular fluorescence was measured by a spectrofluorometer, and the cells were examined by confocal fluorescence microscopy. A single shock wave generated by the shock tube delivered both fluorophores into approximately 50% of the cells (p < 0.01), whereas shock waves from the lasers did not. The cell survival fraction was >0.95. Confocal microscopy showed that, in the case of calcein, there was a uniform fluorescence throughout the cell, whereas, in the case of FITC-dextran, the fluorescence was sometimes in the nucleus and at other times not. We conclude that the impulse of the shock wave (i.e., the pressure integrated over time), rather than the peak pressure, was a dominant factor for causing fluorophore uptake into living cells, and that shock waves might have changed the permeability of the nuclear membrane and transferred molecules directly into the nucleus.

Experimental study of the effects of Optison concentration on sonoporation in vitro

Lethal sonoporation and reparable sonoporation were observed in Jurkat lymphocytes in suspension with the addition of varying amounts of Optison, a commercially available bubble-based contrast agent. For given ultrasound (US) exposure conditions (spatial peak-pressure amplitude of 0.2 MPa, duty cycle 10% and 2-MHz frequency), sonoporation was directly related to the bubble-to-cell ratio (in a range from 0 to 230). It was found that the nearest bubble-cell spacing was also related to the occurrence frequency of bioeffects. A constant bubble-to-cell ratio often provided very different results for two different initial cell concentrations (200,000 cells/mL and 600,000 cells/mL), with the higher cell concentration generally exhibiting higher levels of sonoporation. In contrast, a constant bubble-to-cell spacing provided similar results between the two initial cell concentrations. The frequency of reparable and lethal sonoporation was seen to decay as the inverse-cube power of the nearest bubble-cell spacing. Significant reparable sonoporation was observed at a bubble-cell spacing that was 10 microm larger than the minimum spacing at which significant lethal sonoporation was observed. Preliminary analysis also suggests the possibility of a step-wise increase in lethal sonoporation as spacing decreases; further experiment is needed.

Ultrasound enhancement of liposome-mediated cell transfection is caused by cavitation effects

Cationic liposomes (CL) are widely used vectors for gene transfer. Recently, ultrasound (US) was reported to enhance liposome-mediated gene transfer to eucaryotic cells in culture. The present study was aimed at studying the effects of 2-MHz pulsed Doppler US on malignant brain tumor cells transfection by cationic liposome/plasmid-DNA complexes (lipoplexes). Cationic liposomes consisting of DOSPA/DOPE were complexed with a plasmid carrying the cDNA encoding green autofluorescent protein (EGFP). Rodent (9L) and canine (J3T) glioma cells were exposed to pulsed US in the presence of EGFP-lipoplexes. A diagnostic transcranial Doppler device (MultiDop L) was used for insonation for 30, 60, and 90 s at 2 MHz/0.5 W/cm(2). To eliminate US reflection and cavitation, a custom-made absorption chamber was designed, where US is applied through a water tank before interacting with the cells and is fully absorbed after passing through the cell layer. Expression of the marker gene EGFP was quantified by FACS analysis and intravital fluorescent microscopy. Cell viability was accessed by Trypan Blue staining. US treatment of tumor cells on microplates for 60 s yielded a significant increase in transfection rates without damaging the cells, but 90-s treatment killed most of the cells. In the absorption chamber, no significant effects of US on transfection were noted. Additional experiments employed US contrast agent (Levovist, Schering) which was able to significantly increase tumor cell transfection rate by enhancing cavitation effects, and also severely damaged most cells when applied at a concentration of 200 mg/mL. In conclusion, our results support the assumption that US effects on lipoplex transfection rates in brain tumor cells in culture are mediated by cavitation effects.

Sonoporation of monolayer cells by diagnostic ultrasound activation of contrast-agent gas bodies

Human (A431 epidermoid carcinoma) cells were grown as monolayers on 5 microm thick Mylar sheets, which formed the upper window for a 1-mm thick, 23-mm diameter disc-shaped exposure chamber. A 3.5-MHz curved linear-array transducer was aimed upward at the chamber, 7 cm away, in a 37 degrees C water bath. The chamber contained phosphate-buffered saline (PBS) with 10 mg/mL fluorescent dextran and 1% Optison ultrasound (US) contrast agent. Significant fluorescent cell counts, indicative of membrane damage (i.e., sonoporation), up to about 10% of cells within a 1-mm diameter field of view, were noted for spectral Doppler and two-dimensional (2-D) scan mode with or without a tissue-mimicking phantom. The effect was only weakly dependent on pulse-repetition frequency or exposure duration, but was strongly dependent on contrast agent concentration below 2%. Thus, diagnostic US activation of contrast-agent gas bodies can produce cell membrane damage.

Ultrasonic enhancement of gene transfection in murine melanoma tumors

The enhancement of gene transfection by ultrasound (US) was evaluated in vitro and in vivo using the B16 mouse melanoma model. Cultured cells were either exposed in suspensions in vitro or implanted subcutaneously in female C57BL/6 mice for 10-14 days and, subsequently exposed, in vivo. For comparison to results with a luciferase plasmid, a reporter plasmid for green fluorescent protein (GFP) was used to evaluate transfection efficiency. US was supplied by a system, similar to a Dornier HM-3 lithotripter, that produced shock waves (SW) of 24.4 MPa peak positive and 5.2 MPa peak negative pressure amplitudes at the focus. The plasmids were mixed with the suspensions to achieve 20 ,microL mL(-1), or were injected intratumorally to provide 0.2 mg DNA per mL of tumor. Acoustic cavitation was promoted by retaining 0.2 mL of air in the 1.2-mL exposure chambers in vitro and by injecting air at 10% of tumor volume in vivo. In vitro, cell counts declined to 5.3% of shams after 800 SW exposure, with 1.4% of the cells expressing GFP after 2 days of culture. In vivo, 2 days after 400 SW exposure, viable-cell recovery from excised tumors was reduced to 4.2% of shams and cell transfection was enhanced by a factor of about 8, reaching 2.5% of cell counts (p < 0.005 in t-test). These results show that strong tumor ablation induced by US shock wave treatment can be coupled with simultaneous enhancement of gene transfection.