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Title:
Methods and compositions for blood pool identification, drug distribution
quantification and drug release verification
United States Patent: 7,672,704
Issued: March 2, 2010
Inventors: Viglianti;
Benjamin L. (Durham, NC), Dewhirst; Mark W. (Durham, NC), MacFall; James
R. (Graham, NC), Vujaskovic; Zeljko (Chapel Hill, NC)
Assignee: Duke University
(Durham, NC)
Appl. No.: 10/661,977
Filed: September 11, 2003
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Training Courses -- Pharm/Biotech/etc.
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Abstract
Methods and compositions useful for
detecting an in vivo blood pool, monitoring the distribution of a compound
of interest to a desired site in an organism by magnetic resonance
imaging, monitoring the accumulation of a compound of interest at a
desired site in vivo by magnetic resonance imaging, and monitoring the
release of liposomal contents to an external stimulus at a desired site in
vivo by magnetic resonance imaging are disclosed. Some compositions
comprise envirosensitive or non-sensitive liposomes. Contrast agents, such
as manganese-based compounds, are also disclosed.
Description of the
Invention
II. General Considerations
One aspect of the present disclosure involves magnetic resonance-based
techniques in general, and magnetic resonance imaging techniques in
particular. The magnetic resonance imaging techniques employed herein are
known and are described, for example, in Kean & Smith, (1986) Magnetic
Resonance Imaging: Principles and Applications, Williams and Wilkins,
Baltimore, Md. U.S.A. Representative MR techniques include, but are not
limited to, magnetic resonance imaging ("MRI"), nuclear magnetic resonance
("NMR") and electronic spin resonance ("ESR").
Standard MR equipment, conditions and techniques can be used to generate
images. Appropriate equipment, conditions and techniques can be determined
in the course of experimental design. When in vivo MRI experiments are
performed in the context disclosed herein, they can be performed on any
suitable MRI instrument, such as a 1.5 Tesla or higher whole-body scanner.
According to known principles, nuclei with appropriate spin, when placed
in an applied magnetic field (B.sub.0, expressed generally in units of
Tesla) align in the direction of the field. In the case of protons, these
nuclei precess at a frequency, f, of 42.6 MHz, at a field strength of 1
Tesla (T). At this frequency, an RF pulse of radiation will excite the
nuclei and can be considered to tip the net magnetization out of the field
direction, the extent of this rotation being determined by the pulse
energy (which can be obtained by integrating a time.times.amplitude
curve). After the RF pulse, the nuclei "relax" or return to equilibrium
with the magnetic field, emitting radiation at the resonant frequency. The
decay of the emitted radiation is characterized by two relaxation times,
i.e., T.sub.1, the spin-lattice relaxation time or longitudinal relaxation
time, that is, the time taken by the nuclei to return to equilibrium along
the direction of the externally applied magnetic field, and T.sub.2, the
spin-spin relaxation time associated with the dephasing of the initially
coherent precession of individual proton spins. These relaxation times
have been established for various fluids, organs and tissues in different
species of mammals.
MRI is a diagnostic and research procedure that uses a large,
high-strength magnet and radio frequency signals to produce images. The
most abundant molecular species in biological tissues is water. It is the
quantum mechanical "spin" of the water proton nuclei that ultimately gives
rise to the signal in standard imaging experiments. Other nuclei can be
employed in MRI applications, however low signal-to-noise (S/N) ratios are
a consideration in these applications. In an MRI experiment, the sample to
be imaged is placed in a strong static magnetic field (on the order of
1-12 Tesla) and the spins are excited with a pulse of radio frequency ("RF")
radiation to produce a net magnetization in the sample. Various magnetic
field gradients and other RF pulses then act on the spins to code spatial
information into the recorded signals. The basic MRI experiment can be
described, in one frame of reference, as follows. Pre-RF pulse spins can
be thought of as collectively aligned along the Z-axis of a Cartesian
coordinate system; application of one or a sequence of RF pulses "tip" the
spins into the X-Y plane, from which position they will spontaneously
relax back to the Z-axis. The relaxation of the spins is recorded as a
function of time. Using this basic experiment, MRI is able to generate
structural information in three dimensions in a relatively short period of
time.
By applying magnetic field gradients so that the magnitude of the magnetic
field varies with location inside the subject-receiving space
characteristics of the magnetic resonance signals from different locations
within the region, such as the frequency and phase of the signals, can be
made to vary in a predictable manner depending upon position within the
region. Thus, the magnetic resonance signals are "spatially encoded" so
that it is possible to distinguish between signals from different parts of
the region. After repeating this procedure with various different
gradients, it is possible to derive a map showing the intensity or other
characteristics of the magnetic resonance signals versus position within
the excited region. Because these characteristics vary with concentration
of different chemical substances and other characteristics of the tissue
within the subject's body, different tissues provide different magnetic
resonance signal characteristics. When the map of the magnetic resonance
signal characteristics is displayed in a visual format, such as on screen
or on a printed image, the map forms a visible picture of structures
within the patient's body.
Two characteristic relaxation times are implicated in magnetic relaxation,
the basis for MRI. T.sub.1 is defined as the longitudinal relaxation time,
and is also known as the spin lattice relaxation time (1/T.sub.1 is a rate
constant, R.sub.1, the spin-lattice relaxation rate constant). T.sub.2 is
known as the transverse relaxation time, or spin-spin relaxation
mechanism, which is one of several contributions to T.sub.2 (1/T.sub.2 is
also a rate constant, R.sub.2, the spin-spin relaxation rate constant).
T.sub.1 and T.sub.2 have inverse and reciprocal effects on image
intensity, with image intensity increasing either by shortening the
T.sub.1 or lengthening the T.sub.2.
In another aspect, the presently disclosed subject matter involves the use
of the technique commonly referred to as "hyperthermia". Hyperthermia,
generally, is a technique for locally heating a site of interest to a
temperature above normal body temperature. Hyperthermia is an established
technique and forms the basis of several therapeutic regimens. For
example, typical localized-hyperthermia temperatures required for
therapeutic treatment of cancer are in the 42.5-45.degree. C. range, which
is maintained for approximately 30 to 60 minutes. Healthy tissue,
generally, should be kept at temperatures below 42.5.degree. C. during the
treatment. For targeted chemotherapy drug delivery, temperatures in the
range of about 40 to 45.degree. C. have been demonstrated to be effective
on tumors.
In another aspect of the presently disclosed subject matter, a composition
(e.g., an envirosensitive or non-sensitive liposome composition) can be
introduced into a biological structure disposed in a subject. The mode of
administration of a composition to a sample or subject can determine the
sites and/or cells in the organism to which an agent will be delivered.
The compositions can be administered in admixture with a pharmaceutical
diluent (e.g., a buffer) selected with regard to the intended route of
administration and standard pharmaceutical practice. The compositions can
be injected into a subject parenterally, for example, intra-arterially or
intravenously. For parenteral administration, a preparation can be used,
e.g., in the form of a sterile, aqueous solution; such a solution can
contain other solutes, including, but not limited to, salts or glucose in
quantities that will make the solution isotonic. In another aspect, a
composition can be injected directly into a tumor. In this aspect, the
preparation will be injected in accordance with the above guidelines.
When a composition is administered to humans, the supervising physician or
clinician will ultimately determine the appropriate dosage for a given
human subject, and this can be expected to vary according to the weight,
age and response of the individual as well as the nature of the patient's
condition.
III. Contrast Agents
Paramagnetic contrast agents serve to modulate tissue (or intrinsic)
T.sub.1 and/or T.sub.2 values, and are typically designed with regard to a
given metal nucleus, which is usually selected based on its effect on
relaxation. The capacity to differentiate between regions or tissues that
can be magnetically similar but histologically different is a major
impetus for the preparation of these agents. Paramagnetic contrast agents
provide additional image contrast, and thus enhanced images, of those
areas where the contrast agent is localized. For example, contrast agents
can be injected into the circulatory system and used to visualize vascular
structures and abnormalities (see, e.g., U.S. Pat. No. 5,925,987), or even
intracranially to visualize structures of the brain.
The measured relaxivity of the contrast agent is dominated by the
selection of the metal atom. Paramagnetic metal ions, as a result of their
unpaired electrons, act as potent relaxation enhancement agents. They
decrease the T.sub.1 relaxation times of nearby spins, exhibiting an
r.sup.6 dependency, where r is the distance between the two nuclei. Some
paramagnetic ions decrease the T.sub.1 without causing substantial
linebroadening, for example copper(II) ("Cu(II)"), zinc(II) ("Zn(II)"),
gadolinium(III) ("Gd(III)") and manganese(II) ("Mn(II), while others
induce drastic linebroadening, for example, superparamagnetic iron oxide.
The mechanism of T.sub.1 relaxation is generally a through-space
dipole-dipole interaction between the unpaired electrons of a metal atom
with an unpaired electron (the paramagnet) and those water molecules not
coordinated to the metal atom that are in fast exchange with water
molecules in the metal's inner coordination sphere.
When designing or selecting a liposome composition according to the
present disclosure, an appropriate paramagnetic ion can be selected as a
contrast agent. Any compound that affects the recovery of the magnetic
moment of the water protons to the magnetic field, thereby reducing the
T.sub.1 and T.sub.2 relaxation times of an object of interest is suitable
for use as a contrast agent with the methods and compounds disclosed
herein. Some example metal ions suitable for use include, but are not
limited to, the transition, lanthanide and actinide elements. For example,
the metal ion is selected from the group consisting of Gd(III), Cu(II),
Cr(III), Fe(II), Fe(III), Co(II), Er(II), Ni(II), Eu(III), Dy(III), Zn(II),
Mg(II), Mo(III), Mo(VI), Li(I), Ta(V), and Mn(II).
IV. Liposome Compositions
Drug delivery systems have been developed in which a drug-entrapping
liposome composition is intravenously administered and delivered to a
particular target site in the subject's body (see, e.g., Gregoriadis et
al.; (1980) Receptor-mediated Targeting of Drugs, Plenum Press, New York,
pp. 243-266). A requirement of such systems is that the liposome
composition, after being intravenously or intra-arterially administered,
should stably circulate along with blood in the subject's body for a
longer period of time than provided by conventional systems.
Liposomes are generally not very stable in blood due to interactions
between the liposomes' membrane component lipid and blood components such
as lipoprotein. Also, intravenously and intra-arterially administered
liposomes are sometimes recognized as a foreign substance by the
reticuloendothelial system (RES) and are thus likely to be removed from
the blood, due to the liposomes' physical morphology and biochemical
properties.
Significant efforts have been devoted to solving the problem of
stabilizing liposomes in blood to avoid recognition by the RES, and thus,
to enhance the liposomes' effective lifetime in the blood. For example,
one paper reports a case in which cholesterol was added to liposome
membrane composition to increase blood liposome stability (Knight; (1981)
Liposomes: From physical structure to therapeutic applications, Elsevier,
North Holland, pp. 310-311). However, the effect thus obtained varies
widely depending on the original membrane composition of the liposome
(Senior et al., (1985) Biochim. Biophys. Acta 839: 1-8). It has been
reported that sialic acid-containing glycolipid, when administered as
liposome, is distributed to the liver, a component of the RES (Surolia &
Bachhawat, (1977) Biochim. Biophys. Acta 497: 760-765). It has also been
reported that a drug was delivered into the brain after increasing the
liposome's ability to pass through the blood brain barrier by
functionalizing it with sulfatide, a glycolipid and a sulfo group (Naoi &
Yagi, (1984) Biochem. Int. 9: 267-272).
Recently, thermosensitive liposomes--liposomes that are stable at
mammalian body temperature but become less stable at temperatures higher
than mammalian body temperature--have been employed to encapsulate
chemotherapy agents and to release these agents into heated tissue (see,
e.g., U.S. Pat. No. 6,200,598 to Needham et al., incorporated in its
entirety herein by reference). For example, successful targeted
chemotherapy delivery to brain tumors in animals using thermosensitive
liposomes has been demonstrated (Kakinuma et al., (1996) Int. J. Hyperther.
12(1): 157-165). The results of this study indicated that when
thermosensitive liposomes are employed as a drug carrier, significant
chemotherapy drug levels were measured within brain tumors that were
heated to the range of about 41 to 44.degree. C. One formulation for a
thermosensitive liposome is described in U.S. Pat. No. 5,094,854,
incorporated in its entirety herein by reference.
In one aspect, the presently disclosed methods and compositions comprise
envirosensitive or non-sensitive liposomes, e.g. thermosensitive and
non-thermally sensitive liposome compositions. These liposomes can
comprise virtually any particular combination of lipids, and can further
comprise proteins, carbohydrates and other types of compounds as well.
Some representative, but non-limiting liposome compositions are presented
in the following sections and in the Laboratory Examples. Methods of
forming the liposomes are also described herein. Generally, the same
procedure can be employed for forming both envirosensitive and
non-sensitive liposomes (e.g. thermosensitive and non-thermally sensitive
liposomes), with one difference being the lipid composition of the
liposome.
IV.A. Preparing Non-Sensitive and Envirosensitive Liposomes
Envirosensitive or non-sensitive liposomes can be prepared utilizing
techniques such as those employed in the art for conventional liposome
preparation. Such conventional techniques are referred to, for example, in
Published PCT International Application Serial No. WO 92/21017 and by
Papahadjopolous (Papahadiopolous, (1979) Ann. Rep. Med. Chem. 14: 250-260)
and include reverse evaporation, freeze-thaw, detergent dialysis,
homogenization, sonication, microemulsification and spontaneous formation
upon hydration of a dry lipid film. In one embodiment, a film of the lipid
is deposited on a glass coverslip and then incubated in a sucrose solution
for a predetermined time, such as 12 hours. A thin film of lipid is then
deposited on the inside of a round bottom flask and then rehydrated at a
temperature above its phase transition temperature (T.sub.m). Then, the
hydrated lipids are sonicated in order to form liposomes.
Thermosensitive liposomes can be formed from a combination of lipids.
Although almost any combination of lipids can be employed so long as the
desired functional characteristic(s) is/are obtained, in one example, a.
thermosensitive liposome comprises dipalmitoylphosphatidylcholine-polyethylene
glycol (DPPC-PEG.sub.2000). In another example, a thermosensitive liposome
comprises
dipalmitoylphosphatidylcholine-distearoylphosphatidylethanolamine-polyeth-
ylene glycol (DPPC-DSPE-PEG.sub.2000) (95:5, mol:mol), and in yet another
example, a thermosensitive liposome comprises
polyenylphosphatidylcholine-MSPC-distearoylphosphatidylethanolamine-polye-
thylene glycol (DPPC-MSPC-DSPE-PEG.sub.2000) (90:10:4, mol:mol).
Other embodiments of envirosensitive liposomes include, but are not
limited to radiation-sensitive liposomes. The radiation-sensitive
liposomes disclosed herein can be formed from a combination of lipids.
Although almost any combination of lipids can be employed so long as the
desired functional characteristic(s) is/are obtained, in one example, a
radiation-sensitive liposome comprises dipalmitoylphosphatidylcholine (DPPC),
distearoylphosphatidylcholine (DSPC), or diarachidoylphosphatidylcholine-polyethylene
glycol (DAPC) in combination with PEG. In another example, cholesterol is
added to one or more of these formulations. The addition of cholesterol
reduces membrane fluidity and increases membrane integrity.
The radiation-sensitive formulations can further incorporate a
radiation-sensitive lipid, which is selected based on the desired
wavelength sensitivity. Thus, in one embodiment, liposomes can be made
radiation-sensitive by the incorporation into the liposome wall
radiation-sensitive lipids that undergo substantial alterations, such as
isomerization, fragmentation or polymerization, upon interation with a
particular wavelength range of electromagnetic radiation. For example,
incorporation of polymerizable lipids such as
1,2-bis[10-(2',4'-hexadienoyloxy)decanoyl]-sn-glycero-3-phosphocholine (bis-SorbPC),
react directly with ultraviolet radiation in the presence of oxygen to
form cross-linked polymer networks that significantly alter bilayer
properties in the liposome wall, resulting in destabilization of the
liposome and release of its contents (Bondurant et al., (2001) Biochimica
et Biophysica Acta 1511: 113-122). Spratt et al. have further shown that
using a specific bis-SorbPC (bis-SorbPC.sub.19,19) will increase
reactivity to ultraviolet radiation by a magnitude of at least two orders
(Spratt et al., (2003) Biochimica et Biophysica Acta 1611: 35-43.
Sensitivity to other wavelength ranges of electromagnetic radiation can be
achieved by incorporation of any of a variety of other sensitive lipids or
even other non-lipid radiation-sensitive molecules. For example, visible
light-sensitive liposomes can be formulated by incorporating dyes into the
liposome walls. In one embodiment, ballasted cyanine dyes, such as
distearoyl indocarbocyanine, in combination with polymerizable lipids,
such as bis-SorbPC, are incorporated into liposome walls to produce
light-sensitive liposomes that release their contents when contacted with
visible light (green wavelength) (Mueller et al., (2000) Macromolecules
33: 4799-4804).
For in vivo biological applications, it can be desirable to use radiation
at wavelengths less absorbable by biomolecules than visible or ultraviolet
light. Therefore, liposomes incorporating molecules providing
radiation-sensitivity at other wavelengths, such as ionizing radiation
(e.g. x-rays), or long wavelength radiation (e.g. near-infrared or
infrared) can also be formulated similarly to the previously described
radiation-sensitive liposomes. One of skill in the art would thus
appreciate that radiation-sensitive liposomes providing sensitivity across
the electromagnetic spectrum are encompassed by the methods and
compositions described herein.
Also included in the methods and compositions described herein are
pH-sensitive liposomes. As discussed for thermosensitive liposomes, almost
any combination of lipids can be employed so long as the desired
characteristics of pH-sensitivity at a particular pH range are obtained.
Numerous pH-sensitive liposomes are known and described in the art (see
e.g. Litzinger & Huang, (1992) Biochim Biophys Acta 1113: 201-227). In one
example, dipalmitoyl phosphatidyl ethanolamine/palmitic acid provides a
useful pH-sensitive liposome formulation (Lokling et al., (2001) Magnetic
Resonance Imaging 19: 731-738 and Lokling et al., (2003) Magnetic
Resonance Imaging 21:531-540). Other formulations having similar
properties are also encompassed by the present disclosure. Representative
lipid compositions of non-sensitive liposomes include the thermosensitive
liposome formulations disclosed herein, with the exception that the
non-sensitive formulations often include cholesterol in varying amounts.
For example, a non-sensitive liposome can comprise
dipalmitoylphosphatidylcholine/cholesterol (DSPC/Cholesterol) (55:45,
mol:mol).
Envirosensitive as well as non-sensitive liposomes can be prepared by
extrusion methods. Lipids, at certain ratios, such as those described
above, can be dissolved in a chloroform-methanol mixture. The solvent can
then be removed under a gentle stream of nitrogen gas and the lipid
samples subsequently placed under a high vacuum for a time period of at
least 4 hours to remove any residual solvent.
The dried samples can then be hydrated such that the final lipid
concentration is, for example, about 100 mg/mL. In one embodiment,
hydration can be achieved by contacting the dried samples with 300 mM
MnSO.sub.4 (a contrast agent) adjusted to pH 3.5 by addition of
hydrochloric acid. Hydration of the lipid can be performed at a suitable
temperature for a desired period of time, for example 55.degree. C. for
approximately 30 minutes, and generates multilamellar vesicles (MLVs).
Following hydration, MLVs can be extruded 10-times through stacked
polycarbonate filters of 0.1 and 0.08 .mu.m pore size at 55.degree. C.
using a water-jacketed extrusion apparatus, such as an EXTRUDER.TM.
apparatus (Northern Lipids Inc., Vancouver, British Columbia, Canada).
Extrusion of the MLVs results in liposomes that are ready for loading.
Following preparation, the mean size distribution of a liposome
preparation can be determined. For some preparation, a NICOMP Submicron
Particle Sizer Model 270 (Pacific Scientific, Santa Barbara, Calif.,
United States of America) operating at 632.8 nm can be employed, although
other methods and apparatuses can also be employed. Phospholipid can also
be quantitated, for example by employing a known assay such as the Fiske
and Subbarow phosphate assay (Fiske & Subbarow, (1925) J. Biol. Chem. 2:
375-395)
Once an envirosensitive or non-sensitive liposome is prepared, the
liposome can be loaded with a contrast agent and/or a compound of
interest, such as a drug.
Envirosensitive and non-sensitive liposomes can be loaded with a contrast
agent and/or a compound of interest by employing any of a range of
techniques known in the art. Various methods include osmotic loading, pH
gradient-based loading and ionic gradient-based loading (Kulkarni et al.,
(1995) J. Microencapsul. 12(3): 229-46).
In one embodiment, for example, liposome loading can be achieved by
fractionating a liposome preparation on a SEPHADEX.RTM. G-50 (Amersham
Biosciences, Piscataway, N.J., United States of America) column. For the
fractionation, 1 mL sample volumes can be placed on a column with at least
a 20 mL column bed that has been equilibrated with 500 mM sucrose/20 mM
HEPES (N-[2-hydroxyethyl] piperazine-N'-[2-ethanesulfonic acid]) buffer at
pH 7.5.
Following fractionation, contrast agent and/or a compound of interest can
be loaded by generally following the method described by Abraham et al.
(Abraham et al., (2002) Biochim. Biophys. Acta 1565: 59-72).
Alternatively, in another embodiment, liposomes can be loaded using a pH
gradient-based technique, such as described by Mayer et al. (Mayer et al.,
(1985) J. Biol. Chem. 260(2): 802-808). Generally, MLVs are produced by
extrusion in the presence of K.sup.+ and then placed in a Na.sup.+ buffer
to create a transmembrane Na.sup.+/K.sup.+ gradient with K.sup.+
concentrated within the vesicle and Na.sup.+ outside the vesicle. A
contrast agent and/or a compound of interest in the buffer solution is
accumulated at high concentrations within the liposome as a result of the
transmembrane gradient. The rate of uptake of the contrast agent and/or
compound of interest can be increased by the presence of an ionophore,
such as, for example, valinomycin. Uptake is also sensitive to pH with
this system, and can be maximized based on the pK of the contrast agent
and/or compound of interest.
By way of example, loaded thermosensitive liposomes can be stored at
4.degree. C. for 3-4 days. Loaded non-sensitive liposomes can be stored
for about 1-3 weeks at 4.degree. C. Envirosensitive and non-sensitive
liposomes that have not been loaded can be stored for about 3-4 weeks at
4.degree. C. Unloaded envirosensitive and non-sensitive liposomes can also
be lyophilized and stored in that form.
This approach can be employed in the preparation of envirosensitive and
non-sensitive liposomes. After liposomes are loaded, they can be stored in
a suitable buffer solution and will be immediately ready for use without
further preparation.
V. Applications
The presently disclosed methods and compositions can be employed in a
variety of applications. Several of these applications are described in
detail hereinbelow. Additional applications of the presently disclosed
methods and compositions will be apparent to those of ordinary skill in
the art upon consideration of the present disclosure.
In the following applications, standard magnetic resonance imaging
apparatus and methodology can be employed, as would be apparent to those
of ordinary skill in the art after a review of the present disclosure.
V.A. Monitoring the Accumulation of a Compound of Interest at a Desired
Site In Vivo
In one application, a method of monitoring the accumulation of a compound
of interest at a desired site in vivo by magnetic resonance imaging is
disclosed. This application can be useful for tracking the delivery of a
compound of interest to a site of interest, for example a tumor and for
assuring that the compound of interest is delivered to the site in useful
quantities.
In one embodiment, the method comprises increasing blood flow to a site of
interest. As noted herein, a site of interest can be a tumor. In other
examples, a site of interest can comprise a biological organ, such as the
brain, liver, kidney or eye. In yet other examples, a site of interest can
comprise a specific region or structure associated with the vasculature of
a subject, or can even comprise the subject's vascular system in its
entirety.
After selecting a site of interest, blood flow is increased to the site of
interest. Heating can be used as an effective approach for increasing the
blood flow to the site of interest. The heat results in vasodilation at
the desired site and a subsequent increase in blood flow to the site.
Heating can be achieved by employing any of a variety of techniques. For
example, a site can be heated by RF energy, via application of ultrasonic
energy or by conduction-based heating methods. When conduction-based
heating methods are employed, one convenient method of heating is by
contacting the site of interest with a catheter that is heated to a
desired temperature, for example, with circulating water. When a site of
interest is near an exposed surface of the subject (e.g., skin or eye), a
laser can also be employed to heat the site.
A subject is then administered a non-sensitive liposome composition
comprising (i) a contrast agent; (ii) a compound of interest; and (iii) a
non-sensitive liposome encapsulating the contrast agent and the compound
of interest.
Administration can be by an approach adapted to introduce the
non-sensitive liposome composition into the bloodstream of the subject.
For example, the administration can be by injection into an artery or
vein. In one particular example, when a subject is a rat (for example, a
Fisher 344 female strain rat), a liposome composition can be injected into
the tail vein or femoral vein of the rat. Thus, administration can be, for
example, via intravenous, intramuscular, intraperitoneal, intra-tumoral or
subcutaneous intra-lesional injection.
A contrast agent can comprise any paramagnetic nucleus containing
material, as disclosed herein above. Compounds comprising transition,
lanthanide and actinide elements can also be employed. For example, a
contrast agent can comprise an atom of an inner block element, e.g. a
manganese atom. A contrast agent can also comprise a chemical moiety
associated with the atom, such as a sulfate moiety, in which case a
contrast agent can comprise MnSO.sub.4, which exhibits a linear
relationship between concentration and 1/T.sub.1 (see FIG. 1B (see Original Patent))
and 1/T.sub.2.
A compound of interest can comprise any compound. For example, a compound
of interest can comprise a pharmaceutically active compound, such as a
chemotherapeutic compound (e.g. methotrexate, doxorubicin, cisplatinum,
carboplatinum). A compound of interest can also comprise a compound
suspected of being pharmaceutically active. In other cases, a compound of
interest can generally comprise a compound known or suspected of
modulating one or more biological processes. For example, a compound of
interest can be a polypeptide or a polynucleotide. A non-sensitive
liposome composition also comprises a non-sensitive liposome encapsulating
the contrast agent and the compound of interest. Compositions of
non-sensitive liposomes are disclosed herein, as are methods for preparing
and loading the liposomes.
Continuing with the present embodiment, the accumulation of the compound
of interest at the site of interest is monitored by magnetic resonance
imaging. As the non-sensitive liposomes that have been administered to the
subject circulate in the bloodstream of the subject, they will tend to
accumulate at the site of heating. Over a given time interval, the
presence of the liposomes at the heated site will increase. Thus, as time
progresses, the presence of contrast agent at the heated site will
concomitantly increase (see FIG. 2A (see Original Patent)), since the
contrast agent is encapsulated in the non-sensitive liposomes.
Magnetic resonance images of the heated site can be continuously and
regularly generated, as depicted in FIG. 2A (see Original Patent). Methods
of acquiring magnetic resonance images are established and can be employed
to generate magnetic resonance images of a heated site. A sequence of
images of the heated site shows the accumulation of the contrast agent at
the heated site and in the areas surrounding the heated site (see FIG.
2A). Since the contrast agent and the compound of interest are both
encapsulated in the non-sensitive liposome, the accumulation of the
contrast agent is directly proportional to the accumulation of the
compound of interest.
As depicted in FIG. 2A, accumulation of the contrast agent at a heated
site is evidenced by an increase in the appearance of white pixels in a
timecourse series of images. For example, in FIG. 2A at time point 0,
immediately after injection of a non-sensitive liposome composition, in
particular, a thermoinsensitve liposome composition, there is no contrast
agent found at the site of the tumor, which is heated by hot water flowing
through a catheter, shown as a black spot in the image. At time point 1,
contrast agent, and thus the compound of interest, which is encapsulated
with the contrast agent, is accumulating at the periphery of the tumor.
This is evidenced by the appearance of white pixelation at the tumor edge.
At time point 2, the concentration of contrast agent and compound of
interest is increased. At time point 3, the intensity of pixelation is
seen to slightly increase over the concentration at time point 2. By way
of comparison, no contrast agent or compound of interest is seen to appear
in areas that are not heated.
It is noted that as the non-sensitive liposome compositions accumulate at
the heated site, they remain structurally coherent and the contents of the
liposomes, namely a contrast agent and a compound of interest, remain
inside the liposome. Thus, the accumulation of the compound of interest at
a heated site can be monitored.
As FIG. 2A demonstrates, this technique can be performed in vivo, with the
liposomes eventually being cleared by the renal and/or hepatic systems of
the organism. It is possible to perform the method in vitro, on a tissue
culture, for example, but most commonly the method will be performed in
vivo on a subject.
V.B. In Vivo Method of Monitoring the Localization and Distribution of a
Compound of Interest to a Desired Site in a Subject
Difficulties in delivering drugs to solid tumors in the human body have
been documented in the art. For example, abnormal vessels in tumors can
restrict local blood flow in tumors and, hence, impede the delivery of
drugs to the tumor. Abnormally elevated interstitial pressure within the
tumor is also known to retard the passage of drug molecules from the blood
stream into the tumor (Baxter & Jain, (1989) Microvasc. Res. 37(1):
77-104; Baxter & Jain, (1990) Microvasc. Res. 40(2): 246-63; Baxter & Jain,
(1991) Microvasc. Res. 41(1): 5-23; Baxter & Jain, (1991). Microvasc. Res.
41(2): 252-72)
Effective cancer chemotherapy depends on delivery of therapeutic drugs to
cancer cells at cytotoxic concentrations. Due to the inherent perfusion
limitations that tumors present, delivery of drugs can be hindered. The
ability to monitor and/or predict in vivo concentration distributions
could improve treatment. Thus, in one aspect of the present disclosure,
envirosensitive liposomes can be employed for in vivo monitoring of drug
release and distribution from an envirosensitive liposome using MRI. In
vitro results disclosed herein (FIG. 1B (see Original Patent)) indicate
that T.sub.1 or T.sub.2 shortening correlates with contrast agent (e.g.,
MnSO.sub.4) concentration. Further, contrast agent release from
envirosensitive liposomes, for example thermosensitive liposomes,
significantly shortens T.sub.1 and T.sub.2 and thus can be used to monitor
content release.
The feasibility of using this drug delivery-imaging agent in vivo was
shown in a murine tumor model (FIGS. 2A-2E (see Original Patent)). These
experiments demonstrate that upon tumor heating, thermosensitive and
non-sensitive liposomes selectively collect at the site of the tumor, and
that thermosensitive liposomes release their contents. In addition, FIG.
2E shows that without heating, a less intense but more uniform signal
enhancement occurs, but then fades after five minutes as clearance from
the vasculature occurs. However, there is enhancement remaining in the
tumor (compared to baseline) indicating that some of the liposomes have
collected at the site. The thermosensitive and non-sensitive compositions
and methods of the present disclosure, facilitate clinical treatment by
providing individualized monitoring of tissue drug concentration
distribution. Individualized monitoring provides at least (1) the ability
to modify treatment variables to improve the uniformity of drug delivery;
and (2) the ability to select patients most likely to benefit from a
liposomal treatment as disclosed herein.
Additionally, the methods of loading envirosensitive and non-sensitive
liposomes disclosed herein are applicable to a wider spectrum of compounds
of interest (e.g., drugs) than was previously possible with pH loading
methods, thereby broadening its applicability to other formulations.
In accordance with the present disclosure, an in vivo method of monitoring
the distribution of a compound of interest to a desired site in an
organism by magnetic resonance imaging is disclosed. In one embodiment,
the method comprises increasing blood flow to a site of interest in a
subject by, for example, applying heat. The site can be heated by external
application of hot water, RF, ultrasound, or IR energy. Alternatively,
interstitial application of energy can be obtained using the same physical
methods. The heat results in vasodilation at the desired site and an
increase in blood flow to the site. Other methods of increasing
vasodilatation and blood flow to the site are also acceptable for
targeting the liposomes to a desired site. For example, direct mechanical
massage or ultrasound treatment to the site can increase blood flow
without the use of heat.
As described herein, a subject can be any living organism, for example, a
human, mouse, rat, or rabbit, or a subject can be derived from a living
organism and can comprise, for example, a tissue culture. A site of
interest can comprise any biological structure. For example, a site of
interest can comprise a tumor or an organ, such as a brain, liver, kidney,
stomach, eye or lung.
Continuing with this embodiment, a thermosensitive liposome composition
can be administered to the subject. Again, the administration can be by
convenient method, such as injection of the composition into a vein or
artery of the subject.
An envirosensitive liposome composition of the present disclosure
comprises a contrast agent; a compound of interest; and an envirosensitive
liposome encapsulating the contrast agent and the compound of interest.
The contrast agent can comprise any paramagnetic material, for example
MnSO.sub.4 or any compound comprising, for example, a transition element
or an inner block element. A contrast agent can comprise a paramagnetic
material complexed with an organic material (e.g., a chelator) or an
inorganic material (e.g., a sulfate moiety).
A compound of interest can comprise any compound. Such a compound can
comprise a chemotherapeutic agent, pharmaceutically active agent or an
agent suspect to be of therapeutic value to the subject. Doxorubicin is
employed as a non-limiting embodiment of such a compound in the Laboratory
Examples.
Additionally, one embodiment of the method comprises monitoring the
localization and distribution of the compound of interest to the desired
site by magnetic resonance imaging. The embodiment permits monitoring of
both localization to the site of interest and distribution of the compound
of interest to the site using magnetic resonance imaging. Distribution of
the compound of interest refers to release of the compound from the
liposome and dispersion of the compound at the site. The monitoring can be
conveniently achieved by acquiring magnetic resonance images at any
desired time point. Standard magnetic resonance techniques can be employed
to generate such images.
In one embodiment, envirosensitive liposomes in the form of
thermosensitive liposomes are used. The thermosensitive liposomes are
stable at temperatures near mammalian body temperature, about 37.degree.
C. The temperature of the heated site will be several degrees above
37.degree. C. As the thermosensitive liposomes travel to the heated site
(e.g., through the circulatory system of the subject), they will
accumulate at the heated site due, in part, to their size and release
their contents due to their thermoinstability.
After exposure to heat for a period of time, the thermosensitive liposomes
will become "leaky". That is, the thermosensitive liposomes will lose a
degree of structural integrity, allowing the contents of the liposomes,
namely a contrast agent and a compound of interest, to be released from
the thermosensitive liposome. The release of the contents of the
thermosensitive liposome can be tracked by monitoring an increase in the
presence of contrast agent at a range of points around a given structure.
The association of contrast agent with a structure is denoted by an
increase in the pixelation around the structure in a MR-generated image.
Turning now to FIG. 2B, application of one embodiment of the method is
depicted in a series of MR images. The images correspond to the effect of
injecting loaded thermosensitive liposomes into the tail vein of a rat.
The images generally depict association of contrast agent with the
periphery of a large flank tumor.
At time point 0, a thermosensitive liposome composition has been injected
into the circulatory system of the rat. The flank tumor is heated by
inserting a catheter heated with circulating water and appears as a black
spot in the upper left of the image.
At time point 1 (corresponding to about 15 minutes), the loaded
thermosensitive liposomes have accumulated at the heated site and have
released their contents. The association of the contrast agent with the
periphery of the tumor is evidenced by the pixelation (which appears white
in the figure) surrounding the tumor mass.
At time point 2 (corresponding to about 30 minutes), the pixelation is
seen to be more intense, indicating the further release of contrast agent
from the thermosensitive liposomes. The periphery of the tumor is even
more completely surrounded by contrast agent.
At time point 3 (corresponding to about 90 minutes), the pixelation is
less intense, indicating that the contrast agent is being cleared and the
concentration in the vicinity of the tumor is decreasing.
In addition, FIG. 2E shows that without heating, a less intense but more
uniform signal enhancement occurs, but then fades after five minutes as
clearance from the vasculature occurs.
In a similar embodiment, envirosensitive liposomes in the form of
radiation-sensitive liposomes are used. Like other envirosensitive
liposomes, including the previously described thermosensitive liposomes,
radiation-sensitive liposomes are stable under normal physiological
conditions.
The radiation-sensitive liposomes also travel to and accumulate at the
heated site due, in part, to their size. However, unlike thermosensitive
liposomes, the radiation-sensitive liposomes will not be expected to
release their contents when heated, unless the heat source is producing a
wavelength of electromagnetic radiation within the range of sensitivity of
the particular radiation-sensitive liposomes.
Instead, a source of electromagnetic radiation emitting radiation at a
wavelength within the range of sensitivity of the particular
radiation-sensitive liposomes is directed at the site, which then
interacts with susceptible lipids in the liposome wall. The sensitive
lipids then either isomerize, fragment or polymerize, which then causes
the liposomes to lose structural integrity and increase permeability, in
some formulations, sufficiently to release their contents. Namely, the
radiation-sensitive liposomes become permeable enough to at least allow
exchange of water across the membrane. The membrane in some formulations
will become sufficiently permeable to release the contained contrast agent
and/or compound of interest. As already described, the release of contents
can be tracked by monitoring the presence of contrast agent at a range of
points around a given structure.
One of skill in the art will appreciate that other liposome disruption
agents can be used, such as pH variance, depending on the disruption
characteristics of the particular envirosensitive liposome formulated.
In another aspect, drug release can also be quantified. One method of
quantifying drug release generally involves employing a plot of
concentration against 1/T.sub.1 or 1/T.sub.2 as a calibration curve.
Continuing with this embodiment, before a given experiment is performed,
the T.sub.1 of a pixel is measured. This T.sub.1 measurement can provide
additional information, including proton density and base line noise. If
all the imaging parameters (e.g., T.sub.r, PD, etc.) are kept constant,
which is typical in a dynamic study, a change in signal intensity at a
time point later than time t=0 is accompanied by a reduction in T.sub.1.
Such a change in T.sub.1 is indicative of localization and distribution of
a drug from an envirosensitive liposome composition. This reduction in
T.sub.1 can be converted to concentration using the plot of concentration
against 1/T.sub.1 as a standard curve for the corresponding compound.
Thus, observed changes in T.sub.1, which are associated with drug release,
can be translated into a released drug concentration by indexing the
observed T.sub.1 with a given concentration on a plot of concentration
against 1/T.sub.1.
V.C. Method of Detecting an In Vivo Blood Pool
Contrast agents with prolonged presence in the blood (i.e., good
resistance to uptake by RES and a relatively low diffusivity into the
tissue or extravascular locations) are recognized in the art as useful
"blood pool agents" (see, e.g., U.S. Pat. No. 5,464,696, herein
incorporated by reference in its entirety). Contrast agents exhibiting
long biological half-lives are sometimes desirable for the blood pool
agents if a researcher or clinician desires to produce meaningful
analytical results and to eliminate repeated injections and the repeated
use of a contrast agent.
Several attempts to produce compositions suitable for use as blood pool
agents have been made, including some for use with MRI (see, e.g., U.S.
Pat. Nos. 5,833,948; 5,464,696; 6,010,681; 5,961,953; and 5,888,476,
herein incorporated by reference in its/their entirety). Particularly,
there has been an ongoing effort to develop contrast agents with long
residence times in the blood circulation, that exhibit high relaxivity and
can be completely eliminated from the system of a subject (i.e., agents
that can be employed as "blood pool agents"). Some efforts have focused on
identifying and preparing paramagnetic substances encapsulated into
liposome vesicles, immobilized in the liposome membrane, copolymerized
with polyethylene glycol or grafted on a polymeric chain such as albumin,
dextran or polylysine. Examples of such compositions include
Gd-DTPA-albumin, Gd-DTPA-dextran or Gd-DTPA-polylysine complex molecules
(see, e.g., Ogan et al., (1987) Invest. Radiol. 22: 665; Wang et al.,
(1990) Radiology 175: 483; Schumann-Giampieri et al., (1991) Invest.
Radiol. 26: 969; Vexler et al., (1994) Invest. Radiol. 29 supl. 2: S62;
Dessler et al., (1994) Invest. Radiol. 29 supl. 2: S65; Meyer et al.,
(1994) Invest. Radiol. 29 supl. 2: S90; Shen et al., (1994) Invest. Radiol.
29 supl. 2: S217).
Notwithstanding, the half-life of contrast agents containing paramagnetic
species bonded to macromolecules is often too short to be convenient for
blood-pool imaging or have unexpected toxic side effects. In order to
solve this difficulty, the use of suspensions of liposomal microvesicles
containing encapsulated paramagnetic chelates as carriers of NMR contrast
agents has been proposed. Use of liposomes for carriers has been proposed
for relative biocompatibility and ease of preparation of liposomes and
their suspensions. Encapsulation of known paramagnetic contrast agents
into liposomes has been described (see, e.g., Unger et al., (1993) J. Mag.
Res. Imag. 3: 195-198).
These known compositions exhibit longer dwelling times in the blood than
the water-soluble metal complexes; however, their residence times in the
circulation are still not sufficient and some of these compounds have
shown unacceptable levels of toxicity for blood-pool imaging. Longer
residence times and lower immunogenicity have been reported by Bogdanov et
al. (Bogdanov et al., (1993) Radiology 187: 701) for
Gd-DTPA-MPEG-polylysine complexes which consist of a methoxy(polyethylene
glycol)-shielded macromolecular backbone (polylysine) bearing covalently
attached Gd-DTPA. However, these prior art compositions do not offer the
advantages of the compositions and methods disclosed herein.
Desirable properties of a blood pool agent include the ability to remain
in a subject's bloodstream for protracted periods of time. For contrast
agents administered into the systemic vasculature, as a general rule, low
molecular weight hydrophilic molecules (e.g. molecular weight beneath
about 5000 Da) distribute into the extracellular fluid (ECF) and are
relatively rapidly excreted through the kidneys by glomerular filtration.
Particulates, liposomes or lipophilic molecules tend to accumulate
relatively rapidly in the liver. Thus, an effective blood pool agent would
not be recognized by the RES, and would remaining in the bloodstream for
an extended period, yet would still provide a magnetic relaxation
response. The blood pool agents disclosed herein accomplish this goal.
The use of a blood pool agent can facilitate a wide range of measurements
that can be of interest to researchers and clinicians. For example, one
role that a blood pool agent can play is as an aid in the measurement of
blood volumes and the blood perfusion of various organs, including the
brain, using in vivo, non-invasive techniques.
Accordingly, in one aspect of the present disclosure, a method of
detecting an in vivo blood pool is disclosed. In one embodiment of the
method, a subject is administered a non-sensitive liposome composition. A
suitable non-sensitive liposome composition can comprise a contrast agent
and a non-sensitive liposome encapsulating the contrast agent. The
administering can be carried out by any convenient method, although many
times injection of the composition into a subject's vein or artery can be
the most convenient approach to administering a composition.
A subject, as described herein, can be any living organism or a subject
can even comprise a solution (e.g. blood, plasma, etc.) infused tissue
culture. A contrast agent can comprise any paramagnetic material, such as
MgSO.sub.4. Many such materials are commercially available and can be
employed in a non-sensitive liposome composition disclosed herein.
Non-sensitive liposomes can be loaded with contrast agent by employing any
known technique, such as pH gradient loading, ionic gradient loading and
osmotic loading. One method of loading non-sensitive liposomes is
disclosed in the Laboratory Examples.
After a non-sensitive liposome composition has been administered to a
subject (which can be performed by employing a method disclosed herein or
known to those of ordinary skill in the art), a magnetic resonance image
of a site of interest can be generated. As noted throughout the present
disclosure, a magnetic resonance image can be generated by any known
method and can be generated on any available MRI apparatus, such as a 2T
whole-body clinical scanning instrument (e.g., a Signa Medical Systems
scanner, available from General Electric of Milwaukee, Wis., United States
of America).
In one example of the method, a single image can be generated at a time
point known or suspected to permit enough time for the envirosensitive
liposome composition to circulate through the subject's blood stream to a
site of interest. In another example of the method, a time course series
of images of a site of interest can be acquired, similar to the time
course of images presented in FIGS. 2A and 2B. Such a time course of
images can be focused on a particular region of interest, such as the
brain, or on a biological structure known or suspected to have a vascular
irregularity.
Continuing with the embodiment of the method, the presence of an in vivo
blood pool can be detected by analyzing the magnetic resonance image. Such
an analysis can comprise an evaluation of one or more MR images to
identify the presence or absence of a blood pool at a particular site of
interest. The presence of a blood pool is indicated, in a MR image, by the
pixelation associated with a contrast agent. When images are
black-and-white images, the contrast agent pixelation will show up as
white pixelation.
As noted, the presence of a blood pool can be indicative of a vascular
irregularity. A vascular irregularity can be, for example, a widening of a
vascular structure. In one embodiment, a vascular irregularity can
comprise an aneurysm. In another embodiment, a vascular irregularity can
comprise an ischemic condition.
Ischemia/reperfusion injury is a significant source of morbidity and
mortality in a number of clinical disorders, including myocardial
infarction, cerebrovascular disease, and peripheral vascular disease. In
addition, ischemia/reperfusion is relevant to the function of transplanted
organs and to the recovery expedience following any cardiovascular surgery
(see, e.g., Fan et al., (1999) J. Mol. Med. 77:577-596). Often times,
ischemic conditions are not identified in a subject until after
significant damage or death has resulted. Thus, the presently disclosed
subject matter can be employed to monitor the formation, dissolution and
properties of a blood pool, which can useful in the diagnosis and
prevention of disorders related to vascular diseases and conditions.
V.D. Method of Generating a Heating Profile of a Site of Interest
In another aspect, a method of generating a heating profile of a site of
interest is disclosed. The term "heating profile", as it is used herein,
encompasses the heating of a region of tissue surrounding a site of
heating. A heating profile reflects the increase and/or decrease in heat
as a function of distance from the site of heating or from the source of
heat (e.g., a heated catheter).
In one embodiment, the method comprises administering to a subject a
thermosensitive liposome composition comprising: (i) a contrast agent and
(ii) a thermosensitive liposome encapsulating the contrast agent and the
compound of interest and having a melting temperature, T.sub.m.
Thermosensitive liposome compositions can be formed as described herein.
The thermosensitive liposomes of such compositions will have a given
melting temperature, which can be a function of the composition of the
liposome. At temperatures below the T.sub.m, the thermosensitive liposome
retains its structural integrity; above the T.sub.m, the thermosensitive
liposome loses its structural integrity, allowing release of the
liposome's contents. Representative contrast agents are described herein
and can comprise, for example, MnSO.sub.4.
Continuing with the method, a site of interest in a subject is then
heated. Various methods of heating can be employed in the method, such as
heating via a catheter warmed by passing hot water through the catheter.
Other heating methods are described herein.
The release of the contrast agent from the thermosensitive liposome is
then monitored using magnetic resonance imaging. The steps for acquiring
such a magnetic resonance image are described herein. Standard MRI
methodology can be employed in the acquisition of the image as disclosed
herein and also will be known to those of ordinary skill in the art upon
consideration of the present disclosure.
A heating profile of the site of interest can then be generated. In such a
heating profile, the heating of an area to a temperature of at least
T.sub.m can optionally be indicated by release of contrast agent at a
periphery of the area. Such a heating profile can reflect the distance
from a site of heating (e.g., the radial distance) at which the T.sub.m of
the thermosensitive liposome is reached.
By way of example, a heated catheter can be employed to heat a tumor. The
tumor tissue will be warmest near the site at which the catheter contacts
the tumor, and will be cooler at points further away from the catheter.
When the tumor tissue is homogeneous, this decrease in temperature as a
function of distance from the catheter can reflect a linear or exponential
decrease. At some distance from the catheter, the temperature of the tumor
tissue will be equal to the T.sub.m of a given thermosensitive liposome
composition. When thermosensitive liposomes reach this distance (as
disclosed herein, envirosensitive (e.g. thermosensitive), and
non-sensitive, liposomes accumulate at a site of heating) they melt and
release their contents, namely a contrast agent. By evaluating MR images
acquired as the thermosensitive liposomes approach the site of heating,
the distance at which the T.sub.m of the liposomes is reached can be
determined. At the distance from the catheter that the tissue is heated to
T.sub.m, contrast agent release will be immediate and will resemble a
burst release. Thus distances equal to or less than the T.sub.m distance
from the catheter can be identified, giving rise to a heating profile.
In another embodiment, two or more thermosensitive liposome compositions
can be employed, for example, in succession. In this embodiment, the
liposomes can have lipid compositions that impart different melting
points. By administering several compositions, each with a different
T.sub.m, and compiling the results, a detailed heating profile, similar to
a plot of different isotherms can be generated, which reflects the
temperature of the tissue at various distances from the catheter or site
of heating.
VI. Advantages of the Present Disclosure
The methods and compositions of the present disclosure offer many
advantages over compositions, methods and approaches known and/or employed
in state-of-the-art diagnostic and therapeutic procedures. Representative
advantages of the present disclosure are described below. Other advantages
will be apparent when considered in view of the present disclosure.
VI.A. Selectivity in Targeting
FIGS. 2A and 2B highlight several advantages of the methods and
compositions of the presently disclosed subject matter. First, it is seen
that in both of these figures, the contrast agent, and thus the compound
of interest, is localized to the immediate region surrounding the tumor.
There is no contrast agent detected in any region of this or any other
slice in the immediate area of the tumor. This advantage of the presently
disclosed methods and compositions is highlighted when FIG. 2A and
particularly FIG. 2B are compared with FIG. 2C.
FIG. 2C is a MR image depicting the effect of infusing a rat bearing a
flank tumor with a prior art contrast agent (MAGNAVIST.RTM., available
from Berlex Laboratories, Wayne, N.J., United States of America). When
this prior art contrast agent is injected into a rat having a flank tumor
not heated by a catheter, the contrast agent is seen to associate not only
with the tumor, but with other internal structures as well, including the
presumably necrotic tissue in the center of the tumor and non-tumor flank
tissue. This figure indicates that prior art contrast agents cannot be
employed to specifically target the growing tissue (e.g., the periphery)
of a tumor. Consequently, in contrast to the present disclosure,
treatments based on this approach will suffer from a decreased
concentration of a compound of interest (e.g., a chemotherapeutic agent)
at the tumor, where the agent is most needed for therapeutic reasons.
Another related advantage of the methods and compositions disclosed herein
is their size. The liposome compositions are typically about 120 nm in
diameter. This small size ensures that the liposome compositions can be
stably transported through the vasculature of a subject, while being large
enough to evade trapping by the renal and/or hepatic systems and passing
the normal vasculature wall.
VI.B. Rapid Clearance of Liposomes and Contrast Agent
One problem that can accompany the use of a contrast agent in a living
organism is the toxicity of a contrast agent. If the contrast agent is not
cleared from the system of a subject in a timely fashion, a toxic reaction
can be initiated. This can be complicated by the occasional need to employ
relatively high concentrations of contrast agent to generate an
interpretable, high resolution image.
The presently disclosed methods and compositions do not suffer from this
drawback. The liposome compositions can employ contrast agents that are
highly effective at reducing proton relaxation times (i.e. T1's), and can
therefore be employed in lower quantities than those that are toxic on a
systemic basis. Additionally, in the present methods and compositions, the
contrast agent is encapsulated by a liposome, which remains stable until
it reaches a target site. Therefore, no contrast agent is released into
the bloodstream of the subject as the liposomes travel to their target.
Moreover, as FIG. 3D (see Original Patent) indicates, the contrast agent
is cleared from the circulatory system in about 90 minutes in the case of
the thermosensitive liposomes and about 3-5 hours in the case of the
non-sensitive liposomes. Additionally, the compositions and properties of
these liposomes can be modified to vary their circulation time as desired.
VI.C. In Vivo Monitoring
Another advantage of the methods and compositions of the present
disclosure is the ability to perform the methods in vivo. Often,
diagnostic methods cannot be performed in vivo and are relegated, at least
preliminarily, to artificial in vitro studies. In vitro conditions
typically do not exactly reproduce in vivo conditions, particularly in the
area of drug delivery and drug action/metabolism.
Another advantage is the ability to carry out the methods in a living
organism. MRI is particularly suited to this application since it is a
non-invasive, yet highly sensitive method. Thus, a study performed to
monitor the delivery of a compound to a particular biological structure
can be performed in vivo and a researcher can be confident that the
observed results will be reproducible in similar living organisms.
VI.D. Real Time Monitoring
Yet another advantage of the present methods and compositions is the
ability to perform real time monitoring of events occurring in vivo. A
researcher can monitor, for example, the accumulation of liposome
compositions at a heated site as the accumulation is occurring. The only
delay is that delay associated with obtaining (for example, about 0.5-4
minutes, depending on scan settings) and processing (for example, less
than about 3-6 seconds) the nucleus relaxation times to images.
This ability can be of great benefit in determining the time scale upon
which events are occurring. This can translate into an estimate of the
efficiency with which a given compound of interest is not only delivered
to a site of interest, but also how the compound behaves once it has been
delivered.
VI.E. A Site Can be Heated by Invasive/Noninvasive Techniques
In one aspect of the present disclosure, a site of interest is heated.
Heating of the site of interest leads to the accumulation of liposome
composition at the heated site over a period of time (FIGS. 2A-2B).
Without heating the site of interest, the liposome might at best diffusely
accumulate at the site (particularly if it is a tumor) for a brief time
(FIG. 2E), or not at all (FIG. 2D). The site can be heated by invasive or
non-invasive methods and can depend on the nature of the site being
heated.
For example, in one aspect, a site (i.e., a tumor) is heated by inserting
a catheter which is heated by circulating water, into the tumor mass.
Other similar methods of invasive heating can be employed.
In other instances, it might be desirable to heat a site noninvasively.
Such heating can be achieved by employing a method such as directing RF,
IR, microwave or ultrasonic energy at the site. In these cases, it can be
desirable to monitor the temperature of the heated site for thermal damage
to the site.
In yet other instances, a laser can be employed to heat the site.
Typically, when the site of interest is near the outer surface of the
subject, such as on or near the skin, a laser, for example a laser
emitting light at an IR frequency, can be employed to heat a site. In
another example, the site is a subject's eye, and a laser can be employed
to locally heat an exposed region of the eye.
VI.F. High Resolution Detection
One potential drawback to some MRI techniques is that the images generated
are sometimes of low resolution due to a poor signal-to-noise ratio. To
overcome this limitation, spatial resolution is sacrificed in order to
have enough signal to generate an image. ESR, NMR and resonance frequency
shift are several techniques that suffer from the lower S/N ratio or the
use of different atom of excitation such as .sup.13C. The presently
disclosed methods and compositions, on the other hand, employ the protons
of water. The effect of the contrast agent on these protons is minimal.
The methods and compositions disclosed herein, on the other hand,
routinely provide high resolution images of a site, as depicted in FIGS.
2A and 2B.
VI.G. Low Toxicity
A further advantage is the observation that the liposome compositions are
relatively less toxic and/or damaging to a subject than other MR-based
contrast agent-containing compositions. Some MR contrast agents, such as
gadolinium-based contrast agents, can be toxic in large amounts. Often
these amounts are required to generate high-quality images useful for
diagnostic purposes.
Yet other imaging techniques require the use of radioactive compositions
to monitor in vivo events, such as blood pool detection. Moreover these
methods do not yield detailed high resolution images. For example,
positron emission tomography (PET) is commonly employed, but cannot be
employed to generate high resolution images. In another example,
multiple-gated arteriography (MUGA) is typically employed in the study of
left-ventricular function and wall motion of the heart. In MUGA, a
subject's red cells are infused with .sup.99Tc, a radioactive material.
The radiation emitted from the .sup.99Tc is then detected and used to form
an image of the blood pool within the subject's heart. Images can be
acquired by employing a gamma camera, and data can be acquired at times of
interest to a clinician or researcher. While MUGA has been effective, it
requires the use of potentially damaging radioactive materials and can
lead to toxic anaphylactic shock.
Yet other methods employ fluorescent dyes, which can themselves be toxic
or can lead to undesirable conditions. Additionally, such approaches are
limited to sites that are near an exposed surface of a patient, such as
the skin or the surface of the eye.
The presently disclosed methods and compositions, on the other hand,
employ contrast agents that can be less toxic to a subject. For example,
Cu or Zn, which exhibit very low in vivo toxicity and good contrast agent
properties, can be used. Even compounds that exhibit some toxicity, such
as Mn, are safe to use in vivo with the presently disclosed methods and
compounds, as the liposomes shield the contrast agent until the liposome
loses structural integrity at the site of interest. Further, since the
liposomes are targeted to a specific, less contrast agent is required to
achieve results similar to or superior than those found when the contrast
agent is administered at higher (potentially toxic) doses systemically.
Claim 1 of 26 Claims
1. An in vivo method of monitoring the
localization and distribution of a compound of interest to a desired site
in an organism by magnetic resonance imaging, the method comprising: (a)
administering an envirosensitive liposome composition to a subject, the
composition comprising: (i) a contrast agent; (ii) a compound of interest;
and (iii) an envirosensitive liposome encapsulating the contrast agent and
the compound of interest; and (b) monitoring the localization and
distribution of the compound of interest to a desired site by magnetic
resonance imaging, wherein the monitoring comprises monitoring release of
the contents of the liposome at the desired site by monitoring an increase
in the presence of the contrast agent released from the liposome at the
desired site as the contents of the liposome are being released at the
desired site. ____________________________________________
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