Brain delivery enabled by transient blood-brain barrier disruption induced by regadenoson: a PET imaging study

Expert Opin Drug Deliv. 2024 May;21(5):797-807. doi: 10.1080/17425247.2024.2369765. Epub 2024 Jun 20.

Abstract

Background: Regadenoson, an agonist of adenosine A2 receptors, enables transient blood-brain barrier (BBB) disruption. The relevance of regadenoson as a pharmacological strategy for brain delivery was investigated using in vivo PET imaging in rats.

Research design and methods: Kinetic modeling of brain PET data was performed to estimate the impact of regadenoson (0.05 mg.kg-1, i.v.) on BBB permeation compared with control rats (n = 4-6 per group). Three radiolabeled compounds of different sizes, which do not cross the intact BBB, were tested.

Results: Regadenoson significantly increased the BBB penetration (+116 ± 13%, p < 0.001) of [18F]2-deoxy-2-fluoro-D-sorbitol ([18F]FDS, MW = 183 Da), a small-molecule marker of BBB permeability. The magnitude of the effect was different across brain regions, with a maximum increase in the striatum. Recovery of BBB integrity was observed 30 min after regadenoson injection. Regadenoson also increased the brain penetration (+72 ± 45%, p < 0.05) of a radiolabeled nanoparticle [89Zr]AGuIX (MW = 9 kDa). However, the brain kinetics of a monoclonal antibody ([89Zr]mAb, MW = 150 kDa) remained unchanged (p > 0.05).

Conclusions: PET imaging showed the features and limitations of BBB disruption induced by regadenoson in terms of extent, regional distribution, and reversibility. Nevertheless, regadenoson enables the brain delivery of small molecules or nanoparticles in rats.

Keywords: Blood–brain barrier; brain delivery; immunoPET; nanoparticle; pharmacokinetics; positron emission tomography.

MeSH terms

  • Adenosine A2 Receptor Agonists* / administration & dosage
  • Adenosine A2 Receptor Agonists* / pharmacology
  • Animals
  • Blood-Brain Barrier* / drug effects
  • Blood-Brain Barrier* / metabolism
  • Brain* / diagnostic imaging
  • Brain* / drug effects
  • Brain* / metabolism
  • Drug Delivery Systems
  • Fluorine Radioisotopes
  • Male
  • Nanoparticles
  • Permeability
  • Positron-Emission Tomography* / methods
  • Purines* / administration & dosage
  • Purines* / pharmacokinetics
  • Purines* / pharmacology
  • Pyrazoles* / administration & dosage
  • Pyrazoles* / pharmacokinetics
  • Pyrazoles* / pharmacology
  • Rats
  • Rats, Sprague-Dawley
  • Rats, Wistar

Substances

  • regadenoson
  • Purines
  • Pyrazoles
  • Adenosine A2 Receptor Agonists
  • Fluorine Radioisotopes