Combined electric field and ultrasound therapy as a novel anti-tumour treatment

Computational analysis of the simultaneous application of ultrasound and electric fields in a lipid bilayer

The combined application of electric fields and ultrasonic waves has shown promise in controlling cell membrane permeability, potentially resulting in synergistic effects that can be explored in the biotechnology industry. However, further clarification on how these processes interact is still needed. The objective of the present study was to investigate the atomic-scale effects of these processes on a DPPC lipid bilayer using molecular dynamics simulations. For higher electric fields, capable of independently forming pores, the application of an ultrasonic wave in the absence of cavitation yielded no additional effects on pore formation. However, for lower electric fields, the reduction in bilayer thickness induced by the shock wave catalyzed the electroporation process, effectively shortening the mean path that water molecules must traverse to form pores. When cavitation was considered, synergistic effects were evident only if the wave alone was able to generate pores through the formation of a water nanojet. In these cases, sonoporation acted as a mean to focus the electroporation effects on the initial pore formed by the nanojet. This study contributes to a better understanding of the synergy between electric fields and ultrasonic waves and to an optimal selection of processing parameters in practical applications of these processes.

Combinatorial physical methods for cellular therapy: Towards the future of cellular analysis?

The physical energy activated techniques for cellular delivery and analysis is one of the most rapidly expanding research areas for a variety of biological and biomedical discoveries. These methods, such as electroporation, optoporation, sonoporation, mechanoporation, magnetoporation, etc., have been widely used in delivering different biomolecules into a range of primary and patient-derived cell types. However, the techniques when used individually have had limitations in delivery and co-delivery of diverse biomolecules in various cell types. In recent years, a number of studies have been performed by combining the different membrane disruption techniques, either sequentially or simultaneously, in a single study. The studies, referred to as combinatorial, or hybrid techniques, have demonstrated enhanced transfection, such as efficient macromolecular and gene delivery and co-delivery, at lower delivery parameters and with high cell viability. Such studies can open up new and exciting avenues for understanding the subcellular structure and consequently facilitate the development of novel therapeutic strategies. This review consequently aims at summarising the different developments in hybrid therapeutic techniques. The different methods discussed include mechano-electroporation, electro-sonoporation, magneto-mechanoporation, magnetic nanoparticles enhanced electroporation, and magnetic hyperthermia studies. We discuss the clinical status of the different methods and conclude with a discussion on the future prospects of the combinatorial techniques for cellular therapy and diagnostics.

Intracellular Delivery of Bleomycin by Combined Application of Electroporation and Sonoporation in Vitro

In this study, we aimed to determine whether the combination of electroporation (EP) and ultrasound (US) waves (sonoporation) can result in an increased intracellular delivery of anticancer drug bleomycin. CHO cells were treated with electric pulses (1 or 8 high voltage pulses of 800 or 1200 V/cm, 100 μs or 1 low voltage pulse of 100 or 250 V/cm, 100 ms) and with 880 kHz US of 320 or 500 kPa peak negative pressure, 100 % duty cycle, applied for 2 s in the presence or absence of exogenously added contrast agent microbubbles. Various sequential or simultaneous combinations of EP and sonoporation were used. The results of the study showed that i) sequential treatment of cells by EP and sonoporation enhanced bleomycin electrosonotransfer at the reduced energy of electric field and US; ii) sequential combination of EP and sonoporation induced a summation effect which at some conditions was more prominent when the cells were treated first by EP and then by sonoporation; iii) the most efficient intracellular delivery of bleomycin was achieved by the simultaneous application of cell EP and sonoporation resulting in percentage of reversibly porated cells above the summation level; and iv) compared with sequential application of EP and sonoporation, simultaneous use of electric pulses and US increased cell viability in the absence of bleomycin.

Low intensity-pulsed ultrasound induced apoptosis of human hepatocellular carcinoma cells in vitro

The present study was conducted to determine whether low intensity-pulsed ultrasound (LIPUS) could induce apoptosis of human hepatocellular carcinoma cells, SMMC-7721, and to define the mechanism of ultrasound-induced apoptosis, in vitro. MTT assay was used to measure cell proliferation. Apoptosis was investigated by multiple methods such as flow cytometry, DNA fragmentation, Ca(2+) mobilizations, pro- and anti-apoptotic protein expression, and light as well as ultramicroscopic morphology. The results provide evidence that LIPUS induced a dose-dependent effect on cell viability and apoptosis of SMMC-7721 cells. Specifically, exposure of cells to >0.5 W/cm(2) intensity significantly increased cell apoptosis, caused shifts in cell cycle phase, and induced structural changes. Ultrasound significantly increased intracellular Ca(2+) concentrations and modulated expression of caspase-3, Bcl-2 and Bax. The findings suggest that this novel technology can be used to induce SMMC-7721 apoptosis via the Ca(2+)/mitochondrial pathway and could potentially be of clinical use for the treatment of hepatocellular carcinoma (SMMC-7721 cell line) and other cancers.

From biocontrol to cancer, probiotics and beyond

This invited commentary covers the period 1997-2012 and has seen changes in terminology that progressed from "basic" and "applied" to "translational" research. In the context of Bioengineered, these changes map readily onto the processes of identifying microbial characteristics appropriate for specific applications, isolation of suitable cultures, strain or genome manipulation and exploitation of these or their metabolomes across a range of settings.   To a great degree, this commentary and my career reflect an engagement with molecular microbiology and the trialling of bacteria and derived constructs in applications ranging from intensive-scale crop protection to amelioration of gastrointestinal disease. This engagement began with laboratory and field evaluations of biocontrol, specifically use of pseudomonads effective against nematode and fungal plant pathogens, characterization of mechanisms mediating beneficial effects of probiotic lactobacilli and bifidobacteria and assessment of functional foods in multinational clinical trials relating to inflammatory bowel disease. Subsequent work focused on (1) intellectual property (IP)-based medical devices for localized delivery of systemically toxic and gene cancer therapies; (2) growth of the science base supporting expansion of a multinational business including company acquisitions; (3) complementing existing inter-institutional research capabilities through development of a national industry-led collaboration; and, most recently, (4) strategic research programs at Ireland's newest medical school. My activities as outlined above parallel two distinct aspects of translational research: (1) involvement in knowledge-driven (commercial and research) organizations that brought together necessary resources and infrastructure and (2) availability of scale research funding from European Framework and Irish national programs.

Adenovirus-mediated transcriptional targeting of colorectal cancer and effects on treatment-resistant hypoxic cells

BACKGROUND

Colorectal cancer is the second leading cause of cancer-related mortality and frequently presents with locally advanced or metastatic disease. Adenovirus (Ad) vectors are important gene delivery agents because they offer efficient and broad tissue transduceability. However, their ability to penetrate through multicell layers in colorectal cancers and maintain expression in colon tumor-related hypoxic conditions has yet to be analyzed. Furthermore, their broad tissue tropism presents safety concerns.

MATERIALS AND METHODS

An ex vivo cultured patient tumor sample model was employed to examine Ad transduction of colorectal tumors.

RESULTS

Results obtained from Ad delivery of the firefly luciferase (FLuc) reporter gene indicated that colon tumor tissue was more amenable to Ad transduction than other tumor histologic types examined (breast and ovary). Ad transduction levels were significantly higher than a range of viral and nonviral methods examined in patient colon tissue. Control of transgene expression using the CXC chemokine receptor 4 (CXCR4) promoter was examined as a strategy to confine expression to tumor cells. An Ad construct carrying FLuc under the control of the human CXCR4 promoter demonstrated low reporter gene expression compared with the ubiquitously expressing cytomegalovirus promoter in normal colon and liver tissue while providing high expression in tumors, demonstrating a 'tumour-on' and 'normal-off' phenotype in patient tissue. The effects of changing hypoxia on Ad-related transgene expression were examined in an in vitro model of hypoxic conditions relevant to clinical colorectal tumors. Reporter gene expression varied depending on the level of hypoxia, with significantly reduced levels observed with prolonged hypoxia. However, transgene expression was robust in the cycling hypoxic conditions relevant to colorectal tumors.

CONCLUSION

This study provides novel, clinically relevant data demonstrating the potential for efficient gene delivery to colorectal tumors using Ad.

Preclinical evaluation of gene delivery methods for the treatment of loco-regional disease in breast cancer

Preclinical results with various gene therapy strategies indicate significant potential for new cancer treatments. However, many therapeutics fail at clinical trial, often due to differences in tissue physiology between animal models and humans, and tumor phenotype variation. Clinical data relevant to treatment strategies may be generated prior to clinical trial through experimentation using intact patient tissue ex vivo. We developed a novel tumor slice model culture system that is universally applicable to gene delivery methods, using a realtime luminescence detection method to assess gene delivery. Methods investigated include viruses (adenovirus [Ad] and adeno-associated virus), lipofection, ultrasound (US), electroporation and naked DNA. Viability and tumor populations within the slices were well maintained for seven days, and gene delivery was qualitatively and quantitatively examinable for all vectors. Ad was the most efficient gene delivery vector with transduction efficiency >50%. US proved the optimal non-viral gene delivery method in human tumor slices. The nature of the ex vivo culture system permitted examination of specific elements. Parameters shown to diminish Ad gene delivery included blood, regions of low viability and secondary disease. US gene delivery was significantly reduced by blood and skin, while tissue hyperthermia improved gene delivery. US achieved improved efficacy for secondary disease. The ex vivo model was also suitable for examination of tissue-specific effects on vector expression, with Ad expression mediated by the CXCR4 promoter shown to provide a tumor selective advantage over the ubiquitously active cytomegalovirus promoter. In conclusion, this is the first study incorporating patient tissue models in comparing gene delivery from various vectors, providing knowledge on cell-type specificity and examining the crucial biological factors determining successful gene delivery. The results highlight the importance of in-depth preclinical assessment of novel therapeutics and may serve as a platform for further testing of current, novel gene delivery approaches.

Exploiting ultrasound-mediated effects in delivering targeted, site-specific cancer therapy

Although the concept of employing ultrasound for the treatment of cancer is not a new one, virtually all existing ultrasound-based clinical cancer treatments are based on hyperthermic ablation. This review seeks to highlight the potential offered by more subtle ultrasound-triggered phenomena such as sonoporation in delivering novel targeted cancer treatment modalities.

High-intensity electric pulses induce mitochondria-dependent apoptosis in ovarian cancer xenograft mice

Human ovarian cancer models were established in nude mice by transplanting SKOV(3) cells, and then tumors were exposed to high-intensity electric pulses with a voltage 1000 V, frequency of 1000 Hz, and duration of 250 ns for 1 min. Mitochondria permeability transition pore (PTP) was inspected by cofocal microscope; cytochrome C (Cyt C) and apoptosis-induced factor (AIF) were determined by immunohistochemistry; and voltage-dependent anion channel (VDAC) was measured by immunofluorescence. High-intensity electric pulses exposure led to increases of PTP, Cyt C, and AIF and a decrease of VDAC. These findings revealed that high-intensity electric pulses activated mitochondria electroporation, apoptosis was realized via mitochondria pathway.

Physical mechanisms and methods employed in drug delivery to tumors

In addition to several well-known drug delivery strategies developed to facilitate effective chemotherapy with anticancer agents, some new approaches have been recently established, based on specific effects arising from the applications of ultrasound, magnetic and electric fields on drug delivery systems. This paper gives an overview of newly developed methods of drug delivery to tumors and of the related anticancer therapies based on the combined use of different physical methods and specific drug carriers. The conventional strategies and new approaches have been put into perspective to revisit the existing and to propose new directions to overcome the threatening problem of cancer diseases.

Physicochemical attack against solid tumors based on the reversal of direction of entropy flow: an attempt to introduce thermodynamics in anticancer therapy

BACKGROUND

There are many differences between healthy tissue and growing tumor tissue, including metabolic, structural and thermodynamic differences. Both structural and thermodynamic differences can be used to follow the entropy differences in cancerous and normal tissue. Entropy production is a bilinear form of the rates of irreversible processes and the corresponding "generalized forces". Entropy production due to various dissipation mechanisms based on temperature differences, chemical potential gradient, chemical affinity, viscous stress and exerted force is a promising tool for calculations relating to potential targets for tumor isolation and demarcation.

METHODS

The relative importance of five forms of entropy production was assessed through mathematical estimation. Using our mathematical model we demonstrated that the rate of entropy production by a cancerous cell is always higher than that of a healthy cell apart from the case of the application of external energy. Different rates of entropy production by two kinds of cells influence the direction of entropy flow between the cells. Entropy flow from a cancerous cell to a healthy cell transfers information regarding the cancerous cell and propagates its invasive action to the healthy tissues. To change the direction of entropy flow, in addition to designing certain biochemical pathways to reduce the rate of entropy production by cancerous cells, we suggest supplying external energy to the tumor area, changing the relative rate of entropy production by the two kinds of cells and leading to a higher entropy accumulation in the surrounding normal cells than in the tumorous cells.

CONCLUSION

Through the use of mathematical models it was quantitatively demonstrated that when no external force field is applied, the rate of entropy production of cancerous cells is always higher than that of healthy cells. However, when the external energy of square wave electric pulses is applied to tissues, the rate of entropy production of normal cells may exceed that of cancerous cells. Consequently, the application of external energy to the body can reverse the direction of the entropy current. The harmful effect brought about by the entropy flow from cancerous to healthy tissue can be blocked by the reversed direction of entropy current from the irradiated normal tissue around the tumor.

Ultrasound absorption and entropy production in biological tissue: a novel approach to anticancer therapy

The entropy production of tumorous cells is higher than that of normal cells, and entropy flow is therefore directed from tumorous toward healthy cells. This results in information concerning the cancer propagating into the surrounding normal tissue. However, ultrasound absorption results in additional entropy production in tissues. The entropy mechanism possibly provides a basis for a novel approach to anticancer therapy through the use of ultrasound irradiation.

Through the calculation of ultrasound-induced entropy production and comparison of the theoretical results with the experimental data on ultrasound absorption in biological tissues, we have demonstrated that ultrasound absorption will increase the entropy in normal tissue more efficiently than in tumorous tissue due to the more acidic nature of the latter. Consequently, the direction of entropy flow between these two kinds of cells may be reversed on exposure to ultrasound.

The higher entropy accumulation of normal cells during ultrasound irradiation may possibly lead to a change in the original direction of entropy flow and avoid the propagation of information on the cancer into the normal tissues. We suggest that low-intensity, low-frequency ultrasound irradiation may be an efficient tool for the therapy of solid tumors.