Evaluation of brain toxicity following near infrared light exposure after indocyanine green dye injection.
Indocyanine green (ICG) has excellent safety records and is widely used in medical diagnosis. Recently, a new method has been developed to estimate cerebral blood flow (CBF) using ICG in combination with near-infrared spectroscopy (NIRS). The new technique may be of wide clinical interest, as it is noninvasive and easy to perform at the bedside in stroke patients. Additionally, ICG with the use of specific wavelength lasers is documented to be effective in photodynamic therapy (PDT). Under normal conditions ICG does not cross the intact blood brain barrier (BBB). However, in patients with brain injuries where the BBB may be disturbed, ICG could accumulate in brain parenchyma and in combination with NIR-light exposure, phototoxicity could occur. The aim of the present study was to examine the possible toxicity of ICG in combination with NIRS in a specific setting for CBF measurements. In five rats with mannitol induced BBB breakdown no traces of ICG were found during spectrophotometric analysis of the brain cell suspensions. In ten rats with disrupted BBB there were no significant increases of brain temperature or histological signs of brain damage following 1 h NIR-light exposure after ICG injection. The existing literature concerning the application of ICG in combination with NIR light is reviewed.
Keller
Emanuela
E
Department of Neurosurgery, University of Zurich, University Hospital, Nord 1, Frauenklinikstrasse 10, CH-8091 Zurich, Switzerland. ees@nch.unizh.ch
Ishihara
Hideyuki
H
Nadler
Andreas
A
Niederer
Peter
P
Seifert
Burkhardt
B
Yonekawa
Yasuhiro
Y
Frei
Karl
K
D000818:Animals; D017209:Apoptosis / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D001812:Blood-Brain Barrier / Q000187:drug effects* / Q000502:physiology / Q000528:radiation effects; D001831:Body Temperature / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D001921:Brain / Q000098:blood supply / Q000187:drug effects* / Q000502:physiology / Q000528:radiation effects; D001930:Brain Injuries / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D053148:Caspase 3; D020169:Caspases / Q000378:metabolism; D002461:Cell Line, Transformed; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004396:Coloring Agents / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D020287:In Situ Nick-End Labeling; D007208:Indocyanine Green / Q000633:toxicity*; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D009410:Nerve Degeneration / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D009474:Neurons / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D010775:Photic Stimulation / Q000009:adverse effects*; D010777:Photochemistry / Q000295:instrumentation / Q000379:methods; D010789:Phototherapy / Q000009:adverse effects; D051381:Rats; D019265:Spectroscopy, Near-Infrared / Q000009:adverse effects*
D004396:Coloring Agents; D008353:Mannitol; C505407:CASP3 protein, human; C505410:Casp3 protein, rat; D053148:Caspase 3; D020169:Caspases; D007208:Indocyanine Green