1
|
Lavin L, Erlendsson AM, Aleissa S, Aleisa A, Menzer C, Dusza S, Cordova M, Alshaikh H, Shah R, Pan A, Ketosugbo K, Hosein S, Lee E, Nehal K, Togsverd-Bo K, Haedersdal M, Rossi A. Jet-injection assisted photodynamic therapy for superficial and nodular basal cell carcinoma: A pilot study. Lasers Surg Med 2024; 56:446-453. [PMID: 38804170 DOI: 10.1002/lsm.23793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/02/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Photodynamic therapy (PDT) with topical δ-Aminolevulinic acid (ALA) has efficacy in treating basal cell carcinoma (BCC) but is limited by incomplete penetration of ALA into the deeper dermis. This prospective open-label pilot trial investigated the safety and efficacy of photosensitizer jet injection for PDT (JI-PDT) for BCC treatment. It was performed with 15 patients (n = 15) with histologically confirmed, untreated, low-risk nodular BCCs at a single institution. METHODS For the intervention, JI-PDT patients (n = 11) received two sessions of jet-injected ALA with PDT separated by four to 6 weeks. To further understand treatment technique, another group of patients (n = 4) received jet-injected ALA followed by tumor excision and fluorescence microscopy (JI-E). Treatment tolerability was assessed by local skin responses (LSR) score at five distinct time intervals. Fluorescence microscopy assessed protoporphyrin IX penetration depth and biodistribution within the tumor. At the primary endpoint, tumor clearance was evaluated via visual inspection, dermoscopy and reflectance confocal microscopy. Postinjection and postillumination pain levels, and patient satisfaction, were scored on a 0-10 scale. RESULTS Fifteen participants with mean age of 58.3, who were 15/15 White, non-Hispanic enrolled. The median composite LSR score immediately after JI-PDT was 5 (interquartile range [IQR] = 3) which decreased to 0.5 (IQR = 1) at primary endpoint (p < 0.01). Immunofluorescence of excised BCC tumors with jet-injected ALA showed photosensitizer penetration into papillary and reticular dermis. Of the 13 JI-PDT tumors, 11 had tumor clearance confirmed, 1 recurred, and 1 was lost to follow-up. 1/11 patients experienced a serious adverse event of cellulitis. 70% of patients had local scarring at 3 months. Patients reported an average pain level of 5.6 (standard deviation [SD] = 2.3) during jet injection and 3.7 (SD = 1.8) during light illumination. CONCLUSIONS Jet injection of ALA for PDT treatment of nodular low-risk BCC is tolerable and feasible and may represent a novel modality to improve PDT.
Collapse
Affiliation(s)
- Leore Lavin
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrés M Erlendsson
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Saud Aleissa
- Department of Dermatology, King Abdulaziz University and University Hospital, Jeddah, Saudi Arabia
| | - Abdullah Aleisa
- Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Christian Menzer
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephen Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hesham Alshaikh
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rohan Shah
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Alexander Pan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kwami Ketosugbo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sharif Hosein
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Erica Lee
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Dermatology, Weill Cornell Medical College, New York, New York, USA
| | - Kishwer Nehal
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Dermatology, Weill Cornell Medical College, New York, New York, USA
| | - Katrine Togsverd-Bo
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anthony Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
| |
Collapse
|
2
|
Bekkers VZ, Bik L, van Huijstee JC, Wolkerstorfer A, Prens EP, van Doorn MBA. Efficacy and safety of needle-free jet injector-assisted intralesional treatments in dermatology-a systematic review. Drug Deliv Transl Res 2023; 13:1584-1599. [PMID: 36884194 PMCID: PMC10126042 DOI: 10.1007/s13346-023-01295-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 03/09/2023]
Abstract
Needle-free jet injectors are used for the intralesional treatment of various dermatological indications. However, a systematic review that evaluates the efficacy and safety of these treatments has not been published. The objectives of this study are to evaluate the efficacy and safety of needle-free jet injections for dermatological indications and to provide evidence-based treatment recommendations. An electronic literature search was conducted in April 2022. Two reviewers independently selected studies based on predefined criteria and performed a methodological quality assessment using the Cochrane Collaborations risk-of-bias 2.0 assessment tool and Newcastle-Ottawa Scale. Thirty-seven articles were included, involving 1911 participants. Dermatological indications included scars, alopecia areata, hyperhidrosis, nail diseases, non-melanoma skin cancer, common warts, local anesthesia, and aesthetic indications. Keloids and other types of scars (hypertrophic, atrophic, and burn scars) were investigated most frequently (n = 7). The included studies reported favorable efficacy and safety outcomes for intralesional jet injector-assisted treatment with triamcinolone acetonide/hexacetonide, 5-fluorouracil, bleomycin, or hyaluronic acid. Two high-quality studies showed good efficacy and tolerability of intralesional jet injections with a combination of 5-fluorouracil and triamcinolone acetonide in hypertrophic scars and with saline in boxcar and rolling acne scars. No serious adverse reactions and good tolerability were reported in the included studies. Overall, the methodological quality of the included studies was low. Limited evidence suggests that needle-free jet injector-assisted intralesional treatment is efficacious and safe for hypertrophic and atrophic acne scars. More well-powered RCTs investigating the efficacy and safety of jet injector treatment in dermatology are warranted to make further evidence-based recommendations.
Collapse
Affiliation(s)
| | - Liora Bik
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center, Location AMC, Amsterdam, the Netherlands
| | | | | |
Collapse
|
3
|
Krizek J, Lavickova B, Moser C. Degradation study on molecules released from laser-based jet injector. Int J Pharm 2021; 602:120664. [PMID: 33933639 DOI: 10.1016/j.ijpharm.2021.120664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 12/16/2022]
Abstract
Development of needle-free methods to administer injectable therapeutics has been researched for a few decades. We focused our attention on a laser-based jet injection technique where the liquid-jet actuation mechanism is based on optical cavitation. This study investigates the potential damage to therapeutic molecules which are exposed to nanosecond laser pulses in the configuration of a compact laser-based jet injection device. Implementation of a pulsed laser source at 1574 nm wavelength allowed us to generate jets from pure water solutions and circumvent the need to reformulate therapeutics with absorbing dyes. We performed H1-NMR analysis on exposed samples of Lidocaine and δ-Aminolevulinic acid. We made several tests with linear and plasmid DNA to assess the structural integrity and functional potency after ejection with our device. The tests showed no significant degradation or detectable side products, which is promising for further development and eventually clinical applications.
Collapse
Affiliation(s)
- Jan Krizek
- School of Engineering, Laboratory of Applied Photonics Devices, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015 Lausanne, Switzerland.
| | - Barbora Lavickova
- School of Engineering, Laboratory of Biological Network Characterisation, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015 Lausanne, Switzerland
| | - Christophe Moser
- School of Engineering, Laboratory of Applied Photonics Devices, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015 Lausanne, Switzerland.
| |
Collapse
|
4
|
Requena MB, Permana AD, Vollet-Filho JD, González-Vázquez P, Garcia MR, De Faria CMG, Pratavieira S, Donnelly RF, Bagnato VS. Dissolving microneedles containing aminolevulinic acid improves protoporphyrin IX distribution. JOURNAL OF BIOPHOTONICS 2021; 14:e202000128. [PMID: 32981235 DOI: 10.1002/jbio.202000128] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
One important limitation of topical photodynamic therapy (PDT) is the limited tissue penetration of precursors. Microneedles (MNs) are minimally invasive devices used to promote intradermal drug delivery. Dissolving MNs contain drug-associated to polymer blends, dissolving after insertion into skin, allowing drug release. This study comprises development and characterization of a pyramidal model of dissolving MNs (500 μm) prepared with 5% wt/wt aminolevulinic acid and 20% wt/wt Gantrez AN-139 in aqueous blend. Protoporphyrin IX formation and distribution were evaluated in tumor mice model by using fluorescence widefield imaging, spectroscopy, and confocal microscopy. MNs demonstrated excellent mechanical resistance penetrating about 250 μm with minor size alteration in vitro, and fluorescence intensity was 5-times higher at 0.5 mm on average compared to cream in vivo (being 10 ± 5 a.u. for MNs and 2.4 ± 0.8 a.u. for cream). Dissolving MNs have overcome topical cream application, being extremely promising especially for thicker skin lesions treatment using PDT.
Collapse
Affiliation(s)
| | - Andi Dian Permana
- School of Pharmacy, Queen's University Belfast, Belfast, UK
- Department of Pharmaceutics, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
| | | | | | - Marlon Rodrigues Garcia
- Department of Mechanical Engineering, University of São Paulo, São Carlos, São Paulo, Brazil
| | | | - Sebastião Pratavieira
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | | | - Vanderlei Salvador Bagnato
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
- Hagler Institute for Advanced Studies,Texas A&M University, College Station, Texas, USA
| |
Collapse
|
5
|
Krizek J, De Goumoëns F, Delrot P, Moser C. Needle-free delivery of fluids from compact laser-based jet injector. LAB ON A CHIP 2020; 20:3784-3791. [PMID: 32902554 DOI: 10.1039/d0lc00646g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Jet injection devices have been studied and developed for transdermal drug delivery to avoid the use of needles. Due to bulky actuation mechanisms, they are limited to body areas that are easy to reach such as skin. Here, we demonstrate a thin and long liquid delivery system (e.g. flexible and 30 cm long with 1.2 mm outer diameter) compatible with minimally invasive surgical procedures. The actuation mechanism is based on optical cavitation in a capillary nozzle where a laser pulse is delivered via a multimode optical fibre. We show good controllability of the jet speed by varying the actuation laser fluence. The generated jets can successfully penetrate into a 1% agarose gel which is representative of the mechanical properties of several soft body tissues. We further observe that when the system is used in a low laser energy regime (<60 μJ), the ejection is in the form of the single droplet which is promising for fluid delivery with high volume precision or drop-on-demand inkjet printing. The jet injection system we propose has the potential to deliver heat-sensitive therapeutics as we show processing of biomolecules without altering their functionality.
Collapse
Affiliation(s)
- Jan Krizek
- School of Engineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015 Lausanne, Switzerland.
| | | | | | | |
Collapse
|
6
|
Zhao W, Wang J, Zhang Y, Zheng B. A retrospective study comparing different injection approaches of 5-aminolevulinic acid in patients with non-melanoma skin cancer. J DERMATOL TREAT 2020; 33:1465-1472. [PMID: 33016837 DOI: 10.1080/09546634.2020.1832186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND 5-aminolevulinic acid through a needle-free, plum-blossom needle or conventional needle followed by photodynamic therapy are available options for non-melanoma skin cancer treatment. AIM To compare these three techniques of injection of 5-aminolevulinic, regarding treatment response and adverse effects in patients with non-melanoma skin cancer. PATIENTS AND METHODS Non-melanoma skin cancer patients have received six cycles of 0.5 mL intralesional 20% w/v 5-aminolevulinic acid through a conventional needle (CPT cohort, n = 158), or plum-blossom needle (BPT cohort, n = 118), or needle-free injection (NPT cohort, n = 105) followed by irradiation with a red light. Data regarding treatment response and adverse effects were collected and analyzed. RESULTS The treatment response was higher among patients of NPT cohort than those of CPT (p = .012, q = 3.981) and BPT (p = .012, q = 3.472) cohorts. Conventional and plum-blossom needle injections therapies were reported scar, local redness, and worse cosmetic appearance in the follow-up period. CONCLUSIONS Needle-free injection of intralesional 5-aminolevulinic acid followed by irradiation with red light therapy were reported high treatment response with manageable adverse effects for non-melanoma skin cancer patients than that of conventional and plum-blossom needle injections. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Weihong Zhao
- Department of Dermatology, Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Jun Wang
- Department of Dermatology; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China
| | - Ying Zhang
- Department of Dermatology, Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Baoyong Zheng
- Department of Dermatology, Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| |
Collapse
|
7
|
Christensen RL, Omland SH, Persson DP, Husted S, Haedersdal M, Olesen UH. Topical Delivery of Nivolumab, a Therapeutic Antibody, by Fractional Laser and Pneumatic Injection. Lasers Surg Med 2020; 53:154-161. [PMID: 32997833 DOI: 10.1002/lsm.23322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES PD-L1 is a tumor ligand that binds to the PD-1 receptor on immune cells, thereby inhibiting the antitumor immune response. The antibody nivolumab is a PD-1 inhibitor, Food and Drug Administration approved for systemic treatment of several aggressive cancer types. Topically applied nivolumab may hold potential as a future strategy to treat keratinocyte cancer, but its molecular properties preclude unassisted topical uptake. The aim of this study was to investigate uptake and biodistribution of topically delivered nivolumab, assisted by two physical enhancement techniques with different delivery kinetics; ablative fractional laser (AFL) and electronically controlled pneumatic injection (EPI). STUDY DESIGN/MATERIALS AND METHODS In vitro porcine skin was exposed to CO2 AFL (20 mJ/mb, 5% density), followed by passive diffusion of nivolumab in a Franz cell (1 mg/ml, 18 hours, n = 6) or treated with EPI (4 bar) for immediate delivery of nivolumab (1 mg/ml, 10 minutes, n = 6). The resulting nivolumab skin concentrations were quantified by enzyme-linked immunosorbent assay (ELISA) at three skin depths (100, 500, and 1500 µm), comparing the uptake from assisted delivery with intact skin. Biodistribution of nivolumab in the skin for all interventions was visualized by laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) and fluorescence microscopy. RESULTS Delivery of nivolumab by AFL-assisted passive diffusion and immediate EPI both resulted in significantly enhanced uptake of nivolumab in all skin depths compared with intact skin (P < 0.05). With AFL, nivolumab concentrations reached 86.3 µg/cm3 (100 µm), 105.8 µg/cm3 (500 µm), and 19.3 µg/cm3 (1500 µm), corresponding to 2-10% of the applied concentration, with the highest deposition in the mid dermis. Immediate EPI delivered 429.4 µg/cm3 (100 µm), 584.9 µg/cm3 (500 µm), and 295.9 µg/cm3 (1500 µm) into the skin, corresponding to 29-58% of the applied nivolumab concentration. From qualitative visualization of the biodistribution, it appeared that nivolumab distributed in a horizontal and continuous homogenous band in the upper and mid dermis through AFL-exposed skin, whereas EPI-delivery showed a deep focal deposition extending into the deep dermis. CONCLUSIONS AFL-assisted passive diffusion and immediate EPI-assisted delivery show the potential to deliver therapeutic antibodies locally. Future in vivo and pharmacokinetic studies would reveal the full potential for topical antibody delivery by energy-based devices. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Rikke L Christensen
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, 2400, Denmark
| | - Silje H Omland
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, 2400, Denmark
| | - Daniel P Persson
- Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Frederiksberg, 1870, Denmark
| | - Søren Husted
- Department of Plant and Environmental Sciences, Faculty of Science, University of Copenhagen, Frederiksberg, 1870, Denmark
| | - Merete Haedersdal
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, 2400, Denmark
| | - Uffe H Olesen
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, 2400, Denmark
| |
Collapse
|
8
|
Bik L, van Doorn MBA, Biskup E, Ortner VK, Haedersdal M, Olesen UH. Electronic Pneumatic Injection-Assisted Dermal Drug Delivery Visualized by Ex Vivo Confocal Microscopy. Lasers Surg Med 2020; 53:141-147. [PMID: 32515075 PMCID: PMC7891353 DOI: 10.1002/lsm.23279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/05/2020] [Accepted: 05/23/2020] [Indexed: 12/14/2022]
Abstract
Background and Objectives Electronic pneumatic injection (EPI) is a technique for dermal drug delivery, which is increasingly being used in clinical practice. However, only few studies have been reported on cutaneous drug distribution and related clinical endpoints. We aimed to visualize the immediate cutaneous drug distribution, changes in skin architecture, and related clinical endpoint of EPI. Study Design/Materials and Methods Acridine orange (AO) solution was administered to ex vivo porcine skin by EPI at pressure levels from 4 to 6 bar with a fixed injection volume of 50 µl and nozzle size of 200 µm. Immediate cutaneous distribution was visualized using ex vivo confocal microscopy (EVCM). Changes in skin architecture were visualized using both EVCM and hematoxylin and eosin‐stained cryosections. Results The defined immediate endpoint was a clinically visible papule formation on the skin. The pressure threshold to consistently induce a papule was 4 bar, achieving delivery of AO to the deep dermis (2319 µm axial and 5944 µm lateral distribution). Increasing the pressure level to 6 bar did not lead to significant differences in axial and lateral dispersion (P = 0.842, P = 0.905; respectively). A distinctively hemispherical distribution pattern was identified. Disruption of skin architecture occurred independently of pressure level, and consisted of subepidermal clefts, dermal vacuoles, and fragmented collagen. Conclusions This is the first study to relate a reproducible clinical endpoint to EPI‐assisted immediate drug delivery using EVCM. An EPI‐induced skin papule indicates dermal drug delivery throughout all layers of the dermis, independent of pressure level settings. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC
Collapse
Affiliation(s)
- Liora Bik
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark.,Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Edyta Biskup
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Vinzent K Ortner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Uffe H Olesen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| |
Collapse
|
9
|
Krizek J, Delrot P, Moser C. Repetitive regime of highly focused liquid microjets for needle-free injection. Sci Rep 2020; 10:5067. [PMID: 32193435 PMCID: PMC7081207 DOI: 10.1038/s41598-020-61924-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/27/2020] [Indexed: 11/08/2022] Open
Abstract
Fast liquid jets are investigated for use as a needle-free drug delivery system into an elastic tissue such as skin. Using smaller jet diameters in a repetitive regime can mitigate bruising and pain associated with current injectors. In this study, we aim to unravel the potential of the method to deliver liquids into biological tissues having higher elasticity than healthy skin (i.e >60 kPa). To address this challenge, we have implemented a laser-based jetting system capable of generating supersonic liquid microjets in a repetitive regime. We provide insights on the penetration of microjets into hydrogel samples with elastic modulus ranging from 16 kPa to 0.5 MPa. The unprecedented speeds of injection (>680 m/s) together with a newly introduced repetitive regime opens possibilities for usage in needle-free drug administration into materials with elasticity covering the wide spectrum of biological soft tissues like blood vessels, all skin layers, scarred or dried skin or tumors.
Collapse
Affiliation(s)
- Jan Krizek
- School of Engineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015, Lausanne, Switzerland.
| | - Paul Delrot
- School of Engineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015, Lausanne, Switzerland
| | - Christophe Moser
- School of Engineering, Swiss Federal Institute of Technology in Lausanne (EPFL), Station 17, 1015, Lausanne, Switzerland
| |
Collapse
|
10
|
Requena MB, Vollet Filho JD, Barboza de Nardi A, Escobar A, da Rocha Adams R, Bagnato VS, de Menezes PFC. Topical and intradermal delivery of PpIX precursors for photodynamic therapy with intense pulsed light on porcine skin model. Lasers Med Sci 2019; 34:1781-1790. [PMID: 30903526 DOI: 10.1007/s10103-019-02771-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/06/2019] [Indexed: 11/26/2022]
Abstract
In order to purposely decrease the time of the photodynamic therapy (PDT) sessions, this study evaluated the effects of PDT using topical and intradermal delivery of two protoporphyrin (PpIX) precursors with intense pulsed light (IPL) as irradiation source. This study was performed on porcine skin model, using an IPL commercial device (Intense Pulse Light, HKS801). IPL effect on different administration methods of two PpIX precursors (ALA and MAL) was investigated: a topical cream application and an intradermal application using a needle-free, high-pressure injection system. Fluorescence investigation showed that PpIX distribution by needle-free injection was more homogeneous than that by cream, suggesting that a shorter drug-light interval in PDT protocols is possible. The damage induced by IPL-PDT assessed by histological analysis mostly shows modifications in collagens fibers and inflammation signals, both expected for PDT. This study suggested an alternative protocol for the PDT treatment, possibility half of the incubation time and with just 3 min of irradiation, making the IPL-PDT, even more, promising for the clinical treatment.
Collapse
Affiliation(s)
| | - José Dirceu Vollet Filho
- São Carlos Institute of Physics, University of São Paulo (USP), São Carlos, São Paulo, Brazil
- Institute of Geosciences and Exact Sciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
| | - Andrigo Barboza de Nardi
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Andre Escobar
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Rozana da Rocha Adams
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | | | | |
Collapse
|
11
|
Schwake M, Nemes A, Dondrop J, Schroeteler J, Schipmann S, Senner V, Stummer W, Ewelt C. In-Vitro Use of 5-ALA for Photodynamic Therapy in Pediatric Brain Tumors. Neurosurgery 2018; 83:1328-1337. [PMID: 29538709 DOI: 10.1093/neuros/nyy054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/01/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Light irradiation (635 nm) of cells containing protoporphyrin IX (PPIX) after 5- aminolevulinic acid (5-ALA) pretreatment causes cell death via different pathways including apoptosis and necrosis, as previously demonstrated for malignant glioma cells. OBJECTIVE To elucidate whether various malignant pediatric brain tumors, which have been shown to accumulate PPIX, would also be susceptible to photodynamic therapy (PDT). METHODS Medulloblastoma (DAOY, UW228), pNET (PFSK-1), and rhabdoid tumor (BT16) cell lines were incubated with 5-ALA in variable concentrations for 4 h. Consequently, cells were irradiated by 635 nm diode laser light. After 12 h, cell viability was measured by WST-1 testing and these results were compared to control cells incubated with 5-ALA without irradiation or irradiation only without prior incubation with 5-ALA. RESULTS We demonstrated significant cell death in malignant pediatric tumor cells after incubation with 5-ALA and laser irradiation in comparison to control groups. In all cell lines, we noticed significant cell death above a 5-ALA concentration of 50 μg/ml (P < .05). Neither 5-ALA incubation alone nor irradiation alone caused cell death. DAOY and PFSK cell lines were more susceptible than UW228 and BT16 cells. CONCLUSION We conclude that PDT causes cell death with higher PPIX concentrations after exposure to 5-ALA in vitro in accordance to similar studies with glioma cells. This indicates that PDT might be feasible for eliminating brain tumor cells in malignant pediatric brain tumors. Additionally, we noticed a dependency between fluorescence intensity and death rates.
Collapse
Affiliation(s)
- Michael Schwake
- Department of Neurosurgery, University Hospital Muenster, Muenster, Germany
| | - Andrei Nemes
- Institute of Neuropathology, University Hospital Muenster, Muenster, Germany
| | - Jana Dondrop
- Department of Neurosurgery, University Hospital Muenster, Muenster, Germany
| | | | | | - Volker Senner
- Department of Neurosurgery, University Hospital Muenster, Muenster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Muenster, Muenster, Germany
| | - Christian Ewelt
- Department of Neurosurgery, University Hospital Muenster, Muenster, Germany
| |
Collapse
|
12
|
Moret F, Reddi E. Strategies for optimizing the delivery to tumors of macrocyclic photosensitizers used in photodynamic therapy (PDT). J PORPHYR PHTHALOCYA 2017. [DOI: 10.1142/s1088424617300014] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This review briefly summaries the principles and mechanisms of action of photodynamic therapy (PDT) as concerns its application in the oncological field, highlighting its drawbacks and some of the strategies that have been or are being explored to overcome them. The major aim is to increase the efficiency and selectivity of the photosensitizer (PS) uptake in the cancer cells for optimizing the PDT effects on tumors while sparing normal cells. Some attempts to achieve this are based on the conjugation of the PS to biomolecules (small ligands, peptides) functioning as carriers with the ability to efficiently penetrate cells and/or specifically recognize and bind proteins/receptors overexpressed on the surface of cancer cells. Alternatively, the PS can be entrapped in nanocarriers derived from various types of materials that can target the tumor by exploiting the enhanced permeability and retention (EPR) effects. The use of nanocarriers is particularly attractive because it allows the simultaneous delivery of more than one drug with the possibility of combining PDT with other therapeutic modalities.
Collapse
Affiliation(s)
- Francesca Moret
- Department of Biology, University of Padova, via U. Bassi 58/B 35121 Padova, Italy
| | - Elena Reddi
- Department of Biology, University of Padova, via U. Bassi 58/B 35121 Padova, Italy
| |
Collapse
|