Surface Modification of Esophageal Stent Materials by a Drug-Eluting Layer for Better Anti-Restenosis Function

Nanodrugs systems for therapy and diagnosis of esophageal cancer

With the increasing incidence of esophageal cancer, its diagnosis and treatment have become one of the key issues in medical research today. However, the current diagnostic and treatment methods face many unresolved issues, such as low accuracy of early diagnosis, painful treatment process for patients, and high recurrence rate after recovery. Therefore, new methods for the diagnosis and treatment of esophageal cancer need to be further explored, and the rapid development of nanomaterials has brought new ideas for solving this problem. Nanomaterials used as drugs or drug delivery systems possess several advantages, such as high drug capacity, adjustably specific targeting capability, and stable structure, which endow nanomaterials great application potential in cancer therapy. However, even though the nanomaterials have been widely used in cancer therapy, there are still few reviews on their application in esophageal cancer, and systematical overview and analysis are deficient. Herein, we overviewed the application of nanodrug systems in therapy and diagnosis of esophageal cancer and summarized some representative case of their application in diagnosis, chemotherapy, targeted drug, radiotherapy, immunity, surgery and new therapeutic method of esophageal cancer. In addition, the nanomaterials used for therapy of esophageal cancer complications, esophageal stenosis or obstruction and oesophagitis, are also listed here. Finally, the challenge and the future of nanomaterials used in cancer therapy were discussed.

Characterization of Partially Covered Self-Expandable Metallic Stents for Esophageal Cancer Treatment: In Vivo Degradation

Partially covered self-expandable metallic esophageal stent (SEMS) placement is the most frequently applied palliative treatment in esophageal cancer. Structural characterization of explanted 16 nitinol-polyurethane SEMS (the group of 6 females, 10 males, age 40-80) was performed after their removal due to dysfunction. The adverse bulk changes in the polymer structure were identified using differential scanning calorimetry (DSC), differential mechanical thermal analysis (DMTA), and attenuated total reflectance infrared spectroscopy (ATR-IR) and discussed in terms of melting point shift (9 °C), glass-transition shift (4 °C), differences in viscoelastic behavior, and systematic decrease of peaks intensities corresponding to C-H, C═O, and C-N polyurethane structural bonds. The scanning electron and confocal microscopic observations revealed all major types of surface degradation, i.e., surface cracks, peeling off of the polymer material, and surface etching. The changes in the hydrophobic polyurethane surfaces were also revealed by a significant decrease in wettability (74°) and the corresponding increase of the surface free energy (31 mJ/m²). To understand the in vivo degradation, the in vitro tests in simulated salivary and gastric fluids were performed, which mimic the environments of proximal and distal ends, respectively. It was concluded that the differences in the degradation of the proximal and distal ends of prostheses strongly depend on the physiological environment, in particular stomach content. Finally, the necessity of the in vivo tests for SEMS degradation is pointed out.

Investigation of Mg-xLi-Zn alloys for potential application of biodegradable bone implant materials

Implant therapy after osteosarcoma surgery is a major clinical challenge currently, especially the requirements for mechanical properties, degradability of the implants, and their inhibition of residual tumor cells. Biodegradable magnesium (Mg) alloy as medical bone implant material has full advantages and huge potential development space. Wherein, Mg-lithium (Li) based alloy, as an ultra-light alloy, has good properties for implants under certain conditions, and both Mg and Li have inhibitory effects on tumor cells. Therefore, Mg-Li alloy is expected to be applied in bone implant materials for mechanical supporting and inhibiting tumor cells simultaneously. In this contribution, the Mg-xLi-Zinc (Zn) series alloys (x = 3 wt%, 6 wt%, 9 wt%) were prepared to study the influence of different elements and contents on the structure and properties of the alloy, and the biosafety of the alloy was also evaluated. Our data showed that the yield strength, tensile strength, and elongation of as-cast Mg-xLi-Zn alloy were higher than those of as-cast Mg-Zn alloy; Mg-xLi-Zn alloy can kill osteosarcoma cells (MG-63) in a concentration-dependent manner, wherein Mg-3Li-Zn alloy (x = 3 wt%) and Mg-6Li-Zn alloy (x = 6 wt%) promoted the proliferation of osteoblasts (MC3T3) at a certain concentration of Li. In summary, our study demonstrated that the Mg-6Li-Zn alloy could be potentially applied as a material of orthopedic implant for its excellent multi-functions.

Hyaluronic acid/polyethyleneimine nanoparticles loaded with copper ion and disulfiram for esophageal cancer

In the clinical treatment of cancer, improving the effectiveness and targeting of drugs has always been a bottleneck problem that needs to be solved. In this contribution, inspired by the targeted inhibition on cancer from combination application of disulfiram and divalent copper ion (Cu²⁺), we optimized the concentration of disulfiram and Cu²⁺ ion for inhibiting esophageal cancer cells, and loaded them in hyaluronic acid (HA)/polyethyleneimine (PEI) nanoparticles with specific scales, in order to improve the effectiveness and targeting of drugs. The in vitro cell experiments demonstrated that more drug loaded HA/PEI nanoparticles accumulated to the esophageal squamous cell carcinoma (Eca109) and promoted higher apoptosis ratio of Eca109. Both in vitro and in vivo biological assessment verified that the disulfiram/Cu²⁺ loaded HA/PEI nanoparticles promoted the apoptosis of cancer cells and inhibited the tumor proliferation, but had no toxicity on other normal organs.

Preparing a novel magnesium-doped hyaluronan/polyethyleneimine nanoparticle to improve endothelial functionalisation

Nowadays, tissue engineering vascularisation has become an important means of organ repair and treatment of major traumatic diseases. Vascular endothelial layer regeneration and endothelial functionalisation are prerequisites and important components of tissue engineering vascularisation. The present researches of endothelial functionalisation mainly focus on tissue engineering scaffold preparation and implant surface modification. Few studies have reported the interaction of endothelial functionalisation and scaled materials, especially the nanomaterials. Magnesium (Mg), as an essential cytotropic active element in the human body, should promote the growth of endothelial cells. However, the authors' previous work found that the Mg in the alloys had a defect of delayed endothelialisation, which may be attributed to the non-uniform scales of the degradation products from Mg alloys. To validate this hypothesis and fabricate a novel nanomaterial for tissue engineering vascularisation, the authors prepared Mg-doped hyaluronan (HA)/polyethyleneimine (PEI) nanoparticles for endothelial cells testing. Their data showed that the Mg-doped HA/PEI nanoparticle with small scales (diameter <150 nm) presented better ability on improving endothelial cells growth, functionalisation and nitric oxide release.

Investigation of Mg-Zn-Y-Nd alloy for potential application of biodegradable esophageal stent material

In recent years, due to unhealthy dietary habits and other reasons, advanced esophageal cancer patients are on the rise, threatening human health and life safety at all times. Stents implantation as an important complementary or alternative method for chemotherapy has been widely applied in clinics. However, the adhesion and proliferation of pathological cells, such as tumor cells, fibroblasts and epithelial cells, may interfere the efficacy of stents. Further multiple implantation due to restenosis may also bring pain to patients. In this contribution, we preferred a biodegradable material Mg-Zn-Y-Nd alloy for potential application of esophageal stent. The hardness testing showed that Mg-Zn-Y-Nd alloy owned less mechanical properties compared with the commercial esophageal stents material, 317L stainless steel (317L SS), while Mg-Zn-Y-Nd displayed significantly better biodegradation than 317L SS. Cell apoptosis assay indicated Mg-Zn-Y-Nd inhibited adhesion and proliferation of tumor cells, fibroblasts and epithelial cells. Our research suggested potential application of Mg-Zn-Y-Nd alloy as a novel material for biodegradable esophageal stent.

Biological behavior exploration of a paclitaxel-eluting poly-l-lactide-coated Mg–Zn–Y–Nd alloy intestinal stent in vivo

As a new type of intestinal stent, the MAO/PLLA/paclitaxel/Mg–Zn–Y–Nd alloy stent has shown good degradability, although its biocompatibility in vitro and in vivo has not been investigated in detail. In this study, its in vivo biocompatibility was evaluated by animal study. New Zealand white rabbits were implanted with degradable intestinal Mg–Zn–Y–Nd alloy stents that were exposed to different treatments. Stent degradation behavior was observed both macroscopically and using a scanning electron microscope (SEM). Energy dispersion spectrum (EDS) and histological observations were performed to investigate stent biological safety. Macroscopic analysis showed that the MAO/PLLA/paclitaxel/Mg–Zn–Y–Nd stents could not be located 12 days after implantation. SEM observations showed that corrosion degree of the MAO/PLLA/paclitaxel/Mg–Zn–Y–Nd stents implanted in rabbits was significantly lower than that in the PLLA/Mg–Zn–Y–Nd stent group. Both histopathological testing and serological analysis of in vivo biocompatibility demonstrated that the MAO/PLLA/paclitaxel/Mg–Zn–Y–Nd alloy stents could significantly inhibit intestinal tissue proliferation compared to the PLLA/Mg–Zn–Y–Nd alloy stents, thus providing the basis for designing excellent biodegradable drug stents.

Mg–Zn–Y–Nd alloy stents coated with MAO/PLLA/paclitaxel coating were implanted into the New Zealand rabbits intestine to investigate the biocompatibility and degradation behavior.

Preparing Sodium Alginate/Polyethyleneimine Spheres for Potential Application of Killing Tumor Cells by Reducing the Concentration of Copper Ions in the Lesions of Colon Cancer

Inhibition of residual malignant tumors in patients with colon cancer after operation is one of the difficulties in rehabilitation treatment. At present, using biocompatible materials to remove the copper ion which is the growth dependence of malignant tumors in the lesion site is considered to be the frontier means to solve this problem. In this work, we developed a sodium alginate (SA)/polyethyleneimine (PEI) hydrogel sphere via cross-linking method (SA/SP/SA; SP = SA/PEI) as an oral biomaterial for adsorbing and removing copper ions from colon cancer lesions. The evaluated results showed that the SA/PEI/SA (SPS) hydrogel sphere obtained the largest swelling rate at pH 8.3 which was the acid-base value of colon microenvironment and absorbed more copper ions compared with the SA control. The cell experiment presented that the SPS hydrogel sphere owned better compatibility on normal fibroblasts and promoted higher death of colon cancer cells compared with SA/PEI (SP) and SA control. Our data suggested that the SA/PEI hydrogel sphere had the potentiality as an oral biomaterial for inhibiting colon cancer cells.

Nature-inspired extracellular matrix coating produced by micro-patterned smooth muscle and endothelial cells endows cardiovascular materials with better biocompatibility

Functionalizing cardiovascular biomaterials with an extracellular matrix (ECM) via in vitro decellularization has been applied as an effective method to improve the biocompatibility of implants.

Layer-by-layer films of polysaccharides modified with polyethylene glycol and dextran

Layer-by-layer (LbL) films with enhanced resistance to protein adsorption were obtained on the basis of N-grafted copolymers of chitosan with polyethylene glycol (PEG) or dextran (DEX). The copolymers with the backbone molecular weight of 18 and 450 kDa, side chains of PEG of 5.0 and 0.9 kDa, DEX of 6.0 kDa and the degree of amine groups substitution χ_Sub as high as ∼0.25 were alternated with dextran sulfate (DS) to assemble up to 10 bilayer films. The film material contains 85±5% of water with virtually no effect of the copolymer structure. By utilizing the graft copolymers and applying suitable number of copolymer/DS bilayers to the surface, the mass of adsorbed fetal bovine serum proteins was decreased by 70-85% as compared to that on unmodified chitosan/DS film. In terms of overlapping side chains on the LbL surface the copolymers of PEG and DEX are equally effective in tailoring protein-resistant materials.