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Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.

Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.

期刊: Drug delivery 日期: 2026-12-31 PMID: 42241274 DOI: 10.1080/10717544.2026.2677305 浏览: 65
作者: Liu J, Li Z, Li D, Liu J, Su Y, Leng Y, Li Y, Xu L, Sun L, Su X
J, L., Z, L., D, L., J, L., Y, S., Y, L., Y, L., L, X., L, S., & X, S. (2026). Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.. Drug delivery. https://doi.org/10.1080/10717544.2026.2677305
J L, Z L, D L, J L, Y S, Y L, et al. Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.. Drug delivery. 2026; doi: 10.1080/10717544.2026.2677305
J L, Z L, D L, et al. Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.[J]. Drug delivery. 2026. DOI: 10.1080/10717544.2026.2677305.
@article{j2026,
  author = {Liu J and Li Z and Li D and Liu J and Su Y and Leng Y and Li Y and Xu L and Sun L and Su X},
  title = {Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.},
  journal = {Drug delivery},
  year = {2026},
  doi = {10.1080/10717544.2026.2677305},
  note = {PMID: 42241274},
}
TY  - JOUR
AU  - Liu J
AU  - Li Z
AU  - Li D
AU  - Liu J
AU  - Su Y
AU  - Leng Y
AU  - Li Y
AU  - Xu L
AU  - Sun L
AU  - Su X
TI  - Low-intensity pulsed ultrasound combined with microbubbles enhances amphotericin B delivery across the blood-brain barrier for improved therapy of cryptococcal meningitis.
T2  - Drug delivery
PY  - 2026
DO  - 10.1080/10717544.2026.2677305
AN  - PMID:42241274
ER  - 

摘要

Cryptococcal meningitis (CM), a life-threatening fungal infection of the central nervous system, faces therapeutic challenges due to poor blood‒brain barrier (BBB) penetration of amphotericin B. This study investigates the efficacy of low-intensity pulsed ultrasound (LIPUS) combined with microbubbles in enhancing BBB permeability and improving prognosis in a murine CM model. Our findings suggest that LIPUS combined with microbubbles treatment significantly increased BBB permeability, leading to elevated cerebral concentrations of amphotericin B and improved fungicidal activity against Cryptococcus neoformans in the brain. Mechanistic investigations revealed that LIPUS-microbubble treatment transiently upregulated vascular endothelial growth factor (VEGF) expression levels in cerebral tissues. Notably, these protein expression alterations and the associated BBB permeability enhancement completely normalized within 6 hours post-treatment. Pharmacological inhibition of VEGF abolished the ultrasound-induced BBB permeability increase, indicating that VEGF may serve as a pivotal upstream regulator mediating this transient barrier modulation. Compared with amphotericin B monotherapy, the combined regimen of LIPUS plus microbubbles and amphotericin B achieved a greater reduction in cerebral cryptococcal burden. The India ink staining revealed reduced cryptococcal capsule thickness and smaller yeast cell diameters in treated mice. Furthermore, the intervention ameliorated CM-associated clinical manifestations, including weight loss and neurological deficits, while prolonging survival time. These results suggest the potential of LIPUS-microbubble-mediated BBB modulation as a promising adjunctive strategy to optimize amphotericin B delivery and improve therapeutic efficacy in CM, offering new insights into overcoming the limitations of conventional treatments for neurotropic fungal infections.

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