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Tischfield DJ, Gurevich A, Johnson O, Gatmaytan I, Nadolski GJ, Soulen MC, Kaplan DE, Furth E, Hunt SJ, Gade TPF. Transarterial Embolization Modulates the Immune Response within Target and Nontarget Hepatocellular Carcinomas in a Rat Model. Radiology 2022; 303:215-225. [PMID: 35014906 PMCID: PMC8962821 DOI: 10.1148/radiol.211028] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/12/2021] [Accepted: 10/28/2021] [Indexed: 12/24/2022]
Abstract
Background Transarterial embolization (TAE) is the most common treatment for hepatocellular carcinoma (HCC); however, there remain limited data describing the influence of TAE on the tumor immune microenvironment. Purpose To characterize TAE-induced modulation of the tumor immune microenvironment in a rat model of HCC and identify factors that modulate this response. Materials and Methods TAE was performed on autochthonous HCCs induced in rats with use of diethylnitrosamine. CD3, CD4, CD8, and FOXP3 lymphocytes, as well as programmed cell death protein ligand-1 (PD-L1) expression, were examined in three cohorts: tumors from rats that did not undergo embolization (control), embolized tumors (target), and nonembolized tumors from rats that had a different target tumor embolized (nontarget). Differences in immune cell recruitment associated with embolic agent type (tris-acryl gelatin microspheres [TAGM] vs hydrogel embolics) and vascular location were examined in rat and human tissues. A generalized estimating equation model and t, Mann-Whitney U, and χ2 tests were used to compare groups. Results Cirrhosis-induced alterations in CD8, CD4, and CD25/CD4 lymphocytes were partially normalized following TAE (CD8: 38.4%, CD4: 57.6%, and CD25/CD4: 21.1% in embolized liver vs 47.7% [P = .02], 47.0% [P = .01], and 34.9% [P = .03], respectively, in cirrhotic liver [36.1%, 59.6%, and 4.6% in normal liver]). Embolized tumors had a greater number of CD3, CD4, and CD8 tumor-infiltrating lymphocytes relative to controls (191.4 cells/mm2 vs 106.7 cells/mm2 [P = .03]; 127.8 cells/mm2 vs 53.8 cells/mm2 [P < .001]; and 131.4 cells/mm2 vs 78.3 cells/mm2 [P = .01]) as well as a higher PD-L1 expression score (4.1 au vs 1.9 au [P < .001]). A greater number of CD3, CD4, and CD8 lymphocytes were found near TAGM versus hydrogel embolics (4.1 vs 2.0 [P = .003]; 3.7 vs 2.0 [P = .01]; and 2.2 vs 1.1 [P = .03], respectively). The number of lymphocytes adjacent to embolics differed based on vascular location (17.9 extravascular CD68+ peri-TAGM cells vs 7.0 intravascular [P < .001]; 6.4 extravascular CD68+ peri-hydrogel embolic cells vs 3.4 intravascular [P < .001]). Conclusion Transarterial embolization-induced dynamic alterations of the tumor immune microenvironment are influenced by underlying liver disease, embolic agent type, and vascular location. © RSNA, 2022 Online supplemental material is available for this article. See also the editorials by Kennedy et al and by White in this issue.
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Affiliation(s)
| | | | - Omar Johnson
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Isabela Gatmaytan
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Gregory J. Nadolski
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Michael C. Soulen
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - David E. Kaplan
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Emma Furth
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Stephen J. Hunt
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
| | - Terence P. F. Gade
- From the Penn Image-Guided Interventions Laboratory (D.J.T., A.G.,
O.J., I.G., G.J.N., S.J.H., T.P.F.G.), Department of Radiology (D.J.T., O.J.,
G.J.N., M.C.S., S.J.H., T.P.F.G.), and Department of Pathology (E.F.), Hospital
of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104;
Division of Gastroenterology and Hepatology (D.E.K.) and Department of Cancer
Biology (T.P.F.G.), Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pa; and Gastroenterology Section, Corporal Michael
J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa (D.E.K.)
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Albright V, Penarete-Acosta D, Stack M, Zheng J, Marin A, Hlushko H, Wang H, Jayaraman A, Andrianov AK, Sukhishvili SA. Polyphosphazenes enable durable, hemocompatible, highly efficient antibacterial coatings. Biomaterials 2020; 268:120586. [PMID: 33310537 DOI: 10.1016/j.biomaterials.2020.120586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 02/06/2023]
Abstract
Biocompatible antibacterial coatings are highly desirable to prevent bacterial colonization on a wide range of medical devices from hip implants to skin grafts. Traditional polyelectrolytes are unable to directly form coatings with cationic antibiotics at neutral pH and suffer from high degrees of antibiotic release upon exposure to physiological concentrations of salt. Here, novel inorganic-organic hybrid polymer coatings based on direct layer-by-layer assembly of anionic polyphosphazenes (PPzs) of various degrees of fluorination with cationic antibiotics (polymyxin B, colistin, gentamicin, and neomycin) are reported. The coatings displayed low levels of antibiotic release upon exposure to salt and pH-triggered response of controlled doses of antibiotics. Importantly, coatings remained highly surface active against Escherichia coli and Staphylococcus aureus, even after 30 days of pre-exposure to physiological conditions (bacteria-free) or after repeated bacterial challenge. Moreover, coatings displayed low (<1%) hemolytic activity for both rabbit and porcine blood. Coatings deposited on either hard (Si wafers) or soft (electrospun fiber matrices) materials were non-toxic towards fibroblasts (NIH/3T3) and displayed controllable fibroblast adhesion via PPz fluorination degree. Finally, coatings showed excellent antibacterial activity in ex vivo pig skin studies. Taken together, these results suggest a new avenue to form highly tunable, biocompatible polymer coatings for medical device surfaces.
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Affiliation(s)
- Victoria Albright
- Department of Materials Science & Engineering, Texas A&M University, College Station, TX, USA
| | | | - Mary Stack
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, USA
| | - Jeremy Zheng
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Alexander Marin
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD, USA
| | - Hanna Hlushko
- Department of Materials Science & Engineering, Texas A&M University, College Station, TX, USA
| | - Hongjun Wang
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, USA; Department of Chemistry and Chemical Biology, Stevens Institute of Technology, Hoboken, NJ, USA
| | - Arul Jayaraman
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA; Department of Chemical Engineering, Texas A&M University, College Station, TX, USA
| | - Alexander K Andrianov
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD, USA
| | - Svetlana A Sukhishvili
- Department of Materials Science & Engineering, Texas A&M University, College Station, TX, USA.
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Stechele M, Wittgenstein H, Stolzenburg N, Schnorr J, Neumann J, Schmidt C, Günther RW, Streitparth F. Novel MR-Visible, Biodegradable Microspheres for Transcatheter Arterial Embolization: Experimental Study in a Rabbit Renal Model. Cardiovasc Intervent Radiol 2020; 43:1515-1527. [PMID: 32514611 DOI: 10.1007/s00270-020-02534-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess feasibility, embolization success, biodegradability, reperfusion, biocompatibility and in vivo visibility of novel temporary microspheres (MS) for transcatheter arterial embolization. MATERIAL AND METHODS In 9 New Zealand white rabbits unilateral superselective embolization of the lower kidney pole was performed with biodegradable MS made of polydioxanone (PDO) (size range 90-300 and 200-500 µm) impregnated with super-paramagnetic iron oxide (SPIO). Magnetic resonance imaging (MRI) was performed post-interventionally to assess in vivo visibility. Embolization success was assessed on digital subtraction angiography, MRI and gross pathology. One animal was killed immediately after embolization to assess original particle appearance. 8 animals were randomly assigned to different observation periods (1, 4, 8, 12 and 16 weeks), after which control angiography and MRI were obtained to determine recanalization. Histopathological analysis was performed to determine biodegradability and biocompatibility by using dedicated quantitative assessment analysis. RESULTS Ease of injection was moderate. Embolization was technically successful in 7 of 8 animals, one rabbit received non-selective embolization of the whole kidney and abdominal off-target embolization. Arterial occlusion was achieved in all kidneys, infarct areas in macro- and microscopic analysis confirmed embolization success. Control angiograms showed evidence of partial reperfusion. The microspheres showed extensive degradation over the course of time along with increasing inflammatory response and giant cell formation. SPIO-loaded MS were visible on MRI at all time points. CONCLUSIONS SPIO-impregnated biodegradable PDO-MS achieved effective embolization with in vivo visibility on MRI and increasing biodegradation over time while demonstrating good biocompatibility, i.e., a physiologically immune response without transformation into chronic inflammation. Further studies are needed to provide clinical applicability.
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Affiliation(s)
- Matthias Stechele
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | - Helena Wittgenstein
- Evidensia Veterinary Clinic for Small Animals GmbH, Kabels Stieg 41, 22850, Norderstedt, Germany
| | - Nicola Stolzenburg
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jörg Schnorr
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Neumann
- University Hospital, Institute of Pathology, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | | | - Rolf W Günther
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Florian Streitparth
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany.
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Selin V, Albright V, Ankner JF, Marin A, Andrianov AK, Sukhishvili SA. Biocompatible Nanocoatings of Fluorinated Polyphosphazenes through Aqueous Assembly. ACS APPLIED MATERIALS & INTERFACES 2018; 10:9756-9764. [PMID: 29505245 DOI: 10.1021/acsami.8b02072] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Nonionic fluorinated polyphosphazenes, such as poly[bis(trifluoroethoxy)phosphazene] (PTFEP), display superb biocompatibility, yet their deposition to surfaces has been limited to solution casting from organic solvents or thermal molding. Herein, hydrophobic coatings of fluorinated polyphosphazenes are demonstrated through controlled deposition of ionic fluorinated polyphosphazenes (iFPs) from aqueous solutions using the layer-by-layer (LbL) technique. Specifically, the assemblies included poly[(carboxylatophenoxy)(trifluoroethoxy)phosphazenes] with varied content of fluorine atoms as iFPs (or poly[bis(carboxyphenoxy)phosphazene] (PCPP) as a control nonfluorinated polyphosphazene) and a variety of polycations. Hydrophobic interactions largely contributed to the formation of LbL films of iFPs with polycations, leading to linear growth and extremely low water uptake. Hydrophobicity-enhanced ionic pairing within iFP/BPEI assemblies gave rise to large-amplitude oscillations in surface wettability as a function of capping layer, which were the largest for the most fluorinated iFP, while control PCPP/polycation systems remained hydrophilic regardless of the film top layer. Neutron reflectometry (NR) studies indicated superior layering and persistence of such layering in salt solution for iFP/BPEI films as compared to control PCPP/polycation systems. Hydrophobicity of iFP-capped LbL coatings could be further enhanced by using a highly porous polyester surgical felt rather than planar substrates for film deposition. Importantly, iFP/polycation coatings displayed biocompatibility which was similar to or superior to that of solution-cast coatings of a clinically validated material (PTFEP), as demonstrated by the hemolysis of the whole blood and protein adsorption studies.
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Affiliation(s)
- Victor Selin
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
| | - Victoria Albright
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
| | - John F Ankner
- Spallation Neutron Source , Oak Ridge National Laboratory , Oak Ridge , Tennessee 37831 , United States
| | - Alexander Marin
- Institute for Bioscience and Biotechnology Research , University of Maryland , Rockville , Maryland 20850 , United States
| | - Alexander K Andrianov
- Institute for Bioscience and Biotechnology Research , University of Maryland , Rockville , Maryland 20850 , United States
| | - Svetlana A Sukhishvili
- Department of Materials Science & Engineering , Texas A&M University , College Station , Texas 77843 , United States
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Ulery BD, Nair LS, Laurencin CT. Biomedical Applications of Biodegradable Polymers. JOURNAL OF POLYMER SCIENCE. PART B, POLYMER PHYSICS 2011; 49:832-864. [PMID: 21769165 PMCID: PMC3136871 DOI: 10.1002/polb.22259] [Citation(s) in RCA: 1179] [Impact Index Per Article: 90.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Utilization of polymers as biomaterials has greatly impacted the advancement of modern medicine. Specifically, polymeric biomaterials that are biodegradable provide the significant advantage of being able to be broken down and removed after they have served their function. Applications are wide ranging with degradable polymers being used clinically as surgical sutures and implants. In order to fit functional demand, materials with desired physical, chemical, biological, biomechanical and degradation properties must be selected. Fortunately, a wide range of natural and synthetic degradable polymers has been investigated for biomedical applications with novel materials constantly being developed to meet new challenges. This review summarizes the most recent advances in the field over the past 4 years, specifically highlighting new and interesting discoveries in tissue engineering and drug delivery applications.
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Affiliation(s)
- Bret D. Ulery
- Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut 06030
- Institute of Regenerative Engineering, University of Connecticut Health Center, Farmington, Connecticut 06030
| | - Lakshmi S. Nair
- Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut 06030
- Institute of Regenerative Engineering, University of Connecticut Health Center, Farmington, Connecticut 06030
- Department of Chemical, Materials & Biomolecular Engineering, University of Connecticut, Storrs, Connecticut 06268
| | - Cato T. Laurencin
- Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut 06030
- Institute of Regenerative Engineering, University of Connecticut Health Center, Farmington, Connecticut 06030
- Department of Chemical, Materials & Biomolecular Engineering, University of Connecticut, Storrs, Connecticut 06268
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