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. 2022 Jun 16;14(6):1282. doi: 10.3390/pharmaceutics14061282

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Schematic diagram of the various cellular change mechanisms induced by ultrasound. ① Cavitation caused by ultrasonic waves induces the rupture of bubble contrast agents in cells. ② Drug cargo is released, and acoustically powered drug delivery is provided. ③ Intracellular reactive oxygen species (ROS) may also be involved in cytotoxicity due to ultrasound excitation and generation. ROS-mediated mitochondrial membrane damage and the release of cytochrome c induce apoptosis. ④ There is also membrane damage due to the treatment with high-frequency sound waves since the unavoidable heat generation.