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Rajagopalan NR, Munawar T, Sheehan MC, Fujimori M, Vista WR, Wimmer T, Gutta NB, Solomon SB, Srimathveeravalli G. Electrolysis products, reactive oxygen species and ATP loss contribute to cell death following irreversible electroporation with microsecond-long pulsed electric fields. Bioelectrochemistry 2024; 155:108579. [PMID: 37769509 PMCID: PMC10841515 DOI: 10.1016/j.bioelechem.2023.108579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
Membrane permeabilization and thermal injury are the major cause of cell death during irreversible electroporation (IRE) performed using high electric field strength (EFS) and small number of pulses. In this study, we explored cell death under conditions of reduced EFS and prolonged pulse application, identifying the contributions of electrolysis, reactive oxygen species (ROS) and ATP loss. We performed ablations with conventional high-voltage low pulse (HV-LP) and low-voltage high pulse (LV-HP) conditions in a 3D tumor mimic, finding equivalent ablation volumes when using 2000 V/cm 90 pulses or 1000 V/cm 900 pulses respectively. These results were confirmed by performing ablations in swine liver. In LV-HP treatment, ablation volume was found to increase proportionally with pulse numbers, without the substantial temperature increase seen with HV-LP parameters. Peri-electrode pH changes, ATP loss and ROS production were seen in both conditions, but LV-HP treatments were more sensitive to blocking of these forms of cell injury. Increases in current drawn during HV-LP was not observed during LV-HP condition where the total ablation volume correlated to the charge delivered into the tissue which was greater than HV-LP treatment. LV-HP treatment provides a new paradigm in using pulsed electric fields for tissue ablation with clinically relevant volumes.
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Affiliation(s)
| | - Tarek Munawar
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Mary Chase Sheehan
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - William-Ray Vista
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Thomas Wimmer
- Dept. of Radiology, Division of General Radiology, Medical University of Graz, Austria
| | | | - Stephen B Solomon
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Govindarajan Srimathveeravalli
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA; Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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2
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Salameh ZS, Aycock KN, Alinezhadbalalami N, Imran KM, McKillop IH, Allen IC, Davalos RV. Harnessing the Electrochemical Effects of Electroporation-Based Therapies to Enhance Anti-tumor Immune Responses. Ann Biomed Eng 2024; 52:48-56. [PMID: 37989902 PMCID: PMC10781785 DOI: 10.1007/s10439-023-03403-x] [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: 05/25/2023] [Accepted: 10/31/2023] [Indexed: 11/23/2023]
Abstract
This study introduces a new method of targeting acidosis (low pH) within the tumor microenvironment (TME) through the use of cathodic electrochemical reactions (CER). Low pH is oncogenic by supporting immunosuppression. Electrochemical reactions create local pH effects when a current passes through an electrolytic substrate such as biological tissue. Electrolysis has been used with electroporation (destabilization of the lipid bilayer via an applied electric potential) to increase cell death areas. However, the regulated increase of pH through only the cathode electrode has been ignored as a possible method to alleviate TME acidosis, which could provide substantial immunotherapeutic benefits. Here, we show through ex vivo modeling that CERs can intentionally elevate pH to an anti-tumor level and that increased alkalinity promotes activation of naïve macrophages. This study shows the potential of CERs to improve acidity within the TME and that it has the potential to be paired with existing electric field-based cancer therapies or as a stand-alone therapy.
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Affiliation(s)
- Zaid S Salameh
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger St, Blacksburg, VA, 24061, USA
| | - Kenneth N Aycock
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger St, Blacksburg, VA, 24061, USA
| | - Nastaran Alinezhadbalalami
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger St, Blacksburg, VA, 24061, USA
| | - Khan Mohammad Imran
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - Iain H McKillop
- Department of Surgery, Atrium Health Wake Forest Baptist Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA
| | - Irving C Allen
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - Rafael V Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger St, Blacksburg, VA, 24061, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech - Emory, 313 Ferst Dr, Atlanta, GA, 30308, USA.
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3
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Lv Y, Liu H, Feng Z, Zhang J, Chen G, Yao C. The Enlargement of Ablation Area by Electrolytic Irreversible Electroporation (E-IRE) Using Pulsed Field with Bias DC Field. Ann Biomed Eng 2022; 50:1964-1973. [PMID: 35852648 DOI: 10.1007/s10439-022-03017-9] [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: 03/08/2022] [Accepted: 07/07/2022] [Indexed: 12/30/2022]
Abstract
Irreversible electroporation (IRE) by high-strength electric pulses is a biomedical technique that has been effectively used for minimally invasive tumor therapy while maintaining the functionality of adjacent important tissues, such as blood vessels and nerves. In general, pulse delivery using needle electrodes can create a reversible electroporation region beyond both the ablation area and the vicinity of the needle electrodes, limiting enlargement of the ablation area. Electrochemical therapy (EChT) can also be used to ablate a tumor near electrodes by electrolysis using a direct field with a constant current or voltage (DC field). Recently, reversible electroporated cells have been shown to be susceptible to electrolysis at relatively low doses. Reversible electroporation can also be combined with electrolysis for tissue ablation. Therefore, the objective of this study is to use electrolysis to remove the reversible electroporation area and thereby enlarge the ablation area in potato slices in vitro using a pulsed field with a bias DC field (constant voltage). We call this protocol electrolytic irreversible electroporation (E-IRE). The area over which the electrolytic effect induced a pH change was also measured. The results show that decreasing the pulse frequency using IRE alone is found to enlarge the ablation area. The ablation area generated by E-IRE is significantly larger than that generated by using IRE or EChT alone. The ablation area generated by E-IRE at 1 Hz is 109.5% larger than that generated by IRE, showing that the reversible electroporation region is transformed into an ablation region by electrolysis. The area with a pH change produced by E-IRE is larger than that produced by EChT alone. Decreasing the pulse frequency in the E-IRE protocol can further enlarge the ablation area. The results of this study are a preliminary indication that the E-IRE protocol can effectively enlarge the ablation area and enhance the efficacy of traditional IRE for use in ablating large tumors.
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Affiliation(s)
- Yanpeng Lv
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China.
| | - Heqing Liu
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Zhikui Feng
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Jianhua Zhang
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Genyong Chen
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Chenguo Yao
- School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
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4
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Groen MHA, van Es R, van Klarenbosch BR, Stehouwer M, Loh P, Doevendans PA, Wittkampf FH, Neven K. In vivo analysis of the origin and characteristics of gaseous microemboli during catheter-mediated irreversible electroporation. Europace 2021; 23:139-146. [PMID: 33111141 PMCID: PMC7842095 DOI: 10.1093/europace/euaa243] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/27/2020] [Indexed: 01/21/2023] Open
Abstract
Aims Irreversible electroporation (IRE) ablation is a non-thermal ablation method based on the application of direct current between a multi-electrode catheter and skin electrode. The delivery of current through blood leads to electrolysis. Some studies suggest that gaseous (micro)emboli might be associated with myocardial damage and/or (a)symptomatic cerebral ischaemic events. The aim of this study was to compare the amount of gas generated during IRE ablation and during radiofrequency (RF) ablation. Methods and results In six 60–75 kg pigs, an extracorporeal femoral shunt was outfitted with a bubble-counter to detect the size and total volume of gas bubbles. Anodal and cathodal 200 J IRE applications were delivered in the left atrium (LA) using a 14-electrode circular catheter. The 30 and 60 s 40 W RF point-by-point ablations were performed. Using transoesophageal echocardiography (TOE), gas formation was visualized. Average gas volumes were 0.6 ± 0.6 and 56.9 ± 19.1 μL (P < 0.01) for each anodal and cathodal IRE application, respectively. Also, qualitative TOE imaging showed significantly less LA bubble contrast with anodal than with cathodal applications. Radiofrequency ablations produced 1.7 ± 2.9 and 6.7 ± 7.4 μL of gas, for 30 and 60 s ablation time, respectively. Conclusion Anodal IRE applications result in significantly less gas formation than both cathodal IRE applications and RF applications. This finding is supported by TOE observations.
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Affiliation(s)
- Marijn H A Groen
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - René van Es
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Bas R van Klarenbosch
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marco Stehouwer
- Department of Extracorporeal Circulation, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Peter Loh
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Netherlands Heart Institute, Utrecht, The Netherlands
| | - Fred H Wittkampf
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Kars Neven
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Department of Electrophysiology, Alfried Krupp Krankenhaus, Essen, Germany.,Faculty of Health, Witten/Herdecke University, Witten, Germany
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5
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Kim HB, Chung JH. Incorporation of Reversible Electroporation Into Electrolysis Accelerates Apoptosis for Rat Liver Tissue. Technol Cancer Res Treat 2020; 19:1533033820948051. [PMID: 32985353 PMCID: PMC7534095 DOI: 10.1177/1533033820948051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Tissue electrolysis is an alternative modality that uses a low intensity direct electric current passing through at least 2 electrodes within the tissue and resulting electrochemical products including chlorine and hydrogen. These products induce changes in pH around electrodes and cause dehydration resulting from electroosmotic pressure, leading to changes in microenvironment and thus metabolism of the tissues, yielding apoptosis. The procedure requires adequate time for electrochemical reactions to yield products sufficient to induce apoptosis of the tissues. Incorporation of electroporation into electrolysis can decrease the treatment time and enhance the efficiency of electrolytic ablation. Electroporation causes permeabilization in the cell membrane allowing the efflux of potassium ions and extension of the electrochemical area, facilitating the electrolysis process. However, little is known about the combined effects on apoptosis in liver ablation. In this study, we performed an immunohistochemical evaluation of apoptosis for the incorporation of electroporation into electrolysis in liver tissues. To do so, the study was performed with microelectrodes for fixed treatment time while the applied voltage varied to increase the applied total energy for electrolysis. The apoptotic rate for electrolytic ablation increased with enhanced applied energy. The apoptotic rate was 4.31 ± 1.73 times that of control in the synergistic combination compared to 1.49 ± 0.33 times that of the control in electrolytic ablation alone. Additionally, tissue structure was better preserved in synergistic combination ablation compared to electrolysis with an increment of 3.8 mA. Thus, synergistic ablation may accelerate apoptosis and be a promising modality for the treatment of liver tumors.
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Affiliation(s)
- Hong Bae Kim
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Jong Hoon Chung
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul, Republic of Korea.,Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
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6
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Li C, Li Y, Yao T, Zhou L, Xiao C, Wang Z, Zhai J, Xing J, Chen J, Tan G, Zhou Y, Qi S, Yu P, Ning C. Wireless Electrochemotherapy by Selenium-Doped Piezoelectric Biomaterials to Enhance Cancer Cell Apoptosis. ACS APPLIED MATERIALS & INTERFACES 2020; 12:34505-34513. [PMID: 32508084 DOI: 10.1021/acsami.0c04666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cancer residues around the surgical site remain a significant cause of treatment failure with cancer recurrence. To prevent cancer recurrence and simultaneously repair surgery-caused defects, it is urgent to develop implantable biomaterials with anticancer ability and good biological activity. In this work, a functionalized implant is successfully fabricated by doping the effective anticancer element selenium (Se) into the potassium-sodium niobate piezoceramic, which realizes the wireless combination of electrotherapy and chemotherapy. Herein, we demonstrate that the Se-doped piezoelectric implant can cause mitochondrial damage by increasing intracellular reactive oxygen species levels and then trigger the caspase-3 pathway to significantly promote apoptosis of osteosarcoma cells in vitro. Meanwhile, its good biocompatibility has been verified. These results are of great importance for future deployment of wireless electro- and chemostimulation to modulate biological process around the defective tissue.
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Affiliation(s)
- Changhao Li
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Yangfan Li
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Tiantian Yao
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Lei Zhou
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Cairong Xiao
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Zhengao Wang
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Jinxia Zhai
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Jun Xing
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Junqi Chen
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Guoxin Tan
- School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou 510006, P. R. China
| | - Yahong Zhou
- CAS Key Laboratory of Bio-Inspired Materials and Interfacial Science, Technical Institute of Physics and Chemistry, Chinese Academy of Science, Beijing 100190, China
| | - Suijian Qi
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
| | - Peng Yu
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
| | - Chengyun Ning
- School of Material Science and Engineering, South China University of Technology, Guangzhou 510006, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Engineering of Guangdong Province and Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, P. R. China
- Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, P. R. China
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7
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Klein N, Mercadal B, Stehling M, Ivorra A. In vitro study on the mechanisms of action of electrolytic electroporation (E2). Bioelectrochemistry 2020; 133:107482. [PMID: 32062417 DOI: 10.1016/j.bioelechem.2020.107482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/03/2020] [Accepted: 02/08/2020] [Indexed: 12/18/2022]
Abstract
Electrolytic Electroporation (E2) is the combination of reversible electroporation and electrolysis. It has been proposed as a novel treatment option to ablate tissue percutaneously. The present in vitro study in cells in suspension was performed to investigate the underlying mechanisms of action of E2. Different types of experiments were performed to isolate the effects of the electrolysis and the electroporation components of the treatment. Additionally, thermal simulations were performed to determine whether significant temperature increase contributes to the effect. The results indicate that E2's cell killing efficacy is due to a combinational effect of electrolysis and reversible electroporation that takes place within the first two minutes after E2 application. The results further show that cell death after E2 treatment is significantly delayed. These observations suggest that cell death is induced in permeabilized cells due to the uptake of electrolysis species. Thermal simulations revealed a significant but innocuous temperature increase.
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Affiliation(s)
- Nina Klein
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain; Institut fur Bildgebende Diagnostik, Strahlenbergerstrasse 110, 63067 Offenbach, Germany; Inter Science GmbH, Reussblickstr 23, 6038 Gisikon, Lucerne, Switzerland; Catalan Industrial Doctorates Program, Spain.
| | - Borja Mercadal
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain
| | - Michael Stehling
- Institut fur Bildgebende Diagnostik, Strahlenbergerstrasse 110, 63067 Offenbach, Germany; Inter Science GmbH, Reussblickstr 23, 6038 Gisikon, Lucerne, Switzerland
| | - Antoni Ivorra
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain; Serra Húnter Fellow Programme, Universitat Pompeu Fabra, Barcelona, Spain
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8
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Guenther E, Klein N, Mikus P, Botea F, Pautov M, Lugnani F, Macchioro M, Popescu I, Stehling MK, Rubinsky B. Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2). PeerJ 2020; 8:e7985. [PMID: 31998549 PMCID: PMC6977482 DOI: 10.7717/peerj.7985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/03/2019] [Indexed: 01/05/2023] Open
Abstract
Background Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemotherapy (ECT). It was shown that the combination of electrolysis and electroporation—E2—affords tissue ablation with greater efficiency, that is, lower voltages, lower energy and shorter procedure times than IRE and without the need for chemotoxic additives as in ECT. Methods A new E2 waveform was designed that delivers optimal doses of electroporation and electrolysis in a single waveform. A series of experiments were performed in the liver of pigs to evaluate E2 in the context of clinical applications. The goal was to find initial parameter boundaries in terms of electrical field, pulse duration and charge as well as tissue behavior to enable real time tissue ablation of clinically relevant volumes. Results Histological results show that a single several hundred millisecond long E2 waveform can ablate large volume of tissue at relatively low voltages while preserving the integrity of large blood vessels and lumen structures in the ablation zone without the use of chemotoxic drugs or paralyzing drugs during anesthesia. This could translate clinically into much shorter treatment times and ease of use compared to other techniques that are currently applied.
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Affiliation(s)
- Enric Guenther
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA.,Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Nina Klein
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Institut fur Bildgebende Diagnostik, Offenbach, Germany.,Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Paul Mikus
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland
| | - Florin Botea
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihail Pautov
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | | | | | - Irinel Popescu
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Michael K Stehling
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA.,Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Boris Rubinsky
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA
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9
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Klein N, Guenther E, Botea F, Pautov M, Dima S, Tomescu D, Popescu M, Ivorra A, Stehling M, Popescu I. The combination of electroporation and electrolysis (E2) employing different electrode arrays for ablation of large tissue volumes. PLoS One 2019; 14:e0221393. [PMID: 31437212 PMCID: PMC6705851 DOI: 10.1371/journal.pone.0221393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022] Open
Abstract
Background The combination of electroporation with electrolysis (E2) has previously been introduced as a novel tissue ablation technique. E2 allows the utilization of a wide parameter range and may therefore be a suitable technology for development of tissue-specific application protocols. Previous studies have implied that it is possible to achieve big lesions in liver in a very short time. The goal of this study was to test a variety of electrode configurations for the E2 application to ablate large tissue volumes. Materials and methods 27 lesions were performed in healthy porcine liver of five female pigs. Four, two and bipolar electrode-arrays were used to deliver various E2 treatment protocols. Liver was harvested approx. 20h after treatment and examined with H&E and Masson’s trichrome staining, and via TUNEL staining for selective specimen. Results All animals survived the treatments without complications. With four electrodes, a lesion of up to 35x35x35mm volume can be achieved in less than 30s. The prototype bipolar electrode created lesions of 50x18x18mm volume in less than 10s. Parameters for two-electrode ablations with large exposures encompassing large veins were found to be good in terms of vessel preservation, but not optimal to reliably close the gap between the electrodes. Conclusion This study demonstrates the ability to produce large lesions in liver within seconds at lower limits of the E2 parameter space at different electrode configurations. The applicability of E2 for single electrode ablations was demonstrated with bipolar electrodes. Parameters for large 4-electrode ablation volumes were found suitable, while parameters for two electrodes still need optimization. However, since the parameter space of E2 is large, it is possible that for all electrode geometries optimal waveforms and application protocols for specific tissues will emerge with continuing research.
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Affiliation(s)
- Nina Klein
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- * E-mail:
| | - Enric Guenther
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Florin Botea
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Mihail Pautov
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Simona Dima
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Dana Tomescu
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
- Department of Anesthesiology and Intensive Care 3, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihai Popescu
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
- Department of Anesthesiology and Intensive Care 3, Fundeni Clinical Institute, Bucharest, Romania
| | - Antoni Ivorra
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Michael Stehling
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Irinel Popescu
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
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10
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Zhao L, Rasko A, Drescher C, Maleki S, Cejnar M, McEwan A. Preliminary Validation of Electroporation-Electrolysis (E2) for Cardiac Ablation Using a Parameterisable In-Vivo Model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:289-293. [PMID: 31945898 DOI: 10.1109/embc.2019.8857828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Atrial fibrillation is the most common arrhythmia, increasing the risk of stroke, heart failure and death, and a growing epidemic. Electroporation ablation is emerging in cardiac ablation for atrial fibrillation as a fast, tissue-specific and non-thermal alternative to existing technologies tied by their thermal action to shortcomings in efficacy, speed and risk. Studies so far have aimed to translate the success of irreversible electroporation from tumour treatment, with its kilovolt pulses, to cardiac ablation. However, these high voltages may be less appealing for cardiac ablation from clinical, technical and regulatory standpoints. A novel ablation technique combining electroporation and electrolysis in a single pulse E2 uses lower voltages. A custom E2 ablation system was developed and tested on an in vivo tissue model. Histopathological analysis showed lesions of clinically relevant depth, achieved without any acute complications or severe muscle contractions. Lesions were mapped onto a numerical model developed to refine further prototyping. This study provides preliminary prototype validation and the methodological foundation for dose optimisation towards endocardial application.
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11
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Molecular and histological study on the effects of electrolytic electroporation on the liver. Bioelectrochemistry 2019; 125:79-89. [DOI: 10.1016/j.bioelechem.2018.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/24/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023]
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12
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Ruzgys P, Novickij V, Novickij J, Šatkauskas S. Nanosecond range electric pulse application as a non-viral gene delivery method: proof of concept. Sci Rep 2018; 8:15502. [PMID: 30341389 PMCID: PMC6195529 DOI: 10.1038/s41598-018-33912-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 10/08/2018] [Indexed: 12/28/2022] Open
Abstract
Current electrotransfection protocols are well-established for decades and, as a rule, employ long micro-millisecond range electric field pulses to facilitate DNA transfer while application of nanosecond range pulses is limited. The purpose of this paper is to show that the transfection using ultrashort pulses is possible by regulating the pulse repetition frequency. We have used 200 ns pulses (10-18 kV/cm) in bursts of ten with varied repetition frequency (1 Hz-1 MHz). The Chinese Hamster Ovary (CHO) cells were used as a cell model. Experiments were performed using green fluorescent protein (GFP) and luciferase (LUC) coding plasmids. Transfection expression levels were evaluated using flow cytometry or luminometer. It was shown that with the increase of frequency from 100 kHz to 1 MHz, the transfection expression levels increased up to 17% with minimal decrease in cell viability. The LUC coding plasmid was transferred more efficiently using high frequency bursts compared to single pulses of equivalent energy. The first proof of concept for frequency-controlled nanosecond electrotransfection was shown, which can find application as a new non-viral gene delivery method.
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Affiliation(s)
- Paulius Ruzgys
- Biophysical Research Group, Vytautas Magnus University, Vileikos g. 8-212, 44404, Kaunas, Lithuania
| | - Vitalij Novickij
- Institute of High Magnetic Fields, Vilnius Gediminas Technical University, Vilnius, Lithuania.
| | - Jurij Novickij
- Institute of High Magnetic Fields, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Saulius Šatkauskas
- Biophysical Research Group, Vytautas Magnus University, Vileikos g. 8-212, 44404, Kaunas, Lithuania
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13
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Zhao Y, Liu H, Bhonsle SP, Wang Y, Davalos RV, Yao C. Ablation outcome of irreversible electroporation on potato monitored by impedance spectrum under multi-electrode system. Biomed Eng Online 2018; 17:126. [PMID: 30236121 PMCID: PMC6148960 DOI: 10.1186/s12938-018-0562-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Irreversible electroporation (IRE) therapy relies on pulsed electric fields to non-thermally ablate cancerous tissue. Methods for evaluating IRE ablation in situ are critical to assessing treatment outcome. Analyzing changes in tissue impedance caused by electroporation has been proposed as a method for quantifying IRE ablation. In this paper, we assess the hypothesis that irreversible electroporation ablation outcome can be monitored using the impedance change measured by the electrode pairs not in use, getting more information about the ablation size in different directions. METHODS Using a square four-electrode configuration, the two diagonal electrodes were used to electroporate potato tissue. Next, the impedance changes, before and after treatment, were measured from different electrode pairs and the impedance information was extracted by fitting the data to an equivalent circuit model. Finally, we correlated the change of impedance from various electrode pairs to the ablation geometry through the use of fitted functions; then these functions were used to predict the ablation size and compared to the numerical simulation results. RESULTS The change in impedance from the electrodes used to apply pulses is larger and has higher deviation than the other electrode pairs. The ablation size and the change in resistance in the circuit model correlate with various linear functions. The coefficients of determination for the three functions are 0.8121, 0.8188 and 0.8691, respectively, showing satisfactory agreement. The functions can well predict the ablation size under different pulse numbers, and in some directions it did even better than the numerical simulation method, which used different electric field thresholds for different pulse numbers. CONCLUSIONS The relative change in tissue impedance measured from the non-energized electrodes can be used to assess ablation size during treatment with IRE according to linear functions.
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Affiliation(s)
- Yajun Zhao
- State Key Laboratory of Power Transmission Equipment and System Security and New Technology, School of Electrical Engineering, Chongqing University, No. 174 Shazhengjie, Shapingba District, Chongqing, 400044, China.,Department of Biomedical Engineering and Mechanics, Virginia Tech, 329 ICTAS Stanger St (0298), Blacksburg, VA, 24061, USA
| | - Hongmei Liu
- State Key Laboratory of Power Transmission Equipment and System Security and New Technology, School of Electrical Engineering, Chongqing University, No. 174 Shazhengjie, Shapingba District, Chongqing, 400044, China
| | - Suyashree P Bhonsle
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 329 ICTAS Stanger St (0298), Blacksburg, VA, 24061, USA
| | - Yilin Wang
- State Key Laboratory of Power Transmission Equipment and System Security and New Technology, School of Electrical Engineering, Chongqing University, No. 174 Shazhengjie, Shapingba District, Chongqing, 400044, China
| | - Rafael V Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 329 ICTAS Stanger St (0298), Blacksburg, VA, 24061, USA.
| | - Chenguo Yao
- State Key Laboratory of Power Transmission Equipment and System Security and New Technology, School of Electrical Engineering, Chongqing University, No. 174 Shazhengjie, Shapingba District, Chongqing, 400044, China.
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14
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Perkons NR, Stein EJ, Nwaezeapu C, Wildenberg JC, Saleh K, Itkin-Ofer R, Ackerman D, Soulen MC, Hunt SJ, Nadolski GJ, Gade TP. Electrolytic ablation enables cancer cell targeting through pH modulation. Commun Biol 2018; 1:48. [PMID: 30271931 PMCID: PMC6123816 DOI: 10.1038/s42003-018-0047-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 04/05/2018] [Indexed: 02/07/2023] Open
Abstract
Minimally invasive ablation strategies enable locoregional treatment of tumors. One such strategy, electrolytic ablation, functions through the local delivery of direct current without thermal effects, facilitating enhanced precision. However, the clinical application of electrolytic ablation is limited by an incompletely characterized mechanism of action. Here we show that acid and base production at the electrodes precipitates local pH changes causing the rapid cell death that underlies macroscopic tumor necrosis at pH > 10.6 or < 4.8. The extent of cell death can be modulated by altering the local buffering capacity and antioxidant availability. These data demonstrate that electrolytic ablation is distinguished from other ablation strategies via its ability to induce cellular necrosis by directly altering the tumor microenvironment. These findings may enable further development of electrolytic ablation as a curative therapy for primary, early stage tumors.
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Affiliation(s)
- Nicholas R Perkons
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Bioengineering, 210S 33rd St., Suite 240 Skirkanich Hall, Philadelphia, PA, 19104, USA
| | - Elliot J Stein
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
| | - Chike Nwaezeapu
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Joseph C Wildenberg
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Kamiel Saleh
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Roni Itkin-Ofer
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Daniel Ackerman
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Michael C Soulen
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Stephen J Hunt
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Gregory J Nadolski
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Terence P Gade
- Penn Image-Guided Interventions Laboratory, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, 3400 Civic Center Boulevard, Bldg. 421, Philadelphia, PA, 19104, USA.
- Department of Bioengineering, 210S 33rd St., Suite 240 Skirkanich Hall, Philadelphia, PA, 19104, USA.
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
- Department of Cancer Biology, 421 Curie Boulevard, BRB II/III, Philadelphia, PA, 19104, USA.
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15
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Yang Y, Moser MAJ, Zhang E, Zhang W, Zhang B. Development of a statistical model for cervical cancer cell death with irreversible electroporation in vitro. PLoS One 2018; 13:e0195561. [PMID: 29694357 PMCID: PMC5919048 DOI: 10.1371/journal.pone.0195561] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/23/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The aim of this study was to develop a statistical model for cell death by irreversible electroporation (IRE) and to show that the statistic model is more accurate than the electric field threshold model in the literature using cervical cancer cells in vitro. METHODS HeLa cell line was cultured and treated with different IRE protocols in order to obtain data for modeling the statistical relationship between the cell death and pulse-setting parameters. In total, 340 in vitro experiments were performed with a commercial IRE pulse system, including a pulse generator and an electric cuvette. Trypan blue staining technique was used to evaluate cell death after 4 hours of incubation following IRE treatment. Peleg-Fermi model was used in the study to build the statistical relationship using the cell viability data obtained from the in vitro experiments. A finite element model of IRE for the electric field distribution was also built. Comparison of ablation zones between the statistical model and electric threshold model (drawn from the finite element model) was used to show the accuracy of the proposed statistical model in the description of the ablation zone and its applicability in different pulse-setting parameters. RESULTS The statistical models describing the relationships between HeLa cell death and pulse length and the number of pulses, respectively, were built. The values of the curve fitting parameters were obtained using the Peleg-Fermi model for the treatment of cervical cancer with IRE. The difference in the ablation zone between the statistical model and the electric threshold model was also illustrated to show the accuracy of the proposed statistical model in the representation of ablation zone in IRE. CONCLUSIONS This study concluded that: (1) the proposed statistical model accurately described the ablation zone of IRE with cervical cancer cells, and was more accurate compared with the electric field model; (2) the proposed statistical model was able to estimate the value of electric field threshold for the computer simulation of IRE in the treatment of cervical cancer; and (3) the proposed statistical model was able to express the change in ablation zone with the change in pulse-setting parameters.
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Affiliation(s)
- Yongji Yang
- Tumor Ablation Group, Complex and Intelligent Systems Research Center, East China University of Science and Technology, Shanghai, China
| | - Michael A. J. Moser
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Edwin Zhang
- Division of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Wenjun Zhang
- Tumor Ablation Group, Complex and Intelligent Systems Research Center, East China University of Science and Technology, Shanghai, China
| | - Bing Zhang
- Biomedical Science and Technology Research Center, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
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16
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Yao C, Lv Y, Zhao Y, Dong S, Liu H, Ma J. Synergistic combinations of short high-voltage pulses and long low-voltage pulses enhance irreversible electroporation efficacy. Sci Rep 2017; 7:15123. [PMID: 29123231 PMCID: PMC5680269 DOI: 10.1038/s41598-017-15494-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/27/2017] [Indexed: 12/18/2022] Open
Abstract
Irreversible electroporation (IRE) uses ~100 μs pulsed electric fields to disrupt cell membranes for solid tumor ablation. Although IRE has achieved exciting preliminary clinical results, implementing IRE could be challenging because of volumetric limitations at the ablation region. Combining short high-voltage (SHV: 1600V, 2 μs, 1 Hz, 20 pulses) pulses with long low-voltage (LLV: 240-480 V, 100 μs, 1 Hz, 60-80 pulses) pulses induces a synergistic effect that enhances IRE efficacy. Here, cell cytotoxicity and tissue ablation were investigated. The results show that combining SHV pulses with LLV pulses induced SKOV3 cell death more effectively, and compared to either SHV pulses or LLV pulses applied alone, the combination significantly enhanced the ablation region. Particularly, prolonging the lag time (100 s) between SHV and LLV pulses further reduced cell viability and enhanced the ablation area. However, the sequence of SHV and LLV pulses was important, and the LLV + SHV combination was not as effective as the SHV + LLV combination. We offer a hypothesis to explain the synergistic effect behind enhanced cell cytotoxicity and enlarged ablation area. This work shows that combining SHV pulses with LLV pulses could be used as a focal therapy and merits investigation in larger pre-clinical models and microscopic mechanisms.
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Affiliation(s)
- Chenguo Yao
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China.
| | - Yanpeng Lv
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China.
| | - Yajun Zhao
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
| | - Shoulong Dong
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
| | - Hongmei Liu
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
| | - Jianhao Ma
- The State Key Laboratory of Power Transmission Equipment and System Security and New Technology, the School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
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17
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Klein N, Guenther E, Mikus P, Stehling MK, Rubinsky B. Single exponential decay waveform; a synergistic combination of electroporation and electrolysis (E2) for tissue ablation. PeerJ 2017; 5:e3190. [PMID: 28439465 PMCID: PMC5398292 DOI: 10.7717/peerj.3190] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background Electrolytic ablation and electroporation based ablation are minimally invasive, non-thermal surgical technologies that employ electrical currents and electric fields to ablate undesirable cells in a volume of tissue. In this study, we explore the attributes of a new tissue ablation technology that simultaneously delivers a synergistic combination of electroporation and electrolysis (E2). Method A new device that delivers a controlled dose of electroporation field and electrolysis currents in the form of a single exponential decay waveform (EDW) was applied to the pig liver, and the effect of various parameters on the extent of tissue ablation was examined with histology. Results Histological analysis shows that E2 delivered as EDW can produce tissue ablation in volumes of clinical significance, using electrical and temporal parameters which, if used in electroporation or electrolysis separately, cannot ablate the tissue. Discussion The E2 combination has advantages over the three basic technologies of non-thermal ablation: electrolytic ablation, electrochemical ablation (reversible electroporation with injection of drugs) and irreversible electroporation. E2 ablates clinically relevant volumes of tissue in a shorter period of time than electrolysis and electroporation, without the need to inject drugs as in reversible electroporation or use paralyzing anesthesia as in irreversible electroporation.
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Affiliation(s)
- Nina Klein
- Inter Science GmbH, Gisikon, Switzerland.,Prostata Center, Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Enric Guenther
- Inter Science GmbH, Gisikon, Switzerland.,Prostata Center, Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Paul Mikus
- Inter Science GmbH, Gisikon, Switzerland
| | - Michael K Stehling
- Inter Science GmbH, Gisikon, Switzerland.,Prostata Center, Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Boris Rubinsky
- Inter Science GmbH, Gisikon, Switzerland.,Department of Mechanical Engineering, University of California, Berkeley, CA, United States
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