Max Woolley
University of Bristol
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Publication
Featured researches published by Max Woolley.
PLOS ONE | 2015
Azeem Arshad; Bin Yang; Alison Bienemann; Neil Barua; Marcella Wyatt; Max Woolley; Dave Johnson; Karen J. Edler; Steven S. Gill
We currently use Convection-Enhanced Delivery (CED) of the platinum-based drug, carboplatin as a novel treatment strategy for high grade glioblastoma in adults and children. Although initial results show promise, carboplatin is not specifically toxic to tumour cells and has been associated with neurotoxicity at high infused concentrations in pre-clinical studies. Our treatment strategy requires intermittent infusions due to rapid clearance of carboplatin from the brain. In this study, carboplatin was encapsulated in lactic acid-glycolic acid copolymer (PLGA) to develop a novel drug delivery system. Neuronal and tumour cytotoxicity were assessed in primary neuronal and glioblastoma cell cultures. Distribution, tissue clearance and toxicity of carboplatin nanoparticles following CED was assessed in rat and porcine models. Carboplatin nanoparticles conferred greater tumour cytotoxicity, reduced neuronal toxicity and prolonged tissue half-life. In conclusion, this drug delivery system has the potential to improve the prognosis for patients with glioblastomas.
Journal of Neuroscience Methods | 2012
Alison Bienemann; E. White; Max Woolley; Emma Castrique; D.E. Johnson; Marcella Wyatt; G. Murray; Hannah Taylor; Neil U. Barua; Steven S. Gill
Convection-enhanced delivery (CED) is a promising technique for the administration of therapeutic agents such as cytotoxics, neurotrophins and enzymes to the brain. In this study we describe the development of an implantable catheter system that is compatible with long-term intermittent CED. Catheters made from fused silica, PEEK or carbothane, and of various internal and external diameters were implanted in the striatum of rats and assessed for patency at 21 or 28 days. A high-rate of catheter blockage was observed with all fused silica and PEEK catheters. Carbothane catheters with an outer diameter of 0.6mm and an inner diameter of 0.35 mm had significantly lower rates of blockage (P≤0.01). Carbothane catheters were then implanted into 4 Large White/Landrace pigs and 4 NIH miniature pigs and infusions undertaken at monthly intervals to evaluate catheter patency and infusate distribution. Catheter patency was demonstrated for a maximum period of 163 days in one animal. Widespread and reproducible intraputamenal CED could be achieved with intermittent drug delivery at flow-rates as high as 5 μl/min. Problems were encountered using the pig model due to catheter distortion from rapid animal growth. In conclusion, it is possible to achieve intermittent high-flow CED with a chronic implanted carbothane catheter with a low rate of catheter blockage.
Journal of Neuroscience Methods | 2011
E. White; Max Woolley; Alison Bienemann; D.E. Johnson; Marcella Wyatt; G. Murray; Hannah Taylor; Steven S. Gill
Research highlights ▶ Development of a highly accurate and robust method for MRI-guided, stereotactic delivery of catheters into the brain of pigs. ▶ Reliable head immobilisation, acquisition of high-resolution MR images, precise co-registration of MRI and stereotactic spaces to facilitate accurate burr hole-generation and catheter implantation. ▶ Implants were accurately placed into the putamen with a mean Euclidean distance of 0.623 mm (standard deviation of 0.33 mm).
Drug Delivery | 2016
Neil Barua; Kirsten Hopkins; Max Woolley; Stephen O'Sullivan; Robert Neil Harrison; Richard J Edwards; Alison Bienemann; Marcella Wyatt; Azeem Arshad; Steven S. Gill
Abstract Context: Inadequate penetration of the blood–brain barrier (BBB) by systemically administered chemotherapies including carboplatin is implicated in their failure to improve prognosis for patients with glioblastoma. Convection-enhanced delivery (CED) of carboplatin has the potential to improve outcomes by facilitating bypass of the BBB.Objective: We report the first use of an implantable CED system incorporating a novel transcutaneous bone-anchored port (TBAP) for intermittent CED of carboplatin in a patient with recurrent glioblastoma.Materials and methods: The CED catheter system was implanted using a robot-assisted surgical method. Catheter targeting accuracy was verified by performing intra-operative O-arm imaging. The TBAP was implanted using a skin-flap dermatome technique modeled on bone-anchored hearing aid surgery. Repeated infusions were performed by attaching a needle administration set to the TBAP. Drug distribution was monitored with serial real-time T2-weighted magnetic resonance imaging (MRI).Results: All catheters were implanted to within 1.5 mm of their planned target. Intermittent infusions of carboplatin were performed on three consecutive days and repeated after one month without the need for further surgical intervention. Infused volumes of 27.9 ml per day were well tolerated, with the exception of a single seizure episode. Follow-up MRI at eight weeks demonstrated a significant reduction in the volume of tumor enhancement from 42.6 ml to 24.6 ml, and was associated with stability of the patient’s clinical condition.Conclusion: Reduction in the volume of tumor enhancement indicates that intermittent CED of carboplatin has the potential to improve outcomes in glioblastoma. The novel technology described in this report make intermittent CED infusion regimes an achievable treatment strategy.
Journal of Neuroscience Methods | 2016
Owen Lewis; Max Woolley; David Johnson; Anne Elizabeth Rosser; Neil Barua; Alison Bienemann; Steven S. Gill; Samuel Lewin Evans
BACKGROUND Intraparenchymal convection-enhanced delivery (CED) of therapeutics directly into the brain has long been endorsed as a medium through which meaningful concentrations of drug can be administered to patients, bypassing the blood brain barrier. The translation of the technology to clinic has been hindered by poor distribution not previously observed in smaller pre-clinical models. In part this was due to the larger volumes of target structures found in humans but principally the poor outcome was linked to reflux (backflow) of infusate proximally along the catheter track. Over the past 10 years, improvements have been made to the technology in the field which has led to a small number of commercially available devices containing reflux inhibiting features. NEW METHOD While these devices are currently suitable for acute or short term use, several indications would benefit from longer term repeated, intermittent administration of therapeutics (Parkinsons, Alzheimers, Amyotrophic lateral sclerosis, Brain tumours such as Glioblastoma Multiforme (GBM) and Diffuse intrinsic Pontine Glioma (DIPG), etc.). RESULTS Despite the need for a chronically accessible platform for such indications, limited experience exists in this part of the field. COMPARISON WITH EXISTING METHOD(S) At the time of writing no commercially available clinical platform, indicated for chronic, intermittent or continuous delivery to the brain exists. CONCLUSIONS Here we review the improvements that have been made to CED devices over recent years and current state of the art for chronic infusion systems.
Journal of Neuroscience Methods | 2013
Neil Barua; Max Woolley; Alison Bienemann; D.E. Johnson; Owen T. Lewis; Marcella Wyatt; C. Irving; S.O'Sullivan; G. Murray; C. Fennelly; P. Skinner; Steven S. Gill
Convection-enhanced delivery (CED) describes a novel method of drug delivery to the brain through intraparenchymal microcatheters. One of the barriers to effective translation of CED to clinical trials is the requirement for intermittent delivery over prolonged periods. This is particularly relevant for delivery of neurotrophins for the treatment of Parkinsons disease where chronic infusion of glial cell-line derived neurotrophic factor (GDNF) with subcutaneously implanted pumps has been associated with poor distribution and local toxicity due to point source accumulation. We have previously described the development of an implantable catheter for CED which facilitates repeated drug administrations at intervals of up to one month. The aim of this study was to determine the feasibility of implanting a transcutaneous bone-anchored port (TBAP) which facilitates chronic intermittent drug delivery to the brain. We describe the design and development of a titanium port which was implanted in Large White and NIH miniature pigs for periods of up to three months. By intermittently accessing the port with a needle administration set it was possible to repeatedly perform CED infusions at one month intervals. This study confirms the safety and feasibility of performing intermittent CED through a transcutaneous bone-anchored port. The use of a transcutaneous port has the potential to facilitate clinical translation of CED of therapeutics requiring intermittent delivery to achieve optimum efficacy whilst negating the need for subcutaneously implanted pumps.
Journal of Neuroscience Methods | 2013
Neil Barua; Max Woolley; Alison Bienemann; David Johnson; Marcella Wyatt; C. Irving; Owen Lewis; Emma Castrique; Steven S. Gill
BACKGROUND Convection-enhanced delivery (CED) is currently under investigation for delivering therapeutic agents to subcortical targets in the brain. Direct delivery of therapies to the cerebral cortex, however, remains a significant challenge. NEW METHOD We describe a novel method of targeting adeno-associated viral vector (AAV) mediated gene therapies to specific cerebral cortical regions by performing high volume, high flow rate infusions into underlying white matter in a large animal (porcine) model. RESULTS Infusion volumes of up to 700 μl at flow rates as high as 10 μl/min were successfully performed in white matter without adverse neurological sequelae. Co-infusion of AAV2/5-GFP with 0.2% Gadolinium in artificial CSF confirmed transgene expression in the deep layers of cerebral cortex overlying the infused areas of white matter. COMPARISON WITH EXISTING METHODS AAV-mediated gene therapies have been previously targeted to the cerebral cortex by performing intrathalamic CED and exploiting axonal transport. The novel method described in this study facilitates delivery of gene therapies to specific regions of the cerebral cortex without targeting deep brain structures. CONCLUSIONS AAV-mediated gene therapies can be targeted to specific cortical regions by performing CED into underlying white matter. This technique could be applied to the treatment of neurological disorders characterised by cerebral cortical degeneration.
Journal of Neurosurgery | 2018
William Singleton; Alison Bieneman; Max Woolley; David Johnson; Owen T. Lewis; Marcella Wyatt; Stephen J. P. Damment; Lisa Boulter; Clare Killick-Cole; Daniel J. Asby; Steven S. Gill
OBJECTIVE The pan-histone deacetylase inhibitor panobinostat has preclinical efficacy against diffuse intrinsic pontine glioma (DIPG), and the oral formulation has entered a Phase I clinical trial. However, panobinostat does not cross the blood-brain barrier in humans. Convection-enhanced delivery (CED) is a novel neurosurgical drug delivery technique that bypasses the blood-brain barrier and is of considerable clinical interest in the treatment of DIPG. METHODS The authors investigated the toxicity, distribution, and clearance of a water-soluble formulation of panobinostat (MTX110) in a small- and large-animal model of CED. Juvenile male Wistar rats (n = 24) received panobinostat administered to the pons by CED at increasing concentrations and findings were compared to those in animals that received vehicle alone (n = 12). Clinical observation continued for 2 weeks. Animals were sacrificed at 72 hours or 2 weeks following treatment, and the brains were subjected to neuropathological analysis. A further 8 animals received panobinostat by CED to the striatum and were sacrificed 0, 2, 6, or 24 hours after infusion, and their brains explanted and snap-frozen. Tissue-drug concentration was determined by liquid chromatography tandem mass spectrometry (LC-MS/MS). Large-animal toxicity was investigated using a clinically relevant MRI-guided translational porcine model of CED in which a drug delivery system designed for humans was used. Panobinostat was administered at 30 μM to the ventral pons of 2 juvenile Large White-Landrace cross pigs. The animals were subjected to clinical and neuropathological analysis, and findings were compared to those obtained in controls after either 1 or 2 weeks. Drug distribution was determined by LC-MS/MS in porcine white and gray matter immediately after CED. RESULTS There were no clinical or neuropathological signs of toxicity up to an infused concentration of 30 μM in both small- and large-animal models. The half-life of panobinostat in rat brain after CED was 2.9 hours, and the drug was observed to be distributed in porcine white and gray matter with a volume infusion/distribution ratio of 2 and 3, respectively. CONCLUSIONS CED of water-soluble panobinostat, up to a concentration of 30 μM, was not toxic and was distributed effectively in normal brain. CED of panobinostat warrants clinical investigation in patients with DIPG.
Journal of Neuroscience Methods | 2013
T. Gill; Neil Barua; Max Woolley; Alison Bienemann; D.E. Johnson; S.O'Sullivan; G. Murray; C. Fennelly; Owen T. Lewis; C. Irving; Marcella Wyatt; P. Moore; Steven S. Gill
American Journal of Translational Research | 2014
Takashi Tsujiuchi; Atsushi Natsume; Kazuya Motomura; Goro Kondo; Melissa Ranjit; Rei Hachisu; Itsuro Sugimura; Shinpei Tomita; Isao Takehara; Max Woolley; Neil Barua; Steven S. Gill; Alison Bienemann; Yoriko Yamashita; Shinya Toyokuni; Toshihiko Wakabayashi