Thermal damage assessment of blood vessels in a hamster skin flap model by fluorescence measurement of a liposome-dye system

Light-activated content release from liposomes

Successful integration of diagnostic and therapeutic actions at the level of individual cells requires new materials that combine biological compatibility with functional versatility. This review focuses on the development of liposome-based functional materials, where payload release is activated by light. Methods of sensitizing liposomes to light have progressed from the use of organic molecular moieties to the use of metallic plasmon resonant structures. This development has facilitated application of near infrared light for activation, which is preferred for its deep penetration and low phototoxicity in biological tissues. Presented mechanisms of light-activated liposomal content release enable precise in vitro manipulation of minute amounts of reagents, but their use in clinical diagnostic and therapeutic applications will require demonstration of safety and efficacy.

Comparative Study of the Optical and Heat Generation Properties of IR820 and Indocyanine Green

Near-infrared (NIR) fluorophores are the focus of extensive research for combined molecular imaging and hyperthermia. In this study, we showed that the cyanine dye IR820 has optical and thermal generation properties similar to those of indocyanine green (ICG) but with improved in vitro and in vivo stability. The fluorescent emission of IR820 has a lower quantum yield than ICG but less dependence of the emission peak location on concentration. IR820 demonstrated degradation half-times approximately double those of ICG under all temperature and light conditions in aqueous solution. In hyperthermia applications, IR820 generated lower peak temperatures than ICG (4–9%) after 3-minute laser exposure. However, there was no significant difference in hyperthermia cytotoxicity, with both dyes causing significant cell growth inhibition at concentrations ≥ 5 μM. Fluorescent images of cells with 10 μM IR820 were similar to ICG images. In rats, IR820 resulted in a significantly more intense fluorescence signal and significantly higher organ dye content than for ICG 24 hours after intravenous dye administration ( p < .05). Our study shows that IR820 is a feasible agent in experimental models of imaging and hyperthermia and could be an alternative to ICG when greater stability, longer image collection times, or more predictable peak locations are desirable.

Laser-induced disruption of systemically administered liposomes for targeted drug delivery

Liposomal formulations of drugs have been shown to enhance drug efficacy by prolonging circulation time, increasing local concentration and reducing off-target effects. Controlled release from these formulations would increase their utility, and hyperthermia has been explored as a stimulus for targeted delivery of encapsulated drugs. Use of lasers as a thermal source could provide improved control over the release of the drug from the liposomes with minimal collateral tissue damage. Appropriate methods for assessing local release after systemic delivery would aid in testing and development of better formulations. We use in vivo bioluminescence imaging to investigate the spatiotemporal distribution of luciferin, used as a model small molecule, and demonstrate laser-induced release from liposomes in animal models after systemic delivery. These liposomes were tested for luciferin release between 37 and 45 degrees C in PBS and serum using bioluminescence measurements. In vivo studies were performed on transgenic reporter mice that express luciferase constitutively throughout the body, thus providing a noninvasive readout for controlled release following systemic delivery. An Nd:YLF laser was used (527 nm) to heat tissues and induce rupture of the intravenously delivered liposomes in target tissues. These data demonstrate laser-mediated control of small molecule delivery using thermally sensitive liposomal formulations.

Photothermolysis of blood vessels using indocyanine green and pulsed diode laser irradiation in the dorsal skinfold chamber model

BACKGROUND AND OBJECTIVE

For the treatment of vascular lesions, the use of laser light absorbed by the endogenous chromophore hemoglobin may still be improved.

MATERIALS AND METHODS

Laser treatment (lambda(em) = 805 nm; fluence rate: 106 kW/cm2; fluence: 3.2 J/cm2 (3 milliseconds)), of blood vessels directly after i.v. application of indocyanine green (ICG) (ICG-concentration: 0, 2, or 4 mg/kg body weight (b.w.)) (n = 14,117) was investigated in the skinfold chamber model. Vessel diameters (1-351 microm) were measured using intravital fluorescence microscopy up to 24 hours following irradiation. Histology was taken 1 or 24 hours after irradiation. Results were compared to a mathematical model based on the finite element method.

RESULTS

The reduction of blood vessel perfusion was proportional to ICG-concentration and pulse duration; only a 30 milliseconds pulse duration (2 or 4 mg/kg b.w. ICG-concentration) induced a loss of perfusion even of blood vessels with a diameter <30 microm. Histology revealed photocoagulation of blood vessels up to 24 hours. Results were in agreement with mathematical calculations.

CONCLUSION

ICG-mediated laser irradiation induces irreversible photocoagulation of blood vessels of all diameters in this model.

Treatment of cutaneous vascular lesions using multiple-intermittent cryogen spurts and two-wavelength laser pulses: Numerical and animal studies

BACKGROUND AND OBJECTIVES

Presently, cutaneous vascular lesions are treated using a single cryogen spurt and single laser pulse (SCS-SLP), which do not necessarily produce complete lesion removal in the majority of patients. In this study, the feasibility of applying multiple cryogen spurts intermittently with multiple two-wavelength laser pulses (MCS-MTWLP) was studied using numerical and animal models.

STUDY DESIGN/MATERIALS AND METHODS

Two treatment procedures were simulated: (1) SCS+532 nm SLP; and (2) MCS+532/1064 nm MTWLP. Light transport and heat diffusion in human skin were simulated with the Monte Carlo method and finite element model, respectively. Possible epidermal damage and blood vessel photocoagulation were evaluated with an Arrhenius-type kinetic model. Blood vessels in the rodent window chamber model (RWCM) were irradiated with either SLP or MTWLP. Laser-induced structural and functional changes in the vessels were documented by digital photography and laser speckle imaging (LSI).

RESULTS

The numerical results show that the MCS-MTWLP approach can provide sufficient epidermal protection while simultaneously achieving photocoagulation of larger blood vessels as compared to SCS-SLP. Animal studies show that MTWLP has significant advantages over SLP by inducing irreversible damage to larger blood vessels without adverse effects.

CONCLUSIONS

MCS-MTWLP may be a promising approach to improve therapeutic outcome for patients with cutaneous vascular lesions featuring large blood vessels.

Dynamic modeling of photothermal interactions for laser-induced interstitial thermotherapy: parameter sensitivity analysis

A two-dimensional model was developed to model the effects of dynamic changes in the physical properties on tissue temperature and damage to simulate laser-induced interstitial thermotherapy (LITT) treatment procedures with temperature monitoring. A modified Monte Carlo method was used to simulate photon transport in the tissue in the non-uniform optical property field with the finite volume method used to solve the Pennes bioheat equation to calculate the temperature distribution and the Arrhenius equation used to predict the thermal damage extent. The laser light transport and the heat transfer as well as the damage accumulation were calculated iteratively at each time step. The influences of different laser sources, different applicator sizes, and different irradiation modes on the final damage volume were analyzed to optimize the LITT treatment. The numerical results showed that damage volume was the smallest for the 1,064-nm laser, with much larger, similar damage volumes for the 980- and 850-nm lasers at normal blood perfusion rates. The damage volume was the largest for the 1,064-nm laser with significantly smaller, similar damage volumes for the 980- and 850-nm lasers with temporally interrupted blood perfusion. The numerical results also showed that the variations in applicator sizes, laser powers, heating durations and temperature monitoring ranges significantly affected the shapes and sizes of the thermal damage zones. The shapes and sizes of the thermal damage zones can be optimized by selecting different applicator sizes, laser powers, heating duration times, temperature monitoring ranges, etc.

Fluorescence imaging method for in vivo pH monitoring during liposomes uptake in rat liver using a pH-sensitive fluorescent dye

Liposomes are known to be taken up by the liver cells after intravenous injection. Among the few techniques available to follow this process in vivo are perturbed angular correlation spectroscopy, nuclear magnetic resonance spectroscopy, and scintigraphy. The study of the intracellular pathways and liposomal localization in the different liver cells requires sacrifice of the animals, cells separation, and electronic microscopy. In the acidic intracellular compartments, the in situ rate of release of liposomes remains poorly understood. We present a new method to follow the in situ and in vivo uptake of liposomes using a fluorescent pH-sensitive probe 5,6-carboxyfluorescein (5,6-CF). 5,6-CF is encapsulated in liposomes at high concentration (100 mM) to quench its fluorescence. After laparotomy, liposomes are injected into the penile vein of Wistar rats. Fluorescence images of the liver and the skin are recorded during 90 min and the fluorescence intensity ratio is calculated. Ratio kinetics show different profiles depending on the liposomal formulation. The calculated intracellular liver pH values are, respectively, 4.5 to 5.0 and 6.0 to 6.5 for DSPC/chol and DMPC liposomes. After sacrifice and flush with a cold saline solution, the pH of the intracellular site of the liver (ex vivo) is found to be 4.5 to 5.0. This value can be explained by an uptake of liposomes by the liver cells and subsequent localization into the acidic compartment. An intracellular event such as dye release of a drug carrier (liposomes loaded with a fluorescent dye) can be monitored by pH fluorescence imaging and spectroscopy in vivo and in situ.

Selective laser photocoagulation of blood vessels in a hamster skin flap model using a specific ICG formulation

BACKGROUND AND OBJECTIVE

The present study was undertaken to evaluate the selective laser photocoagulation of blood vessels in a hamster skin flap model using a specific indocyanine green (ICG) formulation.

STUDY DESIGN/MATERIALS AND METHODS

Experiments were performed in a hamster skin flap model after injection of ICG in aqueous solution (ICGA), or after injection of a specific formulation of ICG (ICG in emulsion: ICGE). Laser irradiation was achieved 30 minutes after injection with a 300 microns fiber connected to a 805 nm diode laser (power = 0.8W, spot diameter = 1.3 mm and pulse exposure time lasting from 1 to 5 s). Macroscopic observation and acute histology were performed to compare the tissue effects obtained for each ICG formulation and to assess the selectivity of vessel damage.

RESULTS

The ICGE clearance process was slowed down as compared to the ICGA process. After 30 minutes, the concentration of ICG in blood is higher (2.27 +/- 0.4, P < 0.003) for ICGE compared to ICGA. With ICGA, vessel coagulation required a minimum fluence of 240 J/cm2, which led to very significant skin damage. Conversely with ICGE, vessel coagulation required a fluence of 120 J/cm2. With such a fluence, no laser effect could be detected on the skin. Histological examination confirmed blood vessels coagulation in depth, whereas epidermis and dermis remained intact.

CONCLUSION

The major restrictions of ICG in aqueous solution, which are the very-short half-life of ICG in blood and consequently the lack of selectivity in blood vessels after a few minutes, are alleviated when ICG is used in emulsion. ICG in emulsion increases the circulating half-life of ICG and moreover confines ICG in the vascular compartment. Thanks to this specific property, it is possible to obtain a selective vascular damage 30 minutes after injection.

Diode laser-induced thermal damage evaluation on the retina with a liposome dye system

BACKGROUND AND OBJECTIVES

The aim of the study was to evaluate the feasibility of retinal thermal damage assessment in a rabbit eye model by using laser-induced release of liposome-encapsulated dye.

STUDY DESIGN/MATERIALS AND METHODS

After anesthesia, thermosensitive liposomes (DiStearoyl Phosphatidyl Choline: DSPC) loaded with 5,6-carboxyfluorescein were injected intravenously to pigmented rabbits. Retinal photocoagulations were performed with a 810nm diode laser (P=100-400 mW, laser spot=500 microm, 1s) (OcuLight, IRIS Medical Instruments, Mountain View, CA). Fluorescence measurements in the area of the laser exposures were then realized with a digitized angiograph (CF-60UVi, Canon-Europe, The Netherlands; OcuLab, Life Science Resources, UK).

RESULTS

Fluorescent spots were observed for power ranging from 100 +/- 5 mW to 400 +/- 5 mW. The fluorescence intensity increased linearly with the power and reached a plateau at 280 +/- 5 mW. The fluorescence intensity was correlated to the maximum temperature at the center of the laser spot with a linear increase from 42 +/- 3 degrees C to 65 +/- 3 degrees C. These results are in agreement with our two previous studies with DSPC liposomes for temperature measurements in a tissue model and then in a vascular model.

CONCLUSION

This preliminary study demonstrates the possibility of a laser-induced release of liposome-encapsulated dye for a quantification of diode laser induced thermal damage in ophthalmology. Such a method could be useful for a real-time monitoring of laser photocoagulation for conditions such as choroidal neovascular membranes when a precise thermal damage is required near the foveolar area.

The effects of dynamic optical properties during interstitial laser photocoagulation

A nonlinear mathematical model was developed and experimentally validated to investigate the effects of changes in optical properties during interstitial laser photocoagulation (ILP). The effects of dynamic optical properties were calculated using the Arrhenius damage model, resulting in a nonlinear optothermal response. This response was experimentally validated by measuring the temperature rise in albumen and polyacrylamide phantoms. A theoretical study of ILP in liver was conducted constraining the peak temperatures below the vaporization threshold. The temperature predictions varied considerably between the static and dynamic scenarios, and were confirmed experimentally in phantoms. This suggests that the Arrhenius model can be used to predict dynamic changes in optical and thermal fields. An increase in temperature rise due to a decrease in light penetration within the coagulated region during ILP of the liver was also demonstrated. The kinetics of ILP are complex and nonlinear due to coagulation, which changes the tissue properties during treatment. These complex effects can be adequately modelled using an Arrhenius damage formulation.