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Keum H, Cevik E, Kim J, Demirlenk YM, Atar D, Saini G, Sheth RA, Deipolyi AR, Oklu R. Tissue Ablation: Applications and Perspectives. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2310856. [PMID: 38771628 DOI: 10.1002/adma.202310856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/05/2024] [Indexed: 05/22/2024]
Abstract
Tissue ablation techniques have emerged as a critical component of modern medical practice and biomedical research, offering versatile solutions for treating various diseases and disorders. Percutaneous ablation is minimally invasive and offers numerous advantages over traditional surgery, such as shorter recovery times, reduced hospital stays, and decreased healthcare costs. Intra-procedural imaging during ablation also allows precise visualization of the treated tissue while minimizing injury to the surrounding normal tissues, reducing the risk of complications. Here, the mechanisms of tissue ablation and innovative energy delivery systems are explored, highlighting recent advancements that have reshaped the landscape of clinical practice. Current clinical challenges related to tissue ablation are also discussed, underlining unmet clinical needs for more advanced material-based approaches to improve the delivery of energy and pharmacology-based therapeutics.
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Affiliation(s)
- Hyeongseop Keum
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Enes Cevik
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jinjoo Kim
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Yusuf M Demirlenk
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Dila Atar
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Gia Saini
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Rahul A Sheth
- Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Amy R Deipolyi
- Interventional Radiology, Department of Surgery, West Virginia University, Charleston Area Medical Center, Charleston, WV, 25304, USA
| | - Rahmi Oklu
- Laboratory for Patient Inspired Engineering, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
- Division of Vascular & Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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Martínez-Ortega JI, Franco-Gonzalez S, Ramirez Cibrian AG. An Immune-Based Therapeutical Approach in an Elderly Patient With Fixed Cutaneous Sporotrichosis. Cureus 2024; 16:e53192. [PMID: 38425596 PMCID: PMC10901695 DOI: 10.7759/cureus.53192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Sporotrichosis is a subcutaneous fungal infection caused by thermally dimorphic fungi from the Sporothrix genus, primarily prevalent in tropical regions of Latin America, Africa, and Asia. Mexico's Jalisco state is an endemic hotspot with a remarkable prevalence rate of 54.4%. Clinical presentation varies based on immune status and virulence. The most common form is cutaneous-lymphangitic (67%), with fixed cutaneous cases accounting for 28%. This case study explores a traditional therapeutic approach for fixed cutaneous sporotrichosis but introduces a distinct immunological perspective.
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Hassan H, Hosni A, Mammdoh YM, Fathy E. Serum Galectin-3: A novel predictor of treatment response to cryotherapy in cutaneous warts. Cryobiology 2023; 113:104790. [PMID: 37924930 DOI: 10.1016/j.cryobiol.2023.104790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Affiliation(s)
- Heba Hassan
- Dermatology, Venereology, and Andrology at the Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Egypt.
| | - Amal Hosni
- Clinical Pathology at the Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt
| | - Yousra M Mammdoh
- Clinical Pathology at the Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt
| | - Eman Fathy
- Dermatology, Venereology, and Andrology at the Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Egypt
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Procópio-Azevedo AC, de Abreu Almeida M, Almeida-Paes R, Zancopé-Oliveira RM, Gutierrez-Galhardo MC, de Macedo PM, Novaes E, Bailão AM, de Almeida Soares CM, Freitas DFS. The State of the Art in Transcriptomics and Proteomics of Clinically Relevant Sporothrix Species. J Fungi (Basel) 2023; 9:790. [PMID: 37623561 PMCID: PMC10455387 DOI: 10.3390/jof9080790] [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: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Proteomics provide a robust approach to profile and quantify proteins within cells, organs, or tissues, providing comprehensive insights about the dynamics of cellular processes, modifications, and interactions. Similarly, understanding the transcriptome is essential to decipher functional elements of the genome, unraveling the mechanisms of disease development and the molecular constituents of cells and tissues. Some thermodimorphic fungi of the genus Sporothrix cause sporotrichosis, a subcutaneous mycosis of worldwide relevance. The transcriptome and proteome of the main Sporothrix species of clinical interest can elucidate the mechanisms underlying pathogenesis and host interactions. Studies of these techniques can contribute to the advancement of novel diagnostic and therapeutic strategies. A literature review was carried out, addressing all articles based on proteomics using mass spectrometry and transcriptomics of Sporothrix spp. Twenty-one studies were eligible for this review. The main findings include proteins and genes involved in dimorphism, cell differentiation, thermotolerance, virulence, immune evasion, metabolism, cell adhesion, cell transport, and biosynthesis. With the spread and emergence of sporotrichosis in different countries, ongoing research efforts and new discoveries are welcome to advance knowledge about this mycosis and its agents.
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Affiliation(s)
- Anna Carolina Procópio-Azevedo
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Marcos de Abreu Almeida
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Priscila Marques de Macedo
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
| | - Evandro Novaes
- Setor de Genética, Departamento de Biologia, Universidade Federal de Lavras, Lavras 37203-202, MG, Brazil
| | - Alexandre Melo Bailão
- Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia 74690-900, GO, Brazil
| | - Célia Maria de Almeida Soares
- Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia 74690-900, GO, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
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Medlej ZAA, Medlej W, Slaba S, Torrecillas P, Cueto A, Urbaneja A, Garrido AJ, Lugnani F. Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment. Curr Oncol 2023; 30:4844-4860. [PMID: 37232823 DOI: 10.3390/curroncol30050365] [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: 03/28/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
As less invasive options for surgical tumor removal, minimally invasive ablative techniques have gained popularity. Several solid tumors are being treated with cryoablation, a non-heat-based ablation technique. Cryoablation data in comparison over time demonstrates better tumor response and faster recovery. Combining cryosurgery with other cancer therapies has been explored to improve the cancer-killing process. Cryoablation with the combination of immunotherapy, results in a robust and efficient attack on the cancer cells. This article focuses on investigating the ability of cryosurgery to create a strong antitumor response when combined with immunologic agents resulting in a synergetic effect. To achieve this objective, we combined cryosurgery with immunotherapy using Nivolumab and lpilimumab. Five clinical cases of lymph node, lung cancer, bone, and lung metastasis were followed and analyzed. In this series of patients, percutaneous cryoablation and addressing immunity agents were technically feasible. In the follow-ups, there appeared to be no radiological evidence of new tumor development.
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Affiliation(s)
- Zain Al Abidine Medlej
- Agro-Food and Environmental Biosciences and Technologies Department, University of Teramo, 64100 Teramo, Italy
| | - Wassim Medlej
- Cryolebabon and Medical Devices Sarl, Beirut 1107 2020, Lebanon
| | - Sami Slaba
- Hotel Dieu de France Hospital, Saint-Joseph University, Beirut 1104 2020, Lebanon
| | | | - Antonio Cueto
- Radiology Department, Clinica Santa Elena, 29620 Madrid, Spain
| | | | | | - Franco Lugnani
- Radiology Department, Clinica Santa Elena, 29620 Madrid, Spain
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Robles-Tenorio A, Rocha-Mendez LE, Tarango-Martinez VM. Cryosurgery as adjuvant treatment for cutaneous sporotrichosis in two patients with diabetes mellitus type 2. Clin Exp Dermatol 2023; 48:257-259. [PMID: 36763769 DOI: 10.1093/ced/llac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Sporotrichosis is a subacute or chronic fungal disease caused by the Sporothrix schenckii complex. We report two patients with diabetes mellitus type 2 who developed sporotrichosis. Cryosurgery was used successfully in both patients.
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Affiliation(s)
- Arturo Robles-Tenorio
- Instituto Dermatológico de Jalisco 'Dr Jose Barba Rubio', Zapopan, Jalisco, Mexico.,School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
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Ou W, Stewart S, White A, Kwizera EA, Xu J, Fang Y, Shamul JG, Xie C, Nurudeen S, Tirada NP, Lu X, Tkaczuk KHR, He X. In-situ cryo-immune engineering of tumor microenvironment with cold-responsive nanotechnology for cancer immunotherapy. Nat Commun 2023; 14:392. [PMID: 36693842 PMCID: PMC9873931 DOI: 10.1038/s41467-023-36045-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023] Open
Abstract
Cancer immunotherapy that deploys the host's immune system to recognize and attack tumors, is a promising strategy for cancer treatment. However, its efficacy is greatly restricted by the immunosuppressive (i.e., immunologically cold) tumor microenvironment (TME). Here, we report an in-situ cryo-immune engineering (ICIE) strategy for turning the TME from immunologically "cold" into "hot". In particular, after the ICIE treatment, the ratio of the CD8+ cytotoxic T cells to the immunosuppressive regulatory T cells is increased by more than 100 times in not only the primary tumors with cryosurgery but also distant tumors without freezing. This is achieved by combining cryosurgery that causes "frostbite" of tumor with cold-responsive nanoparticles that not only target tumor but also rapidly release both anticancer drug and PD-L1 silencing siRNA specifically into the cytosol upon cryosurgery. This ICIE treatment leads to potent immunogenic cell death, which promotes maturation of dendritic cells and activation of CD8+ cytotoxic T cells as well as memory T cells to kill not only primary but also distant/metastatic breast tumors in female mice (i.e., the abscopal effect). Collectively, ICIE may enable an efficient and durable way to leverage the immune system for combating cancer and its metastasis.
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Affiliation(s)
- Wenquan Ou
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Samantha Stewart
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Alisa White
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Elyahb A Kwizera
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Jiangsheng Xu
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Yuanzhang Fang
- Department of Medical and Molecular Genetics and Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - James G Shamul
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
| | - Changqing Xie
- Thoracic and Gastrointestinal Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Suliat Nurudeen
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA
| | - Nikki P Tirada
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA
| | - Xiongbin Lu
- Department of Medical and Molecular Genetics and Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Katherine H R Tkaczuk
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA
| | - Xiaoming He
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA.
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA.
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Alvarez CM, Oliveira MME, Pires RH. Sporotrichosis: A Review of a Neglected Disease in the Last 50 Years in Brazil. Microorganisms 2022; 10:2152. [PMID: 36363744 PMCID: PMC9695284 DOI: 10.3390/microorganisms10112152] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 08/15/2023] Open
Abstract
Sporotrichosis is caused by fungi belonging to the genus Sporothrix, which saprophytically are found in plants and organic matter. However, cats are highly susceptible to contamination with fungal spores and, when they become sick, they can transmit it to other animals and to man. The objective of this study is to carry out a systematic review on the emergency, diagnosis, clinical symptoms, therapeutics, and control of zoonotic sporotrichosis. Published data covering the last 50 years using a combination of keywords were selected to answer the question: Why has the zoonotic sporotrichosis been a neglected disease up to now? A total of 135 studies were included in this review. The studies emphasize that in recent decades, Brazil has experienced an unprecedented zoonotic outbreak of sporotrichosis. Advances on the genus Sporothrix allowed one to associate thermotolerance, capacity for melanin synthesis, potential for adhesion to tissue macromolecules, ergosterol peroxide production, and expression of virulence proteins as tools for infection and invasion in S. brasiliensis, the main species involved, although cases with S. schenckii or S. lurei were also reported. Correct diagnosis, early treatment, basic educational measures that emphasize responsible ownership of animals and reproductive control programs for felines can contribute to the control of zoonosis.
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Affiliation(s)
- Carmen Magaly Alvarez
- Laboratory of Mycology and Environmental Diagnosis, Postgraduate Program in Health Promotion, University of Franca, Franca 14404-600, SP, Brazil
- Faculty of Veterinary Medicine, Universidad Agraria del Ecuador, Guayaquil 090104, Ecuador
| | | | - Regina Helena Pires
- Laboratory of Mycology and Environmental Diagnosis, Postgraduate Program in Health Promotion, University of Franca, Franca 14404-600, SP, Brazil
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Park JW, Han HS, Koh YG, Seo SB, Kim GH, Park KY. Split-face comparative trial of 785-nm picosecond neodymium:yttrium-aluminum-garnet laser and precision cryotherapy combination treatment for facial benign pigmented lesions. Dermatol Ther 2021; 35:e15240. [PMID: 34854186 DOI: 10.1111/dth.15240] [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: 10/12/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 11/28/2022]
Abstract
Cryotherapy (or cryosurgery) has been performed to treat various skin lesions in the field of dermatology; however, to the best of our knowledge, no study has investigated its efficacy and safety for benign pigmented lesions. Therefore, we conducted a split-face study to evaluate the efficacy and safety of cryotherapy in the treatment of benign pigmented lesions. A total of five subjects were included. Picosecond laser therapy was performed to treat the whole face and cryotherapy for half the face. Four weeks after completing the treatment sessions, patients showed more clinical improvement on the laser and cryotherapy combination treatment side than on the laser-only side, with no adverse events. Our study demonstrated that cryotherapy is a potential adjuvant therapeutic modality for benign pigmented lesions.
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Affiliation(s)
- Jae Wan Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hye Sung Han
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Young Gue Koh
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Suk Bae Seo
- Department of Dermatology, SAS Dermatologic Clinic, Seoul, South Korea
| | - Gun-Ho Kim
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
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Saleh K. Distant Resolution of Actinic Keratosis following Cryosurgery: An Unusual Phenomenon. Case Rep Dermatol 2021; 13:289-292. [PMID: 34248534 PMCID: PMC8255705 DOI: 10.1159/000517089] [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: 02/09/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022] Open
Abstract
Early after the introduction of cryosurgery to clinical practice, there were reports of metastasis regressing after cryosurgery of a primary tumour, mainly prostate and breast cancer, suggesting a systemic immunological effect to a local reaction. Colleagues within dermatology have occasionally experienced similar systemic effects following cryosurgery. However, published reports of such cases are lacking. In this case, we report a photographed distant resolution of an actinic keratosis (AK) on 68-year-old woman's arm following cryosurgery of another AK on the same arm.
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Affiliation(s)
- Karim Saleh
- Division of Dermatology and Venereology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
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Yi F, Liu L, Ding M, Zhu Y, Song Q, Zeng C. Changes in and effects of Kupffer cells on residual tumor after cryoablation in rabbit hepatic VX2 tumor. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2021; 14:75-85. [PMID: 33532025 PMCID: PMC7847489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Cryoablation can directly kill tumor cells through sudden changes in temperature. It can also enhance lymphocyte function and cause distant tumor regression far from the ablation treatment area. In order to further explore the changes of immune function after cryoablation, the changes of Kupffer cells (KCs), the main immune cells in the liver, and their effects on untreated tumors in vivo were studied. METHODS Rabbit VX2 liver cancer models were constructed. The growth of liver tumors was confirmed by ultrasound after transplantation for 3 weeks. Fifteen Japanese white rabbits were divided into a tumor control group and cryoablation group. Cryoablation group was treated with cryoablation of a single or partial tumor. Histologic and immunohistochemical changes of the treatment area and untreated tumor area before and after cryoablation were observed, and the phagocytic function changes of KCs around the untreated area and treatment area were observed by electron microscopy. RESULTS Cryoablation areas showed necrosis, infiltration of inflammatory cells (including KCs), and fibrosis of tissue. The number of inflammatory cells in the unfrozen tumor area was increased in the same treated rabbit. There was a significant difference in the maximum diameter of unfrozen tumors between the frozen group and control group at 15th days after cryoablation (P<0.05), while the difference was not obvious at the 3rd and 7th day (P>0.05). Electron microscopy showed that the number of debris fragments engulfed by KCs around the tumor after cryoablation was significantly higher than that of the control group. In the same rabbit, we compared the amount of debris between tissue surrounding the unfrozen area and around the cryoablation area. There was a significant difference on the 3rd day after cryoablation, P=0.043, while there was no significant difference on the 7th day, P=0.348. CONCLUSION After cryoablation, inflammatory cells aggregated around the cryoablated area. The activity of KCs had been increased and the function of phagocytosis enhanced. KCs had a certain inhibitory effect on the untreated tumor in the same animal at the early stage (within 15 days), but it was not enough to restrain the growth of the untreated tumors.
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Chang D, Mohan P, Amin A, Garcia-Buitrago M, Rodriguez J, Peaden R. Liquid Nitrogen-Based Cryoablation in In Vivo Porcine Tissue: A Pilot Study. Asian Pac J Cancer Prev 2020; 21:3069-3075. [PMID: 33112569 PMCID: PMC7798152 DOI: 10.31557/apjcp.2020.21.10.3069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction: Liquid nitrogen-based cryoablation induces freezing evenly throughout the probe tip surface, resulting in larger ablation volumes and faster treatment times. The purpose of this preliminary investigation is to determine the efficacy of the liquid nitrogen-based Visica2 Cryoablation System (Sanarus Technologies, Pleasanton, CA) in in vivo porcine kidney, liver, and fibro-fatty tissue. Methods: Ablations were performed under ultrasound guidance in 4 Yorkshire pigs. The target lesion cross-section width (W) and depth (D) were 1 cm for liver (n=8), kidney (n=4), and head-neck (n=5) and 2 cm for kidney (n=4). Expected axial length (L) of the resulting lesion is approximately 4 cm. After three-day survival, the ablated tissue was harvested and histologically analysed. The mean width and depth were compared with the target diameter using a one-sample t-test. Results: All animals survived the procedure. For the 1 cm target, mean dimensions (L x W x D) were 3.8±1.5 x 1.7±0.3 x 1.7±0.7 for liver, 3.0±0.5 x 2.0±0.4 x 1.7±0.6 for kidney, and 3.3±0.8 x 1.8±0.4 x 1.8±0.4 for head-neck. Mean width and depth were significantly greater than desired dimension. For the 2 cm target, mean dimensions were 3.2±0.5 x 3.1±0.8 x 1.9±0.7. Mean width and depth were not significantly different to desired target. Conclusion: Our preliminary results show that the Visica2 liquid nitrogen-based cryoablation system can efficiently and reproducibly create ablation volumes in liver, kidney, and fibro-fatty tissue within 4 minutes and 12 minutes for 1cm and 2cm targeted diameters, respectively. Further investigation is necessary to determine the optimal freeze-thaw-freeze protocol for larger ablation volumes.
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Affiliation(s)
- Doyoung Chang
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Prasoon Mohan
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Ayush Amin
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Monica Garcia-Buitrago
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Jose Rodriguez
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
| | - Robert Peaden
- University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA
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El Hawary M, Bassiouny DA, Esmat S, Sobhi R, Saleh MA, AbdelHalim D, Hegazy R, Gawdat H, Ragab N, Samir N, Sany I. Recipient site preparation by cryoblebbing in melanocyte keratinocyte transplantation procedure over the fingers in vitiligo: A pilot study. Dermatol Ther 2020; 33:e14199. [PMID: 32798282 DOI: 10.1111/dth.14199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/15/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
Surgical treatment of vitiligo lesions over the fingers has poor outcome. In this intra-patient comparative study, 12 patients with stable non-segmental vitiligo (NSV) affecting the middle three fingers of one hand were included. Three variations were used in treatment of finger vitiligo lesions: minipuch grafting, melanocytes keratinocyte transplantation procedure (MKTP) preceded by cryoblebbing or full CO2 laser resurfacing of the recipient site. Liquid nitrogen was used to create blebs in one finger 24 hours before therapy. On the following day, the second finger was treated by minipunch grafting and the third finger was resurfaced by CO2 laser. A suspension was prepared and 0.1 mL was injected into each cryobleb. It was also applied to the resurfaced skin. All patients underwent topical PUVA therapy and were followed-up for 12 months. Ten cases with 52 lesions completed the follow-up period. About 4/18 lesions treated by cryoblebbing followed by MKTP showed ≥75% repigmentation while only 1/17 lesions treated by laser resurfacing + MKTP and 1/17 lesions treated by minipunch grafting showed 30% and 10% repigmentation, respectively. No complications occurred in MKTP treated lesions. Cryoblebbing of the recipient site seems to improve the outcome of MKTP in lesions over the fingers in stable NSV.
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Affiliation(s)
- Marwa El Hawary
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Ahmed Bassiouny
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samia Esmat
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab Sobhi
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwah Adly Saleh
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia AbdelHalim
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab Hegazy
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba Gawdat
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nanis Ragab
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nesrin Samir
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Sany
- The Department of Dermatology, Kasr El-Ainy Teaching Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
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Fichman V, do Valle ACF, Freitas DFS, Sampaio FMS, Lyra MR, de Macedo PM, Almeida-Paes R, de Oliveira RVC, Gutierrez-Galhardo MC. Cryosurgery for the treatment of cutaneous sporotrichosis: experience with 199 cases. Br J Dermatol 2019; 180:1541-1542. [PMID: 30560992 DOI: 10.1111/bjd.17532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V Fichman
- Infectious Dermatology Clinical Research Laboratory, Rio de Janeiro, Brazil
| | - A C F do Valle
- Infectious Dermatology Clinical Research Laboratory, Rio de Janeiro, Brazil
| | - D F S Freitas
- Infectious Dermatology Clinical Research Laboratory, Rio de Janeiro, Brazil
| | - F M S Sampaio
- Infectious Dermatology Clinical Research Laboratory, Rio de Janeiro, Brazil
| | - M R Lyra
- Laboratory for Leishmaniasis Surveillance, Rio de Janeiro, Brazil
| | - P M de Macedo
- Infectious Dermatology Clinical Research Laboratory, Rio de Janeiro, Brazil
| | | | - R V C de Oliveira
- Clinical Epidemiology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Fiocruz, Rio de Janeiro, Brazil
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Firooz A, Hosseini H, Izadi Firouzabadi L, Nassiri Kashani M, Nasrollahi SA. The efficacy and safety of other cryotherapy compounds for the treatment of genital warts: a randomized controlled trial. J DERMATOL TREAT 2018; 30:176-178. [PMID: 29790804 DOI: 10.1080/09546634.2018.1480745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Cryotherapy using Wartner compound that contains a mixture of dimethyl ether (75%) and propane (25%) has been recently reported as an effective treatment for warts. The present study aimed to evaluate the safety and efficacy of Wartner in male patients with genital warts. METHODS A Phase II parallel-randomized clinical trial was performed on 16 Iranian men affected by genital warts who were referred to a dermatology clinic at Tehran University of Medical Sciences. Two genital warts of each patient were selected and randomly assigned to receive either Wartner (intervention) or liquid nitrogen (control). RESULTS Two weeks after the treatment, the sizes of the lesions in control and intervention groups decreased by 17.87 ± 2.14 mm2 and 15.81 ± 1.80 mm2, respectively (p = .299). Fourteen days after a single session of treatment, 81% of lesions in the control group and 50% in the Wartner group were completely eradicated, however, the difference was not statistically significant (p = .063). CONCLUSIONS The Wartner compound is as effective as the conventional cryotherapy method for treating genital warts. It is particularly valuable when there are contraindications or no access to common treatment options.
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Affiliation(s)
- A Firooz
- a Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences , Tehran , Iran.,b Clinical Trial Center, Tehran University of Medical Sciences , Tehran , Iran
| | - H Hosseini
- b Clinical Trial Center, Tehran University of Medical Sciences , Tehran , Iran
| | - L Izadi Firouzabadi
- a Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences , Tehran , Iran
| | - M Nassiri Kashani
- a Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences , Tehran , Iran
| | - S A Nasrollahi
- a Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences , Tehran , Iran
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16
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Kim SN, Akindehin S, Kwon HJ, Son YH, Saha A, Jung YS, Seong JK, Lim KM, Sung JH, Maddipati KR, Lee YH. Anti-inflammatory role of 15-lipoxygenase contributes to the maintenance of skin integrity in mice. Sci Rep 2018; 8:8856. [PMID: 29891910 PMCID: PMC5995961 DOI: 10.1038/s41598-018-27221-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/25/2018] [Indexed: 12/19/2022] Open
Abstract
15-lipoxygenase is involved in the generation of specialized pro-resolving lipid mediators that play essential roles in resolution and inflammatory responses. Here, we investigated anti-inflammatory role of Alox15 in skin homeostasis. We demonstrated that knockout (KO) of Alox15 led to hair loss and disrupted the structural integrity of the dorsal skin. Alox15 KO resulted in loss of hair follicle stem cells and abnormal transition of dermal adipocytes into fibroblasts. Alox15 deficiency increased infiltration of proinflammatory macrophages and upregulated proinflammatory and necroptotic signaling in dermal adipose tissue in the dorsal skin. Lipidomic analysis revealed severe loss of resolvin D2 in the dorsal skin of Alox15 KO mice compared to wild type controls. Treatment with resolvin D2 reduced skin inflammation in Alox15 KO mice. Collectively, these results indicate that Alox15-mediated production of resolvin D2 is required to maintain skin integrity by suppressing dermal inflammation.
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Affiliation(s)
- Sang-Nam Kim
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Seun Akindehin
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Hyun-Jung Kwon
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Yeon-Ho Son
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Abhirup Saha
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Young-Suk Jung
- College of Pharmacy, Pusan National University, Busan, 46241, South Korea
| | - Je-Kyung Seong
- College of Veterinary Medicine, Seoul National University, Korea Mouse Phenotyping Center, Seoul, 08826, South Korea
| | - Kyung-Min Lim
- College of Pharmacy, Ewha Womans University, Seoul, 03760, South Korea
| | - Jong-Hyuk Sung
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea
| | - Krishna Rao Maddipati
- Lipidomics Core Facility and department of Pathology, Wayne State University, School of Medicine, Detroit, Michigan, 48202, USA
| | - Yun-Hee Lee
- College of Pharmacy, Yonsei University, Incheon, 21983, South Korea.
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17
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Lamid-Ochir O, Nakajima T, Miyazaki M, Zhang X, Erdene K, Murakami T, Tsushima Y. Bioluminescence Image as a Quantitative Imaging Biomarker for Preclinical Evaluation of Cryoablation in a Murine Model. J Vasc Interv Radiol 2018; 29:1034-1040. [PMID: 29884506 DOI: 10.1016/j.jvir.2018.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/22/2018] [Accepted: 03/07/2018] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To employ bioluminescence imaging (BLI) as a quantitative imaging biomarker to assess preclinical evaluation of cryoablation in a murine model. MATERIALS AND METHODS In vitro, Colon26-Luc (C26-Luc) cells were seeded at 6 different concentrations in 35-mm dishes. These were divided into 6 groups: group 0 (G0), a control group without treatment; and groups 1-5 (G1-G5) according to the number of freeze-thaw cycles, with each cycle consisting of freezing at -80°C for 10 min followed by thawing at room temperature for 5 minutes. BLI and flow-cytometric analysis were performed after cryotherapy. In vivo, 20 tumor-bearing mice with C26-Luc cells were divided into 4 groups: group 0 (G0), a control group; and groups 1-3 (G1-G3) according to the number of freeze-thaw cycles. Each cryoablation procedure was performed for 30 seconds with liquid nitrogen (-170°C) applied with cotton-tipped applicators. BLI was acquired at 6 hours and 1, 3, and 7 days after treatments. RESULTS In vitro, BLI signal showed a negative correlation with the number of freeze-thaw cycles (r = -0.86, P = .02). In vivo, there was no difference in tumor volume at 1 day after cryoablation among all groups, but the BLI signals were significantly different between G0 and G2/G3 (P = .03 and P = .02, respectively) and between G1 and G3 (P = .04). BLI signals reflected tumor growth speed and survival ratio. CONCLUSIONS This study demonstrates the direct validation of BLI as a quantitative tool for the early assessment of therapeutic effects of cryoablation.
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Affiliation(s)
- Oyunbold Lamid-Ochir
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
| | - Takahito Nakajima
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
| | - Masaya Miyazaki
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
| | - Xieyi Zhang
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
| | - Khongorzul Erdene
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
| | - Takashi Murakami
- Department of Microbiology, Faculty of Medicine, Saitama Medical University, Moroyama, Japan
| | - Yoshito Tsushima
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan; Research Program for Diagnostic and Molecular Imaging, Division of Integrated Oncology Research, Gunma University Initiative for Advanced Research, Maebashi, Japan
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18
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Fichman V, do Valle ACF, de Macedo PM, Freitas DFS, de Oliveira MME, Almeida-Paes R, Gutierrez-Galhardo MC. Cryosurgery for the treatment of cutaneous sporotrichosis in four pregnant women. PLoS Negl Trop Dis 2018; 12:e0006434. [PMID: 29684015 PMCID: PMC5933803 DOI: 10.1371/journal.pntd.0006434] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/03/2018] [Accepted: 04/06/2018] [Indexed: 11/19/2022] Open
Abstract
Background Pregnant women with sporotrichosis should not receive systemic antifungal therapy except in severe cases when amphotericin B is recommended. Thermotherapy is the most reported treatment described in this group of patients. It entails weeks of daily self-application of heat to the lesions, requires that the patient faithfully apply it, and it could cause skin burns. Cryosurgery is a useful therapeutic tool for many cutaneous infectious diseases, safe for pregnant women, but not well evaluated for sporotrichosis treatment in this group. Methodology The authors conducted a retrospective study describing epidemiological, clinical, and therapeutic data related to four pregnant patients with sporotrichosis treated with cryosurgery. The authors reviewed the clinical records of four pregnant patients diagnosed with cutaneous sporotrichosis and treated with cryosurgery. The sessions were carried out monthly up to clinical cure. Molecular identification of the Sporothrix species was performed in two cases using T3B PCR fingerprinting assays. Principal findings All patients were in the second trimester of pregnancy and their age ranged from 18 to 34 years. With regard to clinical presentation, two patients had lymphocutaneous and two had the fixed form. S. brasiliensis was identified in two cases as the causative agent. Cryosurgery was well tolerated and the number of sessions ranged from 1 to 3. All the patients reached a complete clinical cure. Conclusions Cryosurgery was a safe, easy to perform and well tolerated method, and therefore it is suggested to be a suitable option for the treatment of cutaneous sporotrichosis in pregnant women. Sporotrichosis is a cosmopolitan disease, considered the most important subcutaneous mycosis in Latin America. Since 1998, there is an ongoing cat-transmitted zoonotic epidemic of sporotrichosis occurring in Rio de Janeiro, Brazil. Pregnant women are a vulnerable population occasionally affected that require special attention regarding sporotrichosis treatment. Antifungal drugs should be avoided because of their potential risks to the fetus, unless in severe cases when amphotericin B (an intravenous antifungal drug) can be indicated. In this context, local measures are the treatment of choice. Cryosurgery consists in local application of intense cold using liquid nitrogen to destroy some infectious, tumoral and inflammatory cutaneous diseases. It is scarcely reported in the literature for the treatment of sporotrichosis, especially in pregnant women for whom local heat is most used. This works aims to describe the clinical response and outcome of cryosurgery for the treatment of sporotrichosis in four pregnant women. All patients reached clinical cure after one to three sessions. These results suggest that cryosurgery can be a well-tolerated, safe, and efficient method for the treatment of sporotrichosis in pregnancy.
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Affiliation(s)
- Vivian Fichman
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
- * E-mail:
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Priscila Marques de Macedo
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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Appenheimer MM, Evans SS. Temperature and adaptive immunity. HANDBOOK OF CLINICAL NEUROLOGY 2018; 156:397-415. [DOI: 10.1016/b978-0-444-63912-7.00024-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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Bull JMC. A review of immune therapy in cancer and a question: can thermal therapy increase tumor response? Int J Hyperthermia 2017; 34:840-852. [PMID: 28974121 DOI: 10.1080/02656736.2017.1387938] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Immune therapy is a successful cancer treatment coming into its own. This is because checkpoint molecules, adoptive specific lymphocyte transfer and chimeric antigen T-cell (CAR-T) therapy are able to induce more durable responses in an increasing number of malignancies compared to chemotherapy. In addition, immune therapies are able to treat bulky disease, whereas standard cytotoxic therapies cannot treat large tumour burdens. Checkpoint inhibitor monoclonal antibodies are becoming widely used in the clinic and although more complex, adoptive lymphocyte transfer and CAR-T therapies show promise. We are learning that there are nuances to predicting the successful use of the checkpoint inhibitors as well as to specific-antigen adoptive and CAR-T therapies. We are also newly aware of a here-to-fore unrealised natural force, the status of the microbiome. However, despite better understanding of mechanisms of action of the new immune therapies, the best responses to the new immune therapies remain 20-30%. Likely the best way to improve this somewhat low response rate for patients is to increase the patient's own immune response. Thermal therapy is a way to do this. All forms of thermal therapy, from fever-range systemic thermal therapy, to high-temperature HIFU and even cryotherapy improve the immune response pre-clinically. It is time to test the immune therapies with thermal therapy in vivo to test for optimal timing of the combinations that will best enhance tumour response and then to begin to test the immune therapies with thermal therapy in the clinic as soon as possible.
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Affiliation(s)
- Joan M C Bull
- a Division of Oncology, Department of Internal Medicine , The University of Texas Medical School at Houston , Houston , TX , USA
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Labandeira J, Vázquez-Osorio I, Figueroa-Silva O, Pereiro M, Toribio J. Tolerability and effectiveness of liquid nitrogen spray cryotherapy with very short freeze times in the treatment of xanthelasma palpebrarum. Dermatol Ther 2015; 28:346-50. [PMID: 26088022 DOI: 10.1111/dth.12254] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Xanthelasma are cholesterol-filled, soft, yellow plaques that usually appear on the medial aspects of the eyelids bilaterally. They are always benign lesions so therapy is usually undertaken only for cosmetic reasons. Surgical excision, chemical peeling with tricholoroacetic acid, and laser ablation are commonly used treatments. Liquid nitrogen cryotherapy is a potentially effective but rarely used treatment due to the risk of intense eyelid swelling. We report on our experience with four of our patients, and propose an explanation for the effectiveness of gentle liquid nitrogen spray cryotherapy in xanthelasma. We consider that gentle liquid nitrogen cryotherapy should be used in the treatment of xanthelasma due to the ease of application and low risk of adverse effects.
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Affiliation(s)
- Javier Labandeira
- Faculty of Medicine, Department of Dermatology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Igor Vázquez-Osorio
- Faculty of Medicine, Department of Dermatology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Olalla Figueroa-Silva
- Faculty of Medicine, Department of Dermatology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Manuel Pereiro
- Faculty of Medicine, Department of Dermatology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Jaime Toribio
- Faculty of Medicine, Department of Dermatology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
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