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Abstract
While ultrasound is most widely known for its use in diagnostic imaging, the energy carried by ultrasound waves can be utilized to influence cell function and drug delivery. Consequently, our ability to use ultrasound energy at a given intensity unlocks the opportunity to use the ultrasound for therapeutic applications. Indeed, in the last decade ultrasound-based therapies have emerged with promising treatment modalities for several medical conditions. More recently, ultrasound in combination with nanomedicines, i.e., nanoparticles, has been shown to have substantial potential to enhance the efficacy of many treatments including cancer, Alzheimer disease or osteoarthritis. The concept of ultrasound combined with drug delivery is still in its infancy and more research is needed to unfold the mechanisms and interactions of ultrasound with different nanoparticles types and with various cell types. Here we present the state-of-art in ultrasound and ultrasound-assisted drug delivery with a particular focus on cancer treatments. Notably, this review discusses the application of high intensity focus ultrasound for non-invasive tumor ablation and immunomodulatory effects of ultrasound, as well as the efficacy of nanoparticle-enhanced ultrasound therapies for different medical conditions. Furthermore, this review presents safety considerations related to ultrasound technology and gives recommendations in the context of system design and operation.
Highlights
Ultrasound has been used for imaging and diagnostic purposes
The duration of treatment in ultrasound assisted drug delivery and therapeutic ultrasound should be determined by the time required for the ultrasound to generate a desirable effect without inducing unwanted effects on the body
The precise treatment time in every research protocol is different for different therapeutic applications, and it has to be optimized for each treatment indication (Schroeder et al, 2009b; Joshi and Joshi, 2019)
Summary
Ultrasound has been used for imaging and diagnostic purposes. Recent technological advances, in particular in nanotechnology, opened new opportunities for ultrasound to be developed into advanced medical treatments, e.g., ultrasound triggered in situ drug synthesis and non-invasive surgery (Ferrara, 2008). (i) Should comprise of phospholipids or polymers in outer structure which are sensitive to heat (ii) Stable entrapment of therapeutic agent at body temperature (iii) Instant and enhanced drug release after exposure to heat stimuli and (iv) Supply of high concentration of drug to plasma while being hyperthermia treatment is applied (Liu D. et al, 2016; Garello and Terreno, 2018) Another thermal effect of ultrasound is localized thermal ablation, which is achieved with the use of high intensity focused ultrasound (HIFU). The insignificant response of tumor to therapeutic agents and nanoparticles have strongly indicated the need for developing a new strategic approach for improving targeted drug delivery to tumors and minimizing systemic side effects of the treatment at the same time. It is more effective than antimicrobial agents as it has less likelihood of developing resistance and reoccurrence of the biofilm
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