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Göhler D, Oelschlägel K, Ouaissi M, Giger-Pabst U. Performance of different nebulizers in clinical use for Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). PLoS One 2024; 19:e0300241. [PMID: 38696384 PMCID: PMC11065249 DOI: 10.1371/journal.pone.0300241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 02/23/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE Technical ex-vivo comparison of commercial nebulizer nozzles used for Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). METHODS The performance of four different commercial nebulizer nozzles (Nebulizer; HurriChemTM; MCR-4 TOPOL®; QuattroJet) was analysed concerning: i) technical design and principle of operation, ii) operational pressure as function of the liquid flow rate, iii) droplet size distribution via laser diffraction spectrometry, iv) spray cone angle, spray cone form as well as horizontal drug deposition by image-metric analyses and v) chemical resistance via exposing to a cytostatic solution and chemical composition by means of spark optical emission spectral analysis. RESULTS The Nebulizer shows quasi an identical technical design and thus also a similar performance (e.g., mass median droplet size of 29 μm) as the original PIPAC nozzles (MIP/ CapnoPen). All other nozzles show more or less a performance deviation to the original PIPAC nozzles. The HurriChemTM has a similar design and principle of operation as the Nebulizer, but provides a finer aerosol (22 μm). The principle of operation of MCR-4 TOPOL® and QuattroJet differ significantly from that of the original PIPAC nozzle technology. The MCR-4 TOPOL® offers a hollow spray cone with significantly larger droplets (50 μm) than the original PIPAC nozzles. The QuattroJet generates an aerosol (22 μm) similar to that of the HurriChemTM but with improved spatial drug distribution. CONCLUSION The availability of new PIPAC nozzles is encouraging but can also have a negative impact if their performance and efficacy is unknown. It is recommended that PIPAC nozzles that deviate from the current standard should be subject to bioequivalence testing and implementation in accordance with the IDEAL-D framework prior to routine clinical use.
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Affiliation(s)
- Daniel Göhler
- Topas GmbH, Dresden, Germany
- Research Group Mechanical Process Engineering, Institute of Process Engineering and Environmental Technology, Technische Universität Dresden, Dresden, Germany
| | | | - Mehdi Ouaissi
- EA4245 Transplantation, Immunology, Inflammation, Université de Tours, Tours, France
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, University Hospital of Tours, Tours, France
| | - Urs Giger-Pabst
- EA4245 Transplantation, Immunology, Inflammation, Université de Tours, Tours, France
- Fliedner Fachhochschule, University of Applied Sciences Düsseldorf, Düsseldorf, Germany
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2
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Braet H, Fransen PP, Mariën R, Lollo G, Ceelen W, Vervaet C, Balcaen L, Vanhaecke F, Vanhove C, van der Vegte S, Gasthuys E, Vermeulen A, Dankers PYW, De Smedt SC, Remaut K. CO 2-Driven Nebulization of pH-Sensitive Supramolecular Polymers for Intraperitoneal Hydrogel Formation and the Treatment of Peritoneal Metastasis. ACS APPLIED MATERIALS & INTERFACES 2023; 15:49022-49034. [PMID: 37819736 DOI: 10.1021/acsami.3c11274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Because peritoneal metastasis (PM) from ovarian cancer is characterized by non-specific symptoms, it is often diagnosed at advanced stages. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) can be considered a promising drug delivery method for unresectable PM. Currently, the efficacy of intraperitoneal (IP) drug delivery is limited by the off-label use of IV chemotherapeutic solutions, which are rapidly cleared from the IP cavity. Hence, this research aimed to improve PM treatment by evaluating a nanoparticle-loaded, pH-switchable supramolecular polymer hydrogel as a controlled release drug delivery system that can be IP nebulized. Moreover, a multidirectional nozzle was developed to allow nebulization of viscous materials such as hydrogels and to reach an even IP gel deposition. We demonstrated that acidification of the nebulized hydrogelator solution by carbon dioxide, used to inflate the IP cavity during laparoscopic surgery, stimulated the in situ gelation, which prolonged the IP hydrogel retention. In vitro experiments indicated that paclitaxel nanocrystals were gradually released from the hydrogel depot formed, which sustained the cytotoxicity of the formulation for 10 days. Finally, after aerosolization of this material in a xenograft model of PM, tumor progression could successfully be delayed, while the overall survival time was significantly increased compared to non-treated animals.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
| | | | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
| | - Giovanna Lollo
- Laboratoire d'Automatique, de Génie des Procédés et de Génie Pharmaceutique (LAGEPP), Université Claude Bernard Lyon 1, Lyon 69622, France
| | - Wim Ceelen
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent 9000, Belgium
| | - Chris Vervaet
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
| | - Lieve Balcaen
- Department of Chemistry, Ghent University, Ghent 9000, Belgium
| | - Frank Vanhaecke
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Chemistry, Ghent University, Ghent 9000, Belgium
| | - Christian Vanhove
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Electronics and Information Systems, Ghent University, Ghent 9000, Belgium
| | | | - Elke Gasthuys
- Department of Bioanalysis, Ghent University, Ghent 9000, Belgium
| | - An Vermeulen
- Department of Bioanalysis, Ghent University, Ghent 9000, Belgium
| | - Patricia Y W Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
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3
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Braet H, Fransen PP, Chen Y, Van Herck S, Mariën R, Vanhoorne V, Ceelen W, Madder A, Ballet S, Hoogenboom R, De Geest B, Hoorens A, Dankers PYW, De Smedt SC, Remaut K. Smart hydrogels delivered by high pressure aerosolization can prevent peritoneal adhesions. J Control Release 2023; 362:138-150. [PMID: 37619864 DOI: 10.1016/j.jconrel.2023.08.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Postoperative peritoneal adhesions occur in the majority of patients undergoing intra-abdominal surgery and are one of the leading causes of hospital re-admission. There is an unmet clinical need for effective anti-adhesive biomaterials, which can be applied evenly across the damaged tissues. We examined three different responsive hydrogel types, i.e. a thermosensitive PLGA-PEG-PLGA, a pH responsive UPy-PEG and a shear-thinning hexapeptide for this purpose. More specifically, their potential to be homogeneously distributed in the peritoneal cavity by high pressure nebulization and prevent peritoneal adhesions was evaluated. Solutions of each polymer type could be successfully nebulized while retaining their responsive gelation behavior in vitro and in vivo. Furthermore, none of the polymers caused in vitro toxicity on SKOV3-IP2 cells. Following intraperitoneal administration, both the PLGA-PEG-PLGA and the hexapeptide hydrogels resulted in local inflammation and fibrosis and failed in preventing peritoneal adhesions 7 days after adhesion induction. In contrast, the pH sensitive UPy-PEG formulation was well tolerated and could significantly reduce the formation of peritoneal adhesions, even outperforming the commercially available Hyalobarrier® as positive control. To conclude, local nebulization of the bioresponsive UPy-PEG hydrogel can be considered as a promising approach to prevent postsurgical peritoneal adhesions.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | | | - Yong Chen
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Simon Van Herck
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Wim Ceelen
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Annemieke Madder
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Steven Ballet
- Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Richard Hoogenboom
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Bruno De Geest
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Anne Hoorens
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Patricia Y W Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium.
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4
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Lv Q, Wang Y, Xiong Z, Xue Y, Li J, Chen M, Zhou K, Xu H, Zhang X, Liu J, Ren J, Liu B. Microvascularized tumor assembloids model for drug delivery evaluation in colorectal cancer-derived peritoneal metastasis. Acta Biomater 2023; 168:346-360. [PMID: 37393969 DOI: 10.1016/j.actbio.2023.06.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/27/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023]
Abstract
Peritoneal metastasis (PM) is a fatal state of colorectal cancer, and only a few patients may benefit from systemic chemotherapy. Although hyperthermic intraperitoneal chemotherapy (HIPEC) brings hope for affected patients, the drug development and preclinical evaluation of HIPEC are seriously lagging behind, mainly due to the lack of an ideal in vitro PM model that makes drug development over-reliant on expensive and inefficient animal experiments. This study developed an in vitro colorectal cancer PM model [microvascularized tumor assembloids (vTA)] based on an assembly strategy of endothelialized microvessels and tumor spheroids. Our data showed that the in vitro perfusion cultured vTA could maintain a similar gene expression pattern to their parental xenografts. Also, the drug penetration pattern of the in vitro HIPEC in vTA could mimic the drug delivery behavior in tumor nodules during in vivo HIPEC. More importantly, we further confirmed the feasibility of constructing a tumor burden-controlled PM animal model using vTA. In conclusion, we propose a simple and effective strategy to construct physiologically simulated PM models in vitro, thus providing a basis for PM-related drug development and preclinical evaluation of locoregional therapies. STATEMENT OF SIGNIFICANCE: This study developed an in vitro colorectal cancer peritoneal metastasis (PM) model based on microvascularized tumor assembloids (vTA) for drug evaluation. With perfusion culture, vTA could maintain a similar gene expression pattern and tumor heterogeneity to their parental xenografts. And the drug penetration pattern in vTA was similar to the drug delivery behavior in tumor nodules under in vivo treatment. Moreover, vTA was more conducive to construct PM animal models with controllable tumor burden. In conclusion, the construction of vTA could provide a new strategy for the PM-related drug development and preclinical evaluation of locoregional therapies.
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Affiliation(s)
- Qijun Lv
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China; Department of Ultrasound Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China; Department of Gastrointestinal Surgery, the Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Yizhen Wang
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Zhiyong Xiong
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Yifan Xue
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China
| | - Jiajun Li
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Moyang Chen
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Kaijian Zhou
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Hetao Xu
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China
| | - Xiaoge Zhang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China
| | - Jie Liu
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China.
| | - Jie Ren
- Department of Ultrasound Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
| | - Bo Liu
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
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5
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Baggaley AE, Lafaurie GBRC, Tate SJ, Boshier PR, Case A, Prosser S, Torkington J, Jones SEF, Gwynne SH, Peters CJ. Pressurized intraperitoneal aerosol chemotherapy (PIPAC): updated systematic review using the IDEAL framework. Br J Surg 2022; 110:10-18. [PMID: 36056893 PMCID: PMC10364525 DOI: 10.1093/bjs/znac284] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/28/2022] [Accepted: 07/19/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Alice E Baggaley
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | | | - Sophia J Tate
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - Amy Case
- Department of Cancer Services, Swansea Bay University Health Board, Swansea, UK
| | - Susan Prosser
- Department of Library Services, Swansea Bay University Health Board, Swansea, UK
| | - Jared Torkington
- Department of Surgery, University Hospital of Wales, Cardiff, UK
| | - Sadie E F Jones
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK
| | - Sarah H Gwynne
- Department of Cancer Services, Swansea Bay University Health Board, Swansea, UK
| | - Christopher J Peters
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
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6
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Helderman RFCPA, Restrepo MT, Rodermond HM, van Bochove GGW, Löke DR, Franken NAP, Kok HP, Tanis PJ, Crezee J, Oei AL. Non-Invasive Imaging and Scoring of Peritoneal Metastases in Small Preclinical Animal Models Using Ultrasound: A Preliminary Trial. Biomedicines 2022; 10:biomedicines10071610. [PMID: 35884917 PMCID: PMC9313051 DOI: 10.3390/biomedicines10071610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The peritoneum is a common site for the formation of metastases originating from several gastrointestinal and gynecological malignancies. A representative preclinical model to thoroughly explore the pathophysiological mechanisms and to study new treatment strategies is important. A major challenge for such models is defining and quantifying the (total) tumor burden in the peritoneal cavity prior to treatment, since it is preferable to use non-invasive methods. We evaluated ultrasound as a simple and easy-to-handle imaging method for this purpose. Methods: Peritoneal metastases were established in six WAG/Rij rats through i.p. injections of the colon carcinoma cell line CC-531. Using ultrasound, the location, number and size of intraperitoneal tumor nodules were determined by two independent observers. Tumor outgrowth was followed using ultrasound until the peritoneal cancer index (PCI) was ≥8. Interobserver variability and ex vivo correlation were assessed. Results: Visible peritoneal tumor nodules were formed in six WAG/Rij rats within 2–4 weeks after cell injection. In most animals, tumor nodules reached a size of 4–6 mm within 3–4 weeks, with total PCI scores ranging from 10–20. The predicted PCI scores using ultrasound ranged from 11–19 and from 8–18, for observer 1 and 2, respectively, which was quite similar to the ex vivo scores. Conclusions: Ultrasound is a reliable non-invasive method to detect intraperitoneal tumor nodules and quantify tumor outgrowth in a rat model.
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Affiliation(s)
- Roxan F. C. P. A. Helderman
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Center for Experimental and Molecular Medicine (CEMM), Laboratory for Experimental Oncology and Radiobiology (LEXOR), 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Mauricio Tobón Restrepo
- Division of Diagnostic Imaging, Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands;
| | - Hans M. Rodermond
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Center for Experimental and Molecular Medicine (CEMM), Laboratory for Experimental Oncology and Radiobiology (LEXOR), 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Gregor G. W. van Bochove
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Center for Experimental and Molecular Medicine (CEMM), Laboratory for Experimental Oncology and Radiobiology (LEXOR), 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Daan R. Löke
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Nicolaas A. P. Franken
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Center for Experimental and Molecular Medicine (CEMM), Laboratory for Experimental Oncology and Radiobiology (LEXOR), 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - H. Petra Kok
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Pieter J. Tanis
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Johannes Crezee
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
| | - Arlene L. Oei
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (R.F.C.P.A.H.); (H.M.R.); (G.G.W.v.B.); (D.R.L.); (N.A.P.F.); (H.P.K.); (J.C.)
- Center for Experimental and Molecular Medicine (CEMM), Laboratory for Experimental Oncology and Radiobiology (LEXOR), 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, 1105 AZ Amsterdam, The Netherlands
- Correspondence:
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Jiawei Yanghe Decoction Regulates Bone-Lipid Balance through the BMP-SMAD Signaling Pathway to Promote Osteogenic Differentiation of Bone Mesenchymal Stem Cells. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2885419. [PMID: 35769158 PMCID: PMC9236768 DOI: 10.1155/2022/2885419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/21/2022] [Indexed: 11/17/2022]
Abstract
Background The Jiawei Yanghe decoction (JWYHD) is a traditional Chinese medicine formula for the treatment of osteoporosis, but its therapeutic mechanism has not been fully elucidated, and the therapeutic target of the intervention disease needs to be further verified. The dysfunction of bone mesenchymal stem cells (BMSCs) is considered to be an important pathogenesis of postmenopausal osteoporosis (PMOP). The purpose of this study was to explore how JWYHD regulates BMSC differentiation through the BMP-SMAD signal pathway. Methods In the in vivo study, we used an ovariectomized PMOP rat (n = 36, 2-month-old, 200 ± 20 g) model and femur micro-CT analysis to study the effect of JWYHD on bone loss in rats. By immunofluorescence, the translocation expression of BMP2, a key protein in the pathway, was detected. Serum bone metabolism was detected by an enzyme-linked immunosorbent assay (ELISA). Alkaline phosphatase (ALP) activity was detected by alkaline phosphatase staining (ALPS), osteogenesis and matrix mineralization were detected by alizarin red staining (ARS), the adipogenic ability of BMSCs was detected by oil red staining (ORS), and CFU is used to detect the ability of cells to form colonies. The expression of related proteins was detected by western blotting. Results In vivo and in vitro, the OP phenotypes of SD rats induced by ovariectomy (OVX) included impaired bone mineral density and microstructure, abnormal bone metabolism, and impaired MSC differentiation potential. JWYHD treatment reversed this trend and restored the differentiation potential of MSCs. JWYHD medicated serum and direct intervention of drugs activated the BMP-SMAD signaling pathway, promoted the osteogenic differentiation of BMSCs, and inhibited their adipogenic differentiation. Conclusions Our data identified that JWYHD is an effective alternative drug for the treatment of PMOP that functions to stimulate the differentiation of BMSCs into osteoblasts in the BMP-SMAD signaling-dependent mechanism.
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8
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Buggisch JR, Göhler D, Sobilo J, Lerondel S, Rezniczek GA, Stintz M, Rudolph A, Tabchouri N, Roger S, Ouaissi M, Giger-Pabst U. Development and technical validation of an ultrasound nebulizer to deliver intraperitoneal pressurized aerosols in a rat colon cancer peritoneal metastases model. BMC Cancer 2022; 22:570. [PMID: 35597921 PMCID: PMC9124413 DOI: 10.1186/s12885-022-09668-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background/aim To develop and validate a nebulizer device for anti-cancer research on pressurized intraperitoneal aerosol supply in a preclinical peritoneal metastases (PM) rat model. Material and methods For aerosol generation, an ultrasonic nebulizer (USN) was modified. Aerosol analyses were performed ex-vivo by laser diffraction spectrometry (LDS). Intraperitoneal (IP) 99mtechnetium sodium pertechnetate (99mTc) aerosol distribution and deposition were quantified by in-vivo single photon emission computed tomography (SPECT/CT) and compared to liquid IP instillation of equivalent volume/doses of 99mTc with and without capnoperitoneum. PM was induced by IP injection of HCT116-Luc2 human colon cancer cells in immunosuppressed RNU rats. Tumor growth was monitored by bioluminescence imaging (BLI), 18F-FDG positron emission tomography (PET) and tissues examination at necropsy. Results The USN was able to establish a stable and reproducible capnoperitoneum at a pressure of 8 to 10 mmHg. LDS showed that the USN provides a polydisperse and monomodal aerosol with a volume-weighted diameter of 2.6 μm. At a CO2 flow rate of 2 L/min with an IP residence time of 3.9 s, the highest drug deposition efficiency was found to be 15 wt.-%. In comparison to liquid instillation, nebulization showed the most homogeneous IP spatial drug deposition. Compared to BLI, 18F-FDG-PET was more sensitive to detect smaller PM nodules measuring only 1–2 mm in diameter. BLI, 18F-FDG PET and necropsy analyses showed relevant PM in all animals. Conclusions The USN together with the PM rat model are suitable for robust and species-specific preclinical pharmacological studies regarding intraperitoneal delivery of pressurized aerosolized drugs and cancer research.
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Affiliation(s)
- Jonathan R Buggisch
- University of Münster, Medizinische Fakultät, Münster, Germany.,CNRS UPS44, CIPA, PHENOMIN-TAAM, Orléans, France
| | - Daniel Göhler
- Research Group Mechanical Process Engineering, Institute of Process Engineering and Environmental Technology, Technische Universität Dresden, Dresden, Germany.,Technologie-orientierte Partikel-, Analysen- und Sensortechnik, Topas GmbH, Dresden, Germany
| | | | | | - Günther A Rezniczek
- Department of Obstetrics and Gynecology, Marien Hospital Herne, Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Stintz
- Research Group Mechanical Process Engineering, Institute of Process Engineering and Environmental Technology, Technische Universität Dresden, Dresden, Germany
| | - Andreas Rudolph
- Technologie-orientierte Partikel-, Analysen- und Sensortechnik, Topas GmbH, Dresden, Germany
| | - Nicolas Tabchouri
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, University Hospital of Tours, Lille, France
| | - Sébastien Roger
- EA4245 Transplantation, Immunologie, Inflammation, Université de Tours, France.,Institut Universitaire de France, Paris, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, University Hospital of Tours, Lille, France.,EA4245 Transplantation, Immunologie, Inflammation, Université de Tours, France
| | - Urs Giger-Pabst
- EA4245 Transplantation, Immunologie, Inflammation, Université de Tours, France. .,University of Applied Science Düsseldorf, 40489, Düsseldorf, Germany.
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Optimization of intraperitoneal aerosolized drug delivery using computational fluid dynamics (CFD) modeling. Sci Rep 2022; 12:6305. [PMID: 35428819 PMCID: PMC9012796 DOI: 10.1038/s41598-022-10369-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/04/2022] [Indexed: 01/03/2023] Open
Abstract
Intraperitoneal (IP) aerosolized anticancer drug delivery was recently introduced in the treatment of patients with peritoneal metastases. However, little is known on the effect of treatment parameters on the spatial distribution of the aerosol droplets in the peritoneal cavity. Here, computational fluid dynamics (CFD) modeling was used in conjunction with experimental validation in order to investigate the effect of droplet size, liquid flow rate and viscosity, and the addition of an electrostatic field on the homogeneity of IP aerosol. We found that spatial distribution is optimal with small droplet sizes (1–5 µm). Using the current clinically used technology (droplet size of 30 µm), the optimal spatial distribution of aerosol is obtained with a liquid flow rate of 0.6 mL s−1. Compared to saline, nebulization of higher viscosity liquids results in less homogeneous aerosol distribution. The addition of electrostatic precipitation significantly improves homogeneity of aerosol distribution, but no further improvement is obtained with voltages higher than 6.5 kV. The results of the current study will allow to choose treatment parameters and settings in order to optimize spatial distribution of IP aerosolized drug, with a potential to enhance its anticancer effect.
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10
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Development of a rat capnoperitoneum phantom to study drug aerosol deposition in the context of anticancer research on peritoneal carcinomatosis. Sci Rep 2021; 11:21843. [PMID: 34750488 PMCID: PMC8575922 DOI: 10.1038/s41598-021-01332-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023] Open
Abstract
Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a promising approach with a high optimization potential for the treatment of peritoneal carcinomatosis. To study the efficacy of PIPAC and drugs, first rodent cancer models were developed. But inefficient drug aerosol supply and knowledge gaps concerning spatial drug distribution can limit the results based on such models. To study drug aerosol supply/deposition, computed tomography scans of a rat capnoperitoneum were used to deduce a virtual and a physical phantom of the rat capnoperitoneum (RCP). RCP qualification was performed for a specific PIPAC method, where the capnoperitoneum is continuously purged by the drug aerosol. In this context, also in-silico analyses by computational fluid dynamic modelling were conducted on the virtual RCP. The physical RCP was used for ex-vivo granulometric analyses concerning drug deposition. Results of RCP qualification show that aerosol deposition in a continuous purged rat capnoperitoneum depends strongly on the position of the inlet and outlet port. Moreover, it could be shown that the droplet size and charge condition of the drug aerosol define the deposition efficiency. In summary, the developed virtual and physical RCP enables detailed in-silico and ex-vivo analyses on drug supply/deposition in rodents.
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11
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Braet H, Rahimi-Gorji M, Debbaut C, Ghorbaniasl G, Van Walleghem T, Cornelis S, Cosyns S, Vervaet C, Willaert W, Ceelen W, De Smedt SC, Remaut K. Exploring High Pressure Nebulization of Pluronic F127 Hydrogels for Intraperitoneal Drug Delivery. Eur J Pharm Biopharm 2021; 169:134-143. [PMID: 34634467 DOI: 10.1016/j.ejpb.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
Peritoneal metastasis is an advanced cancer type which can be treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Here, chemotherapeutics are nebulized under high pressure in the intraperitoneal (IP) cavity to obtain a better biodistribution and tumor penetration. To prevent the fast leakage of chemotherapeutics from the IP cavity, however, nebulization of controlled release formulations is of interest. In this study, the potential of the thermosensitive hydrogel Pluronic F127 to be applied by high pressure nebulization is evaluated. Therefore, aerosol formation is experimentally examined by laser diffraction and theoretically simulated by computational fluid dynamics (CFD) modelling. Furthermore, Pluronic F127 hydrogels are subjected to rheological characterization after which the release of fluorescent model nanoparticles from the hydrogels is determined. A delicate equilibrium is observed between controlled release properties and suitability for aerosolization, where denser hydrogels (20% and 25% w/v Pluronic F127) are able to sustain nanoparticle release up to 30 hours, but cannot effectively be nebulized and vice versa. This is demonstrated by a growing aerosol droplet size and exponentially decreasing aerosol cone angle when Pluronic F127 concentration and viscosity increase. Novel nozzle designs or alternative controlled release formulations could move intraperitoneal drug delivery by high pressure nebulization forward.
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Affiliation(s)
- Helena Braet
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
| | - Mohammad Rahimi-Gorji
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; IBiTech - bioMMeda, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Charlotte Debbaut
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; IBiTech - bioMMeda, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Ghader Ghorbaniasl
- Department of Mechanical Engineering, Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium.
| | - Thibault Van Walleghem
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium
| | - Senne Cornelis
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium
| | - Sarah Cosyns
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Chris Vervaet
- Laboratory of Pharmaceutical Technology, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium.
| | - Wouter Willaert
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Wim Ceelen
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Stefaan C De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
| | - Katrien Remaut
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
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12
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Park S, Park SJ, Lee HS, Ham J, Lee EJ, Kim J, Ryu S, Seol A, Lim W, Lee JC, Song G, Kim HS. Establishment of an Experimental System for Intraperitoneal Chemotherapy in a Rat Model. In Vivo 2021; 35:2703-2710. [PMID: 34410959 DOI: 10.21873/invivo.12554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 01/28/2023]
Abstract
AIM To establish an experimental system for comparing different methods of intraperitoneal chemotherapy in a rat model. MATERIALS AND METHODS We used six-week-old Sprague-Dawley rats, and created an early postoperative intraperitoneal chemotherapy (EPIC) system using 18-gauge syringes and evacuators, and a hyperthermic intraperitoneal chemotherapy (HIPEC) system using two peristaltic pumps which controlled the flow rate and temperature. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) was achieved using a nozzle for dispersing aerosols at a flow rate up to 41.5 ml/min. The distribution and intensity of 0.2% trypan blue dye was compared among three methods. RESULTS The distribution was limited and the intensity was weak after EPIC, and the dye stained moderately in gravity-dependent regions after HIPEC. On the other hand, the distribution was the most comprehensive, and the intensity was the greatest after PIPAC. CONCLUSION This experimental system in a rat model may reflect the comparative effect among EPIC, HIPEC and PIPAC in humans.
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Affiliation(s)
- Sunwoo Park
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Soo Jin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Su Lee
- Interdisciplinary Program in Bioengineering, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jiyeon Ham
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Eun Ji Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Junsik Kim
- Interdisciplinary Program in Bioengineering, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Soomin Ryu
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Aeran Seol
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Whasun Lim
- Department of Food and Nutrition, Kookmin University, Seoul, Republic of Korea
| | - Jung Chan Lee
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Gwonhwa Song
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea;
| | - Hee Seung Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea;
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13
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Lurvink RJ, Van der Speeten K, Rovers KP, de Hingh IHJT. The emergence of pressurized intraperitoneal aerosol chemotherapy as a palliative treatment option for patients with diffuse peritoneal metastases: a narrative review. J Gastrointest Oncol 2021; 12:S259-S270. [PMID: 33968442 DOI: 10.21037/jgo-20-497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging palliative treatment for patients with unresectable peritoneal metastases. Potential advantages of PIPAC over current treatment options are a homogeneous intraperitoneal distribution, low local and systemic toxicity, and enhanced tumour penetration. Given these possible benefits, PIPAC is increasingly implemented in many centres worldwide. Scientific research into PIPAC is currently available from in vitro/in vivo/in animal studies, retrospective cohorts in humans, and phase I and II studies in humans. There are no results from randomised trials comparing PIPAC with conventional treatment, such as palliative systemic therapy. This narrative review aimed to provide an overview of the currently available literature on PIPAC. In general, repetitive PIPAC was feasible and safe for patients and operating room personnel. Primary and secondary non-access rates varied from 0-17% and 0-15%, respectively. Iatrogenic bowel injury was observed in 0-3% of PIPAC procedures. CTCAE grade 1-2 complications were common, mostly consisting of abdominal pain, nausea, vomiting, and fatigue. CTCAE grade 3-4 complications were uncommon, occurring on 0-15% of PIPAC procedures. Post-operative mortality rates of 0-2% were reported. The risk of occupational exposure to cytotoxic drugs was very low when strict safety guidelines were followed. Clinical heterogeneity was high in most studies, since, in general, patients with unresectable peritoneal metastases from a variety of primary tumours were included. Also, patients received either PIPAC monotherapy or PIPAC combined with concomitant systemic therapy, and were able to receive PIPAC in any line of palliative treatment. Since the results were generally not stratified for these three important factors, this severely complicates the interpretation of results. Based on the current literature, PIPAC may be regarded as a promising palliative treatment option in patients with diffuse peritoneal metastases. Initial results show that it is feasible and safe. However, well designed and (ideally) randomized controlled trials are urgently needed to determine the additional value of PIPAC in this setting. Until then, PIPAC should preferably be performed in the setting of clinical trials.
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Affiliation(s)
- Robin J Lurvink
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Koen P Rovers
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - Ignace H J T de Hingh
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.,GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
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14
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Barral M, Pimpie C, Kaci R, Al-Dybiat I, Mirshahi M, Pocard M, Bonnin P. Assessment of Tumor Response in Mice with Ovarian Peritoneal Carcinomatosis using Doppler Ultrasound of the Superior Mesenteric Artery and Celiac Trunk. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:759-768. [PMID: 33358050 DOI: 10.1016/j.ultrasmedbio.2020.11.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 11/22/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
The goal of the work described here was to assess the performance of Doppler ultrasound (US) of the superior mesenteric artery (SMA) and celiac trunk (CT) in the evaluation of tumor response in female mice with ovarian peritoneal carcinomatosis treated either with bevacizumab or with carboplatin. Compared with untreated mice, carboplatin-treated mice had a lower weight (23.3 ± 2.0 vs. 27.9 ± 2.9 g, p < 0.001), peritoneal carcinomatosis index (PCI, 11 ± 3 vs. 28 ± 6, p < 0.001), Ki67-positive staining surfaces (p < 0.001), vascular density (p < 0.001), mean blood flow velocity (mBFVel) in the SMA (7.0 ± 1.4 vs. 10.9 ± 1.8 cm/s, p < 0.001) and CT (8.0 ± 1.8 vs. 14.3 ± 4.6 cm/s, p < 0.001) and no ascites. Weight and mBFVel were similar in bevacizumab-treated and untreated mice. The mBFVels in the SMA and CT correlated with the PCI used as an estimation of the tumor burden, R = 0.70 (p < 0.0001) and R = 0.65 (p < 0.0001), respectively. Doppler US allows non-invasive assessment of the effects of anticancer therapy in ovarian peritoneal carcinomatosis-induced mice.
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Affiliation(s)
- Matthias Barral
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France
| | - Cynthia Pimpie
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France
| | - Rachid Kaci
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France; Anatomopathologie, hôpital Lariboisière, Université de Paris, Paris, France
| | - Iman Al-Dybiat
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France
| | - Massoud Mirshahi
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France
| | - Marc Pocard
- INSERM Unité 1275 CAP Paris-Tech, Université de Paris, Paris, France; Chirurgie Digestive et cancérologique, hôpital Lariboisière, Université de Paris, Paris, France
| | - Philippe Bonnin
- Physiologie Clinique-Explorations-Fonctionnelles, hopital Lariboisière, Université de Paris, Paris, France; INSERM U1148, LVTS, hôpital Bichat, Université de Paris, Paris, France.
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15
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Wu J, Wang Q, Dong X, Xu M, Yang J, Yi X, Chen B, Dong X, Wang Y, Lou X, Xia F, Wang S, Dai J. Biocompatible AIEgen/p-glycoprotein siRNA@reduction-sensitive paclitaxel polymeric prodrug nanoparticles for overcoming chemotherapy resistance in ovarian cancer. Theranostics 2021; 11:3710-3724. [PMID: 33664857 PMCID: PMC7914360 DOI: 10.7150/thno.53828] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022] Open
Abstract
Nanoparticle drug delivery system (NDDS) is quite different from the widely studied traditional chemotherapy which suffers from drug resistance and side effect. NDDS offers the straightforward solution to the chemotherapy problem and provides an opportunity to monitor the drug delivery process in real time. In this vein, we developed one NDDS, namely Py-TPE/siRNA@PMP, to relieve resistance and side effects during chemotherapy against ovarian cancer. The Py-TPE/siRNA@PMP is a multifunctional polymeric nanoparticle contained several parts as follows: (1) a nanoparticle (NP) self-assembled by reduction-sensitive paclitaxel polymeric prodrug (PMP); (2) the glutathione (GSH)-responsive release of paclitaxel (PTX) for the suppression of ovarian cancer cells; (3) the P-glycoprotein (P-gp) siRNA for restoring the sensitivity of chemo-resistant tumor cells to chemotherapy; (4) the positively charged aggregation-induced emission fluorogen (AIEgen) Py-TPE for tumor imaging and promoting encapsulation of siRNA into the nanoparticle. Methods: The Py-TPE/siRNA@PMP nanoparticles were prepared by self-assembly method and characterized by the UV-Vis absorption spectra, zeta potentials, TEM image, stability assay and hydrodynamic size distributions. The combinational therapeutic effects of Py-TPE/siRNA@PMP on overcoming chemotherapy resistance were explored both in vitro and in vivo.Result: The Py-TPE/siRNA@PMP exhibited an average hydrodynamic size with a good stability. Meanwhile they gave rise to the remarkable chemotoxicity performances in vitro and suppressed the tumors growth in both SKOV-3/PTX (PTX resistance) subcutaneous and intraperitoneal metastasis tumor models. The investigations on ovarian cancer patient-derived xenografts (PDX) model revealed that Py-TPE/siRNA@PMP was able to effectively overcome their chemo-resistance with minimal side effects. Conclusion: Our findings demonstrated the Py-TPE/siRNA@PMP as a promising agent for the highly efficient treatment of PTX-resistant cells and overcoming the shortage of chemotherapy in ovarian cancer.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/antagonists & inhibitors
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Animals
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/pharmacokinetics
- Biocompatible Materials/administration & dosage
- Biocompatible Materials/chemical synthesis
- Cell Line, Tumor
- Drug Delivery Systems
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Female
- Humans
- Materials Testing
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Multifunctional Nanoparticles/administration & dosage
- Multifunctional Nanoparticles/chemistry
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/therapy
- Paclitaxel/administration & dosage
- Paclitaxel/pharmacokinetics
- Precision Medicine
- Prodrugs/administration & dosage
- Prodrugs/pharmacokinetics
- RNA, Small Interfering/administration & dosage
- RNA, Small Interfering/genetics
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Jun Wu
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Quan Wang
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Xiaoqi Dong
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Min Xu
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Juliang Yang
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Xiaoqing Yi
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China
| | - Biao Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiyuan Dong
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ying Wang
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaoding Lou
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Fan Xia
- Engineering Research Center of Nano-Geomaterials of the Ministry of Education, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan 430074, China
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jun Dai
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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16
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Castagna A, Zander AJ, Sautkin I, Schneider M, Shegokar R, Königsrainer A, Reymond MA. Enhanced intraperitoneal delivery of charged, aerosolized curcumin nanoparticles by electrostatic precipitation. Nanomedicine (Lond) 2021; 16:109-120. [PMID: 33448879 DOI: 10.2217/nnm-2020-0373] [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: 12/22/2022] Open
Abstract
Aims: To investigate the potential of curcumin-loaded polylactic-co-glycolic acid nanoparticles (CUR-PLGA-NPs), alone and with electrostatic precipitation, for improving tissue uptake during pressurized intraperitoneal aerosol chemotherapy (PIPAC). Methods: Positively and negatively charged CUR-PLGA-NPs were delivered as PIPAC into inverted bovine urinary bladders ex vivo. The experiment was repeated with the additional use of electrostatic precipitation pressurized intraperitoneal aerosol chemotherapy (electrostatic PIPAC). Results: Positively charged CUR-PLGA-NPs increased depth of tissue penetration by 81.5% and tissue concentration by 80%. Electrostatic precipitation further improved the uptake of positively charged CUR-PLGA-NPs by 41.8%. Conclusion: The combination of positive charge and electrostatic precipitation have significant potential to improve tissue uptake of nanoparticles during intraperitoneal chemotherapy.
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Affiliation(s)
- Arianna Castagna
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Alexandra J Zander
- Department of Pharmacy, Biopharmaceutics & Pharmaceutical Technology, Saarland University, Saarbrücken 66123, Germany
| | - Iaroslaw Sautkin
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Marc Schneider
- Department of Pharmacy, Biopharmaceutics & Pharmaceutical Technology, Saarland University, Saarbrücken 66123, Germany
| | | | - Alfred Königsrainer
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Marc André Reymond
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
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17
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Establishment of a Mouse Ovarian Cancer and Peritoneal Metastasis Model to Study Intraperitoneal Chemotherapy. Cancers (Basel) 2020; 12:cancers12123818. [PMID: 33348855 PMCID: PMC7766637 DOI: 10.3390/cancers12123818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Intraperitoneal chemotherapy (IPC) is a locoregional treatment option in patients with peritoneal metastases (PM). Small animal models are valuable research tools allowing for rapid, reproducible, and inexpensive study and optimization of different forms of IPC. Here, we present a mouse model of ovarian cancer-derived PM and demonstrate its suitability for various modes of IPC, including pressurized intraperitoneal chemotherapy (PIPAC) using a micro-nozzle for aerosolized drug delivery. Abstract Intraperitoneal chemotherapy (IPC) is a locoregional treatment option in patients with peritoneal metastases (PM). Here, we present an ovarian cancer (OC)-derived PM mouse model for the study of different forms of IPC. Xenograft cell proliferation (luciferase-transfected OVCAR3 and SKOV3 clones) and growth kinetics were assessed using PET scan, bioluminescence imaging (BLI), and histological tumor analysis. Liquid IPC was achieved by intraperitoneal injection with/without capnoperitoneum (6–7 mmHg). Pressurized intraperitoneal aerosol chemotherapy (PIPAC) was mimicked using an intratracheal drug aerosol administration system (micro-nozzle), which, as demonstrated by ex vivo granulometric analysis using laser diffraction spectrometry, produced a polydisperse, bimodal aerosol with a volume-weighted median diameter of (26.49 ± 2.76) µm. Distribution of Tc-99m-labeled doxorubicin in mice was characterized using SPECT and was dependent on the delivery mode and most homogeneous when the micro-nozzle was used. A total of 2 mg doxorubicin per kg body weight was determined to be the optimally effective and tolerable dose to achieve at least 50% tumor reduction. Repeated PIPAC (four times at seven-day-intervals) with doxorubicin in SKOV3-luc tumor-bearing mice resulted in halted tumor proliferation and tumor load reduced after the second round of PIPAC versus controls and the number of tumor nodules was significantly reduced (27.7 ± 9.5 vs. 57.3 ± 9.5; p = 0.0003). Thus, we established the first mouse model of OC PM for the study of IPC using a human xenograft with SKOV3 cells and an experimental IPC setup with a miniaturized nozzle. Repeated IPC was feasible and demonstrated time-dependent anti-tumor activity.
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18
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Taibi A, Teixeira Farinha H, Durand Fontanier S, Sayedalamin Z, Hübner M, Sgarbura O. Pressurized Intraperitoneal Aerosol Chemotherapy Enhanced by Electrostatic Precipitation (ePIPAC) for Patients with Peritoneal Metastases. Ann Surg Oncol 2020; 28:3852-3860. [PMID: 33216263 DOI: 10.1245/s10434-020-09332-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new mode of intraperitoneal chemotherapy administration that can potentially be improved by the addition of electrostatic precipitation (ePIPAC). This study aimed to describe the procedural details of ePIPAC and to analyze its safety for patients with nonresectable peritoneal metastasis as well as their tolerance and response to this treatment. METHODS This retrospective cohort study included consecutive patients treated with ePIPAC in three centers from April 2019 to April 2020. The toxicities of each patient were assessed using the Common Terminology Criteria for Adverse Events (CTCAE). Complications were documented according to the Clavien classification. Quality of life (QoL) was assessed using EORTC-QLQ-C30, and the peritoneal regression grading score (PRGS) was used to grade histologic responses. Further surrogates for responses were the Peritoneal Cancer Index (PCI), ascites, and symptoms. RESULTS Overall, 69 patients received 147 ePIPACs with oxaliplatin (n = 34) or cisplatin/doxorubicin (n = 35) mainly for colorectal (n = 25), ovarian (n = 14), and gastric (n = 13) primary cancers. Systemic chemotherapy was used in the treatment of 54 patients (76%). The median electrostatic therapy time was 12 min (range 6-30 min). The overall and major CTCAE toxicity rates were respectively 24.6% and 15.9%. The postoperative complications rate according to Clavien classification was 4.7%. The responses of 22 patients who had three or more ePIPAC treatments were evaluated as follows: PCI (16 vs 14; p = 0.4), ascites (320 vs 98 ml; p = 0.1), and PRGS (2.23 vs 1.73; p = 0.15). The complete (PRGS1) and major (PRGS2) histologic responses at the third ePIPAC were respectively 38.5% and 53.8%. Overall QoL was stable during the first ePIPACs. CONCLUSION Repetitive ePIPACs were safe and well tolerated for patients with unresectable peritoneal metastasis.
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Affiliation(s)
- Abdelkader Taibi
- Digestive Surgery Department, Visceral Surgery Department, Dupuytren Limoges University Hospital, Limoges, France. .,CNRS, XLIM, UMR 7252, University Limoges, 87000, Limoges, France.
| | - Hugo Teixeira Farinha
- Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Sylvaine Durand Fontanier
- Digestive Surgery Department, Visceral Surgery Department, Dupuytren Limoges University Hospital, Limoges, France.,CNRS, XLIM, UMR 7252, University Limoges, 87000, Limoges, France
| | - Zaid Sayedalamin
- Surgical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - Martin Hübner
- Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Olivia Sgarbura
- Surgical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
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19
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Van de Sande L, Rahimi‐Gorji M, Giordano S, Davoli E, Matteo C, Detlefsen S, D'Herde K, Braet H, Shariati M, Remaut K, Xie F, Debbaut C, Ghorbaniasl G, Cosyns S, Willaert W, Ceelen W. Electrostatic Intraperitoneal Aerosol Delivery of Nanoparticles: Proof of Concept and Preclinical Validation. Adv Healthc Mater 2020; 9:e2000655. [PMID: 32548967 DOI: 10.1002/adhm.202000655] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/13/2020] [Indexed: 12/21/2022]
Abstract
There is an increasing interest in intraperitoneal delivery of chemotherapy as an aerosol in patients with peritoneal metastasis. The currently used technology is hampered by inhomogenous drug delivery throughout the peritoneal cavity because of gravity, drag, and inertial impaction. Addition of an electrical force to aerosol particles, exerted by an electrostatic field, can improve spatial aerosol homogeneity and enhance tissue penetration. A computational fluid dynamics model shows that electrostatic precipitation (EP) results in a significantly improved aerosol distribution. Fluorescent nanoparticles (NPs) remain stable after nebulization in vitro, while EP significantly improves spatial homogeneity of NP distribution. Next, pressurized intraperitoneal chemotherapy with and without EP using NP albumin bound paclitaxel (Nab-PTX) in a novel rat model is examined. EP does not worsen the effects of CO2 insufflation and intraperitoneal Nab-PTX on mesothelial structural integrity or the severity of peritoneal inflammation. Importantly, EP significantly enhances tissue penetration of Nab-PTX in the anatomical regions not facing the nozzle of the nebulizer. Also, the addition of EP leads to more homogenous peritoneal tissue concentrations of Nab-PTX, in parallel with higher plasma concentrations. In conclusion, EP enhances spatial homogeneity and tissue uptake after intraperitoneal nebulization of anticancer NPs.
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Affiliation(s)
- Leen Van de Sande
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Mohammad Rahimi‐Gorji
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- IBiTech – bioMMedaGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Silvia Giordano
- Mass Spectrometry LaboratoryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Via Mario Negri 2 Milan 20156 Italy
| | - Enrico Davoli
- Mass Spectrometry LaboratoryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Via Mario Negri 2 Milan 20156 Italy
| | - Cristina Matteo
- Cancer Pharmacology LaboratoryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Via Mario Negri 2 Milan 20156 Italy
| | - Sönke Detlefsen
- Department of PathologyOdense University Hospital J.B. Winsløws Vej 4 Odense 5000 Denmark
- Department of Clinical ResearchUniversity of Southern Denmark Winsløwsparken 19 Odense 5000 Denmark
| | - Katharina D'Herde
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Helena Braet
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Laboratory of General Biochemistry and Physical PharmacyFaculty of Pharmaceutical SciencesGhent University Ottergemsesteenweg 460 Ghent 9000 Belgium
| | - Molood Shariati
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Laboratory of General Biochemistry and Physical PharmacyFaculty of Pharmaceutical SciencesGhent University Ottergemsesteenweg 460 Ghent 9000 Belgium
| | - Katrien Remaut
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Laboratory of General Biochemistry and Physical PharmacyFaculty of Pharmaceutical SciencesGhent University Ottergemsesteenweg 460 Ghent 9000 Belgium
| | - Feifan Xie
- Laboratory of Medical Biochemistry and Clinical AnalysisFaculty of Pharmaceutical SciencesGhent University Ottergemsesteenweg 460 Ghent 9000 Belgium
| | - Charlotte Debbaut
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- IBiTech – bioMMedaGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Ghader Ghorbaniasl
- Department of Mechanical EngineeringVrije Universiteit Brussel (VUB) Pleinlaan 2 Brussels 1050 Belgium
| | - Sarah Cosyns
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Wouter Willaert
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
| | - Wim Ceelen
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Cancer Research Institute Ghent (CRIG)Ghent University Corneel Heymanslaan 10 Ghent 9000 Belgium
- Department of Human Structure and RepairGhent University Corneel Heymanslaan 10 Ghent 9000 Belgium
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20
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Shariati M, Lollo G, Matha K, Descamps B, Vanhove C, Van de Sande L, Willaert W, Balcaen L, Vanhaecke F, Benoit JP, Ceelen W, De Smedt SC, Remaut K. Synergy between Intraperitoneal Aerosolization (PIPAC) and Cancer Nanomedicine: Cisplatin-Loaded Polyarginine-Hyaluronic Acid Nanocarriers Efficiently Eradicate Peritoneal Metastasis of Advanced Human Ovarian Cancer. ACS APPLIED MATERIALS & INTERFACES 2020; 12:29024-29036. [PMID: 32506916 DOI: 10.1021/acsami.0c05554] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intra-abdominal dissemination of peritoneal nodules, a condition known as peritoneal carcinomatosis (PC), is typically diagnosed in ovarian cancer patients at the advanced stages. The current treatment of PC consists of perioperative systemic chemotherapy and cytoreductive surgery, followed by intra-abdominal flushing with solutions of chemotherapeutics such as cisplatin and oxaliplatin. In this study, we developed cisplatin-loaded polyarginine-hyaluronic acid nanoscale particles (Cis-pARG-HA NPs) with high colloidal stability, marked drug loading efficiency, unimpaired biological activity, and tumor-targeting ability. Injected Cis-pARG-HA NPs showed enhanced antitumor activity in a rat model of PC, compared to injection of the free cisplatin drug. The activity of Cis-pARG-HA NPs could even be further improved when administered by an intra-abdominal aerosol therapy, referred to as pressurized intraperitoneal aerosol chemotherapy (PIPAC). PIPAC is hypothesized to ensure a more homogeneous drug distribution together with a deeper drug penetration into peritoneal tumor nodules within the abdominal cavity. Using fluorescent pARG-HA NPs, this enhanced nanoparticle deposit on tumors could indeed be observed in regions opposite the aerosolization nozzle. Therefore, this study demonstrates that nanoparticles carrying chemotherapeutics can be synergistically combined with the PIPAC technique for IP therapy of disseminated advanced ovarian tumors, while this synergistic effect was not observed for the administration of free cisplatin.
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Affiliation(s)
- Molood Shariati
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
| | - Giovanna Lollo
- Laboratoire d'Automatique, de Génie des Procédés et de Génie Pharmaceutique (LAGEPP), Univ Lyon, Université Lyon 1, CNRS, UMR5007, 43 bd du 11 Novembre 1918, F-69622 Lyon, France
| | - Kevin Matha
- Micro et Nanomédecines Translationnelles, MINT, UNIV Angers, UMR INSERM 1066, UMR CNRS 6021, Angers, France
- Département Pharmacie, CHU Angers, 4 rue Larrey, 49933 Angers cedex 9, France
| | - Benedicte Descamps
- Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
| | - Christian Vanhove
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
- Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
| | - Leen Van de Sande
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
- Department of GI Surgery, Ghent University Hospital and Laboratory for Experimental Surgery, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Wouter Willaert
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
- Department of GI Surgery, Ghent University Hospital and Laboratory for Experimental Surgery, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Lieve Balcaen
- Department of Analytical Chemistry, Atomic & Mass Spectrometry-A&MS Research Unit, Campus Sterre, Ghent University, Krijgslaan 281-S12, 9000 Ghent, Belgium
| | - Frank Vanhaecke
- Department of Analytical Chemistry, Atomic & Mass Spectrometry-A&MS Research Unit, Campus Sterre, Ghent University, Krijgslaan 281-S12, 9000 Ghent, Belgium
| | - Jean-Pierre Benoit
- Micro et Nanomédecines Translationnelles, MINT, UNIV Angers, UMR INSERM 1066, UMR CNRS 6021, Angers, France
- Département Pharmacie, CHU Angers, 4 rue Larrey, 49933 Angers cedex 9, France
| | - Wim Ceelen
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
- Department of GI Surgery, Ghent University Hospital and Laboratory for Experimental Surgery, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Stefaan C De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
| | - Katrien Remaut
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
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21
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Intraperitoneal aerosolized drug delivery: Technology, recent developments, and future outlook. Adv Drug Deliv Rev 2020; 160:105-114. [PMID: 33132169 DOI: 10.1016/j.addr.2020.10.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/28/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Current therapies for patients with peritoneal metastases (PM) are only moderately effective. Recently, a novel locoregional treatment method for PM was introduced, consisting of a combination of laparoscopy with intraperitoneal (IP) delivery of anticancer agents as an aerosol. This 'pressurized intraperitoneal aerosol chemotherapy' (PIPAC) may enhance tissue drug penetration by the elevated IP pressure during CO2 capnoperitoneum. Also, repeated PIPAC cycles allow to accurately stage peritoneal disease and verify histological response to treatment. This review provides an overview of the rationale, indications, and currently used technology for therapeutic IP nebulization, and discusses the basic mechanisms governing aerosol particle transport and peritoneal deposition. We discuss early clinical results in patients with advanced, irresectable PM and highlight the potential of electrostatic aerosol precipitation. Finally, we discuss promising novel approaches, including nebulization of nanoparticles and prolonged release formulations.
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22
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Sautkin I, Solass W, Weinreich FJ, Königsrainer A, Schenk M, Thiel K, Reymond MA. A real-time ex vivo model (eIBUB) for optimizing intraperitoneal drug delivery as an alternative to living animal models. Pleura Peritoneum 2019; 4:20190017. [PMID: 31667331 PMCID: PMC6812219 DOI: 10.1515/pp-2019-0017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/26/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Optimization of intraperitoneal drug delivery systems requires functional models. We proposed the Inverted Bovine Urinary Bladder Model (IBUB), but IBUB does not allow repeated measurements over time and there is a significant biological variability between organs. METHODS A further development of IBUB is presented, based on the physical principle of communicating vessels. Fresh bovine bladders were inverted so that the peritoneum lines up the inner surface. The IBUB and a second vessel were then interconnected under the same CO2 pressure and placed on two scales. The therapeutic solution (Doxorubicin 2.7 mg and Cisplatin 13.5 mg) was delivered via an aerosolizer. All experiments were in triplicate and blinded to the origin of samples, measurements in a GLP-certified laboratory. RESULTS The enhanced IBUB (eIBUB) model allows measurements of tissue drug concentration, depth of tissue penetration and spatial distribution. The homogeneous morphology of the peritoneum enables standardized, multiple tissue sampling. eIBUB minimizes biological variability between different bladders and eliminates the bias caused by the liquid collecting at the bottom of the model. Concentration of doxorubicin in the eIBUB (mean ± STDV: 18.5 ± 22.6 ng/mg) were comparable to clinical peritoneal biopsies (19.2 ± 38.6 ng/mg), as was depth of drug penetration (eIBUB: mean (min-max) 433 (381-486) µm, clinical ~ 500 µm). CONCLUSIONS The eIBUB model is a simple and powerful ex vivo model for optimizing intraperitoneal drug delivery and represents an attractive alternative to animal models. Results obtained are similar to those obtained in the human patient.
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Affiliation(s)
- Iaroslav Sautkin
- National Center for Pleura and Peritoneum, University of Tübingen, Tübingen, Germany
| | - Wiebke Solass
- Institute of Pathology, University of Tübingen, Tübingen, Germany
| | | | - Alfred Königsrainer
- Department of General and Transplant Surgery, University of Tübingen, Tübingen, Germany
| | - Martin Schenk
- Experimental Surgical Oncology, Eberhard-Karls-Universitat Tubingen Medizinische Fakultat, Tübingen, Germany
| | - Karolin Thiel
- Department of General and Transplant Surgery, University of Tübingen, Tübingen, Germany
| | - Marc A. Reymond
- National Center for Pleura and Peritoneum, University of Tübingen, Tübingen, Germany
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23
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Graversen M, Detlefsen S, Ellebaek SB, Fristrup C, Pfeiffer P, Mortensen MB. Pressurized IntraPeritoneal Aerosol Chemotherapy with one minute of electrostatic precipitation (ePIPAC) is feasible, but the histological tumor response in peritoneal metastasis is insufficient. Eur J Surg Oncol 2019; 46:155-159. [PMID: 31493986 DOI: 10.1016/j.ejso.2019.08.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/14/2019] [Accepted: 08/28/2019] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Electrostatic precipitation Pressurized IntraPeritoneal Aerosol Chemotherapy (ePIPAC) has shown superior penetration depth and tissue uptake compared to standard PIPAC. We investigated the feasibility and objective tumor response to ePIPAC with 1 min of precipitation in patients with peritoneal metastasis (PM). MATERIALS AND METHODS Patients with PM from various abdominal cancers were included in an amendment to the ongoing prospective PIPAC-OPC2 trial. Colorectal and appendiceal PM were treated with oxaliplatin, patients with PM from other primaries were treated with a combination of cisplatin and doxorubicin. Three ePIPAC procedures were planned in each patient including repeated peritoneal biopsies for response evaluation. After emission to the peritoneal cavity, the aerosolized chemotherapeutics were precipitated for 1 min followed by immediate exsufflation and abdominal closure. Histological regression from the first to the third ePIPAC was evaluated according to the Peritoneal Regression Grading Score (PRGS) and compared to data from the PIPAC-OPC1 trial. Complications and toxicities were recorded according to Dindo-Clavien and CTCAE. RESULTS Sixty-five ePIPAC procedures were performed in 33 patients (median 2, range 1-6). Ten patients were eligible for response evaluation based on biopsies from the first and third ePIPAC procedure. Four patients had disease progression, four patients had regressive disease, and two patients had stable disease according to PRGS. No life threatening adverse reactions and no mortality was observed following ePIPAC. CONCLUSION One minute ePIPAC was feasible and safe, but the histological tumor response was insufficient compared to standard PIPAC directed therapy with 30 min passive diffusion time.
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Affiliation(s)
- Martin Graversen
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Surgery, Upper GI and HPB Section, Odense University Hospital, Denmark; Odense Patient Data Explorative Network, OPEN, University of Southern Denmark, Denmark.
| | - Sönke Detlefsen
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Pathology, Odense University Hospital, Denmark
| | - Signe Bremholm Ellebaek
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Surgery, Upper GI and HPB Section, Odense University Hospital, Denmark
| | - Claus Fristrup
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Surgery, Upper GI and HPB Section, Odense University Hospital, Denmark
| | - Per Pfeiffer
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | - Michael B Mortensen
- Odense PIPAC Center & Odense Pancreas Center (OPAC), Odense University Hospital, J.B. Winsloews Vej 4, 5000, Odense, Denmark; Department of Surgery, Upper GI and HPB Section, Odense University Hospital, Denmark
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