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Challenges and opportunities in the development of metal-based anticancer theranostic agents. Biosci Rep 2022; 42:231168. [PMID: 35420649 PMCID: PMC9109461 DOI: 10.1042/bsr20212160] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 12/02/2022] Open
Abstract
Around 10 million fatalities were recorded worldwide in 2020 due to cancer and statistical projections estimate the number to increase by 60% in 2040. With such a substantial rise in the global cancer burden, the disease will continue to impose a huge socio-economic burden on society. Currently, the most widely used clinical treatment modality is cytotoxic chemotherapy using platinum drugs which is used to treat variety of cancers. Despite its clinical success, critical challenges like resistance, off-target side effects and cancer variability often reduce its overall therapeutic efficiency. These challenges require faster diagnosis, simultaneous therapy and a more personalized approach toward cancer management. To this end, small-molecule ‘theranostic’ agents have presented a viable solution combining diagnosis and therapy into a single platform. In this review, we present a summary of recent efforts in the design and optimization of metal-based small-molecule ‘theranostic’ anticancer agents. Importantly, we highlight the advantages of a theranostic candidate over the purely therapeutic or diagnostic agent in terms of evaluation of its biological properties.
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Neri G, Bondi D, Scordella A, Tartaro A, Neri L, Cazzato F, Pini N, Mariggiò MA. Menière's disease patients improve specific posturographic parameters following diagnostic intratympanic injection. Am J Otolaryngol 2020; 41:102468. [PMID: 32248954 DOI: 10.1016/j.amjoto.2020.102468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Evaluation of specific computerized posturographic parameters in patients with Menière's disease (MD) following the intratympanic injection of gadolinium, a contrast agent, used in radiological diagnosing. MATERIALS AND METHODS We have observed 12 adult patients with unilateral Menière's Disease subjected to inner ear magnetic resonance imaging (MRI) examination after intratympanic gadolinium injection (ITG). The diagnoses have been performed according to the guidelines of the American Academy of otolaryngology. Before and after 24 h the ITG, all patients were subjected to the clinical evaluation and computerized posturography (CP), in 4 conditions depending on open/closed eyes and with/without foam cushion under feet. RESULTS After ITG, in the affected ear the MRI confirmed the endolymphatic hydrops revealing a thin or even disappeared perilymphatic space. The statokinesigram showed improvement of stability only with closed eyes on a foam cushion. The CP performed 24 h after the contrast intratympanic injection showed a significant reduction of Path Length and Confidence Ellipse Area, due to an improvement of vestibular function on static balance. This improvement could be directly dependent to intratympanic pressure modification mediated by volume of contrast liquid, by "columella effect". CONCLUSIONS This study demonstrates the absence of vestibular damage in patients undergoing intratympanic gadolinium infiltration and confirms the relationship between intratympanic pressure and vestibular stability modifications providing positive evidences for an applicative use of CP as a functional assessment to better address diagnosis and follow-up in MD patients treated with intratympanic injections.
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Affiliation(s)
- Giampiero Neri
- Department of Neuroscience, Imaging e Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Danilo Bondi
- Department of Neuroscience, Imaging e Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Laboratory of Functional Evaluation, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Andrea Scordella
- Laboratory of Functional Evaluation, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Armando Tartaro
- Department of Medical and Oral Sciences and Biotechnologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Letizia Neri
- Department of Medical and Oral Sciences and Biotechnologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Fiorella Cazzato
- Department of Medical and Oral Sciences and Biotechnologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Niccolò Pini
- Department of Neuroscience, Imaging e Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Laboratory of Functional Evaluation, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Addolorata Mariggiò
- Department of Neuroscience, Imaging e Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Jeong Y, Hwang HS, Na K. Theranostics and contrast agents for magnetic resonance imaging. Biomater Res 2018; 22:20. [PMID: 30065849 PMCID: PMC6062937 DOI: 10.1186/s40824-018-0130-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 07/18/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Magnetic resonance imaging is one of the diagnostic tools that uses magnetic particles as contrast agents. It is noninvasive methodology which provides excellent spatial resolution. Although magnetic resonance imaging offers great temporal and spatial resolution and rapid in vivo images acquisition, it is less sensitive than other methodologies for small tissue lesions, molecular activity or cellular activities. Thus, there is a desire to develop contrast agents with higher efficiency. Contrast agents are known to shorten both T1 and T2. Gadolinium based contrast agents are examples of T1 agents and iron oxide contrast agents are examples of T2 agents. In order to develop high relaxivity agents, gadolinium or iron oxide-based contrast agents can be synthesized via conjugation with targeting ligands or functional moiety for specific interaction and achieve accumulation of contrast agents at disease sites. MAIN BODY This review discusses the principles of magnetic resonance imaging and recent efforts focused on specificity of contrast agents on specific organs such as liver, blood, lymph nodes, atherosclerotic plaque, and tumor. Furthermore, we will discuss the combination of theranostic such as contrast agent and drug, contrast agent and thermal therapy, contrast agent and photodynamic therapy, and neutron capture therapy, which can provide for cancer diagnosis and therapeutics. CONCLUSION These applications of magnetic resonance contrast agents demonstrate the usefulness of theranostic agents for diagnosis and treatment.
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Affiliation(s)
- Yohan Jeong
- Department of Biotechnology, Center for Photomedicine, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi do 14662 South Korea
| | - Hee Sook Hwang
- Department of Biotechnology, Center for Photomedicine, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi do 14662 South Korea
| | - Kun Na
- Department of Biotechnology, Center for Photomedicine, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi do 14662 South Korea
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Nonoyama H, Tanigawa T, Shibata R, Tanaka H, Katahira N, Horibe Y, Takemura K, Murotani K, Ozeki N, Ueda H. Investigation of the ototoxicity of gadoteridol (ProHance) and gadodiamide (Omniscan) in mice. Acta Otolaryngol 2016; 136:1091-1096. [PMID: 27315460 DOI: 10.1080/00016489.2016.1193892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONCLUSION In the mouse, when a tympanic perforation is present, gadoteridol does not seem to cause ototoxicity. Gadodiamide may cause mild ototoxicity other than toxicity to the outer hair cells of the cochlea. OBJECTIVES Endolymphatic hydrops have been visualized through intra-tympanic injection of gadolinium-based contrast agents (GBCAs) and three-dimensional fluid-attenuated inversion recovery (3-D FLAIR) magnetic resonance imaging. However, reports on the safety of GBCAs are limited. This study aimed to assess ototoxicity of gadoteridol and gadodiamide. METHOD In a prospective, randomized, controlled trial, myringotomies in the left ear were performed in 20 male C57 BL/6 mice. After testing the baseline auditory brainstem response (ABR) (range = 8-32 kHz), the test solution (gadoteridol, gadodiamide, saline, or cisplatin) was injected into the left ear. ABR testing was repeated 14 days after test solution application. In morphological experiments, images of post-mortem surface preparations were assessed for cochlear hair cell status. RESULTS At 14 days following gadoteridol application, there was no significant change in ABR thresholds at 8, 16, or 32 kHz. Gadodiamide application caused a significant change in the ABR threshold at 8 kHz. Apparent cochlear hair cell loss was not observed in the surface preparation after gadoteridol or gadodiamide application.
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Park M, Lee HS, Kim H, Oh SH, Lee JH, Suh MW. Differences in perilymphatic space enhancement and adverse inflammatory reaction after intratympanic injection of two different gadolinium agents: A 9.4-T magnetic resonance imaging study. Hear Res 2016; 333:118-126. [PMID: 26795351 DOI: 10.1016/j.heares.2015.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/30/2015] [Accepted: 10/14/2015] [Indexed: 09/30/2022]
Abstract
PURPOSE To compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 T micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear. METHODS Twelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes. RESULTS The perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8 ± 2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4 ± 6.6 dB SPL) post-injection. CONCLUSIONS Gd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.
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Affiliation(s)
- Mina Park
- Department of Otorhinolaryngology-Head and Neck Surgery and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea; Department of Translational Biomedical Research, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Sun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeonjin Kim
- Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Louza J, Krause E, Gürkov R. Hearing function after intratympanic application of gadolinium-based contrast agent: A long-term evaluation. Laryngoscope 2015; 125:2366-70. [PMID: 25823415 DOI: 10.1002/lary.25259] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/04/2015] [Accepted: 02/17/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to evaluate the long-term influence of intratympanic gadolinium-based contrast agent on hearing function in patients with possible Ménière's disease and normal auditory thresholds who were undergoing locally enhanced magnetic resonance imaging scans. STUDY DESIGN Prospective observational cohort study in a tertiary referral university hospital ear, nose, and throat department. METHODS Between 2009 and 2012, 17 patients with possible or probable Ménière's disease and a four-tone pure-tone average baseline of <25 dB were recruited for our study. Before undergoing intratympanic injection of gadolinium-based contrast agent, all patients underwent a complete audiological evaluation. The study population was then invited back after at least 6 months postinjection for a follow-up auditory evaluation. This consisted of comprehensive clinical and audiological tests on both sides and were evaluated according to the ototoxicity guidelines. RESULTS A long-term evaluation of our study group revealed no significant difference in the air-conduction pure-tone average. Furthermore, no statistical difference at individual frequencies compared to baseline was found. There was no evidence of ototoxicity in the injected ear. CONCLUSIONS Long-term hearing function assessment after intratympanic application of gadolinium-based agent showed no evidence of ototoxicity. The use of intratympanic gadolinium-based agent in the diagnosis of Ménièrés disease is currently a helpful tool, and seems to be a safe method, especially with regard to auditory function. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Julia Louza
- Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Eike Krause
- Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Robert Gürkov
- Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
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Katahira N, Tanigawa T, Tanaka H, Nonoyama H, Ueda H. Diluted gadoteridol (ProHance®) causes mild ototoxicity in cochlear outer hair cells. Acta Otolaryngol 2013; 133:788-95. [PMID: 23638948 DOI: 10.3109/00016489.2013.776177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Administration of diluted solutions of gadoteridol might cause considerably less toxic effects on cochlear outer hair cells (OHCs). OBJECTIVES Visualization of endolymphatic hydrops is done by intratympanic injection of gadolinium-based contrast agents (GBCAs) and three-dimensional fluid-attenuated inversion recovery (3-D FLAIR) magnetic resonance imaging. Here, we investigated the physiological and morphological responses of guinea pig cochlear cells to gadoteridol. METHODS Distortion product otoacoustic emission (DPOAE) levels were measured before and 1, 2, and 4 weeks after intratympanic injection of 1/8 or 1/16 dilution of gadoteridol in guinea pigs. Morphological changes in isolated cochlear OHCs were observed after application of gadoteridol and GdCl3. RESULTS At the highest frequency (F2 = 12 000 Hz), DPOAE level was significantly (p < 0.05) lower in the 1/8 diluted gadoteridol group than in the control group. Cell shape changes were observed in 24% (6/25) and 3% (1/33) of OHCs after application of 1/8 and 1/16 diluted gadoteridol, respectively. The occurrence of morphological damage was significantly lower after application of saline compared with 1/8 diluted gadoteridol. Morphological damage was significantly lower after application of 1/16 diluted gadoteridol compared with 1/8 diluted gadoteridol (p < 0.05). Morphological damage was observed at a high rate (8/10 cells, 80%) after application of GdCl3.
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Affiliation(s)
- Nobuyuki Katahira
- Department of Otolaryngology, Aichi Medical University, Aichi, Japan
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Louza JPR, Flatz W, Krause E, Gürkov R. Short-term audiologic effect of intratympanic gadolinium contrast agent application in patients with Ménière's disease. Am J Otolaryngol 2012; 33:533-7. [PMID: 22317837 DOI: 10.1016/j.amjoto.2011.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 11/22/2011] [Accepted: 12/05/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The aim of this study was to assess whether gadolinium-based contrast agent influences short-term hearing function in patients with Ménière's disease undergoing intratympanically enhanced inner-ear magnetic resonance imaging. DESIGN This is a prospective cohort study. SETTING This study was conducted a tertiary referral university hospital, ENT department. PARTICIPANTS In this study, 21 adult patients with definite, unilateral Ménière's disease were included. According to the criteria of the Committee on Hearing and Equilibrium, all patients were in stage 1 or 2 of the disease, with largely preserved hearing function. OUTCOMES All patients underwent clinical and audiologic testing before and 24 hours after intratympanic application of gadolinium-based contrast agent. The effects of the contrast medium on the hearing function were assessed by analysis of frequency thresholds, pure-tone average from 500 Hz to 3 kHz, and speech audiometry. RESULTS Pure-tone average and single-frequency thresholds in audiometry showed no statistically significant difference after the application of intratympanic gadolinium-based contrast agent. Furthermore, speech audiometry scores remained stable after the application of the contrast agent. CONCLUSIONS This study did not demonstrate clinically significant short-term effects of intratympanic application of gadolinium-based contrast agent on hearing function in patients with Ménière's disease in initial stages.
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Tanigawa T, Tamaki T, Yamamuro O, Tanaka H, Nonoyama H, Shiga A, Sato T, Ueda H. Visualization of endolymphatic hydrops after administration of a standard dose of an intravenous gadolinium-based contrast agent. Acta Otolaryngol 2011; 131:596-601. [PMID: 21351819 DOI: 10.3109/00016489.2010.548402] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Even after the administration of a standard dose of an intravenous gadolinium-based contrast agent (GBCA), visualization of endolymphatic hydrops (ELH) became possible in patients with Meniere's disease. The next step would be to consistently visualize ELH in the upper part of the cochlea. OBJECTIVE To visualize ELH after routine administration of an intravenous GBCA. METHODS An intravenous GBCA (gadodiamide; 0.2 ml/kg) was administered to three patients with unilateral Meniere's disease and two healthy volunteers. Three-dimensional fluid attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) was performed with a 3 T MRI scanner 4 h later. RESULTS In all three patients, ELH was observed in the affected vestibules. In contrast, the endolymphatic space of both vestibules was the same size in healthy volunteers. ELH of the cochlea was not observed in any of the subjects. Gadolinium enhancement was insufficient in the upper turns of both cochleae in patients 1 and 3.
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Affiliation(s)
- Tohru Tanigawa
- Department of Otolaryngology, Aichi Medical University, Japan.
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Tanigawa T, Tanaka H, Sato T, Nakao Y, Katahira N, Tsuchiya Y, Nonoyama H, Ueda H. 3D-FLAIR MRI findings in patients with low-tone sudden deafness. Acta Otolaryngol 2010; 130:1324-8. [PMID: 20632901 DOI: 10.3109/00016489.2010.496461] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The findings suggest that alterations in the composition of inner ear fluid play important roles in the development of low-tone sudden deafness (LTSD). High-intensity signals on three-dimensional fluid attenuated inversion recovery (3D-FLAIR) may reflect an increased concentration of protein in the inner ear due to the increased permeability of blood vessels. Disordered blood flow in the inner ear is associated with an increased permeability of the blood-labyrinth barrier. Therefore, the disordered blood flow in the cochlea may be closely related to the pathophysiological mechanisms of LTSD. OBJECTIVES The 3D-FLAIR sequence has been used to detect alterations in the composition of inner ear fluid. The purpose of this study was to report imaging findings in cases of LTSD. METHODS 3D-FLAIR magnetic resonance imaging was performed in five women with nonrecurrent-type LTSD. RESULTS Three of the five patients (60%) showed high-intensity signals in the cochlear basal turn on precontrast 3D-FLAIR. Postcontrast enhancement was not prominent in any patient. In patient 1, the cochlea of the unaffected side showed high-intensity signals. No patients had such signals in the vestibulae or the semicircular canals.
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Affiliation(s)
- Tohru Tanigawa
- Department of Otolaryngology, Aichi Medical University, Aichi, Japan.
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Medical management of common peripheral vestibular diseases. Curr Opin Otolaryngol Head Neck Surg 2010; 18:407-12. [DOI: 10.1097/moo.0b013e32833e587a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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