Academic literature on the topic 'Perfluorocarbon emulsions'

The issues of practicality in using perfluorocarbon gas transport emulsions (or pure perfluorocarbons) in severe virus-associated pneumonia treatment were considered, including those caused by coronavirus infection. Perfluorocarbons are fully fluorinated carbon compounds, on the basis of which artificial blood substitutes have been developed gas transport perfluorocarbon emulsions for medical purposes. Perfluorocarbon emulsions were widely used in the treatment of patients in critical conditions of various genesis at the end of the lastthe beginning of this century, accompanied by hypoxia, disorders of rheological properties and microcirculation of blood, perfusion of organs and tissues, intoxication, and inflammation. Large-scale clinical trials have shown a domestic plasma substitute advantage based on perfluorocarbons (perfluoroan) over foreign analogues. It is quite obvious that the inclusion of perfluorocarbon emulsions in the treatment regimens of severe virus-associated pneumonia can significantly improve this categorys treatment results after analyzing the accumulated experience. A potentially useful area of therapy for acute respiratory distress syndrome is partial fluid ventilation with the use of perfluorocarbons as respiratory fluids as shown in the result of many studies on animal models and existing clinical experience. There is no gas-liquid boundary in the alveoli, as a result of which, there is an improvement in gas exchange in the lungs and a decrease in pressure in the respiratory tract when using this technique, due to the unique physicochemical properties of liquid perfluorocarbons. A promising strategy for improving liquid ventilation effectiveness using perfluorocarbon compounds is a combination with other therapeutic methods, particularly with moderate hypothermia. Antibiotics, anesthetics, vasoactive substances, or exogenous surfactant can be delivered to the lungs during liquid ventilation with perfluorocarbons, including to the affected areas, which will enhance the drugs accumulation in the lung tissues and minimize their systemic effects. However, the indications and the optimal technique for conducting liquid ventilation of the lungs in patients with acute respiratory distress syndrome have not been determined currently. Further research is needed to clarify the indications, select devices, and determine the optimal dosage regimens for perfluorocarbons, as well as search for new technical solutions for this technique.

Abstract Hemocorrectors based on perfluorocarbon gas-transport blood-substituting emulsions are complex multiphase systems used in the biomedical field as multifunctional drugs, in particular, as gas-transport substitutes for a blood donor. The aim of this review was to discuss their physicochemical and medico-biological properties. A number of preparations from both Russian and foreign manufacturers based on chemically inert perfluorocarbon blood-substituting emulsions of a nano-size level as hemocorrectors with a gas transport function are shown. The analysis of the effect of perfluorocarbon emulsion on the blood gas transport indicators showed that perfluorocarbon particles in the bloodstream will significantly improve the conditions of gas exchange in tissues. The most important issue is the concentration of perfluorocarbon blood-substituting emulsions. The perfluorocarbon emulsions can be considered as a means of correcting the gas transport properties of blood, increasing the reserve capacity of blood cells-red blood cells to deliver oxygen to the tissues. Taking into account all facts about perfluorocarbon hemocorrectors, it can be concluded that they can be used as universal nanocarriers for the transdermal delivery of oxygen and biologically active compounds in various fields of biomedicine and cosmetology.

Background: Hypoxia renders tumor cells refractory to treatment. One way to overcome this problem is the design of drug delivery systems that contain the antitumor agent within an oxygen supply medium. Objective: to evaluate whether the perfluorocarbon liquids (capable of retaining up to 50% v/v amounts of O2 gas) can be tools for delivery of photosensitizers to hypoxic tumors. Method: We synthesized a series of compounds in which fluoroaliphatic or fluoroaromatic moieties were conjugated to the porphyrin ring in meso-positions. Two derivatives were tested as the solutions prepared either from a dimethylformamide stock (‘free’ formulation) or from a perfluorocarbon emulsion in which the photosensitizer is entrapped in the oxygenated medium. Results: In the emulsion the hydrophobic photosensitizer and the gas transporting liquid represented a biocompatible composition. Free formulations or perfluorocarbon emulsions of fluorinated porphyrins evoked little-to-null dark cytotoxicity. In contrast, each formulation triggered cell death upon light activation. Photodamage in the presence of fluorinated porphyrins was achievable not only at normoxic (20.9% O2 v/v) conditions but also in hypoxia (0.5% O2). With new compounds dissolved in the medium the cell photodamage in hypoxia was negligible whereas a significant photodamage was achieved with the emulsions of fluorinated porphyrins. The derivative with the fluoroalkyl substituent was more potent than its structurally close analog carrying the fluoroaryl moiety. Conclusion: Our new fluorinated porphyrin derivatives, especially their emulsions in which the photosensitizer and the oxygenated medium are coupled into one phase, can be perspective for photoelimination of hypoxic tumor cells.

An investigation of different methods for the immobilization of α‐amylase and trypsin on solid and liquid poly(vinyl alcohol) (PVA)‐coated perfluorocarbon supports has been made. It is found that very reactive PVA‐coated perfluorocarbon supports are produced only via the reactions between the hydroxy groups of PVA adsorbed on perfluorocarbons and 2, 2, 2‐trifluethanesulphonyl chloride (tresyl chloride), 2, 4, 6‐trichloro‐1, 3, 5‐triazine (cyanuric chloride) or p‐β‐sulphate‐(ethyl sulphonide)‐aniline (SESA), a preactivating reagent for diazotization reactions. The amounts of immobilized trypsin (specific activity and percentage recovery of enzyme activity toward casein) on solid PVA‐coated perfluorocarbon activated by tresyl chloride, SESA or cyanuric chloride were 58 mg/g (1200 units/g, 5.8%), 25 mg/g (1100 units/g, 12.4%) or 44 mg/g (1128 units/g, 7.2%) respectively. The amounts of immobilized α‐amylase (specific activity and the recovery of enzyme activity towards starch) on the same supports were 32 mg/g (4000 units/g, 7.2%), 20 mg/g (4940 units/g, 14.2%) or 29 mg/g (2725 units/g, 5.4%) respectively. Most other methods, i.e. epoxy activation (with epichlorohydrin or 1, 4‐butanediol diglycidyl ether), periodate oxidation, glutaraldehyde coupling, 1, 1'‐carbonyldi‐imidazole chemistry, 1, 1′‐carbonyldi‐imidazole chemistry in an oriented fashion, isothiocyanate chemistry and carbodiimide activation, all resulted in lower degrees of activation of PVA‐coated perfluorocarbon supports and thus correspondingly lower specific activities of the immobilized enzymes. Only the methods with SESA or cyanuric chloride are suitable for enzyme immobilization on PVA‐coated liquid perfluorocarbon emulsions. The amounts of immobilized enzymes and the specific activities of the enzymes on liquid PVA‐coated perfluorocarbon emulsion were, however, lower than those on solid PVA‐coated perfluorocarbon owing to the lower surface area of this carrier. The method with SESA seems to be the best for all applications. The addition of (NH4)2SO4 to the immobilized reactions significantly enhanced the activity recovery and the specific activity of the α‐amylase. The immobilized enzymes were stable during storage. The study demonstrates that solid PVA‐coated perfluorocarbon supports are promising carriers for enzyme immobilization.

Decompression sickness (DCS) results from a sudden decrease in ambient pressure leading to super-saturation of tissues with inert gas and subsequent bubble formation within both tissues and blood. Perfluorocarbons (PFC) are able to dissolve vast amounts of non-polar gases. The administration of intravenous (I.V.) PFC emulsions reduce both morbidity and mortality of DCS, but the mechanism of this protective effect has not yet been demonstrated. Juvenile Dorper cross sheep between 16 and 24 kg (n=31) were anaesthetized and instrumented for physiological monitoring, the administration of I.V. fluids and sampling of arterial and mixed venous blood. Animals were placed in a hyperbaric chamber and compressed to 6.0 atmospheres absolute for 30 minutes, then rapidly decompressed. Upon chamber exit animals were randomly assigned to receive 6cc/kg of either PFC or saline control over 5 minutes beginning immediately after chamber exit. They were also randomized to receive one of 4 breathing gases post-chamber: 100% O2, 80/20 N2/O2, 50/50 HeO2, or 80/20 HeO2. Blood samples were drawn at 5, 10, 15, 30, 60, and 90 minutes to examine whole-body oxygenation. Respiratory gases were monitored and recorded in real-time using mass spectroscopy to examine nitrogen washout. PFC administration increased arterial oxygen content (16.30±0.27 vs. 14.75±0.25 mL/dL, p<0.0001), oxygen delivery (14.83±0.28 vs. 13.44±0.25 mL/minute/kg, p=0.0004), and tissue oxygen consumption (3.37±0.14 vs. 2.76±0.13 mL/minute/kg, p=0.0018) over saline control, but did not increase mixed venous oxygen content (12.45±0.26 vs. 11.74±0.24 mL/dL, p=0.0558) or extraction ratio (0.23±0.012 vs. 0.21±0.011, p=0.1869). PFC administration lowered the plateau of the curve, increasing the amount of nitrogen washout vs. saline control (22.22±1.566 vs. 15.98±1.380 mmHg, p= 0.0074). Breathing 80/20 HeO2 increased the decay constant of the curve, increasing the rate of washout vs. breathing 100% O2 (0.03176±0.001044 vs. 0.03096±0.0009402, p=0.5777). PFC improves whole-body oxygenation after severe DCS and increases the amount of nitrogen washout. Although the effects of both PFC and 80/20 HeO2 breathing were statistically significant the magnitude of the nitrogen washout effect is quite small, and unlikely to be clinically significant. Thus it is likely that the improved oxygenation is responsible for the previously-observed therapeutic effects of PFC in treating DCS.

Inhaled drug delivery is currently the gold standard for treating many respiratory diseases. However, improved treatments are needed for lung diseases like Cystic Fibrosis (CF) and Acute Respiratory Distress Syndrome (ARDS), where mucus or fluid build-up in the lung limits ventilation and, thus, delivery of inhaled drugs. Delivery is most needed in the diseased or damaged regions of the lung, but if an area is not ventilated, inhaled drug will simply not reach it. To overcome this, this research proposes delivering drugs to the lungs within a perfluorocarbon (PFC) liquid. The lungs will be filled with a reverse emulsion containing a disperse phase of aqueous drugs within the bulk PFC and then ventilated. The PFC functions as both a respiratory medium, providing gas exchange, and as a delivery vehicle, providing a more uniform deposition of drugs. After treatment, the highly volatile PFCs are exhaled, returning the patient to normal respiration. This technique improves upon current therapies as follows. First, drugs are delivered directly to where they are needed, yielding higher concentrations in the lung and lower systemic concentrations. Second, PFCs are ideal for washing out lung exudate and mucus. The low surface tension and high density of PFC allows it to easily penetrate plugged or collapsed alveoli, detach infected mucus from the airway walls, and force these fluids to the top of the lungs where they can then be removed via suction. Mucus and exudate removal should allow drugs to penetrate previously plugged airways during emulsion delivery and subsequent treatment with inhaled therapies. Thus, drug delivery via emulsion would be used as a pre-treatment to enhance inhaled or systemic drug therapy. Third, PFC’s anti-inflammatory properties help return to normal lung function. This research examines two applications of this technology: delivery of antibiotics to combat respiratory infections (antibacterial perfluorocarbon ventilation, APV) or delivery of growth factors to enhance alveolar repair (perfluorocarbon emulsions for alveolar repair, PEAR). This work represents an in-depth analysis of the emulsions used during APV and PEAR. Initial efforts evaluated emulsion efficacy under in vitro setting that better simulated lung in vivo antibiotic delivery. The subsequent studies utilized an in vivo rat model of bacterial respiratory infection to validate the effects of emulsion on pharmacokinetics and to assess APVs potential treatment benefits. Lastly, in vitro methods of cellular response assessed the utility of delivering growth factors in PEAR. Significant advancements were made in optimizing the emulsion as a viable means of pulmonary drug delivery. Final efforts resulted in a promising emulsion formulation that overcame the quick transport of tobramycin away from the lung and successfully reduced pulmonary bacterial load in vivo. In vitro applications of PEAR showed the emulsions posed a significant barrier to the availability and, thus, the biological effect of lysophosphatidic acid growth factors. Further in vivo work is required to improve APV’s efficacy over conventional treatments and to determine PEAR’s feasibility and efficacy in promoting lung repair.

Cette étude présente une avancée significative dans notre compréhension de deux domaines clés : le processus de vaporisation de gouttelettes acoustiques (ADV) dans les gouttelettes de perfluorohexane (PFH). De plus, la livraison d'antibiotiques améliorée acoustiquement ainsi que le rôle de l'alginate dans la résistance aux antibiotiques contre les biofilms sont également explorés. La quête de la localisation spatiale et temporelle des agents thérapeutiques a conduit à l'exploration de la vaporisation de gouttelettes acoustiques (ADV) et de l'échographie dans la livraison ciblée de médicaments. Par conséquent, cette recherche examine le processus ADV, un phénomène avec des applications potentielles dans la livraison de médicaments, l'imagerie par ultrasons et le traitement du cancer. Des informations clés sur les facteurs influençant le processus ADV, tels que la taille et la composition des gouttelettes, et le rôle des différentes interfaces dans la nucléation sont abordées. Un modèle réussi de nucléation hétérogène est présenté, où le noyau apparaît à la surface en contact avec le PFH. Les conclusions de l'étude sur l'apparition préférentielle de la nucléation à différentes interfaces et l'impact de la courbure de surface et des tensions interfaciales pourraient avoir des implications significatives pour la conception de systèmes de livraison de médicaments plus efficaces ou d'agents de contraste pour l'imagerie par ultrasons.Dans le contexte de la résistance aux antibiotiques, l'étude examine les biofilms, comme le modèle P. aeroginosa, qui présentent souvent une résistance accrue aux antibiotiques. Il est démontré que l'alginate,un composant du biofilm, se lie aux antibiotiques positivement chargés, réduisant ainsi leur disponibilité pour atteindre et tuer les bactéries. Cependant, ce phénomène ne s'étend pas au-delà d'une certaine concentration de ces molécules de médicament chargées. Ce travail montre également que l'échographie,ou l'insonation du biofilm, peut perturber cette liaison, permettant à l'antibiotique de diffuser librement et d'atteindre les bactéries. L'action antibiotique améliorée est montrée pour être réalisée en utilisant des ultrasons de haute fréquence et de faible intensité. Cette découverte est particulièrement significative car les paramètres acoustiques utilisés dans l'étude sont compatibles avec les échographes cliniques,suggérant que cette approche pourrait être mise en œuvre de manière réalisable dans un contexte clinique
This study presents a significant advancement in our understanding of two key areas: the acoustic droplet vaporization (ADV) process in perfluorohexane (PFH) droplets. Furthermore, acoustically enhanced antibiotic delivery along with the role of alginate in antibiotic resistance against biofilms is also explored.The quest for spatial and temporal localization of therapeutic agents has led to the exploration of Acoustic Droplet Vaporization (ADV) and ultrasound in targeted drug delivery. Consequently, this research investigates the ADV process, a phenomenon with potential applications in drug delivery, ultrasound imaging, and cancer treatment.Key insights into the factors influencing the ADV process, such as droplet size and composition, and the role of different interfaces in nucleation are addressed. Asuccessful model for heterogeneous nucleation is presented, where the nucleus appears at the surface incontact with PFH. The study's findings on the preferential occurrence of nucleation at differentinterfaces and the impact of surface curvature and interfacial tensions could have significantimplications for the design of more effective drug delivery systems or contrast agents for ultrasoundimaging.In the context of antibiotic resistance, the study investigates biofilms, such as the P. aeroginosa model,which often exhibit increased resistance to antibiotics. It is shown that alginate, a component of thebiofilm, binds to positively charged antibiotics, thereby reducing their availability to reach and killbacteria. However, this phenomenon does not extend beyond a certain concentration of these chargeddrug molecules. This work also shows that ultrasound, or insonation of the biofilm, can disrupt thisbinding, allowing the antibiotic to diffuse freely and reach the bacteria. The enhanced antibiotic actionis shown to be achieved using high frequency and low intensity ultrasound. This finding is particularlysignificant as the acoustic parameters used in the study are compatible with clinical echographs,suggesting that this approach could be feasibly implemented in a clinical setting

People receiving chemotherapy not only suffer from side effects of therapeutics but also must buy expensive drugs. Targeted drug and gene delivery directed to specific tumor-cells is one way to reduce the side effect of drugs and use less amount of therapeutics. In this research, two novel liposomal nanocarriers were developed. This nanocarrier, called an eLiposome, is basically one or more emulsion droplets inside a liposome. Emulsion droplets are made of perfluorocarbons which usually have a high vapor pressure. Calcein (as a model drug) and Paclitaxel were used to demonstrate drug delivery, and plasmids and siRNA were used to exemplify gene delivery. Drugs or genes were encapsulated inside the interior of the liposomes along with emulsion droplets; targeting moieties were attached to the outside of the phospholipid bilayer. Ultrasound was used to break open the bilayer by changing the liquid emulsion droplets to gas, which released the content of the eLiposomes. Transmission electron microscopy (TEM) was used to prove the formation of eLiposomes and confocal microscopy showed the uptake of drugs and genes in vitro. Cell viability was measured to show the effect of uptake in cancer cells. Results indicate that eLiposomes were successfully made and that they were endocytosed into the cell. It was observed that the emulsion and the targeting moiety in combination with ultrasound are the essential elements required to produce release from eLiposomes.

Staphylococcus aureus is a major threat to public health systems all over the globe. This second most cause of nosocomial infections is able to provoke a wide variety of different types of infection in humans and animals, ranging from superficial skin and skin structure infections to invasive disease like sepsis or pneumonia. But not enough, this pathogen is also notorious in acquiring and/or developing resistance to antimicrobial compounds, thus limiting available treatment options severely. Therefore, development of new compounds and strategies to fight S. aureus is of paramount importance. But since only 1 out of 5 compounds, which entered clinical trials, becomes a drug, the preclinical evaluation of promising compounds has to be reconsidered, too. The aim of this thesis was to address both sides of this problem: first, to improve preclinical testing by incorporating in vivo imaging technologies to the preclinical testing procedure in order to acquire additional and clearer data about efficacy of promising compounds and second, by evaluating lysostaphin, which is a promising, new option to fight S. aureus infections. The first aim of this thesis focused on the establishment of a dual modality in vivo imaging platform, consisting of Bioluminescence Imaging (BLI) and Magnetic Resonance Imaging (MRI), to offer detailed insights into the course and gravity of S. aureus infection in the murine thigh infection model. Since luciferase-expressing S. aureus strains were generated in former studies and enabled thus bioluminescence imaging of bacterial infection, this technology should be implemented into the compound evaluation platform in order to non-invasively track the bacterial burden over time. MRI, in contrast, was only rarely used in earlier studies to visualize and measure the course of infection or efficacy of anti-bacterial therapy. Thus, the first set of experiments was performed to identify benefits and drawbacks of visualizing S. aureus infections in the mouse model by different MR methods. Native, proton-based MR imaging showed in this regard increased T2 relaxation times in the infected thigh muscles, but it was not possible to define a clear border between infected and uninfected tissue. Iron oxide nanoparticles and perfluorocarbon emulsions, two MR contrast agents or tracer, in contrast, offered this distinction. Iron oxide particles were detected in this regard by their distortion of 1H signal in proton-based MRI, while perfluorocarbon emulsion was identified by 19F MRI. Mammals do not harbor sufficient intrinsic amounts of 19F to deliver specific signal and therefore, 19F MR imaging visualizes only the signal of administered perfluorocarbon emulsion. The in vivo accumulation of perfluorocarbon emulsion can be imaged by 19F MRI and overlayed on a simultaneously acquired 1H MR image, which shows the anatomical context in clear detail. Since this is advantageous compared to contrast agent based MR methods like iron oxide particle-based MRI, further experiments were performed with perfluorocarbon emulsions and 19F MRI. Experimental studies to elucidate the accumulation of perfluorocarbon emulsion at the site of infection showed robust 19F MR signals after administration between day 2 and at least day 8 p.i.. Perfluorocarbon emulsion accumulated in all investigated mice in the shape of a ‘hollow sphere’ at the rim of the abscess area and the signal remained stable as long as the infection prevailed. In order to identify the mechanism of accumulation, flow cytometry, cell sorting and histology studies were performed. Flow cytometry and cell sorting analysis of immune cells at the site of infection showed that neutrophils, monocytes, macrophages and dendritic cells carried contrast media at the site of infection with neutrophils accounting for the overwhelming portion of perfluorocarbon signal. In general, most of the signal was associated with immune cells, thus indicating specific immune cell dependent accumulation. Histology supported this observation since perfluorocarbon emulsion related fluorescence could only be visualized in close proximity to immune cell nuclei. After establishing and testing of 19F MRI with perfluorocarbon emulsions as infection imaging modality, the effects of antibiotic therapy upon MR signal was investigated in order to evaluate the capability of this modality for preclinical testing procedure. Thus, the efficacy of vancomycin and linezolid, two clinically highly relevant anti - S. aureus compounds, were tested in the murine thigh infection model. Both of them showed reduction of the colony forming units and bioluminescence signal, but also of perfluorocarbon emulsion accumulation strength and volume at the site of infection, which was visualized and quantified by 19F MRI. The efficacy pattern with linezolid being more efficient in clearing bacterial infection was shown similarly by all three methods. In consequence, 19F MRI with perfluorocarbon emulsion as MR tracer proved to be capable to visualize antibacterial therapy in preclinical testing models. The next step was consequently to evaluate a promising new compound against S. aureus infections. Thus, lysostaphin, an endo-peptidase that cleaves the cell wall of S. aureus, was tested in different concentrations alone or in combination with oxacillin for efficacy in murine thigh and catheter associated infection models. Lysostaphin only in the concentration of 5 mg/kg body weight or combined with oxacillin in the concentration of 2 mg/kg showed strong reduction of bacterial burden by colony forming unit determination and bioluminescence imaging in both models. The perfluorocarbon accumulation was investigated in the thigh infection model by 19F MRI and was strongly reduced in terms of volume and signal strength in both above-mentioned groups. In general, lysostaphin showed comparable or superior efficacy than vancomycin or oxacillin alone. Therefore, further development of lysostaphin for the treatment of S. aureus infections is recommended by these experiments. Overall, the antibiotic efficacy pattern of all applied antibiotic regimens was similar with all three applied methods, demonstrating the usefulness of MRI for antibiotic efficacy testing. Importantly, treatment with oxacillin either alone or in combination with lysostaphin resulted in stronger perfluorocarbon emulsion accumulation at the site of infection than expected compared to the results from bioluminescence imaging and colony forming unit determination. This might be an indication for immunomodulatory properties of oxacillin. Further murine infection experiments demonstrated in this context a differential release of cytokine and chemokines in the infected thigh muscle in dependence of the applied antibacterial therapy. Especially treatment with oxacillin, but to a less degree with minocycline or linezolid, too, exhibited high levels of various cytokines and chemokines, although they reduced the bacterial burden efficiently. In consequence, possible immunomodulatory effects of antibacterial compounds have to be taken into account for future applications of imaging platforms relying on the visualization of the immune response. However, this observation opens a new field for these imaging modalities since it might be extraordinary interesting to study the immunomodulatory effects of compounds or even bacterial factors in vivo. And finally, a two modality imaging platform which combines methods to visualize on the one hand the bacterial burden and on the other hand the immune response offers an innovative, new platform to study host-pathogen interaction in vivo in a non-invasive fashion. In summary, it could be shown that perfluorocarbon emulsions accumulate in immune cells at the site of infection in the murine S. aureus thigh infection model. The accumulation pattern shapes a ‘hollow sphere’ at the rim of the abscess area and its size and perfluorocarbon content is dependent on the severity of disease and/or efficacy of antibiotic therapy. Thus, 19F MRI with perfluorocarbon emulsions is a useful imaging modality to visualize sites and course of infection as well as to evaluate promising antibacterial drug candidates. Furthermore, since the accumulation of tracer depends on immune cells, it might be additionally interesting for studies regarding the immune response to infections, auto-immune diseases or cancer, but also to investigate the efficacy of immunomodulatory compounds and immunization
Staphylococcus aureus ist als zweithäufigste Ursache nosokomialer Infektionen eine ernste Bedrohung für Gesundheitssysteme weltweit. Dieses Pathogen ist in der Lage eine Vielzahl verschiedener Krankheitsformen, von oberflächlichen Wund- und Gewebsinfektionen bis hin zu invasiven Erkrankungen wie Bakteriämie oder Pneumonie, in Mensch und Tier zu verursachen. Zudem erwies sich dieser Krankheitserreger in der Vergangenheit als höchst anpassungsfähig durch den Erwerb oder die Entwicklung von Resistenzen gegenüber antibakterieller Substanzen, wodurch die Verfügbarkeit wirksamer Therapiemöglichkeiten drastisch eingeschränkt wurde. Aus diesem Grund ist die Entwicklung neuer Antibiotika und Behandlungsstrategien gegen S. aureus Infektionen von enormem gesellschaftlichem Interesse. Da aber lediglich eine von fünf Substanzen, die in klinische Studien eintreten, später als Medikament zugelassen wird, sollte die präklinische Evaluierung neuer, vielversprechender Therapeutika ebenso verbessert und überdacht werden. Diese Doktorarbeit addressiert in diesem Zusammenhang beide Facetten: zum einen wurde durch Einbeziehung von in vivo Bildgebungstechnologien ein deutlicheres Bild von der Effizienz neuer Substanzen während der präklinischen Evaluierung ermöglicht, zum anderen wurde mit Lysostaphin eine neuartige Substanzklasse zur Behandlung von S. aureus Infektionen getestet. Primärziel dieser Arbeit war deshalb die Entwicklung und Etablierung einer dualen Bildgebungsplattform bestehend aus Biolumineszenz- (BLI) und Kernspintomografischer (MRI) Bildgebung, um detaillierte Einblicke in Verlauf und Schwere von S. aureus Infektionen im Muskelinfektionsmodell der Maus zu ermöglichen. Die Biolumineszenzbildgebung bakterieller Infektionen wurde durch die Entwicklung von Luziferase-exprimierenden S. aureus Stämmen bereits in früheren Arbeiten ermöglicht und wurde in die Bildgebungsplatform integriert, um die Entwicklung der Bakterienlast nicht-invasiv verfolgen zu können. Kernspintomografie wurde in früheren Arbeiten hingegen kaum zur Darstellung der Effizienz anti-bakterieller Therapien während der Präklinik verwendet. Aus diesem Grund dienten die ersten Experimente zur Erkennung von Vor- und Nachteilen der Darstellung von S. aureus Infektionen im Tiermodell durch verschiedene Kernspintomografische Bildgebungsmethoden. Native, Protonen-basierte Kernspintomografie wies verlängerte T2 Relaxationszeiten im infizierten Muskelgewebe nach, doch eine klare Eingrenzung des infizierten Bereiches war nicht möglich. Die Anwendung von Eisenoxid und Perfluorcarbon Nanopartikeln, zwei Kontrastmittel zur Kernspintomografie, ermöglichte ebendiese. Eisenoxid Nanopartikel wurden durch ihren Signalstöreffekt auf das MR Protonensignal detektiert, während Perfluorcarbon Emulsionen durch 19F basierte Kernspintomografie nachgewiesen wurden. Säugetiere verfügen nicht über ausreichende Mengen von 19F Atomen, um ein spezifisches Signal zu liefern, weshalb 19F Kernspintomografie lediglich applizierte Perfluorcarbon Emulsion in vivo abbilden kann. Dieses Bild kann dann über ein zugleich aufgenommenes Protonen MR Bild gelegt werden, wodurch die Akkumulation des Kontrastmittels im Detail in anatomischer Umgebung dargestellt werden kann. Da es sich hierbei um einen Vorteil gegenüber anderen Kontrastmittel-basierten MR Bildgebungsmethoden wie Eisenoxid Nanopartikel gestützter Kernspintomografie handelt, wurden nachfolgende Experimente mit Perfluorcarbon Emulsionen durchgeführt. Studien zur Bildgebung der Perfluorcarbon Akkumulation am Infektionsherd des Muskelabszessmodels von S. aureus in der Maus zeigten deutliches 19F MR Signal nach Gabe zwischen Tag 2 und Tag 8 p.i.. In allen untersuchten Tieren zeigte sich eine Ansammlung des Kontrastmittels in Form einer Hohlkugel um den Abszessbereich, wobei das Signal während der gesamten Infektion stabil war. Um den Akkumulationsmechanismus zu identifizieren, wurden Durchflusszytometrie-, Zellseparations- und histologische Experimente durchgeführt. In diesem Zusammenhang erwiesen sich Neutrophile, Makrophagen, Monozyten und Dendritische Zellen als Perfluorcarbon-tragende Immunzelltypen, wobei das Gros an Kontrastmittel in Neutrophilen nachgewiesen werden konnte. Im Allgemeinen war der Großteil des Perfluorcarbonsignals mit Immunzellen assoziert, weshalb eine spezifische Immunzell-abhängige Akkumulation wahrscheinlich erscheint. Die histologischen Untersuchungen stützten diese Beobachtung, da die Kontrastmittel assoziierten Fluoreszenzmarker nur in der Nähe von Immunzellnuclei gefunden werden konnten. Die Etablierung von 19F Kernspintomografie mit Perfluorcarbon Emulsionen als Infektionsbildgebungsmethode ermöglichte im nächsten Schritt die Untersuchung von antibakterieller Therapie auf das MR Signal, um die Eignung dieser Methode für die Präklinik zu evaluieren. Deshalb wurden die Wirksamkeit von Vancomycin und Linezolid, zweier klinisch höchst relevanter Antibiotika zur Behandlung von S. aureus Infektionen, im Muskelabszessmodel der Maus untersucht. Beide erwiesen sich als effizient in der Verringerung der bakteriellen Last im infizierten Muskel und des Bakterien-Biolumineszenzsignals, aber auch bei der Reduktion der Stärke und des Volumens der Perfluorcarbon Akkumulation am Infektionsherd, die durch 19F Kernspintomografie dargestellt und vermessen wurde. Alle drei Methoden zeigten dabei das gleiche Effizienzmuster nach dem Linezolid wirksamer bei der Bekämpfung der Infektion war. Folglich erwies sich 19F Kernspintomografie mit Perfluorcarbon Emulsionen als effektiv um den antibakteriellen Effekt von Antibiotika in präklinischen Modellen zu untersuchen. Konsequenterweise wurde im nächsten Schritt eine neuartige Substanz zur Behandlung von S. aureus Infektionen mit Hilfe der Bildgebungsplattform untersucht: Lyostaphin. Diese Endopeptidase schneidet spezifisch die Zellwand von S. aureus und wurde in verschiedenen Konzentrationen oder in Kombination mit Oxacillin im Muskelabszess- oder Katheterinfektionsmodell der Maus gestestet. Lysostaphin in der Konzentration von 5 mg/kg Körpergewicht (Maus) oder Lysostaphin in der Konzentration von 2 mg/kg in Kombination mit Oxacillin führten zu einer starken Verringerung der Bakterienlast und des Biolumineszenzsignals in beiden Modellen. Die Ansammlung von Perfluorcarbon Kontrastmittel war zudem in diesen beiden Gruppen stark reduziert im Vergleich zur Negativkontrolle und den mit Vancomycin und Oxacillin behandelten Tieren. Zusammenfassend kann festgestellt werden, dass Lysostaphin eine vergleichbare oder bessere Wirksamkeit als Vancomycin oder Oxacillin alleine lieferte. Aus diesem Grund scheint eine Weiterentwicklung dieser Substanz zur Behandlung von S. aureus empfohlen. Der Nutzen der Bildgebungsplattform wurde in diesen Experimenten zudem dadurch deutlich, dass alle drei Methoden zur Bestimmung der Schwere der Erkrankung ähnliche Wirksamkeiten der Antibiotika anzeigten. Dennoch muss festgestellt werden, dass die Gruppen, die Oxacillin entweder alleine oder in Kombination mit Lysostaphin erhielten, stärkere Perfluorocarbon Akkumulation am Infektionsherd aufwiesen als von den Bakterienlast- oder Biolumineszenz-Ergebnissen zu erwarten gewesen wäre. Ein Grund hierfür könnten mögliche immunomodulatorischen Effekte von Oxacillin sein. Tatsächlich zeigten weitere Experimente Variationen in den Konzentrationen von Cytokinen und Chemokinen im infizierten Muskel in Abhängigkeit der verwendeten Antibiotikatherapie. Besonders die Behandlung mit Oxacillin, in geringerem Maße aber auch mit Minocyclin oder Linezolid, führte zu erhöhten Konzentrationen, wenngleich die Bakterienlast deutlich reduziert werden konnte. Folglich sollten mögliche immuno-modulatorischen Effekte antibakterieller Substanzen bei zukünftiger Anwendung von Bildgebungsplattform, die auf dem Markieren von Immunzellen basieren, mit ins Kalkül gezogen werden. Auf der anderen Seite eröffnet diese Beobachtung ein neues Anwendungsfeld für diese Bildgebungsmethoden, da es außerordentlich interessant erscheint, damit immuno-modulatorische Substanzen oder bakterielle Faktoren in vivo zu untersuchen. Zu guter Letzt, ermöglicht diese Bildgebungsplattform, die Methoden zur Darstellung der bakteriellen Last auf der einen und des Immunsystems auf der anderen Seite verknüpft, eine innovative, neue Möglichkeit Wirt-Pathogen Interaktionen nicht-invasiv und in vivo studieren zu können. Zusammenfassend konnte gezeigt werden, dass Perfluorcarbon Emulsionen in Immunzellen am Infektionsherd des S. aureus Muskelabszessmodells der Maus akkumulieren. Die Ansammlung formt eine Hohlkugel am Rand des Abszessbereiches, deren Größe und Fluorgehalt von der Schwere der Erkrankung und/oder der Wirksamkeit der angewandten Antibiotikatherapie abhängt. Aus diesem Grund erwies sich 19F Kernspintomografie mit Perfluorcarbon Emulsionen als Kontrastmittel als nützliche Platform zur präklinischen Evaluierung antibakterieller Substanzen. Weiterhin erscheint diese Methode wegen der Akkumulation des Kontrastmittels in Immunzellen, als interessant zum Studium der Immunantwort gegenüber Infektionen, aber auch Krebs oder Autoimmunerkrankungen sowie zur Erforschung von immuno-modulatorischen Substanzen und Impfansätzen

AbstractFluorinated compounds feature favorable toxicity profile and can be used as a contrast agent for magnetic resonance imaging and spectroscopy. Fluorine nucleus from fluorinated compounds exhibit well-known advantages of being a high signal nucleus with a natural abundance of its stable isotope, a convenient gyromagnetic ratio close to that of protons, and a unique spectral signature with no detectable background at clinical field strengths. Perfluorocarbon core nanoparticles (PFC NP) are a class of clinically approved emulsion agents recently applied in vivo for ligand-targeted molecular imaging. The objective of this chapter is to outline a multinuclear 1H/19F MRI protocol for functional kidney imaging in rodents for mapping of renal blood volume and oxygenation (pO2) in renal disease models.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This experimental protocol chapter is complemented by a separate chapter describing the basic concept of functional imaging using fluorine (19F) MR methods.