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Yun WS, Kim J, Lim DK, Kim DH, Jeon SI, Kim K. Recent Studies and Progress in the Intratumoral Administration of Nano-Sized Drug Delivery Systems. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2225. [PMID: 37570543 PMCID: PMC10421122 DOI: 10.3390/nano13152225] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/23/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
Over the last 30 years, diverse types of nano-sized drug delivery systems (nanoDDSs) have been intensively explored for cancer therapy, exploiting their passive tumor targetability with an enhanced permeability and retention effect. However, their systemic administration has aroused some unavoidable complications, including insufficient tumor-targeting efficiency, side effects due to their undesirable biodistribution, and carrier-associated toxicity. In this review, the recent studies and advancements in intratumoral nanoDDS administration are generally summarized. After identifying the factors to be considered to enhance the therapeutic efficacy of intratumoral nanoDDS administration, the experimental results on the application of intratumoral nanoDDS administration to various types of cancer therapies are discussed. Subsequently, the reports on clinical studies of intratumoral nanoDDS administration are addressed in short. Intratumoral nanoDDS administration is proven with its versatility to enhance the tumor-specific accumulation and retention of therapeutic agents for various therapeutic modalities. Specifically, it can improve the efficacy of therapeutic agents with poor bioavailability by increasing their intratumoral concentration, while minimizing the side effect of highly toxic agents by restricting their delivery to normal tissues. Intratumoral administration of nanoDDS is considered to expand its application area due to its potent ability to improve therapeutic effects and relieve the systemic toxicities of nanoDDSs.
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Affiliation(s)
- Wan Su Yun
- Korea Institute of Science and Technology (KU-KIST), Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Republic of Korea
| | - Jeongrae Kim
- Korea Institute of Science and Technology (KU-KIST), Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Republic of Korea
| | - Dong-Kwon Lim
- Korea Institute of Science and Technology (KU-KIST), Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Republic of Korea
| | - Dong-Hwee Kim
- Korea Institute of Science and Technology (KU-KIST), Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Republic of Korea
| | - Seong Ik Jeon
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Kwangmeyung Kim
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Republic of Korea
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de Freitas CF, de Araújo Santos J, Pellosi DS, Caetano W, Batistela VR, Muniz EC. Recent advances of Pluronic-based copolymers functionalization in biomedical applications. BIOMATERIALS ADVANCES 2023; 151:213484. [PMID: 37276691 DOI: 10.1016/j.bioadv.2023.213484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Camila Fabiano de Freitas
- Department of Chemistry, Federal University of Santa Catarina - UFSC, Eng. Agronômico Andrei Cristian Ferreira, s/n, Trindade, 88040-900 Florianópolis, Santa Catarina, Brazil.
| | - Jailson de Araújo Santos
- PhD Program in Materials Science and Engineering, Federal University of Piauí, Campus Petrônio Portela, Ininga, Teresina CEP 64049-550, Piauí, Brazil
| | - Diogo Silva Pellosi
- Laboratory of Hybrid Materials, Department of Chemistry, Federal University of São Paulo, Diadema, Brazil
| | - Wilker Caetano
- Department of Chemistry, State University of Maringá, 5790 Colombo Avenue, 87020-900 Maringá, Paraná, Brazil
| | - Vagner Roberto Batistela
- Department of Pharmacology and Therapeutics, State University of Maringá, 5790 Colombo Avenue, 87020-900 Maringá, Paraná, Brazil
| | - Edvani Curti Muniz
- Department of Chemistry, State University of Maringá, 5790 Colombo Avenue, 87020-900 Maringá, Paraná, Brazil; Department of Chemistry, Federal University of Piauí, Campus Petronio Portella, Ininga, Teresina CEP 64049-550, Piauí, Brazil.
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De Silva L, Fu JY, Htar TT, Wan Kamal WHB, Kasbollah A, Muniyandy S, Chuah LH. Biodistribution Study of Niosomes in Tumor-Implanted BALB/C Mice Using Scintigraphic Imaging. Front Pharmacol 2022; 12:778396. [PMID: 35069200 PMCID: PMC8777053 DOI: 10.3389/fphar.2021.778396] [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] [Received: 09/16/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this work was to study the biodistribution of niosomes in tumor-implanted BALB/c mice using gamma scintigraphy. Niosomes were first formulated and characterized, then radiolabeled with Technetium-99 m (99mTc). The biodistribution of 99mTc-labeled niosomes was evaluated in tumor-bearing mice through intravenous injection and imaged with gamma scintigraphy. The labeled complexes possessed high radiolabeling efficiency (98.08%) and were stable in vitro (>80% after 8 h). Scintigraphic imaging showed negligible accumulation in the stomach and thyroid, indicating minimal leaching of the radiolabel in vivo. Radioactivity was found mainly in the liver, spleen and kidneys. Tumor-to-muscle ratio indicated a higher specificity of the formulation for the tumor area. Overall, the formulated niosomes are stable both in vitro and in vivo, and show preferential tumor accumulation.
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Affiliation(s)
- Leanne De Silva
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ju-Yen Fu
- Nutrition Unit, Malaysian Palm Oil Board, Bandar Baru Bangi, Malaysia
| | - Thet Thet Htar
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | - Azahari Kasbollah
- Medical Technology Division, Malaysian Nuclear Agency, Bangi, Malaysia
| | - Saravanan Muniyandy
- Department of Pharmacy, Fatima College of Health Sciences, Al Ain, United Arab Emirates
| | - Lay-Hong Chuah
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
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Gorshkov NI, Murko AY, Zolotova YI, Nazarova OV, Krasikov VD, Shatik SV, Panarin EF. Introduction of Re(CO) 3+/ 99mTc(CO) 3+ Organometallic Species into Vinylpyrrolidone-Allyliminodiacetate Copolymers. Polymers (Basel) 2021; 13:polym13111832. [PMID: 34205969 PMCID: PMC8198885 DOI: 10.3390/polym13111832] [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: 03/19/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
N-vinylpyrrolidone-co-allylamine copolymers (VP-co-AA) containing iminodiacetic (IDA) chelation units were prepared in the range of molecular masses of the copolymers from 9000 to 30,000 Da depending on polymerization conditions. Non-radioactive organometallic species Re(CO)3+ were introduced into polymeric carriers under mild conditions; the prepared metal–polymeric complexes were characterized by IR, NMR, ESI-MS and HPLC. IR spectra data confirmed the coordination of M(CO)3+ moiety to the polymeric backbone via IDA chelation unit (appearance of characteristic fac-M(CO)3+ vibrations (2005, 1890 cm−1), as well as the appearance of group of signals in 1H NMR spectra, corresponding to those inequivalent to methylene protons CH2COO (dd, 4.2 ppm), coordinated to metal ions. The optimal conditions for labeling the PVP-co-AA-IDA copolymers with radioactive 99mTc(CO)3+ species were determined. The radiochemical yields reached 97%. The obtained radiolabeled polymers were stable in blood serum for 3 h. In vivo distribution experiments in intact animals showed the high primary accumulation of technetium-99m MPC (MM = 15,000 Da) in blood with subsequent excretion via the urinary tract.
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Affiliation(s)
- Nikolay Ivanovich Gorshkov
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
- Correspondence: ; Tel.: +7-(812)-323-71-01
| | - Andrei Yur'evich Murko
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
| | - Yulia Igorevna Zolotova
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
| | - Olga Vladimirovna Nazarova
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
| | - Valerii Dmitrievich Krasikov
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
| | - Sergei Vasilievich Shatik
- Federal State Budgetary Institution “Russian Research Center for Radiology and Surgical Technologies” of the Ministry of Health of the Russian Federation, Russian Federation, p. Pesochny, ul. Leningradskaya, 70, 197758 Saint Petersburg, Russia;
| | - Evgenii Fedorovich Panarin
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (Y.I.Z.); (O.V.N.); (V.D.K.); (E.F.P.)
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Gorshkov NI, Murko АY, Gavrilova II, Bezrukova МА, Kipper АI, Shatik SV, Tokarev АV, Krasikov VD, Panarin ЕF. Metal-Polymer Complexes of Gallium/Gallium-68 with Copolymers of N-Vinylpyrrolidonewith N-Vinylformamideand N-Vinyliminodiacetic Acid: A Hint for Radiolabeling of Water-Soluble Synthetic Flexible Chain Macromolecules. Polymers (Basel) 2020; 12:polym12122889. [PMID: 33276572 PMCID: PMC7761557 DOI: 10.3390/polym12122889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
Copolymer of N-vinylpyrrolidone (VP) with vinylformamide (VFA) and N-vinyliminodiacetic acid (VIDA) was synthesized; its metal-polymer complexes (MPCs) with gallium were obtained. The complexes were characterized by size exclusion chromatography, hydrodynamic and optical methods, scanning electron microscopy, and spectral methods (UV, IR, 1Н NMR spectroscopy). It was demonstrated that in going from polymer to complex, hydrodynamic parameters of macromolecules change only slightly, although the polymer contains intramolecular Ga(VIDA)2 fragments in its structure. A new method for preparation of MPCs with gallium and gallium-68 radionuclide was suggested. The obtained metal-polymer complex is stable over a wide range of pH values as well as in the histidine challenge reaction. In vivo distribution experiments in intact animals showed high primary accumulation of thegallium-68 MPC in blood with subsequent excretion via urinary tract.
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Affiliation(s)
- Nikolay I. Gorshkov
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
- Correspondence: ; Tel.: +7-(812)-323-71-01
| | - Аndrey Yu. Murko
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
| | - Iirina I. Gavrilova
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
| | - Мarina А. Bezrukova
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
| | - Аlbert I. Kipper
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
| | - Sergei V. Shatik
- Federal State Budgetary Institution “Russian Research Center for Radiology and Surgical Technologies” of the Ministry of Health of the Russian Federation, Russian Federation, p. Pesochny, ul. Leningradskaya, 70, 197758 Saint Petersburg, Russia; (S.V.S.); (A.V.T.)
| | - Аlexander V. Tokarev
- Federal State Budgetary Institution “Russian Research Center for Radiology and Surgical Technologies” of the Ministry of Health of the Russian Federation, Russian Federation, p. Pesochny, ul. Leningradskaya, 70, 197758 Saint Petersburg, Russia; (S.V.S.); (A.V.T.)
| | - Valerii D. Krasikov
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
| | - Еvgenii F. Panarin
- Federal State Budgetary Institution of Science Institute of Macromolecular Compounds, Russian Academy of Sciences (IMC RAS), Russian Federation, V.O. Bolshoy pr. 31, 199004 Saint Petersburg, Russia; (A.Y.M.); (I.I.G.); (M.A.B.); (A.I.K.); (V.D.K.); (E.F.P.)
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Domingues C, Alvarez-Lorenzo C, Concheiro A, Veiga F, Figueiras A. Nanotheranostic Pluronic-Like Polymeric Micelles: Shedding Light into the Dark Shadows of Tumors. Mol Pharm 2019; 16:4757-4774. [DOI: 10.1021/acs.molpharmaceut.9b00945] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Cátia Domingues
- Faculty of Pharmacy, University of Coimbra, Coimbra 3000-295, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Coimbra 3004-504, Portugal
- CIMAGO, Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra 3004-531, Portugal
| | - Carmen Alvarez-Lorenzo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Angel Concheiro
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Francisco Veiga
- Faculty of Pharmacy, University of Coimbra, Coimbra 3000-295, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Coimbra 3004-504, Portugal
| | - Ana Figueiras
- Faculty of Pharmacy, University of Coimbra, Coimbra 3000-295, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Coimbra 3004-504, Portugal
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A nanomedicine approach enables co-delivery of cyclosporin A and gefitinib to potentiate the therapeutic efficacy in drug-resistant lung cancer. Signal Transduct Target Ther 2018; 3:16. [PMID: 29942660 PMCID: PMC6013461 DOI: 10.1038/s41392-018-0019-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 12/11/2022] Open
Abstract
Drug resistance, accounting for therapeutic failure in the clinic, remains a major challenge to effectively manage cancer. Cyclosporin A (CsA) can reverse multidrug resistance (MDR), especially resistance to epidermal growth factor receptor tyrosine kinase inhibitors. However, the application of both drugs in cancer therapies is hampered by their poor aqueous solubility and low bioavailability due to oral administration. CsA augments the potency of gefitinib (Gef) in both Gef-sensitive and Gef-resistant cell lines. Here, we show that the simultaneous encapsulation of CsA and Gef within polyethylene glycol-block-poly(D, L-lactic acid) (PEG-PLA) produced a stable and systemically injectable nanomedicine, which exhibited a sub-50-nm diameter and spherical structures. Impressively, the co-delivery of therapeutics via single nanoparticles (NPs) outperformed the oral administration of the free drug combination at suppressing tumor growth. Furthermore, in vivo results indicated that CsA formulated in NPs sensitized Gef-resistant cells and Gef-resistant tumors to Gef treatment by inactivating the STAT3/Bcl-2 signaling pathway. Collectively, our nanomedicine approach not only provides an alternative administration route for the drugs of choice but also effectively reverses MDR, facilitating the development of effective therapeutic modalities for cancer. Injection of nanoparticles containing the anticancer drug gefitinib and the immunosuppressant cyclosporin A reverses drug-resistant cancer growth in mice. The development of multidrug resistance is the main reason why many forms of chemotherapy fail. Cyclosporin A, a drug used to prevent immune rejection after organ transplantation, has previously been shown to enhance the potency of gefitinib. Hangxiang Wang and colleagues at Zhejiang University, Hangzhou, China, have successfully combined cyclosporin A and gefitinib, two poorly water-soluble and slowly absorbed drugs, into stable injectable nanoparticles that delay the growth of gefitinib resistant human lung cancer cells as well as the growth of drug resistant tumors in mice. Importantly, this novel co-formulation was more effective than oral co-administration of the two drugs. Further investigation into this drug delivery route could yield much needed alternative treatments for patients with multidrug-resistant cancers.
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Zhao YF, Jiang F, Liang XY, Wei LL, Zhao YY, Ma Q, Hu YS, Su XL. Grifolic acid causes osteosarcoma cell death in vitro and in tumor-bearing mice. Biomed Pharmacother 2018; 103:1035-1042. [PMID: 29710661 DOI: 10.1016/j.biopha.2018.04.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022] Open
Abstract
Grifolic acid is a natural compound isolated from the fungus Albatrellus confluens. In the present study, we assessed the effects of grifolic acid on human osteosarcoma cells. We found that grifolic acid dose- and time-dependently induced cell death in the U-2 OS, MG-63, Saos-2, and 143B human osteosarcoma cell lines. Grifolic acid decreased osteosarcoma cell mitochondrial membrane potential, ATP production, and cellular NADH levels, but did not impact mitochondrial membrane potential in isolated mitochondria from human osteosarcoma cells. Intratumoral injection of grifolic acid also promoted tumor cell death and prolonged survival in nude mice bearing human osteosarcoma xenografts. Grifolic acid had no obvious toxicity in mice, with no histological changes in liver, kidney, lung, or heart, and no changes in blood cell counts or levels of plasma total protein, alanine aminotransferase, or aspartate aminotransferase. These results show that grifolic acid induces osteosarcoma cell death by inhibiting NADH generation and ATP production without obvious toxicity. Intratumoral injection of grifolic acid may be a promising anti-osteosarcoma therapeutic option in patients.
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Affiliation(s)
- Yu-Feng Zhao
- The institute of Basic Medical Sciences, Xi'an Medical University, Xi'an, 710021, China
| | - Feng Jiang
- Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Xiang-Yan Liang
- The institute of Basic Medical Sciences, Xi'an Medical University, Xi'an, 710021, China
| | - Lan-Lan Wei
- The institute of Basic Medical Sciences, Xi'an Medical University, Xi'an, 710021, China
| | - Yan-Yan Zhao
- The institute of Basic Medical Sciences, Xi'an Medical University, Xi'an, 710021, China
| | - Qiong Ma
- Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Yun-Sheng Hu
- Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
| | - Xing-Li Su
- The institute of Basic Medical Sciences, Xi'an Medical University, Xi'an, 710021, China.
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