1. Introduction
Dimethyl sulfoxide (DMSO) is one of the most commonly used pharmaceutical drugs in life sciences. It has a wide spectrum of pharmacological effects, including anti-inflammatory effects, local analgesia, weak bacteriostasis and most importantly membrane penetration. DMSO is not only used on animals and humans itself by various routes including dermal and oral, but also utilized to enhance absorption of many other chemicals along these same routes. At low concentrations, DMSO exhibits anti-inflammatory, analgesic, diuretic, vasodilator, anti-platelet aggregation, radio-protective, and muscle-relaxing properties [
1]. The observed beneficial effects on skin rejuvenation and recovery from thermal injury might be explained by its effective property of being a vigorous scavenger of hydroxyl free radical. Accordingly, it has been applied for a variety of purposes, such as treatment of musculoskeletal and dermatological diseases, cryopreservation of stem cells, treatment of interstitial cystitis, treatment of increased intracranial pressure, and many more [
2,
3,
4,
5,
6,
7].
One of the principal uses of the DMSO is as a vehicle for other drugs, thereby enhancing the effect of the drug, and aiding penetration of other drugs into the skin. For example, it is now well established as a penetration enhancer in topical pharmaceutical formulations. The permeability of drugs to the skin essentially requires that the retained epidermis should be diffused by the drug. DMSO is a safe and effective mechanism for facilitating the transdermal delivery of both hydrophilic and lipophilic medications to provide localized drug delivery.[
8] The effect on cell membranes depends on the concentration of DMSO, from an increased bilayer-fluidity at lower concentrations, through to the formation of water pores and the extraction of lipid molecules at higher concentrations.[
9] Therefore, capability of measuring the local concentration of the DMSO in vivo is important. In addition to these, DMSO is also utilized in other delivery strategies to overcome issues of solubility such as particle size reduction by micronizing the active compound or the use of nanocarriers as a vehicle. As one of those methods, the supercritical antisolvent (SAS) technique utilizes DSMO regularly[
10]. Another example of such a technique is SALT, solvent-assisted active loading technology, which was developed to promote active loading of poorly soluble drugs in the liposomal core to improve the encapsulation efficiency and formulation stability. [
11]
Depending on the application type and its dose, DMSO can induce adverse effects including generation of oxidative stress and cytotoxicity [
12]. When used for the preservation of liquid nitrogen-frozen stem cells, for example, DMSO associated with toxicity in the transplant recipient in a prospective noninterventional study in 64 European Blood and Marrow Transplant Group centers undertaking autologous transplantation on patients with myeloma and lymphoma.[
13] Meanwhile, Madsen et al. reviewed a total of 109 different clinical studies involving intravenous, transdermal, oral, and intravenous administration of DSMO. They showed that gastrointestinal and skin reactions were the commonest reported adverse reactions [
14]. Most importantly, their investigation confirmed a relationship between the given dose of DMSO and the occurrence of adverse reactions.
Since the dose plays an important role in the occurrence of adverse reactions, it is important to have a technique that can provide the distribution and dose of the DSMO. Moreover, DSMO dose also play a critical role effect on cell membranes and hence, the delivery of the drugs. The solubility of the DMSO-mixed water-insoluble drugs depends on the local residual level of the DMSO, and permeability of the drugs decreases by precipitation of the drugs in biological media. Therefore, a technique that can monitor the DSMO concentration will play a critical role in the investigation of the optimum dose of the DMSO for a particular application, from increasing the efficiency of drug delivery to reduce the adverse reactions. Such a technique may also guide the applied DMSO dose real time during these therapeutic applications.
Saar et al. have demonstrated molecular imaging visualizing DMSO with a stimulated Raman scattering technique [
3]. However, this nonlinear microscopy is inadequate for wide-field imaging with an organ-level field of view. Meanwhile, it has long been known that UV/vis/near-IR absorption spectra of chemical compounds may be influenced by the surrounding medium and that solvents can bring about a change in the position, intensity, and shape of absorption bands [
15]. Measuring the environment polarity in different media has been studied extensively with optical fluorescent dyes using solvatochromism [
4]. Indeed, optical dyes are used for this purpose since their molecular spectral profiles are significantly affected by the local polarity of biological media. These compounds whose absorption and emission spectra depend on the environment polarity are known as solvatochromic dyes, which can operate in a wide range of the optical spectrum including ultraviolet, visible, and near-infrared (NIR, ~650-950 nm). However, it is challenging to perform solvatochromic dye-mediated polarity measurements in vivo since these dyes unfortunately have heavily overlapping excitation and emission spectra and exhibit weak solvatochromic shifts in their spectral profiles. Moreover, tissue optical properties affect the measured fluorescence spectra [
5,
6].
Establishing a regular solvatochromic response to various DSMO concentration can serve as a technique for DMSO sensing. Truksa et al. very recently investigated the change in absorption and emission spectra of lumazine, alloxazine and their cyanated or fluorinated derivatives with DSMO [
16]. They measured the modulated spectroscopic properties by varying water concentration in DMSO solutions. Cyano-substituted lumazine has shown a remarkable sensitivity for the relative DMSO-water concentrations, including an unexpected behavior in the solution containing 65 % of water and 35 % of DMSO. It seemed like water-DMSO trimers were formed at this particular concentration and this sensitivity was the manifestation of changes in the local structure of the solvent, i.e., the formation or dissolution of H2O clusters. The authors concluded that together with its enhanced water solubility, the cyanated lumazine derivate could be used for non-destructive DMSO detection in vitro for applications [
16].
In this work, our aim is to develop an in vivo DSMO sensing technique utilizing solvatochromic response of fluorescence dyes. Among the various solvatochromic dyes, Indocyanine green (ICG) is the most widely used NIR dye for fluorescence imaging [
17,
18,
19,
20,
21,
22,
23]. Its absorption peak lies around 800 nm where biological tissue attenuates the fluorescence less and generates low autofluorescence [
8]. Furthermore, hemoglobin absorption stays low and has an isosbestic point at 800 nm. Despite these spectroscopic merits of ICG in the 800 nm spectral window, the use of ICG has been limited to visualize blood perfusion volume and tissue permeability rate-based physiological assessment due to the lack of molecular specificity.
To be able to measure this complex solvatochromic response of ICG, a fluorescence lifetime imaging technique has been introduced [
24]. However, this fluorescence lifetime technique requires either pulsed laser or radio-frequency amplitude modulated light source. In addition, expensive high-speed electronics are necessary to measure the time-domain or the frequency-domain signals. Meanwhile, we have previously developed a novel hyperspectral excitation-resolved near-infrared fluorescence imaging system (HER-NIRF) based on a continuous-wave wavelength-swept laser [
25]. Based on a semiconductor optical amplifier and a wavelength-selector consisting of a holographic transmission grating, a reflection mirror, and a galvo-scanner mirror, this laser source can provide any wavelength between 784 and 805 nm, a range that is particularly optimum for ICG absorption peak. In this study, this technique is applied for measuring the distribution of the therapeutic agent dimethyl sulfoxide (DMSO) by utilizing solvatochromic shift in the spectral profile of ICG. Since ICG is an U.S. Food and Drug Administration approved fluorescent dye, the technique presented in this paper has a great potential to guide DMSO applications
in vivo.
4. Discussion
In this work, we successfully demonstrate the potential of our proof-of-concept HER-NIRF system in monitoring DMSO distribution in turbid media. The spectroscopic measurement of the local polarity expands the information contents of conventional wide-field fluorescence imaging techniques. Our method is based on the solvatochromic shift of ICG, which depends on the local environment. DMSO amount in the local area regulates the amount of the solvatochromic shift and HER-NIRF system measures the extent of this shift to determine the DSMO amount in return. This methodology works perfectly in free space; however, the effect of scattering on the measured signals should be considered in turbid medium such as biological tissue. For this purpose, free-space measurements are performed first prior to using tissue simulating agar phantom, which is designed to mimic in vivo conditions. Different ICG solutions are embedded deep in the phantom to demonstrate the effect of the scattering on the measured fluorescence spectrum. Since the scattering in tissue is dominated by mie-scattering, it is wavelength dependent [
31]. Hence, the lower wavelengths experience higher scattering that creates a red-shift in the fluorescence signals travelling from the ICG target to the surface.
Since the HER-NIRF system differentiates the DSMO solution by the solvatochromic shift that resembles blue-shift, scattering distorts the spectral information in the opposite way. Regardless, our measurements demonstrate that our HER-NIRF system can differentiate DSMO-ICG solution. Although the sign of the slope is used to qualitatively identify the presence of DMSO in each pixel, our measurements show that quantitative imaging can be possible if one can choose appropriate reference signals to minimize the spectral distortion. However, a reference point at the same depth may not be available for all applications. In such cases, one alternative strategy might be performing HER-NIRF imaging before and after the application of DMSO. Hence, determination can be made by considering the change in the slope of the ratiometric fluorescence of the same target. For example, if ICG is accumulated in lymph nodes and imaging is performed before and after the application of DMSO, the technique presented here can be applied since the depth of the reference and target will be the same.
The wavelength-swept laser is the key for our HER-NIRF technique due to its superior performance compared to other available light sources [
16]. Being low-cost, fast in the spectral scan, and able to perform coherent light amplification, this wavelength-swept laser can be a very powerful light source for real-time measurement in various DSMO sensing/mapping applications. While its superior spectral resolution is a big advantage for this application, the HER-NIRF technique also provides much higher signal to noise ratio by measuring the whole fluorescence emission spectrum as opposed to conventional systems utilizing multiple or variable band-pass filters at the detection site. This will be important, particularly for the tomographic HER-NIRF application, where speed is important [
25,
32,
33,
34]. For in vivo applications that requires higher power, optical amplifiers can be utilized to amplify the signal output of the swept-wavelength source. Future tomographic applications will also allow 3D imaging as opposed to 2D mapping of DMSO demonstrated in this study.
One of the strengths of our technique is that the wavelength-swept laser at the core of our system works in the NIR range, centered around 800nm, where auto-fluorescence from the tissue components diminish. Hence, our technique is immune to the contamination of the auto-fluorescence signals originated from various tissue components. On the other hand, there are some weaknesses our system that should be noted. As seen from
Figure 1c, the emitter bandpass filter F2 has a significantly larger bandwidth than the its originally stated bandwidth of 10 nm. This was due to the fact that the performance of the fluorescence emission filters unfortunately depends on the incident angle of the incoming photons. The performance of these filters is optimum when the photons hit the filter perpendicularly. However, in our camera-based system, they are positioned between the lens and the CCD camera, which makes their performance far from ideal. While the lens is focusing the image on to the CCD, different portions of the light beam pass through the filter with various angles that deteriorates the performance of the filter. Although there might be some ways to collimate the beam while passing through emission filter, in practical imaging applications this is the regular configuration so we chose to test the system under this imperfect conditions [
17,
35,
36,
37].
Meanwhile, it important to evaluate the detection limits of this technique. The error in the measured slopes, msolvato and mturbid, is around 11% (0.0018 nm-1). This error is nearly five times smaller than the change in the slope due the blue-shift due solvatochromic shift in DSMO, despite the opposite red-shift in the fluorescence signals travelling from the ICG target to the surface, msolvato–mturbid (0.0090 nm-1). Therefore, the method of applying a thresholding worked as shown in our study. It should be noted that though, the red-shift due to the scattering depends on the depth of the inclusions, and the scattering of the medium. Therefore, the signal generated by the deeper inclusions will experience higher red-shift and at some point, when the error in the measured slopes is comparable to the msolvato - mturbid, our technique will reach to its detection limit. Since there are two parameters that govern this limit, the reduced scattering coefficient of the medium and depth of the inclusion, the depth limit of our technique will depend on the tissue type. However, it might be safe to state that in regular tissues, our technique will be limited to 1cm.
The ability to measure distribution of DMSO in vivo can lead to a better understanding of the optimum DSMO concentration required for many therapeutic and drug delivery applications. Furthermore, such a system can guide those applications real-time by optimizing the DSMO dose in the future. On the other hand, this technique can also help increasing the knowledge of the pharmacokinetic properties of ICG in tissue. For instance, K. Licha et al. have demonstrated that increasing hydrophilicity of cyanine dyes enhances the fluorescence image contrast of tumor by inhibiting the plasma protein binding of these dyes [
14]. Thus, the properties of DMSO inhibiting the albumin binding of ICG can lead to better understanding of the pharmacokinetics of ICG for tumor imaging. Finally, by providing additional spectral information, HER-NIRF technique can be applied for measuring solvatochromic response of other fluorescence dyes and even be adapted for endoscopic applications due to efficient light guiding by fiber optics.