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Rajagopalan NR, Munawar T, Sheehan MC, Fujimori M, Vista WR, Wimmer T, Gutta NB, Solomon SB, Srimathveeravalli G. Electrolysis products, reactive oxygen species and ATP loss contribute to cell death following irreversible electroporation with microsecond-long pulsed electric fields. Bioelectrochemistry 2024; 155:108579. [PMID: 37769509 PMCID: PMC10841515 DOI: 10.1016/j.bioelechem.2023.108579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
Membrane permeabilization and thermal injury are the major cause of cell death during irreversible electroporation (IRE) performed using high electric field strength (EFS) and small number of pulses. In this study, we explored cell death under conditions of reduced EFS and prolonged pulse application, identifying the contributions of electrolysis, reactive oxygen species (ROS) and ATP loss. We performed ablations with conventional high-voltage low pulse (HV-LP) and low-voltage high pulse (LV-HP) conditions in a 3D tumor mimic, finding equivalent ablation volumes when using 2000 V/cm 90 pulses or 1000 V/cm 900 pulses respectively. These results were confirmed by performing ablations in swine liver. In LV-HP treatment, ablation volume was found to increase proportionally with pulse numbers, without the substantial temperature increase seen with HV-LP parameters. Peri-electrode pH changes, ATP loss and ROS production were seen in both conditions, but LV-HP treatments were more sensitive to blocking of these forms of cell injury. Increases in current drawn during HV-LP was not observed during LV-HP condition where the total ablation volume correlated to the charge delivered into the tissue which was greater than HV-LP treatment. LV-HP treatment provides a new paradigm in using pulsed electric fields for tissue ablation with clinically relevant volumes.
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Affiliation(s)
| | - Tarek Munawar
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Mary Chase Sheehan
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - William-Ray Vista
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Thomas Wimmer
- Dept. of Radiology, Division of General Radiology, Medical University of Graz, Austria
| | | | - Stephen B Solomon
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Govindarajan Srimathveeravalli
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA; Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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2
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Lv Y, Liu H, Feng Z, Zhang J, Chen G, Yao C. The Enlargement of Ablation Area by Electrolytic Irreversible Electroporation (E-IRE) Using Pulsed Field with Bias DC Field. Ann Biomed Eng 2022; 50:1964-1973. [PMID: 35852648 DOI: 10.1007/s10439-022-03017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/07/2022] [Indexed: 12/30/2022]
Abstract
Irreversible electroporation (IRE) by high-strength electric pulses is a biomedical technique that has been effectively used for minimally invasive tumor therapy while maintaining the functionality of adjacent important tissues, such as blood vessels and nerves. In general, pulse delivery using needle electrodes can create a reversible electroporation region beyond both the ablation area and the vicinity of the needle electrodes, limiting enlargement of the ablation area. Electrochemical therapy (EChT) can also be used to ablate a tumor near electrodes by electrolysis using a direct field with a constant current or voltage (DC field). Recently, reversible electroporated cells have been shown to be susceptible to electrolysis at relatively low doses. Reversible electroporation can also be combined with electrolysis for tissue ablation. Therefore, the objective of this study is to use electrolysis to remove the reversible electroporation area and thereby enlarge the ablation area in potato slices in vitro using a pulsed field with a bias DC field (constant voltage). We call this protocol electrolytic irreversible electroporation (E-IRE). The area over which the electrolytic effect induced a pH change was also measured. The results show that decreasing the pulse frequency using IRE alone is found to enlarge the ablation area. The ablation area generated by E-IRE is significantly larger than that generated by using IRE or EChT alone. The ablation area generated by E-IRE at 1 Hz is 109.5% larger than that generated by IRE, showing that the reversible electroporation region is transformed into an ablation region by electrolysis. The area with a pH change produced by E-IRE is larger than that produced by EChT alone. Decreasing the pulse frequency in the E-IRE protocol can further enlarge the ablation area. The results of this study are a preliminary indication that the E-IRE protocol can effectively enlarge the ablation area and enhance the efficacy of traditional IRE for use in ablating large tumors.
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Affiliation(s)
- Yanpeng Lv
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China.
| | - Heqing Liu
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Zhikui Feng
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Jianhua Zhang
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Genyong Chen
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Chenguo Yao
- School of Electrical Engineering, Chongqing University, Chongqing, 400030, China
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3
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Poulkouras R, Dijk G, Lefevre M, Bača M, Moreau D, O'Connor RP. PEDOT:PSS coated electrodes reduce intracellular oxidation and cell damage with pulsed electric field application. Bioelectrochemistry 2022; 147:108163. [DOI: 10.1016/j.bioelechem.2022.108163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
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4
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Sachdev S, Potočnik T, Rems L, Miklavčič D. Revisiting the role of pulsed electric fields in overcoming the barriers to in vivo gene electrotransfer. Bioelectrochemistry 2022; 144:107994. [PMID: 34930678 DOI: 10.1016/j.bioelechem.2021.107994] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/15/2021] [Accepted: 11/02/2021] [Indexed: 12/21/2022]
Abstract
Gene therapies are revolutionizing medicine by providing a way to cure hitherto incurable diseases. The scientific and technological advances have enabled the first gene therapies to become clinically approved. In addition, with the ongoing COVID-19 pandemic, we are witnessing record speeds in the development and distribution of gene-based vaccines. For gene therapy to take effect, the therapeutic nucleic acids (RNA or DNA) need to overcome several barriers before they can execute their function of producing a protein or silencing a defective or overexpressing gene. This includes the barriers of the interstitium, the cell membrane, the cytoplasmic barriers and (in case of DNA) the nuclear envelope. Gene electrotransfer (GET), i.e., transfection by means of pulsed electric fields, is a non-viral technique that can overcome these barriers in a safe and effective manner. GET has reached the clinical stage of investigations where it is currently being evaluated for its therapeutic benefits across a wide variety of indications. In this review, we formalize our current understanding of GET from a biophysical perspective and critically discuss the mechanisms by which electric field can aid in overcoming the barriers. We also identify the gaps in knowledge that are hindering optimization of GET in vivo.
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Affiliation(s)
- Shaurya Sachdev
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, 1000 Ljubljana, Slovenia
| | - Tjaša Potočnik
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, 1000 Ljubljana, Slovenia
| | - Lea Rems
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, 1000 Ljubljana, Slovenia
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, 1000 Ljubljana, Slovenia.
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5
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Cytotoxicity of a Cell Culture Medium Treated with a High-Voltage Pulse Using Stainless Steel Electrodes and the Role of Iron Ions. MEMBRANES 2022; 12:membranes12020184. [PMID: 35207105 PMCID: PMC8877239 DOI: 10.3390/membranes12020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/01/2023]
Abstract
High-voltage pulses applied to a cell suspension cause not only cell membrane permeabilization, but a variety of electrolysis reactions to also occur at the electrode–solution interfaces. Here, the cytotoxicity of a culture medium treated by a single electric pulse and the role of the iron ions in this cytotoxicity were studied in vitro. The experiments were carried out on mouse hepatoma MH-22A, rat glioma C6, and Chinese hamster ovary cells. The cell culture medium treated with a high-voltage pulse was highly cytotoxic. All cells died in the medium treated by a single electric pulse with a duration of 2 ms and an amplitude of just 0.2 kV/cm. The medium treated with a shorter pulse was less cytotoxic. The cell viability was inversely proportional to the amount of electric charge that flowed through the solution. The amount of iron ions released from the stainless steel anode (>0.5 mM) was enough to reduce cell viability. However, iron ions were not the sole reason of cell death. To kill all MH-22A and CHO cells, the concentration of Fe3+ ions in a medium of more than 2 mM was required.
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6
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Groen MHA, van Es R, van Klarenbosch BR, Stehouwer M, Loh P, Doevendans PA, Wittkampf FH, Neven K. In vivo analysis of the origin and characteristics of gaseous microemboli during catheter-mediated irreversible electroporation. Europace 2021; 23:139-146. [PMID: 33111141 PMCID: PMC7842095 DOI: 10.1093/europace/euaa243] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/27/2020] [Indexed: 01/21/2023] Open
Abstract
Aims Irreversible electroporation (IRE) ablation is a non-thermal ablation method based on the application of direct current between a multi-electrode catheter and skin electrode. The delivery of current through blood leads to electrolysis. Some studies suggest that gaseous (micro)emboli might be associated with myocardial damage and/or (a)symptomatic cerebral ischaemic events. The aim of this study was to compare the amount of gas generated during IRE ablation and during radiofrequency (RF) ablation. Methods and results In six 60–75 kg pigs, an extracorporeal femoral shunt was outfitted with a bubble-counter to detect the size and total volume of gas bubbles. Anodal and cathodal 200 J IRE applications were delivered in the left atrium (LA) using a 14-electrode circular catheter. The 30 and 60 s 40 W RF point-by-point ablations were performed. Using transoesophageal echocardiography (TOE), gas formation was visualized. Average gas volumes were 0.6 ± 0.6 and 56.9 ± 19.1 μL (P < 0.01) for each anodal and cathodal IRE application, respectively. Also, qualitative TOE imaging showed significantly less LA bubble contrast with anodal than with cathodal applications. Radiofrequency ablations produced 1.7 ± 2.9 and 6.7 ± 7.4 μL of gas, for 30 and 60 s ablation time, respectively. Conclusion Anodal IRE applications result in significantly less gas formation than both cathodal IRE applications and RF applications. This finding is supported by TOE observations.
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Affiliation(s)
- Marijn H A Groen
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - René van Es
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Bas R van Klarenbosch
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marco Stehouwer
- Department of Extracorporeal Circulation, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Peter Loh
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Netherlands Heart Institute, Utrecht, The Netherlands
| | - Fred H Wittkampf
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Kars Neven
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Department of Electrophysiology, Alfried Krupp Krankenhaus, Essen, Germany.,Faculty of Health, Witten/Herdecke University, Witten, Germany
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7
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Wang M, Yoon G, Song J, Jo J. Exendin-4 improves long-term potentiation and neuronal dendritic growth in vivo and in vitro obesity condition. Sci Rep 2021; 11:8326. [PMID: 33859286 PMCID: PMC8050263 DOI: 10.1038/s41598-021-87809-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
Metabolic syndrome, which increases the risk of obesity and type 2 diabetes has emerged as a significant issue worldwide. Recent studies have highlighted the relationship between metabolic imbalance and neurological pathologies such as memory loss. Glucagon-like peptide 1 (GLP-1) secreted from gut L-cells and specific brain nuclei plays multiple roles including regulation of insulin sensitivity, inflammation and synaptic plasticity. Although GLP-1 and GLP-1 receptor agonists appear to have neuroprotective function, the specific mechanism of their action in brain remains unclear. We investigated whether exendin-4, as a GLP-1RA, improves cognitive function and brain insulin resistance in metabolic-imbalanced mice fed a high-fat diet. Considering the result of electrophysiological experiments, exendin-4 inhibits the reduction of long term potentiation (LTP) in high fat diet mouse brain. Further, we identified the neuroprotective effect of exendin-4 in primary cultured hippocampal and cortical neurons in in vitro metabolic imbalanced condition. Our results showed the improvement of IRS-1 phosphorylation, neuronal complexity, and the mature of dendritic spine shape by exendin-4 treatment in metabolic imbalanced in vitro condition. Here, we provides significant evidences on the effect of exendin-4 on synaptic plasticity, long-term potentiation, and neural structure. We suggest that GLP-1 is important to treat neuropathology caused by metabolic syndrome.
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Affiliation(s)
- Ming Wang
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, 264 seoyangro, Hwasun, 58128, Republic of Korea
| | - Gwangho Yoon
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, 264 seoyangro, Hwasun, 58128, Republic of Korea.,Department of Anatomy, Chonnam National University Medical School, Hwasun, Jeollanam-do, 58128, Republic of Korea
| | - Juhyun Song
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, 264 seoyangro, Hwasun, 58128, Republic of Korea. .,Department of Anatomy, Chonnam National University Medical School, Hwasun, Jeollanam-do, 58128, Republic of Korea.
| | - Jihoon Jo
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, 264 seoyangro, Hwasun, 58128, Republic of Korea. .,NeuroMedical Convergence Lab, Biomedical Research Institute, Chonnam National University Hospital, Jebong-ro, Gwangju, 501-757, Republic of Korea. .,Department of Neurology, Chonnam National University Medical School, Gwangju, 501-757, Republic of Korea.
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8
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Potočnik T, Miklavčič D, Maček Lebar A. Gene transfer by electroporation with high frequency bipolar pulses in vitro. Bioelectrochemistry 2021; 140:107803. [PMID: 33975183 DOI: 10.1016/j.bioelechem.2021.107803] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022]
Abstract
High-frequency bipolar pulses (HF-BP) have been demonstrated to be efficient for membrane permeabilization and irreversible electroporation. Since membrane permeabilization has been achieved using HF-BP pulses we hypothesized that with these pulses we can also achieve successful gene electrotransfer (GET). Three variations of bursts of 2 µs bipolar pulses with 2 µs interphase delay were applied in HF-BP protocols. We compared transfection efficiency of monopolar micro and millisecond pulses and HF-BP protocols at various plasmid DNA (pDNA) concentrations on CHO - K1 cells. GET efficiency increased with increasing pDNA concentration. Overall GET obtained by HF-BP pulse protocols was comparable to overall GET obtained by longer monopolar pulse protocols. Our results, however, suggest that although we were able to achieve similar percent of transfected cells, the number of pDNA copies that were successfully transferred into cells seemed to be higher when longer monopolar pulses were used. Interestingly, we did not observe any direct correlation between fluorescence intensity of pDNA aggregates formed on cell membrane and transfection efficiency. The results of our study confirmed that we can achieve successful GET with bipolar microsecond i. e. HF-BP pulses, although at the expense of higher pDNA concentrations.
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Affiliation(s)
- Tjaša Potočnik
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia
| | - Alenka Maček Lebar
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia.
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O'Brien C, Ignaszak A. Advances in the Electrochemical Treatment of Cancers and Tumors: Exploring the Current Trends, Advancements, and Mechanisms of Electrolytic Tumor Ablation. ChemElectroChem 2020. [DOI: 10.1002/celc.202000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Connor O'Brien
- Connor O'Brien Department of Chemistry University of New Brunswick 30 Dineen Drive Fredericton NB E3B 5A3
| | - Anna Ignaszak
- Department of Chemistry University of New Brunswick 30 Dineen Drive Fredericton NB E3B 5A3
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10
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Kim HB, Chung JH. Incorporation of Reversible Electroporation Into Electrolysis Accelerates Apoptosis for Rat Liver Tissue. Technol Cancer Res Treat 2020; 19:1533033820948051. [PMID: 32985353 PMCID: PMC7534095 DOI: 10.1177/1533033820948051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Tissue electrolysis is an alternative modality that uses a low intensity direct electric current passing through at least 2 electrodes within the tissue and resulting electrochemical products including chlorine and hydrogen. These products induce changes in pH around electrodes and cause dehydration resulting from electroosmotic pressure, leading to changes in microenvironment and thus metabolism of the tissues, yielding apoptosis. The procedure requires adequate time for electrochemical reactions to yield products sufficient to induce apoptosis of the tissues. Incorporation of electroporation into electrolysis can decrease the treatment time and enhance the efficiency of electrolytic ablation. Electroporation causes permeabilization in the cell membrane allowing the efflux of potassium ions and extension of the electrochemical area, facilitating the electrolysis process. However, little is known about the combined effects on apoptosis in liver ablation. In this study, we performed an immunohistochemical evaluation of apoptosis for the incorporation of electroporation into electrolysis in liver tissues. To do so, the study was performed with microelectrodes for fixed treatment time while the applied voltage varied to increase the applied total energy for electrolysis. The apoptotic rate for electrolytic ablation increased with enhanced applied energy. The apoptotic rate was 4.31 ± 1.73 times that of control in the synergistic combination compared to 1.49 ± 0.33 times that of the control in electrolytic ablation alone. Additionally, tissue structure was better preserved in synergistic combination ablation compared to electrolysis with an increment of 3.8 mA. Thus, synergistic ablation may accelerate apoptosis and be a promising modality for the treatment of liver tumors.
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Affiliation(s)
- Hong Bae Kim
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Jong Hoon Chung
- Department of Biosystems & Biomaterials Science and Engineering, Seoul National University, Seoul, Republic of Korea.,Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
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Goris NAV, Rodríguez JLG, González MM, Borges BO, Morales DF, Calzado EM, Castañeda ARS, Torres LM, Montijano JI, González VGS, Pérez DJ, Posada OO, Martínez JA, Delgado AG, Martínez KG, Mon ML, Monzón KL, Ciria HMC, Cabrales LEB. Efficacy of direct current generated by multiple-electrode arrays on F3II mammary carcinoma: experiment and mathematical modeling. J Transl Med 2020; 18:190. [PMID: 32381006 PMCID: PMC7206687 DOI: 10.1186/s12967-020-02352-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/25/2020] [Indexed: 11/29/2022] Open
Abstract
Background The modified Gompertz equation has been proposed to fit experimental data for direct current treated tumors when multiple-straight needle electrodes are individually inserted into the base perpendicular to the tumor long axis. The aim of this work is to evaluate the efficacy of direct current generated by multiple-electrode arrays on F3II mammary carcinoma that grow in the male and female BALB/c/Cenp mice, when multiple-straight needle electrodes and multiple-pairs of electrodes are inserted in the tumor. Methods A longitudinal and retrospective preclinical study was carried out. Male and female BALB/c/Cenp mice, the modified Gompertz equation, intensities (2, 6 and 10 mA) and exposure times (10 and 20 min) of direct current, and three geometries of multiple-electrodes (one formed by collinear electrodes and two by pair-electrodes) were used. Tumor volume and mice weight were measured. In addition, the mean tumor doubling time, tumor regression percentage, tumor growth delay, direct current overall effectiveness and mice survival were calculated. Results The greatest growth retardation, mean doubling time, regression percentage and growth delay of the primary F3II mammary carcinoma in male and female mice were observed when the geometry of multiple-pairs of electrodes was arranged in the tumor at 45, 135, 225 and 325o and the longest exposure time. In addition, highest direct current overall effectiveness (above 66%) was observed for this EChT scheme. Conclusions It is concluded that electrochemical therapy may be potentially addressed to highly aggressive and metastic primary F3II murine mammary carcinoma and the modified Gompertz equation may be used to fit data of this direct current treated carcinoma. Additionally, electrochemical therapy effectiveness depends on the exposure time, geometry of multiple-electrodes and ratio between the direct current intensity applied and the polarization current induced in the tumor.
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Affiliation(s)
- Narciso Antonio Villar Goris
- Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana.,Universidad Católica del Cibao, La Vega, República Dominicana.,Departamento de Investigación e Innovación, Centro Nacional de Electromagnetismo Aplicado, Dirección de Ciencia e Innovación , Universidad de Oriente, Ave. Las Américas s/n, Santiago de Cuba, 90400, Cuba
| | - Jorge Luis García Rodríguez
- Departamento de Investigación e Innovación, Centro Nacional de Electromagnetismo Aplicado, Dirección de Ciencia e Innovación , Universidad de Oriente, Ave. Las Américas s/n, Santiago de Cuba, 90400, Cuba
| | - Maraelys Morales González
- Departamento de Farmacia, Facultad de Ciencias Naturales y Exactas, Universidad de Oriente, Santiago de Cuba, Cuba
| | | | | | - Enaide Maine Calzado
- Departamento de Telecomunicaciones, Facultad de Ingeniería Eléctrica, Universidad de Oriente, Santiago de Cuba, Cuba
| | | | - Leonardo Mesa Torres
- Departamento de Investigación e Innovación, Centro Nacional de Electromagnetismo Aplicado, Dirección de Ciencia e Innovación , Universidad de Oriente, Ave. Las Américas s/n, Santiago de Cuba, 90400, Cuba
| | - Juan Ignacio Montijano
- Instituto Universitario de Investigación de Matemáticas y Aplicaciones, Universidad de Zaragoza, Saragossa, Spain
| | | | - Daniel Jay Pérez
- Centro Nacional para la Producción de Animales de Laboratorio, La Habana, Cuba
| | - Oscar Ortiz Posada
- Centro Nacional para la Producción de Animales de Laboratorio, La Habana, Cuba
| | | | | | | | | | | | - Héctor Manuel Camué Ciria
- Departamento de Investigación e Innovación, Centro Nacional de Electromagnetismo Aplicado, Dirección de Ciencia e Innovación , Universidad de Oriente, Ave. Las Américas s/n, Santiago de Cuba, 90400, Cuba
| | - Luis Enrique Bergues Cabrales
- Departamento de Investigación e Innovación, Centro Nacional de Electromagnetismo Aplicado, Dirección de Ciencia e Innovación , Universidad de Oriente, Ave. Las Américas s/n, Santiago de Cuba, 90400, Cuba.
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12
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Klein N, Mercadal B, Stehling M, Ivorra A. In vitro study on the mechanisms of action of electrolytic electroporation (E2). Bioelectrochemistry 2020; 133:107482. [PMID: 32062417 DOI: 10.1016/j.bioelechem.2020.107482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/03/2020] [Accepted: 02/08/2020] [Indexed: 12/18/2022]
Abstract
Electrolytic Electroporation (E2) is the combination of reversible electroporation and electrolysis. It has been proposed as a novel treatment option to ablate tissue percutaneously. The present in vitro study in cells in suspension was performed to investigate the underlying mechanisms of action of E2. Different types of experiments were performed to isolate the effects of the electrolysis and the electroporation components of the treatment. Additionally, thermal simulations were performed to determine whether significant temperature increase contributes to the effect. The results indicate that E2's cell killing efficacy is due to a combinational effect of electrolysis and reversible electroporation that takes place within the first two minutes after E2 application. The results further show that cell death after E2 treatment is significantly delayed. These observations suggest that cell death is induced in permeabilized cells due to the uptake of electrolysis species. Thermal simulations revealed a significant but innocuous temperature increase.
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Affiliation(s)
- Nina Klein
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain; Institut fur Bildgebende Diagnostik, Strahlenbergerstrasse 110, 63067 Offenbach, Germany; Inter Science GmbH, Reussblickstr 23, 6038 Gisikon, Lucerne, Switzerland; Catalan Industrial Doctorates Program, Spain.
| | - Borja Mercadal
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain
| | - Michael Stehling
- Institut fur Bildgebende Diagnostik, Strahlenbergerstrasse 110, 63067 Offenbach, Germany; Inter Science GmbH, Reussblickstr 23, 6038 Gisikon, Lucerne, Switzerland
| | - Antoni Ivorra
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/Roc Boronat 138, E-08018 Barcelona, Spain; Serra Húnter Fellow Programme, Universitat Pompeu Fabra, Barcelona, Spain
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13
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Guenther E, Klein N, Mikus P, Botea F, Pautov M, Lugnani F, Macchioro M, Popescu I, Stehling MK, Rubinsky B. Toward a clinical real time tissue ablation technology: combining electroporation and electrolysis (E2). PeerJ 2020; 8:e7985. [PMID: 31998549 PMCID: PMC6977482 DOI: 10.7717/peerj.7985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/03/2019] [Indexed: 01/05/2023] Open
Abstract
Background Percutaneous image-guided tissue ablation (IGA) plays a growing role in the clinical management of solid malignancies. Electroporation is used for IGA in several modalities: irreversible electroporation (IRE), and reversible electroporation with chemotoxic drugs, called electrochemotherapy (ECT). It was shown that the combination of electrolysis and electroporation—E2—affords tissue ablation with greater efficiency, that is, lower voltages, lower energy and shorter procedure times than IRE and without the need for chemotoxic additives as in ECT. Methods A new E2 waveform was designed that delivers optimal doses of electroporation and electrolysis in a single waveform. A series of experiments were performed in the liver of pigs to evaluate E2 in the context of clinical applications. The goal was to find initial parameter boundaries in terms of electrical field, pulse duration and charge as well as tissue behavior to enable real time tissue ablation of clinically relevant volumes. Results Histological results show that a single several hundred millisecond long E2 waveform can ablate large volume of tissue at relatively low voltages while preserving the integrity of large blood vessels and lumen structures in the ablation zone without the use of chemotoxic drugs or paralyzing drugs during anesthesia. This could translate clinically into much shorter treatment times and ease of use compared to other techniques that are currently applied.
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Affiliation(s)
- Enric Guenther
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA.,Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Nina Klein
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Institut fur Bildgebende Diagnostik, Offenbach, Germany.,Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Paul Mikus
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland
| | - Florin Botea
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihail Pautov
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | | | | | - Irinel Popescu
- Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.,Center of Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Michael K Stehling
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA.,Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Boris Rubinsky
- Biophysics, Inter Science GmbH, Gisikon, Lucerne, Switzerland.,Department of Bioengineering and Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA, USA
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Klein N, Guenther E, Botea F, Pautov M, Dima S, Tomescu D, Popescu M, Ivorra A, Stehling M, Popescu I. The combination of electroporation and electrolysis (E2) employing different electrode arrays for ablation of large tissue volumes. PLoS One 2019; 14:e0221393. [PMID: 31437212 PMCID: PMC6705851 DOI: 10.1371/journal.pone.0221393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022] Open
Abstract
Background The combination of electroporation with electrolysis (E2) has previously been introduced as a novel tissue ablation technique. E2 allows the utilization of a wide parameter range and may therefore be a suitable technology for development of tissue-specific application protocols. Previous studies have implied that it is possible to achieve big lesions in liver in a very short time. The goal of this study was to test a variety of electrode configurations for the E2 application to ablate large tissue volumes. Materials and methods 27 lesions were performed in healthy porcine liver of five female pigs. Four, two and bipolar electrode-arrays were used to deliver various E2 treatment protocols. Liver was harvested approx. 20h after treatment and examined with H&E and Masson’s trichrome staining, and via TUNEL staining for selective specimen. Results All animals survived the treatments without complications. With four electrodes, a lesion of up to 35x35x35mm volume can be achieved in less than 30s. The prototype bipolar electrode created lesions of 50x18x18mm volume in less than 10s. Parameters for two-electrode ablations with large exposures encompassing large veins were found to be good in terms of vessel preservation, but not optimal to reliably close the gap between the electrodes. Conclusion This study demonstrates the ability to produce large lesions in liver within seconds at lower limits of the E2 parameter space at different electrode configurations. The applicability of E2 for single electrode ablations was demonstrated with bipolar electrodes. Parameters for large 4-electrode ablation volumes were found suitable, while parameters for two electrodes still need optimization. However, since the parameter space of E2 is large, it is possible that for all electrode geometries optimal waveforms and application protocols for specific tissues will emerge with continuing research.
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Affiliation(s)
- Nina Klein
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- * E-mail:
| | - Enric Guenther
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Florin Botea
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Mihail Pautov
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Simona Dima
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
| | - Dana Tomescu
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
- Department of Anesthesiology and Intensive Care 3, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihai Popescu
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
- Department of Anesthesiology and Intensive Care 3, Fundeni Clinical Institute, Bucharest, Romania
| | - Antoni Ivorra
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Michael Stehling
- Inter Science GmbH, Lucerne, Switzerland
- Institut fur Bildgebende Diagnostik, Offenbach, Germany
| | - Irinel Popescu
- Center of General Surgery and Liver Transplantation–Fundeni Clinical Institute, Bucharest, Romania
- Center of Translational Medicine–Fundeni Clinical Institute, Bucharest, Romania
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Mokhtare A, Shiv Krishna Reddy M, Roodan VA, Furlani EP, Abbaspourrad A. The role of pH fronts, chlorination and physicochemical reactions in tumor necrosis in the electrochemical treatment of tumors: A numerical study. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.03.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Molecular and histological study on the effects of electrolytic electroporation on the liver. Bioelectrochemistry 2019; 125:79-89. [DOI: 10.1016/j.bioelechem.2018.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/24/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023]
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17
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Zhang Y, Lyu C, Liu Y, Lv Y, Chang TT, Rubinsky B. Molecular and histological study on the effects of non-thermal irreversible electroporation on the liver. Biochem Biophys Res Commun 2018; 500:665-670. [PMID: 29678581 DOI: 10.1016/j.bbrc.2018.04.132] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 04/17/2018] [Indexed: 01/25/2023]
Abstract
Non-thermal irreversible electroporation (NTIRE) is a biophysical phenomenon in which certain electric fields delivered across the cell membrane in tissue, cause cell death, without affecting the extracellular matrix. "Minimally invasive regenerative surgery" is a new medical modality for treatment of end-stage organ or tissue failure in which exogenous cells are implanted in a decellularized niche in tissue, formed by the delivery of NTIRE electric fields across a targeted volume of tissue. We anticipate that the success of the procedure will depend on the time of implantation relative to the application of NTIRE. This study was performed to elucidate the histological and molecular events that occur within 24 h after NTIRE, in the context of optimal criteria for the time of implantation. To this end, we examined the histology of NTIRE treated rat liver with H&E, Masson trichrome and TUNEL staining. Western blot was used to examine pro and cleaved caspase-3 (marker for apoptosis), pro and cleaved caspase-1 and gasdermin D (markers for pyroptosis), and RIP3 and MLKL (markers for necroptosis). The key findings are that, complete hepatocytes disintegration within an intact extracellular matrix is seen at 6 h and, new hepatocytes are seen in the treated region at 24 h, after NTIRE. There is no evidence of apoptotic cell death from NTIRE, contrary to commonly made claims in the NTIRE literature. However, molecular pathways of pyroptosis and necroptosis, programed necrosis associated with inflammation, are activated at 6 h after NTIRE and are not evident at 24 h after NTIRE. These are fundamental new findings of basic value to the field of NTIRE in all its applications. Taken together the results suggest the hypothesis that an optimal time for implantation is about 24 h after NTIRE. Future studies in which exogenous cells are implanted at different times after NTIRE are required to examine this hypothesis.
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Affiliation(s)
- Yanfang Zhang
- Department of Mechanical Engineering and Department of Bioengineering, University of California Berkeley, CA 94720, USA; Department of Endocrinology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471009, China.
| | - Chenang Lyu
- Department of Mechanical Engineering and Department of Bioengineering, University of California Berkeley, CA 94720, USA; Zhejiang University, College of Biosystems Engineering and Food Science, Hangzhou 310058, China
| | - Yu Liu
- Department of Pathology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Yanpeng Lv
- Department of Mechanical Engineering and Department of Bioengineering, University of California Berkeley, CA 94720, USA; Chongqing University, College of Electrical Engineering, Chongqing 400030, China
| | - Tammy T Chang
- Department of Surgery, University of California, San Francisco, CA 94143, USA
| | - Boris Rubinsky
- Department of Mechanical Engineering and Department of Bioengineering, University of California Berkeley, CA 94720, USA
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18
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Cryoelectrolysis; an acute case study in the pig liver. Cryobiology 2017; 78:110-114. [PMID: 28782504 DOI: 10.1016/j.cryobiol.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/16/2017] [Accepted: 08/01/2017] [Indexed: 11/23/2022]
Abstract
We report results from an acute, single case study in the pig liver on the effects of a tissue ablation protocol (we named cryoelectrolysis) in which 10 min of cryosurgery, with a commercial cryosurgical probe, are delivered after 10 min of electrolysis generated by a current of about 60 mA. The histological appearance of tissue treated with cryoelectrolysis is compared with the appearance of tissue treated with 10 min of cryosurgery alone and with 10 min of electrolysis alone. Histology done after 3 h survival shows that the mixed rim of live and dead cells found around the ablated lesion in both cryosurgery and electrolytic ablation is replaced by a sharp margin between life and dead cells in cryoelectrolysis. The appearance of the dead cells in each, cryoelectrolysis, cryosurgery and electrolytic ablation is different. Obviously, this is an acute study and the results are only relevant to the conditions of this study. There is no doubt that additional acute and chronic studies are needed to strengthen and expand the findings of this study.
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19
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Manuel TJ, Munnangi P, Rubinsky B. An Electrochemistry Study of Cryoelectrolysis in Frozen Physiological Saline. IEEE Trans Biomed Eng 2017; 64:1654-1659. [PMID: 28113196 DOI: 10.1109/tbme.2016.2627402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cryoelectrolysis is a new minimally invasive tissue ablation surgical technique that combines the processes of electrolysis and solid/liquid phase transformation (freezing). This study investigated this new technique by measuring the pH front propagation and the changes in resistance in a tissue simulant made of physiological saline gel with a pH dye as a function of the sample temperature in the high subzero range above the eutectic. Results demonstrated that effective electrolysis can occur in a high subzero freezing milieu and that the propagation of the pH front is only weakly dependent on temperature. These observations are consistent with a mechanism involving ionic movement through the concentrated saline solution channels between ice crystals at subfreezing temperatures above the eutectic. Moreover, results suggest that Joule heating in these microchannels may cause local microscopic melting, the observed weak dependence of pH front propagation on temperature, and the large changes in resistance with time. A final insight provided by the results is that the pH front propagation from the anode is more rapid than from the cathode, a feature indicative of the electro-osmotic flow from the cathode to the anode. The findings in this paper may be critical for designing future cryoelectrolytic ablation surgery protocols.
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20
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Lugnani F, Macchioro M, Rubinsky B. Cryoelectrolysis-electrolytic processes in a frozen physiological saline medium. PeerJ 2017; 5:e2810. [PMID: 28123904 PMCID: PMC5244893 DOI: 10.7717/peerj.2810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/21/2016] [Indexed: 11/23/2022] Open
Abstract
Background Cryoelectrolysis is a new minimally invasive tissue ablation surgical technique that combines the ablation techniques of electrolytic ablation with cryosurgery. The goal of this study is to examine the hypothesis that electrolysis can take place in a frozen aqueous saline solution. Method To examine the hypothesis we performed a cryoelectrolytic ablation protocol in which electrolysis and cryosurgery are delivered simultaneously in a tissue simulant made of physiological saline gel with a pH dye. We measured current flow, voltage and extents of freezing and pH dye staining. Results Using optical measurements and measurements of currents, we have shown that electrolysis can occur in frozen physiological saline, at high subzero freezing temperatures, above the eutectic temperature of the frozen salt solution. It was observed that electrolysis occurs when the tissue resides at high subzero temperatures during the freezing stage and essentially throughout the entire thawing stage. We also found that during thawing, the frozen lesion temperature raises rapidly to high subfreezing values and remains at those values throughout the thawing stage. Substantial electrolysis occurs during the thawing stage. Another interesting finding is that electro-osmotic flows affect the process of cryoelectrolysis at the anode and cathode, in different ways. Discussion The results showing that electrical current flow and electrolysis occur in frozen saline solutions imply a mechanism involving ionic movement in the fluid concentrated saline solution channels between ice crystals, at high subfreezing temperatures. Temperatures higher than the eutectic are required for the brine to be fluid. The particular pattern of temperature and electrical currents during the thawing stage of frozen tissue, can be explained by the large amounts of energy that must be removed at the outer edge of the frozen lesion because of the solid/liquid phase transformation on that interface. Conclusion Electrolysis can occur in a frozen domain at high subfreezing temperature, probably above the eutectic. It appears that the most effective period for delivering electrolytic currents in cryoelectrolysis is during the high subzero temperatures stage while freezing and immediately after cooling has stopped, throughout the thawing stage.
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Affiliation(s)
| | | | - Boris Rubinsky
- Department of Bioengineering and Department of Mechanical Engineering, University of California , Berkley , CA , United States
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21
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Rubinsky L, Patrick B, Mikus P, Rubinsky B. Germicide wound pad with active, in situ, electrolytically produced hypochlorous acid. Biomed Microdevices 2016; 18:26. [PMID: 26888442 DOI: 10.1007/s10544-016-0052-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We describe a new wound dressing technology that can actively generate an inorganic germicide agent, in situ, within the wound pad. The technology provides real time control over the quantitative, spatial and temporal delivery of the germicide. The identity of the germicide is hypochlorous acid (HClO). The HClO is produced in a flexible wound pad, made of a composite of thin (micrometer scale) layers of various materials, with different electrochemical properties that enhance HClO production. Active control over the production of HClO is achieved by control of the pH and of the electric potential across the layers. The effectiveness of the Active HClO Pad (AHClOP) concept is demonstrated in a study on sterilization of E. coli in a deep wound contamination simulating gel. The performance of the AHClOP is compared with that of four commercial wound dressings. Results show that the AHClOP can sterilize throughout the gel, while the commercial dressings cannot.
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Affiliation(s)
- L Rubinsky
- RM2 Technologies LTD., 31 Pegasus Drive, Coto De Caza, CA, 92679, USA
| | - B Patrick
- RM2 Technologies LTD., 31 Pegasus Drive, Coto De Caza, CA, 92679, USA.,Exponent, Inc., 149 Commonwealth Dr., Menlo Park, CA, 94025, USA
| | - P Mikus
- RM2 Technologies LTD., 31 Pegasus Drive, Coto De Caza, CA, 92679, USA
| | - B Rubinsky
- RM2 Technologies LTD., 31 Pegasus Drive, Coto De Caza, CA, 92679, USA. .,Department of Mechanical Engineering, University of California Berkeley, Berkeley, CA, 94720, USA.
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Phillips M, Krishnan H, Raju N, Rubinsky B. Tissue Ablation by a Synergistic Combination of Electroporation and Electrolysis Delivered by a Single Pulse. Ann Biomed Eng 2016; 44:3144-3154. [DOI: 10.1007/s10439-016-1624-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/20/2016] [Indexed: 01/20/2023]
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23
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Synergistic Combination of Electrolysis and Electroporation for Tissue Ablation. PLoS One 2016; 11:e0148317. [PMID: 26866693 PMCID: PMC4750947 DOI: 10.1371/journal.pone.0148317] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/15/2016] [Indexed: 01/04/2023] Open
Abstract
Electrolysis, electrochemotherapy with reversible electroporation, nanosecond pulsed electric fields and irreversible electroporation are valuable non-thermal electricity based tissue ablation technologies. This paper reports results from the first large animal study of a new non-thermal tissue ablation technology that employs "Synergistic electrolysis and electroporation" (SEE). The goal of this pre-clinical study is to expand on earlier studies with small animals and use the pig liver to establish SEE treatment parameters of clinical utility. We examined two SEE methods. One of the methods employs multiple electrochemotherapy-type reversible electroporation magnitude pulses, designed in such a way that the charge delivered during the electroporation pulses generates the electrolytic products. The second SEE method combines the delivery of a small number of electrochemotherapy magnitude electroporation pulses with a low voltage electrolysis generating DC current in three different ways. We show that both methods can produce lesion with dimensions of clinical utility, without the need to inject drugs as in electrochemotherapy, faster than with conventional electrolysis and with lower electric fields than irreversible electroporation and nanosecond pulsed ablation.
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Electrical breakdown in tissue electroporation. Biochem Biophys Res Commun 2015; 467:736-41. [PMID: 26482855 DOI: 10.1016/j.bbrc.2015.10.072] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/13/2015] [Indexed: 01/25/2023]
Abstract
Electroporation, the permeabilization of the cell membrane by brief, high electric fields, has become an important technology in medicine for diverse application ranging from gene transfection to tissue ablation. There is ample anecdotal evidence that the clinical application of electroporation is often associated with loud sounds and extremely high currents that exceed the devices design limit after which the devices cease to function. The goal of this paper is to elucidate and quantify the biophysical and biochemical basis for this phenomenon. Using an experimental design that includes clinical data, a tissue phantom, sound, optical, ultrasound and MRI measurements, we show that the phenomenon is caused by electrical breakdown across ionized electrolysis produced gases near the electrodes. The breakdown occurs primarily near the cathode. Electrical breakdown during electroporation is a biophysical phenomenon of substantial importance to the outcome of clinical applications. It was ignored, until now.
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Meir A, Rubinsky B. Electrical impedance tomography of electrolysis. PLoS One 2015; 10:e0126332. [PMID: 26039686 PMCID: PMC4454594 DOI: 10.1371/journal.pone.0126332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 04/01/2015] [Indexed: 11/27/2022] Open
Abstract
The primary goal of this study is to explore the hypothesis that changes in pH during electrolysis can be detected with Electrical Impedance Tomography (EIT). The study has relevance to real time control of minimally invasive surgery with electrolytic ablation. To investigate the hypothesis, we compare EIT reconstructed images to optical images acquired using pH-sensitive dyes embedded in a physiological saline agar gel phantom treated with electrolysis. We further demonstrate the biological relevance of our work using a bacterial E.Coli model, grown on the phantom. The results demonstrate the ability of EIT to image pH changes in a physiological saline phantom and show that these changes correlate with cell death in the E.coli model. The results are promising, and invite further experimental explorations.
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Affiliation(s)
- Arie Meir
- Biophysics Graduate Program, University of California, Berkeley, California, United States of America
| | - Boris Rubinsky
- Department of Mechanical Engineering, University of California, Berkeley, California, United States of America
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