摘要
Malignant pleural effusion burdens quality of life and often recurs after pleurodesis because sclerosants distribute unevenly and interact variably with mesothelium. Here, we report an ultrasound-responsive liquid-foam of microbubbles designed to coat pleural surfaces broadly and to transiently enhance cellular permeability via sonoporation. Foam formulations were characterized for size, stability, ultrasound-mediated cavitation in vitro and in an orthotopic mouse model. Insonation of drug-loaded foam increased drug penetration with dependencies on exposure duration and acoustic pressure. Aligning bubble size with ultrasound frequency improved sonoporation efficiency. In vivo, tigecycline-laden foam combined with extracorporeal ultrasound induced broad tissue adhesion and fibrosis across pleural surfaces, accompanied by elevated fibrogenic signaling, consistent with successful pleurodesis and superior to solution or gel formulations. Quantification of pleurodesis endpoints combined histology with deep-learning image analysis to measure coverage, adhesion uniformity, and fibrosis across lung lobes, indicating robust and durable treatment effects and a practical path toward clinical deployment. This approach provides a clinically accessible strategy to improve pleurodesis and establishes a generalizable platform for ultrasound-guided delivery of therapeutic agents into body cavities. © 2026 Elsevier B.V.