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Behrendt P, Boettcher M, Zierke KT, Najem S, Zapf H, Reinshagen K, Wößmann W, Boettcher J. Health-Related Quality of Life and Mental Health of Children with Embryonal Abdominal Tumors. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1720. [PMID: 37892383 PMCID: PMC10605597 DOI: 10.3390/children10101720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/12/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Abstract
(1) Background: Embryonal abdominal tumors are one of the most common entities of solid childhood cancer. The present study investigates the Health-Related Quality of Life (HRQoL) and the mental health of children to obtain a comprehensive picture of their health status and uncover a possible gap in healthcare. (2) Methods: The sample consisted of 54 children who were treated for embryonal abdominal tumors and a control group of 46 children who received uncomplicated outpatient surgery. The HRQoL and the mental health were assessed by the parent proxy reports of the questionnaires Pediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaire (SDQ). (3) Results: Children with embryonal abdominal tumors showed significantly lower HRQoL and mental health values compared to the norm data. The index group showed lower values in the social subscales of HRQoL and mental health compared to the control group. (4) Conclusions: Embryonal abdominal tumors affect the well-being of children. There is still a gap in healthcare due to children's HRQoL and mental health, especially regarding social development. It is essential to further advance the psychological care of children and improve their chances to develop social relationships.
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Affiliation(s)
- Paulina Behrendt
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (M.B.); (S.N.); (K.R.)
| | - Michael Boettcher
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (M.B.); (S.N.); (K.R.)
- Department of Pediatric Surgery, University Medical Center Mannheim, University Heidelberg, Theodor-Kutzner-Ufer 1-3, 68167 Mannheim, Germany
| | - Kira Tabea Zierke
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (M.B.); (S.N.); (K.R.)
| | - Safiullah Najem
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (M.B.); (S.N.); (K.R.)
| | - Holger Zapf
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (W.W.)
| | - Konrad Reinshagen
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (M.B.); (S.N.); (K.R.)
| | - Wilhelm Wößmann
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (W.W.)
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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Simić K, Miladinović Z, Todorović N, Trifunović S, Avramović N, Gavrilović A, Jovanović S, Gođevac D, Vujisić L, Tešević V, Tasic L, Mandić B. Metabolomic Profiling of Bipolar Disorder by 1H-NMR in Serbian Patients. Metabolites 2023; 13:metabo13050607. [PMID: 37233648 DOI: 10.3390/metabo13050607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
Bipolar disorder (BD) is a brain disorder that causes changes in a person's mood, energy, and ability to function. It has a prevalence of 60 million people worldwide, and it is among the top 20 diseases with the highest global burden. The complexity of this disease, including diverse genetic, environmental, and biochemical factors, and diagnoses based on the subjective recognition of symptoms without any clinical test of biomarker identification create significant difficulties in understanding and diagnosing BD. A 1H-NMR-based metabolomic study applying chemometrics of serum samples of Serbian patients with BD (33) and healthy controls (39) was explored, providing the identification of 22 metabolites for this disease. A biomarker set including threonine, aspartate, gamma-aminobutyric acid, 2-hydroxybutyric acid, serine, and mannose was established for the first time in BD serum samples by an NMR-based metabolomics study. Six identified metabolites (3-hydroxybutyric acid, arginine, lysine, tyrosine, phenylalanine, and glycerol) are in agreement with the previously determined NMR-based sets of serum biomarkers in Brazilian and/or Chinese patient samples. The same established metabolites (lactate, alanine, valine, leucine, isoleucine, glutamine, glutamate, glucose, and choline) in three different ethnic and geographic origins (Serbia, Brazil, and China) might have a crucial role in the realization of a universal set of NMR biomarkers for BD.
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Affiliation(s)
- Katarina Simić
- Institute of Chemistry, Technology and Metallurgy, National Institute, University of Belgrade, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Zoran Miladinović
- Institute of General and Physical Chemistry, Studentski trg 12-16, 11158 Belgrade, Serbia
| | - Nina Todorović
- Institute of Chemistry, Technology and Metallurgy, National Institute, University of Belgrade, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Snežana Trifunović
- University of Belgrade - Faculty of Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Nataša Avramović
- University of Belgrade - Faculty of Medicine, Institute of Medical Chemistry, Višegradska 26, 11000 Belgrade, Serbia
| | - Aleksandra Gavrilović
- Special Hospital for Psychiatric Diseases "Kovin", Cara Lazara 253, 26220 Kovin, Serbia
| | - Silvana Jovanović
- Special Hospital for Psychiatric Diseases "Kovin", Cara Lazara 253, 26220 Kovin, Serbia
| | - Dejan Gođevac
- Institute of Chemistry, Technology and Metallurgy, National Institute, University of Belgrade, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Ljubodrag Vujisić
- University of Belgrade - Faculty of Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Vele Tešević
- University of Belgrade - Faculty of Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
| | - Ljubica Tasic
- Institute of Chemistry, Organic Chemistry Department, State University of Campinas, Campinas 13083-970, SP, Brazil
| | - Boris Mandić
- University of Belgrade - Faculty of Chemistry, Studentski trg 12-16, 11000 Belgrade, Serbia
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Sherif S, Roelands J, Mifsud W, Ahmed EI, Raynaud CM, Rinchai D, Sathappan A, Maaz A, Saleh A, Ozer E, Fakhro KA, Mifsud B, Thorsson V, Bedognetti D, Hendrickx WRL. The immune landscape of solid pediatric tumors. J Exp Clin Cancer Res 2022; 41:199. [PMID: 35690832 PMCID: PMC9188257 DOI: 10.1186/s13046-022-02397-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Large immunogenomic analyses have demonstrated the prognostic role of the functional orientation of the tumor microenvironment in adult solid tumors, this variable has been poorly explored in the pediatric counterpart.
Methods
We performed a systematic analysis of public RNAseq data (TARGET) for five pediatric tumor types (408 patients): Wilms tumor (WLM), neuroblastoma (NBL), osteosarcoma (OS), clear cell sarcoma of the kidney (CCSK) and rhabdoid tumor of the kidney (RT). We assessed the performance of the Immunologic Constant of Rejection (ICR), which captures an active Th1/cytotoxic response. We also performed gene set enrichment analysis (ssGSEA) and clustered more than 100 well characterized immune traits to define immune subtypes and compared their outcome.
Results
A higher ICR score was associated with better survival in OS and high risk NBL without MYCN amplification but with poorer survival in WLM. Clustering of immune traits revealed the same five principal modules previously described in adult tumors (TCGA). These modules divided pediatric patients into six immune subtypes (S1-S6) with distinct survival outcomes. The S2 cluster showed the best overall survival, characterized by low enrichment of the wound healing signature, high Th1, and low Th2 infiltration, while the reverse was observed in S4. Upregulation of the WNT/Beta-catenin pathway was associated with unfavorable outcomes and decreased T-cell infiltration in OS.
Conclusions
We demonstrated that extracranial pediatric tumors could be classified according to their immune disposition, unveiling similarities with adults’ tumors. Immunological parameters might be explored to refine diagnostic and prognostic biomarkers and to identify potential immune-responsive tumors.
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Tasic L, Avramović N, Jadranin M, Quintero M, Stanisic D, Martins LG, Costa TBBC, Novak E, Odone V, Rivas M, Aguiar T, Carraro DM, Werneck da Cunha I, Lima da Costa CM, Maschietto M, Krepischi A. High-Resolution Magic-Angle-Spinning NMR in Revealing Hepatoblastoma Hallmarks. Biomedicines 2022; 10:3091. [PMID: 36551847 PMCID: PMC9775661 DOI: 10.3390/biomedicines10123091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
Cancer is one of the leading causes of death in children and adolescents worldwide; among the types of liver cancer, hepatoblastoma (HBL) is the most common in childhood. Although it affects only two to three individuals in a million, it is mostly asymptomatic at diagnosis, so by the time it is detected it has already advanced. There are specific recommendations regarding HBL treatment, and ongoing studies to stratify the risks of HBL, understand the pathology, and predict prognostics and survival rates. Although magnetic resonance imaging spectroscopy is frequently used in diagnostics of HBL, high-resolution magic-angle-spinning (HR-MAS) NMR spectroscopy of HBL tissues is scarce. Using this technique, we studied the alterations among tissue metabolites of ex vivo samples from (a) HBL and non-cancer liver tissues (NCL), (b) HBL and adjacent non-tumor samples, and (c) two regions of the same HBL samples, one more centralized and the other at the edge of the tumor. It was possible to identify metabolites in HBL, then metabolites from the HBL center and the border samples, and link them to altered metabolisms in tumor tissues, highlighting their potential as biochemical markers. Metabolites closely related to liver metabolisms such as some phospholipids, triacylglycerides, fatty acids, glucose, and amino acids showed differences between the tissues.
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Affiliation(s)
- Ljubica Tasic
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, SP, Brazil
| | - Nataša Avramović
- Institute of Medical Chemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milka Jadranin
- Institute of Chemistry, Technology, and Metallurgy, Department of Chemistry, University of Belgrade, 11000 Belgrade, Serbia
| | - Melissa Quintero
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, SP, Brazil
| | - Danijela Stanisic
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, SP, Brazil
| | - Lucas G. Martins
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, SP, Brazil
| | - Tássia Brena Barroso Carneiro Costa
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), Campinas 13083-970, SP, Brazil
| | - Estela Novak
- Pediatric Cancer Institute (ITACI), Pediatric Department, Sao Paulo University Medical School, Sao Paulo 05403-901, SP, Brazil
| | - Vicente Odone
- Pediatric Cancer Institute (ITACI), Pediatric Department, Sao Paulo University Medical School, Sao Paulo 05403-901, SP, Brazil
| | - Maria Rivas
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of Sao Paulo, Sao Paulo 05508-090, SP, Brazil
| | - Talita Aguiar
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of Sao Paulo, Sao Paulo 05508-090, SP, Brazil
- Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Dirce Maria Carraro
- International Center for Research, A. C. Camargo Cancer Center, Sao Paulo 01509-010, SP, Brazil
| | | | | | - Mariana Maschietto
- National Laboratory of Biosciences (LNBio), National Center for Research in Energy and Materials (CNPEM), Campinas 13083-100, SP, Brazil
| | - Ana Krepischi
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of Sao Paulo, Sao Paulo 05508-090, SP, Brazil
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Tasic L, Avramović N, Quintero M, Stanisic D, Martins LG, da Costa TBBC, Jadranin M, de Souza Accioly MT, Faria P, de Camargo B, de Sá Pereira BM, Maschietto M. A Metabonomic View on Wilms Tumor by High-Resolution Magic-Angle Spinning Nuclear Magnetic Resonance Spectroscopy. Diagnostics (Basel) 2022; 12:diagnostics12010157. [PMID: 35054324 PMCID: PMC8775120 DOI: 10.3390/diagnostics12010157] [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: 11/14/2021] [Revised: 12/13/2021] [Accepted: 01/01/2022] [Indexed: 11/16/2022] Open
Abstract
Pediatric cancer NMR-metabonomics might be a powerful tool to discover modified biochemical pathways in tumor development, improve cancer diagnosis, and, consequently, treatment. Wilms tumor (WT) is the most common kidney tumor in young children whose genetic and epigenetic abnormalities lead to cell metabolism alterations, but, so far, investigation of metabolic pathways in WT is scarce. We aimed to explore the high-resolution magic-angle spinning nuclear magnetic resonance (HR-MAS NMR) metabonomics of WT and normal kidney (NK) samples. For this study, 14 WT and 7 NK tissue samples were obtained from the same patients and analyzed. One-dimensional and two-dimensional HR-MAS NMR spectra were processed, and the one-dimensional NMR data were analyzed using chemometrics. Chemometrics enabled us to elucidate the most significant differences between the tumor and normal tissues and to discover intrinsic metabolite alterations in WT. The metabolic differences in WT tissues were revealed by a validated PLS-DA applied on HR-MAS T2-edited 1H-NMR and were assigned to 16 metabolites, such as lipids, glucose, and branched-chain amino acids (BCAAs), among others. The WT compared to NK samples showed 13 metabolites with increased concentrations and 3 metabolites with decreased concentrations. The relative BCAA concentrations were decreased in the WT while lipids, lactate, and glutamine/glutamate showed increased levels. Sixteen tissue metabolites distinguish the analyzed WT samples and point to altered glycolysis, glutaminolysis, TCA cycle, and lipid and BCAA metabolism in WT. Significant variation in the concentrations of metabolites, such as glutamine/glutamate, lipids, lactate, and BCAAs, was observed in WT and opened up a perspective for their further study and clinical validation.
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Affiliation(s)
- Ljubica Tasic
- Laboratory of Chemical Biology, Institute of Chemistry, University of Campinas (UNICAMP), Campinas, Sao Paulo 13083-970, Brazil; (M.Q.); (D.S.); (L.G.M.); (T.B.B.C.d.C.)
- Correspondence:
| | - Nataša Avramović
- Faculty of Medicine, Institute of Medical Chemistry, University of Belgrade, Višegradska 26, 11000 Belgrade, Serbia;
| | - Melissa Quintero
- Laboratory of Chemical Biology, Institute of Chemistry, University of Campinas (UNICAMP), Campinas, Sao Paulo 13083-970, Brazil; (M.Q.); (D.S.); (L.G.M.); (T.B.B.C.d.C.)
| | - Danijela Stanisic
- Laboratory of Chemical Biology, Institute of Chemistry, University of Campinas (UNICAMP), Campinas, Sao Paulo 13083-970, Brazil; (M.Q.); (D.S.); (L.G.M.); (T.B.B.C.d.C.)
| | - Lucas G. Martins
- Laboratory of Chemical Biology, Institute of Chemistry, University of Campinas (UNICAMP), Campinas, Sao Paulo 13083-970, Brazil; (M.Q.); (D.S.); (L.G.M.); (T.B.B.C.d.C.)
| | - Tassia Brena Barroso Carneiro da Costa
- Laboratory of Chemical Biology, Institute of Chemistry, University of Campinas (UNICAMP), Campinas, Sao Paulo 13083-970, Brazil; (M.Q.); (D.S.); (L.G.M.); (T.B.B.C.d.C.)
| | - Milka Jadranin
- Institute of Chemistry, Technology and Metallurgy, Department of Chemistry, University of Belgrade, Njegoševa 12, 11000 Belgrade, Serbia;
| | | | - Paulo Faria
- Department of Pathology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, Brazil;
| | - Beatriz de Camargo
- Clinical Research Department, National Cancer Institute (INCA), Rio de Janeiro 20231-091, Brazil; (B.d.C.); (B.M.d.S.P.)
| | - Bruna M. de Sá Pereira
- Clinical Research Department, National Cancer Institute (INCA), Rio de Janeiro 20231-091, Brazil; (B.d.C.); (B.M.d.S.P.)
| | - Mariana Maschietto
- National Laboratory of Biosciences (LNBio), National Center for Research in Energy and Materials (CNPEM), Campinas, Sao Paulo 13083-100, Brazil;
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Fang LJ, Lin XC, Huang D, Pan TT, Yan XM, Hu WG, Zhu H, Xu Z, Zhu XZ, Lu HJ, Chen GP, Huang KY. 1H NMR-based metabolomics analyses in children with Helicobacter pylori infection and the alteration of serum metabolites after treatment. Microb Pathog 2020; 147:104292. [PMID: 32505653 DOI: 10.1016/j.micpath.2020.104292] [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: 09/11/2019] [Revised: 03/28/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Helicobacter pylori (H. pylori) infection can occur in early childhood, without eradication therapies such infection can persist throughout life and cause many different diseases. This study investigated the metabolic characteristics and explored the underlying mechanism of children with H. pylori infection, and identified potential biomarkers for evaluating the efficacy of H. pylori eradication therapies. METHODS We performed 1H NMR-based metabonomics coupled with multivariate analysis to investigate the metabolic profiling of serum samples between Children with and without H. pylori infection. In the same manner, we compared the alternations of metabolites in H. pylori-infected children before and after H. pylori eradication therapies. RESULTS 21 metabolites from serum in H. pylori-infected and H. pylori-uninfected children were identified, which were mainly involved in energy, amino acid, lipid and microbial metabolism. We found that the serum levels of trimethylamine N-oxide and alanine were significantly higher in H. pylori-infected children compared to uninfected sera, whereas lactate was significantly lower. We also found that the levels of trimethylamine N-oxide and creatine in H. pylori-infected children was significantly decreased after H. pylori eradication therapies, whereas lactate and low-density lipoprotein/very low-density lipoprotein was significantly increased. CONCLUSIONS This is the first study using 1H NMR-based metabolomics approach to explore the effects of H. pylori infection in children. Our results demonstrated that the disturbances of metabolism in energy, amino acids, lipids and microbiota could play an important role in the pathogenesis of gastrointestinal and extragastric diseases caused by H. pylori infection. Trimethylamine N-oxide and lactate might serve as potential serum biomarkers for evaluating the efficacy of H. pylori eradication therapies.
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Affiliation(s)
- Ling-Juan Fang
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiao-Chun Lin
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Dian Huang
- The Second School of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Tong-Tong Pan
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiu-Mei Yan
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Wei-Guo Hu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Huan Zhu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhang Xu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiao-Zhou Zhu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Hua-Jun Lu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Gui-Ping Chen
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Kai-Yu Huang
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
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Avramović N, Mandić B, Savić-Radojević A, Simić T. Polymeric Nanocarriers of Drug Delivery Systems in Cancer Therapy. Pharmaceutics 2020; 12:E298. [PMID: 32218326 PMCID: PMC7238125 DOI: 10.3390/pharmaceutics12040298] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 01/10/2023] Open
Abstract
Conventional chemotherapy is the most common therapeutic method for treating cancer by the application of small toxic molecules thatinteract with DNA and causecell death. Unfortunately, these chemotherapeutic agents are non-selective and can damage both cancer and healthy tissues,producing diverse side effects, andthey can have a short circulation half-life and limited targeting. Many synthetic polymers have found application as nanocarriers of intelligent drug delivery systems (DDSs). Their unique physicochemical properties allow them to carry drugs with high efficiency,specificallytarget cancer tissue and control drug release. In recent years, considerable efforts have been made to design smart nanoplatforms, including amphiphilic block copolymers, polymer-drug conjugates and in particular pH- and redox-stimuli-responsive nanoparticles (NPs). This review is focused on a new generation of polymer-based DDSs with specific chemical functionalities that improve their hydrophilicity, drug loading and cellular interactions.Recentlydesigned multifunctional DDSs used in cancer therapy are highlighted in this review.
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Affiliation(s)
- Nataša Avramović
- Institute of Medical Chemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Boris Mandić
- Faculty of Chemistry, University of Belgrade, Studentski trg 12–16, 11000 Belgrade, Serbia;
| | - Ana Savić-Radojević
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.S.-R.); (T.S.)
| | - Tatjana Simić
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.S.-R.); (T.S.)
- Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia
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