[논문]초음파 기반 혈뇌장벽 개방에 관한 최신 임상시험 연구 현황

박주영

doi:10.7776/ask.2022.41.5.564

초음파 기반 혈뇌장벽 개방에 관한 최신 임상시험 연구 현황
Recent clinical trials with ultrasound induced blood-brain barrier opening 원문보기

한국음향학회지= The journal of the acoustical society of Korea, v.41 no.5, 2022년, pp.564 - 569

박주영 (가천대학교 바이오의료기기학과)

초록
AI-Helper

인체의 다른 장기들과 달리, 뇌는 혈뇌장벽(Blood-Brain Barrier, BBB)라는 보호 장치가 존재하여 뇌혈관내 물질들이 뇌조직으로 투과되는 것을 제한하는 역할을 한다. 이러한 BBB는 알츠하이머, 뇌종양 등 다양한 뇌질환에 직접적으로 전달이 필요한 약물의 투과까지 제한하기 때문에 치료 효능 검증 및 임상 적용이 어려운 것으로 보고되고 있다. 이러한 문제를 극복하기 위해 비침습적 특성의 집속 초음파(Focused Ultrasound, FUS)를 뇌의 국소 부위에 조사할 경우 마이크로버블의 음향공동화 현상으로 인해 BBB가 일시적으로 개방될 수 있는 기술이 개발되었으며, 해당 기술을 안전성 및 유효성 검증, 약물 전달 효율을 증대시킬 수 있는 다양한 연구가 전 세계적으로 수행되고 있다. 따라서, 본 논문에서는 알츠하이머, 뇌종양 등 뇌질환 치료를 위해 활발히 연구가 진행중인 집속초음파 기반 BBB 개방 기술에 대한 연구 동향을 분석하였다.

Abstract ▼ AI-Helper

Blood-Brain Barrier (BBB) is the brain protecting system blocking the inflow of harmful substances into brain parenchyma from brain blood vessel. However, the BBB has a negative effect on the treatment of various brain diseases such as Alzheimer's dementia or brain tumors because it also prevents drug delivery into brain parenchyma. To overcome this problem, a brain drug delivery technique using Focused Ultrasound (FUS) which allows BBB to be temporarily opened by inducing the acoustic cavitation effect of microbubbles has been developed. Thus far, various studies using the FUS technique has been conducted to improve drug delivery efficiency, and therefore, this paper discusses recently developed drug delivery technologies using the FUS-induced BBB opening.

주제어

표/그림 (6)

그림 Fig. 1. (Color available online) Schematic representation of the anatomical structure of the blood-brain barrier (BBB) and the accompanying neurovascular unit. Note the abluminal CEC surface is ensheathed by a basement membrane embedded with pericytes.^[2]
그림 Fig. 2. (Color available online) Schematic diagram of stable and inertial cavitation effect according to ultrasound pressure.
그림 Fig. 4. (Color available online) (Top) Schematic diagram of neuronavigation-guided FUS treatment, (Bottom) Immune cell infiltration in human tissues 7 days after FUS treatement.^[15]
그림 Fig. 3. (Color available online) Post: Blood-brain barrier opening of patient 2 in the targeted area immediately after sonication. 24 h: Same targeted area of patient 2, 24 h after treatment, without recognizable BBB opening. Top and bottom panels, respectively, show axial and coronal views of the parieto-occipito-temporal region.^[14]
그림 Fig. 5. (Color available online) Feasibility of bloodbrain barrier opening using MRgFUS in the hand control region of the right primary motor cortex. a Hand control region mapping using motor-task functional MRI (fMRI). b, c show confirmation of successful blood-brain barrier permeabilization in the sonicated primary motor cortex area as demonstrated by new gadolinium enhancement in T1- weighted imaging. Subject two is represented in the top row and subject three in the bottom row.^[10]
그림 Fig. 6. (Color available online) Example of spectrums that can be generated under inertial cavitation conditions or in the absence of cavitation.

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