The antitumor effect of cisplatin-loaded thermosensitive chitosan hydrogel combined with radiotherapy on nasopharyngeal carcinoma

Platinum-based drugs and hydrogel: a promising anti-tumor combination

Platinum-based drugs are widely used as first-line anti-tumor chemotherapy agents. However, they also have nonnegligible side effects due to the free drugs in circulation. Therefore, it is necessary to develop efficient and safe delivery systems for better tumor cell targeting. Hydrogel is a promising anti-tumor drug carrier that can form a platinum/hydrogel combination system for drug release, which has shown better anti-tumor effects in some studies. However, there is a lack of systematic summary in this field. This review aims to provide a comprehensive overview of the platinum/hydrogel combination system with the following sections: firstly, an introduction of platinum-based drugs; secondly, an analysis of the platinum/hydrogel combination system; and thirdly, a discussion of the advantages of the hydrogel-based delivery system. We hope this review can offer some insights for the development of the platinum/hydrogel combination system for better cancer therapy.

Developing a nomogram model and prognostic analysis of nasopharyngeal squamous cell carcinoma patients: a population-based study

BACKGROUND

Nasopharyngeal squamous cell carcinoma (NPSCC) is a common histo-logical subtype of nasopharyngeal cancer with a generally poor prognosis. The aim of this study is to identify factors affecting the survival prognosis of NPSCC patients and develop a specialized nomogram model.

METHODS

We extracted clinical data of 1235 diagnosed cases of NPSCC from the SEER database using SEER*Stat software. Univariate and multivariate Cox proportional hazards regression analyses were conducted to explore clinical factors that impact the prognosis of NPSCC patients. Based on significant independent factors, we developed a nomogram to predict the 1, 3, and 5 years overall survival rates. The discriminative and predictive abilities of the nomogram were evaluated using C-index, calibration curve, area under the curve (AUC), and receiver operating characteristic curve. We evaluated the clinical value of the nomogram using decision curve analysis (DCA) and clinical impact curve (CIC).

RESULTS

We performed a cohort analysis on 846 patients with nasopharyngeal cancer in the training cohort. Multivariate Cox regression analysis revealed age, race, marital status, primary tumor, radiation therapy, chemotherapy, SJCC stage, primary tumor size, Lung metastasis and brain metastasis as independent prognostic factors for NPSCC patients, which we used to construct the nomogram prediction model. The C-index of the training cohort was 0.737. The ROC curve analysis indicated that the AUC of the OS rate at 1, 3, and 5 years in the training cohort was > 0.75. The calibration curves of the two cohorts showed good consistency between the predicted and observed results. DCA and CIC demonstrated that the nomogram prediction model had good clinical benefits.

CONCLUSIONS

The nomogram risk prediction model for NPSCC patient survival prognosis, constructed in this study, has exhibited excellent predictive capability. This model can be employed for swift and precise assessment of individualized survival prognosis. It can offer valuable guidance to clinical physicians in diagnosing and treating NPSCC patients.

Gold-Enhanced Brachytherapy by a Nanoparticle-Releasing Hydrogel and 3D-Printed Subcutaneous Radioactive Implant Approach

Brachytherapy (BT) is a widely used clinical procedure for localized cervical cancer treatment. In addition, gold nanoparticles (AuNPs) have been demonstrated as powerful radiosensitizers in BT procedures. Prior to irradiation by a BT device, their delivery to tumors can enhance the radiation effect by generating low-energy photons and electrons, leading to reactive oxygen species (ROS) production, lethal to cells. No efficient delivery system has been proposed until now for AuNP topical delivery to localized cervical cancer in the context of BT. This article reports an original approach developed to accelerate the preclinical studies of AuNP-enhanced BT procedures. First, an AuNP-containing hydrogel (Pluronic F127, alginate) is developed and tested in mice for degradation, AuNP release, and biocompatibility. Then, custom-made 3D-printed radioactive BT inserts covered with a AuNP-containing hydrogel cushion are designed and administered by surgery in mice (HeLa xenografts), which allows for measuring AuNP penetration in tumors (≈100 µm), co-registered with the presence of ROS produced through the interactions of radiation and AuNPs. Biocompatible AuNPs-releasing hydrogels could be used in the treatment of cervical cancer prior to BT, with impact on  the total amount of radiation needed per BT treatment, which will result in benefits to the preservation of healthy tissues surrounding cancer.

Chitosan/glycyrrhizic acid hydrogel: Preparation, characterization, and its potential for controlled release of gallic acid

In the present work, chitosan (CHT) as a biodegradable polymer was crosslinked using various amounts of glycyrrhizic acid (GLA) as a novel crosslinking agent to prepare biocompatible hydrogels. The prepared hydrogels were used for the controlled release of gallic acid (GA) in transdermal therapy application. FTIR, XRD, and SEM were used to characterize the prepared gels. The results indicated that the carboxylic acid groups of GLA react with the amine groups of the CHT in the presence of activating coupling reagents to form covalent amide linkage between the polymer chains of CHT and construct CHT cross-linked hydrogel (CCH) network structure. The prepared CCH samples were characterized and used for the controlled release of a drug, i.e. (GA). For this purpose, the swelling kinetic, loading and encapsulation efficiency, in vitro drug release, drug release kinetics, cell viability assay, and anti-bacterial activity of the samples were evaluated. The swelling ratio of CCH samples were in the range of 455-37 % depending on the pH of environment. Swelling kinetic results showed an aggregate to the non-linear second-order kinetic model. Drug release results were fitted by kinetic models while the Korsmeyer-Peppas model was fitted better. The CCH samples exhibited high biocompatibility for 5 mg/ml hydrogel concentration. In addition, the CHT and CCH sample without the GA did not show anti-bacterial properties for 1200 and 150 μg/ml concentrations, respectively. The CCH sample containing the GA exhibited enough anti-bacterial activity on the S. aureus bacteria strain at 150 μg/ml concentration. In contrast, the CCH sample containing the GA has a light anti-bacterial effect on the E. coli bacteria strain. The calculated mesh size of hydrogel networks, drug size, and kinetics models revealed that the CCH samples could release GA based on a diffusion mechanism. In conclusion, the designed CCH samples have enough ability for controlled drug release in transdermal applications.

Hydrogels for Antitumor and Antibacterial Therapy

As a highly absorbent and hydrophobic material with a three-dimensional network structure, hydrogels are widely used in biomedical fields for their excellent biocompatibility, low immunogenicity, adjustable physicochemical properties, ability to encapsulate a variety of drugs, controllability, and degradability. Hydrogels can be used not only for wound dressings and tissue repair, but also as drug carriers for the treatment of tumors. As multifunctional hydrogels are the focus for many researchers, this review focuses on hydrogels for antitumor therapy, hydrogels for antibacterial therapy, and hydrogels for co-use in tumor therapy and bacterial infection. We highlighted the advantages and representative applications of hydrogels in these fields and also outlined the shortages and future orientations of this useful tool, which might give inspirations for future studies.

Utility of diffusion-weighted magnetic resonance imaging in predicting the treatment response of nasopharyngeal carcinoma

OBJECTIVE

Predicting the treatment response in patients with nasopharyngeal carcinoma (NPC) is challenging. This study evaluated the utility of diffusion-weighted imaging (DWI) in predicting the treatment response in patients with NPC.

METHODS

We prospectively enrolled 33 patients with newly diagnosed NPC who underwent magnetic resonance imaging with the propeller DWI and apparent diffusion coefficient (ADC) map before and at 5 weeks after chemoradiation. The following ADC values of the primary tumor were calculated: pre-treatment ADC (pre-ADC), pre-treatment ADC ratio (pre-ADC ratio), ADC change (▵ADC), ADC change ratio (▵ADC ratio), and percentage of ADC change (▵%ADC). The correlations between these parameters and treatment outcomes were explored, and the patients were classified as good responders (complete response) and poor responders (stable disease, partial response, or progressive disease) based on the Response Evaluation Criteria in Solid Tumors, version 1.1.

RESULTS

The ▵ADC, ▵ADC ratio, and ▵%ADC were significantly lower in the poor-responder group (n = 12) than in the good-responder group (n = 21; p = 0.001, p = 0.002, and p = 0.004, respectively). There was no significant difference between groups in the pre-ADC and pre-ADC ratios (p = 0.602 and p = 0.685, respectively). The optimal ▵ADC, ▵ADC ratio, and ▵%ADC cutoff values for predicting poor response were >0.65 mm²/sec, 0.28, and 60%, respectively (sensitivity: 83.3%, 75%, and 83.3%; specificity: 71.4%, 85.7%, and 71.4%, respectively).

CONCLUSION

The ▵ADC, ▵ADC ratio, and ▵%ADC obtained during the pre-treatment and mid-treatment periods could be potential biomarkers for predicting treatment response in patients with NPC.

Enhanced photocatalytic and photodynamic activity of chitosan and garlic loaded CdO-TiO2 hybrid bionanomaterials

Herein, the work addresses the synthesis of biomaterials (chitosan and garlic) loaded CdO-TiO₂ hybrid nanocomposites for photocatalytic water treatment and photodynamic cancer therapeutic applications that were reported the first time. CdO-TiO₂ (CT) nanocomposites were synthesized and loaded with the biomaterials such as chitosan and garlic by simple sol-gel method. The nanomaterials were characterized and the photodegradation of three model pollutants, Methylene blue (MB), Methyl orange (MO) and Rhodamine B (Rh-B) was opted to investigate the efficiency of the synthesized photocatalyst under the solar light. From the results, the garlic-loaded CdO-TiO₂ (AS-CT) hybrid nanocomposites exhibit a superior photocatalytic activity than the chitosan-loaded CdO-TiO₂ (CS-CT) and CdO-TiO₂ (CT) nanocomposites under the irradiation of solar light. Additionally, the cell viability of the synthesized nanocomposites was carried out in HeLa cell lines under different concentrations, light doses and incubation periods using an LED light source. Compared to the CS-CT and CT nanocomposites, an efficient photodynamic activity was achieved in the case of AS-CT hybrid nanocomposites. Actually, the end-use properties required for both processes in AS-CT nanocomposites appear similar due to the presence of organo sulphurus compounds.

Enhanced Anti-Cancer Effect of Folate-Conjugated Olaparib Nanoparticles Combined with Radiotherapy in Cervical Carcinoma

BACKGROUND

Radiotherapy (RT), one of the main treatments for cervical cancer, has tremendous potential for improvement in the efficacy. Poly (ADP-ribose) polymerase (PARP) is a key enzyme in the repair of DNA strand breaks (DSB). Olaparib (Ola) is a PARP inhibitor that is involved in preventing the release of PARP from RT-induced damaged DNA to potentiate the effect of RT. Although the basic mechanism of Ola's radiosensitization is well known, the radiosensitization mechanism of its nanomedicine is still unclear. In addition, the lack of tumor tissue targeting is a major obstacle for the clinical success of Ola.

MATERIALS AND METHODS

In this study, we developed folate-conjugated active targeting olaparib nanoparticles (ATO) and investigated the anti-tumor effect of ATO combined with radiotherapy (RT) in nude mice using cervical cancer xenograft models. We used folate (FA)-conjugated poly (ε-caprolactone)-poly (ethyleneglycol)-poly (e-caprolactone) (PCEC) copolymer to prepare ATO via emulsification/solvent diffusion. Further, we evaluated ATO particle size, potential, encapsulation efficiency, and in vitro release characteristics, and evaluated the shape of ATO via transmission electron microscopy (TEM). We then performed MTT and cell uptake assays to detect cytotoxicity and targeting uptake in vitro. We investigated the anti-tumor properties of ATO in vivo by apoptosis test, 18 F-FDG PET/CT, and immunohistochemical analysis. Finally, the xenografted tumor in nude mice was subjected to RT and/or ATO treatment.

RESULTS

The results confirmed that ATO in combination with RT significantly inhibited tumor growth and prolonged survival time of tumor-bearing mice. This may be related to the inhibition of tumor proliferation and DNA damage repair and induction of cell apoptosis in vivo.

CONCLUSION

The ATO developed in this study may represent a novel formulation for olaparib delivery and have promising potential for treating tumors with an over-expression of folate receptors.

Cytotoxicity influence of new chitosan composite on HEPG-2, HCT-116 and MCF-7 carcinoma cells

Chitosan/aroylhydrazine composite were synthesized in hydrogel form in which aroylhyrazines, heteroaroylhydrazines as well as p-tolylsulphonylhydrazine embedded in the cross linked Chitosan/oxalic acid network. Their structures were characterized by (elemental analysis, FT-IR, 1H NMR, and XRD). Antimicrobial behavior and Cytotoxicity screening of the examined compounds against breast, colon and hepatocellular cancer were investigated. The obtained data revealed that the examined compounds have promising cell growth inhibitory effect on the cell lines as compared to standard. Also, some of the newly synthesized derivatives had shown better antibacterial and antifungal activities, comparing with that of the parent chitosan.

Chemical and physical chitosan hydrogels as prospective carriers for drug delivery: a review

This review summarizes and discusses recent research progress in chemical and physical chitosan hydrogels for drug delivery.

Curcumin micelles suppress gastric tumor cell growth by upregulating ROS generation, disrupting redox equilibrium and affecting mitochondrial bioenergetics

A proposed novel mechanism of anticancer activity of curcumin micelles through redox equilibrium in gastric cancer.

Eco-friendly and biodegradable cellulose hydrogels produced from low cost okara: towards non-toxic flexible electronics

With increasing resource shortage and environmental pollution, it is preferable to utilize materials which are sustainable and biodegradable. Side-streams products generated from the food processing industry is one potential avenue that can be used in a wide range of applications. In this study, the food by-product okara was effectively reused for the extraction of cellulose. Then, the okara cellulose was further employed to fabricate cellulose hydrogels with favorable mechanical properties, biodegrablability, and non-cytotoxicity. The results showed that it could be biodegraded in soil within 28 days, and showed no cytotoxicity on NIH3T3 cells. As a proof of concept, a demostration of wearable and biocompatible strain sensor was achieved, which allowed a good and stable detection of human body movement behaviors. The okara-based hydrogels could provide an alternative platform for further physical and/or chemical modification towards tissue engineering, medical supplies, or smart biomimetic soft materials.

An injectable thermosensitive hydrogel for sustained release of apelin-13 to enhance flap survival in rat random skin flap

With the advantage of handy process, random pattern skin flaps are generally applied in limb reconstruction and wound repair. Apelin-13 is a discovered endogenous peptide, that has been shown to have potent multiple biological functions. Recently, thermosensitive gel-forming systems have gained increasing attention as wound dressings due to their advantages. In the present study, an apelin-13-loaded chitosan (CH)/β-sodium glycerophosphate (β-GP) hydrogel was developed for promoting random skin flap survival. Random skin flaps were created in 60 rats after which the animals were categorized to a control hydrogel group and an apelin-13 hydrogel group. The water content of the flap as well as the survival area were then measured 7 days post-surgery. Hematoxylin and eosin staining was used to evaluate the flap angiogenesis. Cell differentiation 34 (CD34) and vascular endothelial growth factor (VEGF) levels were detected by immunohistochemistry and Western blotting. Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were assessed by enzyme linked immunosorbent assays (ELISAs). Oxidative stress was estimated via the activity of tissue malondialdehyde (MDA) and superoxide dismutase (SOD). Our results showed that CH/β-GP/apelin-13 hydrogel could not only reduce the tissue edema, but also improve the survival area of flap. CH/β-GP/apelin-13 hydrogel also upregulated levels of VEGF protein and increased mean vessel densities. Furthermore, CH/β-GP/apelin-13 hydrogel was shown to significantly inhibit the expression of TNF-α and IL-6, along with increasing the activity of SOD and suppressing the MDA content. Taken together, these results indicate that this CH/β-GP/apelin-13 hydrogel may be a potential therapeutic way for random pattern skin flap.

Chitosan-Based Drug Delivery Systems for Optimization of Photodynamic Therapy: a Review

Drug delivery systems (DDS) can be designed to enrich the pharmacological and therapeutic properties of several drugs. Many of the initial obstacles that impeded the clinical applications of conventional DDS have been overcome with nanotechnology-based DDS, especially those formed by chitosan (CS). CS is a linear polysaccharide obtained by the deacetylation of chitin, which has potential properties such as biocompatibility, hydrophilicity, biodegradability, non-toxicity, high bioavailability, simplicity of modification, aqueous solubility, and excellent chemical resistance. Furthermore, CS can prepare several DDS as films, gels, nanoparticles, and microparticles to improve delivery of drugs, such as photosensitizers (PS). Thus, CS-based DDS are broadly investigated for photodynamic therapy (PDT) of cancer and fungal and bacterial diseases. In PDT, a PS is activated by light of a specific wavelength, which provokes selective damage to the target tissue and its surrounding vasculature, but most PS have low water solubility and cutaneous photosensitivity impairing the clinical use of PDT. Based on this, the application of nanotechnology using chitosan-based DDS in PDT may offer great possibilities in the treatment of diseases. Therefore, this review presents numerous applications of chitosan-based DDS in order to improve the PDT for cancer and fungal and bacterial diseases.