Thromb Haemost 2008; 100(02): 356-361
DOI: 10.1160/TH07-09-0583
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

Thrombolysis effect of a novel targeted microbubble with low-frequency ultrasound in vivo

Bing Wang
1   Department of Pathology, School of Medicine, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Li Wang
2   Department of Pharmacology, School of Medicine, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Xiao-Bo Zhou
3   Department of Immunology, School of Medicine, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Ya-Min Liu
4   Peripheral Ve ssels Department of the First Hospital, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Mei Wang
5   Department of Dermatology of the Second Hospital, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Hao Qin
4   Peripheral Ve ssels Department of the First Hospital, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Chong-Bao Wang
4   Peripheral Ve ssels Department of the First Hospital, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Ju Liu
6   Department of Intervention of the First Hospital of Xi’an, Xi’an Shaanxi, P.R. China
,
Xiao-Jiang Yu
2   Department of Pharmacology, School of Medicine, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
,
Wei-Jin Zang
2   Department of Pharmacology, School of Medicine, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
7   Key Laboratory of Environment and Genes Related to Diseases of the Ministry of Education, Xi’an Jiaotong University, Xi’an Shaanxi, P. R. China
› Author Affiliations
Financial support: This study was supported by the National 863 Plan (No. 2006AA02Z4A5), the National Basic Research Program of China (973 Program No. 2007CB512005), the National Natural Science Foundation (Nos. 30300325 and 30770785), Province Natural Science Foundation (Nos. 2002K10-G6–07, 2003k10-G10(1) and 2004C201), the Chinese Biomedical Foundation of Xi’an City (No. ZX05012), the Province T e chnology Special Foundation (No. 2006kz04-G1),. the National Natural Science Foundation of China (No. 30770785), the Cultivation Fund of the Key Scientific and Technical Innovation Project of Chinese Ministry of Education (No. 705045) and the Specialized Research Fund for the Doctoral Program of Higher Education (No.20050698012).
Further Information

Publication History

Received 26 September 2007

Accepted after major revision: 02 June 2008

Publication Date:
22 November 2017 (online)

Summary

Clot-targeted microbubbles (TMB) were developed based on oligopeptide specific to the glycoprotein IIb/IIIa receptor on active platelets. In this study, we aimed to elucidate the thrombolysis effect of this TMB in both intraarterial and intravenous application and compare the clot lysis efficiency of the TMB and untargeted microbubbles(UTMB) in presence of external low frequency ultrasound (LFUS) (800kHz, 2.4w/cm2, pulse-wave). An acute arterial occlusion model was induced in rabbits by blocking the common carotid artery with an autogenous clot. Animals were randomized to five groups to receive the following treatment: 1) intra-arterial TMB and LFUS (IA TMB/LFUS); 2) intravenous TMB and LFUS (IV TMB/LFUS); 3) intravenous untargeted-microbubbles and LFUS (IV UTMB/LFUS);4) LFUS only; 5) intra-arterial normal saline (NS) control. Declotting score and a variation of thrombolysis-in-myocardial-infarction (TIMI) flow scale were applied to assess clot clearance and flow restore according to the angiogram. IA TMB/LFUS treatment produced highest declotting score (3.5 ± 0.53) and success rate (100%).IV TMB/LFUS treatment produced a higher declotting score (1.95 ± 1.12) than LFUS treatment (0.53 ± 0.38) (P=0.026).and higher TIMI (1.94 ± 0.62 vs.0.47 ± 0.44, P=0.020).When administrated intravenously, TMB/LFUS created a higher declotting score (1.95 ± 1.12) than that of UTMB/LFUS (0.61 ± 0.43) (P=0.033).The superiority was observed in TIMI also (1.94 ± 0.62 vs.0.72 ± 0.25, P=0.041).The results demonstrate that either intra-arterial or intravenous TMB is effective in clearing clot in-vivo model. The TMB showed advantage over UTMB in systemic administration.

 
  • References

  • 1 Pfaffenberger S, Devcic-Kuhar B, Kastll SP. et al. Ultrasound thrombolysis. Thromb Haemost 2005; 94: 26-36.
  • 2 Behrens S, Spengos K, Daffertshofer M. Potential use of therapeutic ultrasound in ischemic stroke treatment. Echocardiography 2001; 18: 259-263.
  • 3 Alexandrov AV, Molina CA, Grotta JC. et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med 2004; 351: 2170-2178.
  • 4 Daffertshofer M, Gass A, Ringleb P. et al. Transcranial low-frequency ultrasound-mediated throm-bolysis in brain ischemia: increased risk of hemorrhage with combined ultrasound and tissue plasminogen activator: results of a phase II clinical trial. Stroke 2005; 36: 1441-1446.
  • 5 Unger EC, Matsunaga TO, Schumann PA. et al. Microbubbles in molecular imaging and therapy. Medica mundi 2003; 47: 58-65.
  • 6 Culp WC, Erdem E, Roberson PK. Microbubble potentiated ultrasound as a method of stroke therapy in a pig model: preliminary findings. J Vasc Interv Radiol 2003; 14: 1433-1443.
  • 7 Suchkova VN, Baggs RB, Francis CW. et al. Effect of 40-kHz ultrasound on acute thrombotic ischemia in a rabbit femoral artery thrombosis model enhancement of thrombolysis and improvement in capillary muscle perfusion. Circulation 2000; 101: 2296-2301.
  • 8 Xie F, Tsutsui JM, Lof J. et al. Effectiveness of lipid microbubbles and ultrasound in declotting thrombosis. Ultrasound Med Biol 2005; 31: 979-985.
  • 9 Molina CA, Ribo M, Rubiera M. et al. Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator. Stroke 2006; 37: 425-429.
  • 10 Klibanov AL. Microbubble contrast agents targeted ultrasound imaging and ultrasound-assisted drug delivery application. Invest Radiol 2006; 41: 354-362.
  • 11 Alonso A, Martina AD, Stroick M. et al. Molecular imaging of human thrombus with novel abciximab immunobubbles and ultrasound. Stroke 2007; 38: 1508-1514.
  • 12 Schumann PA, Christiansen JP, Quigley RM. et al. Targeted-microbubble binding selectively to GPIIb IIIa receptors of platelet thrombi. Invest Radiol 2002; 37: 587-593.
  • 13 Tiukinhoy-Laing SD, Huang S, Klegerman M. et al. Ultrasound-facilitated thrombolysis using tissue-plasminogen activator-loaded echogenic liposomes. Thromb Res 2007; 119: 777-784.
  • 14 Wu Y, Unger EC, McCreery TP. et al. Binding and lysing of blood clots using MRX-408. Invest Radiol 1998; 33: 880-885.
  • 15 Culp WC, Porter TR, Lowery J. et al. Intracranial clot lysis with intravenous microbubbles a transcranial ultrasound in swine. Stroke 2004; 35: 2407-2411.
  • 16 Wang B, Zang WJ, Wang M. et al. Prolonging the ultrasound signal nhancement from thrombi using targeted microbubbles based on sulfur-hexafluoride-filled gas. Acad Radiol 2006; 13: 428-433.
  • 17 Francis CW, Suchkova VN. Ultrasound and thrombolysis. Va scular Med 2001; 06: 181-187.
  • 18 Motarjeme A. Ultrasound-enhanced thrombolysis. J Endovasc Ther 2007; 14: 251-256.
  • 19 Pfaffenberger S, Devcic-Kuhar B, Kollmann C. et al. Can a commercial diagnostic ultrasound device accelerate thrombolysis? An in vitro skull model. Stroke 2005; 36: 124-128.
  • 20 Tsivgoulis G, Culp WC, Alexandrov AV. Ultrasound enhanced thrombolysis in acute arterial ischemia. Ultrasonics 2008. prepub online doi:10.1016/j.ultras. 2007.11.008..
  • 21 Birnbaum Y, Luo H, Nagai T. Noninvasive in vivo clot dissolution without a thrombolytic drugrecanalization of thrombosed iliofemoral arteries by transcutaneous ultrasound combined with intravenous infusion of microbubbles. Circulation 1998; 97: 130-134.
  • 22 Datta S, Coussios CC, McAdory LE. et al. Correlation of cavitation with ultrasound enhancement of thrombolysis. Ultrasound Med Biol 2006; 32: 1257-1267.
  • 23 Prokop AF, Soltani A, Roy RA. Cavitational mechanisms in ultrasound-accelerated fibrinolysis. Ultrasound Med Biol 2007; 33: 924-933.
  • 24 Devcic-Kuhar B, Pfaffenberger S, Gherardini L. et al. Ultrasound affects distribution of plasminogen and tissue type plasminogen activator in whole blood clots in vitro. Thromb Haemost 2004; 92: 980-985.
  • 25 Matthew J, Martin BS, Emma ML. et al. Enhanced detection of thromboemboli with the use of targeted microbubbles. Stroke 2007; 38: 2726-2732.