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In medicine, an administered drug must penetrate many obstacles in the living system before reaching the desired targets. However, most drugs are rapidly cleaned away from the blood stream. The targeting efficiency is low and they cannot easily cross cell membranes, leading to ineffective drug delivery. Currently, the use of microbubbles in combination with ultrasound has been proposed as an innovative method for noninvasive, precise and targeted delivery of drugs and genes to pathological tissues and cells1. In this approach, microbubbles can play a role as carriers where free drugs are either co-injected with a gas bubble suspension or loaded on its surface. Microbubbles can also act as a local vector for refocusing the ultrasound energy in order to interact with the cells. Basically, under ultrasound exposure, bubbles stably compress and expand, a regime called stable cavitation that generates liquid flows and hence shear stress on nearby objects. Microbubbles may also oscillate non-linearly and expand until collapse, in the regime of inertial cavitation, producing shock waves that propagate radially from the collapse site2. It has been shown that cavitation, either stable or inertial, enhances the permeabilization of cell membranes, and thus enhances the internalization of drugs into the cell3.
In therapeutic applications, understanding the mechanism of the bubble-cell interaction is very important, but there are several barriers, both from scientific and technical sides, that prevent our knowledge from advancing. First, capturing the dynamics of cells in response to bubble-induced mechanical stimuli is very difficult4. At the acoustic timescale, the first-order microbubble oscillations can lead to activation of membrane channels, facilitating molecular passage across biological interfaces. This occurs through the direct oscillation of the cell membrane, also called "cellular massage"5. Channel activation following direct mechanical stress was evidenced using patch-clamp techniques that measured electrophysiological properties of cell membranes during and after ultrasound exposure6. Measuring bubble-induced cell dynamics (meaning the complete field of deformation of the cell membrane) at the acoustic timescale, would also provide insights in the threshold of membrane area expansion ΔA/A required to induce pores into the cell membrane7. The second barrier is controlling the collapsing bubble regime to avoid microbubble-induced cell lysis. Bubble collapses and induced microjets have been identified as a mechanism through which membrane perforation occurs8,9. Once permeabilized, the cell membrane repairs through calcium self-sealing of the lipid bilayers and fusion of intracellular vesicles9. The occurrence of bubble collapses may also cause lethal damages to the cell and induce unnecessary side effects in the surrounding ones. In sensitive applications such as ultrasound-mediated blood-brain barrier opening, it is generally accepted that inertial bubble collapses should be avoided10.
Therefore, huge efforts are currently devoted to the design of ultrasound emission sequences, coupled with passive cavitation monitoring and control, in order to ensure stable oscillations of microbubbles11. In this stable regime, it has been hypothesized that stably oscillating bubbles play a strong role in the triggering of membrane permeabilization by promoting spatially-targeted shear stress on the cell membrane7. The shear stress results from the liquid flows created in the vicinity of the oscillating bubbles. These liquid flows are called cavitation microstreaming, and, as mentioned above, they are one of the several possible mechanisms which are responsible for enhanced uptake of extracellular molecules. When dealing with suspension of bubbles or cells such as in-vitro biological transfections assays12, permeabilization by microstreaming might be much more efficient than permeabilization by bubble collapse. This can be shown by a simple geometrical consideration. In cell suspensions, sonoporation will be efficient if the majority of the suspended cells is submitted to sufficiently large mechanical effects (leading to membrane permeabilization). It is known that bubble collapses are directed along the direction of isotropic symmetry breaking, such as the bubble-wall axis13 or the bubble-bubble and bubble-cell line joining their center of mass14. The produced microjet is therefore a spatially-localized phenomenon along a finite number of lines joining the cell and bubble centers. Depending on the cell and bubble concentration, as well as the bubble-cell distance, this effect may not be the most efficient to permeabilize the whole number of suspended cells. In contrast, cavitation microstreaming is a phenomenon occurring at a slow timescale, with a large spatial expansion in comparison to the bubble radius. Also, the liquid flow is distributed all around the bubble, and may therefore impacts a larger number of cells, at a very long range. Therefore, understanding the generated cavitation microstreaming around an oscillating bubble is a prerequisite for controlling and quantifying the bubble-induced shear stress that is applied to cells.
To do so, a preliminary step consists in controlling the spherical and nonspherical oscillations of an ultrasound-driven bubble, as the generated liquid flows are induced by the motion of the bubble interface15,16. In particular, shape oscillations of microbubbles have to be triggered and kept stable. Furthermore, the orientation of the bubble shape oscillations has to be controlled to properly analyze the correlation between the bubble interface dynamics and the induced microstreaming pattern. When summarizing the existing literature, it is obvious that detailed experimental results of cavitation-induced microstreaming are only available for bubbles attached to a surface. Wall-attached microbubbles are commonly-used for assessing accurate interface dynamics and cell interactions at the micrometer scale under an ultrafast microscopy system. This configuration is therapeutically relevant when considering vibrating microbubbles located on the cell membrane17,18,19. The study of substrate-attached bubble may however make the analysis of bubble dynamics more complicated, partly due to the complex nature of contact line dynamics20, and the triggering of asymmetric shape modes21. In medical and biological applications, bubbles that are not attached to a wall are commonly found in confined geometries such as small vessels. This impacts significantly bubble dynamics and shape instabilities. Particularly, the presence of a nearby wall shifts the pressure threshold for shape mode triggering to lower pressure values depending on the shape mode number and bubble size22. The wall also affects the bubble-induced microstreaming with possibly higher intensity for the produced flow23.
Amongst all the possible scenario that microbubbles may experience (free or attached, close to a wall, collapsing or stably-oscillating), we propose to investigate the nonspherical dynamics of a single bubble far from any boundary. The experimental setup is based on an acoustic levitation system24 in which a standing ultrasound wave is used to trap the bubble. This scenario is consistent with medical applications in which a collection of suspended bubbles and cells coexist in a sonotransfection chamber, for instance. As far as bubbles and cells are not too close, it is assumed that the presence of a cell does not impact the bubble interface dynamics. When cells follow the loop-like trajectories of the cavitation-induced microstreaming, they are cyclically approaching and repelling from the bubble location and we can assume that the cell presence impacts neither the streaming pattern nor its mean velocity. In addition, nonspherical dynamics and induced microstreaming from single bubbles far from boundary are well known from a theoretical point of view. In order to link the bubble-induced liquid flow to the bubble contour dynamics, it is required to accurately characterize the bubble interface dynamics. To do so, it is preferable to adapt the spatiotemporal scale in experimental studies with respect to those used in therapeutics so that acquisition with common high-speed cameras (below 1 million frame/second) is possible by using large bubbles excited at lower frequencies. When considering uncoated bubbles, the eigenfrequency ωn of a given mode n is related to the bubble size as
25. This radius-eigenfrequency relationship is slightly modified when considering shelled bubbles26, but the order of magnitude of the eigenfrequency ωn remains the same. Thus, investigating bubbles with equilibrium radii ~50μm in a 30 kHz ultrasound field is similar to studying coated bubbles of radii ~3μm in a 1.7 MHz field, as proposed by Dollet et al.27. Similar shape mode numbers and hence microstreaming patterns are therefore expected.
In order to trigger nonspherical oscillations of the bubble interface, it is necessary to exceed a certain pressure threshold that is radius-dependent, as shown in Figure 1. Existing experimental techniques rely on the increase of the acoustic pressure to trigger surface modes (illustrated by path (1) in Figure 1), either by step-by-step pressure increase28 or by modulated-amplitude excitation responsible of periodic onset and extinction of surface modes29. The main drawbacks of these techniques are (i) a random orientation of the symmetry axis of the surface oscillations that cannot be controlled to be in the imaging plane, (ii) a short lifetime of the bubble shape oscillations that makes the analysis of the induced liquid flows difficult at larger timescales, and (iii) the frequent triggering of unstable shape modes. We propose an alternative technique to cross the pressure threshold at a constant acoustic pressure in the radius/pressure map, as illustrated by the path (2) in Figure 1. To do so, it is required to increase the bubble size such that it will be in the instability zone. Such an increase is performed by a bubble coalescence technique. The coalescence of two, initially spherically-oscillating, microbubbles is exploited to create one single deformed bubble. If the acoustic pressure and bubble size of the coalesced bubble are in the instability zone, surface modes are triggered. We also evidenced that the coalescence technique induces stable shape oscillations in a steady-state regime, as well as a controlled symmetry axis defined by the rectilinear motion of the two approaching bubbles. Because a stable shape oscillation is ensured over minutes, the analysis of bubble-induced fluid flow is possible by seeding the liquid medium with fluorescent microparticles, lighted by a thin laser sheet. Recording the motion of the solid microparticles in the vicinity of the bubble interface allows identifying the pattern of the induced fluid flow30. The overall principle of the triggering of bubble shape oscillations, leading to a time-stable fluid flow, is illustrated in Figure 2.
In the following protocol, we outline the steps required to create stable bubble shape oscillations via the coalescence technique and describe the measurements of fluid flow. This includes the design of the acoustic levitation system, the acoustic calibration, bubble nucleation and the coalescence technique, the measurement of bubble interface dynamics and surrounding fluid flow, and the image processing.