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Arellano L, Martínez R, Pardo A, Diez I, Velasco B, Moreda-Piñeiro A, Bermejo-Barrera P, Barbosa S, Taboada P. Assessing the Effect of Surface Coating on the Stability, Degradation, Toxicity and Cell Endocytosis/Exocytosis of Upconverting Nanoparticles. J Colloid Interface Sci 2024; 668:575-586. [PMID: 38691966 DOI: 10.1016/j.jcis.2024.04.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/26/2024] [Accepted: 04/26/2024] [Indexed: 05/03/2024]
Abstract
Lanthanide-doped up-converting nanoparticles (UCNPs) have emerged as promising biomedical tools in recent years. Most research efforts were devoted to the synthesis of inorganic cores with the optimal physicochemical properties. However, the careful design of UCNPs with the adequate surface coating to optimize their biological performance still remains a significant challenge. Here, we propose the functionalization of UCNPs with four distinct types of surface coatings, which were compared in terms of the provided colloidal stability and resistance to degradation in different biological-relevant media, including commonly avoided analysis in acidic lysosomal-mimicking fluids. Moreover, the influence of the type of particle surface coating on cell cytotoxicity and endocytosis/exocytosis was also evaluated. The obtained results demonstrated that the functionalization of UCNPs with poly(isobutylene-alt-maleic anhydride) grafted with dodecylamine (PMA-g-dodecyl) constitutes an outstanding strategy for their subsequent biomedical application, whereas poly(ethylene glycol) (PEG) coating, although suitable for colloidal stability purposes, hinders extensive cell internalization. Conversely, surface coating with small ligand were found not to be suitable, leading to large degradation degrees of UCNPs. The analysis of particle' behavior in different biological media and in vitro conditions here performed pretends to help researchers to improve the design and implementation of UCNPs as theranostic nanotools.
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Affiliation(s)
- Lilia Arellano
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Raquel Martínez
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Alberto Pardo
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Iago Diez
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Brenda Velasco
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Antonio Moreda-Piñeiro
- Trace Element, Spectroscopy and Speciation Group (GETEE), Faculty of Chemistry and Materials Institute (iMATUS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Pilar Bermejo-Barrera
- Trace Element, Spectroscopy and Speciation Group (GETEE), Faculty of Chemistry and Materials Institute (iMATUS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Silvia Barbosa
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Pablo Taboada
- Colloids and Polymers Physics Group, Particle Physics Department, Materials Institute (iMATUS), and Health Research Institute (IDIS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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2
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Megahed S, Wutke N, Liu Y, Klapper M, Schulz F, Feliu N, Parak WJ. Encapsulation of Nanoparticles with Statistical Copolymers with Different Surface Charges and Analysis of Their Interactions with Proteins and Cells. Int J Mol Sci 2024; 25:5539. [PMID: 38791579 PMCID: PMC11122285 DOI: 10.3390/ijms25105539] [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: 04/10/2024] [Revised: 05/03/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Encapsulation with polymers is a well-known strategy to stabilize and functionalize nanomaterials and tune their physicochemical properties. Amphiphilic copolymers are promising in this context, but their structural diversity and complexity also make understanding and predicting their behavior challenging. This is particularly the case in complex media which are relevant for intended applications in medicine and nanobiotechnology. Here, we studied the encapsulation of gold nanoparticles and quantum dots with amphiphilic copolymers differing in their charge and molecular structure. Protein adsorption to the nanoconjugates was studied with fluorescence correlation spectroscopy, and their surface activity was studied with dynamic interfacial tensiometry. Encapsulation of the nanoparticles without affecting their characteristic properties was possible with all tested polymers and provided good stabilization. However, the interaction with proteins and cells significantly depended on structural details. We identified statistical copolymers providing strongly reduced protein adsorption and low unspecific cellular uptake. Interestingly, different zwitterionic amphiphilic copolymers showed substantial differences in their resulting bio-repulsive properties. Among the polymers tested herein, statistical copolymers with sulfobetaine and phosphatidylcholine sidechains performed better than copolymers with carboxylic acid- and dimethylamino-terminated sidechains.
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Affiliation(s)
- Saad Megahed
- Fachbereich Physik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany; (S.M.); (Y.L.); (F.S.)
- Physics Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt
| | - Nicole Wutke
- Max Planck Institute für Polymerforschung, 55128 Mainz, Germany; (N.W.); (M.K.)
| | - Yang Liu
- Fachbereich Physik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany; (S.M.); (Y.L.); (F.S.)
| | - Markus Klapper
- Max Planck Institute für Polymerforschung, 55128 Mainz, Germany; (N.W.); (M.K.)
| | - Florian Schulz
- Fachbereich Physik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany; (S.M.); (Y.L.); (F.S.)
| | - Neus Feliu
- Zentrum für Angewandte Nanotechnologie CAN, Fraunhofer-Institut für Angewandte Polymerforschung IAP, 20146 Hamburg, Germany;
| | - Wolfgang J. Parak
- Fachbereich Physik, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany; (S.M.); (Y.L.); (F.S.)
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3
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Melo BL, Lima-Sousa R, Alves CG, Correia IJ, de Melo-Diogo D. Sulfobetaine methacrylate-coated reduced graphene oxide-IR780 hybrid nanosystems for effective cancer photothermal-photodynamic therapy. Int J Pharm 2023; 647:123552. [PMID: 37884216 DOI: 10.1016/j.ijpharm.2023.123552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Nanomaterials with near infrared light absorption can mediate an antitumoral photothermal-photodynamic response that is weakly affected by cancer cells' resistance mechanisms. Such nanosystems are commonly prepared by loading photosensitizers into nanomaterials displaying photothermal capacity, followed by functionalization to achieve biological compatibility. However, the translation of these multifunctional nanomaterials has been limited by the fact that many of the photosensitizers are not responsive to near infrared light. Furthermore, the reliance on poly(ethylene glycol) for functionalizing the nanomaterials is also not ideal due to some immunogenicity reports. Herein, a novel photoeffective near infrared light-responsive nanosystem for cancer photothermal-photodynamic therapy was assembled. For such, dopamine-reduced graphene oxide was, for the first time, functionalized with sulfobetaine methacrylate-brushes, and then loaded with IR780 (IR780/SB/DOPA-rGO). This hybrid system revealed a nanometric size distribution, optimal surface charge and colloidal stability. The interaction of IR780/SB/DOPA-rGO with near infrared light prompted a temperature increase (photothermal effect) and production of singlet oxygen (photodynamic effect). In in vitro studies, the IR780/SB/DOPA-rGO per se did not elicit cytotoxicity (viability > 78 %). In contrast, the combination of IR780/SB/DOPA-rGO with near infrared light decreased breast cancer cells' viability to just 21 %, at a very low nanomaterial dose, highlighting its potential for cancer photothermal-photodynamic therapy.
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Affiliation(s)
- Bruna L Melo
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Rita Lima-Sousa
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Cátia G Alves
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Ilídio J Correia
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal; CIEPQPF - Departamento de Engenharia Química, Universidade de Coimbra, Rua Sílvio Lima, 3030-790 Coimbra, Portugal.
| | - Duarte de Melo-Diogo
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.
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Delille F, Balloul E, Hajj B, Hanafi M, Morand C, Xu XZ, Dumas S, Coulon A, Lequeux N, Pons T. Sulfobetaine-Phosphonate Block Copolymer Coated Iron Oxide Nanoparticles for Genomic Locus Targeting and Magnetic Micromanipulation in the Nucleus of Living Cells. NANO LETTERS 2023. [PMID: 37390368 DOI: 10.1021/acs.nanolett.3c00688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Exerting forces on biomolecules inside living cells would allow us to probe their dynamic interactions in their native environment. Magnetic iron oxide nanoparticles represent a unique tool capable of pulling on biomolecules with the application of an external magnetic field gradient; however, their use has been restricted to biomolecules accessible from the extracellular medium. Targeting intracellular biomolecules represents an additional challenge due to potential nonspecific interactions with cytoplasmic or nuclear components. We present the synthesis of sulfobetaine-phosphonate block copolymer ligands, which provide magnetic nanoparticles that are stealthy and targetable in living cells. We demonstrate, for the first time, their efficient targeting in the nucleus and their use for magnetic micromanipulation of a specific genomic locus in living cells. We believe that these stable and sensitive magnetic nanoprobes represent a promising tool to manipulate specific biomolecules in living cells and probe the mechanical properties of living matter at the molecular scale.
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Affiliation(s)
- Fanny Delille
- Laboratoire Physique et Etude des Matériaux, ESPCI-Paris, PSL Research University, CNRS, Sorbonne Université, UMR 8213, 10, rue Vauquelin, 75005 Paris, France
| | - Elie Balloul
- Laboratoire Physico Chimie Curie, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR168, 75005 Paris, France
| | - Bassam Hajj
- Laboratoire Physico Chimie Curie, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR168, 75005 Paris, France
| | - Mohamed Hanafi
- Sciences et Ingénierie de la Matière Molle, UMR 7615, ESPCI Paris PSL-CNRS-Sorbonne Université, 10 Rue Vauquelin, 75005 Paris, France
| | - Colin Morand
- Laboratoire Physico Chimie Curie, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR168, 75005 Paris, France
- Laboratoire Dynamique du Noyau, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR3664, 75005 Paris, France
| | - Xiang Zhen Xu
- Laboratoire Physique et Etude des Matériaux, ESPCI-Paris, PSL Research University, CNRS, Sorbonne Université, UMR 8213, 10, rue Vauquelin, 75005 Paris, France
| | - Simon Dumas
- Institut Pierre-Gilles de Gennes, Institut Curie, Sorbonne Université, PSL Research University, 6 rue Jean Calvin, 75005 Paris, France
| | - Antoine Coulon
- Laboratoire Physico Chimie Curie, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR168, 75005 Paris, France
- Laboratoire Dynamique du Noyau, Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR3664, 75005 Paris, France
| | - Nicolas Lequeux
- Laboratoire Physique et Etude des Matériaux, ESPCI-Paris, PSL Research University, CNRS, Sorbonne Université, UMR 8213, 10, rue Vauquelin, 75005 Paris, France
| | - Thomas Pons
- Laboratoire Physique et Etude des Matériaux, ESPCI-Paris, PSL Research University, CNRS, Sorbonne Université, UMR 8213, 10, rue Vauquelin, 75005 Paris, France
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5
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Toro-Mendoza J, Maio L, Gallego M, Otto F, Schulz F, Parak WJ, Sanchez-Cano C, Coluzza I. Bioinspired Polyethylene Glycol Coatings for Reduced Nanoparticle-Protein Interactions. ACS NANO 2023; 17:955-965. [PMID: 36602983 DOI: 10.1021/acsnano.2c05682] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Nanoparticles (NPs) and other engineered nanomaterials have great potential as nanodrugs or nanomedical devices for biomedical applications. However, the adsorption of proteins in blood circulation or similar physiological fluids can significantly alter the surface properties and therapeutic response induced by most nanomaterials. For example, interaction with proteins can change the bloodstream circulation time and availability of therapeutic NPs or hinder the accumulation in their desired target organs. Proteins can also trigger or prevent agglomeration. By combining experimental and computational approaches, we have developed NPs carrying polyethylene glycol (PEG) polymeric coatings that mimic the surface charge distribution of proteins typically found in blood, which are known to show low aggregation under normal blood conditions. Here, we show that NPs with coatings based on apoferritin or human serum albumin display better antifouling properties and weaker protein interaction compared to similar NPs carrying conventional PEG polymeric coatings.
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Affiliation(s)
- Jhoan Toro-Mendoza
- CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramón 182, 20014Donostia-San Sebastián, Spain
| | - Lucia Maio
- CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramón 182, 20014Donostia-San Sebastián, Spain
| | - Marta Gallego
- CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), Paseo de Miramón 182, 20014Donostia-San Sebastián, Spain
| | - Ferdinand Otto
- Universität Hamburg, Luruper Chaussee 149, 22607Hamburg, Germany
| | - Florian Schulz
- Universität Hamburg, Luruper Chaussee 149, 22607Hamburg, Germany
| | - Wolfgang J Parak
- Universität Hamburg, Luruper Chaussee 149, 22607Hamburg, Germany
| | - Carlos Sanchez-Cano
- Ikerbasque, Basque Foundation for Science, Plaza de Euskadi 5, Bilbao48009, Spain
- Donostia International Physics Center (DIPC)Paseo Manuel de Lardizabal, 4, 20018Donostia/San Sebastian, Gipuzkoa, Spain
| | - Ivan Coluzza
- Ikerbasque, Basque Foundation for Science, Plaza de Euskadi 5, Bilbao48009, Spain
- BCMaterials, Bld. Martina Casiano, Third Floor, UPV/EHU Science Park, Barrio Sarriena s/n, 48940Leioa, Spain
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6
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Almoshari Y, Iqbal H, Razzaq A, Ali Ahmad K, Khan MK, Saeed Alqahtani S, Hadi Sultan M, Ali Khan B. Development of nanocubosomes co-loaded with dual anticancer agents curcumin and temozolomide for effective Colon cancer therapy. Drug Deliv 2022; 29:2633-2643. [PMID: 35942514 PMCID: PMC9367652 DOI: 10.1080/10717544.2022.2108938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Current research aimed to develop nanocubosomes co-loaded with dual anticancer drugs curcumin and temozolomide for effective colon cancer therapy. Drugs co-loaded nanocubosomal dispersion was prepared by modified emulsification method using glyceryl monooleate (GMO), pluronic F127 and bovine serum albumin (BSA) as a lipid phase, surfactant, and stabilizer, respectively. The resulting nanocubosomes were characterized by measuring hydrodynamic particle size, particle size distribution (PSD), drug loading capacity (DL), encapsulation efficiency (EE), colloidal stability and drug release profile. We also physiochemically characterized the nanocubosomes by transmission electron microscopy (TEM), Fourier transform infrared (FTIR), and x-rays diffraction (XRD) for their morphology, polymer drug interaction and its nature, respectively. Further, the in-vitro cell-uptake, mechanism of cell-uptake, in-vitro anti-tumor efficacy and apoptosis level were evaluated using HCT-116 colon cancer cells. The prepared nanocubosomes exhibited a small hydrodynamic particle size (PS of 150 ± 10 nm in diameter) with nearly cubic shape and appropriate polydispersity index (PDI), enhanced drug loading capacity (LC of 6.82 ± 2.03% (Cur) and 9.65 ± 1.53% (TMZ), high entrapment efficiency (EE of 67.43 ± 2.16% (Cur) and 75.55 ± 3.25% (TMZ), pH-triggered drug release profile and higher colloidal stability in various physiological medium. Moreover, the nanocubosomes showed higher cellular uptake, in-vitro cytotoxicity and apoptosis compared to free drugs, curcumin and temozolomide, most likely because its small particle size. In addition, BSA-stabilized nanocubosomes were actively taken by aggressive colon cancer cells that over-expressed the albumin receptors and utilized BSA as nutrient source for their growth. In short, this study provides a new and simple strategy to improve the efficacy and simultaneously overawed the adaptive treatment tolerance in colon cancer.
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Affiliation(s)
- Yosif Almoshari
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Haroon Iqbal
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences Hangzhou, Zhejiang, China
| | - Anam Razzaq
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Khalil Ali Ahmad
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences Hangzhou, Zhejiang, China
| | - Muhammad Khalid Khan
- Drug Delivery and Cosmetic Lab (DDCL), Gomal Center of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Saad Saeed Alqahtani
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Muhammad Hadi Sultan
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Barkat Ali Khan
- Drug Delivery and Cosmetic Lab (DDCL), Gomal Center of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
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Fan Z, Wang Y, Li L, Zeng F, Shang Q, Liao Y, Liang C, Nie L. Tumor-Homing and Immune-Reprogramming Cellular Nanovesicles for Photoacoustic Imaging-Guided Phototriggered Precise Chemoimmunotherapy. ACS NANO 2022; 16:16177-16190. [PMID: 36136614 DOI: 10.1021/acsnano.2c04983] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Many studies have focused on developing effective therapeutic strategies to selectively destroy primary tumors, eliminate metastatic lesions, and prevent tumor recurrence with minimal side effects on normal tissues. In this work, we synthesized engineered cellular nanovesicles (ECNVs) with tumor-homing and immune-reprogramming functions for photoacoustic (PA) imaging-guided precision chemoimmunotherapy. M1-macrophage-derived cellular nanovesicles (CNVs) were loaded with gold nanorods (GNRs), gemcitabine (GEM), CpG ODN, and PD-L1 aptamer. The good histocompatibility and tumor-homing effect of CNVs improved drug retention in the bloodstream and led to their enrichment in tumor tissues. Furthermore, the photothermal ability of GNRs enabled PA imaging-guided drug release. GEM induced tumor immunogenic cell death (ICD), and CpG ODN promoted an immune response to the antigens released by ICD, leading to long-term specific antitumor immunity. In addition, the PD-L1 aptamer relieved the inhibitory effect of the PD1/PD-L1 checkpoint on CD8+ T-cells and augmented the immunotherapeutic effect. The synergistic innate and adaptive immune responses enhanced the antitumor effect of ECNVs. In summary, this nanoplatform integrates local targeted photothermal therapy with extensive progressive chemotherapy and uses ICD to reshape the immune microenvironment for tumor ablation.
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Affiliation(s)
- Zhijin Fan
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Yichao Wang
- Department of Clinical Laboratory Medicine, Tai Zhou Central Hospital (Taizhou University Hospital), No.999 Donghai Road, Jiaojiang District, Taizhou, Zhejiang 318000, People's Republic of China
| | - Lanqing Li
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Fanchu Zeng
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Qiuping Shang
- Molecular Diagnosis and Treatment Center for Infectious Diseases, Dermatology Hospital, Southern Medical University, Guangzhou 510091, People's Republic of China
| | - Yuhui Liao
- Molecular Diagnosis and Treatment Center for Infectious Diseases, Dermatology Hospital, Southern Medical University, Guangzhou 510091, People's Republic of China
| | - Changhong Liang
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
| | - Liming Nie
- School of Medicine, South China University of Technology, Guangzhou 510006, People's Republic of China
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People's Republic of China
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