1
|
Sun X, Wu L, Du L, Xu W, Han M. Targeting the organelle for radiosensitization in cancer radiotherapy. Asian J Pharm Sci 2024; 19:100903. [PMID: 38590796 PMCID: PMC10999375 DOI: 10.1016/j.ajps.2024.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/29/2023] [Accepted: 01/16/2024] [Indexed: 04/10/2024] Open
Abstract
Radiotherapy is a well-established cytotoxic therapy for local solid cancers, utilizing high-energy ionizing radiation to destroy cancer cells. However, this method has several limitations, including low radiation energy deposition, severe damage to surrounding normal cells, and high tumor resistance to radiation. Among various radiotherapy methods, boron neutron capture therapy (BNCT) has emerged as a principal approach to improve the therapeutic ratio of malignancies and reduce lethality to surrounding normal tissue, but it remains deficient in terms of insufficient boron accumulation as well as short retention time, which limits the curative effect. Recently, a series of radiosensitizers that can selectively accumulate in specific organelles of cancer cells have been developed to precisely target radiotherapy, thereby reducing side effects of normal tissue damage, overcoming radioresistance, and improving radiosensitivity. In this review, we mainly focus on the field of nanomedicine-based cancer radiotherapy and discuss the organelle-targeted radiosensitizers, specifically including nucleus, mitochondria, endoplasmic reticulum and lysosomes. Furthermore, the organelle-targeted boron carriers used in BNCT are particularly presented. Through demonstrating recent developments in organelle-targeted radiosensitization, we hope to provide insight into the design of organelle-targeted radiosensitizers for clinical cancer treatment.
Collapse
Affiliation(s)
- Xiaoyan Sun
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- National Key Laboratory of Advanced Drug Delivery and Release Systems, Zhejiang University, Hangzhou 310058, China
| | - Linjie Wu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- National Key Laboratory of Advanced Drug Delivery and Release Systems, Zhejiang University, Hangzhou 310058, China
| | - Lina Du
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing 100850, China
| | - Wenhong Xu
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, The Second Afliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Min Han
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, The Second Afliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310058, China
- Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310058, China
- Jinhua Institute of Zhejiang University, Jinhua 321299, China
- National Key Laboratory of Advanced Drug Delivery and Release Systems, Zhejiang University, Hangzhou 310058, China
| |
Collapse
|
2
|
Pidcoke HF, Delacruz W, Herzig MC, Schaffer BS, Leazer ST, Fedyk CG, Montogomery RK, Prat NJ, Parida BK, Aden JK, Scherer MR, Reddick RL, Shade RE, Cap AP. Perfluorocarbons cause thrombocytopenia, changes in RBC morphology and death in a baboon model of systemic inflammation. PLoS One 2022; 17:e0279694. [PMID: 36584001 PMCID: PMC9803179 DOI: 10.1371/journal.pone.0279694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
A perfluorocarbon (PFC) investigated for treatment of traumatic brain injury (TBI) delivers oxygen to support brain function, but causes transient thrombocytopenia. TBI can cause acute inflammation with resulting thrombocytopenia; an interaction between the PFC effects and TBI inflammation might exacerbate thrombocytopenia. Therefore, PFC effects on platelet (PLT) function and hemostasis in a lipopolysaccharide (LPS) model of inflammation in the baboon were studied. Animals were randomized to receive saline ±LPS, and ± one of two doses of PFC. PLT count, transmission electron microscopy, and microparticle populations were quantified at baseline (BL) and at 2, 24, 48, 72, and 96 hours; hemostatic parameters for aggregometry and for blood clotting were measured at baseline (BL) and days 3 and 4. Injection of vehicle and LPS caused thrombocytopenia within hours; PFCs caused delayed thrombocytopenia beginning 48 hours post-infusion. LPS+PFC produced a more prolonged PLT decline and decreased clot strength. LPS+PFC increased ADP-stimulated aggregation, but PFC alone did not. Microparticle abundance was greatest in the LPS+PFC groups. LPS+PFC caused diffuse microvascular hemorrhage and death in 2 of 5 baboons in the low dose LPS-PFC group and 2 of 2 in the high dose LPS-PFC group. Necropsy and histology suggested death was caused by shock associated with hemorrhage in multiple organs. Abnormal morphology of platelets and red blood cells were notable for PFC inclusions. In summary, PFC infusion caused clinically significant thrombocytopenia and exacerbated LPS-induced platelet activation. The interaction between these effects resulted in decreased hemostatic capacity, diffuse bleeding, shock and death.
Collapse
Affiliation(s)
- Heather F. Pidcoke
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Wilfred Delacruz
- Hematology-Oncology Service, San Antonio Military Medical Center, Fort Sam Houston, TX, United States of America
| | - Maryanne C. Herzig
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Beverly S. Schaffer
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Sahar T. Leazer
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Chriselda G. Fedyk
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Robbie K. Montogomery
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Nicolas J. Prat
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Bijaya K. Parida
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - James K. Aden
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Michael R. Scherer
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| | - Robert L. Reddick
- Department of Pathology and Laboratory Medicine, University of Texas, Health Science Center, San Antonio, TX, United States of America
| | - Robert E. Shade
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, United States of America
| | - Andrew P. Cap
- Blood and Shock Resuscitation, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, United States of America
| |
Collapse
|
3
|
Krafft MP, Riess JG. Therapeutic oxygen delivery by perfluorocarbon-based colloids. Adv Colloid Interface Sci 2021; 294:102407. [PMID: 34120037 DOI: 10.1016/j.cis.2021.102407] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023]
Abstract
After the protocol-related indecisive clinical trial of Oxygent, a perfluorooctylbromide/phospholipid nanoemulsion, in cardiac surgery, that often unduly assigned the observed untoward effects to the product, the development of perfluorocarbon (PFC)-based O2 nanoemulsions ("blood substitutes") has come to a low. Yet, significant further demonstrations of PFC O2-delivery efficacy have continuously been reported, such as relief of hypoxia after myocardial infarction or stroke; protection of vital organs during surgery; potentiation of O2-dependent cancer therapies, including radio-, photodynamic-, chemo- and immunotherapies; regeneration of damaged nerve, bone or cartilage; preservation of organ grafts destined for transplantation; and control of gas supply in tissue engineering and biotechnological productions. PFC colloids capable of augmenting O2 delivery include primarily injectable PFC nanoemulsions, microbubbles and phase-shift nanoemulsions. Careful selection of PFC and other colloid components is critical. The basics of O2 delivery by PFC nanoemulsions will be briefly reminded. Improved knowledge of O2 delivery mechanisms has been acquired. Advanced, size-adjustable O2-delivering nanoemulsions have been designed that have extended room-temperature shelf-stability. Alternate O2 delivery options are being investigated that rely on injectable PFC-stabilized microbubbles or phase-shift PFC nanoemulsions. The latter combine prolonged circulation in the vasculature, capacity for penetrating tumor tissues, and acute responsiveness to ultrasound and other external stimuli. Progress in microbubble and phase-shift emulsion engineering, control of phase-shift activation (vaporization), understanding and control of bubble/ultrasound/tissue interactions is discussed. Control of the phase-shift event and of microbubble size require utmost attention. Further PFC-based colloidal systems, including polymeric micelles, PFC-loaded organic or inorganic nanoparticles and scaffolds, have been devised that also carry substantial amounts of O2. Local, on-demand O2 delivery can be triggered by external stimuli, including focused ultrasound irradiation or tumor microenvironment. PFC colloid functionalization and targeting can help adjust their properties for specific indications, augment their efficacy, improve safety profiles, and expand the range of their indications. Many new medical and biotechnological applications involving fluorinated colloids are being assessed, including in the clinic. Further uses of PFC-based colloidal nanotherapeutics will be briefly mentioned that concern contrast diagnostic imaging, including molecular imaging and immune cell tracking; controlled delivery of therapeutic energy, as for noninvasive surgical ablation and sonothrombolysis; and delivery of drugs and genes, including across the blood-brain barrier. Even when the fluorinated colloids investigated are designed for other purposes than O2 supply, they will inevitably also carry and deliver a certain amount of O2, and may thus be considered for O2 delivery or co-delivery applications. Conversely, O2-carrying PFC nanoemulsions possess by nature a unique aptitude for 19F MR imaging, and hence, cell tracking, while PFC-stabilized microbubbles are ideal resonators for ultrasound contrast imaging and can undergo precise manipulation and on-demand destruction by ultrasound waves, thereby opening multiple theranostic opportunities.
Collapse
Affiliation(s)
- Marie Pierre Krafft
- University of Strasbourg, Institut Charles Sadron (CNRS), 23 rue du Loess, 67034 Strasbourg, France.
| | - Jean G Riess
- Harangoutte Institute, 68160 Ste Croix-aux-Mines, France
| |
Collapse
|
4
|
Pigott A, Rudloff E. Traumatic Brain Injury-A Review of Intravenous Fluid Therapy. Front Vet Sci 2021; 8:643800. [PMID: 34307515 PMCID: PMC8299062 DOI: 10.3389/fvets.2021.643800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
This manuscript will review intravenous fluid therapy in traumatic brain injury. Both human and animal literature will be included. Basic treatment recommendations will also be discussed.
Collapse
Affiliation(s)
- Armi Pigott
- BluePearl Specialty + Emergency Pet Hospital, Glendale, WI, United States
| | - Elke Rudloff
- BluePearl Specialty + Emergency Pet Hospital, Glendale, WI, United States
| |
Collapse
|
5
|
Jayaraman MS, Graham K, Unger EC. Injectable oxygenation therapeutics: evaluating the oxygen delivery efficacy of artificial oxygen carriers and kosmotropes in vitro. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2021; 49:317-324. [PMID: 33739901 DOI: 10.1080/21691401.2021.1879103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this paper was to utilise an existing in vitro setup to quantify the oxygen offloading capabilities of two different subsets of injectable oxygenation therapeutics: (1) artificial oxygen carriers (AOCs), which bind or dissolve oxygen and act as transport vectors, and (2) kosmotropes, which increase water hydrogen bonding and thereby decrease the resistance to oxygen movement caused by the blood plasma. Dodecafluoropentane emulsion (DDFPe) was chosen to represent the AOC subset while trans sodium crocetinate (TSC) was selected to represent the kosmotrope subset. PEG-Telomer-B (PTB), the surfactant utilised to encapsulate DDFP in emulsion form, was also tested to determine whether it affected the oxygen transport ability of DDFPe. The in vitro set-up was used to simulate a semi closed-loop circulatory system, in which oxygen could be delivered from the lungs to hypoxic tissues. Results of this study showed that (1) 0.5 ml of a PFC outperformed 6.25 ml of a kosmotrope in a controlled, in vitro setting and (2) that PTB and sucrose do not contribute to the overall oxygen transportation efficacy of DDFPe. These results could be therapeutically beneficial to ongoing and future pre-clinical and clinical studies involving various oxygenation agents.
Collapse
|
6
|
Functional, Metabolic and Morphologic Results of Ex Vivo Donor Lung Perfusion with a Perfluorocarbon-Based Oxygen Carrier Nanoemulsion in a Large Animal Transplantation Model. Cells 2020; 9:cells9112501. [PMID: 33218154 PMCID: PMC7698917 DOI: 10.3390/cells9112501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Ex vivo lung perfusion (EVLP) is a technology that allows the re-evaluation of questionable donor lung before implantation and it has the potential to repair injured donor lungs that are otherwise unsuitable for transplantation. We hypothesized that perfluorocarbon-based oxygen carrier, a novel reconditioning strategy instilled during EVLP would improve graft function. Methods: We utilized perfluorocarbon-based oxygen carrier (PFCOC) during EVLP to recondition and improve lung graft function in a pig model of EVLP and lung transplantation. Lungs were retrieved and stored for 24 h at 4 °C. EVLP was done for 6 h with or without PFCOC. In the transplantation groups, left lung transplantation was done after EVLP with or without PFCOC. Allograft function was assessed by means of pulmonary gas exchange, lung mechanics and vascular pressures, histology and transmission electron microscopy (TEM). Results: In the EVLP only groups, physiological and biochemical markers during the 6-h perfusion period were comparable. However, perfusate lactate potassium levels were lower and ATP levels were higher in the PFCOC group. Radiologic assessment revealed significantly more lung infiltrates in the controls than in the PFCOC group (p = 0.04). In transplantation groups, perfusate glucose consumption was higher in the control group. Lactate levels were significantly lower in the PFCOC group (p = 0.02). Perfusate flavin mononucleotide (FMN) was significantly higher in the controls (p = 0.008). Post-transplant gas exchange was significantly better during the 4-h reperfusion period in the PFCOC group (p = 0.01). Plasma IL-8 and IL-12 levels were significantly lower in the PFCOC group (p = 0.01, p = 0.03, respectively). ATP lung tissue levels at the end of the transplantation were higher and myeloperoxidase (MPO) levels in lung tissue were lower in the PFCOC group compared to the control group. In the PFCOC group, TEM showed better tissue preservation and cellular viability. Conclusion: PFCOC application is safe during EVLP in lungs preserved 24 h at 4 °C. Although this strategy did not significantly affect the EVLP physiology, metabolic markers of the donor quality such as lactate production, glucose consumption, neutrophil infiltration and preservation of mitochondrial function were better in the PFCOC group. Following transplantation, PFCOC resulted in better graft function and TEM showed better tissue preservation, cellular viability and improved gas transport.
Collapse
|
7
|
Arnaud F, Haque A, Morris MAJE, Moon-Massat P, Auker C, Biswajit S, Hazzard B, Tran Ho LTV, McCarron R, Scultetus A. Treatment of Swine Closed Head Injury with Perfluorocarbon NVX-428. ACTA ACUST UNITED AC 2020; 8:medsci8040041. [PMID: 32992571 PMCID: PMC7712073 DOI: 10.3390/medsci8040041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022]
Abstract
Pre-hospital treatment of traumatic brain injury (TBI) with co-existing polytrauma is complicated by requirements for intravenous fluid volume vs. hypotensive resuscitation. A low volume, small particle-size-oxygen-carrier perfluorocarbon emulsion NVX-428 (dodecafluoropentane emulsion; 2% w/v) could improve brain tissue with minimal additional fluid volume. This study examined whether the oxygen-carrier NVX-428 shows safety and efficacy for pre-hospital treatment of TBI. Anesthetized swine underwent fluid percussion injury TBI and received 1 mL/kg IV NVX-428 (TBI-NVX) at 15 min (T15) or normal saline (no-treatment) (TBI-NON). Similarly, uninjured swine received NVX-428 (SHAM-NVX) or normal saline (SHAM-NON). Animals were monitored and measurements were taken for physiological and neurological parameters before euthanasia at the six-hour mark (T360). Histopathological analysis was performed on paraffin embedded tissues. Physiological, biochemical and blood gas parameters were not different, with the exception of a significant but transient increase in mean pulmonary artery pressure observed in the TBI-experimental group immediately after drug administration. There were no initial differences in brain oxygenation at baseline, but over time oxygen decreased ~50% in both TBI groups. Histological brain injury scores were similar between TBI-NVX and TBI-NON, although a number of subcategories (spongiosis-ischemic/dead neurons-hemorrhage-edema) in TBI-NVX had a tendency for lower scores. The cerebellum showed significantly lower spongiosis and ischemic/dead neuron injury scores and a lower number of Fluoro-Jade-B-positive cerebellar-Purkinje-cells after NVX-428 treatment compared to controls. NVX-428 may assist in mitigating secondary cellular brain damage.
Collapse
Affiliation(s)
- Francoise Arnaud
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA
- Correspondence: ; Tel.: +301-319-7687
| | - Ashraful Haque
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - MAJ Erin Morris
- Walter Reed Army Institute of Research, Veterinary Pathology Services, 503 Robert Grant Ave, Silver Spring, MD 20910, USA;
| | - Paula Moon-Massat
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - Charles Auker
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - Saha Biswajit
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - Brittany Hazzard
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - Lam Thuy Vi Tran Ho
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 6720 Rockledge Drive, Bethesda, MD 20817, USA
| | - Richard McCarron
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA
| | - Anke Scultetus
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Ave, Silver Spring, MD 20910, USA; (A.H.); (P.M.-M.); (C.A.); (S.B.); (B.H.); (L.T.V.T.H.); (R.M.); (A.S.)
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA
| |
Collapse
|
8
|
Dodecafluoropentane Emulsion (DDFPE) as a Resuscitation Fluid for Treatment of Hemorrhagic Shock and Traumatic Brain Injury: A Review. Shock 2020; 52:50-54. [PMID: 29176401 DOI: 10.1097/shk.0000000000001060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Dodecafluoropentane emulsion (DDFPe) is a novel nanotechnology for oxygen delivery with therapeutic potential for hemorrhagic shock and/or traumatic brain injury (TBI). DDFPe demonstrates efficacy at smaller doses than previously tested perfluorocarbon oxygen therapeutics. This smaller dose potentially eliminates toxicities exhibited by previous oxygen therapeutics, whereas anti-inflammatory properties of DDFPe may alleviate damage from ischemia reperfusion injury. This minireview summarizes our progress in developing a battlefield-ready product to prevent combat death due to hemorrhagic shock and/or TBI. Preclinical studies, for both indications, show promising effects of DDFPe as a resuscitation fluid. DDFPe may become a part of the toolkit for tactical healthcare professionals in battlefield and domestic emergency medicine.
Collapse
|
9
|
Mini-review: Perfluorocarbons, Oxygen Transport, and Microcirculation in Low Flow States: in Vivo and in Vitro Studies. Shock 2020; 52:19-27. [PMID: 28930919 DOI: 10.1097/shk.0000000000000994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The in vivo study of microvascular oxygen transport requires accurate and challenging measurements of several mass transfer parameters. Although recommended, blood flow and oxygenation are typically not measured in many studies where treatments for ischemia are tested. Therefore, the aim of this communication is to briefly review cardinal aspects of oxygen transport, and the effects of perfluorocarbon (PFC) treatment on blood flow and oxygenation based mostly on studies performed in our laboratory. As physiologically relevant events in oxygen transport take place at the microvascular level, we implemented the phosphorescence quenching technique coupled with noninvasive intravital videomicroscopy for quantitative evaluation of these events in vivo. Rodent experimental models and various approaches have been used to induce ischemia, including hemorrhage, micro- and macroembolism, and microvessel occlusion. Measurements show decrease in microvascular blood flow as well as intravascular and tissue oxygen partial pressure (PO2) after these procedures. To minimize or reverse the effects of ischemia and hypoxia, artificial oxygen carriers such as different PFCs were tested. Well-defined endpoints such as blood flow and tissue PO2 were measured because they have significant effect on tissue survival and outcome. In several cases, enhancement of flow and oxygenation could be demonstrated. Similar results were found in vitro: PFC emulsion mixed with blood (from healthy donors and sickle cell disease patients) enhanced oxygen transport. In summary, PFCs may provide beneficial effects in these models by mechanisms at the microvascular level including facilitated diffusion and bubble reabsorption leading to improved blood flow and oxygenation.
Collapse
|
10
|
A Role for Nanoparticles in Treating Traumatic Brain Injury. Pharmaceutics 2019; 11:pharmaceutics11090473. [PMID: 31540234 PMCID: PMC6781280 DOI: 10.3390/pharmaceutics11090473] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the main causes of disability in children and young adults, as well as a significant concern for elderly individuals. Depending on the severity, TBI can have a long-term impact on the quality of life for survivors of all ages. The primary brain injury can result in severe disability or fatality, and secondary brain damage can increase the complexities in cellular, inflammatory, neurochemical, and metabolic changes in the brain, which can last decades post-injury. Thus, survival from a TBI is often accompanied by lifelong disabilities. Despite the significant morbidity, mortality, and economic loss, there are still no effective treatment options demonstrating an improved outcome in a large multi-center Phase III trial, which can be partially attributed to poor target engagement of delivered therapeutics. Thus, there is a significant unmet need to develop more effective delivery strategies to overcome the biological barriers that would otherwise inhibit transport of materials into the brain to prevent the secondary long-term damage associated with TBI. The complex pathology of TBI involving the blood-brain barrier (BBB) has limited the development of effective therapeutics and diagnostics. Therefore, it is of great importance to develop novel strategies to target the BBB. The leaky BBB caused by a TBI may provide opportunities for therapeutic delivery via nanoparticles (NP). The focus of this review is to provide a survey of NP-based strategies employed in preclinical models of TBI and to provide insights for improved NP based diagnostic or treatment approaches. Both passive and active delivery of various NPs for TBI are discussed. Finally, potential therapeutic targets where improved NP-mediated delivery could increase target engagement are identified with the overall goal of providing insight into open opportunities for NP researchers to begin research in TBI.
Collapse
|
11
|
Jayaraman MS, Graham K, Unger EC. In vitro model to compare the oxygen offloading behaviour of dodecafluoropentane emulsion (DDFPe). ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:783-789. [DOI: 10.1080/21691401.2019.1577882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
12
|
Liu Z, Barber C, Gupta A, Wan L, Won YW, Furenlid LR, Chen Q, Desai AA, Zhao M, Bull DA, Unger EC, Martin DR. Imaging assessment of cardioprotection mediated by a dodecafluoropentane oxygen-carrier administered during myocardial infarction. Nucl Med Biol 2019; 70:67-77. [PMID: 30772168 DOI: 10.1016/j.nucmedbio.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/18/2018] [Accepted: 01/14/2019] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The objective of this study was to investigate the cardioprotective effects of a dodecafluoropentane (DDFP)-based perfluorocarbon emulsion (DDFPe) as an artificial carrier for oxygen delivery to ischemic myocardium, using 99mTc-duramycin SPECT imaging. METHODS Rat hearts with Ischemia-reperfusion (I/R) was prepared by coronary ligation for 45-min followed by reperfusion. The feasibility of 99mTc-duramycin in detecting myocardial I/R injury and its kinetic profile were first verified in the ischemic hearts with 2-h reperfusion (n = 6). DDFPe (0.6 mL/kg) was intravenously administered at 10 min after coronary ligation in fifteen rats and saline was given in thirteen rats as controls. 99mTc-duramycin SPECT images were acquired in the DDFPe-treated hearts and saline controls at 2-h (DDFPe-2 h, n = 7 and Saline-2 h, n = 6) or 24-h (DDFPe-24 h, n = 8 and Saline-24 h, n = 7) of reperfusion. RESULTS SPECT images, showing "hot-spot" 99mTc-duramycin uptake in the ischemic myocardium, exhibited significantly lower radioactive retention and smaller hot-spot size in the DDFPe-2 h and DDFPe-24 h hearts compared to controls. The infarcts in the Saline-24 h hearts extended significantly relative to measurements in the Saline-2 h. The extension of infarct size did not reach a statistical difference between the DDFPe-2 h and DDFPe-24 h hearts. Ex vivo measurement of 99mTc-duramycin activity (%ID/g) was lower in the ischemic area of DDFPe-2 h and DDFPe-24 h than that of the Saline-2 h and Saline-24 h hearts (P < 0.05). The area of injured myocardium, delineated by the uptake of 99mTc-duramycin, extended more substantially outside the infarct zone in the controls. CONCLUSIONS Significant reduction in myocardial I/R injury, as assessed by 99mTc-duramycin cell death imaging and histopathological analysis, was induced by DDFPe treatment after acute myocardial ischemia. 99mTc-duramycin imaging can reveal myocardial cell death in ischemic hearts and may provide a tool for the non-invasive assessment of cardioprotective interventions.
Collapse
Affiliation(s)
- Zhonglin Liu
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America.
| | - Christy Barber
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America
| | - Akash Gupta
- Division of Cardiology of Department of Medicine, University of Arizona, Tucson, AZ, United States of America
| | - Li Wan
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America
| | - Young-Wook Won
- Division of Cardiothoracic Surgery of Department of Surgery, University of Arizona, Tucson, AZ, United States of America
| | - Lars R Furenlid
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America
| | - Qin Chen
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States of America
| | - Ankit A Desai
- Division of Cardiology of Department of Medicine, University of Arizona, Tucson, AZ, United States of America
| | - Ming Zhao
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - David A Bull
- Division of Cardiothoracic Surgery of Department of Surgery, University of Arizona, Tucson, AZ, United States of America
| | - Evan C Unger
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America; NuvOx Pharma, LLC., Tucson, AZ, United States of America
| | - Diego R Martin
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America.
| |
Collapse
|
13
|
Abutarboush R, Mullah SH, Saha BK, Haque A, Walker PB, Aligbe C, Pappas G, Tran Ho LTV, Arnaud FG, Auker CR, McCarron RM, Scultetus AH, Moon-Massat P. Brain oxygenation with a non-vasoactive perfluorocarbon emulsion in a rat model of traumatic brain injury. Microcirculation 2018; 25:e12441. [DOI: 10.1111/micc.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/12/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Rania Abutarboush
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Saad H. Mullah
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Biswajit K. Saha
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Ashraful Haque
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Peter B. Walker
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Chioma Aligbe
- Department of Surgery; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Georgina Pappas
- Department of Surgery; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | | | - Francoise G. Arnaud
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
- Department of Surgery; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Charles R. Auker
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| | - Richard M. McCarron
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
- Department of Surgery; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Anke H. Scultetus
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
- Department of Surgery; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Paula Moon-Massat
- NeuroTrauma Department; Naval Medical Research Center; Silver Spring MD USA
| |
Collapse
|
14
|
Duvigneau JC, Kozlov AV. Pathological Impact of the Interaction of NO and CO with Mitochondria in Critical Care Diseases. Front Med (Lausanne) 2017; 4:223. [PMID: 29312941 PMCID: PMC5743798 DOI: 10.3389/fmed.2017.00223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/27/2017] [Indexed: 12/14/2022] Open
Abstract
The outcome of patients with critical care diseases (CCD) such as sepsis, hemorrhagic shock, or trauma is often associated with mitochondrial dysfunction. In turn, mitochondrial dysfunction is frequently induced upon interaction with nitric oxide (NO) and carbon monoxide (CO), two gaseous messengers formed in the body by NO synthase (NOS) and heme oxygenase (HO), respectively. Both, NOS and HO are upregulated in the majority of CCD. A multitude of factors that are associated with the pathology of CCD exert a potential to interfere with mitochondrial function or the effects of the gaseous messengers. From these, four major factors can be identified that directly influence the effects of NO and CO on mitochondria and which are defined by (i) local concentration of NO and/or CO, (ii) tissue oxygenation, (iii) redox status of cells in terms of facilitating or inhibiting reactive oxygen species formation, and (iv) the degree of tissue acidosis. The combination of these four factors in specific pathological situations defines whether effects of NO and CO are beneficial or deleterious.
Collapse
Affiliation(s)
- J Catharina Duvigneau
- Institute of Medical Biochemistry, Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Andrey V Kozlov
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
| |
Collapse
|
15
|
Oxygen Carriers: Are They Enough for Cellular Support? SPRINGER SERIES IN TRANSLATIONAL STROKE RESEARCH 2017. [DOI: 10.1007/978-3-319-45345-3_26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
16
|
Abutarboush R, Saha BK, Mullah SH, Arnaud FG, Haque A, Aligbe C, Pappas G, Auker CR, McCarron RM, Moon-Massat PF, Scultetus AH. Cerebral Microvascular and Systemic Effects Following Intravenous Administration of the Perfluorocarbon Emulsion Perftoran. J Funct Biomater 2016; 7:jfb7040029. [PMID: 27869709 PMCID: PMC5197988 DOI: 10.3390/jfb7040029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/09/2016] [Accepted: 11/11/2016] [Indexed: 12/02/2022] Open
Abstract
Oxygen-carrying perfluorocarbon (PFC) fluids have the potential to increase tissue oxygenation during hypoxic states and to reduce ischemic cell death. Regulatory approval of oxygen therapeutics was halted due to concerns over vasoconstrictive side effects. The goal of this study was to assess the potential vasoactive properties of Perftoran by measuring brain pial arteriolar diameters in a healthy rat model. Perftoran, crystalloid (saline) or colloid (Hextend) solutions were administered as four sequential 30 min intravenous (IV) infusions, thus allowing an evaluation of cumulative dose-dependent effects. There were no overall changes in diameters of small-sized (<50 μm) pial arterioles within the Perftoran group, while both saline and Hextend groups exhibited vasoconstriction. Medium-sized arterioles (50–100 μm) showed minor (~8–9%) vasoconstriction within saline and Hextend groups and only ~5% vasoconstriction within the Perftoran group. For small- and medium-sized pial arterioles, the mean percent change in vessel diameters was not different among the groups. Although there was a tendency for arterial blood pressures to increase with Perftoran, pressures were not different from the other two groups. These data show that Perftoran, when administered to healthy anesthetized rats, does not cause additional vasoconstriction in cerebral pial arterioles or increase systemic blood pressure compared with saline or Hextend.
Collapse
Affiliation(s)
- Rania Abutarboush
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Biswajit K Saha
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Saad H Mullah
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Francoise G Arnaud
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20895, USA.
| | - Ashraful Haque
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Chioma Aligbe
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Georgina Pappas
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Charles R Auker
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Richard M McCarron
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20895, USA.
| | - Paula F Moon-Massat
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
| | - Anke H Scultetus
- NeuroTrauma Department, Naval Medical Research Center (NMRC), Silver Spring, MD 20910, USA.
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20895, USA.
| |
Collapse
|
17
|
Haque A, Scultetus AH, Arnaud F, Dickson LJ, Chun S, McNamee G, Auker CR, McCarron RM, Mahon RT. The Emulsified PFC Oxycyte ® Improved Oxygen Content and Lung Injury Score in a Swine Model of Oleic Acid Lung Injury (OALI). Lung 2016; 194:945-957. [PMID: 27704259 DOI: 10.1007/s00408-016-9941-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/12/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE Perfluorocarbons (PFCs) can transport 50 times more oxygen than human plasma. Their properties may be advantageous in preservation of tissue viability in oxygen-deprived states, such as in acute lung injury. We hypothesized that an intravenous dose of the PFC emulsion Oxycyte® would improve tissue oxygenation and thereby mitigate the effects of acute lung injury. METHODS Intravenous oleic acid (OA) was used to induce lung injury in anesthetized and instrumented Yorkshire swine assigned to three experimental groups: (1) PFC post-OA received Oxycyte® (5 ml/kg) 45 min after oleic acid-induced lung injury (OALI); (2) PFC pre-OA received Oxycyte® 45 min before OALI; and (3) Controls which received equivalent dose of normal saline. Animals were observed for 3 h after OALI began, and then euthanized. RESULTS The median survival times for PFC post-OA, PFC pre-OA, and control were 240, 87.5, and 240 min, respectively (p = 0.001). Mean arterial pressure and mean pulmonary arterial pressure were both higher in the PFC post-OA (p < 0.001 for both parameters). Oxygen content was significantly different between PFC post-OA and the control (p = 0.001). Histopathological grading of lung injury indicated that edema and congestion was significantly less severe in the PFC post-OA compared to control (p = 0.001). CONCLUSION The intravenous PFC Oxycyte® improves blood oxygen content and lung histology when used as a treatment after OALI, while Oxycyte® used prior to OALI was associated with increased mortality. Further exploration in other injury models is indicated.
Collapse
Affiliation(s)
- Ashraful Haque
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA.
| | - Anke H Scultetus
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Francoise Arnaud
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Leonora J Dickson
- Department of Pathology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
| | - Steve Chun
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
- Department of Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA
| | - George McNamee
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Charles R Auker
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
| | - Richard M McCarron
- NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Richard T Mahon
- Undersea Medicine Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910-7500, USA
| |
Collapse
|
18
|
Mullah SH, Abutarboush R, Moon-Massat PF, Saha BK, Haque A, Walker PB, Auker CR, Arnaud FG, McCarron RM, Scultetus AH. Sanguinate's effect on pial arterioles in healthy rats and cerebral oxygen tension after controlled cortical impact. Microvasc Res 2016; 107:83-90. [PMID: 27287870 DOI: 10.1016/j.mvr.2016.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/23/2016] [Accepted: 06/06/2016] [Indexed: 01/18/2023]
Abstract
Sanguinate, a polyethylene glycol-conjugated carboxyhemoglobin, was investigated for cerebral vasoactivity in healthy male Sprague-Dawley rats (Study 1) and for its ability to increase brain tissue oxygen pressure (PbtO2) after controlled cortical impact (CCI) - traumatic brain injury (TBI) (Study 2). In both studies ketamine-acepromazine anesthetized rats were ventilated with 40% O2. In Study 1, a cranial window was used to measure the diameters of medium - (50-100μm) and small-sized (<50μm) pial arterioles before and after four serial infusions of Sanguinate (8mL/kg/h, cumulative 16mL/kg IV), volume-matched Hextend, or normal saline. In Study 2, PbtO2 was measured using a phosphorescence quenching method before TBI, 15min after TBI (T15) and then every 10min thereafter for 155min. At T15, rats received either 8mL/kg IV Sanguinate (40mL/kg/h) or no treatment (saline, 4mL/kg/h). Results showed: 1) in healthy rats, percentage changes in pial arteriole diameter were the same among the groups, 2) in TBI rats, PbtO2 decreased from 36.5±3.9mmHg to 19.8±3.0mmHg at T15 in both groups after TBI and did not recover in either group for the rest of the study, and 3) MAP increased 16±4mmHg and 36±5mmHg after Sanguinate in healthy and TBI rats, respectively, while MAP was unchanged in control groups. In conclusion, Sanguinate did not cause vasoconstriction in the cerebral pial arterioles of healthy rats but it also did not acutely increase PbtO2 when administered after TBI. Sanguinate was associated with an increase in MAP in both studies.
Collapse
Affiliation(s)
- Saad H Mullah
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Rania Abutarboush
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Paula F Moon-Massat
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Biswajit K Saha
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Ashraful Haque
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Peter B Walker
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Charles R Auker
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA.
| | - Francoise G Arnaud
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA; Uniformed Services University of the Health Sciences, Department of Surgery, Bethesda, MD 20814, USA.
| | - Richard M McCarron
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA; Uniformed Services University of the Health Sciences, Department of Surgery, Bethesda, MD 20814, USA.
| | - Anke H Scultetus
- Naval Medical Research Center, NeuroTrauma Department, 503 Robert Grant Avenue Silver Spring, MD 20910, USA; Uniformed Services University of the Health Sciences, Department of Surgery, Bethesda, MD 20814, USA.
| |
Collapse
|