1
|
Kim E, Yoo JS, Kim YJ, Joo J, Oh ES, Chung Y, Chung SH, Kim TH. Toxicity Evaluation of Dose-Escalation in Hypofractionated Regional Nodal Irradiation for Breast Cancer: A Retrospective Study. Int J Radiat Oncol Biol Phys 2024; 120:823-834. [PMID: 38631540 DOI: 10.1016/j.ijrobp.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Regional nodal irradiation (RNI) to the axilla and supraclavicular area presents distinct toxicities, such as lymphedema and shoulder stiffness, compared with whole-breast irradiation. There is insufficient evidence on the safety of dose-escalation in hypofractionated RNI. We aimed to evaluate and compare toxicity rates in patients with breast cancer who received hypofractionated RNI with and without dose-escalation. METHODS AND MATERIALS We retrospectively analyzed 381 patients with breast cancer treated with hypofractionated RNI between March 2015 and February 2017. Patients received either the standard-dose to the regional nodal area (43.2 Gy/16 fx; 48.7 Gy3.5 equivalent dose [EQD2], 2 Gy equivalent dose with α/β= 3.5 Gy) or dose-escalation with a median dose of 54.8 Gy3.5 EQD2 (range, 51.7-60.9 Gy3.5 EQD2), depending on clinical and pathologic nodal stage. Toxicity rates of lymphedema and shoulder stiffness were assessed, and statistical analyses were conducted to identify associated factors. RESULTS The median follow-up time was 32.3 months (5.7-47.0 months). After radiation therapy, 71 (18.6%) patients developed lymphedema, and 48 (12.6%) developed shoulder stiffness. Patients who received dose-escalation exhibited significantly higher rates of lymphedema (32.1% vs 14.8%; odds ratio, 2.72, P = .0004) and shoulder stiffness (23.8% vs 9.4%; odds ratio, 2.01, P = .0205) compared with the standard-dose group. Moreover, dose-escalation showed a tendency to increase the severity of lymphedema and shoulder stiffness. CONCLUSIONS Patients who received dose-escalation in hypofractionated RNI face a higher risk of developing lymphedema and shoulder stiffness compared with those who received standard-dose hypofractionated RNI. Therefore, it is crucial to implement close and frequent monitoring for early detection, along with timely rehabilitation interventions for these patients.
Collapse
Affiliation(s)
- Euidam Kim
- Department of Nuclear Engineering, Hanyang University, Seoul, Republic of Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
| | - Yeon-Joo Kim
- Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
| | - Jungnam Joo
- Office of Biostatistics Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Eun Sang Oh
- Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Yoonsun Chung
- Department of Nuclear Engineering, Hanyang University, Seoul, Republic of Korea
| | - Seung Hyun Chung
- Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Tae Hyun Kim
- Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| |
Collapse
|
2
|
Xue Q, Lai H, Zhang H, Li G, Pi F, Wu Q, Liu S, Yang F, Chen T. Selenium Attenuates Radiation Colitis by Regulating cGAS-STING Signaling. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2403918. [PMID: 39348242 DOI: 10.1002/advs.202403918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 08/12/2024] [Indexed: 10/02/2024]
Abstract
Radiation colitis is one of the most common complications in patients undergoing pelvic radiotherapy and there is no effective treatment in the clinic. Therefore, searching for effective agents for the treatment of radiation colitis is urgently needed. Herein, it is found that the essential element selenium (Se) is protective against radiation colitis through inhibiting X-ray-induced apoptosis, cell cycle arrest, and inflammation with the involvement of balancing the generation of reactive oxygen species after the irradiation. Mechanistically, Se, especially for selenium nanoparticles (SeNPs), induced selenoprotein expression and then functioned to effectively restrain DNA damage response, which reduced X-ray-induced intestinal injury. Additionally, SeNPs treatment also restrained the cyclic GMP-AMP synthas (cGAS)- stimulator of interferon genes (STING)-TBK1-IRF3 signaling pathway cascade, thereby blocking the transcription of inflammatory cytokine gene, IL-6 and TNF-α, and thus alleviating inflammation. Moreover, inducing selenoprotein expression, such as GPX4, with SeNPs in vivo can regulate intestinal microenvironment immunity and gut microbiota to attenuate radiation-induced colitis by inhibiting oxidative stress and maintaining microenvironment immunity homeostasis. Together, these results unravel a previously unidentified modulation role that SeNPs restrained radiation colitis with the involvement of inducing selenoprotein expression but suppressing cGAS-STING-TBK1-IRF3 cascade.
Collapse
Affiliation(s)
- Qian Xue
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Haoqiang Lai
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Haimei Zhang
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Guizhen Li
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Fen Pi
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Qifeng Wu
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Siwei Liu
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Fang Yang
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| | - Tianfeng Chen
- Department of Oncology of the First Affiliated Hospital, Department of Chemistry, State Key Laboratory of Bioactive Molecules and Druggalibility Assessment, Key laboratory of Viral Pathogenesis & Infection Prevention and Control, Ministry of Education, MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou, 510632, China
| |
Collapse
|
3
|
Oppermann A, James S, Minotti MM, Schotz KM, Francis ME, Kleckner IR, Vyfhuis MAL, Ferris MJ, Baguley BJ, Kleckner AS. Dietary Counseling Interventions During Radiation Therapy: A Systematic Review of Feasibility, Safety, and Efficacy. Nutr Cancer 2024:1-25. [PMID: 39340400 DOI: 10.1080/01635581.2024.2406999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 09/14/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
Radiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26-468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes.
Collapse
Affiliation(s)
- Alexie Oppermann
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Shalet James
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
- Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Mackenzie M Minotti
- University of Maryland Medical System, Baltimore, Maryland, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Kaitlin M Schotz
- University of Maryland Medical System, Baltimore, Maryland, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | - Ian R Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Melissa A L Vyfhuis
- University of Maryland Medical System, Baltimore, Maryland, USA
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Matthew J Ferris
- University of Maryland Medical System, Baltimore, Maryland, USA
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Brenton J Baguley
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Amber S Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| |
Collapse
|
4
|
Attar GS, Kumar M, Bhalla V. Targeting sub-cellular organelles for boosting precision photodynamic therapy. Chem Commun (Camb) 2024. [PMID: 39320942 DOI: 10.1039/d4cc02702g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
Among various cancer treatment methods, photodynamic therapy has received significant attention due to its non-invasiveness and high efficiency in inhibiting tumour growth. Recently, specific organelle targeting photosensitizers have received increasing interest due to their precise accumulation and ability to trigger organelle-mediated cell death signalling pathways, which greatly reduces the drug dosage, minimizes toxicity, avoids multidrug resistance, and prevents recurrence. In this review, recent advances and representative photosensitizers used in targeted photodynamic therapy on organelles, specifically including the endoplasmic reticulum, Golgi apparatus, mitochondria, nucleus, and lysosomes, have been comprehensively reviewed with a focus on organelle structure and organelle-mediated cell death signalling pathways. Furthermore, a perspective on future research and potential challenges in precision photodynamic therapy has been presented at the end.
Collapse
Affiliation(s)
- Gopal Singh Attar
- Department of chemistry UGC Sponsored-Centre for Advanced Studies-I, Guru Nanak Dev University, Amritsar-143005, Punjab, India.
| | - Manoj Kumar
- Department of chemistry UGC Sponsored-Centre for Advanced Studies-I, Guru Nanak Dev University, Amritsar-143005, Punjab, India.
| | - Vandana Bhalla
- Department of chemistry UGC Sponsored-Centre for Advanced Studies-I, Guru Nanak Dev University, Amritsar-143005, Punjab, India.
| |
Collapse
|
5
|
Cui J, Wang TJ, Zhang YX, She LZ, Zhao YC. Molecular biological mechanisms of radiotherapy-induced skin injury occurrence and treatment. Biomed Pharmacother 2024; 180:117470. [PMID: 39321513 DOI: 10.1016/j.biopha.2024.117470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 09/03/2024] [Accepted: 09/19/2024] [Indexed: 09/27/2024] Open
Abstract
Radiotherapy-Induced Skin Injury (RISI) is radiation damage to normal skin tissue that primarily occurs during tumor Radiotherapy and occupational exposure. The risk of RISI is high due to the fact that the skin is not only the first body organ that ionizing radiation comes into contact with, but it is also highly sensitive to it, especially the basal cell layer and capillaries. Typical clinical manifestations of RISI include erythema, dry desquamation, moist desquamation, and ulcers, which have been established to significantly impact patient care and cancer treatment. Notably, our current understanding of RISI's pathological mechanisms and signaling pathways is inadequate, and no standard treatments have been established. Radiation-induced oxidative stress, inflammatory responses, fibrosis, apoptosis, and cellular senescence are among the known mechanisms that interact and promote disease progression. Additionally, radiation can damage all cellular components and induce genetic and epigenetic changes, which play a crucial role in the occurrence and progression of skin injury. A deeper understanding of these mechanisms and pathways is crucial for exploring the potential therapeutic targets for RISI. Therefore, in this review, we summarize the key mechanisms and potential treatment methods for RISI, offering a reference for future research and development of treatment strategies.
Collapse
Affiliation(s)
- Jie Cui
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
| | - Tie-Jun Wang
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
| | - Yu-Xuan Zhang
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
| | - Li-Zhen She
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
| | - Yue-Chen Zhao
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130022, China.
| |
Collapse
|
6
|
Yang YJ, Lee YS, Tae JH, Choi J, Kim JH, Yang EJ, Nguyen TT, Choi SY. Salvage lymphadenectomy or radiation therapy in prostate cancer patients with biochemical recurrence and PET positive lymph nodes after radical prostatectomy: A systematic review and pooled analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108704. [PMID: 39326304 DOI: 10.1016/j.ejso.2024.108704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/15/2024] [Accepted: 09/20/2024] [Indexed: 09/28/2024]
Abstract
OBJECTIVE To analyze the oncologic outcomes of biochemical recurrence (BCR) patients who received salvage treatment of lymph node dissection (LND) or radiation therapy (RT) for positron emission tomography (PET)-positive lymph node recurrences following radical prostatectomy (RP). METHODS Research using the MEDLINE, Cochrane, and Web of Science databases was conducted until June 2023. Inclusion criteria were BCR patients that received salvage LND or RT for PET-positive lymph node recurrence following primary RP for prostate cancer. Studies with a follow-up period of less than 12 months were excluded. RESULTS This study included 2476 patients (995 LND, 1481 RT) from 19 publications. The pooled incidences were 51.1 % and 74.3 % in PSA response, 69.8 % and 26.9 % in PSA progression, 41.5 % and 26.9 % in image progression, 41.5 % and 32.0 % in systemic progression, 0.9 % and 0.5 % in overall mortality, and 6.5 % and 1.3 % in cancer-specific mortality in LND and RT, respectively. Limitations include high heterogeneity. CONCLUSION Although heterogeneity is high across all studies, the pooled rates of PSA, image, and systemic progressions are higher in LND than in RT concerning BCR patients with PET-positive lymph nodes. For future trial designs in BCR, assessing the optimal timing of PSMA PET scans, concurrent systemic therapy, and salvage therapy type is imperative.
Collapse
Affiliation(s)
- Yun-Jung Yang
- Institute of Biomedical Science, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
| | - Yong Seong Lee
- Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Jong Hyun Tae
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
| | - Joongwon Choi
- Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Jung Hoon Kim
- Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Eun-Jung Yang
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Tuan Thanh Nguyen
- Department of Urology, Cho Ray Hospital, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Se Young Choi
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Liao Y, Wang D, Gu C, Wang X, Zhu S, Zheng Z, Zhang F, Yan J, Gu Z. A cuproptosis nanocapsule for cancer radiotherapy. NATURE NANOTECHNOLOGY 2024:10.1038/s41565-024-01784-1. [PMID: 39300223 DOI: 10.1038/s41565-024-01784-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 08/08/2024] [Indexed: 09/22/2024]
Abstract
Residual tumours that persist after radiotherapy often develop acquired radiation resistance, increasing the risk of recurrence and metastasis while providing obstacles to re-irradiation. Using samples from patients and experimental mice, we discovered that FDX1 and LIAS, key regulators of cuproptosis, were up-regulated in residual tumours following radiotherapy, conferring the increased sensitivity to cuproptosis. Therefore, we proposed a novel radiosensitization strategy focused on cuproptosis, using a copper-containing nanocapsule-like polyoxometalate as a paradigm. In an initial demonstration, we showed that the nanocapsule released copper ions in a controlled manner upon exposure to ionizing radiation. Furthermore, radiation-triggered cuproptosis overcame acquired radiation resistance even at clinically relevant radiation doses and activated a robust abscopal effect, with a 40% cure rate in both radioresistant and re-irradiation tumour models. Collectively, targeting cuproptosis is a compelling strategy for addressing acquired radiation resistance, optimizing the local antitumour effects of radiotherapy while simultaneously activating systemic antitumour immunity.
Collapse
Affiliation(s)
- You Liao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Chenglu Gu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Xue Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Shuang Zhu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Ziye Zheng
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junfang Yan
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Zhanjun Gu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China.
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
8
|
Chaswal V, Ramirez JC, Morcos M, Romaguera T, Abraham U, George SC, McCulloch J, Llanes Lopez A, Rodrigues MA, Gutierrez AN, Tolakanahalli R. SAVI catheter digitization impact: A single institution multiuser uncertainty study. Med Dosim 2024:S0958-3947(24)00038-4. [PMID: 39266380 DOI: 10.1016/j.meddos.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/04/2024] [Indexed: 09/14/2024]
Abstract
To assess the impact of Strut Adjusted Volume Implant (SAVI) catheter digitization variability on dosimetric evaluation parameters of HDR breast brachytherapy treatment plans. Four clinically approved SAVI cases were chosen for this digitization variability analysis. All patients were implanted with 6-1 SAVI device. Six experienced physicists independently digitized SAVI catheters. Plans utilizing significant peripheral loading were used for this study where SAVI catheters were near the chest wall and/or skin. After digitization was completed for each case by each physicist, the original clinical dwell times were copied over for comparison. This ensured that only variability among plans is the digitization of SAVI catheters by different users. The original plan that went through two physicists' checks and one physician's review was considered the "ground truth" plan to which all other plans were compared. Plans were evaluated on planning parameters for lumpectomy cavity's PTV_Eval D90, V150, V200 and for the OARs (Chest-Wall/Ribs and Skin), on D0.03cc, D0.1cc, D1cc, D2cc. Additionally, a visualization window setting-based uncertainty test was performed on the same 4 cases. Our results showed that the average and maximum dwell positional digitization uncertainties were 0.36 and 0.75 mm, respectively. Average PTV_Eval D90 was 97.11+/-2.93 %, V150 was 23.10+/-4.25 cc, V200 was 11.88+/-1.93 cc. All OAR constraints were met on all plans - Chest-Wall/Ribs (CW/Ribs) and Skin D0.03cc was 103.40+/-9.23 % and 93.60+/-6.14 %, respectively. Aggregate analysis across all plans shows a clinically nonsignificant spread around the mean for all parameters considered. The robustness of SAVI treatment plans to minor variation in catheter digitization was proved through our multiuser study. Our study showed that SAVI planning constraints are stable within reasonable variation of digitization differences. Such uncertainty analysis is useful in standardization of digitization practices in a department and in defining action levels on digitization fixing request during a 2nd check.
Collapse
Affiliation(s)
- Vibha Chaswal
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA.
| | - Juan C Ramirez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Marc Morcos
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Tino Romaguera
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Usha Abraham
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Siju C George
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - James McCulloch
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Alejandro Llanes Lopez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA
| | - Maria Amelia Rodrigues
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA
| | - Alonso N Gutierrez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Ranjini Tolakanahalli
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Fl, 33176, USA.; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| |
Collapse
|
9
|
Giuranno L, Piepers JAF, Korsten E, Borman R, van de Kamp G, De Ruysscher D, Essers J, Vooijs MA. Enhanced radiation sensitivity, decreased DNA damage repair, and differentiation defects in airway stem cells derived from patients with chronic obstructive pulmonary disease. Stem Cells Transl Med 2024; 13:927-939. [PMID: 38946043 PMCID: PMC11386216 DOI: 10.1093/stcltm/szae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 05/22/2024] [Indexed: 07/02/2024] Open
Abstract
Radiation therapy (RT) is a common treatment for lung cancer. Still, it can lead to irreversible loss of pulmonary function and a significant reduction in quality of life for one-third of patients. Preexisting comorbidities, such as chronic obstructive pulmonary disease (COPD), are frequent in patients with lung cancer and further increase the risk of complications. Because lung stem cells are crucial for the regeneration of lung tissue following injury, we hypothesized that airway stem cells from patients with COPD with lung cancer might contribute to increased radiation sensitivity. We used the air-liquid interface model, a three-dimensional (3D) culture system, to compare the radiation response of primary human airway stem cells from healthy and patients with COPD. We found that COPD-derived airway stem cells, compared to healthy airway stem cell cultures, exhibited disproportionate pathological mucociliary differentiation, aberrant cell cycle checkpoints, residual DNA damage, reduced survival of stem cells and self-renewal, and terminally differentiated cells post-irradiation, which could be reversed by blocking the Notch pathway using small-molecule γ-secretase inhibitors. Our findings shed light on the mechanisms underlying the increased radiation sensitivity of COPD and suggest that airway stem cells reflect part of the pathological remodeling seen in lung tissue from patients with lung cancer receiving thoracic RT.
Collapse
Affiliation(s)
- Lorena Giuranno
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| | - Jolanda A F Piepers
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| | - Evelien Korsten
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| | - Reitske Borman
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| | - Gerarda van de Kamp
- Department of Molecular Genetics, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
- Oncode Institute, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
| | - Dirk De Ruysscher
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| | - Jeroen Essers
- Department of Molecular Genetics, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
- Department of Radiotherapy, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
- Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
| | - Marc A Vooijs
- Department of Radiation Oncology (MAASTRO)/GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, 6200 MD, The Netherlands
| |
Collapse
|
10
|
Hoshi R, Gorospe KA, Labouta HI, Azad T, Lee WL, Thu KL. Alternative Strategies for Delivering Immunotherapeutics Targeting the PD-1/PD-L1 Immune Checkpoint in Cancer. Pharmaceutics 2024; 16:1181. [PMID: 39339217 PMCID: PMC11434872 DOI: 10.3390/pharmaceutics16091181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 09/30/2024] Open
Abstract
The programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) immune checkpoint constitutes an inhibitory pathway best known for its regulation of cluster of differentiation 8 (CD8)+ T cell-mediated immune responses. Engagement of PD-L1 with PD-1 expressed on CD8+ T cells activates downstream signaling pathways that culminate in T cell exhaustion and/or apoptosis. Physiologically, these immunosuppressive effects exist to prevent autoimmunity, but cancer cells exploit this pathway by overexpressing PD-L1 to facilitate immune escape. Intravenously (IV) administered immune checkpoint inhibitors (ICIs) that block the interaction between PD-1/PD-L1 have achieved great success in reversing T cell exhaustion and promoting tumor regression in various malignancies. However, these ICIs can cause immune-related adverse events (irAEs) due to off-tumor toxicities which limits their therapeutic potential. Therefore, considerable effort has been channeled into exploring alternative delivery strategies that enhance tumor-directed delivery of PD-1/PD-L1 ICIs and reduce irAEs. Here, we briefly describe PD-1/PD-L1-targeted cancer immunotherapy and associated irAEs. We then provide a detailed review of alternative delivery approaches, including locoregional (LDD)-, oncolytic virus (OV)-, nanoparticle (NP)-, and ultrasound and microbubble (USMB)-mediated delivery that are currently under investigation for enhancing tumor-specific delivery to minimize toxic off-tumor effects. We conclude with a commentary on key challenges associated with these delivery methods and potential strategies to mitigate them.
Collapse
Affiliation(s)
- Ryunosuke Hoshi
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5S 1A8, Canada; (R.H.); (K.A.G.); (W.L.L.)
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada;
| | - Kristyna A. Gorospe
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5S 1A8, Canada; (R.H.); (K.A.G.); (W.L.L.)
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada;
| | - Hagar I. Labouta
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada;
- Leslie Dan Faculty of Pharmacy, University of Toronto, St. George Campus, Toronto, ON M5S 3M2, Canada
- Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, St. George Campus, Toronto, ON M5S 3E2, Canada
| | - Taha Azad
- Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Health Campus, Sherbrooke, QC J1K 2R1, Canada;
- Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1J 3H5, Canada
| | - Warren L. Lee
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5S 1A8, Canada; (R.H.); (K.A.G.); (W.L.L.)
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada;
- Biochemistry, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5S 1A8, Canada
- Medicine and the Interdepartmental Division of Critical Care Medicine, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5B 1T8, Canada
| | - Kelsie L. Thu
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, St. George Campus, Toronto, ON M5S 1A8, Canada; (R.H.); (K.A.G.); (W.L.L.)
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, ON M5B 1T8, Canada;
| |
Collapse
|
11
|
Xie LW, Lu HY, Tang LF, Tang FL, Zhu RQ, Wang DF, Cai S, Tian Y, Li M. Probiotic Consortia Protect the Intestine Against Radiation Injury by Improving Intestinal Epithelial Homeostasis. Int J Radiat Oncol Biol Phys 2024; 120:189-204. [PMID: 38485099 DOI: 10.1016/j.ijrobp.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/25/2024] [Accepted: 03/02/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE Radiation-induced intestinal injury (RIII) commonly occur during abdominal-pelvic cancer radiation therapy; however, no effective prophylactic or therapeutic agents are available to manage RIII currently. This study aimed to clarify the potential of probiotic consortium supplementation in alleviating RIII. METHODS AND MATERIALS Male C57BL/6J mice were orally administered a probiotic mixture comprising Bifidobacterium longum BL21, Lactobacillus paracasei LC86, and Lactobacillus plantarum Lp90 for 30 days before exposure to 13 Gy of whole abdominal irradiation. The survival rates, clinical scores, and histologic changes in the intestines of mice were assessed. The impacts of probiotic consortium treatment on intestinal stem cell proliferation, differentiation, and epithelial barrier function; oxidative stress; and inflammatory cytokines were evaluated. A comprehensive examination of the gut microbiota composition was conducted through 16S rRNA sequencing, while changes in metabolites were identified using liquid chromatography-mass spectrometry. RESULTS The probiotic consortium alleviated RIII, as reflected by increased survival rates, improved clinical scores, and mitigated mucosal injury. The probiotic consortium treatment exhibited enhanced therapeutic effects at the histologic level compared with individual probiotic strains, although there was no corresponding improvement in survival rates and colon length. Moreover, the probiotic consortium stimulated intestinal stem cell proliferation and differentiation, enhanced the integrity of the intestinal epithelial barrier, and regulated redox imbalance and inflammatory responses in irradiated mice. Notably, the treatment induced a restructuring of the gut microbiota composition, particularly enriching short-chain fatty acid-producing bacteria. Metabolomic analysis revealed distinctive metabolic changes associated with the probiotic consortium, including elevated levels of anti-inflammatory and antiradiation metabolites. CONCLUSIONS The probiotic consortium attenuated RIII by modulating the gut microbiota and metabolites, improving inflammatory symptoms, and regulating oxidative stress. These findings provide new insights into the maintenance of intestinal health with probiotic consortium supplementation and will facilitate the development of probiotic-based therapeutic strategies for RIII in clinical practice.
Collapse
Affiliation(s)
- Li-Wei Xie
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China
| | - Hai-Yan Lu
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China
| | - Lin-Feng Tang
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, China
| | - Feng-Ling Tang
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China
| | - Rui-Qiu Zhu
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China
| | - Di-Fan Wang
- Medical College of Soochow University, Suzhou, China
| | - Shang Cai
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China
| | - Ye Tian
- Department of Radiotherapy and Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China; Institute of Radiotherapy and Oncology, Soochow University, Suzhou, China.
| | - Ming Li
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, China.
| |
Collapse
|
12
|
Omar O, Rydén L, Wamied AR, Al-Otain I, Alhawaj H, Abuohashish H, Al-Qarni F, Emanuelsson L, Johansson A, Palmquist A, Thomsen P. Molecular mechanisms of poor osseointegration in irradiated bone: In vivo study in a rat tibia model. J Clin Periodontol 2024; 51:1236-1251. [PMID: 38798064 DOI: 10.1111/jcpe.14021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/30/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
AIM Radiotherapy is associated with cell depletion and loss of blood supply, which are linked to compromised bone healing. However, the molecular events underlying these effects at the tissue-implant interface have not been fully elucidated. This study aimed to determine the major molecular mediators associated with compromised osseointegration due to previous exposure to radiation. MATERIALS AND METHODS Titanium implants were placed in rat tibiae with or without pre-exposure to 20 Gy irradiation. Histomorphometric, biomechanical, quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay analyses were performed at 1 and 4 weeks after implantation. RESULTS The detrimental effects of irradiation were characterized by reduced bone-implant contact and removal torque. Furthermore, pre-exposure to radiation induced different molecular dysfunctions such as (i) increased expression of pro-inflammatory (Tnf) and osteoclastic (Ctsk) genes and decreased expression of the bone formation (Alpl) gene in implant-adherent cells; (ii) increased expression of bone formation (Alpl and Bglap) genes in peri-implant bone; and (iii) increased expression of pro-inflammatory (Tnf) and pro-fibrotic (Tgfb1) genes in peri-implant soft tissue. The serum levels of pro-inflammatory, bone formation and bone resorption proteins were greater in the irradiated rats. CONCLUSIONS Irradiation causes the dysregulation of multiple biological activities, among which perturbed inflammation seems to play a common role in hindering osseointegration.
Collapse
Affiliation(s)
- Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Louise Rydén
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Ibrahim Al-Otain
- Radiation Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Hussain Alhawaj
- Department of Environmental Health Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hatem Abuohashish
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal Al-Qarni
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lena Emanuelsson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Johansson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
13
|
Andrianu K, Works D, Christiansen A, Enke C, Chaiken L, Baine M. Exploring the Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Genitourinary Toxicities in Prostate Cancer Patients Undergoing Radiation Therapy: A Case Study and Discussion. Pract Radiat Oncol 2024; 14:373-376. [PMID: 38752974 DOI: 10.1016/j.prro.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 09/03/2024]
Abstract
Radiation therapy is a common treatment modality offered to patients with localized prostate cancer. It can be associated with early radiation-induced toxicities including dysuria, nocturia, frequency, urgency, spasm, and, rarely, hematuria. Early toxicities usually resolve once the treatment period has ended. Chronic toxicities are less common, and rarely, patients may experience radiation-induced hemorrhagic cystitis and hematuria months or years after radiation. We herein describe the case of a 65-year-old man with a past medical history of type-2 diabetes mellitus who experienced hemorrhagic cystitis for months following his radiation therapy. The patient was on sodium-glucose cotransporter-2 inhibitor therapy (empagliflozin), which we highlight as a potential risk factor for hemorrhagic cystitis. After cessation of Jardiance and initiation of semaglutide (GLP-1 agonist), his urinary symptoms significantly improved. To the best of our knowledge, this is the first such case reported.
Collapse
Affiliation(s)
- Kelly Andrianu
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
| | - Duncan Works
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Andrew Christiansen
- Department of Urology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Charles Enke
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lisa Chaiken
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Michael Baine
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| |
Collapse
|
14
|
Zhang D, Li Y, Pan J, Zheng Y, Xu X. Copper homeostasis and cuproptosis in radiation-induced injury. Biomed Pharmacother 2024; 178:117150. [PMID: 39047417 DOI: 10.1016/j.biopha.2024.117150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024] Open
Abstract
Radiation therapy for cancer treatment brings about a series of radiation injuries to normal tissues. In recent years, the discovery of copper-regulated cell death, cuproptosis, a novel form of programmed cell death, has attracted widespread attention and exploration in various biological functions and pathological mechanisms of copper metabolism and cuproptosis. Understanding its role in the process of radiation injury may open up new avenues and directions for exploration in radiation biology and radiation oncology, thereby improving tumor response and mitigating adverse reactions to radiotherapy. This review provides an overview of copper metabolism, the characteristics of cuproptosis, and their potential regulatory mechanisms in radiation injury.
Collapse
Affiliation(s)
- Daoming Zhang
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yuan Li
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jinghui Pan
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yongfa Zheng
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Ximing Xu
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| |
Collapse
|
15
|
Chu Z, Wang W, Zheng W, Fu W, Wang Y, Wang H, Qian H. Biomaterials with cancer cell-specific cytotoxicity: challenges and perspectives. Chem Soc Rev 2024; 53:8847-8877. [PMID: 39092634 DOI: 10.1039/d4cs00636d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Significant advances have been made in materials for biomedical applications, including tissue engineering, bioimaging, cancer treatment, etc. In the past few decades, nanostructure-mediated therapeutic strategies have been developed to improve drug delivery, targeted therapy, and diagnosis, maximizing therapeutic effectiveness while reducing systemic toxicity and side effects by exploiting the complicated interactions between the materials and the cell and tissue microenvironments. This review briefly introduces the differences between the cells and tissues of tumour or normal cells. We summarize recent advances in tumour microenvironment-mediated therapeutic strategies using nanostructured materials. We then comprehensively discuss strategies for fabricating nanostructures with cancer cell-specific cytotoxicity by precisely controlling their composition, particle size, shape, structure, surface functionalization, and external energy stimulation. Finally, we present perspectives on the challenges and future opportunities of nanotechnology-based toxicity strategies in tumour therapy.
Collapse
Affiliation(s)
- Zhaoyou Chu
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
- The First Affiliated Hospital of Anhui Medical University, Hefei 230022, P. R. China.
| | - Wanni Wang
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
| | - Wang Zheng
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
| | - Wanyue Fu
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
| | - Yujie Wang
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
| | - Hua Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei 230022, P. R. China.
| | - Haisheng Qian
- School of Biomedical Engineering, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, Anhui 230032, P. R. China.
- Anhui Engineering Research Center for Medical Micro-Nano Devices, Anhui Medical University, Hefei 230011, P. R. China
| |
Collapse
|
16
|
Sarogni P, Frusca V, Zamborlin A, Giannini N, Menicagli M, Brancato L, Linsalata S, Di Martino F, Gonnelli A, Paiar F, Van den Bossche J, Bogers J, Voliani V. Neoadjuvant Hyperthermia Combined with Hybrid Nanoarchitectures Enhances Chemoradiotherapy Efficacy in Head and Neck Carcinoma. ACS APPLIED MATERIALS & INTERFACES 2024; 16:43272-43282. [PMID: 39126693 DOI: 10.1021/acsami.4c07393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Head and neck squamous cell carcinomas are characterized by a high incidence of recurrence, especially in patients with locally advanced disease. Standard treatment strategies can be associated with severe side effects to healthy tissues that can negatively impact the patient's quality of life. Hyperthermia (HT) is a noninvasive treatment modality that has improved the effectiveness of chemotherapy (CT) and/or radiotherapy (RT) for the management of some solid neoplasms. In this context, the association of this approach with rationally designed nanomaterials may further enhance the treatment outcome. In this study, we demonstrate the enhanced effect of neoadjuvant HT in combination with hybrid nanoarchitectures enclosing a cisplatin prodrug (NAs-CisPt) and RT. All the treatments and their combinations have been fully evaluated by employing standardized chorioallantoic membrane tumor models of HPV-negative head and neck carcinoma. An improved tumor-shrinking effect was observed by the administration of the trimodal treatment (HT/NAs-CisPt/RT), which also highlighted a significant increase in apoptosis. Our findings demonstrate that the combination of HT with nanotechnology-based CT and RT in a certain order enhances the in vivo treatment outcome. On a broader basis, this study paves the way for the next exploration of noninvasive treatment approaches for the clinical management of oral cancer based on innovative strategies.
Collapse
Affiliation(s)
- Patrizia Sarogni
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Valentina Frusca
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Agata Zamborlin
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
- NEST-Scuola Normale Superiore, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - Noemi Giannini
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
- Radiation Oncology Unit, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, 56126 Pisa, Italy
| | - Michele Menicagli
- Fondazione Pisana per la Scienza ONLUS, via Ferruccio Giovannini 13, S. Giuliano Terme, 56017 Pisa, Italy
| | | | - Stefania Linsalata
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, 56126 Pisa, Italy
| | - Fabio Di Martino
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, 56126 Pisa, Italy
| | - Alessandra Gonnelli
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
- Radiation Oncology Unit, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, 56126 Pisa, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Via Roma 67, 56126 Pisa, Italy
| | | | - Johannes Bogers
- ElmediX NV, Esperantolaan 4, 3001 Heverlee, Belgium
- Laboratory of Cell Biology and Histology, University of Antwerp, 2610 Antwerp, Belgium
| | - Valerio Voliani
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
- Department of Pharmacy, School of Medical and Pharmaceutical Sciences, University of Genoa, Viale Cembrano, 4, 16148 Genoa, Italy
| |
Collapse
|
17
|
Chmil V, Živná N, Milanová M, Filipová A, Pejchal J, Prchal L, Muthná D, Řeháček V, Řezáčová M, Marek J, Tichý A, Havelek R. Second-generation piperazine derivatives as promising radiation countermeasures. RSC Med Chem 2024; 15:2855-2866. [PMID: 39149108 PMCID: PMC11324046 DOI: 10.1039/d4md00311j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/06/2024] [Indexed: 08/17/2024] Open
Abstract
The increasing threat of nuclear incidents and the widespread use of ionizing radiation (IR) in medical treatments underscore the urgent need for effective radiation countermeasures. Despite the availability of compounds such as amifostine, their clinical utility is significantly limited by adverse side effects and logistical challenges in administration. This study focuses on the synthesis and evaluation of novel piperazine derivatives as potential radioprotective agents, with the aim of overcoming the limitations associated with current countermeasures. We designed, synthesized, and evaluated a series of 1-(2-hydroxyethyl)piperazine derivatives. The compounds were assessed for cytotoxicity across a panel of human cell lines, and for their radioprotective effects in the MOLT-4 lymphoblastic leukemia cell line and in peripheral blood mononuclear cells (PBMCs) exposed to gamma radiation. The radioprotective efficacy was further quantified using the dicentric chromosome assay (DCA) to measure DNA damage mitigation. Among the synthesized derivatives, compound 6 demonstrated the most significant radioprotective effects in vitro, with minimal cytotoxicity across the tested cell lines. Compound 3 also showed notable efficacy, particularly in reducing dicentric chromosomes, thus indicating its potential to mitigate DNA damage from IR. Both compounds exhibited superior safety profiles and effectiveness compared to amifostine, suggesting their potential as more viable radioprotective agents. This study highlights the development of novel piperazine derivatives with promising radioprotective properties. Compound 6 emerged as the leading candidate, offering an optimal balance between efficacy and safety, with compound 3 also displaying significant potential. These findings support the further development and clinical evaluation of these compounds as safer, and more effective radiation countermeasures.
Collapse
Affiliation(s)
- Vojtěch Chmil
- Department of Radiobiology, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
| | - Natálie Živná
- Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
- Biomedical Research Centre, University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove Czech Republic
| | - Marcela Milanová
- Department of Radiobiology, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
| | - Alžběta Filipová
- Department of Radiobiology, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
| | - Lukáš Prchal
- Biomedical Research Centre, University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove Czech Republic
| | - Darina Muthná
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University Simkova 870 500 03 Hradec Kralove Czech Republic
| | - Vít Řeháček
- Transfusion Department, University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove - Novy Hradec Kralove Czech Republic
| | - Martina Řezáčová
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University Simkova 870 500 03 Hradec Kralove Czech Republic
| | - Jan Marek
- Biomedical Research Centre, University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove Czech Republic
- Department of Epidemiology, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
| | - Aleš Tichý
- Department of Radiobiology, Military Faculty of Medicine, University of Defence in Brno Trebesska 1575 500 05 Hradec Kralove Czech Republic
- Biomedical Research Centre, University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove Czech Republic
| | - Radim Havelek
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University Simkova 870 500 03 Hradec Kralove Czech Republic
| |
Collapse
|
18
|
Rose ML, Sachdeva R, Mezgueldi Y, Yen RW, Serraj LA, Corbett KL, Yock TI. Systematic Review and Meta-Analysis of Adjuvant Radiation Dose for Pediatric Patients (≤22 years) with Nonmetastatic Intracranial Ependymomas. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)03206-1. [PMID: 39147207 DOI: 10.1016/j.ijrobp.2024.07.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/27/2024] [Accepted: 07/28/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE Ependymomas are the third most common brain tumors in children. Standard of care is surgery followed by adjuvant radiation therapy. Controversy in the literature still exists over optimal radiation therapy dose. We completed a systematic review and meta-analysis to determine the optimal dose for local control (LC), event-free survival (EFS), and overall survival (OS) in pediatric patients. METHODS AND MATERIALS We searched MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and Web of Science through January 2024. We included cohort studies that compared adjuvant radiation therapy of ≤54 Gy with >54 Gy in pediatric patients (≤22 years) with nonmetastatic intracranial ependymomas. We assessed study quality using the Newcastle-Ottawa Quality Assessment Scale of Cohort Studies. We pooled studies using a random effects meta-analysis for hazard ratios (HR), 95% confidence intervals (CI), and assessed statistical heterogeneity via I2. When HRs were unavailable, we transformed risks using established methods. We narratively summarized qualitative outcomes. RESULTS Seven studies met our inclusion criteria, covering a combined 1321 patients. Studies included a range of doses from 45 to 66.6 Gy. Compared with >54 Gy, we found no difference in LC for those receiving ≤54 Gy (HR, 0.83; 95% CI, 0.56-1.24; I2, 49.1%), in EFS (HR, 1.02; 95% CI, 0.95-1.09; I2, 0.00%), and OS (HR, 0.99; 95% CI, 0.82-1.20; I2, 37.5%). Two studies reported on subtotal resection by radiation therapy dose, neither study reporting statistical differences in LC, EFS, or OS, although the number of patients was small (n ≤ 30). Five studies reported on late effects, with brainstem radionecrosis, radiation-induced vasculopathy, and secondary tumors being the most frequent. Overall study quality was high, although lower scores were consistently seen in comparability of cohorts. To our knowledge, no studies reported on molecular subgroups. CONCLUSIONS We found no difference in LC, EFS, or OS for those treated with ≤54 Gy compared with >54 Gy. There were insufficient data to complete a subgroup meta-analysis on radiation therapy dosing based on extent of resection or molecular subgroups.
Collapse
Affiliation(s)
- Melanie L Rose
- Dartmouth Cancer Center, Dartmouth-Hitchcock, Lebanon, New Hampshire; The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
| | - Rhea Sachdeva
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Yakout Mezgueldi
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Renata W Yen
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Laila Andaloussi Serraj
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Kelly L Corbett
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Pediatrics, Dartmouth Health Children's, Lebanon, New Hampshire
| | - Torunn I Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
19
|
Wang X, Peng J, Meng C, Feng F. Recent advances for enhanced photodynamic therapy: from new mechanisms to innovative strategies. Chem Sci 2024; 15:12234-12257. [PMID: 39118629 PMCID: PMC11304552 DOI: 10.1039/d3sc07006a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Photodynamic therapy (PDT) has been developed as a potential cancer treatment approach owing to its non-invasiveness, spatiotemporal control and limited side effects. Currently, great efforts have been made to improve the PDT effect in terms of safety and efficiency. In this review, we highlight recent advances in innovative strategies for enhanced PDT, including (1) the development of novel radicals, (2) design of activatable photosensitizers based on the TME and light, and (3) photocatalytic NADH oxidation to damage the mitochondrial electron transport chain. Additionally, the new mechanisms for PDT are also presented as an inspiration for the design of novel PSs. Finally, we discuss the current challenges and future prospects in the clinical practice of these innovative strategies. It is hoped that this review will provide a new angle for understanding the relationship between the intratumoural redox environment and PDT mechanisms, and new ideas for the future development of smart PDT systems.
Collapse
Affiliation(s)
- Xia Wang
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, School of Chemistry & Chemical Engineering, Nanjing University Nanjing 210023 China
| | - Jinlei Peng
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, School of Chemistry & Chemical Engineering, Nanjing University Nanjing 210023 China
| | - Chi Meng
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, School of Chemistry & Chemical Engineering, Nanjing University Nanjing 210023 China
| | - Fude Feng
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, School of Chemistry & Chemical Engineering, Nanjing University Nanjing 210023 China
| |
Collapse
|
20
|
Qiao R, Yuan Z, Yang M, Tang Z, He L, Chen T. Selenium-Doped Nanoheterojunctions for Highly Efficient Cancer Radiosensitization. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2402039. [PMID: 38828705 PMCID: PMC11304322 DOI: 10.1002/advs.202402039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/30/2024] [Indexed: 06/05/2024]
Abstract
Exploring efficient and low-toxicity radiosensitizers to break through the bottleneck of radiation tolerance, immunosuppression and poor prognosis remains one of the critical developmental challenges in radiotherapy. Nanoheterojunctions, due to their unique physicochemical properties, have demonstrated excellent radiosensitization effects in radiation energy deposition and in lifting tumor radiotherapy inhibition. Herein, they doped selenium (Se) into prussian blue (PB) to construct a nano-heterojunction (Se@PB), which could promote the increase of Fe2+/Fe3+ ratio and conversion of Se to a high valence state with Se introduction. The Fe2+-Se-Fe3+ electron transfer chain accelerates the rate of electron transfer on the surface of the nanoparticles, which in turn endows it with efficient X-ray energy transfer and electron transport capability, and enhances radiotherapy physical sensitivity. Furthermore, Se@PB induces glutathione (GSH) depletion and Fe2+ accumulation through pro-Fenton reaction, thereby disturbs the redox balance in tumor cells and enhances biochemical sensitivity of radiotherapy. As an excellent radiosensitizer, Se@PB effectively enhances X-ray induced mitochondrial dysfunction and DNA damage, thereby promotes cell apoptosis and synergistic cervical cancer radiotherapy. This study elucidates the radiosensitization mechanism of Se-doped nanoheterojunction from the perspective of the electron transfer chain and biochemistry reaction, which provides an efficient and low-toxic strategy in radiotherapy.
Collapse
Affiliation(s)
- Rui Qiao
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| | - Zhongwen Yuan
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| | - Meijin Yang
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| | - Zhiying Tang
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| | - Lizhen He
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| | - Tianfeng Chen
- College of Chemistry and Materials ScienceDepartment of Oncology of The First Affiliated HospitalJinan UniversityGuangzhou510632China
| |
Collapse
|
21
|
Berkman AM, Goodenough CG, Durakiewicz P, Howell CR, Wang Z, Easton J, Mulder HL, Armstrong GT, Hudson MM, Kundu M, Ness KK. Associations between mitochondrial copy number, exercise capacity, physiologic cost of walking, and cardiac strain in young adult survivors of childhood cancer. J Cancer Surviv 2024; 18:1154-1167. [PMID: 38635100 PMCID: PMC11324404 DOI: 10.1007/s11764-024-01590-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Childhood cancer survivors are at risk for cardiac dysfunction and impaired physical performance, though underlying cellular mechanisms are not well studied. In this cross-sectional study, we examined the association between peripheral blood mitochondrial DNA copy number (mtDNA-CN, a proxy for mitochondrial function) and markers of performance impairment and cardiac dysfunction. METHODS Whole-genome sequencing, validated by quantitative polymerase chain reaction, was used to estimate mtDNA-CN in 1720 adult survivors of childhood cancer (48.5% female; mean age = 30.7 years, standard deviation (SD) = 9.0). Multivariable logistic regression was performed to evaluate the associations between mtDNA-CN and exercise intolerance, walking inefficiency, and abnormal global longitudinal strain (GLS), adjusting for treatment exposures, age, sex, and race and ethnicity. RESULTS The prevalence of exercise intolerance, walking inefficiency, and abnormal GLS among survivors was 25.7%, 10.7%, and 31.7%, respectively. Each SD increase of mtDNA-CN was associated with decreased odds of abnormal GLS (adjusted odds ratio (OR) = 0.88, p = 0.04) but was not associated with exercise intolerance (OR = 1.02, p = 0.76) or walking inefficiency (OR = 1.06, p = 0.46). Alkylating agent exposure was associated with increased odds of exercise intolerance (OR = 2.25, p < 0.0001), walking inefficiency (OR = 2.37, p < 0.0001), and abnormal GLS (OR = 1.78, p = 0.0002). CONCLUSIONS Increased mtDNA-CN is associated with decreased odds of abnormal cardiac function in childhood cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS These findings demonstrate a potential role for mtDNA-CN as a biomarker of early cardiac dysfunction in this population.
Collapse
Affiliation(s)
- Amy M Berkman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Chelsea G Goodenough
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA
| | - Paul Durakiewicz
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA
| | - Carrie R Howell
- Division of Preventive Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John Easton
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Heather L Mulder
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA
| | - Mondira Kundu
- Department of Cell and Molecular Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN, 38105, USA.
| |
Collapse
|
22
|
Aristophanous M, Aliotta E, Lichtenwalner P, Abraham S, Nehmeh M, Caringi A, Zhang P, Hu YC, Zhang P, Cervino L, Gelblum D, McBride S, Riaz N, Chen L, Yu Y, Zakeri K, Lee N. Clinical Experience With an Offline Adaptive Radiation Therapy Head and Neck Program: Dosimetric Benefits and Opportunities for Patient Selection. Int J Radiat Oncol Biol Phys 2024; 119:1557-1568. [PMID: 38373657 DOI: 10.1016/j.ijrobp.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 01/26/2024] [Accepted: 02/08/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE The objective of this study was to develop a linear accelerator (LINAC)-based adaptive radiation therapy (ART) workflow for the head and neck that is informed by automated image tracking to identify major anatomic changes warranting adaptation. In this study, we report our initial clinical experience with the program and an investigation into potential trigger signals for ART. METHODS AND MATERIALS Offline ART was systematically performed on patients receiving radiation therapy for head and neck cancer on C-arm LINACs. Adaptations were performed at a single time point during treatment with resimulation approximately 3 weeks into treatment. Throughout treatment, all patients were tracked using an automated image tracking system called the Automated Watchdog for Adaptive Radiotherapy Environment (AWARE). AWARE measures volumetric changes in gross tumor volumes (GTVs) and selected normal tissues via cone beam computed tomography scans and deformable registration. The benefit of ART was determined by comparing adaptive plan dosimetry and normal tissue complication probabilities against the initial plans recalculated on resimulation computed tomography scans. Dosimetric differences were then correlated with AWARE-measured volume changes to identify patient-specific triggers for ART. Candidate trigger variables were evaluated using receiver operator characteristic analysis. RESULTS In total, 46 patients received ART in this study. Among these patients, we observed a significant decrease in dose to the submandibular glands (mean ± standard deviation: -219.2 ± 291.2 cGy, P < 10-5), parotids (-68.2 ± 197.7 cGy, P = .001), and oral cavity (-238.7 ± 206.7 cGy, P < 10-5) with the adaptive plan. Normal tissue complication probabilities for xerostomia computed from mean parotid doses also decreased significantly with the adaptive plans (P = .008). We also observed systematic intratreatment volume reductions (ΔV) for GTVs and normal tissues. Candidate triggers were identified that predicted significant improvement with ART, including parotid ΔV = 7%, neck ΔV = 2%, and nodal GTV ΔV = 29%. CONCLUSIONS Systematic offline head and neck ART was successfully deployed on conventional LINACs and reduced doses to critical salivary structures and the oral cavity. Automated cone beam computed tomography tracking provided information regarding anatomic changes that may aid patient-specific triggering for ART.
Collapse
Affiliation(s)
- Michalis Aristophanous
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Eric Aliotta
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Phillip Lichtenwalner
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shira Abraham
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mohammad Nehmeh
- Department of Applied Physics, Columbia University, New York, New York
| | - Amanda Caringi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peng Zhang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yu-Chi Hu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pengpeng Zhang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Laura Cervino
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daphna Gelblum
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean McBride
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nadeem Riaz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Linda Chen
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yao Yu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
23
|
Guo QQ, Ma SZ, Zhao DY, Beeraka NM, Gu H, Zheng YF, Zhao RW, Li ST, Nikolenko VN, Bulygin KV, Basappa B, Fan RT, Liu JQ. Association of Definitive Radiotherapy for Esophageal Cancer and the Incidence of Secondary Head and Neck Cancers: A SEER Population-Based Study. World J Oncol 2024; 15:598-611. [PMID: 38993244 PMCID: PMC11236375 DOI: 10.14740/wjon1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/06/2024] [Indexed: 07/13/2024] Open
Abstract
Background Impact of radiotherapy (RT) for esophageal cancer (EC) patients on the development of secondary head and neck cancer (SHNC) remains equivocal. The objective of this study was to investigate the link between definitive RT used for EC treatment and subsequent SHNC. Methods This study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database to collect the data of primary EC patients. Fine-Gray competing risk regression and standardized incidence ratio (SIR) and propensity score matching (PSM) method were used to match SHNC patients with only primary head and neck cancer (HNC) patients. Overall survival (OS) rates were applied by Kaplan-Meier analysis. Results In total, 14,158 EC patients from the SEER database were included, of which 9,239 patients (65.3%) received RT and 4,919 patients (34.7%) received no radiation therapy (NRT). After a 12-month latency period, 110 patients (1.2%) in the RT group and 36 patients (0.7%) in the NRT group experienced the development of SHNC. In individuals with primary EC, there was an increased incidence of SHNC compared to the general US population (SIR = 5.95, 95% confidence interval (CI): 5.15 - 6.84). Specifically, the SIR for SHNC was 8.04 (95% CI: 6.78 - 9.47) in the RT group and 3.51 (95% CI: 2.64 - 4.58) in the NRT group. Patients who developed SHNC after RT exhibited significantly lower OS compared to those after NRT. Following PSM, the OS of patients who developed SHNC after RT remained significantly lower than that of matched patients with only primary HNC. Conclusion An association was discovered between RT for EC and increased long-term risk of SHNC. This work enables radiation oncologists to implement mitigation strategies to reduce the long-term risk of SHNC in patients who have received RT following primary EC.
Collapse
Affiliation(s)
- Qian Qian Guo
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Shi Zhou Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
- These authors contributed equally to this article
| | - De Yao Zhao
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
- These authors contributed equally to this article
| | - Narasimha M. Beeraka
- Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Chiyyedu, Andhra Pradesh 515721, India
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russian Federation
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Hao Gu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Yu Fei Zheng
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Rui Wen Zhao
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Si Ting Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Vladimir N. Nikolenko
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russian Federation
| | - Kirill V. Bulygin
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russian Federation
| | - Basappa Basappa
- Laboratory of Chemical Biology, Department of Studies in Organic Chemistry, University of Mysore, Mysore, Karnataka 570006, India
| | - Rui Tai Fan
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
- Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
- College of Medicine, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jun Qi Liu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
- Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
| |
Collapse
|
24
|
Geng F, Chen J, Song B, Tang Z, Li X, Zhang S, Yang T, Liu Y, Mo W, Zhang Y, Sun C, Tan L, Tu W, Yu D, Cao J, Zhang S. Chaperone- and PTM-mediated activation of IRF1 tames radiation-induced cell death and the inflammatory response. Cell Mol Immunol 2024; 21:856-872. [PMID: 38849539 PMCID: PMC11291999 DOI: 10.1038/s41423-024-01185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
The key role of structural cells in immune modulation has been revealed with the advent of single-cell multiomics, but the underlying mechanism remains poorly understood. Here, we revealed that the transcriptional activation of interferon regulatory factor 1 (IRF1) in response to ionizing radiation, cytotoxic chemicals and SARS-CoV-2 viral infection determines the fate of structural cells and regulates communication between structural and immune cells. Radiation-induced leakage of mtDNA initiates the nuclear translocation of IRF1, enabling it to regulate the transcription of inflammation- and cell death-related genes. Novel posttranslational modification (PTM) sites in the nuclear localization sequence (NLS) of IRF1 were identified. Functional analysis revealed that mutation of the acetylation site and the phosphorylation sites in the NLS blocked the transcriptional activation of IRF1 and reduced cell death in response to ionizing radiation. Mechanistically, reciprocal regulation between the single-stranded DNA sensors SSBP1 and IRF1, which restrains radiation-induced and STING/p300-mediated PTMs of IRF1, was revealed. In addition, genetic deletion or pharmacological inhibition of IRF1 tempered radiation-induced inflammatory cell death, and radiation mitigators also suppressed SARS-CoV-2 NSP-10-mediated activation of IRF1. Thus, we revealed a novel cytoplasm-oriented mechanism of IRF1 activation in structural cells that promotes inflammation and highlighted the potential effectiveness of IRF1 inhibitors against immune disorders.
Collapse
Affiliation(s)
- Fenghao Geng
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Jianhui Chen
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Bin Song
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Zhicheng Tang
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine, Soochow University, Suzhou, 215123, China
| | - Xiaoqian Li
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Shuaijun Zhang
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Tingyi Yang
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Yulan Liu
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, 610051, China
| | - Wei Mo
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine, Soochow University, Suzhou, 215123, China
| | - Yining Zhang
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
| | - Chuntang Sun
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Lei Tan
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Wenling Tu
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, 610051, China
| | - Daojiang Yu
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, 610051, China
| | - Jianping Cao
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine, Soochow University, Suzhou, 215123, China
| | - Shuyu Zhang
- Laboratory of Radiation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
- Department of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China.
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, 610051, China.
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, Mianyang, 621099, China.
| |
Collapse
|
25
|
Haghparast M, Parwaie W, Bakhshandeh M, Tuncel N, Rabi Mahdavi S. Evaluation of Perkin Elmer Amorphous Silicon Electronic Portal Imaging Device for Small Photon Field Dosimetry. J Biomed Phys Eng 2024; 14:347-356. [PMID: 39175562 PMCID: PMC11336047 DOI: 10.31661/jbpe.v0i0.2112-1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/29/2022] [Indexed: 08/24/2024]
Abstract
Background Electronic portal imaging devices (EPIDs) are applied to measure the dose and verify patients' position. Objective The present study aims to evaluate the performance of EPID for measuring dosimetric parameters in small photon fields. Material and Methods In this experimental study, the output factors and beam profiles were obtained using the amorphous silicon (a-Si) EPID for square field sizes ranging from 1×1 to 10×10 cm2 at energies 6 and 18 mega-voltage (MV). For comparison, the dosimetric parameters were measured with the pinpoint, diode, and Semiflex dosimeters. Additionally, the Monaco treatment planning system was selected to calculate the output factors and beam profiles. Results There was a significant difference between the output factors measured using the EPID and that measured with the other dosimeters for field sizes lower than 8×8 cm2. In the energy of 6 MV, the gamma passing rates (3%/3 mm) between EPID and diode profile were 98%, 98%, 95%, 94%, 93%, and 94% for 1×1, 2×2, 3×3, 4×4, 5×5, and 10×10 cm2, respectively. The measured penumbra width with EPID was higher compared to that measured by the diode dosimeter for both energies. Conclusion The EPID can measure the dosimetric parameters in small photon fields, especially for beam profiles and penumbra measurements.
Collapse
Affiliation(s)
- Mohammad Haghparast
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare-Abbas, Iran
| | - Wrya Parwaie
- Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohsen Bakhshandeh
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Nina Tuncel
- Radiation Oncology Department, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Seied Rabi Mahdavi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
26
|
Yue R, Li Z, Liu H, Wang Y, Li Y, Yin R, Yin B, Qian H, Kang H, Zhang X, Song G. Imaging-guided companion diagnostics in radiotherapy by monitoring APE1 activity with afterglow and MRI imaging. Nat Commun 2024; 15:6349. [PMID: 39068156 PMCID: PMC11283504 DOI: 10.1038/s41467-024-50688-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 07/18/2024] [Indexed: 07/30/2024] Open
Abstract
Companion diagnostics using biomarkers have gained prominence in guiding radiotherapy. However, biopsy-based techniques fail to account for real-time variations in target response and tumor heterogeneity. Herein, we design an activated afterglow/MRI probe as a companion diagnostics tool for dynamically assessing biomarker apurinic/apyrimidinic endonuclease 1(APE1) during radiotherapy in vivo. We employ ultrabright afterglow nanoparticles and ultrasmall FeMnOx nanoparticles as dual contrast agents, significantly broadening signal change range and enhancing the sensitivity of APE1 imaging (limit of detection: 0.0092 U/mL in afterglow imaging and 0.16 U/mL in MRI). We devise longitudinally and transversely subtraction-enhanced imaging (L&T-SEI) strategy to markedly enhance MRI contrast and signal-to-noise ratio between tumor and normal tissue of living female mice. The combined afterglow and MRI facilitate both anatomical and functional imaging of APE1 activity. This probe enables correlation of afterglow and MRI signals with APE1 expression, radiation dosage, intratumor ROS, and DNA damage, enabling early prediction of radiotherapy outcomes (as early as 3 h), significantly preceding tumor size reduction (6 days). By monitoring APE1 levels, this probe allows for early and sensitive detection of liver organ injury, outperforming histopathological analysis. Furthermore, MRI evaluates APE1 expression in radiation-induced abscopal effects provides insights into underlying mechanisms, and supports the development of treatment protocols.
Collapse
Affiliation(s)
- Renye Yue
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
- School of Biomedical Engineering, Research and Engineering Center of Biomedical Materials, Anhui Medical University, Hefei, PR China
| | - Zhe Li
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Huiyi Liu
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Youjuan Wang
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Yuhang Li
- Department of Hepatobiliary Surgery/Central Laboratory, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, PR China
| | - Rui Yin
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Baoli Yin
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Haisheng Qian
- School of Biomedical Engineering, Research and Engineering Center of Biomedical Materials, Anhui Medical University, Hefei, PR China
| | - Heemin Kang
- Department of Materials Science and Engineering and College of Medicine, Korea University, Seoul, South Korea
| | - Xiaobing Zhang
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China
| | - Guosheng Song
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, PR China.
- Shenzhen Research Institute, Hunan University, Shenzhen, China.
| |
Collapse
|
27
|
Muggiolu G, Sauvaigo S, Libert S, Millet M, Daguenet E, Bouleftour W, Maillet T, Deutsch E, Magné N. Baseline DSB repair prediction of chronic rare Grade ≥ 3 toxicities induced by radiotherapy using classification algorithms. JOURNAL OF RADIATION RESEARCH 2024; 65:540-548. [PMID: 38899572 PMCID: PMC11262860 DOI: 10.1093/jrr/rrae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/29/2024] [Indexed: 06/21/2024]
Abstract
Small fractions of patients suffer from radiotherapy late severe adverse events (AEs Grade ≥ 3), which are usually irreversible and badly affect their quality of life. A novel functional DNA repair assay characterizing several steps of double-strand break (DSB) repair mechanisms was used. DNA repair activities of peripheral blood mononuclear cells were monitored for 1 week using NEXT-SPOT assay in 177 breast and prostate cancer patients. Only seven patients had Grade ≥ 3 AEs, 6 months after radiotherapy initiation. The machine learning method established the importance of variables among demographic, clinical and DNA repair data. The most relevant ones, all related to DNA repair, were employed to build a predictor. Predictors constructed with random forest and minimum bounding sphere predicted late Grade ≥ 3 AEs with a sensitivity of 100% and specificity of 77.17 and 86.22%, respectively. This multiplex functional approach strongly supports a dominant role for DSB repair in the development of chronic AEs. It also showed that affected patients share specific features related to functional aspects of DSB repair. This strategy may be suitable for routine clinical analysis and paves the way for modelling DSB repair associated with severe AEs induced by radiotherapy.
Collapse
Affiliation(s)
- Giovanna Muggiolu
- LXRepair, Research Department, 5 Avenue du Grand Sablon, La Tronche 38700, France
| | - Sylvie Sauvaigo
- LXRepair, Research Department, 5 Avenue du Grand Sablon, La Tronche 38700, France
| | - Sarah Libert
- LXRepair, Research Department, 5 Avenue du Grand Sablon, La Tronche 38700, France
| | - Mathias Millet
- LXRepair, Research Department, 5 Avenue du Grand Sablon, La Tronche 38700, France
| | - Elisabeth Daguenet
- Clinical Research Department, Cancerology and Hematology Institute, CHU de Saint Etienne, 108 Avenue Albert Raimond, 42055 Cedex 02, France
| | - Wafa Bouleftour
- Clinical Research Department, Cancerology and Hematology Institute, CHU de Saint Etienne, 108 Avenue Albert Raimond, 42055 Cedex 02, France
| | - Thierry Maillet
- LXRepair, Research Department, 5 Avenue du Grand Sablon, La Tronche 38700, France
| | - Eric Deutsch
- Gustave Roussy Cancer Campus (GRCC), 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Nicolas Magné
- Department of Radiation Oncology, Institut Bergonié, 229 Cr de l'Argonne, 33076 Bordeaux, France
- Cellular and Molecular Radiobiology Laboratory, Lyon-Sud Medical School, Unité Mixte de Recherche CNRS5822/IP2I, University of Lyon, Ouliins, 69600, France
| |
Collapse
|
28
|
Xing Z, Li L, Liao T, Wang J, Guo Y, Xu Z, Yu W, Kuang Y, Li C. A multifunctional cascade enzyme system for enhanced starvation/chemodynamic combination therapy against hypoxic tumors. J Colloid Interface Sci 2024; 666:244-258. [PMID: 38598997 DOI: 10.1016/j.jcis.2024.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
Starvation therapy has shown promise as a cancer treatment, but its efficacy is often limited when used alone. In this work, a multifunctional nanoscale cascade enzyme system, named CaCO3@MnO2-NH2@GOx@PVP (CMGP), was fabricated for enhanced starvation/chemodynamic combination cancer therapy. CMGP is composed of CaCO3 nanoparticles wrapped in a MnO2 shell, with glucose oxidase (GOx) adsorbed and modified with polyvinylpyrrolidone (PVP). MnO2 decomposes H2O2 in cancer cells into O2, which enhances the efficiency of GOx-mediated starvation therapy. CaCO3 can be decomposed in the acidic cancer cell environment, causing Ca2+ overload in cancer cells and inhibiting mitochondrial metabolism. This synergizes with GOx to achieve more efficient starvation therapy. Additionally, the H2O2 and gluconic acid produced during glucose consumption by GOx are utilized by MnO2 with catalase-like activity to enhance O2 production and Mn2+ release. This process accelerates glucose consumption, reactive oxygen species (ROS) generation, and CaCO3 decomposition, promoting the Ca2+ release. CMGP can alleviate tumor hypoxia by cycling the enzymatic cascade reaction, which increases enzyme activity and combines with Ca2+ overload to achieve enhanced combined starvation/chemodynamic therapy. In vitro and in vivo studies demonstrate that CMGP has effective anticancer abilities and good biosafety. It represents a new strategy with great potential for combined cancer therapy.
Collapse
Affiliation(s)
- Zihan Xing
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Linwei Li
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Tao Liao
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Jinyu Wang
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Yuhao Guo
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Ziqiang Xu
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
| | - Wenqian Yu
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China.
| | - Ying Kuang
- Hubei Key Laboratory of Industry Microbiology, National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Glyn O. Phillips Hydrocolloid Research Centre at HBUT, School of Life and Health Sciences, Hubei University of Technology, Wuhan 430068, China.
| | - Cao Li
- Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, College of Health Science and Engineering, School of Materials Science and Engineering, Hubei University, Wuhan 430062, China; Hubei Key Laboratory of Industry Microbiology, National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Glyn O. Phillips Hydrocolloid Research Centre at HBUT, School of Life and Health Sciences, Hubei University of Technology, Wuhan 430068, China.
| |
Collapse
|
29
|
Geng F, Zhong L, Yang T, Chen J, Yang P, Jiang F, Yan T, Song B, Yu Z, Yu D, Zhang J, Cao J, Zhang S. A Frog Skin-Derived Peptide Targeting SCD1 Exerts Radioprotective Effects Against Skin Injury by Inhibiting STING-Mediated Inflammation. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306253. [PMID: 38582510 PMCID: PMC11220654 DOI: 10.1002/advs.202306253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/22/2024] [Indexed: 04/08/2024]
Abstract
The extensive application of nuclear technology has increased the potential of uncontrolled radiation exposure to the public. Since skin is the largest organ, radiation-induced skin injury remains a serious medical concern. Organisms evolutionally develop distinct strategies to protect against environment insults and the related research may bring novel insights into therapeutics development. Here, 26 increased peptides are identified in skin tissues of frogs (Pelophylax nigromaculatus) exposed to electron beams, among which four promoted the wound healing of irradiated skin in rats. Specifically, radiation-induced frog skin peptide-2 (RIFSP-2), from histone proteolysis exerted membrane permeability property, maintained cellular homeostasis, and reduced pyroptosis of irradiated cells with decreased TBK1 phosphorylation. Subsequently, stearyl-CoA desaturase 1 (SCD1) is identified, a critical enzyme in biogenesis of monounsaturated fatty acids (MUFAs) as a direct target of RIFSP-2 based on streptavidin-biotin system. The lipidomic analysis further assured the restrain of MUFAs biogenesis by RIFSP-2 following radiation. Moreover, the decreased MUFA limited radiation-induced and STING-mediated inflammation response. In addition, genetic depletion or pharmacological inhibition of STING counteracted the decreased pyroptosis by RIFSP-2 and retarded tissue repair process. Altogether, RIFSP-2 restrains radiation-induced activation of SCD1-MUFA-STING axis. Thus, the stress-induced amphibian peptides can be a bountiful source of novel radiation mitigators.
Collapse
Affiliation(s)
- Fenghao Geng
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
- Laboratory of Radiation MedicineWest China Second University HospitalSichuan UniversityChengdu610041China
- Radiation Medicine Department of Institute of Preventive MedicineFourth Military Medical UniversityXi'an710032China
| | - Li Zhong
- School of Radiation Medicine and ProtectionState Key Laboratory of Radiation MedicineSoochow UniversitySuzhou215123China
| | - Tingyi Yang
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Jianhui Chen
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Ping Yang
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Fengdi Jiang
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Tao Yan
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Bin Song
- Laboratory of Radiation MedicineWest China Second University HospitalSichuan UniversityChengdu610041China
| | - Zuxiang Yu
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
| | - Daojiang Yu
- The Second Affiliated Hospital of Chengdu Medical CollegeChina National Nuclear Corporation 416 HospitalChengdu610051China
| | - Jie Zhang
- Radiation Medicine Department of Institute of Preventive MedicineFourth Military Medical UniversityXi'an710032China
| | - Jianping Cao
- School of Radiation Medicine and ProtectionState Key Laboratory of Radiation MedicineSoochow UniversitySuzhou215123China
| | - Shuyu Zhang
- Laboratory of Radiation MedicineWest China School of Basic Medical Sciences & Forensic MedicineSichuan UniversityChengdu610041China
- Laboratory of Radiation MedicineWest China Second University HospitalSichuan UniversityChengdu610041China
- The Second Affiliated Hospital of Chengdu Medical CollegeChina National Nuclear Corporation 416 HospitalChengdu610051China
- NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)Mianyang621099China
| |
Collapse
|
30
|
Arıkan F, Kartöz F, Karakuş Z, Altınışık M, Özer Z, Korcum Şahin AF. Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: Across-sectional study. BMC Psychol 2024; 12:363. [PMID: 38915070 PMCID: PMC11194963 DOI: 10.1186/s40359-024-01856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy. METHODS The cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria. RESULTS Patients' mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05). CONCLUSIONS Radiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.
Collapse
Affiliation(s)
- Fatma Arıkan
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Dumlupınar Boulevard, Campus, Antalya, 07070, Türkiye
| | - Funda Kartöz
- Department of Radiation Oncology, Akdeniz University Hospital, Dumlupınar Boulevard, Antalya, 07059, Türkiye
| | - Zeynep Karakuş
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Dumlupınar Boulevard, Campus, Antalya, 07070, Türkiye.
| | - Müge Altınışık
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Dumlupınar Boulevard, Campus, Antalya, 07070, Türkiye
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Dumlupınar Boulevard, Campus, Antalya, 07070, Türkiye
| | - Aylin Fidan Korcum Şahin
- Department of Radiation Oncology, Faculty of Medicine, Akdeniz University, Dumlupınar Boulevard, Campus, Antalya, 07059, Türkiye
| |
Collapse
|
31
|
Bates JE, Marples B, Hudson MM, Williams AM, Marcus K, Howell R, Paulino A, Constine LS. Biodevelopmental Considerations in Pediatric Patients With Cancer and Childhood Cancer Survivors: A PENTEC Introductory Review. Int J Radiat Oncol Biol Phys 2024; 119:354-359. [PMID: 37966404 DOI: 10.1016/j.ijrobp.2023.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/19/2023] [Accepted: 09/30/2023] [Indexed: 11/16/2023]
Affiliation(s)
- James E Bates
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
| | - Brian Marples
- Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - AnnaLynn M Williams
- Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Karen Marcus
- Department of Radiation Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Rebecca Howell
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Arnold Paulino
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Louis S Constine
- Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York; Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
32
|
Cumming J, Thompson K, Woodford K, Panettieri V, Sapkaroski D. The impact of a prophylactic skin dressing on surface-guided patient positioning in chest wall Radiation Therapy. J Med Radiat Sci 2024; 71:177-185. [PMID: 38525921 PMCID: PMC11177042 DOI: 10.1002/jmrs.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 03/01/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Surface-guided radiation therapy (SGRT) has emerged as a powerful tool to improve patient setup accuracy in radiation therapy (RT). Combined with the goal of increasing RT accuracy is an ongoing effort to decrease RT side effects. The application of a prophylactic skin dressing to the treatment site is a well-documented method of reducing skin-related side effects from RT. This paper aims to investigate whether the application of Mepitel, a prophylactic skin dressing, has an impact on the accuracy of surface-guided patient setups in chest wall RT. METHODS A retrospective analysis of daily image-guided Online Corrections (OLCs) from patients undergoing chest wall irradiation with SGRT was performed. Translational (superior-inferior, lateral, and anterior-posterior) OLC magnitude and direction were compared between patients treated with Mepitel applied and those treated without. Systematic and random errors were calculated and compared between groups. RESULTS OLCs from 275 fractions were analysed. Mean OLCs were larger for patients with Mepitel applied in the superior_inferior axis (0.34 vs. 0.22 cm, P = 0.049) and for the combined translational vector (0.54 vs. 0.43 cm, P = 0.043). Combined translational systematic error was slightly larger for patients with Mepitel applied (0.15 vs. 0.09 cm). CONCLUSION Mepitel can impact the accuracy of SGRT patient-positioning in chest wall RT. The variation however is small and unlikely to have any clinical impact if SGRT is coupled with image guidance and appropriate PTV margins. Further investigation is required to assess the effect of Mepitel on SGRT accuracy in other treatment sites, as well as any potential dosimetric impacts.
Collapse
Affiliation(s)
- James Cumming
- Department of Radiation Therapy ServicesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Kenton Thompson
- Department of Radiation Therapy ServicesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Katrina Woodford
- Department of Radiation Therapy ServicesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Medical Imaging and Radiation SciencesMonash UniversityClaytonVictoriaAustralia
| | - Vanessa Panettieri
- Department of Medical Imaging and Radiation SciencesMonash UniversityClaytonVictoriaAustralia
- Department of Physical SciencesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Daniel Sapkaroski
- Department of Radiation Therapy ServicesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Medical Imaging and Radiation SciencesMonash UniversityClaytonVictoriaAustralia
- Department of Health and Biomedical SciencesRoyal Melbourne Institute of TechnologyBundooraVictoriaAustralia
- The Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| |
Collapse
|
33
|
He C, Chen Y, Guo L, Zheng M, Wan J, Fan S, Zhang X, Deng Z, Zhao X, Yin S, Zhao X, Peng H, Fu X, Xiao P. Voice Changes of Patients With Nasopharyngeal Carcinoma in Eleven Years After Radiotherapy: A Cross-Sectional Study. J Voice 2024:S0892-1997(24)00136-X. [PMID: 38772832 DOI: 10.1016/j.jvoice.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES The objective of this study was to assess voice changes in patients with nasopharyngeal carcinoma (NPC) using subjective and objective assessment tools and to make inferences regarding the underlying pathological causes for different phases of radiotherapy (RT). METHODS A total of 187 (123 males and 64 females) patients with post-RT NPC with no recurrence of malignancy or other voice diseases and 17 (11 males and 6 females) healthy individuals were included in this study. The patients were equally divided into 11 groups according to the number of years after RT. The acoustic analyses, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, and Voice Handicap Index (VHI)-10 scores were collected and analyzed. RESULTS The fundamental frequency (F0) parameters in years 1 and 2 and year 11 were significantly lower in patients with NPC than in healthy individuals. The maximum phonation times in years 1 and 11 were significantly shorter than those in healthy individuals. The jitter parameters were significantly different between year 1 and from years 8 to 11 and the healthy individuals. The shimmer parameters were significantly different between years 1, from years 9 to 11, and healthy individuals. Hoarseness was the most prominent problem compared to other items of the GRBAS. The VHI-10 scores were significantly different between years 1 and 2 and year 11 after RT in patients with NPC. CONCLUSIONS Voice quality was worse in the first 2 years and from years 8 to 11 but remained relatively normal from years 3 to 7 after RT. Patient-reported voice handicaps began during year 3 after RT. The most prominent problem was perceived hoarseness, which was evident in the first 2 years and from years 9 to 11 after RT. The radiation-induced mucous edema, laryngeal intrinsic muscle fibrosis, nerve injuries, upper respiratory tract changes, and decreased lung capacity might be the pathological reasons for voice changes in post-RT patients with NPC.
Collapse
Affiliation(s)
- Cui He
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China.
| | - Yixin Chen
- Hearing and Speech Science Department, Guangzhou Xinhua University, Guangzhou City, Guangdong Province, China
| | - Libing Guo
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Mingfen Zheng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Jian Wan
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Suxiao Fan
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xuhui Zhang
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Zeyi Deng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xiangdong Zhao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Shengsong Yin
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xueman Zhao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Hong Peng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xiangjun Fu
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Ping Xiao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| |
Collapse
|
34
|
Wahab A, Muhammad M, Ullah S, Abdi G, Shah GM, Zaman W, Ayaz A. Agriculture and environmental management through nanotechnology: Eco-friendly nanomaterial synthesis for soil-plant systems, food safety, and sustainability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171862. [PMID: 38527538 DOI: 10.1016/j.scitotenv.2024.171862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
Through the advancement of nanotechnology, agricultural and food systems are undergoing strategic enhancements, offering innovative solutions to complex problems. This scholarly essay thoroughly examines nanotechnological innovations and their implications within these critical industries. Traditional practices are undergoing radical transformation as nanomaterials emerge as novel agents in roles traditionally filled by fertilizers, pesticides, and biosensors. Micronutrient management and preservation techniques are further enhanced, indicating a shift towards more nutrient-dense and longevity-oriented food production. Nanoparticles (NPs), with their unique physicochemical properties, such as an extraordinary surface-to-volume ratio, find applications in healthcare, diagnostics, agriculture, and other fields. However, concerns about their potential overuse and bioaccumulation raise unanswered questions about their health effects. Molecule-to-molecule interactions and physicochemical dynamics create pathways through which nanoparticles cause toxicity. The combination of nanotechnology and environmental sustainability principles leads to the examination of green nanoparticle synthesis. The discourse extends to how nanomaterials penetrate biological systems, their applications, toxicological effects, and dissemination routes. Additionally, this examination delves into the ecological consequences of nanomaterial contamination in natural ecosystems. Employing robust risk assessment methodologies, including the risk allocation framework, is recommended to address potential dangers associated with nanotechnology integration. Establishing standardized, universally accepted guidelines for evaluating nanomaterial toxicity and protocols for nano-waste disposal is urged to ensure responsible stewardship of this transformative technology. In conclusion, the article summarizes global trends, persistent challenges, and emerging regulatory strategies shaping nanotechnology in agriculture and food science. Sustained, in-depth research is crucial to fully benefit from nanotechnology prospects for sustainable agriculture and food systems.
Collapse
Affiliation(s)
- Abdul Wahab
- Shanghai Center for Plant Stress Biology, CAS Center for Excellence in Molecular Plant Sciences, Chinese Academy of Sciences, Shanghai 200032, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Murad Muhammad
- University of Chinese Academy of Sciences, Beijing 100049, China; State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, 830011, China
| | - Shahid Ullah
- Department of Botany, University of Peshawar, Peshawar, Pakistan
| | - Gholamreza Abdi
- Department of Biotechnology, Persian Gulf Research Institute, Persian Gulf University, Bushehr 75169, Iran
| | | | - Wajid Zaman
- Department of Life Sciences, Yeungnam University, Gyeongsan 38541, Republic of Korea.
| | - Asma Ayaz
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China.
| |
Collapse
|
35
|
Qiu J, Cheng Z, Jiang Z, Gan L, Zhang Z, Xie Z. Immunomodulatory Precision: A Narrative Review Exploring the Critical Role of Immune Checkpoint Inhibitors in Cancer Treatment. Int J Mol Sci 2024; 25:5490. [PMID: 38791528 PMCID: PMC11122264 DOI: 10.3390/ijms25105490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
An immune checkpoint is a signaling pathway that regulates the recognition of antigens by T-cell receptors (TCRs) during an immune response. These checkpoints play a pivotal role in suppressing excessive immune responses and maintaining immune homeostasis against viral or microbial infections. There are several FDA-approved immune checkpoint inhibitors (ICIs), including ipilimumab, pembrolizumab, and avelumab. These ICIs target cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed death ligand 1 (PD-L1). Furthermore, ongoing efforts are focused on developing new ICIs with emerging potential. In comparison to conventional treatments, ICIs offer the advantages of reduced side effects and durable responses. There is growing interest in the potential of combining different ICIs with chemotherapy, radiation therapy, or targeted therapies. This article comprehensively reviews the classification, mechanism of action, application, and combination strategies of ICIs in various cancers and discusses their current limitations. Our objective is to contribute to the future development of more effective anticancer drugs targeting immune checkpoints.
Collapse
Affiliation(s)
- Junyu Qiu
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zilin Cheng
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zheng Jiang
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Luhan Gan
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Huan Kui School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zixuan Zhang
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zhenzhen Xie
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
| |
Collapse
|
36
|
Li S, Tao K, Yun H, Yang J, Meng Y, Zhang F, Ma X. Ferroptosis is a protective factor for the prognosis of cancer patients: a systematic review and meta-analysis. BMC Cancer 2024; 24:604. [PMID: 38760742 PMCID: PMC11102205 DOI: 10.1186/s12885-024-12369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Cancer is a leading global cause of death. Conventional cancer treatments like surgery, radiation, and chemotherapy have associated side effects. Ferroptosis, a nonapoptotic and iron-dependent cell death, has been identified and differs from other cell death types. Research has shown that ferroptosis can promote and inhibit tumor growth, which may have prognostic value. Given the unclear role of ferroptosis in cancer biology, this meta-analysis aims to investigate its impact on cancer prognosis. METHODS This systematic review and meta-analysis conducted searches on PubMed, Embase, and the Cochrane Library databases. Eight retrospective studies were included to compare the impact of ferroptosis inhibition and promotion on cancer patient prognosis. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Studies lacking clear descriptions of hazard ratios (HR) and 95% confidence intervals for OS and PFS were excluded. Random-effects meta-analysis and meta-regression were performed on the included study data to assess prognosis differences between the experimental and control groups. Meta-analysis results included HR and 95% confidence intervals. This study has been registered with PROSPERO, CRD 42023463720 on September 27, 2023. RESULTS A total of 2,446 articles were screened, resulting in the inclusion of 5 articles with 938 eligible subjects. Eight studies were included in the meta-analysis after bias exclusion. The meta-analysis, after bias exclusion, demonstrated that promoting ferroptosis could increase cancer patients' overall survival (HR 0.31, 95% CI 0.21-0.44) and progression-free survival (HR 0.26, 95% CI 0.16-0.44) compared to ferroptosis inhibition. The results showed moderate heterogeneity, suggesting that biological activities promoting cancer cell ferroptosis are beneficial for cancer patient's prognosis. CONCLUSIONS This systematic review and meta-analysis demonstrated that the promotion of ferroptosis yields substantial benefits for cancer prognosis. These findings underscore the untapped potential of ferroptosis as an innovative anti-tumor therapeutic strategy, capable of addressing challenges related to drug resistance, limited therapeutic efficacy, and unfavorable prognosis in cancer treatment. REGISTRATION CRD42023463720.
Collapse
Affiliation(s)
- Shen Li
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Kai Tao
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Yun
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqing Yang
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, China
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanling Meng
- West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fan Zhang
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
37
|
Chaudary N, Hill RP, Milosevic M. Targeting the CXCL12/CXCR4 pathway to reduce radiation treatment side effects. Radiother Oncol 2024; 194:110194. [PMID: 38447871 DOI: 10.1016/j.radonc.2024.110194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
High precision, image-guided radiotherapy (RT) has increased the therapeutic ratio, enabling higher tumor and lower normal tissue doses, leading to improved patient outcomes. Nevertheless, some patients remain at risk of developing serious side effects.In many clinical situations, the radiation tolerance of normal tissues close to the target volume limits the dose that can safely be delivered and thus the potential for tumor control and cure. This is particularly so in patients being re-treated for tumor progression or a second primary tumor within a previous irradiated volume, scenarios that are becoming more frequent in clinical practice.Various normal tissue 'radioprotective' drugs with the potential to reduce side effects have been studied previously. Unfortunately, most have failed to impact clinical practice because of lack of therapeutic efficacy, concern about concurrent tumor protection or excessive drug-related toxicity. This review highlights the evidence indicating that targeting the CXCL12/CXCR4 pathway can mitigate acute and late RT-induced injury and reduce treatment side effects in a manner that overcomes these previous translational challenges. Pre-clinical studies involving a broad range of normal tissues commonly affected in clinical practice, including skin, lung, the gastrointestinal tract and brain, have shown that CXCL12 signalling is upregulated by RT and attracts CXCR4-expressing inflammatory cells that exacerbate acute tissue injury and late fibrosis. These studies also provide convincing evidence that inhibition of CXCL12/CXCR4 signalling during or after RT can reduce or prevent RT side effects, warranting further evaluation in clinical studies. Greater dialogue with the pharmaceutical industry is needed to prioritize the development and availability of CXCL12/CXCR4 inhibitors for future RT studies.
Collapse
Affiliation(s)
- Naz Chaudary
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Richard P Hill
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Michael Milosevic
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
38
|
Feng Y, Feng Y, Gu L, Mo W, Wang X, Song B, Hong M, Geng F, Huang P, Yang H, Zhu W, Jiao Y, Zhang Q, Ding WQ, Cao J, Zhang S. Tetrahydrobiopterin metabolism attenuates ROS generation and radiosensitivity through LDHA S-nitrosylation: novel insight into radiogenic lung injury. Exp Mol Med 2024; 56:1107-1122. [PMID: 38689083 PMCID: PMC11148139 DOI: 10.1038/s12276-024-01208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 05/02/2024] Open
Abstract
Genotoxic therapy triggers reactive oxygen species (ROS) production and oxidative tissue injury. S-nitrosylation is a selective and reversible posttranslational modification of protein thiols by nitric oxide (NO), and 5,6,7,8-tetrahydrobiopterin (BH4) is an essential cofactor for NO synthesis. However, the mechanism by which BH4 affects protein S-nitrosylation and ROS generation has not been determined. Here, we showed that ionizing radiation disrupted the structural integrity of BH4 and downregulated GTP cyclohydrolase I (GCH1), which is the rate-limiting enzyme in BH4 biosynthesis, resulting in deficiency in overall protein S-nitrosylation. GCH1-mediated BH4 synthesis significantly reduced radiation-induced ROS production and fueled the global protein S-nitrosylation that was disrupted by radiation. Likewise, GCH1 overexpression or the administration of exogenous BH4 protected against radiation-induced oxidative injury in vitro and in vivo. Conditional pulmonary Gch1 knockout in mice (Gch1fl/fl; Sftpa1-Cre+/- mice) aggravated lung injury following irradiation, whereas Gch1 knock-in mice (Gch1lsl/lsl; Sftpa1-Cre+/- mice) exhibited attenuated radiation-induced pulmonary toxicity. Mechanistically, lactate dehydrogenase (LDHA) mediated ROS generation downstream of the BH4/NO axis, as determined by iodoacetyl tandem mass tag (iodoTMT)-based protein quantification. Notably, S-nitrosylation of LDHA at Cys163 and Cys293 was regulated by BH4 availability and could restrict ROS generation. The loss of S-nitrosylation in LDHA after irradiation increased radiosensitivity. Overall, the results of the present study showed that GCH1-mediated BH4 biosynthesis played a key role in the ROS cascade and radiosensitivity through LDHA S-nitrosylation, identifying novel therapeutic strategies for the treatment of radiation-induced lung injury.
Collapse
Affiliation(s)
- Yang Feng
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
- Department of Oncology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, 214002, Wuxi, China
| | - Yahui Feng
- Laboratory of Radiation Medicine, Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, 610051, Chengdu, China
| | - Liming Gu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Wei Mo
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Xi Wang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Bin Song
- West China Second University Hospital, Sichuan University, 610041, Chengdu, China
| | - Min Hong
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Fenghao Geng
- West China Second University Hospital, Sichuan University, 610041, Chengdu, China
| | - Pei Huang
- Department of Oncology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, 214002, Wuxi, China
| | - Hongying Yang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Wei Zhu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Yang Jiao
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Qi Zhang
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China
| | - Wei-Qun Ding
- Department of Pathology, Stephenson Cancer Centre, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Jianping Cao
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, 215123, Suzhou, China.
| | - Shuyu Zhang
- Laboratory of Radiation Medicine, Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, 610051, Chengdu, China.
- West China Second University Hospital, Sichuan University, 610041, Chengdu, China.
- Laboratory of Radiation Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, 610041, Chengdu, China.
- NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital), 621099, Mianyang, China.
| |
Collapse
|
39
|
Vikatmaa P, Pilz M. Expanding Treatment Options in Hopeless Situations: The Value of Endovascular Therapy in Carotid Blowout Syndrome. Eur J Vasc Endovasc Surg 2024; 67:717. [PMID: 38295941 DOI: 10.1016/j.ejvs.2024.01.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Pirkka Vikatmaa
- Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Manuela Pilz
- Department of Cardiac, Vascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
40
|
Wang P, Chen J, Zhong R, Xia Y, Wu Z, Zhang C, Yao H. Recent advances of ultrasound-responsive nanosystems in tumor immunotherapy. Eur J Pharm Biopharm 2024; 198:114246. [PMID: 38479562 DOI: 10.1016/j.ejpb.2024.114246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/20/2024] [Accepted: 03/05/2024] [Indexed: 04/19/2024]
Abstract
Immunotherapy has revolutionized cancer treatment by boosting the immune system and preventing disease escape mechanisms. Despite its potential, challenges like limited response rates and adverse immune effects impede its widespread clinical adoption. Ultrasound (US), known for its safety and effectiveness in tumor diagnosis and therapy, has been shown to significantly enhance immunotherapy when used with nanosystems. High-intensity focused ultrasound (HIFU) can obliterate tumor cells and elicit immune reactions through the creation of immunogenic debris. Low-intensity focused ultrasound (LIFU) bolsters tumor immunosuppression and mitigates metastasis risk by concentrating dendritic cells. Ultrasonic cavitation (UC) produces microbubbles that can transport immune enhancers directly, thus strengthening the immune response and therapeutic impact. Sonodynamic therapy (SDT) merges nanotechnology with immunotherapy, using specialized sonosensitizers to kill cancer cells and stimulate immune responses, increasing treatment success. This review discusses the integration of ultrasound-responsive nanosystems in tumor immunotherapy, exploring future opportunities and current hurdles.
Collapse
Affiliation(s)
- Penghui Wang
- Department of Ultrasound Medicine, Rui'an people's Hospital (The Third Affiliated Hospital of Wenzhou Medical University), Rui'an 325200, China
| | - Ji Chen
- Department of Ultrasound Medicine, Rui'an people's Hospital (The Third Affiliated Hospital of Wenzhou Medical University), Rui'an 325200, China
| | - Runming Zhong
- Department of Ultrasound Medicine, Rui'an people's Hospital (The Third Affiliated Hospital of Wenzhou Medical University), Rui'an 325200, China
| | - Yuanyuan Xia
- Center For Peak of Excellence on Biological Science and Food Engineering, National University of Singapore (Suzhou) Research Institute, Suzhou 215004, China
| | - Zhina Wu
- Department of Ultrasound Medicine, Rui'an people's Hospital (The Third Affiliated Hospital of Wenzhou Medical University), Rui'an 325200, China
| | - Chunye Zhang
- Center For Peak of Excellence on Biological Science and Food Engineering, National University of Singapore (Suzhou) Research Institute, Suzhou 215004, China
| | - Hai Yao
- Center For Peak of Excellence on Biological Science and Food Engineering, National University of Singapore (Suzhou) Research Institute, Suzhou 215004, China.
| |
Collapse
|
41
|
Zhao D, Fan W, Jiang H, Meng L, Cai B, Zhang X, Yu W, Zhao L, Ma L. The impact of submandibular glands protection on xerostomia as monitored by diffusion-weighted imaging in nasopharyngeal carcinoma patients. Strahlenther Onkol 2024; 200:377-388. [PMID: 37955647 DOI: 10.1007/s00066-023-02167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/01/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To determine the impact of sparing submandibular glands (SMGs) on alleviating xerostomia and the functional dynamics of the irradiated parotid glands (PGs) and sublingual glands (SLGs) by diffusion-weighted imaging. METHODS 97 participants underwent 9 rounds of DWI scans before IC (pre-IC), pre-radiation (pre-RT), the midpoint of radiation (mid-RT), the end of radiation (post-RT), 1, 3, 6, 9, 12 (12m-RT) months following radiation. Apparent diffusion coefficient of SMGs (ADCSMG), PGs (ADCPG), and SLGs (ADCSLG), xerostomia questionnaire scores (XQ), and saliva flow rate measures under unstimulated (uSFR) and stimulated condition (sSFR) were documented. RESULTS ADCPG, ADCSMG, ADCSLG, and XQ showed a rapid increase with a top at 3m-RT followed by regression, whereas uSFR and sSFR had the reverse trend. The change rate of ADC correlated with the dose to PGs, SMGs, and SLGs, as well as uSFR, sSFR, and XQ scores (p < 0.05 for all, except for uSFR with ADCPG (p = 0.063)). Maingroup for ADCPG, uSFR, and sSFR were significant (p values were 0.028, 0.000, 0.000 respectively); ADCPG in SMG sparing group was lower while uSFR, and sSFR were higher than those in the SMG-unsparing group. Simplegroup for ADCSMG, ADCSLG (all p < 0.05 from mid-RT to 12m-RT), and XQ (all p < 0.001 at mid-, 6m-, 9m-, and 12m-RT) were significant; ADCSMG, ADCSLG, and XQ were lower in the SMG-sparing group. CONCLUSIONS SMG protection has a great impact on the functional retention of PGs and SLGs, resulting in alleviating xerostomia and improving quality of life. TRIAL REGISTRATION The clinical trial was also registered with the Chinese Clinical Study Registry (registered number: ChiCTR1900024328, Date: July 6, 2019; URL: https://www.chictr.org.cn/showproj.aspx?proj=40726 ).
Collapse
Affiliation(s)
- Dawei Zhao
- Tianjin Medical University, Tianjin, China
- Department of Radiation Oncology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, No.1 West Huan-Hu Rd, Tianjin, China
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
- Department of Radiology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Wenjun Fan
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
- Department of Radiation Oncology, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Huayong Jiang
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lingling Meng
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
| | - Boning Cai
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
| | - Xinxin Zhang
- Department of Otolaryngology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Yu
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China.
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Lujun Zhao
- Department of Radiation Oncology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, No.1 West Huan-Hu Rd, Tianjin, China.
| | - Lin Ma
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China.
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
42
|
Lee J, Nandalur S, Hazy A, Al-Katib S, Kim K, Ye H, Kolderman N, Dhaliwal A, Krauss D, Quinn T, Marvin K, Nandalur KR. Prostatic Urethral Length on MRI Potentially Predicts Late Genitourinary Toxicity After Prostate Cancer Radiation. Acad Radiol 2024; 31:1950-1958. [PMID: 37858506 DOI: 10.1016/j.acra.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 10/21/2023]
Abstract
RATIONALE AND OBJECTIVES The purpose of our study was to evaluate pretreatment prostate quantitative magnetic resonance imaging (MRI) measurements and clinical characteristics in predicting genitourinary (GU) toxicity after radiotherapy (RT) for prostate cancer. MATERIALS AND METHODS In this single-institution retrospective cohort study, we evaluated patients with prostate adenocarcinoma who underwent MRI within 6 months before completing definitive RT and follow-up information in our GU toxicity database from June 2016 to February 2023. MRI measurements included quantitative urethra, prostate, and bladder measurements. GU toxicity was physician-scored using the Common Terminology Criteria for Adverse Events (CTCAE v4.0) with acute toxicity defined as ≤180 days and late defined as >180 days. Multivariable logistic regression model was constructed for grade ≥2 acute toxicity and Cox proportional hazards regression for late toxicity, adjusted for clinical factors and RT method. RESULTS A total of 361 men (median age 68 years, interquartile range [IQR] 62-73) were included; 14.4% (50/347) men experienced grade ≥2 acute toxicity. Brachytherapy (odds ratio [OR]: 2.9, 95% confidence interval [CI]: 1.5-5.8), P < 0.01) was associated with increased odds of acute GU toxicity, and longer MUL (OR: 0.41 [95%CI: 0.18-0.92], P = 0.03) with decreased odds. Median follow-up for late toxicity was 15.0 months (IQR: 9.0-28.0) with approximately 88.7% and 72.0% patients free of toxicity at 1 and 3 years, respectively. Only longer prostatic urethral length (hazard ratio [HR]: 1.6, 95%CI: 1.2-2.1, P < 0.01) was associated with increased risk of late GU toxicity, notably urinary frequency/urgency symptoms (HR: 1.7 [95%CI: 1.3-2.3], P < 0.01). CONCLUSION Longer prostatic urethral length measured on prostate MRI is independently associated with higher risk of developing late grade ≥2 GU toxicity after radiation therapy for prostate cancer. This pretreatment metric may be potentially valuable in risk-stratification models for quality of life following prostate RT.
Collapse
Affiliation(s)
- Joseph Lee
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Sirisha Nandalur
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Allison Hazy
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Sayf Al-Katib
- Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.); Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (S.A.K., N.K., A.D., K.R.N.)
| | - Kyu Kim
- Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Hong Ye
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Nathan Kolderman
- Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.); Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (S.A.K., N.K., A.D., K.R.N.)
| | - Abhay Dhaliwal
- Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.); Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (S.A.K., N.K., A.D., K.R.N.)
| | - Daniel Krauss
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Thomas Quinn
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.); Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.)
| | - Kimberly Marvin
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (J.L., S.N., A.H., H.Y., D.K., T.Q., K.M.)
| | - Kiran R Nandalur
- Medical School, Oakland University William Beaumont School of Medicine, Rochester, Michigan (J.L., S.N., A.H., S.A.K., K.K., H.Y., N.K., A.D., D.K., T.Q., K.R.N.); Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (S.A.K., N.K., A.D., K.R.N.).
| |
Collapse
|
43
|
Alkhalidi HM, Alahmadi AA, Rizg WY, Yahya EB, H P S AK, Mushtaq RY, Badr MY, Safhi AY, Hosny KM. Revolutionizing Cancer Treatment: Biopolymer-Based Aerogels as Smart Platforms for Targeted Drug Delivery. Macromol Rapid Commun 2024; 45:e2300687. [PMID: 38430068 DOI: 10.1002/marc.202300687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/15/2024] [Indexed: 03/03/2024]
Abstract
Cancer stands as a leading cause of global mortality, with chemotherapy being a pivotal treatment approach, either alone or in conjunction with other therapies. The primary goal of these therapies is to inhibit the growth of cancer cells specifically, while minimizing harm to healthy dividing cells. Conventional treatments, often causing patient discomfort due to side effects, have led researchers to explore innovative, targeted cancer cell therapies. Thus, biopolymer-based aerogels emerge as innovative platforms, showcasing unique properties that respond intelligently to diverse stimuli. This responsiveness enables precise control over the release of anticancer drugs, enhancing therapeutic outcomes. The significance of these aerogels lies in their ability to offer targeted drug delivery with increased efficacy, biocompatibility, and a high drug payload. In this comprehensive review, the author discuss the role of biopolymer-based aerogels as an emerging functionalized platforms in anticancer drug delivery. The review addresses the unique properties of biopolymer-based aerogels showing their smart behavior in responding to different stimuli including temperature, pH, magnetic and redox potential to control anticancer drug release. Finally, the review discusses the application of different biopolymer-based aerogel in delivering different anticancer drugs and also discusses the potential of these platforms in gene delivery applications.
Collapse
Affiliation(s)
- Hala M Alkhalidi
- Department of Clinical Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Amerh Aiad Alahmadi
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Waleed Y Rizg
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
- Center of Innovation in Personalized Medicine, 3D Bioprinting Unit, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Esam Bashir Yahya
- Bioprocess Technology Division, School of Industrial Technology, Universiti Sains Malaysia, Penang, 11800, Malaysia
- Green Biopolymer, Coatings and Packaging Cluster, School of Industrial Technology, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Abdul Khalil H P S
- Green Biopolymer, Coatings and Packaging Cluster, School of Industrial Technology, Universiti Sains Malaysia, Penang, 11800, Malaysia
- Bioresource Technology Division, School of Industrial Technology, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Rayan Y Mushtaq
- Department of Pharmaceutics, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Moutaz Y Badr
- Department of Pharmaceutical Sciences, College of Pharmacy, Umm Al-Qura University, Makkah, 24381, Saudi Arabia
| | - Awaji Y Safhi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Khaled M Hosny
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| |
Collapse
|
44
|
Krug D, Tio J, Abaci A, Beurer B, Brügge S, Elsayad K, Meixner E, Park-Simon TW, Smetanay K, Winkelmann F, Wittig A, Wöckel A. The Safety and Efficacy of the Combination of Sacituzumab Govitecan and Palliative Radiotherapy-A Retrospective Multi-Center Cohort Study. Cancers (Basel) 2024; 16:1649. [PMID: 38730602 PMCID: PMC11083716 DOI: 10.3390/cancers16091649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/05/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Sacituzumab govitecan (SG) is a new treatment option for patients with metastatic triple-negative and hormone receptor-positive, HER2-negative breast cancer. This antibody-drug conjugate is currently approved as monotherapy. Palliative radiotherapy is frequently used to treat symptomatic metastases locally. Concurrent use of SG and irradiation was excluded in clinical trials of SG, and there are currently limited published data. We report here a systematic review, as well as a retrospective multi-center study of 17 patients with triple-negative breast cancer who received concurrent SG and radiotherapy. In these patients, concurrent use was found to be efficient, safe and well tolerated. There were no apparent differences in moderate or severe acute toxicity according to the timing of SG administration.
Collapse
Affiliation(s)
- David Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Joke Tio
- Department of Gynecology and Obstetrics, Section Senology, University Hospital of Muenster, 48149 Muenster, Germany;
| | - Ali Abaci
- Department of Radiotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Björn Beurer
- Department of Obstetrics and Gynecology, Ernst von Bergmann Clinic, 14467 Potsdam, Germany;
| | - Sandra Brügge
- Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, 24105 Kiel, Germany;
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, 48149 Muenster, Germany;
| | - Eva Meixner
- Department of Radiation Oncology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Tjoung-Won Park-Simon
- Department of Obstetrics and Gynecology, Medizinische Hochschule Hannover, 30625 Hannover, Germany;
| | - Katharina Smetanay
- National Center for Tumor Diseases and Department of Obstetrics and Gynecology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Franziska Winkelmann
- Department of Radiation Oncology, Ernst von Bergmann Clinic, 14467 Potsdam, Germany;
| | - Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, University Hospital of Wuerzburg, 97080 Wuerzburg, Germany;
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, 97080 Wuerzburg, Germany;
| |
Collapse
|
45
|
Sarkar Lotfabadi A, Abadi B, Rezaei N. Biomimetic nanotechnology for cancer immunotherapy: State of the art and future perspective. Int J Pharm 2024; 654:123923. [PMID: 38403091 DOI: 10.1016/j.ijpharm.2024.123923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/11/2024] [Accepted: 02/18/2024] [Indexed: 02/27/2024]
Abstract
Cancer continues to be a significant worldwide cause of mortality. This underscores the urgent need for novel strategies to complement and overcome the limitations of conventional therapies, such as imprecise targeting and drug resistance. Cancer Immunotherapy utilizes the body's immune system to target malignant cells, reducing harm to healthy tissue. Nevertheless, the efficacy of immunotherapy exhibits variation across individuals and has the potential to induce autoimmune responses. Biomimetic nanoparticles (bNPs) have transformative potential in cancer immunotherapy, promising improved accurate targeting, immune system activation, and resistance mechanisms, while also reducing the occurrence of systemic autoimmune side effects. This integration offers opportunities for personalized medicine and better therapeutic outcomes. Despite considerable potential, bNPs face barriers like insufficient targeting, restricted biological stability, and interactions within the tumor microenvironment. The resolution of these concerns is crucial in order to expedite the integration of bNPs from the research setting into clinical therapeutic uses. In addition, optimizing manufacturing processes and reducing bNP-related costs are essential for practical implementation. The present research introduces comprehensive classifications of bNPs as well as recent achievements in their application in cancer immunotherapies, emphasizing the need to address barriers for swift clinical integration.
Collapse
Affiliation(s)
- Alireza Sarkar Lotfabadi
- Department of Cellular and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Banafshe Abadi
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran; Brain Cancer Research Core (BCRC), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
46
|
Tang R, Yin J, Liu Y, Xue J. FLASH radiotherapy: A new milestone in the field of cancer radiotherapy. Cancer Lett 2024; 587:216651. [PMID: 38342233 DOI: 10.1016/j.canlet.2024.216651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/03/2023] [Accepted: 01/13/2024] [Indexed: 02/13/2024]
Abstract
Radiotherapy plays a pivotal role in the control and eradication of tumors, but it can also induce radiation injury to surrounding normal tissues while targeting tumor cells. In recent years, FLASH-Radiotherapy (FLASH-RT) has emerged as a cutting-edge research focus in the field of radiation therapy. By delivering high radiation doses to the treatment target in an ultra-short time, FLASH-RT produces the FLASH effect, which reduces the toxicity to normal tissues while achieving comparable tumor control efficacy to conventional radiotherapy. This review provides a brief overview of the development history of FLASH-RT and its impact on tumor control. Additionally, it focuses on introducing the protective effects and molecular mechanisms of this technology on various normal tissues, as well as exploring its synergistic effects when combined with other tumor therapies. Importantly, this review discusses the challenges faced in translating FLASH-RT into clinical practice and outlines its promising future applications.
Collapse
Affiliation(s)
- Rui Tang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China; Division of Thoracic Tumor Multimodality Treatment, Cancer Center, The National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jianqiong Yin
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, The National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yuanxin Liu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, The National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jianxin Xue
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, The National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; Disaster Medical Center, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
47
|
Nafie MS, Ali MA, Youssef MM. N-allyl quinoxaline derivative exhibited potent and selective cytotoxicity through EGFR/VEGFR-mediated apoptosis: In vitro and in vivo studies. J Biochem Mol Toxicol 2024; 38:e23690. [PMID: 38493304 DOI: 10.1002/jbt.23690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024]
Abstract
The cytotoxic activity, EGFR/VEGFR2 target inhibition, apoptotic activity, RT-PCR gene expression, in vivo employing a solid-Ehrlich carcinoma model, and in silico investigations for highlighting the binding affinity of eight quinoxaline derivatives were tested for anticancer activities. The results showed that compound 8 (N-allyl quinoxaline) had potent cytotoxicity against A594 and MCF-7 cancer cells with IC50 values of 0.86 and 1.06 µM, respectively, with noncytotoxic activity against WISH and MCF-10A cells having IC50 values more than 100 µM. Furthermore, it strongly induced apoptotic cell death in A549 and MCF-7 cells by 43.13% and 34.07%, respectively, stopping the cell cycle at S and G1-phases. For the molecular target, the results showed that compound 8 had a promising EGFR inhibition activity with an IC50 value of 0.088 µM compared to Sorafenib (IC50 = 0.056 µM), and it had a promising VEGFR2 inhibition activity with an IC50 value of 0.108 µM compared to Sorafenib (IC50 = 0.049 µM). Treatment with compound 8 ameliorated biochemical and histochemical parameters near normal in the in vivo investigation, with a tumor inhibition ratio of 68.19% compared to 64.8% for 5-FU treatment. Finally, the molecular docking study demonstrated the binding affinity through binding energy and interactive binding mode inside the EGFR/VEGFR2 proteins. Potent EGFR and VEGFR2 inhibition of compound 8 suggests its potential for development as a selective anticancer drug.
Collapse
Affiliation(s)
- Mohamed S Nafie
- Department of Chemistry, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Chemistry, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Mohab A Ali
- Department of Chemistry, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Magdy M Youssef
- Division of Biochemistry, Department of Chemistry, Faculty of Science, Mansoura University, Mansoura, Egypt
| |
Collapse
|
48
|
Ling Z, Wang Z, Chen L, Mao J, Ma D, Han X, Tian L, Zhu Q, Lu G, Yan X, Ding Y, Xiao W, Chen Y, Peng A, Yin X. Naringenin Alleviates Radiation-Induced Intestinal Injury by Inhibiting TRPV6 in Mice. Mol Nutr Food Res 2024; 68:e2300745. [PMID: 38581304 DOI: 10.1002/mnfr.202300745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/27/2024] [Indexed: 04/08/2024]
Abstract
SCOPE Naringenin (NAR) possesses unique anti-inflammatory, antiapoptosis effects and various bioactivities; however, its role against radiation-induced intestinal injury (RIII) remains unclear. This study aims to investigate whether NAR has protective effects against radiation-induced intestinal injury and the underlying mechanisms. METHODS AND RESULTS C57BL/6J mice are exposed to a single dose of 13 Gy X-ray total abdominal irradiation (TAI), then gavaged with NAR for 7 days. NAR treatment prolongs the survival rate, protects crypts and villi from damage, alleviates the level of radiation-induced inflammation, and mitigates intestinal barrier damage in the irradiated mice. Additionally, NAR reduces immune cell infiltration and intestinal epithelial cell apoptosis. NAR also shows radioprotective effects in human colon cancer cells (HCT116) and human intestinal epithelial cells (NCM460). It reduces cell damage by reducing intracellular calcium ion levels and reactive oxygen species (ROS) levels. NAR-mediated radioprotection is associated with the downregulation of transient receptor potential vanilloid 6 (TRPV6), and inhibition of apoptosis pathway. Notably, treatment with NAR fails to further increase the protective effects of the TRPV6 inhibitor 2-APB, indicating that TRPV6 inhibition is essential for NAR activity. CONCLUSION NAR inhibits the apoptosis pathway by downregulating TRPV6 and reducing calcium ion level, thereby alleviating RIII. Therefore, NAR is a promising therapeutic drug for RIII.
Collapse
Affiliation(s)
- Zhi Ling
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Zheng Wang
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Pathology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Lin Chen
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Gastroenterology, Yangzhou Key Laboratory for Precision Treatment of Refractory Bowel Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Jingxian Mao
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Dongmei Ma
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Xiao Han
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Linlin Tian
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Qingtian Zhu
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Gastroenterology, Yangzhou Key Laboratory for Precision Treatment of Refractory Bowel Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Guotao Lu
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Gastroenterology, Yangzhou Key Laboratory for Precision Treatment of Refractory Bowel Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Xuebing Yan
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Yanbing Ding
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Gastroenterology, Yangzhou Key Laboratory for Precision Treatment of Refractory Bowel Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Weiming Xiao
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Gastroenterology, Yangzhou Key Laboratory for Precision Treatment of Refractory Bowel Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Yong Chen
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Aijun Peng
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Department of Neurosurgery, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| | - Xudong Yin
- Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
- Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China
| |
Collapse
|
49
|
Cao X, Yan Z, Chen Z, Ge Y, Hu X, Peng F, Huang W, Zhang P, Sun R, Chen J, Ding M, Zong D, He X. The Emerging Role of Deubiquitinases in Radiosensitivity. Int J Radiat Oncol Biol Phys 2024; 118:1347-1370. [PMID: 38092257 DOI: 10.1016/j.ijrobp.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/03/2023] [Accepted: 12/03/2023] [Indexed: 02/05/2024]
Abstract
Radiation therapy is a primary treatment for cancer, but radioresistance remains a significant challenge in improving efficacy and reducing toxicity. Accumulating evidence suggests that deubiquitinases (DUBs) play a crucial role in regulating cell sensitivity to ionizing radiation. Traditional small-molecule DUB inhibitors have demonstrated radiosensitization effects, and novel deubiquitinase-targeting chimeras (DUBTACs) provide a promising strategy for radiosensitizer development by harnessing the ubiquitin-proteasome system. This review highlights the mechanisms by which DUBs regulate radiosensitivity, including DNA damage repair, the cell cycle, cell death, and hypoxia. Progress on DUB inhibitors and DUBTACs is summarized, and their potential radiosensitization effects are discussed. Developing drugs targeting DUBs appears to be a promising alternative approach to overcoming radioresistance, warranting further research into their mechanisms.
Collapse
Affiliation(s)
- Xiang Cao
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Zhenyu Yan
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Zihan Chen
- Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yizhi Ge
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Xinyu Hu
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Fanyu Peng
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Wenxuan Huang
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Pingchuan Zhang
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Ruozhou Sun
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Jiazhen Chen
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Mingjun Ding
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China
| | - Dan Zong
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China.
| | - Xia He
- Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China; Xuzhou Medical University, Xuzhou, Jiangsu, China; Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
50
|
Zhu Y, Dai J, Song B, Zhang Y, Yang T, Xu H, Xu X, Gao Y, Yan T, Shen W, Zhang W, Zhang S, Liu P. Connexin 43 Prevents Radiation-Induced Intestinal Damage via the Ca2+-Dependent PI3K/Akt Signaling Pathway. Radiat Res 2024; 201:294-303. [PMID: 38588381 DOI: 10.1667/rade-22-00190.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2024] [Indexed: 04/10/2024]
Abstract
Radiation-induced intestinal damage (RIID) is a common side effect of radiotherapy in patients with abdominopelvic malignancies. Gap junctions are special structures consisting of connexins (Cxs). This study aimed to investigate the expression and role of connexins in RIID and underlying mechanism. In this study, a calcein-AM fluorescence probe was used to detect changes in gap junctional intercellular communication in intestinal epithelial IEC-6 cells. Our results show that gap junctional intercellular communication of IEC-6 cells was reduced at 6, 12, 24, and 48 h after irradiation, with the most pronounced effect at 24 h. Western blotting and immunofluorescence results showed that the expression of Cx43, but not other connexins, was reduced in irradiated intestinal epithelial cells. Silencing of Cx43 reduced gap junctional intercellular communication between irradiated intestinal epithelial cells with increased ROS and intracellular Ca2+ levels. Furthermore, knockdown of Cx43 reduced the number of clonal clusters, decreased cell proliferation with increased cytotoxicity and apoptosis. Western blotting results showed that silencing of Cx43 resulted in changed γ-H2AX and PI3K/AKT pathway proteins in irradiated intestinal epithelial cells. Administration of the PI3K/AKT pathway inhibitor LY294002 inhibited the radioprotective effects in Cx43-overexpressing intestinal epithelial cells. Our study demonstrated that Cx43 expression is decreased by ionizing radiation, which facilitates the radioprotection of intestinal epithelial cells.
Collapse
Affiliation(s)
- Yue Zhu
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
- Department of Gastroenterology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Traditional Chinese Medicine Hospital Affiliated to Yangzhou University Kunshan, Kunshan 215300, China
| | - Jun Dai
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
| | - Bin Song
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Yuehua Zhang
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Tingyi Yang
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Hongwei Xu
- Department of Gastroenterology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Traditional Chinese Medicine Hospital Affiliated to Yangzhou University Kunshan, Kunshan 215300, China
| | - Xiaopeng Xu
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
| | - Yi Gao
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
- Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215123, China
| | - Tao Yan
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Weidong Shen
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
| | - Wenhao Zhang
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Shuyu Zhang
- Laboratory of Radiation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610041, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital), Mianyang 621099, China
| | - Pengfei Liu
- Department of Gastroenterology, the Affiliated Jiangyin Hospital of Xuzhou Medical University, Jiangyin 214400, China
| |
Collapse
|