Enhancing Anti-CTLA-4 Antibody Delivery to the Brain Using Focused Ultrasound and Microbubbles
Year: 2026
Type: article
Abstract: Introduction: Gliomas, particularly glioblastomas, are characterised by their poor prognosis and low patient survival rate. Cytotoxic T lymphocyte-associated antigen-4 antibodies, a type of immune checkpoint inhibitor, have shown promise as an effective treatment strategy against the most aggressive tumour cells within the microenvironment of gliomas. However, their delivery to the brain is hindered by the blood-brain barrier, which is leaky in a heterogenous way, leading to uneven drug distribution across the tumour. Focused ultrasound, combined with intravenously administered microbubbles, is a technique that can non-invasively, safely, and reversibly increase the permeability of the blood-brain barrier in a targeted area, promoting the delivery of therapeutics, such as immune checkpoint inhibitors, to inaccessible tumour areas and thereby helping to prevent tumour relapse. Methods: We applied two different types of focused ultrasound sequences (long pulses vs rapid short-pulses) with microbubbles to the left hippocampus of wild-type female C57BL/6 mice before administering fluorescently labelled cytotoxic T lymphocyte-associated antigen-4 antibodies. Results: We determined that the targeted brain region had a significant increase in antibody delivery following ultrasound treatment with both pulse sequences. A more uniform delivery was achieved when treating with rapid short-pulse sequences ( p-value = 0.0130), where bursts of short 5 μs pulses of focused ultrasound were emitted at a fast repetition frequency (1.25 kHz). We observed a significant increase in anti-tumour immune cells in long-pulse treated brains ( p-value = 0.0021 (CD3 + cells) and p-value = 0.0001 (MHC class II + cells)). Conclusion: These results provide a proof-of-principle for how focused ultrasound with microbubbles can promote homogenous anti-tumour drug delivery and modulate the immune microenvironment. Keywords: focused ultrasound, blood-brain barrier, microbubbles, drug delivery, immunotherapy, immune checkpoint inhibitors
Source: ImmunoTargets and Therapy
DOI: 10.2147/itt.s569804
Authors: Maria Afonso Pereira, Vanessa Drevenakova, Qiyixing Liu, Sarina Grewal, Sophie Morse
Institutions: Imperial College London, UK Dementia Research Institute
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,320
Awards: A Superresolution microscope for biological research in the multi-user Microscopy Facility [FILM]: ALERT 13, FILM microscopy facility: New generation confocal and high content screening microscopes, and upgrades for intravital microscopy., FILM microscopy facility: New generation confocal and high content screening microscopes, and upgrades for intravital microscopy., G2948680474, G3165519751, DTP Bid Led by Imperial College London, G6501379603, G6566734513
OpenAlex ID: W7127039816
