Michael Benchimol

Acoustic Droplet Vaporization and Propulsion of Perfluorocarbon‐Loaded Microbullets for Targeted Tissue Penetration and Deformation

Acoustic droplet vaporization of perfluorocarbon-loaded microbullets triggered by an ultrasound pulse provides the necessary force to penetrate, cleave, and deform cellular tissue for potential targeted drug delivery and precision nanosurgery.

A novel nested liposome drug delivery vehicle capable of ultrasound triggered release of its payload.

The use of focused ultrasound can be an effective method to locally highlight tumor tissue and specifically trigger the activation of echogenic drug delivery vehicles in an effort to reduce systemic chemotherapy side effects. Here we demonstrate a unique ultrasound triggered vehicle design and fabrication method where the payload and a perfluorocarbon gas microbubble are both encapsulated within the internal aqueous space of a liposome. This nested lipid shell geometry both stabilized the microbubble and ensured it was spatially close enough to interact with the liposome membrane at all times. The internal microbubble was shown to fragment the outer liposome membrane upon exposure to ultrasound at intensities of 1-1.5MPa. The focused ultrasound allowed the release of the internal payload to localized regions within tissue phantoms. The vehicles showed high payload loading efficiency of 16%, stability in blood of several hours, and low level macrophage recognition in vitro. High speed fluorescent videos present the first optical images of such vehicles interacting with ultrasound. This ability to open the outer membrane in small regions of deep tissue could provide a second level of spatial and temporal control beyond biochemical targeting, making these particles promising for in vivo animal studies.

Isolation of Rare Tumor Cells from Blood Cells with Buoyant Immuno-Microbubbles

Circulating tumor cells (CTCs) are exfoliated at various stages of cancer, and could provide invaluable information for the diagnosis and prognosis of cancers. There is an urgent need for the development of cost-efficient and scalable technologies for rare CTC enrichment from blood. Here we report a novel method for isolation of rare tumor cells from excess of blood cells using gas-filled buoyant immuno-microbubbles (MBs). MBs were prepared by emulsification of perfluorocarbon gas in phospholipids and decorated with anti-epithelial cell adhesion molecule (EpCAM) antibody. EpCAM-targeted MBs efficiently (85%) and rapidly (within 15 minutes) bound to various epithelial tumor cells suspended in cell medium. EpCAM-targeted MBs efficiently (88%) isolated frequent tumor cells that were spiked at 100,000 cells/ml into plasma-depleted blood. Anti-EpCAM MBs efficiently (>77%) isolated rare mouse breast 4T1, human prostate PC-3 and pancreatic cancer BxPC-3 cells spiked into 1, 3 and 7 ml (respectively) of plasma-depleted blood. Using EpCAM targeted MBs CTCs from metastatic cancer patients were isolated, suggesting that this technique could be developed into a valuable clinical tool for isolation, enumeration and analysis of rare cells.

Neural progenitor cells labeling with microbubble contrast agent for ultrasound imaging in vivo

Tracking neuroprogenitor cells (NPCs) that are used to target tumors, infarction or inflammation, is paramount for cell-based therapy. We employed ultrasound imaging that can detect a single microbubble because it can distinguish its unique signal from those of surrounding tissues. NPCs efficiently internalized positively charged microbubbles allowing a clinical ultrasound system to detect a single cell at 7 MHz. When injected intravenously, labeled NPCs traversed the lungs to be imaged in the left ventricle and the liver where they accumulated. Internalized microbubbles were not only less sensitive to destruction by ultrasound, but remained visible in vivo for days as compared to minutes when given free. The extended longevity provides ample time to allow cells to reach their intended target. We were also able to transfect NPCs in vitro when microbubbles were preloaded with GFP plasmid only when cells were insonated. Transfection efficiency and cell viability were both greater than 90%.

Fluorescent Microscope System to Monitor Real-Time Interactions between Focused Ultrasound, Echogenic Drug Delivery Vehicles, and Live Cell Membranes

Rapid development in the field of ultrasound triggered drug delivery has made it essential to study the real-time interaction between the membranes of live cells and the membranes of echogenic delivery vehicles under exposure to focused ultrasound. The objective of this work was to design an analysis system that combined fluorescent imagining, high speed videography, and definable pulse sequences of focused ultrasound to allow for real time observations of both cell and vehicle membranes. Documenting the behavior of the membranes themselves has not previously been possible due to limitations with existing optical systems used to understand the basic physics of microbubble/ultrasound interaction and the basic interaction between microbubbles and cells. The performance of this new system to monitor membrane behavior was demonstrated by documenting the modes of vehicle fragmentation at different ultrasound intensity levels. At 1.5MPa the membranes were shown to completely fragment while at intensities below 1MPa the membranes pop open and slowly unfold. The interaction between these vehicles and cell membranes was also documented by the removal of fluorescent particles from the surfaces of live cells out to 20μm from the microbubble location. The fluid flow created by microstreaming around ensonated microbubbles was documented at video recording speeds from 60 to 18,000 frames per second. This information about membrane behavior allows the chemical and physical properties of the drug delivery vehicle to be designed along with the ultrasound pulse sequence to cause the most efficient drug delivery.

Phospholipid/Carbocyanine Dye-Shelled Microbubbles as Ultrasound-Modulated Fluorescent Contrast Agents

Fluorescent microbubbles have been fabricated with the capacity to have their emission modulated by ultrasound. These contrast agent particles could potentially be used in the future to extract fluorescence modulation from a strong light background to increase imaging depth and resolution in scattering media. Fluorescence intensity modulation was demonstrated at the ultrasound driving frequency.

Ultrasound Mediated Localized Drug Delivery

Chemotherapy is one of the frontline treatments for cancer patients, but the toxic side effects limit its effectiveness and potential. The goal of drug delivery is to reduce these side effects by encapsulating the drugs in a carrier which prevents release and can circulate throughout the body causing minimal damage to the healthy tissue. Slow release carriers have been developed which reduce the exposure to healthy tissue but this slow release also limits the maximum levels of drug in the tumor and nonspecific accumulation in healthy tissue remains a major hurdle. The next advance is to design these carriers to produce a rapid burst release of drug, but only in response to a localized trigger. The trigger of choice is low intensity focused ultrasound. A new particle is described here which incorporates an ultrasound sensitive microbubble of perfluorocarbon gas within a protective liposome carrier along with the payload. It is shown that this design can accomplish the desired burst release when exposed to ultrasound focused to small spatial locations within tissue phantoms. The ability to trigger release could provide a second level of spatial and temporal control beyond biochemical targeting or passive accumulation, making these promising particles for further development.

Ultrasound-modulated fluorescent contrast agent for optical imaging through turbid media

Optical imaging in a highly scattering medium is effective only at very shallow depths which limits its use as a diagnostic tool in biomedical imaging. By combining optical and acoustic modalities, high-contrast, physiologicallyrelevant optical information at higher spatial resolutions can be achieved. Hybrid imaging modalities such as acoustooptic and photoacoustic imaging improve resolution over conventional optical imaging, but tissue scattering results in poor signal-to-background ratios especially in deeper tissues. To overcome these challenges, we have developed a novel microbubble (MB) contrast agent surface-loaded with a self-quenching fluorophore. In response to ultrasound, the MB expands and contracts, generating changes in fluorophore surface density. The changes in physical separation between fluorophores modulate the quenching efficiency and produce a fluorescence intensity modulation. To our knowledge, this is the first experimental demonstration of ultrasound modulation of fluorescence using a self-quenching MB scheme. The modulation is spatially localized to the ultrasound focal zone where the pressure is greatest and the largest MB oscillations are induced. The modulated signal can be extracted from a large constant light background, increasing detection sensitivity. This technique can enable sensitive optical imaging with ultrasound-scale sub-millimeter spatial resolution, overcoming significant challenges of optical imaging in deep tissue. The contrast agent MBs were prepared with a shell of phospholipid and lipophilic self-quenching fluorophore. MB ultrasound response was studied in a custom setup which monitored fluorescence emitted from an insonified sample. Fluorescence signals displayed clearly modulated intensity and the fast Fourier transform (FFT) showed a strong component at the ultrasound driving frequency.

Manipulating nanoscale features on the surface of dye-loaded microbubbles to increase their ultrasound-modulated fluorescence output.

The nanoscale surface features of lipid-coated microbubbles can dramatically affect how the lipids interact with one another as the microbubble diameter expands and contracts under the influence of ultrasound. During microbubble manufacturing, the different lipid shell species naturally partition forming concentrated lipid islands. In this study the dynamics of how these nanoscale islands accommodate the expansion of the microbubbles are monitored by measuring the fluorescence intensity changes that occur as self-quenching lipophilic dye molecules embedded in the lipid layer change their distance from one another. It was found that when the dye molecules were concentrated in islands, less than 5% of the microbubbles displayed measurable fluorescence intensity modulation indicating the islands were not able to expand sufficiently for the dye molecules to separate from one another. When the microbubbles were heated and cooled rapidly through the lipid transition temperature the islands were melted creating an even distribution of dye about the surface. This resulted in over 50% of the microbubbles displaying the fluorescence-modulated signal indicating that the dye molecules could now separate sufficiently to change their self-quenching efficiency. The separation of the surface lipids in these different formations has significant implications for microbubble development as ultrasound and optical contrast agents.

Longitudinal monitoring of skin accumulation of nanocarriers and biologicals with fiber optic near infrared fluorescence spectroscopy (FONIRS)

ABSTRACT Systemically injected drug delivery systems distribute into various organs and tissues, including liver, spleen and kidneys. Recent reports pointed out a significant accumulation of systemically injected nanoparticles in the skin. Skin constitutes the largest organ in the body with important immune functions, and accumulation of drug delivery systems could have significant implications for skin toxicity in living subjects. Fiber optic‐based near‐infrared spectroscopy (FONIRS) setup was developed and tested for measuring of NIR (760 nm excitation) emission spectra in the skin. Ex vivo spectral measurements of NIR fluorescence through the skin showed linear response down to 34 femtomole of dye DiR. Following systemic injection of IRDye 800 labeled 500 kDa dextran, FONIRS detected an immediate and stable accumulation of fluorescence in the skin. Longitudinal monitoring of skin accumulation and elimination of IRDye 800‐labeled therapeutic anti‐epidermal growth factor antibody (cetuximab) showed significant signal in the skin after the antibody cleared from circulation. Comparison of skin accumulation of DiR labeled, long‐circulating PEGylated liposomes with short‐circulating non‐PEGylated liposomes showed much higher accumulation of PEGylated liposomes that persisted several days after the liposomes cleared from blood. Measurements with FONIRS enabled to estimate skin concentration of liposomes (percent of injected dose per gram). This simple and practical approach can be used to monitor accumulation of drug delivery systems in preclinical and clinical studies.