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Drug Delivery using Low Frequency Ultrasound
Sumit Paliwal

Ultrasound has a variety of applications, including animal communication, fetal imaging, underwater range finding (SONAR) and non-destructive testing of metals for flaws. Ultrasound has also been instrumental in the field of biological research and medicine.

Interactions of ultrasound with cells and tissues can be broadly classified into physical and biological effects. While physical effects include ultrasound-induced structural modifications of the cells and tissues (for example, permeabilization of cell membranes), biological effects include the response generated by cells and tissues due to the physical effects of ultrasound (for example, heat shock response). Both these effects are thought to be mediated by inertial cavitation, which refers to the rapid growth and collapse of gas bubbles. Using in vitro and intermediate models (reconstructed tissues), we seek to develop a multi-scale understanding of the effects of ultrasound on biological structures in the context of two specific applications, trans-cutaneous immunization (TCI) and chemotherapy.

TCI offers an advantageous mode of immunization due to the unique ability of dermal immune cells, especially Langerhans cells, to present antigens to the immune system. Langerhans cells, upon activation, migrate to the regional lymph nodes and lead to the generation of systemic and mucosal immune responses. However, simple topical application of vaccines does not yield sufficient contact between the antigen and Langerhans cells to generate an adequate immune response. Using tetanus toxoid as a model vaccine, we found that low-frequency ultrasound enhances the immune response induced by topical application of tetanus toxoid. The adjuvant effect of ultrasound is partly explained by the enhanced delivery of tetanus toxoid into the skin after ultrasound application and partly by migration/activation
of immune cells after ultrasonic TCI. Ultrasonic TCI offers a needle-free and painless mode of immunization.

We have also identified a novel application of ultrasound in chemotherapy. Current techniques of cytotoxic chemotherapeutic agents target a narrow range of cancers and have low specificity.  We discovered that a short application of low-frequency ultrasound selectively
sensitizes prostate and skin cancer cells against a bioflavonoid, quercetin. About 90% of the viable skin cancer cell population was lost in vitro after ultrasound application followed by 48 hour incubation with 50 µM quercetin. Ultrasound under the same conditions induced no loss of viability in corresponding normal cells lines. Ultrasound also reduced the LC50 of quercetin for skin cancer cells by almost 100-fold. Mechanistic studies of this phenomenon are underway.