Curiouser and curiouser—Sonoluminescence, sonoporation, and sonodynamic therapy

The potential of sonodynamic therapy (SDT) for delivering highly localised therapy with minimal side-effects is extremely attractive for a range of applications, including multiple forms of cancer and antibiotic resistant infections. There is also increasing evidence of beneficial immunostimulatory effects for treating metastatic disease. Yet, despite the growing evidence for both the pre-clinical and now clinical efficacy of SDT, the mechanisms underpinning ultrasound mediated drug activation remain unclear. This has inhibited optimisation of ultrasound exposure conditions and dosing protocols. This talk will review the range of mechanisms proposed in the literature and the corresponding supporting and contradictory evidence. These will include recent investigations by the authors into the role of sonoporation, and theoretical and experimental quantification of sonoluminescence. The importance of selecting appropriate treatment monitoring protocols to detect cavitation will also be discussed.