A review of research into the uses of low level ultrasound in cancer therapy

Monitoring Apoptosis and Myeloid Differentiation of Acridine Orange-Mediated Sonodynamic Therapy-Induced Human Promyelocytic Leukemia HL60 Cells

OBJECTIVES

In the treatment of acute myeloid leukemia (AML), conventional therapies can lead to severe side effects and drug resistance. There is a need for alternative treatments that do not cause treatment resistance and have minimal or no side effects. Sonodynamic therapy (SDT), due to its noninvasive, multiple repeatability, localized treatment feature and do not cause treatment resistance, emerges as an alternative treatment option. However, it has not received sufficient attention in the treatment of AML especially acute promyelocytic leukemia (APL). The aim of the study was to investigate the potential differentiation and antileukemic effects of acridine orange (AO)-mediated SDT on HL60 cells.

METHODS

Cell viability was determined by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) method in the control, ultrasound, AO concentrations, and ultrasound-exposed AO concentrations groups. Transmission electron microscopy (TEM) was used to determine morphology, and flow cytometry was used to determine apoptosis, DNA cycle, cell volume, mitochondria membrane potential (Δψm), reactive oxygen species (ROS) production, and differentiation markers (CD11b and CD15) expressions. Additionally, toluidine blue staining for semithin sections was used to determine differentiation.

RESULTS

The cytotoxicity of AO-mediated SDT on HL60 cells was significantly higher than other groups, and TEM images showed that it caused various morphological changes typical for apoptosis. Flow cytometry results showed the presence of early apoptosis, subG1 arrest, loss of Δψm, increase of intracellular ROS production, decreased cell volume, and increased expression of CD11b (1.3-fold) antigen and CD15 (1.2-fold) antigen.

CONCLUSION

Data showed that AO-mediated SDT significantly induced apoptosis in HL60 cells. Increased expression of CD11b and CD15 antigens and morphological findings demonstrated that AO-mediated SDT contributes to granulocytic differentiation in HL60 cells. AO-mediated SDT has potential as an alternative treatment of APL.

Nanosensitizer-mediated augmentation of sonodynamic therapy efficacy and antitumor immunity

The dense stroma of desmoplastic tumor limits nanotherapeutic penetration and hampers the antitumor immune response. Here, we report a denaturation-and-penetration strategy and the use of tin monosulfide nanoparticles (SnSNPs) as nano-sonosensitizers that can overcome the stromal barrier for the management of desmoplastic triple-negative breast cancer (TNBC). SnSNPs possess a narrow bandgap (1.18 eV), allowing for efficient electron (e-)-hole (h+) pair separation to generate reactive oxygen species under US activation. More importantly, SnSNPs display mild photothermal properties that can in situ denature tumor collagen and facilitate deep penetration into the tumor mass upon near-infrared irradiation. This approach significantly enhances sonodynamic therapy (SDT) by SnSNPs and boosts antitumor immunity. In mouse models of malignant TNBC and hepatocellular carcinoma (HCC), the combination of robust SDT and enhanced cytotoxic T lymphocyte infiltration achieves remarkable anti-tumor efficacy. This study presents an innovative approach to enhance SDT and antitumor immunity using the denaturation-and-penetration strategy, offering a potential combined sono-immunotherapy approach for the cancer nanomedicine field.

Power Amplifier Design for Ultrasound Applications

A design analysis of the power amplifiers developed for ultrasound applications was conducted because ultrasound applications require different types of power amplifiers, which are one of the most critical electronic components in ultrasound systems. To generate acoustic signals using transducers, which are among the most important mechanical devices in ultrasound systems, an appropriate output voltage, current, or power signal must be produced by a power amplifier. Therefore, an appropriate design analysis of the power amplifier must be conducted to obtain the optimal performance from a transducer. In addition, because of new ultrasound research trends, such as ultrasound systems with other imaging modalities and wireless ultrasound systems, the selection of an appropriate power amplifier could improve the performance of an ultrasound system with other imaging and therapy modalities. This paper describes the design parameters of a power amplifier, including the gain, bandwidth, harmonic distortion, and efficiency. Each power amplifier has specific applications and limitations. Therefore, this review will assist design engineers and ultrasound researchers who need to develop or use power amplifiers in ultrasound applications.

Evading Doxorubicin-Induced Systemic Immunosuppression Using Ultrasound-Responsive Liposomes Combined with Focused Ultrasound

Doxorubicin (DOX) is a representative anticancer drug with a unique ability to induce immunogenic cell death of cancer cells. However, undesired toxicity on immune cells has remained a significant challenge, hindering the usage of DOX in cancer immunotherapy. Here, we report a combined therapy to avoid the off-target toxicity of DOX by adapting ultrasound-responsive liposomal doxorubicin and focused ultrasound exposure. Histological analysis demonstrated that the combined therapy induced less hemosiderosis of splenocytes and improved tumor infiltration of cytotoxic T lymphocytes. Additionally, in vivo therapeutic evaluation results indicate that the combined therapy achieved higher efficacy when combined with PD-1 immune-checkpoint blockade therapy by improving immunogenicity.

Landscape of Cellular Bioeffects Triggered by Ultrasound-Induced Sonoporation

Sonoporation is the process of transient pore formation in the cell membrane triggered by ultrasound (US). Numerous studies have provided us with firm evidence that sonoporation may assist cancer treatment through effective drug and gene delivery. However, there is a massive gap in the body of literature on the issue of understanding the complexity of biophysical and biochemical sonoporation-induced cellular effects. This study provides a detailed explanation of the US-triggered bioeffects, in particular, cell compartments and the internal environment of the cell, as well as the further consequences on cell reproduction and growth. Moreover, a detailed biophysical insight into US-provoked pore formation is presented. This study is expected to review the knowledge of cellular effects initiated by US-induced sonoporation and summarize the attempts at clinical implementation.

Simultaneous chemotherapy/sonodynamic therapy of the melanoma cancer cells using a gold-paclitaxel nanostructure

Nanodrug delivery systems are novel strategies for tumor treatment since delivery of chemotherapy drugs such as paclitaxel (PTX) is associated with substantial challenges due to its poor aqueous solubility. In addition, sonodynamic therapy (SDT) is a promising approach that can increase the uptake, accumulation, and dispersion of desirable amounts of the drugs by activating sonosensitizer and enhancing cell membrane permeability. Herein, gold-paclitaxel nanoparticles (Au-PTX NPs) were synthesized and characterized to evaluate the cytotoxicity toward C540 cancer cells in comparison of free PTX, AuNPs, and AuNPs+free PTX in the absence and presence of ultrasound radiation. Evidence shows that AuNPs have a median diameter size of 95.0 ± 15.4, while the size of Au-PTX NPs is roughly 219.7 ±  40.4 nm. Negative zeta-potential results indicate high stability and good dispersion of nanoparticles. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay results revealed that Au-PTX NPs increased the cytotoxicity compared to other treatment groups that ensure the great potential of AuNPs as a promising nano-carrier for PTX drug delivery. Moreover, the viability of C540 cells treated by Au-PTX NPs under ultrasound radiation was decreased significantly by generating more reactive oxygen species (ROS) upon STD, with representing synergism effects confirming the role of gold nanoparticles as an excellent sonosensitizer and the role of SDT as an adjunctive treatment method with chemotherapy.

Application of Gold Nanoparticle-Based Materials in Cancer Therapy and Diagnostics

Several metal nanoparticles have been developed for medical application. While all have their benefits, gold nanoparticles (AuNPs) are ideal in cancer therapy and diagnosis as they are chemically inert and minimally toxic. Several studies have shown the potential of AuNPs in the therapeutic field, as photosensitizing agents in sonochemical and photothermal therapy and as drug delivery, as well as in diagnostics and theranostics. Although there is a significant number of reviews on the application of AuNPs in cancer medicine, there is no comprehensive review on their application both in therapy and diagnostics. Therefore, considering the high number of studies on AuNPs’ applications, this review summarizes data on the application of AuNPs in cancer therapy and diagnostics. In addition, we looked at the influence of AuNPs’ shape and size on their biological properties. We also present the potential use of hybrid materials based on AuNPs in sonochemical and photothermal therapy and the possibility of their use in diagnostics. Despite their potential, the use of AuNPs and derivatives in cancer medicine still has some limitations. In this review, we provide an overview of the biological, physicochemical, and legal constraints on using AuNPs in cancer medicine.

Far field during sonication experiments in vitro - Is it really far enough?

In many in vitro experiments studying ultrasound bioeffects the sonicated samples are placed to far field with intention of exposing them to as uniform ultrasound field as possible. The main aim of this work is to assess whether the sonicated samples really experience what they are believed to. Also we would like to suggest basic rules for construction of sonication vessels. We used 3.5 MHz and 7 MHz ultrasound transducers for measurements. We measured ultrasound field inside and behind common culture plates and special 3D printed plates placed to last axial maximum in water sonication tank with use of a needle hydrophone. Our results show that even though the sonication vessels with sonicated samples are placed into far field, the sonicated samples are actually exposed to some kind of a near field pattern which develops due to the interaction between ultrasound and well of culture plate. The variability of local acoustic intensity can reach up to several hundreds of percent. Our results are also supported by theoretical calculation and software for simulation of ultrasound fields. Even though the sonicated samples may have actually been exposed to some kind of near field pattern in many past studies, the whole phenomenon of creation of near field pattern can be controlled to some extent for future studies. Thus, we suggest that the sonication vessel should always be designed for particular ultrasound transducer.

Design and Challenges of Sonodynamic Therapy System for Cancer Theranostics: From Equipment to Sensitizers

As a novel noninvasive therapeutic modality combining low-intensity ultrasound and sonosensitizers, sonodynamic therapy (SDT) is promising for clinical translation due to its high tissue-penetrating capability to treat deeper lesions intractable by photodynamic therapy (PDT), which suffers from the major limitation of low tissue penetration depth of light. The effectiveness and feasibility of SDT are regarded to rely on not only the development of stable and flexible SDT apparatus, but also the screening of sonosensitizers with good specificity and safety. To give an outlook of the development of SDT equipment, the key technologies are discussed according to five aspects including ultrasonic dose settings, sonosensitizer screening, tumor positioning, temperature monitoring, and reactive oxygen species (ROS) detection. In addition, some state-of-the-art SDT multifunctional equipment integrating diagnosis and treatment for accurate SDT are introduced. Further, an overview of the development of sonosensitizers is provided from small molecular sensitizers to nano/microenhanced sensitizers. Several types of nanomaterial-augmented SDT are in discussion, including porphyrin-based nanomaterials, porphyrin-like nanomaterials, inorganic nanomaterials, and organic-inorganic hybrid nanomaterials with different strategies to improve SDT therapeutic efficacy. There is no doubt that the rapid development and clinical translation of sonodynamic therapy will be promoted by advanced equipment, smart nanomaterial-based sonosensitizer, and multidisciplinary collaboration.

Ultrasound-Responsive Nanocarriers in Cancer Treatment: A Review

The safe and effective delivery of anticancer agents to diseased tissues is one of the significant challenges in cancer therapy. Conventional anticancer agents are generally cytotoxins with poor pharmacokinetics and bioavailability. Nanocarriers are nanosized particles designed for the selectivity of anticancer drugs and gene transport to tumors. They are small enough to extravasate into solid tumors, where they slowly release their therapeutic load by passive leakage or biodegradation. Using smart nanocarriers, the rate of release of the entrapped therapeutic(s) can be increased, and greater exposure of the tumor cells to the therapeutics can be achieved when the nanocarriers are exposed to certain internally (enzymes, pH, and temperature) or externally (light, magnetic field, and ultrasound) applied stimuli that trigger the release of their load in a safe and controlled manner, spatially and temporally. This review gives a comprehensive overview of recent research findings on the different types of stimuli-responsive nanocarriers and their application in cancer treatment with a particular focus on ultrasound.

30 Years of sonochemistry links with China

Most scientists consider that sonochemistry became recognised as a discrete subject in the 1980's - some 40 years ago which coincidentally is when my own interests in the subject began. This review briefly outlines how I first became involved in sonochemistry and then in its development. However its main theme is the way in which my links with China through sonochemistry have developed from their beginnings in 1990. This was the subject of my presentation at AOSS4 and involves a range of topics which started with the extraction of natural products and surface treatment but later expanded to include therapeutic ultrasound and environmental protection.

Inhibition of Human Breast Cancer Cell Proliferation by Low-Intensity Ultrasound Stimulation

OBJECTIVES

Cancer is characterized by uncontrolled cell proliferation, which makes novel therapies highly desired. In this study, the effects of near-field low-intensity pulsed ultrasound (LIPUS) stimulation on T47D human breast cancer cell and healthy immortalized MCF-12A breast epithelial cell proliferation were investigated in monolayer cultures.

METHODS

A customized ultrasound (US) exposure setup was used for the variation of key US parameters: intensity, excitation duration, and duty cycle. Cell proliferation was quantified by 5-bromo-2'-deoxyuridine and alamarBlue assays after LIPUS excitation.

RESULTS

At a 20% duty cycle and 10-minute excitation period, we varied LIPUS intensity from to 100 mW/cm² (spatial-average temporal-average) to find a gradual decrease in T47D cell proliferation, the decrease being strongest at 100 mW/cm² . In contrast, healthy MCF-12A breast cells showed an increase in proliferation when exposed to the same conditions. Above a 60% duty cycle, T47D cell proliferation decreased drastically. Effects of continuous wave US stimulation were further explored by varying the intensity and excitation period.

CONCLUSIONS

These experiments concluded that, irrespective of the waveform (pulsed or continuous), LIPUS stimulation could inhibit the proliferation of T47D breast cancer cells, whereas the same behavior was not observed in healthy cells. The study demonstrates the beneficial bioeffects of LIPUS on breast cancer cells and offers the possibility of developing novel US-mediated cancer therapy.

Therapeutic ultrasound experiments in vitro: Review of factors influencing outcomes and reproducibility

Current in vitro sonication experiments show immense variability in experimental set-ups and methods used. As a result, there is uncertainty in the ultrasound field parameters experienced by sonicated samples, poor reproducibility of these experiments and thus reduced scientific value of the results obtained. The scope of this narrative review is to briefly describe mechanisms of action of ultrasound, list the most frequently used experimental set-ups and focus on a description of factors influencing the outcomes and reproducibility of these experiments. The factors assessed include: proper reporting of ultrasound exposure parameters, experimental geometry, coupling medium quality, influence of culture vessels, formation of standing waves, motion/rotation of the sonicated sample and the characteristics of the sample itself. In the discussion we describe pros and cons of particular exposure geometries and factors, and make a few recommendations as to how to increase the reproducibility and validity of the experiments performed.

Effect of ClAlPcS(2) photodynamic and sonodynamic therapy on HeLa cells

Photodynamic therapy (PDT) uses photosensitive substance to provoke a cytotoxic reaction causing a cell damage or cell death. The substances, photosensitizers, are usually derivates of porphyrine or phtalocyanine. Photosensitizers must be activated by light in order to produce reactive oxygen species, mainly singlet oxygen. Sonodynamic therapy (SDT) utilizes ultrasound to enhance a cytotoxic effects of compounds called sonosensitizers. In this study we investigated photodynamic and sonodynamic effect of chloraluminium phtalocyanine disulfonate (ClAlPcS(2)) on HeLa cells. DNA damage, cell viability and reactive oxygen species (ROS) production were assessed to find whether the combination of PDT and SDT inflicts HeLa cells more than PDT alone. We found that the combined therapy increases DNA fragmentation, enhances ROS production and decreases cell survival. Our results indicate that ClAlPcS(2) can act as a sonosentitiser and combined with PDT causes more irreversible changes to the cells resulting in cell death than PDT alone.

A Macro Lens-Based Optical System Design for Phototherapeutic Instrumentation

Light emitting diode (LED) and ultrasound have been powerful treatment stimuli for tumor cell growth due to non-radiation effects. This research is the first preliminary study of tumor cell suppression using a macro-lens-supported 460-nm LED combined with high-frequency ultrasound. The cell density, when exposed to the LED combined with ultrasound, was gradually reduced after 30 min of induction for up to three consecutive days when 48-W DC, 20-cycle, and 50 V_p-p sinusoidal pulses were applied to the LEDs through a designed macro lens and to the ultrasound transducer, respectively. Using a developed macro lens, the non-directional light beam emitted from the LED could be localized to a certain spot, likewise with ultrasound, to avoid additional undesirable thermal effects on the small sized tumor cells. In the experimental results, compared to LED-only induction (14.49 ± 2.73%) and ultrasound-only induction (13.27 ± 2.33%), LED combined with ultrasound induction exhibited the lowest cell density (6.25 ± 1.25%). Therefore, our measurement data demonstrated that a macro-lens-supported 460-nm LED combined with an ultrasound transducer could possibly suppress early stage tumor cells effectively.

A comparative study on generating hydroxyl radicals by single and two-frequency ultrasound with gold nanoparticles and protoporphyrin IX

Sonodynamic therapy (SDT) is a new manner of killing cancer cells based on the cytotoxic interactions of ultrasound with sonosensitizing agents. It is shown that gold nanoparticles (GNPs) increase the efficiency of cavitation activity of ultrasound. In this study the influence of a single and/or two frequencies of ultrasound waves to generate hydroxyl radicals (^·OH) was assessed in the presence of protoporphyrin IX (PpIX) and/or GNPs. Ultrasound cavitation activity was determined by recording fluorescence signals from chemical terephthalic acid (TA) dosimeters with or without PpIX and/or GNPs at the frequencies of 0.8 and 2.4 MHz individually and aggregately. To study hydroxyl radicals, experiments were performed with and without hydroxyl radical scavengers mannitol, histidine, and sodium azide. Cavitation activity was amplified by increasing ultrasound intensity and exposure time. The cavitation activity induced by dual ultrasound frequency was remarkably higher than the summation of effects produced by individual frequencies. All three scavengers reduced the fluorescence signal level. The effect of GNPs on intensifying cavitation activity at higher frequency was greater than that of lower frequency. PpIX showed a more effective sonosensitizing property at the lower frequency. Also, estimated synergism at dual frequency irradiation was improved in the presence of GNPs. We found that GNPs increased hydroxyl radical production at 2.4 MHz and that PpIX increased hydroxyl radical production at 0.8 MHz. Dual frequency exposure was more effective than single frequency exposure. PpIX at low frequency and gold nanoparticles at high frequency both enhance sonodynamic treatment efficacy.

An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation

Acoustic cavitation which occurs at high intensities of ultrasound waves can be fatal for tumor cells. The existence of dissolved gases and also the presence of nanoparticles (NPs) in a liquid, irradiated by ultrasound, decrease the acoustic cavitation onset threshold and the resulting bubbles collapse. On the other hand, due to unique capabilities and optical properties of gold nanoparticles (GNPs), they have been emphasized as effective NPs in the field of tumor therapy. Absorption of the laser light by GNPs causes the water molecules around the NPs to evaporate and produces vapor cavities. In this paper, we have reviewed published studies in the fields of ultrasound therapy, sonodynamic therapy (SDT) and synergism of low-level ultrasound and also laser radiation in the presence of GNPs.

Low‑intensity ultrasound enhances the chemosensitivity of hepatocellular carcinoma cells to cisplatin via altering the miR‑34a/c‑Met axis

Recently, the use of low-intensity ultrasound (LIUS) combined with chemotherapeutic agents is widely used in clinical practice, mainly for the treatment of cancer; however, the mechanisms as to how LIUS enhances the antitumor effects of these agents are not fully understood. The aim of the present study was to explore the synergistic antitumor effects and mechanisms of cisplatin (DDP) combined with LIUS (LIUS-DDP) in hepatocellular carcinoma (HCC). We reported that LIUS effectively enhanced Huh7 and HCCLM3 cell sensitivity to a low concentration of DDP. Reverse transcription-quantitative polymerase chain reaction analysis revealed that LIUS could increase the expression of microRNA-34a (miR-34a) in HCC cells following DDP treatment. In addition, LIUS-DDP significantly increased intracellular reactive oxygen species (ROS) levels in vitro, and the upregulation of miR-34a induced by LIUS-DDP was reversed by the ROS scavenger N-acetylcysteine, suggesting that LIUS upregulates the expression of miR-34a via production of ROS. In addition, knockdown of miR-34a in HCC cells significantly suppressed the synergistic effects of LIUS-DDP treatment. Conversely, overexpression of miR-34a enhanced these synergistic effects. The results of a dual-luciferase assay indicated that c-Met, a well-known oncogene, was a target of miR-34a. We also determined that LIUS-DDP treatment inhibited the expression of c-Met, possibly due to increased ROS production, which upregulated miR-34a expression. Furthermore, overexpression of c-Met reversed the synergistic effects of LIUS-DDP treatment. Our findings suggest that LIUS could enhance the chemosensitivity of HCC cells to DDP by altering the miR-34a/c-Met axis. Therefore, DDP combined with LIUS may be a potential therapeutic application for the clinical treatment of patients with HCC.

Multifunctional Polypyrrole-Coated Mesoporous TiO2 Nanocomposites for Photothermal, Sonodynamic, and Chemotherapeutic Treatments and Dual-Modal Ultrasound/Photoacoustic Imaging of Tumors

TiO₂ nanoparticles have emerged as satisfactory sonosensitizers in sonodynamic therapy over the years, but shortcomings such as poor drug loading capability and inadequate techniques to construct suitable TiO₂ nanoparticles, limit their broader applications. Hence, in this paper, versatile nanocomposites that combine mesoporous TiO₂ nanoparticles (mTiO₂ s) with the promising photothermal material, polypyrrole (PPY) to exert synergistic therapeutic effects on tumors are fabricated. The PPY-coated mesoporous TiO₂ nanocomposites (mTiO₂ @PPYs) act as drug delivery vehicles and ultrasonically activated sonosensitizers as well as photothermal agents. Besides, mTiO₂ @PPY may have potential as an ultrasound/photoacoustic (US/PA) imaging contrast agent. The mTiO₂ @PPY shows a favorable drug loading and good photothermal conversion ability. Moreover, intracellular reactive oxygen species generation is verified. The in vitro cell experiments on HepG2 and 4T1 cells demonstrate that honokiol (HNK)-loaded mTiO₂ @PPY has satisfactory cytotoxicity under laser and US irradiation, and the results are further validated by animal experiments. The ability of mTiO₂ @PPY as a contrast agent for US and PA imaging is investigated both in vitro and in vivo. The results indicate that mTiO₂ @PPY-HNK has multitherapeutic effects and bimodal imaging property, which shows great prospect as a novel nanosystem in antitumor applications.

In Situ-Induced Multivalent Anticancer Drug Clusters in Cancer Cells for Enhancing Drug Efficacy

Increasing intracellular drug concentration is an effective way for cancer chemotherapeutics to enhance efficacy and combat drug resistance. In this work, a series of anticancer drug conjugates were prepared by linking thiol-modified oligo( p-phenylene vinylene) with paclitaxel, vincristine, teniposide, tamoxifen, doxorubicin, or podophyllotoxin (OPV-S-Drugs) through a Michael addition reaction. These OPV-S-Drugs could undergo intracellular assembly and aggregation upon oxidation to yield multivalent anticancer drug clusters, which inhibited their diffusion from cancer cells. The intracellular aggregation of OPV-S-Drugs originates from π–π stacking and hydrophobic interactions between OPV backbones, followed by cross-linking via disulfide bond formation in the presence of reactive oxygen species (ROS). The drug clusters occur only in the cytoplasm of cancer cells expressing high ROS levels, but not in healthy mammalian cells, thus reducing the cytotoxicity to normal cells. Specifically, the super-toxicity of podophyllotoxin to normal cells was obviously suppressed while the drug efficacy was maintained through our new strategy. The diverse action mechanisms of OPV-S-Drugs toward cancer cells is proposed.

Acoustic Stimulation by Shunt-Diode Pre-Linearizer using Very High Frequency Piezoelectric Transducer for Cancer Therapeutics

In this paper, we proposed cancer cell acoustic stimulation by shunt-diode pre-linearizer scheme using a very high frequency (≥100 MHz) piezoelectric transducer. To verify the concept of our proposed scheme, we performed pulse-echo detection, and accessed therapeutic effects of human cervical cancer cells exposed to acoustic stimulation experiments using 100 MHz focused piezoelectric transducer triggered by PA with and without the proposed shunt-diode pre-linearizer scheme. In the pulse-echo detection responses, the peak-to-peak voltage of the echo signal when using the PA with shunt-diode pre-linearizer (49.79 mV) was higher than that when using the PA alone (29.87 mV). In the experimental results, the cell densities of cancer cells on Day 4 when using no acoustic stimulation (control group), the very high-frequency piezoelectric transducer triggered by PA only and PA combined with proposed pre-linearizer schemes (1 V and 5 V DC bias voltages) showed 100%, 92.8 ± 4.2%, 84.2 ± 4.6%, and 78 ± 2.9%, respectively. Therefore, we confirmed that the shunt-diode pre-linearizer could improve the performances of the pulse signals of the PA, thus, enabling better therapeutic stimulation performances for cancer cell suppression.

Synthesis and characterization of a novel Fe3O4@SiO2–BenzIm-Fc[Cl]/BiOCl nano-composite and its efficient catalytic activity in the ultrasound-assisted synthesis of diverse chromene analogs

A new magnetic nano-catalyst bearing ionic liquid, ferrocene and BiOCl was synthesized and its catalytic activities were evaluated in the synthesis of a wide variety of 2-amino-3-cyano-4H-chromene derivatives (54 compounds) under ultrasound irradiation.

Suppression Technique of HeLa Cell Proliferation Using Ultrasonic Power Amplifiers Integrated with a Series-Diode Linearizer

A series-diode linearizer scheme is developed, which can possibly generate higher voltage signals. To verify our proposed concept, ultrasonic power amplifiers with and without the linearizer were tested for HeLa cells proliferation in vitro. In general, ultrasonic stimulus initiates the process of cavitation which can cause cell lysis and disruption of cell attachment. The cavitation can also induce formation of free radicals so that a rigid membrane of malignant cancer cells have increased sensitivity to ultrasonic stimulus. The cell density of the control group increased up to almost 100% on Day 3. However, cell densities of the experimental group when using an isolated ultrasonic power amplifier, and ultrasonic power amplifiers integrated with the linearizer at 1 V and 5 V DC (direct current) bias could be suppressed more than that when using an ultrasonic power amplifier (90.7 ± 1.2%, 75.8 ± 3.5%, and 68.1 ± 1.1%, respectively). Additionally, the proliferation suppressing ratios of each experimental group confirmed that the cell density decrements of the experimental groups exhibited statistical significance compared to the control group (ultrasonic power amplifier = 8.87%, ultrasonic power amplifier with 1 V biased linearizer = 23.87%, and ultrasonic power amplifier with 5 V biased linearizer = 31.56%).

Therapeutic Effect Enhancement by Dual-bias High-voltage Circuit of Transmit Amplifier for Immersion Ultrasound Transducer Applications

The dual-bias high-voltage circuit of a transmit amplifier for immersion ultrasound transducer applications is proposed to enhance the therapeutic effect of human HeLa cells. High-voltage output signals generated from a transmit amplifier are typically preferable for immersion ultrasound transducers owing to their high sensitivity at the desired frequency. However, high-voltage output signals typically produce high-order harmonic distortions, thus triggering several unwanted high-order spectral signals in the ultrasound transducers. By reducing high-order harmonic distortions, we expect that improving the signal quality of excited pulses for immersion ultrasound transducers would be beneficial for the therapeutic effect on human cervical cancer HeLa cell suppression. Therefore, an additional bias circuit is developed to merge with the original bias circuit for transmit amplifier to control the harmonic distortions of the immersion ultrasonic transducer. To properly select the components of dual-bias high-voltage circuit, we need to calculate and measure the DC bias voltages of the transmit amplifier with and without dual-bias high-voltage circuit for different period of the time for therapeutic applications. To evaluate the performances of the developed circuit, pulse-echo measurements using a transmit amplifier with or without dual-bias high-voltage circuit were obtained. The measured second, third, and fourth harmonic distortions of the echo signals when using the transmit amplifier with dual-bias high-voltage circuit at 10 V DC bias voltage are lower than those when using the transmit amplifier only. Subsequently, the therapeutic effects using the enhanced performances of the transmit amplifier with dual-bias high-voltage circuit were verified and compared with those using the performances of the transmit amplifier by comparison of quantitative changes in HeLa cell concentrations. The control group without any ultrasonic induction increased the cell density up to about 100% on Day4, however the experimental groups with ultrasonic induction (TA = 91.2 ± 0.8%, TA+Dual-bias high-voltage circuit (0.8 V) = 78.8 ± 1.7% and TA+Dual-bias high-voltage circuit (10 V) = 66.3 ± 1.1%) showed statistically significant cell density changes compared to the control group. We confirmed that the therapeutic effect from using the dual-bias high-voltage circuit is improved. Therefore, it can be a potential candidate to improve the therapeutic effect of HeLa cells.

Mesoporous Silica Nanoparticles for Dual-Mode Chemo-Sonodynamic Therapy by Low-Energy Ultrasound

Low-energy ultrasound (LEUS), exhibiting obvious advantages as a safe therapeutic strategy, would be promising for cancer therapy. We had synthesized a LEUS-responsive targeted drug delivery system based on functional mesoporous silica nanoparticle for cancer therapy. Paclitaxel (PTX) was loaded in mesoporous silica nanoparticles with a hydrophobic internal channel, and folic acid (FA) functionalized β-Cyclodextrin (β-CD) was capped on the surface of the nanoparticles (DESN), which acted as a cancer-targeting moiety and solubilizer. The existence of a hydrophobic internal channel in the DESN was beneficial to the storage of hydrophobic PTX, along with the enhancement of the cavitation effect produced by mild low-energy ultrasound (LEUS, ≤1.0 W/cm², 1 MHz). The DESN showed significantly enhanced cavitation effect, selective targeting, and achieved a rapid drug release under mild LEUS. To investigate the in vivo antitumor efficacy of the DESN upon LEUS irradiation, we established a 4T1 mammary tumor model. The DESN were confirmed to be of great biodegradability/biocompatibility. The tumor growth was significantly inhibited when the mice were treated with DESN (10 mg/kg) + LEUS with the relative tumor volume reduced to 4.72 ± 0.70 compared with the control group (V/V₀ = 17.12 ± 2.75). The DESN with LEUS represented excellent inhibiting effect on tumor cell in vivo. This work demonstrated that DESN mediating dual mode chemo-sonodynamic therapy could be triggered by extracorporeal remote control, may suggest a promising clinical application in cancer therapy.

Green in water sonochemical synthesis of tetrazolopyrimidine derivatives by a novel core-shell magnetic nanostructure catalyst

A green approach for the one-pot four-component sonochemical synthesis of 5-methyl-7-aryl-4,7-dihydrotetrazolo[1,5-a]pyrimidine-6-carboxylic esters from the reaction of 2-cyano-guanidine, sodium azide, various aromatic aldehydes and methyl or ethyl acetoacetate in the presence of a catalytic amount of Fe₂O₃@SiO₂-(CH₂)₃NHC(O)(CH₂)₂PPh₂ as a new hybrid organic-inorganic core-shell nanomagnetic catalyst is described. This is the first design, preparation, characterization and application of the present nanomaterial and also the first ultrasound irradiated synthesis of the biologically and pharmaceutically important heterocyclic compounds in water as a green solvent. This novel sonocatalysis/nanocatalysis protocol offers several advantages such as high yields, short reaction times, environmentally-friendly reaction media, easily isolation of the products, simple preparation, full characterization and recoverability of the nanocatalyst by an external magnet and reusing several times without significant loss of activity.

Sonodynamic therapy (SDT): a novel strategy for cancer nanotheranostics

Sonodynamic therapy (SDT) is a promising non-invasive therapeutic modality. Compared to photo-inspired therapy, SDT provides many opportunities and benefits, including deeper tissue penetration, high precision, less side effects, and good patient compliance. Thanks to the facile engineerable nature of nanotechnology, nanoparticles-based sonosensitizers exhibit predominant advantages, such as increased SDT efficacy, binding avidity, and targeting specificity. This review aims to summarize the possible mechanisms of SDT, which can be expected to provide the theoretical basis for SDT development in the future. We also extensively discuss nanoparticle-assisted sonosensitizers to enhance the outcome of SDT. Additionally, we focus on the potential strategy of combinational SDT with other therapeutic modalities and discuss the limitations and challenges of SDT toward clinical applications.

A Prototype Therapeutic Capsule Endoscope for Ultrasound-Mediated Targeted Drug Delivery

The prevalence of gastrointestinal (GI) diseases such as Crohn’s disease, which is chronic and incurable, are increasing worldwide. Treatment often involves potent drugs with unwanted side effects. The technological–pharmacological combination of capsule endoscopy with ultrasound-mediated targeted drug delivery (UmTDD) described in this paper carries new potential for treatment of these diseases throughout the GI tract. We describe a proof-of-concept UmTDD capsule and present preliminary results to demonstrate its promise as an autonomous tool to treat GI diseases.

Cell Damage of Hepatoma-22 Cells Exposed to Continuous Wave Ultrasound

Aims and background

The cellular response of hepatoma-22 cells to ultrasonic irradiation and the potential cause for the action were evaluated.

Methods and study design

Hepatoma-22 cells were subjected to ultrasound irradiation at a frequency of 2.17 MHz and a spatial average intensity of 1.6 W/cm2 for variable periods of time, and several biological parameters were analyzed. The terephthalic acid (TA) dosimetry method was used to evaluate the efficacies of irradiation parameters on the acoustic cavitation activity by monitoring hydroxyl radical (OH) production. Lactate dehydrogenase (LDH) leakage was assayed to investigate cell membrane integrity. The polarization value of fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH) was measured to monitor plasma membrane fluidity. The malonaldehyde content in cells was determined to reflect lipid peroxidation. Trypan blue exclusion was used to detect cell viability. Additionally, electron microscopy was used to observe morphological changes. The generation of intracellular reactive oxygen species, mitochondria swelling and the loss of mitochondria membrane potential were also investigated.

Results

The results showed that 1) the concentration of ·OH production by ultrasonic irradiation in air-saturated cell suspensions increased as ultrasound exposure time increased; 2) compared with control, lactate dehydrogenase leakage, the polarization value of 1,6-diphenyl-1,3,5-hexatriene, malonaldehyde content and cell lysis were significantly elevated when cells were treated by ultrasound for 60 s; 3) cytotoxicity by ultrasound irradiation was also accompanied by an increase in production of intracellular reactive oxygen species and dissipation of mitochondria membrane potential as well as by mitochondria swelling.

Conclusions

Presently available information indicates that the plasma membrane and mitochondria are the main targets for ultrasound treatment, and free radicals formation such as ·OH due to ultrasound cavitation may play an important role in mediating these cellular response processes. Moreover the mechanical effect might also be involved in inducing cell damage because there was significant mitochondria membrane potential loss and no visible ROS detection when cells were exposed to ultrasound for 30 s.

Doxorubicin combined with low intensity ultrasound suppresses the growth of oral squamous cell carcinoma in culture and in xenografts

Background

Oral squamous cell carcinoma (OSCC) invades surrounding tissues by upregulating matrix metalloproteinases (MMPs) -2 and −9, which causes over-expression of the Hedgehog signaling proteins Shh and Gli-1 and degradation of the extracellular matrix, thereby creating a “highway” for tumor invasion. We explored the potential of low intensity ultrasound (LIUS) and doxorubicin (DOX) to inhibit the formation of this “highway”.

Methods

MTT assays were used to examine OSCC cell viability after exposure to LIUS and DOX. The cell morphological changes and ultrastructure were detected by scanning electron microscopy and transmission electron microscopy. Endogenous autophagy-associated proteins were analyzed by immunofluorescent staining and western blotting. Cell migration and invasion abilities were evaluated by Transwell assays. Collagen fiber changes were evaluated by Masson’s trichrome staining. Invasion-associated proteins were analyzed by immunohistochemistry and western blotting.

Results

LIUS of 1 W/cm² increased the in vitro DOX uptake into OSCC by nearly 3-fold in three different cell lines and induced transient autophagic vacuoles on the cell surface. The combination of LIUS and 0.2 μg/ml DOX inhibited tumor cell viability and invasion, promoted tumor stromal collagen deposition, and prolonged the survival of mice. This combination also down-regulated MMP-2, MMP-9, Shh and Gli-1 in tumor xenografts. Collagen fiber expression was negatively correlated with the expression of these proteins in human OSCC samples.

Conclusions

Our findings suggest that effective low dosages of DOX in combination with LIUS can inhibit cell proliferation, migration and invasion, which might be through MMP-2/9 production mediated by the Hedgehog signaling pathway.

Electronic supplementary material

The online version of this article (10.1186/s13046-017-0633-y) contains supplementary material, which is available to authorized users.

Ultrasound reverses chemoresistance in breast cancer stem cell like cells by altering ABCG2 expression

Doxorubicin (DOX) resistance in breast cancer largely results from the breast cancer stem cell like cells (BCSCs) which could be targetted to improve the efficacy of chemotherapy. Cell permeabilization using microbubbles (MBs) and ultrasound (US) have the potential for delivering molecules into the cytoplasm. We aim to evaluate a new methodology of US on BCSCs. First, our findings indicated that ALDHA1⁺ spheres which were derived from fresh primary breast cancer samples displayed stem cell like features and were resistant to DOX. In patient cohort, we revealed the presence of a variable fraction of ALDHA1⁺cells in nine out of ten. We, for the first time, showed a new US-MB treatment condition which could be used on ALDHA1⁺ BCSCs by fluorescence measurement and calcein assay. Next, we demonstrated the efficacy of combined treatment on human BCSCs in vitro and in vivo using DOX and US-MB: the combined treatment with much reduced drug dosage significantly suppressed the stem cell like features of BCSCs and induced BCSCs apoptosis. Furthermore, we suggested that decreased ABCG2 level might be one of the mechanisms by which US-MB medicated DOX treatment. In conclusion, this new US-MB treatment condition has clinical potential in breast cancer therapy by targetting BCSCs; thereby holding benefits for breast cancer patients.

Ultrasonic-assisted environmentally-friendly synergetic synthesis of nitroaromatic compounds in core/shell nanoreactor: A green protocol

An efficient sonochemical protocol for the nitration of aromatic compounds was described in the presence of a catalytic amount of sulfuric acid-functionalized silica-based core/shell magnetic nanocomposite at room temperature in an eco-friendly and recyclable media, deep eutectic solvent (DES), based on choline chloride and urea. The particle size, morphology and elemental analysis of the core/shell nanocatalyst were carried out by TEM, SEM, EDX and XRD analyses. The nanocatalyst and DES were easily recovered from the reaction mixture quantitatively and reused several times.

Ultrasonic irradiation enhanced the ability of Fluorescein-DA-Fe(III) on sonodynamic and sonocatalytic damages of DNA molecules

The interaction of DNA with Bis [N,N-bis (carboxymethyl) aminomethyl] fluorescein-Ferrous(III) (Fluorescein-DA-Fe(III)) with dual functional (sonodynamic and sonocatalytic) activity was studied by UV-vis spectroscopy, fluorescence spectroscopy, FT-IR spectroscopy, circular dichroism (CD) spectroscopy and viscosity measurements. And then, the damage of DNA caused by Fluorescein-DA-Fe(III) under ultrasonic irradiation (US) was researched by agarose gel electrophoresis and cytotoxicity assay. Meanwhile, some influenced factors such as ultrasonic irradiation time and Fluorescein-DA-Fe(III) concentration on the damage degree of DNA molecules were also examined. As a control, for Bis [N,N-bis (carboxymethyl) aminomethyl] fluorescein (Fluorescein-DA), the same experiments were carried out. The results showed that both Fluorescein-DA-Fe(III) and Fluorescein-DA can interact with DNA molecules. Under ultrasonic irradiation, Fluorescein-DA shows sonodynamic activity, which can damage DNA molecules. While, in the presence of Fe(III) ion, the Fluorescein-DA-Fe(III) displays not only sonodynamic activity but also sonocatalytic activity under ultrasonic irradiation, which injures DNA more serious than Fluorescein-DA. The researches confirmed the dual function (sonodynamic activity and sonocatalytic activity) of Fluorescein-DA-Fe(III) and expanded the usage of Fluorescein-DA-Fe(III) as a sonosensitizer in sonodynamic therapy (SDT).

Luminescence from cavitation bubbles deformed in uniform pressure gradients

Presented here are observations that demonstrate how the deformation of millimetric cavitation bubbles by a uniform pressure gradient quenches single-collapse luminescence. Our innovative measurement system captures a broad luminescence spectrum (wavelength range, 300-900 nm) from the individual collapses of laser-induced bubbles in water. By varying the bubble size, driving pressure, and perceived gravity level aboard parabolic flights, we probed the limit from aspherical to highly spherical bubble collapses. Luminescence was detected for bubbles of maximum radii within the previously uncovered range, R_{0}=1.5-6 mm, for laser-induced bubbles. The relative luminescence energy was found to rapidly decrease as a function of the bubble asymmetry quantified by the anisotropy parameter ζ, which is the dimensionless equivalent of the Kelvin impulse. As established previously, ζ also dictates the characteristic parameters of bubble-driven microjets. The threshold of ζ beyond which no luminescence is observed in our experiment closely coincides with the threshold where the microjets visibly pierce the bubble and drive a vapor jet during the rebound. The individual fitted blackbody temperatures range between T_{lum}=7000 and T_{lum}=11500 K but do not show any clear trend as a function of ζ. Time-resolved measurements using a high-speed photodetector disclose multiple luminescence events at each bubble collapse. The averaged full width at half-maximum of the pulse is found to scale with R_{0} and to range between 10 and 20 ns.

Sonochemical rate enhanced by a new nanomagnetic embedded core/shell nanoparticles and catalytic performance in the multicomponent synthesis of pyridoimidazoisoquinolines

A sonochemical approach for the one-pot three-component synthesis of pyridoimidazoisoquinolines via by using phthalaldehyde, trimethylsilylcyanide and aminopyridines the presence of a catalytic amount of a new nanomagnetic catalyst Fe₃O₄@SiO₂-CO-C₆H₄-NH₂ is described. The characterization of the nanocatalyst and the product was done by various methods, such as FT-IR, SEM, EDX, TGA/DTA, NMR, MS and CHN analyses. This is the first design, preparation, characterization and application of the present core/shell nanomaterial and also the first ultrasound irradiated synthesis of the biologically and pharmaceutically important fused polycyclic compounds in ethanol as a green solvent. This novel protocol offers several advantages such as high yields, short reaction times, environmentally-friendly reaction media, easily isolation of the products, simple preparation and recoverability of the nanocatalyst by an external magnet and reusing several times without significant decrease in catalytic activity.

Ultrasonic assisted synergetic green synthesis of polycyclic imidazo(thiazolo)pyrimidines by using Fe3O4@clay core-shell

A practical and green approach for the ultrasound-enhanced one-pot multicomponent synthesis of tetraheterocyclic imidazo(thiazolo)pyrimidines is described via the condensation of an 2-aminobenzimidazole or 2-aminobenzothiazole, dimedone and various aldehydes in the presence of Fe₃O₄@clay as an environmentally benign and reusable core/shell nanocomposite catalyst in relatively quantitative yields. This novel eco-friendly protocol includes several advantages such as avoiding hazardous solvents, reusability of the catalyst, easy work-up, short reaction times, room temperature and mild reaction conditions. Furthermore, ultrasonic irradiation and synergistic catalyst showed considerable superiority vs. traditional heating or stirring conditions.

Ultrasonic treatment of CoFe2O4@B2O3-SiO2 as a new hybrid magnetic composite nanostructure and catalytic application in the synthesis of dihydroquinazolinones

New hybrid magnetic composite nanostructure are prepared via ultrasonic treatment by glass-ceramic method, characterized by field-emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD), vibrating sample magnetometer (VSM), energy-dispersive X-ray (EDX), element distribution image (EDX mapping), thermal gravimetric analysis (TGA)/differential thermal analysis (DTA) and N₂ adsorption-desorption by Brunauer-Emmett-Teller (BET) analyses. Then, the catalytic activity of the prepared CoFe₂O₄@B₂O₃-SiO₂ nanoparticles was tested in the synthesis of 2-substituted-3-(phenylamino)-dihydroquinazolin-4(1H)-ones in deep eutectic solvent (DES) based on choline chloride as an eco-friendly and recyclable media. This novel protocol offers several advantages such as high yields (70-93%), short reaction times (10-20min), environmentally-friendly reaction media, easily isolation of the products, simple preparation and recoverability of the nanocatalysts (at least 5 times), recyclability of the solvents from the reaction mixture without use of hazardous volatile organic solvent. The catalyst was readily recycled by the use of an external magnetic field and could be reused several times without significant loss of activity or mass. The saturation magnetization of CoFe₂O₄@B₂O₃-SiO₂ nanoparticles was 8.97emug^-1. Their average size distribution was about 12.5nm. DES was a mixture of choline chloride and urea that was recovered from the filtrate by evaporating the water under vacuum.

Fast and high temperature hyperthermia coupled with radiotherapy as a possible new treatment for glioblastoma

Background

A new transcranial focused ultrasound device has been developed that can induce hyperthermia in a large tissue volume. The purpose of this work is to investigate theoretically how glioblastoma multiforme (GBM) can be effectively treated by combining the fast hyperthermia generated by this focused ultrasound device with external beam radiotherapy.

Methods/Design

To investigate the effect of tumor growth, we have developed a mathematical description of GBM proliferation and diffusion in the context of reaction–diffusion theory. In addition, we have formulated equations describing the impact of radiotherapy and heat on GBM in the reaction–diffusion equation, including tumor regrowth by stem cells. This formulation has been used to predict the effectiveness of the combination treatment for a realistic focused ultrasound heating scenario.

Our results show that patient survival could be significantly improved by this combined treatment modality.

Discussion

High priority should be given to experiments to validate the therapeutic benefit predicted by our model.

Electronic supplementary material

The online version of this article (doi:10.1186/s40349-016-0078-3) contains supplementary material, which is available to authorized users.

Suppression of human 8-oxoguanine DNA glycosylase (OGG1) augments ultrasound-induced apoptosis in cervical cancer cells

PURPOSE

Human 8-oxoguanine DNA glycosylase (OGG1) is a major base excision repair enzyme, and it was reported to suppress the activation of intrinsic apoptotic signaling pathway in response to oxidative stress. In this study, our aim was to investigate the effects of OGG1 downregulation on ultrasound-induced apoptosis in cervical cancer cells.

METHODS

OGG1 expression was silenced by shRNA in the cervical cancer SW756 and CaSki cells. Cell viability was evaluated by MTT assay after OGG1 knockdown following ultrasound treatment. Ultrasound-induced apoptosis was measured by Annexin V-FITC/propidium iodide. Intracellular reactive oxygen species (ROS) production and Ca(2+) concentration were detected using a fluorescent probe, 2',7'-dichlorofluorescin diacetate (DCFH-DA) and a green fluorescent dye fluo-4AM, respectively. Western blotting was used to analyze the expression of Bcl-2, Bax, cleaved caspase-3, and nuclear factor-κB p65 (NF-κB p65).

RESULTS

The results indicated that OGG1 knockdown did not suppress cell proliferation, but significantly augmented ultrasound-induced inhibitory effects on the cell viability, and increased ultrasound-induced early apoptosis and late apoptosis and necrosis in the SW756 and CaSki cells when exposure to ultrasound (1MHz) at 1.5W/cm(2) for 30 and 60s. OGG1 knockdown significantly increased intracellular ROS production and Ca(2+) concentration after incubation of 6, 24, and 48h post-ultrasound treatment. The downregulation of Bcl-2 protein and the upregulation of Bax, cleaved caspase-3, and NF-κB p65 protein levels were observed in the shRNA-OGG1 cells and mock-shRNA cells, but no significant change of these protein levels was found between of them.

CONCLUSIONS

These results indicate that downregulation of OGG1 expression can augment ultrasound-induced apoptosis in cervical cancer cells, which suggests that OGG1 suppression might provide a new insight for ultrasound-induced therapeutic effects on cervical cancer treatment.

Micro/Nanoparticle-Augmented Sonodynamic Therapy (SDT): Breaking the Depth Shallow of Photoactivation

The fast development of photoactivation for cancer treatment provides an efficient photo-therapeutic strategy for cancer treatment, but traditional photodynamic or photothermal therapy suffers from the critical issue of low in vivo penetration depth of tissues. As a non-invasive therapeutic modality, sonodynamic therapy (SDT) can break the depth barrier of photoactivation because ultrasound has an intrinsically high tissue-penetration performance. Micro/nanoparticles can efficiently augment the SDT efficiency based on nanobiotechnology. The state-of-art of the representative achievements on micro/nanoparticle-enhanced SDT is summarized, and specific functions of micro/nanoparticles for SDT are discussed, from the different viewpoints of ultrasound medicine, material science and nanobiotechnology. Emphasis is put on the relationship of structure/composition-SDT performance of micro/nanoparticle-based sonosensitizers. Three types of micro/nanoparticle-augmented SDT are discussed, including organic and inorganic sonosensitizers and micro/nanoparticle-based but sonosensitizer-free strategies to enhance the SDT outcome. SDT-based synergistic cancer therapy augmented by micro/nanoparticles and their biosafety are also included. Some urgent critical issues and potential developments of micro/nanoparticle-augmented SDT for efficient cancer treatment are addressed. It is highly expected that micro/nanoparticle-augmented SDT will be quickly developed as a new and efficient therapeutic modality which will find practical applications in cancer treatment. At the same time, fundamental disciplines regarding materials science, chemistry, medicine and nanotechnology will be advanced.

Caveolin-1 Mediates Low-Intensity Ultrasound-Induced Apoptosis via Downregulation of Signal Transducer and Activator of Transcription 3 Phosphorylation in Laryngeal Carcinoma Cells

Low-intensity ultrasound therapy has been found to be a potential tool in the management of malignant tumors in recent years. However, the molecular mechanism underlying low-intensity ultrasound-induced apoptosis is still not clear. In this study, we investigated the effects of low-intensity ultrasound-induced apoptosis in HEp-2 cells. We found that low-intensity ultrasound significantly induced apoptosis, and the expression level of caveolin-1 (Cav-1) was dramatically increased after ultrasound treatment of HEp-2 cells. After inhibiting the expression level of Cav-1 using siRNA transfection, we found that the cellular apoptosis induced by low-intensity ultrasound was significantly suppressed. In addition, inhibition of Cav-1 expression promoted phosphorylation of signal transducer and activator of transcription 3 (STAT3), suggesting that the STAT3 signaling pathway was involved in low-intensity ultrasound-induced apoptosis via Cav-1 regulation. Our results indicate that Cav-1/STAT3 signaling pathway may mediate low-intensity ultrasound-induced apoptosis, and this technology could potentially be used clinically for the treatment of cancers.