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Hayashi F, Shigemura K, Maeda K, Hiraoka A, Maeshige N, Ooya T, Sung SY, Yang YM, Fujisawa M. Combined Treatment with Ultrasound and Immune Checkpoint Inhibitors for Prostate Cancer. J Clin Med 2022; 11:jcm11092448. [PMID: 35566574 PMCID: PMC9104877 DOI: 10.3390/jcm11092448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Ultrasound (US) is mostly used for diagnostic purpose but could be used for cancer treatments with a US intensity or frequency fitted to such a purpose. Prostate cancer (PC) has the highest prevalence in the urological field, but indications for immune checkpoint inhibitors (ICIs) for PC are limited to very few cases. In this study, we compared the antitumor effect of US irradiation alone with the combined use of US and ICIs in vitro and in vivo. Methods: PC cell line TRAMP-C2 cells were used in our experiments. TRAMP-C2 cells were irradiated with US with pulse repeated frequencies (PRF) of 1, 10, and 100 Hz. Cell proliferation was evaluated by MTS assay and apoptotic cells were analyzed using flow cytometry. To verify the antitumor effect of US irradiation on PC in vivo, we conducted animal experiments using mice. TRAMP-C2-bearing mice were irradiated with US with PRF of 10 and 100 Hz. Three weeks after the start of US irradiation, anti-PD-1 antibody was administered to the mice. Finally, mice were sacrificed and tumors were collected. Immunohistochemical (IHC) analyses were assessed for cleaved caspase-3 and CD3 in tumor cell extracts. Results: Cell proliferation assays showed that 1 and 10 Hz US significantly inhibited cell survival (p < 0.0001). In addition, US irradiation induced apoptosis at 1, 10, and 100 Hz (p = 0.0129, p = 0.0150, and p = 0.0017, respectively). In animal experiments, a significant tumor growth inhibitory effect was observed at 10 and 100 Hz, and 100 Hz + ICIs (p < 0.05, respectively). Hematoxylin−eosin (H−E) staining showed a significant increase in the necrotic area of the tumor at 100 Hz and 100 Hz + ICIs (p < 0.05, respectively). In addition, under IHC staining the expression level of cleaved caspase-3 and the number of CD3-positive cells increased at 100 Hz (p < 0.05, respectively). Conclusion: US irradiation induced apoptosis in cells and reduced cell viability. In vivo tumor growth was suppressed by combined treatment with US irradiation and ICIs. Further research on immune system activation will lead to less invasive and more efficient treatments for PC.
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Affiliation(s)
- Fuuka Hayashi
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan;
| | - Katsumi Shigemura
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan;
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (K.M.); (Y.-M.Y.); (M.F.)
- Correspondence: ; Tel.: +81-78-382-6155
| | - Koki Maeda
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (K.M.); (Y.-M.Y.); (M.F.)
| | - Aya Hiraoka
- Department of Medical Technology, Kobe University of Medicine Faculty of Health Sciences, Kobe 654-0142, Japan;
| | - Noriaki Maeshige
- Department of Rehabilitation Science, Kobe University Graduate School of Health Science, Kobe 654-0142, Japan;
- John B. Little Center for Radiation Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Tooru Ooya
- Department of Chemical Science and Engineering, Graduate School of Engineering, Kobe University, Kobe 657-8501, Japan;
- Center for Advanced Medical Engineering Research & Development (CAMED), Kobe University, Kobe 650-0047, Japan
| | - Shian-Ying Sung
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan;
| | - Yong-Ming Yang
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (K.M.); (Y.-M.Y.); (M.F.)
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (K.M.); (Y.-M.Y.); (M.F.)
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Xia H, Yang D, He W, Zhu X, Yan Y, Liu Z, Liu T, Yang J, Tan S, Jiang J, Hou X, Gao H, Ni L, Lu J. Ultrasound-mediated microbubbles cavitation enhanced chemotherapy of advanced prostate cancer by increasing the permeability of blood-prostate barrier. Transl Oncol 2021; 14:101177. [PMID: 34271256 PMCID: PMC8287239 DOI: 10.1016/j.tranon.2021.101177] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/04/2021] [Accepted: 07/08/2021] [Indexed: 12/25/2022] Open
Abstract
Combination therapy increased cell apoptosis and the inhibition of cell viability. Combination therapy enhanced chemotherapy efficacy by increasing cell permeability. Success in developing an orthotopic model of prostate tumor implantation in mice. Combination therapy inhibited tumor growth and prolonged the survival of mice.
Although chemotherapy is an important treatment for advanced prostate cancer, its efficacy is relatively limited. Ultrasound-induced cavitation plays an important role in drug delivery and gene transfection. However, whether cavitation can improve the efficacy of chemotherapy for prostate cancer remains unclear. In this study, we treated RM-1 mouse prostate carcinoma cells with a combination of ultrasound-mediated microbubble cavitation and paclitaxel. Our results showed that combination therapy led to a more pronounced inhibition of cell viability and increased cell apoptosis. The enhanced efficacy of chemotherapy was attributed to the increased cell permeability induced by cavitation. Importantly, compared with chemotherapy alone (nab-paclitaxel), chemotherapy combined with ultrasound-mediated microbubble cavitation significantly inhibited tumor growth and prolonged the survival of tumor-bearing mice in an orthotopic mouse model of RM-1 prostate carcinoma, indicating the synergistic effects of combined therapy on tumor reduction. Furthermore, we analyzed tumor-infiltrating lymphocytes and found that during chemotherapy, the proportions of CTLA4+ cells and PD-1+/CTLA4+ cells in CD8+ T cells slightly increased after cavitation treatment.
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Affiliation(s)
- Haizhui Xia
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Decao Yang
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing 100191, China
| | - Wei He
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Xuehua Zhu
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Ye Yan
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Zenan Liu
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Tong Liu
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing 100191, China
| | - Jianling Yang
- Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing 100191, China
| | - Shi Tan
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Jie Jiang
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Xiaofei Hou
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Huile Gao
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu 610064, China
| | - Ling Ni
- Institute for Immunology and School of Medicine, Tsinghua University, Medical Research Building, Beijing 100084, China
| | - Jian Lu
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.
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