Multifunctional silica-coated mixed polymeric micelles for integrin-targeted therapy of pediatric patient-derived glioblastoma

Innovative drug delivery strategies for targeting glioblastoma: overcoming the challenges of the tumor microenvironment

INTRODUCTION

Glioblastoma multiforme(GBM) presents a challenging endeavor in therapeutic management because of its highly aggressive tumor microenvironment(TME). This complex TME, characterized by hypoxia, nutrient deprivation, immunosuppression, stromal barriers, increased interstitial fluid pressure and the presence of the blood-brain barrier(BBB), frequently compromises the efficacy of promising therapeutic strategies. Consequently, a deeper understanding of the TME and the development of innovative methods to overcome its associated challenges are essential for improving treatment outcomes in GBM.

AREAS COVERED

This review critically evaluates the major obstacles within the GBM TME, focusing on the biological and structural barriers that limit therapeutic delivery and efficacy. Novel approaches designed to address these barriers, including advanced formulation strategies and precise targeting mechanisms, are explored in detail. Additionally, the review highlights the potential of emerging technologies such as 3D-printed models, scaffolds, Robotics and artificial intelligence(AI) techniques and machine learning, in tackling TME- associated hurdles.

EXPERT OPINION

The integration of these innovative methods presents a promising path for enhancing the specificity and efficacy of GBM therapies. By combining these advanced strategies, the potential for improving patient outcomes in GBM treatment can be significantly enhanced, offering hope for overcoming the limitations posed by the TME.

State of the art in pediatric nanomedicines

In recent years, the continuous development of innovative nanopharmaceuticals is expanding their biomedical and clinical applications. Nanomedicines are being revolutionized to circumvent the limitations of unbound therapeutic agents as well as overcome barriers posed by biological interfaces at the cellular, organ, system, and microenvironment levels. In many ways, the use of nanoconfigured delivery systems has eased challenges associated with patient differences, and in our opinion, this forms the foundation for their potential usefulness in developing innovative medicines and diagnostics for special patient populations. Here, we present a comprehensive review of nanomedicines specifically designed and evaluated for disease management in the pediatric population. Typically, the pediatric population has distinguishing needs relative to those of adults majorly because of their constantly growing bodies and age-related physiological changes, which often need specialized drug formulation interventions to provide desirable therapeutic effects and outcomes. Besides, child-centric drug carriers have unique delivery routes, dosing flexibility, organoleptic properties (e.g., taste, flavor), and caregiver requirements that are often not met by traditional formulations and can impact adherence to therapy. Engineering pediatric medicines as nanoconfigured structures can potentially resolve these limitations stemming from traditional drug carriers because of their unique capabilities. Consequently, researchers from different specialties relentlessly and creatively investigate the usefulness of nanomedicines for pediatric disease management as extensively captured in this compilation. Some examples of nanomedicines covered include nanoparticles, liposomes, and nanomicelles for cancer; solid lipid and lipid-based nanostructured carriers for hypertension; self-nanoemulsifying lipid-based systems and niosomes for infections; and nanocapsules for asthma pharmacotherapy.

Current Non-Metal Nanoparticle-Based Therapeutic Approaches for Glioblastoma Treatment

The increase in the variety of nano-based tools offers new possibilities to approach the therapy of poorly treatable tumors, which includes glioblastoma multiforme (GBM; a primary brain tumor). The available nanocomplexes exhibit great potential as vehicles for the targeted delivery of anti-GBM compounds, including chemotherapeutics, nucleic acids, and inhibitors. The main advantages of nanoparticles (NPs) include improved drug stability, increased penetration of the blood-brain barrier, and better precision of tumor targeting. Importantly, alongside their drug-delivery ability, NPs may also present theranostic properties, including applications for targeted imaging or photothermal therapy of malignant brain cells. The available NPs can be classified into two categories according to their core, which can be metal or non-metal based. Among non-metal NPs, the most studied in regard to GBM treatment are exosomes, liposomes, cubosomes, polymeric NPs, micelles, dendrimers, nanogels, carbon nanotubes, and silica- and selenium-based NPs. They are characterized by satisfactory stability and biocompatibility, limited toxicity, and high accumulation in the targeted tumor tissue. Moreover, they can be easily functionalized for the improved delivery of their cargo to GBM cells. Therefore, the non-metal NPs discussed here, offer a promising approach to improving the treatment outcomes of aggressive GBM tumors.

Peptide-Hitchhiking for the Development of Nanosystems in Glioblastoma

Glioblastoma (GBM) remains the epitome of aggressiveness and lethality in the spectrum of brain tumors, primarily due to the blood-brain barrier (BBB) that hinders effective treatment delivery, tumor heterogeneity, and the presence of treatment-resistant stem cells that contribute to tumor recurrence. Nanoparticles (NPs) have been used to overcome these obstacles by attaching targeting ligands to enhance therapeutic efficacy. Among these ligands, peptides stand out due to their ease of synthesis and high selectivity. This article aims to review single and multiligand strategies critically. In addition, it highlights other strategies that integrate the effects of external stimuli, biomimetic approaches, and chemical approaches as nanocatalytic medicine, revealing their significant potential in treating GBM with peptide-functionalized NPs. Alternative routes of parenteral administration, specifically nose-to-brain delivery and local treatment within the resected tumor cavity, are also discussed. Finally, an overview of the significant obstacles and potential strategies to overcome them are discussed to provide a perspective on this promising field of GBM therapy.

Cell membrane-based biomimetic vehicles for effective central nervous system target delivery: Insights and challenges

Central nervous system (CNS) disorders, including brain tumor, ischemic stroke, Alzheimer's disease, and Parkinson's disease, threaten human health. And the existence of the blood-brain barrier (BBB) hinders the delivery of drugs and the design of drug targeting delivery vehicles. Over the past decades, great interest has been given to cell membrane-based biomimetic vehicles since the rise of targeting drug delivery systems and biomimetic nanotechnology. Cell membranes are regarded as natural multifunction biomaterials, and provide potential for targeting delivery design and modification. Cell membrane-based biomimetic vehicles appear timely with the participation of cell membranes and nanoparticles, and raises new lights for BBB recognition and transport, and effective therapy with its biological multifunction and high biocompatibility. This review summarizes existing challenges in CNS target delivery and recent advances of different kinds of cell membrane-based biomimetic vehicles for effective CNS target delivery, and deliberates the BBB targeting mechanism. It also discusses the challenges and possibility of clinical translation, and presents new insights for development.

Recent advances of Pluronic-based copolymers functionalization in biomedical applications

The design of polymeric biocompatible nanomaterials for biological and medical applications has received special attention in recent years. Among different polymers, the triblock type copolymers (EO)_x(PO)_y(EO)_x or Pluronics® stand out due its favorable characteristics such as biocompatibility, low tissue adhesion, thermosensitivity, and structural capacity to produce different types of macro and nanostructures, e.g. micelles, vesicles, nanocapsules, nanospheres, and hydrogels. However, Pluronic itself is not the "magic bullet" and its functionalization via chemical synthesis following biologically oriented design rules is usually required aiming to improve its properties. Therefore, this paper presents some of the main publications on new methodologies for synthetic modifications and applications of Pluronic-based nanoconstructs in the biomedical field in the last 15 years. In general, the polymer modifications aim to improve physical-chemical properties related to the micellization process or physical entrapment of drug cargo, responsive stimuli, active targeting, thermosensitivity, gelling ability, and hydrogel formation. Among these applications, it can be highlighted the treatment of malignant neoplasms, infectious diseases, wound healing, cellular regeneration, and tissue engineering. Functionalized Pluronic has also been used for various purposes, including medical diagnosis, medical imaging, and even miniaturization, such as the creation of lab-on-a-chip devices. In this context, this review discusses the main scientific contributions to the designing, optimization, and improvement of covalently functionalized Pluronics aiming at new strategies focused on the multiple areas of the biomedical field.

New Drug Delivery Systems Developed for Brain Targeting

The blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (B_CSF) are two of the most complex and sophisticated concierges that defend the central nervous system (CNS) by numerous mechanisms. While they maintain the neuro-ecological homeostasis through the regulated entry of essential biomolecules, their conservative nature challenges the entry of most of the drugs intended for CNS delivery. Targeted delivery challenges for a diverse spectrum of therapeutic agents/drugs (non-small molecules, small molecules, gene-based therapeutics, protein and peptides, antibodies) are diverse and demand specialized delivery and disease-targeting strategies. This review aims to capture the trends that have shaped the current brain targeting research scenario. This review discusses the physiological, neuropharmacological, and etiological factors that participate in the transportation of various drug delivery cargoes across the BBB/B_CSF and influence their therapeutic intracranial concentrations. Recent research works spanning various invasive, minimally invasive, and non-invasive brain- targeting approaches are discussed. While the pre-clinical outcomes from many of these approaches seem promising, further research is warranted to overcome the translational glitches that prevent their clinical use. Non-invasive approaches like intranasal administration, P-glycoprotein (P-gp) inhibition, pro-drugs, and carrier/targeted nanocarrier-aided delivery systems (alone or often in combination) hold positive clinical prospects for brain targeting if explored further in the right direction.

Comprehensive Analysis of Inhibitor of Apoptosis Protein Expression and Prognostic Significance in Non-Small Cell Lung Cancer

Inhibitors of apoptosis proteins (IAPs) have been associated with tumor development and progression by affecting apoptosis through cell death signaling pathways. To date, eight IAPs (BIRC1-8) have been identified in mammalian cells. However, the role of IAPs in non-small cell lung cancer (NSCLC) development and progression has not been explored in depth. In this study, we used public datasets and bioinformatics tools to compare the expression, prognostic significance, and function of IAPs in NSCLC and its subtypes. Expression of IAPs in cancer and normal tissues and at different stages of NSCLC was compared with gene expression profiling interactive analysis, and their prognostic significance was analyzed with the Kaplan-Meier Plotter database. The correlations among IAPs were analyzed with the STRING database and SPSS19.0. Functional annotation of IAPs was analyzed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment on the basis of the DAVID tool. Among patients with lung adenocarcinoma (LUAD), the expression level of BIRC5 was higher than that in normal samples, and the expression of BIRC1 and BIRC5 significantly varied in different stages. Moreover, the BIRC1-3 and BIRC5 mRNA levels were associated with overall survival (OS), and the BIRC1-2 and BIRC5-6 mRNA levels were associated with progression-free survival (PFS). Among patients with lung squamous cell carcinoma (LUSC), the expression level of BIRC1 was lower and that of BIRC5 was higher than those in normal tissues, and BIRC5 expression significantly varied in different stages. BIRC1 expression was associated with OS, whereas BIRC2 and BIRC6 expression was associated with PFS. Enrichment analysis showed that most IAPs are associated with ubiquitin- and apoptosis-related pathways. Collectively, this study suggests BIRC5 as a potential diagnostic and staging marker, BIRC1 as a potential marker of OS, and BIRC2 and BIRC6 as potential PFS markers for patients with NSCLC. These highlight new targets for the early detection, treatment, and management of NSCLC.