Biological effects of laser-induced shock waves: structural and functional cell damage in vitro

In vitro effect of Er: YAG laser irradiation in caries cavity preparation on biobehaviors of adjacent human dental pulp cells in the pulp chamber

The erbium-doped yttrium aluminum garnet (Er: YAG) laser has been successfully applied in caries removal; however, little is known about proper parameters of Er: YAG laser on different conditions of caries removal, especially the influence of Er: YAG irradiation on human dental pulp cells (hDPCs). Here, we tested the effects of Er: YAG laser at different output energy levels (100, 200, 300, 400, and 500 mJ) on biobehaviors of hDPCs. To simulate clinical deep caries conditions, hDPCs were cultured on the pulpal side of 500-μm-thick dentin disks in an in vitro pulp chamber model. Temperature change, structural change, and ablation depth of dentin disk were also recorded. The findings suggested that the biological behaviors of hDPCs are strongly correlated with the energy output of the Er: YAG laser. Er: YAG laser irradiation at 100 mJ may be proper and safe for deep caries removal since it would not cause any adverse effect on hDPCs biobehaviors.

Mechanically Induced Cavitation in Biological Systems

Cavitation bubbles form in soft biological systems when subjected to a negative pressure above a critical threshold, and dynamically change their size and shape in a violent manner. The critical threshold and dynamic response of these bubbles are known to be sensitive to the mechanical characteristics of highly compliant biological systems. Several recent studies have demonstrated different biological implications of cavitation events in biological systems, from therapeutic drug delivery and microsurgery to blunt injury mechanisms. Due to the rapidly increasing relevance of cavitation in biological and biomedical communities, it is necessary to review the current state-of-the-art theoretical framework, experimental techniques, and research trends with an emphasis on cavitation behavior in biologically relevant systems (e.g., tissue simulant and organs). In this review, we first introduce several theoretical models that predict bubble response in different types of biological systems and discuss the use of each model with physical interpretations. Then, we review the experimental techniques that allow the characterization of cavitation in biologically relevant systems with in-depth discussions of their unique advantages and disadvantages. Finally, we highlight key biological studies and findings, through the direct use of live cells or organs, for each experimental approach.

Optical Vortex Beam for Gentle and Ultraprecise Intrastromal Corneal Dissection in Refractive Surgery

Purpose

We introduce a novel focus shaping concept for intrastromal corneal dissection that facilitates cleavage along corneal lamellae, and we analyze laser-tissue interactions governing cutting effectiveness and mechanical side effects.

Methods

Focus shaping was achieved by a spiral phase plate that converts an incident Gaussian beam into a Laguerre-Gaussian beam with a helical phase. Such vortex beams have zero intensity at their center, are propagation invariant, and possess a ring focus equal in length to the Gaussian focus but with a larger diameter. Cutting precision and the required absorbed energy for flap dissection were compared for Gaussian and vortex beams on ex vivo porcine corneal specimens at pulse durations between 480 fs and 9 ps. Cutting quality and bubble formation were characterized by scanning electron microscopy and macro photography.

Results

With the vortex beam, the cuts were much smoother. Bubble formation was markedly reduced because cutting can be performed close to the bubble threshold, whereas with the Gaussian beam energies well above threshold are needed. Although the incident energy at the flap dissection threshold was slightly larger for the vortex beam, the absorbed energy was much smaller and contributed more effectively to cutting. This reduced plasma-induced pressure more than sevenfold.

Conclusions

The vortex beam approach for corneal dissection is a simple, versatile, and cost-effective way of improving the precision of refractive surgery while reducing bubble formation and pressure-related mechanical side effects.

Translational Relevance

Phase plates for propagation invariant vortex beams are easily implemented in the beam path of next-generation clinical devices.

Shock wave impact on the viability of MDA-MB-231 cells

Shock waves are gaining interests in biological and medical applications. In this work, we investigated the mechanical characteristics of shock waves that affect cell viability. In vitro testing was conducted using the metastatic breast epithelial cell line MDA-MB-231. Shock waves were generated using a high-power pulse laser. Two different coating materials and different laser energy levels were used to vary the peak pressure, decay time, and the strength of subsequent peaks of the shock waves. Within the testing capability of the current study, it is shown that shock waves with a higher impulse led to lower cell viability, a higher detached cell ratio, and a higher cell death ratio, while shock waves with the same peak pressure could lead to different levels of cell damage. The results also showed that the detached cells had a higher cell death ratio compared to the attached cells. Moreover, a critical shock impulse of 5 Pa·s was found to cause the cell death ratio of the detached cells to exceed 50%. This work has demonstrated that, within the testing range shown here, the impulse, rather than the peak pressure, is the governing shock wave parameter for the damage of MDA-MB-231 breast cancer cells. The result suggests that a lower-pressure shock wave with a longer duration, or multiple sequential low amplitude shock waves can be applied over a duration shorter than the fundamental response period of the cells to achieve the same impact as shock waves with a high peak pressure but a short duration. The finding that cell viability is better correlated with shock impulse rather than peak pressure has potential significant implications on how shock waves should be tailored for cancer treatments, enhanced drug delivery, and diagnostic techniques to maximize efficacy while minimizing potential side effects.

Intracellular Delivery by Membrane Disruption: Mechanisms, Strategies, and Concepts

Intracellular delivery is a key step in biological research and has enabled decades of biomedical discoveries. It is also becoming increasingly important in industrial and medical applications ranging from biomanufacture to cell-based therapies. Here, we review techniques for membrane disruption-based intracellular delivery from 1911 until the present. These methods achieve rapid, direct, and universal delivery of almost any cargo molecule or material that can be dispersed in solution. We start by covering the motivations for intracellular delivery and the challenges associated with the different cargo types-small molecules, proteins/peptides, nucleic acids, synthetic nanomaterials, and large cargo. The review then presents a broad comparison of delivery strategies followed by an analysis of membrane disruption mechanisms and the biology of the cell response. We cover mechanical, electrical, thermal, optical, and chemical strategies of membrane disruption with a particular emphasis on their applications and challenges to implementation. Throughout, we highlight specific mechanisms of membrane disruption and suggest areas in need of further experimentation. We hope the concepts discussed in our review inspire scientists and engineers with further ideas to improve intracellular delivery.

[Novel concepts for treatment of the corneal endothelium with nanoparticles]

BACKGROUND

The number of corneal transplantations has increased in Germany in recent years. One reason is an earlier time point of surgery due to less invasive posterior lamellar grafting techniques. To date, penetrating and lamellar corneal transplantations are the only established therapeutic options to treat corneal diseases resulting from endothelial cell pathologies.

AIM

This review article provides an insight into nanoparticle-related translational strategies to improve or to avoid corneal transplantation.

RESULTS

Nanoparticle-based strategies for optimization of the corneal endothelium have different fields of application: 1. during donor cornea cultivation in culture medium, 2. for single cell injection therapies and 3. to treat the patients' own endothelium in an effort to avoid transplantation.

CONCLUSION

Several translational concepts exist to improve or to avoid grafting of a donor cornea. The coming decade will provide established alternatives to conventional corneal transplantation.

Cell viability and shock wave amplitudes in the endothelium of porcine cornea exposed to ultrashort laser pulses

PURPOSE

Some forms of keratoplasty assisted by ultrashort-pulse lasers require performing laser cuts close to the endothelium, which requires the knowledge of "safe" values concerning incision depth and pulse energy preserving endothelial cell viability. Our study aims to determine the thresholds for cell death in porcine corneas exposed to ultrashort laser pulses, in terms of laser pulse energy and nearness of the impacts to the endothelium.

METHODS

Using a laboratory laser set-up, lamellar cuts were induced while varying pulse energies and distances from the endothelium. A fluorescent staining protocol was used to determine the percentage of surviving endothelial cells. Numerical simulations of the Euler equations for compressible fluids provided pressure level and axial and radial pressure gradient estimates at the endothelium.

RESULTS

Ninety percent of the endothelial cells survived when using 16.5 μJ pulses no closer than 200 μm to the endothelium, or pulses not exceeding 2 μJ at a distance of 50 μm. The comparison of the observed percentage of surviving cells with the estimates of the shock wave amplitudes and gradients generated by the laser pulses yielded cell death thresholds at amplitudes in the megapascal range, or gradients of the order of 10⁸ Pa/m.

CONCLUSIONS

Our results provide limits in terms of pulse energy and distance of the incision from the endothelium within which endothelial cell viability is preserved. Current forms of corneal laser surgery are compatible with these limits. However, these limits will need to be considered for the development of future laser routines working in close proximity to the endothelium.

Characterization of the temperature rise in a single cell during photoacoustic tomography at the nanoscale

We are developing a label-free nanoscale photoacoustic tomography (nPAT) for imaging a single living cell. nPAT uses a laser-induced acoustic pulse to generate a nanometer-scale image. The primary motivation behind this imaging technique is the imaging of biological cells in the context of diagnosis without fluorescent tagging. During this procedure, thermal damage due to the laser pulse is a potential risk that may damage the cells. A physical model is built to estimate the temperature rise and thermal relaxation during the imaging procedure. Through simulations using finite element methods, two lasers (532 nm at 5 ps pulse duration and 830 nm at 0.2 ps pulse duration) were simulated for imaging red blood cells (RBCs). We demonstrate that a single 5-ps pulse laser with a 400-Hz repetition rate will generate a steady state temperature rise of less than a Kelvin on the surface of the RBCs. All the simulation results show that there is no significant temperature rise in an RBC in either single pulse or multiple pulse illumination with a 532-nm laser with 219 W fluence. Therefore, our simulation results demonstrate the thermal safety of an nPAT system. The photoacoustic signal generated by this laser is on the order of 2.5 kPa, so it should still be large enough to generate high-resolution images with nPAT. Frequency analysis of this signal shows a peak at 1.47 GHz, with frequencies as high as 3.5 GHz still being present in the spectrum. We believe that nPAT will open an avenue for disease diagnosis and cell biology studies at the nanometer-level.

Gold Nanoparticle-Mediated Delivery of Molecules into Primary Human Gingival Fibroblasts Using ns-Laser Pulses: A Pilot Study

Interaction of gold nanoparticles (AuNPs) in the vicinity of cells’ membrane with a pulsed laser (λ = 532 nm, τ = 1 ns) leads to perforation of the cell membrane, thereby allowing extracellular molecules to diffuse into the cell. The objective of this study was to develop an experimental setting to deliver molecules into primary human gingival fibroblasts (pHFIB-G) by using ns-laser pulses interacting with AuNPs (study group). To compare the parameters required for manipulation of pHFIB-G with those needed for cell lines, a canine pleomorphic adenoma cell line (ZMTH3) was used (control group). Non-laser-treated cells incubated with AuNPs and the delivery molecules served as negative control. Laser irradiation (up to 35 mJ/cm²) resulted in a significant proportion of manipulated fibroblasts (up to 85%, compared to non-irradiated cells: p < 0.05), while cell viability (97%) was not reduced significantly. pHFIB-G were perforated as efficiently as ZMTH3. No significant decrease of metabolic cell activity was observed up to 72 h after laser treatment. The fibroblasts took up dextrans with molecular weights up to 500 kDa. Interaction of AuNPs and a pulsed laser beam yields a spatially selective technique for manipulation of even primary cells such as pHFIB-G in high throughput.

Delivery of Molecules into Human Corneal Endothelial Cells by Carbon Nanoparticles Activated by Femtosecond Laser

Corneal endothelial cells (CECs) form a monolayer at the innermost face of the cornea and are the engine of corneal transparency. Nevertheless, they are a vulnerable population incapable of regeneration in humans, and their diseases are responsible for one third of corneal grafts performed worldwide. Donor corneas are stored in eye banks for security and quality controls, then delivered to surgeons. This period could allow specific interventions to modify the characteristics of CECs in order to increase their proliferative capacity, increase their resistance to apoptosis, or release immunosuppressive molecules. Delivery of molecules specifically into CECs during storage would therefore open up new therapeutic perspectives. For clinical applications, physical methods have a more favorable individual and general benefit/risk ratio than most biological vectors, but are often less efficient. The delivery of molecules into cells by carbon nanoparticles activated by femtosecond laser pulses is a promising recent technique developed on non-adherent cells. The nanoparticles are partly consummated by the reaction releasing CO and H₂ gas bubbles responsible for the shockwave at the origin of cell transient permeation. Our aim was to develop an experimental setting to deliver a small molecule (calcein) into the monolayer of adherent CECs. We confirmed that increased laser fluence and time exposure increased uptake efficiency while keeping cell mortality below 5%. We optimized the area covered by the laser beam by using a motorized stage allowing homogeneous scanning of the cell culture surface using a spiral path. Calcein uptake reached median efficiency of 54.5% (range 50.3–57.3) of CECs with low mortality (0.5%, range (0.55–1.0)). After sorting by flow cytometry, CECs having uptaken calcein remained viable and presented normal morphological characteristics. Delivery of molecules into CECs by carbon nanoparticles activated by femtosecond laser could prove useful for future cell or tissue therapy.

[Alternatives to femtosecond laser technology: subnanosecond UV pulse and ring foci for creation of LASIK flaps]

BACKGROUND

In refractive corneal surgery femtosecond (fs) lasers are used for creating LASIK flaps, dissecting lenticules and for astigmatism correction by limbal incisions.

OBJECTIVES

Femtosecond laser systems are complex and expensive and cutting precision is compromised by the large focal length associated with the commonly used infrared (IR) wavelengths. Based on investigations of the cutting dynamics, novel approaches for corneal dissection using ultraviolet A (UVA) picosecond (ps) pulses and ring foci from vortex beams are presented.

METHODS

Laser-induced bubble formation in corneal stroma was investigated by high-speed photography at 1-50 million frames/s. Using Gaussian and vortex beams of UVA pulses with durations between 200 and 850 ps the laser energy needed for easy removal of flaps created in porcine corneas was determined and the quality of the cuts by scanning electron microscopy was documented. Cutting parameters for 850 ps are reported also for rabbit eyes. The UV-induced and mechanical stress were evaluated for Gaussian and vortex beams.

RESULTS

The results show that UVA picosecond lasers provide better cutting precision than IR femtosecond lasers, with similar processing times. Cutting energy decreases by >50 % when the laser pulse duration is reduced to 200 ps. Vortex beams produce a short, donut-shaped focus allowing efficient and precise dissection along the corneal lamellae which results in a dramatic reduction of the absorbed energy needed for cutting and of mechanical side effects as well as in less bubble formation in the cutting plane.

CONCLUSION

A combination of novel approaches for corneal dissection provides the option to replace femtosecond lasers by compact UVA microchip laser technology. Ring foci are also of interest for femtosecond laser surgery, especially for improved lenticule excision.

Photodynamic inactivation of biofilm: taking a lightly colored approach to stubborn infection

Microbial biofilms are responsible for a variety of microbial infections in different parts of the body, such as urinary tract infections, catheter infections, middle-ear infections, gingivitis, caries, periodontitis, orthopedic implants, and so on. The microbial biofilm cells have properties and gene expression patterns distinct from planktonic cells, including phenotypic variations in enzymic activity, cell wall composition and surface structure, which increase the resistance to antibiotics and other antimicrobial treatments. There is consequently an urgent need for new approaches to attack biofilm-associated microorganisms, and antimicrobial photodynamic therapy (aPDT) may be a promising candidate. aPDT involves the combination of a nontoxic dye and low-intensity visible light which, in the presence of oxygen, produces cytotoxic reactive oxygen species. It has been demonstrated that many biofilms are susceptible to aPDT, particularly in dental disease. This review will focus on aspects of aPDT that are designed to increase efficiency against biofilms modalities to enhance penetration of photosensitizer into biofilm, and a combination of aPDT with biofilm-disrupting agents.

Bio-Rapid-Prototyping of Tissue Engineering Scaffolds and the Process-Induced Cell Damage

Tissue scaffolds play a vital role in tissue engineering by providing a native tissue-mimicking environment for cell proliferation and differentiation as well as tissue regeneration. Fabrication of tissue scaffolds has been drawing increasing research attention and a number of fabrication techniques have been developed. To better mimic the microenvironment of native tissues, novel techniques have emerged in recent years to encapsulate cells into the engineered scaffolds during the scaffold fabrication process. Among them, bio-Rapid-Prototyping (bioRP) techniques, by which scaffolds with encapsulated cells can be fabricated with controlled internal microstructure and external shape, shows significant promise. It is noted in the bioRP processes, cells may be continuously subjected to environmental stresses such as mechanical, electrical forces and laser exposure. If the stress is greater than a certain level, the cell membrane may be ruptured, leading to the so-called process-induced cell damage. This paper reviews various cell encapsulation techniques for tissue scaffold fabrication, with emphasis on the bioRP technologies and their technical features. To understand the process-induced cell damage in the bioRP processes, this paper also surveys the cell damage mechanisms under different stresses. The process-induced cell damage models are also examined to provide a cue to the cell viability preservation in the fabrication process. Discussions on further improvements of bioRP technologies are given and ongoing research into mechanical cell damage mechanism are also suggested in this review.

Can ultrasound enable efficient intracellular uptake of molecules? A retrospective literature review and analysis

Most applications of therapeutic ultrasound (US) for intracellular delivery of drugs, proteins, DNA/RNA and other compounds would benefit from efficient uptake of these molecules into large numbers of cells without killing cells in the process. In this study we tested the hypothesis that efficient intracellular uptake of molecules can be achieved with high cell viability after US exposure in vitro. A search of the literature for studies with quantitative data on uptake and viability yielded 26 published papers containing 898 experimental data points. Analysis of these studies showed that just 7.7% of the data points corresponded to relatively efficient uptake (>50% of cells exhibiting uptake). Closer examination of the data showed that use of Definity US contrast agent (as opposed to Optison) and elevated sonication temperature at 37°C (as opposed to room temperature) were associated with high uptake, which we further validated through independent experiments carried out in this study. Although these factors contributed to high uptake, almost all data with efficient uptake were from studies that had not accounted for lysed cells when determining cell viability. Based on retrospective analysis of the data, we showed that not accounting for lysed cells can dramatically increase the calculated uptake efficiency. We further argue that if all the data considered in this study were re-analyzed to account for lysed cells, there would be essentially no data with efficient uptake. We therefore conclude that the literature does not support the hypothesis that efficient intracellular uptake of molecules can be achieved with high cell viability after US exposure in vitro, which poses a challenge to future applications of US that require efficient intracellular delivery.

Rapid release of tissue enzymes into blood after blast exposure: potential use as biological dosimeters

Explosive blast results in multiple organ injury and polytrauma, the intensity of which varies with the nature of the exposure, orientation, environment and individual resilience. Blast overpressure alone may not precisely indicate the level of body or brain injury after blast exposure. Assessment of the extent of body injury after blast exposure is important, since polytrauma and systemic factors significantly contribute to blast-induced traumatic brain injury. We evaluated the activity of plasma enzymes including aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatine kinase (CK) at different time points after blast exposure using a mouse model of single and repeated blast exposures to assess the severity of injury. Our data show that activities of all the enzymes in the plasma were significantly increased as early as 1 h after blast exposure. The elevated enzyme activity remained up to 6 h in an overpressure dose-dependent manner and returned close to normal levels at 24 h. Head-only blast exposure with body protection showed no increase in the enzyme activities suggesting that brain injury alone does not contribute to the systemic increase. In contrast to plasma increase, AST, ALT and LDH activity in the liver and CK in the skeletal muscle showed drastic decrease at 6 h after blast exposures. Histopathology showed mild necrosis at 6 h and severe necrosis at 24 h after blast exposures in liver and no changes in the skeletal muscle suggesting that the enzyme release from the tissue to plasma is probably triggered by transient cell membrane disruption from shockwave and not due to necrosis. Overpressure dependent transient release of tissue enzymes and elevation in the plasma after blast exposure suggest that elevated enzyme activities in the blood can be potentially used as a biological dosimeter to assess the severity of blast injury.

Optical fiber-based photomechanical gene transfer system for in vivo application

We developed an optical-fiber-based photomechanical gene transfer system for endoscopic or catheter-based application. A fiber tip with a laser-absorbing film covered with a transparent plastic disk for plasma confinement was attached to a quartz fiber; the film was irradiated with nanosecond laser pulses transmitted through the fiber to generate photomechanical waves (PMWs). Characteristics of PMWs emitted from the fiber tip were examined to confirm the necessary conditions for gene transfer. We then attempted to transfer reporter genes to the rat skin as a test tissue in vivo with the fiber system, and the results showed significantly high protein levels and spatially selective pinpoint gene expressions in the tissue.

Mechanisms of primary blast-induced traumatic brain injury: insights from shock-wave research

Traumatic brain injury caused by explosive or blast events is traditionally divided into four phases: primary, secondary, tertiary, and quaternary blast injury. These phases of blast-induced traumatic brain injury (bTBI) are biomechanically distinct and can be modeled in both in vivo and in vitro systems. The primary bTBI injury phase represents the response of brain tissue to the initial blast wave. Among the four phases of bTBI, there is a remarkable paucity of information about the cause of primary bTBI. On the other hand, 30 years of research on the medical application of shockwaves (SW) has given us insight into the mechanisms of tissue and cellular damage in bTBI, including both air-mediated and underwater SW sources. From a basic physics perspective, the typical blast wave consists of a lead SW followed by supersonic flow. The resultant tissue injury includes several features observed in bTBI, such as hemorrhage, edema, pseudoaneurysm formation, vasoconstriction, and induction of apoptosis. These are well-described pathological findings within the SW literature. Acoustic impedance mismatch, penetration of tissue by shock/bubble interaction, geometry of the skull, shear stress, tensile stress, and subsequent cavitation formation, are all important factors in determining the extent of SW-induced tissue and cellular injury. Herein we describe the requirements for the adequate experimental set-up when investigating blast-induced tissue and cellular injury; review SW physics, research, and the importance of engineering validation (visualization/pressure measurement/numerical simulation); and, based upon our findings of SW-induced injury, discuss the potential underlying mechanisms of primary bTBI.

Laser-based gene transfection and gene therapy

The plasma membrane of mammalian cells can be transiently permeablized by optical means and exogenous materials or genes can be introduced into the cytoplasm of living cells. Until now, few mechanisms were exploited for the manipulation: laser is directly and tightly focused on the cells for optoinjection, laser-induced stress waves, photochemical internalization, and irradiation of selective cell targeting with light-absorbing particles. During the past few years, extensive progress and numerous breakthroughs have been made in this area of research. This review covers four different laser-assisted transfection techniques and their advantages and disadvantages. Universality towards various cell lines is possibly the main advantage of laser-assisted optoporation in comparison with presently existing methods of cell transfection.

Laser-induced explosion of gold nanoparticles: potential role for nanophotothermolysis of cancer

AIMS

This article explores the laser-induced explosion of absorbing nanoparticles in selective nanophotothermolysis of cancer.

METHODS

This is realized through fast overheating of a strongly absorbing target during the time of a short laser pulse when the influence of heat diffusion is minimal.

RESULTS

On the basis of simple energy balance, it is found that the threshold laser fluence for thermal explosion of different gold nanoparticles is in the range of 25-40 mJ/cm(2).

CONCLUSION

Explosion of nanoparticles may be accompanied by optical plasma, generation of shock waves with supersonic expansion and particle fragmentation with fragments of high kinetic energy, all of which can contribute to the killing of cancer cells.

Biophysical mechanisms of transient optical stimulation of peripheral nerve

A new method for in vivo neural activation using low-intensity, pulsed infrared light exhibits advantages over standard electrical means by providing contact-free, spatially selective, artifact-free stimulation. Here we investigate the biophysical mechanism underlying this phenomenon by careful examination of possible photobiological effects after absorption-driven light-tissue interaction. The rat sciatic nerve preparation was stimulated in vivo with a Holmium:yttrium aluminum garnet laser (2.12 microm), free electron laser (2.1 microm), alexandrite laser (750 nm), and prototype solid-state laser nerve stimulator (1.87 microm). We systematically determined relative contributions from a list of plausible interaction types resulting in optical stimulation, including thermal, pressure, electric field, and photochemical effects. Collectively, the results support our hypothesis that direct neural activation with pulsed laser light is induced by a thermal transient. We then present data that characterize and quantify the spatial and temporal nature of this required temperature rise, including a measured surface temperature change required for stimulation of the peripheral nerve (6 degrees C-10 degrees C). This interaction is a photothermal effect from moderate, transient tissue heating, a temporally and spatially mediated temperature gradient at the axon level (3.8 degrees C-6.4 degrees C), resulting in direct or indirect activation of transmembrane ion channels causing action potential generation.

Structural change in lipid bilayers and water penetration induced by shock waves: molecular dynamics simulations

The structural change of a phospholipid bilayer in water under the action of a shock wave is numerically studied with unsteady nonequilibrium molecular dynamics simulations. The action of shock waves is modeled by the momentum change of water molecules, and thereby we demonstrate that the resulting collapse and rebound of the bilayer are followed by the penetration of water molecules into the hydrophobic region of the bilayer. The high-speed phenomenon that occurs during the collapse and rebound of the bilayer is analyzed in detail, particularly focusing on the change of bilayer thickness, the acyl chain bend angles, the lateral fluidity of lipid molecules, and the penetration rate of water molecules. The result shows that the high-speed phenomenon can be divided into two stages: in the first stage the thickness of bilayer and the order parameter are rapidly reduced, and then in the second stage they are recovered relatively slowly. It is in the second stage that water molecules are steadily introduced into the hydrophobic region. The penetration of water molecules is enhanced by the shock wave impulse and this qualitatively agrees with a recent experimental result.

Hyperplasia suppression by Ho:YAG laser intravascular irradiation in rabbit

The proliferation of smooth muscle cells (SMCs) was suppressed in denudated rabbit aorta by holmium-yttrium-aluminum-garnet (Ho:YAG) laser intravascular irradiation. This study was dedicated to determine the applicability of the Ho:YAG laser irradiation on chronic restenosis after balloon angioplasty. The proliferation of SMCs in denudated rabbit aortas was suppressed in vivo 6 weeks after the laser irradiation of 20 pulses with 60 mJ per pulse. To investigate the mechanisms of this in vivo effect, the death of SMCs by the Ho:YAG laser-induced bubble collapse pressure was studied in vitro. No significant cell death attributed to this pressure was found. We conclude that the suppression of the proliferation of SMCs in vivo might not be caused by a reduction in density of SMCs induced by the collapse in pressure. We submit that the suppression of SMC proliferation in vivo could be caused by the bubble expansion pressure and/or heat induced by the laser irradiation.

Feasibility of cord blood stem cell manipulation with high-energy shock waves: An in vitro and in vivo study

OBJECTIVE

Cord blood CD34+ cells are more uncommitted than their adult counterparts as they can be more easily maintained and expanded in vitro and transduced with lentiviral vectors. The aim of this study was to evaluate whether pretreatment with high-energy shock waves (HESW) could further enhance the expansion of cord blood progenitors and the transduction efficiency with lentiviral vectors.

METHODS

Human cord blood CD34+ cells underwent HESW treatment with a wide range of energy and number of shots (from 0.22 mJ/mm2 to 0.43 mJ/mm2 and from 200 to 1500 shots). Cells were then evaluated both for their in vitro expansion ability and in vivo engraftment in primary, secondary, and tertiary NOD/SCID mice. The transduction efficiency with a lentiviral vector (LV) was also evaluated in vitro and in vivo.

RESULTS

Cell viability following HESW ranged from 75 to 92%. Pretreatment with HESW significantly improved early progenitor cell expansion after short-term suspension culture. Upon transplantation in primary NOD/SCID mice, the HESW treatment enhanced progenitor cell engraftment (total human CD45(+)CD34+ cells were 10% in controls and 14.5% following HESW, human CD45(+)CD34(+)CD38(-) cells were 0.87% in controls and 1.8% following HESW). HESW treatment enhanced the transduction of a GFP+ lentiviral vector (e.g., at day 42 of culture 6.5% GFP+ cells in LV-treated cell cultures compared to 11.4% of GFP+ cells in HESW-treated cell cultures). The percentage of human GFP+ cell engrafting NOD/SCID mice was similar (34% vs 26.4% in controls); however, the total number of human cells engrafted after HESW was higher (39.6% vs 15%).

CONCLUSION

The pretreatment of CD34+ cells with HESW represents a new method to manipulate the CD34+ population without interfering with their ability to both expand and engraft and it might be considered as a tool for genetic approaches.

Spectral evaluation of laser-induced cell damage with photothermal microscopy

BACKGROUND AND OBJECTIVES

Determining cell photo-damage is important for laser medicine and laser safety standards. This work evaluated the potential of photothermal (PT) technique for studying invasive laser-cell interaction, with a focus on PT evaluation of spectral dependence of laser-induced damage in visible region at single intact cell level.

STUDY DESIGN/MATERIALS AND METHODS

PT is based on irradiation of a single intact cells with a tunable pump laser pulse (420-570 nm, 8 nanoseconds, 0.1-300 microJ) and monitoring of temperature-dependent variations of the refractive index with a second, collinear probe beam in pulse (imaging) mode (639 nm, 13 nanoseconds, 10 nJ), and continuous (integrated PT response) mode (633 nm, 2 mW). The local and the integrated PT responses from the individual living red blood cells, lymphocytes, and cancer cells (K562) in vitro were obtained at different pump laser fluence and wavelength and compared with data obtained by conventional viability tests (Annexin V--propidium iodide).

RESULTS

The cell damage with pump pulse lead to specific change in PT response's temporal shape and PT image's structure. The photodamage thresholds varied in the range of 0.5-5 J/cm2 for red blood cells, 4.4-42 J/cm2 for lymphocytes, and 36-90 J/cm2 for blast cells in the pump wavelength range of 417-555 nm.

CONCLUSION

Damage threshold at different wavelength depends on absorption spectra of cells. Spectral evaluation of laser-damage thresholds can be done in two supplements for each PT mode--PT imaging and integrated PT response. The correlation between specific change of PT parameters and cell damage permits using PT technique to rapidly estimate the invasive conditions of the laser-cell interactions.

Transdermal drug delivery with a pressure wave

Pressure waves, which are generated by intense laser radiation, can permeabilize the stratum corneum (SC) as well as the cell membrane. These pressure waves are compression waves and thus exclude biological effects induced by cavitation. Their amplitude is in the hundreds of atmospheres (bar) while the duration is in the range of nanoseconds to a few microseconds. The pressure waves interact with cells and tissue in ways that are probably different from those of ultrasound. Furthermore, the interactions of the pressure waves with tissue are specific and depend on their characteristics, such as peak pressure, rise time and duration. A single pressure wave is sufficient to permeabilize the SC and allow the transport of macromolecules into the epidermis and dermis. In addition, drugs delivered into the epidermis can enter the vasculature and produce a systemic effect. For example, insulin delivered by pressure waves resulted in reducing the blood glucose level over many hours. The application of pressure waves does not cause any pain or discomfort and the barrier function of the SC always recovers.

Photothermal detection of laser-induced damage in single intact cells

BACKGROUND AND OBJECTIVE

Most of the studies of laser-induced damage do not analyze individual cells. Objective of this work was to evaluate local photo-induced thermal phenomena in single cells at theoretical and experimental levels for developing the method for real-time detection of laser damage in intact cells.

STUDY DESIGN/MATERIALS AND METHODS

Theoretical model of cell-laser interaction assumes local nature of photo-induced thermal effects and describes photodamage through bubble formation. Photothermal (PT) method was suggested for damage detection. Laser-induced damage was verified for individual cells with two techniques through detection of Trypan blue penetration into damaged cell.

RESULTS

Specific PT responses from blast-transformed lymphocytes were identified independently as result of bubble formation and cell damage. Probability of cell damage was obtained for cells as function of laser pulse energy.

CONCLUSIONS

The Laser load test (LLT) was suggested for real-time detection of damage, damage threshold measurement, and investigation of intact single cells.

Ultrastructural evidence of stratum corneum permeabilization induced by photomechanical waves

Photomechanical waves (high amplitude pressure transients generated by lasers) have been shown to permeabilize the stratum corneum in vivo and facilitate the transport of macromolecules into the viable epidermis. The permeabilization of the stratum corneum is transient and its barrier function recovers. Sites on the volar forearm of humans were exposed to photomechanical waves and biopsies were obtained immediately after the exposure and processed for electron microscopy. Electron microscopy showed an expansion of the lacunar spaces within the stratum corneum lipid bilayers but no changes in the organization of the secreted lamellar bodies at the stratum corneum-stratum granulosum boundary. The combination of photomechanical waves and sodium lauryl sulfate enhances the efficiency of transdermal delivery and delays the recovery of the barrier function of the stratum corneum. Electron microscopy from sites exposed to photomechanical waves and sodium lauryl sulfate showed that the lacunar spaces expanded significantly more and the secreted lamellar bodies also appeared to be altered. In either case, there were no changes in the papillary dermis. These observations support the hypothesis that the photomechanical waves induce the expansion of the lacunar spaces within the stratum corneum leading to the formation of transient channels.

Nuclear transport by laser-induced pressure transients

PURPOSE

Control of the transport of molecules into the nucleus represents a key regulatory mechanism for differentiation, transformation, and signal transduction. Permeabilization of the nuclear envelope by physical methods can have applications in gene therapy. Laser-induced pressure transients can produce temporary aqueous pores analogous to those produced by electroporation and that the cells can survive this procedure. In this study, we examine the role of the pressure transients in creating similar pores in the nuclear envelope.

METHODS

The target human peripheral blood mononuclear cells in a 62 microM 72 kDa fluoresceinated dextran solution were exposed to the pressure transients generated by laser ablation. An in vitro fluorescence confocal microscope was used to visualize and quantify the fluoresceinated dextran in the cytoplasmic and nuclear compartments.

RESULTS

In contrast to electroporation, the pressure transients could deliver 72 kDa fluoresceinated dextrans, which are normally excluded by the nucleus, across the nuclear envelope into the nucleus. In addition to creating pores in the plasma membrane, temporary pores were also created in the nuclear envelope following exposure to pressure transients.

CONCLUSION

The production of temporary nuclear pores could provide a unique resource for drug-delivery and gene therapy.

Photothermal time-resolved imaging of living cells

BACKGROUND AND OBJECTIVES

Thermal effects of laser radiation at cell level play very important role in cell functioning and in many laser applications. The aim of this study was to evaluate a new method of photothermal imaging (PTI) for monitoring short-time nano-scale thermal effects in individual living cells.

STUDY DESIGN/MATERIALS AND METHODS

PTI is based on the irradiation of a cell with a short laser pump pulse (8 nanoseconds, 532 nm) and on registration of the laser-induced local thermal effects using time-resolved phase-contrast imaging with a pulsed probe laser.

RESULTS

PT images of lymphocytes, lympholeukemia cells in vitro were obtained at different laser energies. PTI in time-resolved mode allowed visualizing the structures with size less than diffraction limit (90-nm liposomes). The photodamage process was visualized for a single human leukocyte in suspension.

CONCLUSIONS

PTI in non-invasive mode offered better contrast of living cell image than conventional optical phase-contrast microscopy. The data obtained showed that PTI is in perspective for studies of live non-fluorescent cells.

Mechanisms of shock wave induced endothelial cell injury

BACKGROUND AND OBJECTIVES

Medical procedures, for example, laser angioplasty and extracorporeal lithotripsy as well as high-energy trauma expose human tissues to shock waves (SWs) that may cause tissue injury. The mechanisms for this injury, often affecting blood vessel walls, are poorly understood. Here we sought to assess the role of two suggested factors, viz., cavitation or reactive oxygen species (ROS).

STUDY DESIGN/MATERIALS AND METHODS

A laser driven flyer-plate model was used to expose human umbilical cord vein endothelial cell (HUVEC) monolayers to SWs or to SWs plus cavitation (SWC). Cell injury was quantified with morphometry, trypan blue staining, and release of (51)Cr from labeled HUVECs.

RESULTS

HUVECs, exposed to SWs only, could not be distinguished from controls in morphological appearance or ability to exclude trypan blue. Yet, release of (51)Cr, indicated a significant cell injury (P < 0.05). HUVEC cultures exposed to SWC, exhibited cell detachment and cell membrane damage detectable with trypan blue. Release of (51)Cr was fourfold compared to SW samples (P < 0.01). Signs of cell injury were evident at 15 minutes and did not change over the next 4 hours. No protective effects of ROS scavengers were demonstrated.

CONCLUSIONS

Independent of ROS, SWC generated an immediate cell injury, which can explain, for example, vessel wall perturbation described in relation to SW treatments and trauma.

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.

Stress-wave-assisted transport through the plasma membrane in vitro

BACKGROUND AND OBJECTIVE

Laser-induced stress waves have been shown to alter the permeability of the plasma membrane without affecting cell viability. The aim of the work reported here was to quantify the molecular uptake by cell cultures in vitro and determine optimal stress-wave parameters.

STUDY DESIGN/MATERIALS AND METHODS

Human peripheral blood mononuclear cells were exposed to laser-induced stress waves in an experimental arrangement that eliminated interference from ancillary effects such as plasma, heat, or cavitation. A radiolabeled compound (tritiated thymidine) was used as the probe.

RESULTS

Stress waves enhanced the diffusion of tritiated thymidine by inducing a transient permeabilization of the plasma membrane. Furthermore, maximum intracellular concentration (2 x 10(5) thymidine molecules/cell or 10% of the extracellular concentration) was reached with only 2-3 stress waves.

CONCLUSION

Laser-induced stress waves provide an efficient method for delivering molecules through the plasma membrane into the cytoplasm of cells.

Cell loading with laser-generated stress waves: the role of the stress gradient

PURPOSE

To determine the dependence of the permeabilzation of the plasma membrane on the characteristics of laser-generated stress waves.

METHODS

Laser pulses can generate stress waves by ablation. Depending on the laser wavelength, fluence, and target material, stress waves of different characteristics (rise time, peak stress) can be generated. Human red blood cells were subjected to stress waves and the permeability changes were measured by uptake of extracellular dye molecules.

RESULTS

A fast rise time (high stress gradient) of the stress wave was required for the permeabilization of the plasma membrane. While the membrane was permeable, the cells could rapidly uptake molecules from the surrounding medium by diffusion.

CONCLUSIONS

Stress waves provide a potentially powerful tool for drug delivery.

Dynamic behavior of bubbles during extracorporeal shock-wave lithotripsy

The interaction of air bubbles attached to gelatin surfaces, extirpated livers or abdominal aortas of rats with underwater shock waves was investigated to help clarify the tissue-damage mechanism associated with cavitation bubbles induced during extracorporeal shock-wave lithotripsy. The overpressure of the shock wave was 10.2 +/- 0.5 MPa. The initial bubble radii varied from 0.12 to 3.06 mm. The subsequent collapse of the bubbles was recorded by a high-speed camera. The liver-cell damage was histochemically evaluated. The bubble attached to gelatin or rat's liver surface migrates away from the surface with an oscillatory growth/collapse behavior after the shock-wave interaction. The penetration depth of the liquid jet into the gelatin and the radius of the subsequent damage pit on the surface depend on the initial bubble radius. The elongation and split of the nuclei in the liver parenchymal cells in the direction of the liquid jet and the increase in the cell density within the circumference of the injured region are revealed histologically.

A new technology for revascularization of cerebral embolism using liquid jet impact

Revascularization time is the dominant factor in the treatment of acute cerebral embolism. In this paper we describe a rapid revascularization therapy using liquid jets generated by the interaction of gas bubbles with shock waves, which impact on the thrombi. The interaction of a shock wave with a gas bubble attached to an artificial thrombus which was inserted into a tube model of a cerebral artery was investigated. The shock wave was generated by detonating a microexplosive pellet. The overpressure of the shock wave was 3.0 +/- 0.6 MPa (n = 7) and 12.7 +/- 0.4 MPa (n = 3). The initial air bubble radii were varied from 0.87 mm to 2.18 mm. The subsequent collapse of the bubble was photographed using a high-speed framing camera, and the liquid jet penetrating into the artificial thrombus was visualized using x-ray photography. The penetration depth of the liquid jet increased with increasing bubble size. There was an optimal separation distance between the bubble and the shock wave source to obtain the maximum penetration depth. Liquid jets have the potential to penetrate through thrombi in as little as a few microseconds, and with very efficient ablation.

Nonlinear absorption: intraocular microsurgery and laser lithotripsy

The paper reviews the principles of nonlinear absorption with reference to the present major clinical applications of plasma-mediated effects: intraocular microsurgery and laser lithotripsy. Emphasis is laid on the analysis of the working mechanisms, sources of collateral damage, and on strategies for both the optimization of efficacy and the minimization of side effects.

Stress-wave-induced membrane permeation of red blood cells is facilitated by aquaporins

Stress waves generated by lasers and extracorporeal lithotripters have been shown to transiently increase the permeability of the plasma membrane, without affecting cell viability. Molecules present in the medium can diffuse into the cytoplasm under the concentration gradient. Molecular uptake under stress waves correlates with the presence of functioning aquaporins in the plasma membrane.

Alteration of cell membrane by stress waves in vitro

Experiments on the biological effects of laser-induced stress waves indicate that there is a transient increase in the permeability of the cell membrane. A cell viability assay (propidium iodide exclusion) shows that mouse breast sarcoma cells are viable after a stress wave. The kinetics of this transient membrane permeability are measured using time-resolved fluorescence imaging. The efflux of a membrane-impermeable fluorescent probe (calcein) following the application of a 300-bar stress wave implies that there is an increase in the membrane permeability. This efflux ceases within 80 s after a stress wave, suggesting that the membrane is no longer permeable to the fluorescent probe. Fitting the observed kinetics to a simple diffusion model yields an average initial diffusion constant of 2.2 +/- 1.3 x 10(-7) cm2/s for mouse breast sarcoma cells following the application of a laser-induced stress wave.

Physical characteristics and biological effects of laser-induced stress waves

Laser-induced stress waves can be generated by one of the following mechanisms: optical breakdown, ablation, or rapid heating of an absorbing medium. These three modes of laser interaction with matter allow the investigation of cellular and tissue responses to stress waves with different characteristics and under different conditions. The effects of stress waves on cells and tissues can be quite disparate. Stress waves can fracture tissue, kill cells, decrease cell viability and increase the permeability of the plasma membrane. They can induce deleterious effects during medical procedures of high power, short pulse lasers or, alternatively, may facilitate new therapeutic modalities, such as drug delivery and gene therapy. This review covers the generation of laser-induced stress waves and their effects on cell cultures and tissue.

Stress-wave-induced injury to retinal pigment epithelium cells in vitro

BACKGROUND AND OBJECTIVE

To determine the survival of in vitro retinal pigment epithelium (RPE) cells subjected to laser-generated stress transients (shock waves) and compare it to that of other cell lines.

STUDY DESIGN/MATERIALS AND METHODS

Normal and transformed human retinal pigment epithelium cell lines were used. The cells were imbedded in a gel to prevent motion and cavitation and located in a thin layer at the bottom of a pipette tube closed at one end by a polyimide film. Stress transients were generated by pulsed excimer laser (193 nm and 248 nm wavelength) ablation of the polyimide film. Cell survival, compared to that of unirradiated cells, was assessed by counting surviving cells. The stress was varied from 300 to 740 bars and the number of shock wave pulses applied varied from 5 to 150.

RESULTS

Cell survival decreased sharply at the higher stresses but some cells always survived. The lowest survival rate was 50%. Increasing the number of shock wave pulses did not increase cell killing after 20 pulses, demonstrating a saturation effect. In contrast to the transformed cell line, normal cells could not be killed at the highest stress available to us.

CONCLUSION

The susceptibility of RPE cells to damage by stress waves varies with cell line. Transformed retinal pigment epithelium cells are more susceptible than normal ones. Saturation of the damage versus number of pulses is observed and a threshold-like behavior for cell killing versus stress is found. Because at least 50% of the cells survived, normal cell growth can serve to replenish damaged cells.

Pulsed laser ablation of soft tissues, gels, and aqueous solutions at temperatures below 100 degrees C

BACKGROUND AND OBJECTIVE

It is desirable for laser microsurgical procedures to remove tissue accurately and with minimal thermal and mechanical damage to adjacent non-irradiated tissues. Pulsed laser ablation can potentially remove biological tissue with microprecision if appropriate irradiation conditions are applied. The major goal of this study was to determine whether laser ablation is possible at temperatures below 100 degrees C. Another aim was to test thermoelastic and recoil stress magnitudes and to estimate their effects on phantom and biological tissue.

STUDY DESIGN/MATERIALS AND METHODS

Pulsed laser ablation of water (aqueous solution of potassium chromate) and water containing soft tissues (collagen gel and pig liver) irradiated under confined stress conditions was studied. The ablation mechanism and stages of the ablation process were determined based on time-resolved measurements of laser-induced acoustic waves with simultaneous imaging of the ablation process by laser-flash photography.

RESULTS

This study reveals the important role of tensile thermoelastic stress, which produces efficient cavitation that drives material ejection at temperatures substantially below 100 degrees C. Ablation thresholds for the aqueous solution, collagen gel, and liver were 20, 38, and 55 J/cm3, respectively, which correspond to temperature jumps of 5, 10, and 15 degrees C. Two distinct stages of material ejection were observed: (1) initial removal of small volumes of material due to the rupture of single subsurface bubbles, (2) bulk material ablation in the form of jets produced by intense hydrodynamic motions formed upon collapse of large bubbles after coalescence of smaller bubbles. The duration of material ejection upon short-pulse ablation may vary from microseconds to submilliseconds, and depended on the mechanical properties of materials and the incident laser fluence.

CONCLUSION

Nanosecond laser ablation of water, gels, and soft tissue under confined-stress conditions of irradiation may occur at temperatures below 100 degrees C. This ablation regime minimizes thermal injury to adjacent tissues and involves thermoelastic stress and recoil pressure magnitudes, which may be tolerated by tissues adjacent to an ablated crater.