Background-We have previously shown that microbubbles adhere to leukocytes
in regions of inflammation. We hypothesized that these microbubbles are pha
gocytosed by neutrophils and monocytes and remain acoustically active, perm
itting their detection in inflamed tissue.
Methods and Results-In vitro studies were performed in which activated leuk
ocytes were incubated with albumin or lipid microbubbles and observed under
microscopy. Microbubbles attached to the surface of activated neutrophils
and monocytes, were phagocytosed, and remained intact for up to 30 minutes.
The rate of destruction of the phagocytosed microbubbles on exposure to ul
trasound was less (P less than or equal to 0.05) than that of free microbub
bles at all acoustic pressures applied. Intravital microscopy and simultane
ous ultrasound imaging of the cremaster muscle was performed in 6 mice to d
etermine whether phagocytosed microbubbles could be detected in vive. Fifte
en minutes after intravenous injection of fluorescein-labeled microbubbles,
when the blood-pool concentration was negligible, the number of phagocytos
ed/ attached microbubbles within venules was 7-fold greater in tumor necros
is factor-alpha (TNF-alpha)-treated animals than in control animals (P<0.01
). This increase in retained microbubbles resulted in a 5- to 6-fold-greate
r (P<0.01) degree of ultrasound contrast enhancement than in controls.
Conclusions-After attaching to activated neutrophils and monocytes, microbu
bbles are phagocytosed intact. Despite viscoelastic damping, phagocytosed m
icrobubbles remain responsive to ultrasound and can be detected by ultrasou
nd in vive after clearance of freely circulating microbubbles from the bloo
d pool. Thus, contrast ultrasound has potential for imaging sites of inflam
mation.