Ultrasound-Responsive Cyclodextrin Delivery as Therapy for Atherosclerosis

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Atherosclerosis is a major cause of mortality and morbidity worldwide. Left undiagnosed and untreated, atherosclerotic plaques can rupture and cause cardiovascular complications such as myocardial infarction and stroke. Atherosclerotic plaques are composed of lipids, including oxidized low-density lipoproteins and cholesterol crystals, and immune cells, including macrophages. 2-Hydroxypropyl-beta-cyclodextrin (CD) is FDA-approved for capturing, solubilizing, and delivering lipophilic drugs in humans. It is also known to dissolve cholesterol crystals and decrease atherosclerotic plaque size. However, its low retention time necessitates high dosages for successful therapy. This study reports CD delivery via air-trapped polybutylcyanoacrylate nanoparticles (with diameters of 388 ± 34 nm) loaded with CD (CDNPs). The multimodal contrast ability of these nanoparticles after being loaded with IR780 dye in mice is demonstrated using ultrasound and near-infrared imaging. It is shown that CDNPs enhance the cellular uptake of CD in murine cells. In an ApoE–/– mouse model of atherosclerosis, treatment with CDNPs significantly improves the anti-atherosclerotic efficacy of CD. Ultrasound triggering further improves CD uptake, highlighting that CDNPs can be used for ultrasound imaging and ultrasound-responsive CD delivery. Thus, CDNPs represent a theranostic nanocarrier for potential application in patients with atherosclerosis.

Theranostic nanoparticles (NPs) synthesized using n-butylcyanoacrylate (BCA). Air trapped NPs were synthesized using the sonication-based mini-emulsion method. The monomer BCA is emulsified in the aqueous phase and loaded with 2-hydroxypropyl-beta-cyclodextrin (CD) and indocyanine green (ICG)/IR780 dye. During the generation step, air is being trapped in the NPs. Intravenously injected CD-loaded NPs will accumulate at the atherosclerotic plaque and release CD, which reduces plaque size. The ICG/IR780-loaded and air-trapped NPs provided contrast enhancement via NIR fluorescence and ultrasound imaging. The generated theranostic NPs allow both the identification/diagnosis of atherosclerosis and effective anti-atherosclerotic therapy.

Sourabh Mehta, Viktoria Bongcaron, Tien K Nguyen, Yugandhara Jirwanka, Ana Maluenda, Aidan P G Walsh, Jathushan Palasubramaniam, Mark D Hulett, Rohit Srivastava, Alex Bobik, Xiaowei Wang, and Karlheinz Peter: An Ultrasound-Responsive Theranostic Cyclodextrin-Loaded Nanoparticle for Multimodal Imaging and Therapy for Atherosclerosis. Small 2022, 2200967. DOI: 10.1002/smll.202200967

Featured image: credit to szimpatika.hu

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