Name: intrathecal delivery of antisense oligonucleotides in the rat central nervous system
Uploaded: 2019-10-29T14:00:00
Description: Watch this Scientific Journal Video about Intrathecal Delivery of Antisense Oligonucleotides in the Rat Central Nervous System at JoVE.com

We would like to thank Ionis Pharmaceuticals for supplying the ASOs described in the article.

All in vivo procedures were performed under Biogen Institutional Animal Use and Care Committee (IACUC) approved protocols which follow the guidelines set forth by the United States National Institutes of Health guide for the care and use of laboratory animals.
1. Material and instrument preparation
<ol>
	<li>Prepare the special guide cannulas.
	<ol>
		<li>Use a rotary tool with cut-off wheel (or a sharp saw) to cut off the two ends of a 19 G needle, resulting in a ~1.5&#8722;2 cm long guide ...

<ol>
	<li>Abbott, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamics+of+CNS+barriers:+evolution,+differentiation,+and+modulation.">Dynamics of CNS barriers: evolution, differentiation, and modulation.</a> Cellular and Molecular Neurobiology. 25 (1), 5-23 (2005).</li><li>Greene, C., Campbell, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tight+junction+modulation+of+the+blood+brain+barrier:+CNS+delivery+of+small+molecules.">Tight junction modulation of the blood brain barrier: CNS delivery of small molecules.</a> Tissue Barriers. 4 (1), e1138017 (2016).</li><li>Daneman, R., Engelhardt, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brain+barriers+in+health+and+disease.">Brain barriers in health and disease.</a> Neurobiology of Disease. 107, 1-3 (2017).</li><li>Ballabh, P., Braun, A., Nedergaard, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+blood-brain+barrier:+an+overview:+structure,+regulation,+and+clinical+implications.">The blood-brain barrier: an overview: structure, regulation, and clinical implications.</a> Neurobiology of Disease. 16 (1), 1-13 (2004).</li><li>Cardoso, F. 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F., Yee, F., Heilig, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+anxiety+and+neuropeptide+Y-Y1+receptors+by+antisense+oligodeoxynucleotides.">Modulation of anxiety and neuropeptide Y-Y1 receptors by antisense oligodeoxynucleotides.</a> Science. 259 (5094), 528-531 (1993).</li><li>Mazur, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+simple,+rapid,+and+robust+intrathecal+catheterization+method+in+the+rat.">Development of a simple, rapid, and robust intrathecal catheterization method in the rat.</a> Journal of Neuroscience Methods. 280, 36-46 (2017).</li><li>Wolf, D. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamic+dual-isotope+molecular+imaging+elucidates+principles+for+optimizing+intrathecal+drug+delivery.">Dynamic dual-isotope molecular imaging elucidates principles for optimizing intrathecal drug delivery.</a> Journal of Clinical Investigation Insight. 1 (2), e85311 (2016).</li><li>Becker, L. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Therapeutic+reduction+of+ataxin-2+extends+lifespan+and+reduces+pathology+in+TDP-43+mice.">Therapeutic reduction of ataxin-2 extends lifespan and reduces pathology in TDP-43 mice.</a> Nature. 544 (7650), 367-371 (2017).</li><li>Zhang, X., Hamblin, M. H., Yin, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+long+noncoding+RNA+Malat1:+Its+physiological+and+pathophysiological+functions.">The long noncoding RNA Malat1: Its physiological and pathophysiological functions.</a> RNA Biology. 14 (12), 1705-1714 (2017).</li><li>Crooke, S. T., Witztum, J. L., Bennett, C. F., Baker, B. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=RNA-Targeted+Therapeutics.">RNA-Targeted Therapeutics.</a> Cell Metabolism. 27 (4), 714-739 (2018).</li><li>DeVos, S. L., Miller, T. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Direct+intraventricular+delivery+of+drugs+to+the+rodent+central+nervous+system.">Direct intraventricular delivery of drugs to the rodent central nervous system.</a> Journal of Visualized Experiments. (75), e50326 (2013).</li><li>McCampbell, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antisense+oligonucleotides+extend+survival+and+reverse+decrement+in+muscle+response+in+ALS+models.">Antisense oligonucleotides extend survival and reverse decrement in muscle response in ALS models.</a> Journal of Clinical Investigation. 128 (8), 3558-3567 (2018).</li><li>Schoch, K. M., Miller, T. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antisense+Oligonucleotides:+Translation+from+Mouse+Models+to+Human+Neurodegenerative+Diseases.">Antisense Oligonucleotides: Translation from Mouse Models to Human Neurodegenerative Diseases.</a> Neuron. 94 (6), 1056-1070 (2017).</li><li>Lane, R. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Translating+Antisense+Technology+into+a+Treatment+for+Huntington's+Disease.">Translating Antisense Technology into a Treatment for Huntington's Disease.</a> Methods in Molecular Biology. 1780, 497-523 (2018).</li><li>Wurster, C. D., Ludolph, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antisense+oligonucleotides+in+neurological+disorders.">Antisense oligonucleotides in neurological disorders.</a> Therapeutic Advances in Neurological Disorders. 11, (2018).</li><li>Hach&#233;, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intrathecal+Injections+in+Children+With+Spinal+Muscular+Atrophy:+Nusinersen+Clinical+Trial+Experience.">Intrathecal Injections in Children With Spinal Muscular Atrophy: Nusinersen Clinical Trial Experience.</a> Journal of Child Neurology. 31 (7), 899-906 (2016).</li><li>Goodkey, K., Aslesh, T., Maruyama, R., Yokota, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nusinersen+in+the+Treatment+of+Spinal+Muscular+Atrophy.">Nusinersen in the Treatment of Spinal Muscular Atrophy.</a> Methods in Molecular Biology. 1828, 69-76 (2018).</li><li>Wurster, C. D., Ludolph, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nusinersen+for+spinal+muscular+atrophy.">Nusinersen for spinal muscular atrophy.</a> Therapeutic Advances in Neurological Disorders. 11, (2018).</li></ol>

The present article shows a powerful method to deliver therapeutic agents directly into the rat CNS. In theory, a similar technique can be also performed in mice, though due to the smaller size, the method can be more challenging. Therefore, our group performs intracerebroventricular (ICV) injections in mice for CNS drug delivery, which reach the same goals through a different route of administration. That method has been described in another study16.
The advantage of t...

The vascular system of the central nervous system (CNS) has evolved as a critical regulator of homeostasis, controlling traffic of molecules, supplying nutrients and getting rid of waste. This system is also the first line of defense from attacks of external pathogens, thanks to a dense distribution of tight junctions along the walls of the endothelial cells. These tight junctions make up one aspect of the blood brain barrier (BBB). While the BBB allows the transport of molecules required to fulfill nutrient and energy demands (e.g., ions, glucose), it also selectively limits the passage of pathogens as well as toxic chemicals1,2,3.
Ironically, the same protective function of the BBB that limits passage of pathogens and toxic chemicals also is the major obstacle to our ability to easily access the CNS with therapeutic treatments after systemic administration to the organism2,4,5. This role of the BBB has prompted the development of a plethora of new drug distribution technologies and approaches6.
One way to overcome this obstacle is to inject the drugs directly into the cerebrospinal fluid (CSF) that continuously perfuses both the brain and spinal cord7,8,9,10. In this article, we describe a method to successfully deliver agents into the lumbar intrathecal space by placing the internal end of the catheter completely in the cauda equina space of the rat spine. A description of this procedure was previously published by Mazur et al. elsewhere11.
The protocol is very effective and produces a greater than 90% success rate of antisense oligonucleotide (ASO) delivery to the CNS when assessed by quantitative polymerase chain reaction (qPCR) analysis of target gene knockdown8. The procedure causes minimal discomfort to the animals, as 100% of the rats survive the surgery and show minimal swelling around the surgical wound and no signs of distress (e.g., hyperactivity, dehydration, circling, loss of balance, decreased food intake, and dehydration) during post-op observation. Another advantage of the method described here is that it does not require expensive equipment, nor any special tools.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>3M Steri-Drape Small Drape with Adhesive Aperture</td>
			<td>3M</td>
			<td></td>
			<td>1020</td>
			<td></td>
		</tr>
		<tr>
			<td>70% ethanol</td>
			<td>Decon Laboratories, Inc</td>
			<td></td>
			<td>8416-160Z</td>
			<td></td>
		</tr>
		<tr>
			<td>Alcohol swab sticks</td>
			<td>Dynarex</td>
			<td></td>
			<td>NO 1204</td>
			<td></td>
		</tr>
		<tr>
			<td><a href="https://punchout.fishersci.com/shop/products/bd-general-use-syringes-5/22124967?crossRef=BD%20302830#?keyword=BD+302830">BD General Use Syringes 1 mL Luer-Lok tip</a></td>
			<td>BD</td>
			<td>1ml TB Luer-Lok tip</td>
			<td>BD 302830</td>
			<td></td>
		</tr>
		<tr>
			<td>BD Intramedic PE Tubing</td>
			<td>BD</td>
			<td>Polyethylene tubing PE50 Diameter 0.023 in</td>
			<td>BD 427400 (10ft, Fischer Scientific 22-204008) or 427401 (100ft, Fischer Scientific 14-170-12P)</td>
			<td></td>
		</tr>
		<tr>
			<td>BD Intramedic PE Tubing</td>
			<td>BD</td>
			<td>Polyethylene tubing PE10 Diameter 0.011 in</td>
			<td>BD 427410 (10ft, Fischer Scientific 14-170-11B) or 4274011 (100ft, Fischer Scientific 14-170-12B)</td>
			<td></td>
		</tr>
		<tr>
			<td>BD Intramedic PE Tubing Adapters</td>
			<td>BD</td>
			<td>23 gauge intramedic luer stub adaper</td>
			<td>BD 427565 or Fisher Scientific 14-826-19E</td>
			<td>120V 1.2A</td>
		</tr>
		<tr>
			<td>BD PrecisionGlide Single-use Needles 30G</td>
			<td>BD</td>
			<td></td>
			<td>BD 305128</td>
			<td></td>
		</tr>
		<tr>
			<td>Buprenorphine Sustained Release-lab</td>
			<td>ZooPharm</td>
			<td>Prescription required</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ethylene oxide sterilizer</td>
			<td>Andersen Sterilizer INC.</td>
			<td>AN 74i, gas sterilizer</td>
			<td>AN 74i</td>
			<td></td>
		</tr>
		<tr>
			<td>Guide cannula</td>
			<td>BD</td>
			<td>19G x 1 WT (1.1 mm x 25mm) needle</td>
			<td>BD 305186</td>
			<td></td>
		</tr>
		<tr>
			<td>Hamilton syringe 100ul</td>
			<td>Hamilton company</td>
			<td>Hamilton syringe 100ul</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hot bead Sterilizer</td>
			<td>Fine Science Tools</td>
			<td></td>
			<td>STERILIZER MODELNO FST 250</td>
			<td></td>
		</tr>
		<tr>
			<td>Ophthalmic ointment</td>
			<td>Dechra veterranery product</td>
			<td></td>
			<td>17033-211-38</td>
			<td></td>
		</tr>
		<tr>
			<td>Pocket Pro Pet Trimmer</td>
			<td>Braintree Scientific</td>
			<td></td>
			<td>CLP-9931 B</td>
			<td></td>
		</tr>
		<tr>
			<td>Povidone scrub</td>
			<td>PDI</td>
			<td></td>
			<td>S48050</td>
			<td></td>
		</tr>
		<tr>
			<td>Saline</td>
			<td>Baxter</td>
			<td>Sodium Chloride 0.9% Intravenous Infusion BP 50ml</td>
			<td>FE1306G</td>
			<td></td>
		</tr>
		<tr>
			<td>Scalpel</td>
			<td>Feather</td>
			<td>disposable scalpel</td>
			<td>No. 10</td>
			<td></td>
		</tr>
		<tr>
			<td>Small animal heating pad</td>
			<td>K&#38;H Manufacturing</td>
			<td></td>
			<td>Model # 1060</td>
			<td></td>
		</tr>
		<tr>
			<td>Stylet Wire</td>
			<td>McMaster-Carr</td>
			<td>1749T14</td>
			<td>LH-36233780</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgery Towel drape</td>
			<td>Dynarex</td>
			<td></td>
			<td>4410</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical scissors and forceps</td>
			<td>FST and Fisher Scientific</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sutures</td>
			<td>Ethicon</td>
			<td></td>
			<td>4-0 or 5-0</td>
			<td></td>
		</tr>
		<tr>
			<td>Tool to make the Guide cannular</td>
			<td>Grainger</td>
			<td>Rotary tool (Dremel)</td>
			<td>14H446 (Mfr: EZ456)</td>
			<td>1.5&#8221; diameter, Pk5</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td>EZ lock cut off Wheel</td>
			<td>1PKX5 (Mfr: 3000-1/24)</td>
			<td>1.5&#8221;, Pk2</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td>Grinding Wheel, Aluminum Oxide</td>
			<td>38EY44 (Mfr: EZ541GR)</td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td>EZ lock Mandrel</td>
			<td>1PKX8 (Mfr: EZ402-01)</td>
			<td>1.5&#8221; diameter</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td>Diamond wheel floor Tile</td>
			<td>3DRN4 (Mfr: EZ545)</td>
			<td></td>
		</tr>
		<tr>
			<td>Alternative source for pre-made and sterilized materials for this procedure</td>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dosing catheter system</td>
			<td>SAI Infusion Systems</td>
			<td></td>
			<td>RIDC-01</td>
			<td></td>
		</tr>
		<tr>
			<td>Guide cannula</td>
			<td>SAI Infusion Systems</td>
			<td></td>
			<td>RIDC-GCA</td>
			<td></td>
		</tr>
		<tr>
			<td>Internal Catheters</td>
			<td>SAI Infusion Systems</td>
			<td></td>
			<td>RIDC-INC</td>
			<td></td>
		</tr>
		<tr>
			<td>Stylet Wire</td>
			<td>SAI Infusion Systems</td>
			<td></td>
			<td>RIDC-STY</td>
			<td></td>
		</tr>
	</tbody>
</table>

intrathecal delivery of antisense oligonucleotides in the rat central nervous system

The blood brain barrier (BBB) is an important defense against the entrance of potentially toxic or pathogenic agents from the blood into the central nervous system (CNS). However, its existence also dramatically lowers the accessibility of systemically administered therapeutic agents to the CNS. One method to overcome this, is to inject those agents directly into the cerebrospinal fluid (CSF), thus bypassing the BBB. This can be done via implantation of a catheter for either continuous infusion using an osmotic pump, or for single bolus delivery. In this article, we describe a surgical protocol for delivery of CNS-targeting antisense oligonucleotides (ASOs) via a catheter implanted directly into the cauda equina space of the adult rat spine. As representative results, we show the efficacy of a single bolus ASO intrathecal (IT) injection via this catheterization system in knocking down the target RNA in different regions of the rat CNS. The procedure is safe, effective and does not require expensive equipment or surgical tools. The technique described here can be adapted to deliver drugs in other modalities as well.

Using the method described here, we injected two groups of adult female rats (250&#8722;300 g; n = 10/group) with either a single bolus of phosphate-buffered saline PBS or 300 &#181;g of ASO targeting the long non-coding (linc) RNA Malat1; in our lab we routinely use the Malat1 ASO as a tool compound, because Malat1 is expressed ubiquitously and at high levels in all tissues14, including brain and spinal cord. The Malat1 ASO works via an RNaseH1-mediated mechanism<...

Watch this Scientific Journal Video about Intrathecal Delivery of Antisense Oligonucleotides in the Rat Central Nervous System at JoVE.com

Intrathecal Delivery of Antisense Oligonucleotides in the Rat Central Nervous System

Here, we describe a method for delivering drugs to the rat central nervous system by implanting a catheter into the lumbar intrathecal space of the spine. We focus on the delivery of antisense oligonucleotides, though this method is suitable for delivery of other therapeutic modalities as well.

The blood brain barrier (BBB) is an important defense against the entrance of potentially toxic or pathogenic agents from the blood into the central ...

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