High-Performance Upconversion Nanoprobes for Multimodal MR Imaging of Acute Ischemic Stroke

Progress in ultrasmall ferrite nanoparticles enhanced T1 magnetic resonance angiography

Contrast-enhanced magnetic resonance angiography (CE-MRA) plays a critical role in diagnosing and monitoring various vascular diseases. Achieving high-sensitivity detection of vascular abnormalities in CE-MRA depends on the properties of contrast agents. In contrast to clinically used gadolinium-based contrast agents (GBCAs), the new generation of ultrasmall ferrite nanoparticles-based contrast agents have high relaxivity, long blood circulation time, easy surface functionalization, and high biocompatibility, hence showing promising prospects in CE-MRA. This review aims to comprehensively summarize the advancements in ultrasmall ferrite nanoparticles-enhanced MRA for detecting vascular diseases. Additionally, this review also discusses the future clinical translational potential of ultrasmall ferrite nanoparticles-based contrast agents for vascular imaging. By investigating the current status of research and clinical applications, this review attempts to outline the progress, challenges, and future directions of using ultrasmall ferrite nanoparticles to drive the field of CE-MRA into a new frontier of accuracy and diagnostic efficacy.

Optimization of the structure, morphology and luminescent properties of NaYF4 upconversion nanoparticles

We designed and constructed rare earth doped upconversion nanoparticles β-Na(Y0.78Yb0.18Er0.04)F4, sensitizing layer encapsulated β-Na(Y0.9Er0.1)F4@β-NaYbF4 and inert layer encapsulated β-Na(Y0.9Er0.1)F4@β-NaYbF4@β-NaYF4. Compared with the mononuclear material, the luminescence intensity of the particles encapsulated with double shells in the three main bands of blue, green and red emissions increased by 346, 22, and 54 times respectively. While improving the upconversion luminescence performance, the underlying reasons for this improvement were analyzed in detail. The effects of shell coating on the fluorescence lifetime, thermal stability and energy level transition are discussed. On this basis, the composite film material was constructed by combining the shell coating strategy and the plasma resonance interaction strategy, which further improved the upconversion efficiency. In addition, by combining performance optimized upconversion particles with information coding, we explored its potential as an anti-counterfeiting material.

A FRET Based Composite Sensing Material Based on UCNPs and Rhodamine Derivative for Highly Sensitive and Selective Detection of Fe3

The existence of excessive concentration of iron ion (Fe3+) in water will do harm to the environment and biology. Presently, sensitive and selective determination of Fe3+ directly in real environment samples is still a challenging job because of the high complexity of the sample matrix. In this work, we reported a new sensor system for Fe3+ based on fluorescence resonance energy transfer (FRET) from upconversion nanoparticles (UCNPs) to Rhodamine derivative probe (RhB). The NaYF4: Yb, Er@SiO2@P(NIPAM-co-RhB) nanocomposites was constructed, in which PNIPAm was used as the probe carrier. The nanocomposites can not only be excited by infrared light to avoid the interference of background light in the Fe3+ detection process, but also enhance the detection signal output through temperature control. Under the optimum conditions, the RSD (Relative standard deviation) of actual sample measurements ranges was from 1.95% to 4.96%, with the recovery rate from 97.4% to 103.3%, which showed high reliability for Fe3+ detection. This work could be extended to sensing other target ions or molecules and may promote the widespread use of FRET technique.

Targeted delivery of nanomedicines for promoting vascular regeneration in ischemic diseases

Ischemic diseases, the leading cause of disability and death, are caused by the restriction or blockage of blood flow in specific tissues, including ischemic cardiac, ischemic cerebrovascular and ischemic peripheral vascular diseases. The regeneration of functional vasculature network in ischemic tissues is essential for treatment of ischemic diseases. Direct delivery of pro-angiogenesis factors, such as VEGF, has demonstrated the effectiveness in ischemic disease therapy but suffering from several obstacles, such as low delivery efficacy in disease sites and uncontrolled modulation. In this review, we summarize the molecular mechanisms of inducing vascular regeneration, providing the guidance for designing the desired nanomedicines. We also introduce the delivery of various nanomedicines to ischemic tissues by passive or active targeting manner. To achieve the efficient delivery of nanomedicines in various ischemic diseases, we highlight targeted delivery of nanomedicines and controllable modulation of disease microenvironment using nanomedicines.

Boosting Vascular Imaging-Performance and Systemic Biosafety of Ultra-Small NaGdF4 Nanoparticles via Surface Engineering with Rationally Designed Novel Hydrophilic Block Co-Polymer

Revealing the anatomical structures, functions, and distribution of vasculature via contrast agent (CA) enhanced magnetic resonance imaging (MRI) is crucial for precise medical diagnosis and therapy. The clinically used MRI CAs strongly rely on Gd-chelates, which exhibit low T₁ relaxivities and high risks of nephrogenic systemic fibrosis (NSF) for patients with renal dysfunction. It is extremely important to develop high-performance and safe CAs for MRI. Herein, it is reported that ultra-small NaGdF₄ nanoparticles (UGNs) can serve as an excellent safe MRI CA via surface engineering with rationally designed novel hydrophilic block co-polymer (BP_n ). By optimizing the polymer molecular weights, the polymer-functionalized UGNs (i.e., UGNs-BP₁₄ ) are obtained to exhibit remarkably higher relaxivity (11.8 mm^-1 s^-1 at 3.0 T) than Gd-DTPA (3.6 mm^-1 s^-1 ) due to their ultracompact and abundant hydrophilic surface coating. The high performance of UGNs-BP₁₄ enables us to sensitively visualize microvasculature with a small diameter of ≈0.17 mm for up to 2 h, which is the thinnest blood vessel and the longest time window for low field (1.0 T) MR angiography ever reported, and cannot be achieved by using the clinically used Gd-DTPA under the same conditions. More importantly, renal clearable UGNs-BP₁₄ show lower risks of inducing NSF in comparison with Gd-DTPA due to their negligible release of Gd³⁺ ions after modification with the novel hydrophilic block copolymer. The study presents a novel avenue for boosting imaging-performance and systemic biosafety of UGNs as a robust MRI CA with great potential in precise diagnosis of vasculature-related diseases.

Dual-Modal FexCuySe and Upconversion Nanoparticle Assemblies for Intracellular MicroRNA-21 Detection

In situ quantification and imaging of low-level intracellular microRNAs (miRs) are important areas in biosensor research. Herein, DNA-driven Fe_xCu_ySe@upconversion nanoparticle (UCNP) core@satellite nanostructures were developed to probe microRNA-21 (miR-21). Fe_xCu_ySe@UCNP probes displayed dual signals: upconversion luminescence (UCL) and magnetic resonance imaging (MRI). In the presence of miR-21, the luminescence signal was restored and the T₂ value was significantly increased because of dissociation of UCNPs from the assemblies. There was a good linear relationship between the dual signals and the expression levels of miR-21 in the range of 0.035-31.824 amol/ng_RNA. The limit of detection (LOD) was 0.0058 amol/ng_RNA for the luminescence intensity and 0.0182 amol/ng_RNA for the MRI signal. This method opens a new avenue for intracellular miR-21 detection with high sensitivity and specificity.

Long-Term Tri-Modal In Vivo Tracking of Engrafted Cartilage-Derived Stem/Progenitor Cells Based on Upconversion Nanoparticles

Cartilage-derived stem/progenitor cells (CSPCs) are a potential choice for seed cells in osteal and chondral regeneration, and the outcomes of their survival and position distribution in vivo form the basis for the investigation of their mechanism. However, the current use of in vivo stem cell tracing techniques in laboratories is relatively limited, owing to their high operating costs and cytotoxicity. Herein, we performed tri-modal in vivo imaging of CSPCs during subcutaneous chondrogenesis using upconversion nanoparticles (UCNPs) for 28 days. Distinctive signals at accurate positions were acquired without signal noise from X-ray computed tomography, magnetic resonance imaging, and upconversion luminescence. The measured intensities were all significantly proportional to the cell numbers, thereby enabling real-time in vivo quantification of the implanted cells. However, limitations of the detectable range of cell numbers were also observed, owing to the imaging shortcomings of UCNPs, which requires further improvement of the nanoparticles. Our study explores the application value of upconversion nanomaterials in the tri-modal monitoring of implanted stem cells and provides new perspectives for future clinical translation.

Biocompatible BSA-MnO2 nanoparticles for in vivo timely permeability imaging of blood-brain barrier and prediction of hemorrhage transformation in acute ischemic stroke

Hemorrhage transformation (HT) is a frequent but maybe fatal complication following acute ischemic stroke due to severe damage of the blood-brain barrier (BBB). Quantitative BBB permeability imaging is a promising method to predict HT in stroke patients for a favorable prognosis. However, clinical gadolinium chelate-based magnetic resonance (MR) imaging of the stroke suffers from a relatively low sensitivity and potential side effects of nephrogenic systemic fibrosis and intracranial gadolinium deposition. Herein, BSA-MnO2 nanoparticles (BM NPs) fabricated by a facile disinfection-mimic method were employed for the permeability imaging of BBB in the stroke for the first time. The BM NPs showed a high T1 relaxivity (r1 = 5.9 mM-1 s-1), remarkable MR imaging ability, and good biocompatibility, allowing the noninvasive timely visualization of BBB permeability in the model rats of middle cerebral artery occlusion (MCAO). Furthermore, increased peak intensity, extended imaging duration, and expanded imaging region indicated by BM NPs in MR imaging showed a good prediction for the onset of HT in MCAO rats. Therefore, BM NPs hold an attractive potential to be an alternative biocompatible MR contrast agent for the noninvasive BBB permeability imaging in vivo, benefiting the fundamental research of diverse neurological disorders and the clinical treatment for stroke patients.

Towards precision nanomedicine for cerebrovascular diseases with emphasis on Cerebral Cavernous Malformation (CCM)

Introduction: Cerebrovascular diseases encompass various disorders of the brain vasculature, such as ischemic/hemorrhagic strokes, aneurysms, and vascular malformations, also affecting the central nervous system leading to a large variety of transient or permanent neurological disorders. They represent major causes of mortality and long-term disability worldwide, and some of them can be inherited, including Cerebral Cavernous Malformation (CCM), an autosomal dominant cerebrovascular disease linked to mutations in CCM1/KRIT1, CCM2, or CCM3/PDCD10 genes.Areas covered: Besides marked clinical and etiological heterogeneity, some commonalities are emerging among distinct cerebrovascular diseases, including key pathogenetic roles of oxidative stress and inflammation, which are increasingly recognized as major disease hallmarks and therapeutic targets. This review provides a comprehensive overview of the different clinical features and common pathogenetic determinants of cerebrovascular diseases, highlighting major challenges, including the pressing need for new diagnostic and therapeutic strategies, and focusing on emerging innovative features and promising benefits of nanomedicine strategies for early detection and targeted treatment of such diseases.Expert opinion: Specifically, we describe and discuss the multiple physico-chemical features and unique biological advantages of nanosystems, including nanodiagnostics, nanotherapeutics, and nanotheranostics, that may help improving diagnosis and treatment of cerebrovascular diseases and neurological comorbidities, with an emphasis on CCM disease.

Nanomedicine for Ischemic Stroke

Stroke is a severe brain disease leading to disability and death. Ischemic stroke dominates in stroke cases, and there are no effective therapies in clinic, partly due to the challenges in delivering therapeutics to ischemic sites in the brain. This review is focused on the current knowledge of pathogenesis in ischemic stroke, and its potential therapies and diagnosis. Furthermore, we present recent advances in developments of nanoparticle-based therapeutics for improved treatment of ischemic stroke using polymeric NPs, liposomes and cell-derived nanovesicles. We also address several critical questions in ischemic stroke, such as understanding how nanoparticles cross the blood brain barrier and developing in vivo imaging technologies to address this critical question. Finally, we discuss new opportunities in developing novel therapeutics by targeting activated brain endothelium and inflammatory neutrophils to improve the current therapies for ischemic stroke.

Recent Advances in the Therapeutic and Diagnostic Use of Liposomes and Carbon Nanomaterials in Ischemic Stroke

The complexity of the central nervous system (CNS), its limited self-repairing capacity and the ineffective delivery of most CNS drugs to the brain contribute to the irreversible and progressive nature of many neurological diseases and also the severity of the outcome. Therefore, neurological disorders belong to the group of pathologies with the greatest need of new technologies for diagnostics and therapeutics. In this scenario, nanotechnology has emerged with innovative and promising biomaterials and tools. This review focuses on ischemic stroke, being one of the major causes of death and serious long-term disabilities worldwide, and the recent advances in the study of liposomes and carbon nanomaterials for therapeutic and diagnostic purposes. Ischemic stroke occurs when blood flow to the brain is insufficient to meet metabolic demand, leading to a cascade of physiopathological events in the CNS including local blood brain barrier (BBB) disruption. However, to date, the only treatment approved by the FDA for this pathology is based on the potentially toxic tissue plasminogen activator. The techniques currently available for diagnosis of stroke also lack sensitivity. Liposomes and carbon nanomaterials were selected for comparison in this review, because of their very distinct characteristics and ranges of applications. Liposomes represent a biomimetic system, with composition, structural organization and properties very similar to biological membranes. On the other hand, carbon nanomaterials, which are not naturally encountered in the human body, exhibit new modes of interaction with biological molecules and systems, resulting in unique pharmacological properties. In the last years, several neuroprotective agents have been evaluated under the encapsulated form in liposomes, in experimental models of stroke. Effective drug delivery to the brain and neuroprotection were achieved using stealth liposomes bearing targeting ligands onto their surface for brain endothelial cells and ischemic tissues receptors. Carbon nanomaterials including nanotubes, fullerenes and graphene, started to be investigated and potential applications for therapy, biosensing and imaging have been identified based on their antioxidant action, their intrinsic photoluminescence, their ability to cross the BBB, transitorily decrease the BBB paracellular tightness, carry oligonucleotides and cells and induce cell differentiation. The potential future developments in the field are finally discussed.

Epitaxial growth of ultrathin layers on the surface of sub-10 nm nanoparticles: the case of β-NaGdF4:Yb/Er@NaDyF4 nanoparticles

Upconversion core–shell nanoparticles have attracted a large amount of attention due to their multifunctionality and specific applications. In this work, based on a NaGdF₄ sub-10 nm ultrasmall nanocore, a series of core–shell upconversion nanoparticles with uniform size doped with Yb³⁺, Er³⁺ and NaDyF₄ shells with different thicknesses were synthesized by a facile sequential growth process. NaDyF₄ coated upconversion luminescent nanoparticles showed an obvious fluorescence quenching under excitation at 980 nm as a result of energy resonance transfer between Yb³⁺, Er³⁺ and Dy³⁺. NaGdF₄:Yb,Er@NaDyF₄ core–shell nanoparticles with ultrathin layer shells exhibited a better T₁-weighted MR contrast.

In this work, a series of core–shell upconversion nanoparticles with uniform size doped with Yb³⁺, Er³⁺ and NaDyF₄ shells with different thicknesses were synthesized by a facile sequential growth process.

Theranostic system based on NaY(Mn)F4:Yb/Er upconversion nanoparticles with multi-drug resistance reversing ability

An innovative theranostic system (D-UNT) for MDR tumors diagnosis and therapy based on the red emitter NaY(Mn)F₄:Yb/Er with optimized luminescence was developed.

Predictors of short-term outcome in patients with acute middle cerebral artery occlusion: unsuitability of fluid-attenuated inversion recovery vascular hyperintensity scores

Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days (National Institutes of Health Stroke Scale) and 90 days (modified Rankin Scale) to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.

Stable gadolinium based nanoscale lyophilized injection for enhanced MR angiography with efficient renal clearance

There is a great demand to develop high-relaxivity nanoscale contrast agents for magnetic resonance (MR) angiography with high resolution. However, there should be more focus on stability, ion leakage and excretion pathway of the intravenously injected nanoparticles, which are closely related to their clinic potentials. Herein, uniform ultrasmall-sized NaGdF₄ nanocrystal (sub-10 nm) was synthesized using a facile high temperature organic solution method, and the nanocrystals were modified by a ligand-exchange approach using PEG-PAA di-block copolymer. The PEG-PAA modified NaGdF₄ nanocrystal (denoted as ppNaGdF₄ nanocrystal) exhibited a high r₁ relaxivity which was twice of commercially used gadopentetate dimeglumine (Gd-DTPA) injection. MR angiography on rabbit using ppNaGdF₄ nanocrystal at a low dose showed enhanced vascular details and long circulation time. Lyophilized powder of ppNaGdF₄ nanocrystals have been successfully prepared without aggregation or reduction of MR performance, indicating the stability and an effective way to store this nanoscale contrast agent. No haemolysis was induced by ppNaGdF₄ nanocrystal, and an extremely low leakage of gadolinium ions was confirmed. Furthermore, efficient renal excretion was one of the clearance pathways of ppNaGdF₄ nanocrystal according to both the time dependent distribution data in blood and tissues and MR images. The in vivo toxicity evaluation further validated the great potential as a clinical agent for blood pool imaging.

Optimization of Bi3+ in Upconversion Nanoparticles Induced Simultaneous Enhancement of Near-Infrared Optical and X-ray Computed Tomography Imaging Capability

Bioimaging probes have been extensive studied for many years, while it is still a challenge to further improve the image quality for precise diagnosis in clinical medicine. Here, monodisperse NaGdF₄:Yb³⁺,Tm³⁺,x% Bi³⁺ (abbreviated as GYT-x% Bi³⁺, x = 0, 5, 10, 15, 20, 25, 30) upconversion nanoparticles (UCNPs) have been prepared through the solvothermal method. The near-infrared upconversion emission intensity of GYT-25% Bi³⁺ has been enhanced remarkably than that of NaGdF₄:Yb³⁺,Tm³⁺ (GYT) with a factor of ∼60. Especially, the near-infrared upconversion emission band centered at 802 nm is 150 times stronger than the blue emission band of GYT-25% Bi³⁺ UCNPs. Such high ratio of NIR/blue UCL intensity could reduce the damage to tissues in the bioimaging process. The possibility of using GYT-25% Bi³⁺ UCNPs with strong near-infrared upconversion emission for optical imaging in vitro and in vivo was performed. Encouragingly, the UCL imaging penetration depth can be achieved as deep as 20 mm. Importantly, GYT-25% Bi³⁺ UCNPs exhibit a much higher X-ray computed tomography (CT) contrast efficiency than GYT and iodine-based contrast agent under the same clinical conditions, due to the high X-ray attenuation coefficient of bismuth. Hence, simultaneous remarkable enhancement of NIR emission and X-ray CT signal in upconversion nanoparticles could be achieved by optimizing the doping concentration of Bi³⁺ ions. Additionally, Gd³⁺ ions in the UCNPs endow GYT-25% Bi³⁺ UCNPs with T₁-weighted magnetic resonance (MR) imaging capability.