Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with acute kidney disease. This novel technology focuses beams of ultrasound energy precisely and accurately on targets in the kidney.
How it Works
Where the beams converge, focused ultrasound is being used to improve the homing and implantation of mesenchymal stem cells in the diseased kidney. Preclinical results show improved renal cell survival compared to controls. While early work is promising, there is still much to be done before this technology will be widely available.
The primary options for treatment of acute kidney disease include medication, dialysis and potentially invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
At the present time, there are no clinical trials recruiting patients for focused treatment of acute kidney disease.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for acute kidney disease is not yet approved by regulatory bodies or covered by medical insurance companies.
Qi T, Yang R, Liu X, Lu M, Liu Y, Li R, Mao J, Zhang Y, Jing Y, Chang J, Zhang Q, Wan M. Ultrasound-guided in vivo histotripsy in rabbit kidneys using millisecond-length two-stage ultrasound pulses combined with fundamental and second harmonic superposition. Phys Med Biol. 2022 Nov 2;67(21). doi: 10.1088/1361-6560/ac9661.
Ullah M, Liu DD, Rai S, Razavi M, Concepcion W, Thakor AS. Pulsed focused ultrasound enhances the therapeutic effect of mesenchymal stromal cell-derived extracellular vesicles in acute kidney injury. Stem Cell Res Ther. 2020 Sep 14;11(1):398. doi: 10.1186/s13287-020-01922-1.
Ullah M, Liu DD, Rai S, Concepcion W, Thakor AS. HSP70-Mediated NLRP3 Inflammasome Suppression Underlies Reversal of Acute Kidney Injury Following Extracellular Vesicle and Focused Ultrasound Combination Therapy. Int J Mol Sci. 2020 Jun 8;21(11):E4085. doi: 10.3390/ijms21114085.
Ullah M, Liu DD, Rai S, Dadhania A, Jonnakuti S, Concepcion W, Thakor AS. Reversing Acute Kidney Injury Using Pulsed Focused Ultrasound and MSC Therapy: A Role for HSP-Mediated PI3K/AKT Signaling. Mol Ther Methods Clin Dev. 2020 Mar 30;17:683-694. doi: 10.1016/j.omtm.2020.03.023. eCollection 2020 Jun 12.
Burks SR, Nagle ME, Bresler MN, Kim SJ, Star RA, Frank JA. Mesenchymal stromal cell potency to treat acute kidney injury increased by ultrasound-activated interferon-γ/interleukin-10 axis. J Cell Mol Med. 2018 Dec;22(12):6015-6025. doi: 10.1111/jcmm.13874. Epub 2018 Sep 14.
Fischer K, Meral FC, Zhang Y, Vangel MG, Jolesz FA, Ichimura T, Bonventre JV. High-resolution renal perfusion mapping using contrast-enhanced ultrasonography in ischemia-reperfusion injury monitors changes in renal microperfusion. Kidney Int. 2016 Jun;89(6):1388-98. doi: 10.1016/j.kint.2016.02.004.
Burks SR, Nguyen BA, Tebebi PA, Kim SJ, Bresler MN, Ziadloo A, Street JM, Yuen PS, Star RA, Frank JA. Pulsed focused ultrasound pretreatment improves mesenchymal stromal cell efficacy in preventing and rescuing established acute kidney injury in mice. Stem Cells. 2015 Apr;33(4):1241-53. doi: 10.1002/stem.1965.
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