Exogenous sickle erythrocytes combined with vascular disruption trigger disseminated tumor vaso-occlusion and lung tumor regression

Biomaterials-Mediated Tumor Infarction Therapy

Agents for tumor vascular infarction are recently developed therapeutic agents for the vascular destruction of tumors. They can suppress the progression of the tumor by preventing the flow of nutrition and oxygen to its tissues. Agents of tumor vascular infarction can be divided into three categories according to the differences in their pathways of action: those that use the thrombin-activating pathway, fibrin-activating pathway, and platelet-activating pathway. However, poor targeting ability, low permeation, and potential side-effects restrict the development of the corresponding drugs. Biomaterials can subtly avoid these drawbacks to suppress the tumor. In this article, the authors summarize currently used biomaterials for tumor infarction therapy with the goal of identifying its mechanism, and discuss outstanding deficiencies in methods of this kind.

The Prevalence of Uterine Fibroids in African American Women with Hemoglobin SS Sickle Cell Disease as Determined by Pelvic Magnetic Resonance Imaging

RATIONALE AND OBJECTIVES

This study explores the relationship between the development of uterine fibroids and hemoglobin SS sickle cell disease (SCD) by examining the prevalence of uterine fibroids as detected by pelvic magnetic resonance imaging (MRI) in African American (AA) women with and without SCD.

MATERIALS AND METHODS

A single-center, retrospective review was performed of all adult AA women at a large, academic medical center who received pelvic MRI from January 1, 2007 to December 31, 2018. Propensity score matching conditional on age and ZIP code evaluated the differences in fibroid prevalence between the two groups. Subanalyses by age in 10-year intervals were also performed.

RESULTS

Twenty-one (23.9%) of 88 patients with SCD had fibroids on pelvic MRI versus 1493 (52.1%) of 2868 patients without SCD (p value <0.001). After propensity score matching, 21 (24.7%) of 85 patients with SCD compared to 52 (61.2%) of 85 patients without SCD had fibroids (p value <0.001). Subanalyses in 10-year age intervals showed significance for patients between 30 and 39 years old in which 4 (13.8%) of 29 SCD patients versus 374 (65.3%) of 573 no SCD patients had fibroids (p value <0.001), and for patients between 40 and 49 years old in which 9 (42.9%) of 21 SCD patients versus 667 (73.8%) of 904 no SCD patients had fibroids (p value = 0.002).

CONCLUSION

These findings indicate an overall significantly lower prevalence of uterine fibroids in AA women with SCD, suggesting that SCD may be protective against the development of uterine fibroids in these patients.

Positioning Remodeling Nanogels Mediated Codelivery of Antivascular Drug and Autophagy Inhibitor for Cooperative Tumor Therapy

Tumor vasculature and enhanced autophagy collectively provide the source of nutrients for tumor growth, invasion, and metastasis. Blocking the source of nutrients will be a novel and promising antitumor approach. Herein, we exploited an intelligent nanogel (CA4-FeAlg/HCQ) with a positioning remodeling feature to precisely kill A549 cancer cells in all directions based on frontal and rear attack strategies. CA4-FeAlg/HCQ nanogels could remain stable during blood circulation. When they reached the tumor vascular site, the vascular blocker combretastatin A4 (CA4) would be released at first to exert an antiangiogenic effect. Thereafter, FeAlg/HCQ disintegrated into small nanogels (<30 nm) for tumor deep penetration. Once small nanogels entered tumor cells, FeAlg/HCQ would undergo phase remodeling (gel to sol) to release the autophagy inhibitor hydroxychloroquine (HCQ) quickly. The autophagy induced by CA4 can be effectively inhibited by HCQ to achieve synergistic treatment of tumors. In addition, after Fe³⁺ in FeAlg being reduced to Fe²⁺, it catalyzed intratumoral hydrogen peroxide (H₂O₂) to generate cytotoxic hydroxyl radicals (·OH), which further strengthened the antitumor effect. The in vivo pharmacodynamic result revealed that CA4-FeAlg/HCQ showed the greatest therapeutic effect, with the final V/V₀ of 0.40 ± 0.10. Our study provided a hopeful platform for rational and precise tumor treatment, which may be of great significance in the combined pharmacotherapy.