Intracerebroventricular injection (often abbreviated as ICV injection) is a route of administration for drugs via injection into the cerebral ventricles so that it reaches the cerebrospinal fluid (CSF). This route of administration is often used to bypass the blood-brain barrier because it can prevent important medications from reaching the central nervous system. This injection method is widely used in diseased mice models to study the effect of drugs, plasmid DNA, and viral vectors on the central nervous system. In humans, ICV injection can be used for the administration of drugs for various reasons. Examples include the treatment of Spinal Muscular Atrophy (SMA), the administration of chemotherapy in gliomas, and the administration of drugs for long-term pain management. ICV injection is also used in the creation of diseased animal models specifically to model neurological disorders.
Uses
Creation of Animal Models Intracerebroventricular injection has been used to inject drugs that induce a diseased state to create animal models for a variety of diseases. Of these, Alzheimer's disease (AD) animal models are heavily represented in the literature. ICV injection of Streptozotocin has been used to create a metabolic model of Alzheimer's disease. This protocol works by damaging the control level of cerebral glucose metabolism to mimic Alzheimer's disease symptoms. An early sign of AD is glucose hypometabolism and impaired insulin signaling has been seen in AD patients. Streptozotocin has also largely been used to create diabetes animal models, by injecting either intravenously or intraperitoneally. These ICV injections result in models for the sporadic Alzheimer's disease (sAD) form, rather than familial. A characteristic of sAD is an insulin-resistant brain state (IRBS). Streptozotocin is a beta-cytotoxic drug and by injecting it directly into the cerebral ventricles, the treated mice develop symptoms that align with sAD symptoms in humans. Some of these symptoms include IRBS-associated memory impairment, glucose hypometabolism, oxidative stress, and neurodegeneration. More recently, a model for AD that represents both familial and sporadic AD has emerged. In the clinic, as well as independent experiments, an increase in amyloid beta (Aβ) levels in the brain has been seen to cause Alzheimer-like symptoms. To create an animal model of AD, Aβ can be injected using ICV injection. A benefit of this pathogen-induced model is that it shows Alzheimer's-like symptoms, while also exhibiting Aβ pathology. This is present in both familial and sporadic AD, making it a more inclusive model. Additionally, the level of Aβ can be controlled, making it an ideal candidate for AD investigation. However, damage to the brain tissue during ICV injection must be minimized to prevent neuronal injury. This requires a highly trained individual or surgeon.
Testing in Animals Intracerebroventricular injection has also been used to test therapeutics and other drugs in animals. Examples of these studies include injection of bromodeoxyuridine for proliferation tracing, Apelin-13 for cerebral ischemia, and α-interferon for its antiviral and antibiotic properties. ICV injection of bromodeoxyuridine (BrdU) has been used to determine the effectiveness of this injection method compared to intraperitoneal administration. BrdU is a widely used marker to detect proliferative cells in the brain. It is assumed that the number of labeled nuclei after BrdU administration is an indicator of the intensity of cell proliferation. In the study, there was an increase in BrdU-positive nuclei in the parenchyma for ICV injection compared to the levels for intraperitoneal administration. This indicates a greater level of the tracer is introduced when injected directly into the ventricular cerebrospinal fluid. Cerebral ischemia/reperfusion (I/R) injury is the main pathophysiological process present in ischemic stroke. Apelin regulates many physiological functions including cardiovascular function, endocrine function, nervous system function, and feeding behavior. This regulation occurs through combination with the APJ receptor, and this system is present in many brain regions. In previous studies, lateral ICV injection of Apelin-13 was done to observe apoptosis during cerebral I/R injury. This route of administration allows for the necessary level of Apelin-13 to reach the brain regions that are impacted by ischemia and hypoxia. ICV injection of α-Interferon has been used for the treatment of intracranial malignancies in the clinic. α-Interferon has antiviral, antibacterial, and immunostimulatory properties. However, severe central nervous system symptoms occur after injection for ICV, intravenous, and intramuscular routes of administration. Additionally, only .09-.18% of the total Interferon dose was seen to pass through the blood-brain barrier when injected intramuscularly. In one study, intraperitoneal injection of α-Interferon was done on mice and there was no impact on monoamine levels. Another study conducted a similar experiment using the ICV injection method. This study showed reduced monoamine levels in the frontal cortex, in a dose-dependent manner. This indicates that ICV injection increases the percentage of the dose that reaches the mouse brain.
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