CHRONIC INTERSTITIAL INFUSION OF PROTEIN TO PRIMATE BRAIN - DETERMINATION OF DRUG DISTRIBUTION AND CLEARANCE WITH SINGLE-PHOTON EMISSION COMPUTERIZED-TOMOGRAPHY IMAGING
Dw. Laske et al., CHRONIC INTERSTITIAL INFUSION OF PROTEIN TO PRIMATE BRAIN - DETERMINATION OF DRUG DISTRIBUTION AND CLEARANCE WITH SINGLE-PHOTON EMISSION COMPUTERIZED-TOMOGRAPHY IMAGING, Journal of neurosurgery, 87(4), 1997, pp. 586-594
High-flow interstitial infusion into the brain, which uses bulk fluid
flow to achieve a relatively homogeneous-drug distribution in the extr
acellular space of the brain, has the potential to perfuse large volum
es of brain. The authors report reproducible long-term delivery of In-
111-diethylenetriamine pentaacetic acid-apontransferrin (In-111-DTPA-T
f) (molecular mass 81 kD) to Macaca mulatta brain and monitoring with
single-photon emission computerized tomography (SPECT). The In-111-DTP
A-Tf was infused at 1.9 mu l/minute over 87 hours into the frontal por
tion of the centrum semiovale using a telemetry-controlled fully impla
nted pump. On Days 1, 3, 4, 8, 11, and 15 after beginning the infusion
, planar and SPECT scans of In-111-DTPA-Tf were obtained. Spread of pr
otein in the brain ranged from 2 to 3 cm and infusion volumes ranged f
rom 3.9 to 6.7 cm(3). Perfusion of over one-third of the white matter
of the infused hemisphere was achieved. From brain SPECT images of Tc-
99m-hexamethylpropyleneamine oxime, which was administered intravenous
ly before each In-111 scan, the authors also found that blood perfusio
n in the infused region was reduced by less than 5% relative to corres
ponding noninfused regions. Histological, examination at 30 days revea
led only mild gliosis limited to the area immediately surrounding the
needle tract. These findings indicate that long-term interstitial brai
n infusion is effective for the delivery of drugs on a multicentimeter
scale In the primate brain. The results also indicate that it should
be possible to perfuse targeted regions of the brain for extended inte
rvals to investigate the potential utility of neurotrophic factors, an
titumor agents, and other materials for the treatment of central nervo
us system disorders.