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Ramon J, Engelen Y, De Keersmaecker H, Goemaere I, Punj D, Mejía Morales J, Bonte C, Berx G, Hoste E, Stremersch S, Lentacker I, De Smedt SC, Raemdonck K, Braeckmans K. Laser-induced vapor nanobubbles for B16-F10 melanoma cell killing and intracellular delivery of chemotherapeutics. J Control Release 2024; 365:1019-1036. [PMID: 38065413 DOI: 10.1016/j.jconrel.2023.12.006] [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] [Received: 10/07/2022] [Revised: 11/23/2023] [Accepted: 12/02/2023] [Indexed: 12/25/2023]
Abstract
The most lethal form of skin cancer is cutaneous melanoma, a tumor that develops in the melanocytes, which are found in the epidermis. The treatment strategy of melanoma is dependent on the stage of the disease and often requires combined local and systemic treatment. Over the years, systemic treatment of melanoma has been revolutionized and shifted toward immunotherapeutic approaches. Phototherapies like photothermal therapy (PTT) have gained considerable attention in the field, mainly because of their straightforward applicability in melanoma skin cancer, combined with the fact that these strategies are able to induce immunogenic cell death (ICD), linked with a specific antitumor immune response. However, PTT comes with the risk of uncontrolled heating of the surrounding healthy tissue due to heat dissipation. Here, we used pulsed laser irradiation of endogenous melanin-containing melanosomes to induce cell killing of B16-F10 murine melanoma cells in a non-thermal manner. Pulsed laser irradiation of the B16-F10 cells resulted in the formation of water vapor nanobubbles (VNBs) around endogenous melanin-containing melanosomes, causing mechanical cell damage. We demonstrated that laser-induced VNBs are able to kill B16-F10 cells with high spatial resolution. When looking more deeply into the cell death mechanism, we found that a large part of the B16-F10 cells succumbed rapidly after pulsed laser irradiation, reaching maximum cell death already after 4 h. Practically all necrotic cells demonstrated exposure of phosphatidylserine on the plasma membrane and caspase-3/7 activity, indicative of regulated cell death. Furthermore, calreticulin, adenosine triphosphate (ATP) and high-mobility group box 1 (HMGB1), three key damage-associated molecular patterns (DAMPs) in ICD, were found to be exposed from B16-F10 cells upon pulsed laser irradiation to an extent that exceeded or was comparable to the bona fide ICD-inducer, doxorubicin. Finally, we could demonstrate that VNB formation from melanosomes induced plasma membrane permeabilization. This allowed for enhanced intracellular delivery of bleomycin, an ICD-inducing chemotherapeutic, which further boosted cell death with the potential to improve the systemic antitumor immune response.
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Affiliation(s)
- Jana Ramon
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Biophotonics Research Group, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium.
| | - Yanou Engelen
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; Ghent Research Group on Nanomedicines, Ghent University, 9000 Ghent, Belgium.
| | - Herlinde De Keersmaecker
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; Ghent Light Microscopy Core Facility, Ghent University, 9000 Ghent, Belgium.
| | - Ilia Goemaere
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Biophotonics Research Group, Ghent University, 9000 Ghent, Belgium.
| | - Deep Punj
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Biophotonics Research Group, Ghent University, 9000 Ghent, Belgium.
| | - Julián Mejía Morales
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium.
| | - Cédric Bonte
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium.
| | - Geert Berx
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; VIB Center for Inflammation Research, 9052 Ghent, Belgium; Molecular and Cellular Oncology Laboratory, Department of Biomedical Molecular Biology, Ghent University, 9000 Ghent, Belgium.
| | - Esther Hoste
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; VIB Center for Inflammation Research, 9052 Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, 9000 Ghent, Belgium.
| | - Stephan Stremersch
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium
| | - Ine Lentacker
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; Ghent Research Group on Nanomedicines, Ghent University, 9000 Ghent, Belgium.
| | - Stefaan C De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; Ghent Research Group on Nanomedicines, Ghent University, 9000 Ghent, Belgium.
| | - Koen Raemdonck
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; Ghent Research Group on Nanomedicines, Ghent University, 9000 Ghent, Belgium.
| | - Kevin Braeckmans
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, 9000 Ghent, Belgium; Biophotonics Research Group, Ghent University, 9000 Ghent, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium.
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Russano F, Del Fiore P, Di Prata C, Pasqual A, Marconato R, Campana LG, Spina R, Gianesini CM, Collodetto A, Tropea S, Dall’Olmo L, Carraro S, Parisi A, Galuppo S, Scarzello G, De Terlizzi F, Rastrelli M, Mocellin S. The Role of Electrochemotherapy in the Cutaneous and Subcutaneous Metastases From Breast Cancer: Analysis of Predictive Factors to Treatment From an Italian Cohort of Patients. Front Oncol 2021; 11:772144. [PMID: 34993137 PMCID: PMC8724516 DOI: 10.3389/fonc.2021.772144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
The treatment of cutaneous and subcutaneous localizations from breast cancer (BC) is still a therapeutic challenge. Electrochemotherapy (ECT) is one of the available options, and it is characterized by the association between the administration of a chemotherapic agent (Bleomycin) with the temporary raise of permeability of the cellular membrane induced by the local administration of electrical impulses (electroporation). ECT represents an effective therapy for loco-regional control of this disease. This study aimed to investigate the predictive factors of response in cutaneous and subcutaneous localizations from breast cancer treated with ECT. We decided to evaluate the response to this treatment in 55 patients who underwent ECT between January 2013 and March 2020 at our Institute. We performed a monocentric retrospective cohort study. ECT was administered following the ESOPE (European Standard Operative Procedure of Electrochemotherapy) guidelines, a set of criteria updated in 2018 by a panel of European experts on ECT who defined the indications for selecting the patients who can benefit from the ECT treatment and the ones for technically performing the procedure. The responses were evaluated with the RECIST criteria (Response Evaluation Criteria in Solid Tumor). We found after 12 weeks of treatment a complete response (CR) in 64% of our patients. From the analysis divided for subgroups of covariates is emerged that lower BMI, reduced body surface, and absence of previous radiation treatment could be predictive for a better complete response. This study suggests that the efficacy of the ECT treatment is related to the concurrent systemic therapies while administering ECT. The association between ECT and immunotherapy has offered better results than the association between ECT and chemotherapy (p-value = 0.0463). So, ECT is a valuable tool in the treatment of cutaneous and subcutaneous metastases from breast cancer and its efficacy in local control of these lesions improves when it is well planned in a therapeutic scenario.
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Affiliation(s)
- Francesco Russano
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- *Correspondence: Paolo Del Fiore,
| | - Claudia Di Prata
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Andrea Pasqual
- Department of Medicine, University of Padua, Padua, Italy
| | - Roberto Marconato
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Luca Giovanni Campana
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Romina Spina
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Carlo Maria Gianesini
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Alessandra Collodetto
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Saveria Tropea
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Luigi Dall’Olmo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Sabrina Carraro
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Alessandro Parisi
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Sara Galuppo
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Giovanni Scarzello
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Marco Rastrelli
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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Zimmermann CE, Faesser HA, Gassling V, Wiltfang J. The role of electrochemotherapy with intratumoral bleomycin for early tongue carcinoma. Acta Otolaryngol 2021; 141:424-431. [PMID: 33591860 DOI: 10.1080/00016489.2020.1871511] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of electrochemotherapy (ECT) using intratumoral bleomycin and electroporation as a first line treatment for oral tongue carcinoma has not been defined. AIMS/OBJECTIVES To evaluate the method of ECT in oral tongue carcinoma. MATERIAL AND METHODS Twenty-one successive patients with primary T1-T2 oral cancer predominantly of the oral tongue underwent either ECT (test; n = 9), or standard surgical resection and reconstruction (control; n = 12). Outcome variables were: local recurrence rates, 10-year-survival, adverse events, treatment cost, and quality of life. RESULTS The 10-year local recurrence rate (44.4%) was higher and the tumour-specific survival rate (55.6%) was lower in the ECT group compared to the control group (17% and 91.6%, respectively). Postoperative haemorrhage, dysphagia, and pain were more frequent in ECT patients, treatment time was shorter, but treatment cost was higher. Quality of life was not improved by ECT. CONCLUSIONS AND SIGNIFICANCE Our results indicate that ECT seems not as suitable for the treatment of early tongue cancer as it is for neoplastic and metastatic skin lesions and less favourable than standard surgical therapy.
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Affiliation(s)
- Corinna E. Zimmermann
- Department of Craniomaxillofacial Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
- University of Lübeck, Lübeck, Germany
| | | | - Volker Gassling
- Department of Craniomaxillofacial Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jörg Wiltfang
- Department of Craniomaxillofacial Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
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Electrochemotherapy in the Treatment of Head and Neck Cancer: Current Conditions and Future Directions. Cancers (Basel) 2021; 13:cancers13061418. [PMID: 33808884 PMCID: PMC8003720 DOI: 10.3390/cancers13061418] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Electrochemotherapy (ECT) was first introduced in the late 1980s and was initially used mainly on cutaneous tumors. It has now evolved into a clinically verified treatment approach. Thanks to its high feasibility, it has been extended to treating mucosal and deep-seated tumors, including head and neck cancer (HNC) and in heavily pretreated settings. This review describes current knowledge and data on the use of ECT in various forms of HNCs across different clinical settings, with attention to future clinical and research perspectives. Abstract Despite recent advances in the development of chemotherapeutic drug, treatment for advanced cancer of the head and neck cancer (HNC) is still challenging. Options are limited by multiple factors, such as a prior history of irradiation to the tumor site as well as functional limitations. Against this background, electrochemotherapy (ECT) is a new modality which combines administration of an antineoplastic agent with locally applied electric pulses. These pulses allow the chemotherapeutic drug to penetrate the intracellular space of the tumor cells and thereby increase its cytotoxicity. ECT has shown encouraging efficacy and a tolerable safety profile in many clinical studies, including in heavily pre-treated HNC patients, and is considered a promising strategy. Efforts to improve its efficacy and broaden its application are now ongoing. Moreover, the combination of ECT with recently developed novel therapies, including immunotherapy, represented by immune checkpoint inhibitor (ICI)s, has attracted attention for its potent theoretical rationale. More extensive, well-organized clinical studies and timely updating of consensus guidelines will bring this hopeful treatment to HNC patients under challenging situations.
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Compact High-Voltage Pulse Generator for Pulsed Electric Field Applications: Lab-Scale Development. JOURNAL OF ELECTRICAL AND COMPUTER ENGINEERING 2020. [DOI: 10.1155/2020/6525483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Square wave pulses have been identified as more lethal compared to exponential decay pulses in PEF applications. This is because of the on-time which is longer causes a formidable impact on the microorganisms in the food media. To have a reliable high-voltage pulse generator, a technique of capacitor discharge was employed. Four units of capacitor rated 100 μF 1.2 kV were connected in series to produce 25 μF 4.8 kV which were used to store the energy of approximately 200 J. The energy stored was discharged via HTS 181-01-C to the load in the range of nano to microseconds of pulse duration. The maximum voltage applied was limited to 4 kV because it is a lab-scale project. The electrical circuit diagram and the development procedure, as well as experimental results, are presented.
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Mertz D, Harlepp S, Goetz J, Bégin D, Schlatter G, Bégin‐Colin S, Hébraud A. Nanocomposite Polymer Scaffolds Responding under External Stimuli for Drug Delivery and Tissue Engineering Applications. ADVANCED THERAPEUTICS 2019. [DOI: 10.1002/adtp.201900143] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Damien Mertz
- Institut de Physique et Chimie des Matériaux de Strasbourg (IPCMS)UMR‐7504 CNRS‐Université de Strasbourg 23 rue du Loess, BP 34 67034 Strasbourg Cedex 2 France
| | - Sébastien Harlepp
- INSERM UMR_S1109, Tumor Biomechanics, StrasbourgUniversité de Strasbourg Fédération de Médecine Translationnelle de Strasbourg (FMTS) 67000 Strasbourg France
| | - Jacky Goetz
- INSERM UMR_S1109, Tumor Biomechanics, StrasbourgUniversité de Strasbourg Fédération de Médecine Translationnelle de Strasbourg (FMTS) 67000 Strasbourg France
| | - Dominique Bégin
- Institut de Chimie et Procédés pour l'Energie l'Environnement et la Santé (ICPEES)UMR‐7515 CNRS‐Université de Strasbourg 25 rue Becquerel 67087 Strasbourg Cedex 2 France
| | - Guy Schlatter
- Institut de Chimie et Procédés pour l'Energie l'Environnement et la Santé (ICPEES)UMR‐7515 CNRS‐Université de Strasbourg 25 rue Becquerel 67087 Strasbourg Cedex 2 France
| | - Sylvie Bégin‐Colin
- Institut de Physique et Chimie des Matériaux de Strasbourg (IPCMS)UMR‐7504 CNRS‐Université de Strasbourg 23 rue du Loess, BP 34 67034 Strasbourg Cedex 2 France
| | - Anne Hébraud
- Institut de Chimie et Procédés pour l'Energie l'Environnement et la Santé (ICPEES)UMR‐7515 CNRS‐Université de Strasbourg 25 rue Becquerel 67087 Strasbourg Cedex 2 France
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De Virgilio A, Ralli M, Longo L, Mancini P, Attanasio G, Atturo F, De Vincentiis M, Greco A. Electrochemotherapy in head and neck cancer: A review of an emerging cancer treatment. Oncol Lett 2018; 16:3415-3423. [PMID: 30127943 DOI: 10.3892/ol.2018.9140] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/17/2018] [Indexed: 12/12/2022] Open
Abstract
Patients affected by aggressive neoplasms with a high propensity to metastasize to the skin, including some types of head and neck cancer, may benefit from electrochemotherapy, a modality that combines the electroporation of cell membranes and chemotherapy to facilitate the transport of non-permeant molecules into cells; the host immune response consequently participates in achieving the abolition of tumors. Electrochemotherapy can be successfully used for skin metastases of head and neck tumors and, with some limitations, for primary and relapsing neoplasms; it can also be applied on an outpatient basis with a favorable cost-benefit ratio and it is a repeatable treatment that, if necessary, can be followed by traditional antineoplastic therapies. Although still a palliative treatment, the good level of tolerability and the high success rates of electrochemotherapy make it worth consideration among treatment options in selected patients.
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Affiliation(s)
- Armando De Virgilio
- Department of Otolaryngology, Humanitas Clinical and Research Center, I-20089 Milan, Italy
| | - Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, I-00186 Rome, Italy
| | - Lucia Longo
- Department of Sense Organs, Sapienza University of Rome, I-00186 Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, I-00186 Rome, Italy
| | - Giuseppe Attanasio
- Department of Sense Organs, Sapienza University of Rome, I-00186 Rome, Italy
| | - Francesca Atturo
- Department of Sense Organs, Sapienza University of Rome, I-00186 Rome, Italy
| | - Marco De Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, I-00186 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, I-00186 Rome, Italy
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Kim J, Narayan RJ, Lu X, Jay M. Neutron-activatable needles for radionuclide therapy of solid tumors. J Biomed Mater Res A 2017; 105:3273-3280. [DOI: 10.1002/jbm.a.36185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Junghyun Kim
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy; University of North Carolina; Chapel Hill North Carolina 27599
| | - Roger J. Narayan
- Joint Department of Biomedical Engineering; University of North Carolina and North Carolina State University; Raleigh North Carolina 27599
| | - Xiuling Lu
- Department of Pharmaceutical Sciences; University of Connecticut; Storrs Connecticut 06269
| | - Michael Jay
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy; University of North Carolina; Chapel Hill North Carolina 27599
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Xu D, Jiang L, DeRidder L, Elmore B, Bukhari M, Wei Q, Samways DSK, Dong H. Membrane activity of a supramolecular peptide-based chemotherapeutic enhancer. MOLECULAR BIOSYSTEMS 2017; 12:2695-9. [PMID: 27397555 DOI: 10.1039/c6mb00369a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Self-assembly of de novo designed multidomain peptides (MDPs) resulted in functional membrane-active supramolecular nanofibers. The membrane activity was analyzed through fluorescence membrane localization and patch-clamp electrophysiology yielding important information that can be used for the development of a new type of supramolecular peptide-based chemotherapeutic enhancer.
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Affiliation(s)
- Dawei Xu
- Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, NY 13699, USA.
| | - Linhai Jiang
- Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, NY 13699, USA.
| | - Louis DeRidder
- Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, NY 13699, USA.
| | - Brendan Elmore
- Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, NY 13699, USA.
| | - Maurish Bukhari
- Department of Biology, Clarkson University, Potsdam, NY 13699, USA
| | - Qiang Wei
- Department of Chemistry, State University of New York at Binghamton, Binghamton, NY 13902, USA.
| | | | - He Dong
- Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, NY 13699, USA.
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Lenzi R, Muscatello L, Saibene AM, Felisati G, Pipolo C. The controversial role of electrochemotherapy in head and neck cancer: a systematic review of the literature. Eur Arch Otorhinolaryngol 2017; 274:2389-2394. [PMID: 28236011 DOI: 10.1007/s00405-017-4490-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/29/2017] [Indexed: 12/21/2022]
Abstract
Electroporation, also known as electrochemotherapy, combines an antineoplastic agent with electroporation, causing localized progressive necrosis in the treated area. Today it is primarily used in the palliative treatment of cutaneous and subcutaneous metastases and has been found to be safe and efficacious in head and neck cancer recurrences. Despite the steady increase in the number of published studies this treatment is not universally available and used systematically in head and neck carcinomas. To shed light on its limitations and analyze treatment outcome we have, therefore, reviewed all available literature regarding this topic. This systematic review includes 16 studies on head and neck squamous cell carcinoma and reports the data of 200 treated patients. The combined results show a very heterogeneous overall response rate, ranging from 0 to 100%, while the complete response rate ranges between 0 and 83.3%. No major side effects have been described in those who used electrochemotherapy as a mono modality palliative treatment. This systematic review shows how standardization of treatment is still pivotal to achieve a more homogeneous response rate in the approach to head and neck tumors. In conclusion, due to the scarcity of alternatives of treatment in advanced stage cancer in this anatomical region and the good tolerability and mostly high success rates of electrochemotherapy, this palliative approach should be taken into consideration in these patients.
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Affiliation(s)
- Riccardo Lenzi
- Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Massa, Italy
| | - Luca Muscatello
- Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Massa, Italy
| | | | - Giovanni Felisati
- Unit of Otolaryngology, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Via Antonio di Rudinì 8, 20142, Milan, Italy
| | - Carlotta Pipolo
- Unit of Otolaryngology, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Via Antonio di Rudinì 8, 20142, Milan, Italy.
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Tschon M, Salamanna F, Ronchetti M, Cavani F, Gasbarrini A, Boriani S, Fini M. Feasibility of Electroporation in Bone and in the Surrounding Clinically Relevant Structures: A Preclinical Investigation. Technol Cancer Res Treat 2015; 15:737-748. [PMID: 26351303 DOI: 10.1177/1533034615604454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/14/2015] [Accepted: 08/11/2015] [Indexed: 12/12/2022] Open
Abstract
Skeletal metastases are a common cause of severe morbidity, reduction in quality of life and often early mortality. Consequently, improvements in therapies are necessary. Electroporation uses electric energy to alter cancer cell membrane permeability and enhance the local uptake of chemotherapeutics, thus leading to local tumor control. The aim of this study was to investigate the feasibility and safety of delivering electric field protocols causing electroporation of healthy bone and structures of clinical relevance using small and large animal models. Reversible electroporation was used in the rabbit sciatic nerve by applying 2 series of 8 pulses 100ms long at 1000 V/cm. Irreversible electroporation was used in rabbit distal femur condyles and in sheep vertebral body by applying 120 pulses 100ms long at 1750 V/cm. Any effect on surrounding sensitive structures was investigated. Reversible electroporation of sciatic nerve was associated with transient foot functional deficit that completely recovered at 30 days. Irreversible electroporation removed cells from trabeculae in the femurs of rabbits and in the vertebral body of sheep. After irreversible protocol, histology and microtomography demonstrated that the trabecular structure was maintained, the presence of new bone marrow cells, osteoblasts, and mineral apposition characterized by new trabeculae thinner than controls (P = .005) and a significant reduction in the ablated areas (-225%, P = .0219). Spinal cord, vertebral pedicles and spinal nerves showed transient edema in the absence of functional or structural alterations. Collectively, these results show that electroporation can be safely applied to bone even in the proximity of neuronal structures.
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Affiliation(s)
- Matilde Tschon
- Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopaedic Institute, Bologna, Italy .,Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Department RIT Rizzoli, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Francesca Salamanna
- Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Department RIT Rizzoli, Rizzoli Orthopaedic Institute, Bologna, Italy
| | | | - Francesco Cavani
- Department of Biomedical, Metabolic and Neural Sciences, Section of Human Morphology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Gasbarrini
- Spine Surgery prevalently Oncologic and Degenerative, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Stefano Boriani
- Spine Surgery prevalently Oncologic and Degenerative, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Milena Fini
- Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopaedic Institute, Bologna, Italy.,Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Department RIT Rizzoli, Rizzoli Orthopaedic Institute, Bologna, Italy
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Möller MG, Salwa S, Soden DM, O’Sullivan GC. Electrochemotherapy as an adjunct or alternative to other treatments for unresectable or in-transit melanoma. Expert Rev Anticancer Ther 2014; 9:1611-30. [DOI: 10.1586/era.09.129] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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In vivo electroporation of minicircle DNA as a novel method of vaccine delivery to enhance HIV-1-specific immune responses. J Virol 2013; 88:1924-34. [PMID: 24284319 DOI: 10.1128/jvi.02757-13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
DNA vaccines offer advantage over conventional vaccines, as they are safer to use, easier to produce, and able to induce humoral as well cellular immune responses. Unfortunately, no DNA vaccines have been licensed for human use for the difficulties in developing an efficient and safe in vivo gene delivery system. In vivo electroporation (EP)-based DNA delivery has attracted great attention for its potency to enhance cellular uptake of DNA vaccines and function as an adjuvant. Minicircle DNA (a new form of DNA containing only a gene expression cassette and lacking a backbone of bacterial plasmid DNA) is a powerful candidate of gene delivery in terms of improving the levels and the duration of transgene expression in vivo. In this study, as a novel vaccine delivery system, we combined in vivo EP and the minicircle DNA carrying a codon-optimized HIV-1 gag gene (minicircle-gag) to evaluate the immunogenicity of this system. We found that minicircle-gag conferred persistent and high levels of gag expression in vitro and in vivo. The use of EP delivery further increased minicircle-based gene expression. Moreover, when delivered by EP, minicircle-gag vaccination elicited a 2- to 3-fold increase in cellular immune response and a 1.5- to 3-fold augmentation of humoral immune responses compared with those elicited by a pVAX1-gag positive control. Increased immunogenicity of EP-assisted minicircle-gag may benefit from increasing local antigen expression, upregulating inflammatory genes, and recruiting immune cells. Collectively, in vivo EP of minicircle DNA functions as a novel vaccine platform that can enhance efficacy and immunogenicity of DNA vaccines.
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Charpentier KP, Wolf F, Noble L, Winn B, Resnick M, Dupuy DE. Irreversible electroporation of the liver and liver hilum in swine. HPB (Oxford) 2011; 13:168-73. [PMID: 21309933 PMCID: PMC3048967 DOI: 10.1111/j.1477-2574.2010.00261.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Irreversible electroporation (IRE) is a novel, non-thermal form of ablation. We studied the safety and efficacy of IRE for the ablation of liver tissue around the liver hilum. We also studied the ability of triphenyltetrazolium chloride staining (TTC) to predict the zone of ablation after IRE. METHODS Eight swine underwent 20 ablations of the liver and liver hilum. Two monopolar probes were positioned 2 cm apart. IRE was performed using 90 pulses of 2500-3000 V/cm. IRE treatments were performed from 15 min to 14 days (n= 4) before sacrifice. RESULTS All animals survived. No major complications were encountered. Ablation width ranged from 2.27 to 4.45 cm and ablation height ranged from 1.5 to 1.8 cm. TTC staining demonstrated the zone of ablation in all animals. Hepatocyte necrosis occurs immediately adjacent to large central veins without evidence of heat sink. Bile ducts, portal veins and hepatic arteries appear to be more resistant to the effects of IRE. CONCLUSIONS IRE appears to be safe and effective for liver tissue ablation in the liver hilum. The portal structures appear more resistant to the effects of IRE. TTC staining can predict the zone of IRE ablation as early as 15 min after treatment.
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Affiliation(s)
- Kevin P Charpentier
- Department of Surgery, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
| | - Farrah Wolf
- Department of Radiology, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
| | - Lelia Noble
- Department of Pathology, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
| | - Brody Winn
- Department of Pathology, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
| | - Murray Resnick
- Department of Pathology, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
| | - Damian E Dupuy
- Department of Radiology, Rode Island Hospital and the Warren Alpert School of Medicine at Brown UniversityProvidence, RI, USA
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Dupuy DE, Aswad B, Ng T. Irreversible electroporation in a Swine lung model. Cardiovasc Intervent Radiol 2010; 34:391-5. [PMID: 21191587 DOI: 10.1007/s00270-010-0091-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 12/03/2010] [Indexed: 01/19/2023]
Abstract
PURPOSE This study was designed to evaluate the safety and tissue effects of IRE in a swine lung model. METHODS This study was approved by the institutional animal care committee. Nine anesthetized domestic swine underwent 15 percutaneous irreversible electroporation (IRE) lesion creations (6 with bipolar and 3 with 3-4 monopolar electrodes) under fluoroscopic guidance and with pancuronium neuromuscular blockade and EKG gating. IRE electrodes were placed into the central and middle third of the right mid and lower lobes in all animals. Postprocedure PA and lateral chest radiographs were obtained to evaluate for pneumothorax. Three animals were sacrificed at 2 weeks and six at 4 weeks. Animals underwent high-resolution CT scanning and PA and lateral radiographs 1 h before sacrifice. The treated lungs were removed en bloc, perfused with formalin, and sectioned. Gross pathologic and microscopic changes after standard hematoxylin and eosin staining were analyzed within the areas of IRE lesion creation. RESULTS No significant adverse events were identified. CT showed focal areas of spiculated high density ranging in greatest diameter from 1.1-2.2 cm. On gross inspection of the sectioned lung, focal areas of tan discoloration and increased density were palpated in the areas of IRE. Histological analysis revealed focal areas of diffuse alveolar damage with fibrosis and inflammatory infiltration that respected the boundaries of the interlobular septae. No pathological difference could be discerned between the 2- and 4-week time points. The bronchioles and blood vessels within the areas of IRE were intact and did not show signs of tissue injury. CONCLUSION IRE creates focal areas of diffuse alveolar damage without creating damage to the bronchioles or blood vessels. Short-term safety in a swine model appears to be satisfactory.
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Affiliation(s)
- Damian E Dupuy
- Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
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Prototype development and preclinical immunogenicity analysis of a novel minimally invasive electroporation device. Gene Ther 2010; 18:258-65. [DOI: 10.1038/gt.2010.137] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Plasmid injection and application of electric pulses alter endogenous mRNA and protein expression in B16.F10 mouse melanomas. Cancer Gene Ther 2010; 17:864-71. [PMID: 20706286 PMCID: PMC2981654 DOI: 10.1038/cgt.2010.43] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The application of electric pulses to tissues causes cell membrane destabilization, allowing exogenous molecules to enter the cells. This delivery technique can be used for plasmid gene therapy. Reporter gene expression after plasmid delivery with eight representative published protocols was compared in B16.F10 mouse melanoma tumors. This expression varied significantly based on the pulse parameters utilized for delivery. To observe the possible influence of plasmid injection and/or pulse application on endogenous gene expression, levels of stress related mRNAs four and 24 hours after delivery were determined by PCR array. Increases in mRNA levels for several inflammatory chemokines and cytokines were observed in response to plasmid injection, electric pulses alone, or the combination. This upregulation was confirmed by individual real-time reverse transcription TaqMan PCR assays. Proteins were extracted at the same time points from identically treated tumors and inflammatory protein levels were assayed by ELISA and by a custom multiplex bead array. Increases in inflammatory protein levels generally paralleled mRNA levels. Some differences were observed, which may have been due to differing expression kinetics. The observed upregulated expression of these cytokines and chemokines may aid or inhibit the therapeutic effectiveness of immune-based cancer gene therapies.
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Charpentier KP, Wolf F, Noble L, Winn B, Resnick M, Dupuy DE. Irreversible electroporation of the pancreas in swine: a pilot study. HPB (Oxford) 2010; 12:348-51. [PMID: 20590911 PMCID: PMC2951824 DOI: 10.1111/j.1477-2574.2010.00174.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Irreversible electroporation (IRE) is a novel, non-thermal method of tissue ablation using short pulses of high-voltage DC current to ablate tissue. METHODS Irreversible electroporation of the pancreas was performed in four domestic female swine using two monopolar probes spaced 9-15 mm apart. Ninety pulses of 1500 V/cm were delivered for each ablation. RESULTS All animals survived for their designated times of 2 h (n = 1), 2 days (n = 1) and 14 days (n = 2), respectively. No procedure-related complications occurred. Three animals in which probes had been spaced at intervals of 10 ± 1 mm showed evidence of irreversible ablation, with ablation height ranging from < 10 mm to 21 mm and ablation width ranging from < 10 mm to 16 mm by gross appearance and triphenyltetrazolium chloride (TTC) staining. The only animal in which probes had been spaced at intervals of 15 mm did not show evidence of irreversible ablation at 2 weeks. This may be secondary to the wider probe spacing and relatively low voltage, which results in a mostly reversible form of electroporation without cell death. CONCLUSIONS Irreversible electroporation appears to be a safe method for pancreas tissue ablation. Staining with TTC can predict the zone of IRE ablation within 2 h of treatment.
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Affiliation(s)
- Kevin P Charpentier
- Departments of Surgery, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
| | - Farrah Wolf
- Departments of Radiology, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
| | - Lelia Noble
- Departments of Pathology, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
| | - Brody Winn
- Departments of Pathology, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
| | - Murray Resnick
- Departments of Pathology, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
| | - Damian E Dupuy
- Departments of Radiology, Rhode Island Hospital and the Warren Alpert School of Medicine, Brown UniversityProvidence, RI, USA
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Ortega VV, Martínez AF, Gascón JY, Sánchez NA, Baños MA, Rubiales FC. Transdermal Transport of India Ink by Electromagnetic Electroporation in Guinea Pigs: An Ultrastructural Study. Ultrastruct Pathol 2009; 30:65-74. [PMID: 16517472 DOI: 10.1080/01913120500214200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Transdermic administration by electroporation has developed over recent years for applying drugs in a variety of pathological processes. However, mechanisms are still not finally settled. India ink was applied to the backs of guinea pigs and for the transdermic transport short, high-voltage pulses (TDES, Dencort Dell) were administrated. Punch biopsies (4 mm) immediately taken after 24, 48, 72, 96 and at 26 days were studied by light and electronic microscopy. The ultrastructural characteristics and image pigment particles were reported. Particles of India ink were observed in the stratum corneum and in the epidermic keratinocytes of samples studied immediately after treatment. Particles were also seen in the epidermic and folicular keratinocytes, and in the papillary and reticular dermis (among collagen fibers, vessel walls, and macrophages) in all the subsequent biopsies; but not in the controls, which were conducted with electromagnetic waves alone. No tissue alterations were observed. The efficacy and noninvasive nature of electroporation for the transdermic administration of macromolecules is confirmed.
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Affiliation(s)
- V Vicente Ortega
- Department of Pathology, Faculty of Medicine, University of Murcia, Murcia, Spain.
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Wallace M, Evans B, Woods S, Mogg R, Zhang L, Finnefrock AC, Rabussay D, Fons M, Mallee J, Mehrotra D, Schödel F, Musey L. Tolerability of two sequential electroporation treatments using MedPulser DNA delivery system (DDS) in healthy adults. Mol Ther 2009; 17:922-8. [PMID: 19277016 DOI: 10.1038/mt.2009.27] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Immunotherapy against infectious agents and malignant tumors requires efficient priming of effector cells through direct expression and/or efficient cross-presentation of antigens by antigen-presenting cells. Electroporation is a new procedure aimed at transiently increasing cell membrane permeability and direct delivery of antigen or antigen-encoding nucleic acids inside targeted cells. We evaluated the tolerability including compliance with repeated electroporation treatments using MedPulser DDS in 24 healthy adults. Pain severity was evaluated at time of electroporation treatment, and at 1, 5, 10, and 20 minutes, and 24 hours thereafter, using two clinically validated questionnaires: McGill Pain Questionnaire (MPQ) (Present Pain Intensity) and Brief Pain Inventory (BPI). Electroporation treatments were generally well tolerated. Twenty-two out of 24 subjects returned for the second electroporation treatment 14 days after first treatment. Only two subjects reported a treatment-related systemic adverse experience following either electroporation application. For both pain assessment tools, maximum pain and/or discomfort were mostly reported immediately (within 5 minutes) after electroporation; Furthermore, no difference was observed when comparing peak-pain scores after first and second electroporation treatments. This study supports the clinical application of MedPulser DDS for the improvement of antigen-induced immune responses for prophylactic or therapeutic vaccines, especially in gene-based therapies for cancer.
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Affiliation(s)
- Mark Wallace
- Department of Anesthesiology, University of California San Diego, San Diego, California, USA
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Yang Q, Larsen SK, Mi Z, Robbins PD, Basse PH. PTD-mediated loading of tumor-seeking lymphocytes with prodrug-activating enzymes. AAPS JOURNAL 2008; 10:614-21. [PMID: 19104945 DOI: 10.1208/s12248-008-9066-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 11/10/2008] [Indexed: 12/21/2022]
Abstract
Using the approach of peptide transduction domain (PTD)-mediated loading of interleukin-2(IL-2)-activated natural killer (A-NK) cells, tumor-seeking lymphocytes, with prodrug-activating enzymes, we primarily aim to generate a cytotoxic drug selectively within tumors and minimize damage to normal tissues. A-NK cells are able to accumulate selectively at tumor sites. While these cells by themselves possess significant antitumor effect in vivo, we suggest that they can also serve as Trojan horses, by bringing anticancer agents, such as prodrug-activating enzymes, selectively to tumors. We have successfully demonstrated in a mouse model that A-NK cells can be rapidly loaded with prodrug-activating enzymes, such as alkaline phosphatase (AP) and beta-galactosidase (beta-gal), in vitro using enzyme-conjugated peptide PTD5. Upon adoptive transfer into lung-tumor-bearing animals, the loaded A-NK cells are able to bring their cargo of the prodrug-activating enzymes selectively to pulmonary metastases. The targeting of the AP to the tumor tissues is highly specific, since more than a fivefold higher concentration of AP was found in the tumor tissues compared to the surrounding normal lung tissue at 24 h after injection. The approach of transporting prodrug-activating enzymes selectively into tumors clearly shows potential for future targeted chemotherapy. Ongoing studies in our laboratory are evaluating the antitumor efficacy of cellular-dependent enzyme prodrug therapy.
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Affiliation(s)
- Qin Yang
- Department of Immunology, University of Pittsburgh School of Medicine, University of Pittsburgh Cancer Institute, University of Pittsburgh, 5150 Center Avenue, Suite 1A-106, Pittsburgh, Pennsylvania. 15232, USA.
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Abstract
As in vivo electroporation advances from the preclinical phase to clinical studies and eventually to routine medical practice, the design of electroporation devices becomes increasingly important. Achieving safety and efficacy levels that meet regulatory requirements, as well as user and patient friendliness, are major design considerations. In addition, the devices will have to be economical to manufacture. This chapter will focus on the design of applicators and electrodes, the pieces of hardware in direct contact with the user and the patient, and thus key elements responsible for the safety and efficacy of the procedure. The two major foreseeable applications of the technology in the DNA field are for gene therapy and DNA vaccination. Design requirements differ considerably for these applications and for the diseases to be treated or prevented. In addition to the trend of device differentiation, there is also a trend to build devices capable of performing both the step of delivering the DNA to the target tissue and the subsequent step of electroporation. This chapter presents the electrical and biological principles underlying applicator and electrode design, gives an overview of existing devices, and discusses their advantages and disadvantages. The chapter also outlines major design considerations, including regulatory pathways, and points out potential future developments.
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Abstract
This chapter provides an overview of the application of electroporation to areas other than gene delivery. These areas include the delivery of drugs and vaccines to tissues and tumors as well as into and through the skin. Achievements and limitations of electroporation in these areas are presented. Alternative physical methods for gene and drug delivery besides electroporation are described. The advantages and drawbacks of electroporation, compared with these methods, are also discussed.
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Ahlén G, Söderholm J, Tjelle T, Kjeken R, Frelin L, Höglund U, Blomberg P, Fons M, Mathiesen I, Sällberg M. In Vivo Electroporation Enhances the Immunogenicity of Hepatitis C Virus Nonstructural 3/4A DNA by Increased Local DNA Uptake, Protein Expression, Inflammation, and Infiltration of CD3+ T Cells. THE JOURNAL OF IMMUNOLOGY 2007; 179:4741-53. [PMID: 17878373 DOI: 10.4049/jimmunol.179.7.4741] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The mechanisms by which in vivo electroporation (EP) improves the potency of i.m. DNA vaccination were characterized by using the hepatitis C virus nonstructural (NS) 3/4A gene. Following a standard i.m. injection of DNA with or without in vivo EP, plasmid levels peaked immediately at the site of injection and decreased by 4 logs the first week. In vivo EP did not promote plasmid persistence and, depending on the dose, the plasmid was cleared or almost cleared after 60 days. In vivo imaging and immunohistochemistry revealed that protein expression was restricted to the injection site despite the detection of significant levels of plasmid in adjacent muscle groups. In vivo EP increased and prolonged NS3/4A protein expression levels as well as an increased infiltration of CD3+ T cells at the injection site. These factors most likely additively contributed to the enhanced and broadened priming of NS3/4A-specific Abs, CD4+ T cells, CD8+ T cells, and gamma-IFN production. The primed CD8+ responses were functional in vivo, resulting in elimination of hepatitis C virus NS3/4A-expressing liver cells in transiently transgenic mice. Collectively, the enhanced protein expression and inflammation at the injection site following in vivo EP contributed to the priming of in vivo functional immune responses. These localized effects most likely help to insure that the strength and duration of the responses are maintained when the vaccine is tested in larger animals, including rabbits and humans. Thus, the combined effects mediated by in vivo EP serves as a potent adjuvant for the NS3/4A-based DNA vaccine.
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Affiliation(s)
- Gustaf Ahlén
- Division of Clinical Microbiology, F68, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden
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Grimard L, Esche B, Lamothe A, Cygler J, Spaans J. Interstitial low-dose-rate brachytherapy in the treatment of recurrent head and neck malignancies. Head Neck 2006; 28:888-95. [PMID: 16721742 DOI: 10.1002/hed.20422] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recurrent head and neck malignancies are therapeutically challenging. Brachytherapy is a retreatment alternative to external-beam radiation therapy (EBRT). METHODS Patients receiving brachytherapy during 1987-2004 for recurrent head and neck cancer were identified. Tumor and treatment characteristics and toxicities were recorded. Progression-free survival (PFS) and overall survival (OS) estimates were generated. The influence of prognostic factors was determined. RESULTS Eighty-two patients were analyzable. Analysis was limited to patients who had brachytherapy for a first recurrence (n = 45). Brachytherapy (> or = 55 Gy) was a monotherapy in 22 of 45 patients. As part of their salvage brachytherapy treatments, 14 patients also underwent surgery; 3 patients also underwent EBRT; and 6 patients underwent surgery, EBRT, and brachytherapy. Retreatment morbidity included acute toxicity (n = 7) and late toxicity (n = 18). Median PFS was 15 months, and locoregional control rates at 1 and 2 years were 50% and 37%, respectively. Time to progression differed by site of the primary tumor (p = .10). Median OS was 16 months, and OS at 2 and 5 years was 33% and 11%, respectively. CONCLUSIONS Brachytherapy for recurrent head and neck cancer has an acceptable toxicity profile and is viable alternative to EBRT. Further optimization of the best sites and doses for neck brachytherapy is required.
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Affiliation(s)
- Laval Grimard
- Department of Radiation Oncology, Ottawa Hospital Regional Cancer Centre, 503 Smyth Road, Ottawa, Ontario, Canada K1H 1C4.
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Nakashima M, Iohara K, Ishikawa M, Ito M, Tomokiyo A, Tanaka T, Akamine A. Stimulation of reparative dentin formation by ex vivo gene therapy using dental pulp stem cells electrotransfected with growth/differentiation factor 11 (Gdf11). Hum Gene Ther 2005; 15:1045-53. [PMID: 15610605 DOI: 10.1089/hum.2004.15.1045] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Dental pulp progenitor/stem cells have the capacity to differentiate into odontoblasts and they provide a potential for dentin repair and regeneration by gene therapy. To develop a successful ex vivo gene therapy to induce reparative dentin formation rapidly and effectively after treatment of caries, we developed a three-dimensional pellet culture system of pulp cells electrotransfected with growth/differentiation factor 11 (Gdf11). The viability after electrotransfection was more than 85%, and the efficiency was about 70% as determined by flow cytometry. After 10 days of culture, the total amount of type I and type III collagen was 3-fold higher in the pEGFP-Gdf11-transfected pellet than in the control. Real-time RT-PCR analysis demonstrated that the expression of markers of odontoblast differentiation (alkaline phosphatase, dentin matrix protein 1 [Dmp1], dentin sialophosphoprotein [Dspp], enamelysin, and phosphate-regulating gene with homologies to endopeptidases on X-chromosome [Phex]) was increased in the pEGFP-Gdf11-transfected pellet compared with the control on day 14. On the basis of this in vitro evaluation, an in vivo investigation in the dog was performed. Autogenous transplantation of Gdf11-transfected cells cultured as a pellet on amputated pulp stimulated reparative dentin formation. Thus, Gdf11 gene therapy may be potentially used in endodontic treatment in dentistry.
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Affiliation(s)
- Misako Nakashima
- Division of Oral Rehabilitation, Department of Clinical Oral Molecular Biology, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan.
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Stimulation of Reparative Dentin Formation by Ex Vivo Gene Therapy Using Dental Pulp Stem Cells Electrotransfected with Growth/differentiation factor 11 (Gdf11). Hum Gene Ther 2004. [DOI: 10.1089/hum.2004.15.ft-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zhang L, Nolan E, Kreitschitz S, Rabussay DP. Enhanced delivery of naked DNA to the skin by non-invasive in vivo electroporation. BIOCHIMICA ET BIOPHYSICA ACTA 2002; 1572:1-9. [PMID: 12204326 DOI: 10.1016/s0304-4165(02)00270-2] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
DNA delivery to skin may be useful for the treatment of skin diseases, DNA vaccinations, and other gene therapy applications requiring local or systemic distribution of a transgene product. However, the effective, consistent and patient-friendly transfection of skin cells remains a challenge. In a mouse model, we evaluated the effectiveness of intradermal injection of plasmid DNA followed by noninvasive in vivo electroporation (EP) as a method to improve transfection in skin. We achieved a several hundred-fold stimulation of gene expression by EP, sufficient to produce clinically relevant amounts of transgene product. We studied the effect of DNA dose and time after treatment as well as various EP pulse parameters on the efficiency of gene expression. EP under conditions of constant charge transfer revealed that the applied voltage was the main determinant for transgene expression efficiency while other pulse parameters had lesser effects. Patient-friendly, noninvasive meander electrodes which we designed for clinical applications proved equally effective and safe as plate electrodes. We also showed for the first time that noninvasive EP is effective in stimulating transfection and gene expression in human skin, particularly in the epidermis. Our findings demonstrate the applicability of EP-enhanced DNA delivery to skin for gene therapy, DNA immunization and other areas.
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Affiliation(s)
- Lei Zhang
- Department of Research and Development, Genetronics, Inc., San Diego, CA 92121-1334, USA.
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