3D-Printed Radiopaque Microdevices with Enhanced Mucoadhesive Geometry for Oral Drug Delivery

During the past decades, microdevices have been evaluated as a means to overcome challenges within oral drug delivery, thus improving bioavailability. Fabrication of microdevices is often limited to planar or simple 3D designs. Therefore, this work explores how microscale stereolithography 3D printing can be used to fabricate radiopaque microcontainers with enhanced mucoadhesive geometries, which can enhance bioavailability by increasing gastrointestinal retention. Ex vivo force measurements suggest increased mucoadhesion of microcontainers with adhering features, such as pillars and arrows, compared to a neutral design. In vivo studies, utilizing planar X-ray imaging, show the time-dependent gastrointestinal location of microcontainers, whereas computed tomography scanning and cryogenic scanning electron microscopy reveal information about their spatial dynamics and mucosal interactions, respectively. For the first time, the effect of 3D microdevice modifications on gastrointestinal retention is traced in vivo, and the applied methods provide a much-needed approach for investigating the impact of device design on gastrointestinal retention.

A thermosensitive Pickering gel emulsion with a high oil-water ratio for long-term X-ray imaging and permanent embolization of arteries

Iodized oil has an excellent X-ray imaging effect, but it shows poor embolization performance. When used as an embolic agent, it is easily washed off by the blood flow and eliminated from the body. Therefore, it is essential to use iodized oil in combination with solid embolic agents such as gelatin sponge or to perform multiple embolization procedures to achieve the therapeutic effect. In the present study, a poly(N-isopropyl acrylamide)-co-acrylic acid (PNCAA) temperature-sensitive nanogel was synthesized by emulsion polymerization; the nanogel was then emulsified with iodized oil to prepare a thermosensitive iodized oil Pickering gel emulsion (TIPE). The oil-water (O/W) ratio of an O/W emulsion system can reach 4 : 6. When injected into the body, TIPE transforms into a nonflowing coagulated state at physiological temperature; the iodized oil is locked in the emulsion structure, thereby achieving local embolization and continuous imaging effects, which not only retain the X-ray imaging effect of the iodized oil but also improve its embolization effect. Subsequently, we further evaluated renal artery embolization in a normal rabbit renal artery model, and the results showed that TIPE shows a long-term conformal embolization performance and excellent long-term X-ray imaging ability.

Renal and hepatic artery embolization with Pickering gel emulsion of lipiodol in rabbit

OBJECTIVE

This research aimed to evaluate the feasibility of a novel liquid embolic agent Pickering gel emulsion of lipiodol (PGEL) for renal and hepatic artery embolization in the rabbit experimental model.

METHODS

Embolization was performed in the right renal artery of 24 adult New Zealand White rabbits and 24 VX2 tumors in the left liver lobe. The rabbits were randomly allocated to four treatment groups (n = 6 per group): (A) normal saline (NS), (B) lipiodol, (C) 180-300 μm polyvinyl alcohol (PVA), and (D) PGEL.

RESULTS

Renal artery embolization in normal rabbits and transarterial embolization (TAE) in VX2 tumor-bearing rabbits indicated that PGEL achieved a better embolization effect for a longer time than lipiodol and PVA. The tumor growth ratio of the PGEL group was significantly lower than that of the NS, lipiodol, and PVA groups at 3 (P < 0.001) and 7 (P < 0.001) days after embolization. In addition, hematoxylin and eosin and immunohistochemical staining revealed that the tumor necrosis ratio was higher in the PGEL group than in the NS, lipiodol, and PVA groups (P < 0.01), and the expression levels of HIF-1α, VEGF, and CD31 decreased after PGEL embolization compared with the lipiodol and PVA treatments.

CONCLUSION

PGEL is an effective embolic material that provides immediate and total occlusion of the renal artery and may be a potential therapeutic embolic agent for TAE of HCC.

Recent advances and applications of microspheres and nanoparticles in transarterial chemoembolization for hepatocellular carcinoma

Transarterial chemoembolization (TACE) is a recommended treatment for patients suffering from intermediate and advanced hepatocellular carcinoma (HCC). As compared to the conventional TACE, drug-eluting bead TACE demonstrates several advantages in terms of survival, treatment response, and adverse effects. The selection of embolic agents is critical to the success of TACE. Many studies have been performed on the modification of the structure, size, homogeneity, biocompatibility, and biodegradability of embolic agents. Continuing efforts are focused on efficient loading of versatile chemotherapeutics, controlled sizes for sufficient occlusion, real-time detection intra- and post-procedure, and multimodality imaging-guided precise treatment. Here, we summarize recent advances and applications of microspheres and nanoparticles in TACE for HCC. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease.

Fabrication of Fe3O4@PVA microspheres by one-step electrospray for magnetic resonance imaging during transcatheter arterial embolization

Magnetic resonance imaging (MRI) has attracted increasing attention as a feasible alternative or adjunctive imaging modality for X-ray digital subtraction angiography because of the high tissue resolution and non-ionization radiation. In this study, a one-step electrospray method was developed to fabricate PVA microspheres encapsulated with in situ synthesized Fe₃O₄ nanoparticles. Fe₃O₄@PVA microspheres were mono-dispersed black spheres with a wide range of sizes (262-958 µm). The in situ-synthesized Fe₃O₄ nanoparticles were used as the contrast agent of MRI and the cross-linkers of PVA matrixes for the embolization purpose. In vivo evaluation of renal arteries of normal rabbits showed that Fe₃O₄@PVA microspheres had good embolic effect and enhanced capability of MRI. In vitro and in vivo biosafety assessment confirmed that Fe₃O₄@PVA microspheres had favorable biocompatibility. The DOX-loaded Fe₃O₄@PVA microspheres showed a typical drug-sustained release profile. These results suggest that the prepared DOX-loaded Fe₃O₄@PVA microspheres have the function of MRI, embolotherapy and chemotherapy. We expect our study could provide a simple and useful approach for the systematic design, fabrication, and application of a new type of magnetic microspheres as a triple-functional embolic agent for the development of MRI-guided TACE. STATEMENT OF SIGNIFICANCE: Due to the low tissue resolution and hazardous ionization radiation of X-ray digital subtraction angiography, it is beneficial to study MR imaging embolic microspheres for the development of MRI-guided TACE. In this study, a one-step electrospray method was firstly developed to fabricate PVA microspheres encapsulated with in situ synthesized Fe₃O₄ nanoparticles. Then, chemotherapeutic agent (DOX), contrast media of MRI (Fe₃O₄) and embolic agent (PVA matrix) were combined together in one body (DOX-loaded Fe₃O₄@PVA microspheres) to achieve the triple effects of chemotherapy, MR imaging and embolization. This triple-functional embolic agent offers potential for the future development of MRI-guided TACE.

Magnetic liquid metal loaded nano-in-micro spheres as fully flexible theranostic agents for SMART embolization

Transcatheter arterial chemoembolization (TACE) has become one of the preferred choices for advanced liver cancer patients. Current clinically used microsphere embolic agents, such as PVA, gelatin, and alginate microspheres, have limited therapeutic efficacy and lack the function of real-time imaging. In this work, we fabricated magnetic liquid metal nanoparticle (Fe@EGaIn NP) loaded calcium alginate (CA) microspheres (denoted as Fe@EGaIn/CA microspheres), which integrate CT/MR dual-modality imaging and photothermal/photodynamic functions of the Fe@EGaIn NP core, as well as embolization and drug-loading functions of CA microspheres. Namely, such nano-in-micro spheres can be used as fully flexible theranostic agents to achieve smart-chemoembolization. It has been confirmed by in vitro and in vivo experiments that Fe@EGaIn/CA microspheres have advantageous morphology, favorable biocompatibility, splendid versatility, and advanced embolic efficacy. Benefiting from these properties, excellent therapeutic efficiency was achieved with a tumor growth-inhibiting value of 100% in tumor-bearing rabbits. As a novel microsphere embolic agent with promising therapeutic efficacy and diagnostic capability, Fe@EGaIn/CA microspheres have shown potential applications in clinical transcatheter arterial chemoembolization. And the preparation strategy presented here provides a generalized paradigm for achieving multifunctional and fully flexible theranostics.

Immobilized thrombin on X-ray radiopaque polyvinyl alcohol/chitosan embolic microspheres for precise localization and topical blood coagulation

Trans-catheter arterial embolization (TAE) plays an important role in treating various diseases. The available embolic agents lack X-ray visibility and do not prevent the reflux phenomenon, thus hindering their application for TAE therapy. Herein, we aim to develop a multifunctional embolic agent that combines the X-ray radiopacity with local procoagulant activity. The barium sulfate nanoparticles (BaSO₄ NPs) were synthesized and loaded into the polyvinyl alcohol/chitosan (PVA/CS) to prepare the radiopaque BaSO₄/PVA/CS microspheres (MS). Thereafter, thrombin was immobilized onto the BaSO₄/PVA/CS MS to obtain the thrombin@BaSO₄/PVA/CS MS. The prepared BaSO₄/PVA/CS MS were highly spherical with diameters ranging from 100 to 300 μm. In vitro CT imaging showed increased X-ray visibility of BaSO₄/PVA/CS MS with the increased content of BaSO₄ NPs in the PVA/CS MS. The biocompatibility assessments demonstrated that the MS were non-cytotoxic and possessed permissible hemolysis rate. The biofunctionalized thrombin@BaSO₄/PVA/CS MS showed improved hemostatic capacity and facilitated hemostasis in vitro. Additionally, in vivo study performed on a rabbit ear embolization model confirmed the excellent X-ray radiopaque stability of the BaSO₄/PVA/CS MS. Moreover, both the BaSO₄/PVA/CS and thrombin@BaSO₄/PVA/CS MS achieved superior embolization effects with progressive ischemic necrosis on the ear tissue and induced prominent ultrastructural changes in the endothelial cells. The findings of this study suggest that the developed MS could act as a radiopaque and hemostatic embolic agent to improve the embolization efficiency.

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Excellent in vitro and in vivo visibility of BaSO₄/PVA/CS MS.

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Excellent cytocompatibility and hemocompatibility of BaSO₄/PVA/CS MS.

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Enhanced hemostatic capacity and hemostasis of thrombin@BaSO₄/PVA/CS MS.

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Potential application of thrombin@BaSO₄/PVA/CS MS for in vivo embolization.

A near-infrared light-triggered shape-memory polymer for long-time fluorescence imaging in deep tissues

Implanting a stent in the body through a minimally invasive operation and tracking its location in real-time is still a challenge. Herein, a near-infrared (NIR) light-triggered shape-memory polymer possessing a long-time fluorescence imaging function has been developed by cross-linking 6-arm poly(ethylene glycol)-poly(ε-caprolactone) using a croconate dye YHD798 as the chemical crosslinker and NIR-absorption perssad. Due to the extraordinary photothermal conversion property of YHD798, the temperature of the material raised from 20 °C to 120 °C under 808 nm near-infrared irradiation at 0.4 W cm^-2, leading to shape recovery in 50 s in a programmed shape-transition process. YHD798 also exerted an aggregation-induced emission effect, endowing the polymer with a clear NIR fluorescence imaging function even when covered by a 2 mm pork slab and could be used for the real-time visualization of the implanted device fabricated from this polymer in deep tissues of the body. When a tubular stent that was fabricated from this polymer, was implanted into the carotid artery of a Sprague-Dawley rat, it could recover to its permanent shape under 808 nm laser irradiation in 60 s owing to the shape-memory function and facilitated NIR-I fluorescence imaging after implantation for a week owing to the croconate dye. This work provides a new strategy for designing and developing smart polymers with NIR-light-triggered shape-memory effect and long-term fluorescence imaging function for biomedical applications.

Smart Nanotherapeutic Targeting of Tumor Vasculature

The past decades have witnessed the development of a field dedicated to targeting tumor vasculature for cancer therapy. In contrast to conventional chemotherapeutics that need to penetrate into tumor tissues for killing tumor cells, the agents targeting tumor vascular system have two major advantages: direct contact with vascular endothelial cells or the blood and less possibility to induce drug resistance because of high gene stability of endothelial cells. More specifically, various angiogenesis inhibitors (AIs) and vascular disrupting agents (VDAs) that block tumor blood supply to inhibit tumor progression, some of which have been applied clinically, have been described. However, off-target effects and high effective doses limit the utility of these formulations in cancer patients. Thus, new strategies with improved therapeutic efficacy and safety are needed for tumor vessel targeting therapy. With the burgeoning developments in nanotechnology, smart nanotherapeutics now offer unprecedented potential for targeting tumor vasculature. Based on specific structural and functional features of the tumor vasculature, a number of different nanoscale delivery systems have been proposed for cancer therapy. In this Account, we summarize several distinct strategies to modulate tumor vasculature with various smart nanotherapeutics for safe and effective tumor therapy developed by our research programs. Inspired by the blood coagulation cascade, we generated nanoparticle-mediated tumor vessel infarction strategies that selectively block tumor blood supply to starve the tumor to death. By specifically delivering thrombin loaded DNA nanorobots (Nanorobot-Th) into tumor vessels, an intratumoral thrombosis is triggered to induce vascular infarction and, ultimately, tumor necrosis. Mimicking the coagulation cascade, a smart polymeric nanogel achieves permanent and peripheral embolization of liver tumors. Considering the critical role of platelets in maintaining tumor vessel integrity, a hybrid (PLP-D-R) nanoparticle selectively depleting tumor-associated platelets (TAP) to boost tumor vessel permeability was developed for enhancing intratumoral drug accumulation. In addition, benefiting from a better understanding of the molecular and cellular underpinnings of vascular normalization, several tumor acidity responsive nanotherapeutics, encapsulating therapeutic peptides, and small interfering RNA were developed to correct the abnormal features of the tumor vasculature. This made the tumor vessels more efficient for drug delivery. While we are still exploring the mechanisms of action of these novel nanoformulations, we expect that the strategies summarized here will offer a promising platform to design effective next-generation nanotherapeutics against cancer and facilitate the clinical translation of smart nanotherapeutics that target tumor vasculature.