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Farzad Maroufi S, Sadegh Fallahi M, Parmis Maroufi S, Sheehan JP. Focused ultrasound blood-brain barrier disruption in high-grade gliomas: Scoping review of clinical studies. J Clin Neurosci 2024; 128:110786. [PMID: 39146579 DOI: 10.1016/j.jocn.2024.110786] [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: 05/24/2024] [Revised: 08/01/2024] [Accepted: 08/10/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND This scoping review aims to comprehensively review the available literature on the safety and efficacy of focused ultrasound (FUS) for blood-brain barrier disruption (BBBD) in patients with high-grade gliomas, including glioblastoma (GBM). High-grade gliomas pose significant challenges in neuro-oncology due to their aggressiveness and intricate location, often limiting the efficacy of traditional treatments. FUS offers a promising approach by transiently disrupting the blood-brain barrier, thereby facilitating enhanced drug delivery to tumor cells while minimizing systemic side effects. METHODS A scoping review adhering to PRISMA guidelines was conducted to explore the literature on FUS-induced BBBD in glioma patients. PubMed and Embase databases were searched from inception to April 2024 using defined keywords. Original clinical studies focusing on FUS for BBBD in gliomas were included. Two reviewers independently screened records, with conflicts resolved by a third reviewer. Data extraction and quality assessment were performed accordingly. RESULTS A total of 1,310 studies were initially identified, resulting in nine eligible studies after screening and selection. These studies, published between 2016 and 2024, included 106 patients (39.6 % female) with ages ranging from 29 to 80 years. Recurrent GBM was the most common diagnosis (100 patients), with other diagnoses including anaplastic astrocytoma, diffuse infiltrating glioma, and oligodendroglioma. Various FUS devices and microbubble contrast agents were employed across the studies. Safety and efficacy were assessed in both experimental and clinical settings, with no significant adverse events reported during BBBD procedures. Notably, BBBD facilitated enhanced drug delivery to tumor tissue, demonstrating potential therapeutic benefits. CONCLUSION Studies investigating BBBD using FUS demonstrate promising outcomes in experimental and clinical settings. BBBD procedures in patients with malignant gliomas and recurrent GBM show safety and successful enhancement of drug delivery potential. Overall, FUS-mediated BBBD emerges as a safe and feasible approach for improving therapeutic outcomes in brain tumor patients, warranting further clinical exploration and optimization.
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Affiliation(s)
- Seyed Farzad Maroufi
- Neurosurgical Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Fallahi
- Neurosurgical Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyede Parmis Maroufi
- Neurosurgical Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
| | - Jason P Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, USA.
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Li J, Long Q, Ding H, Wang Y, Luo D, Li Z, Zhang W. Progress in the Treatment of Central Nervous System Diseases Based on Nanosized Traditional Chinese Medicine. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308677. [PMID: 38419366 PMCID: PMC11040388 DOI: 10.1002/advs.202308677] [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: 11/13/2023] [Revised: 02/07/2024] [Indexed: 03/02/2024]
Abstract
Traditional Chinese Medicine (TCM) is widely used in clinical practice to treat diseases related to central nervous system (CNS) damage. However, the blood-brain barrier (BBB) constitutes a significant impediment to the effective delivery of TCM, thus substantially diminishing its efficacy. Advances in nanotechnology and its applications in TCM (also known as nano-TCM) can deliver active ingredients or components of TCM across the BBB to the targeted brain region. This review provides an overview of the physiological and pathological mechanisms of the BBB and systematically classifies the common TCM used to treat CNS diseases and types of nanocarriers that effectively deliver TCM to the brain. Additionally, drug delivery strategies for nano-TCMs that utilize in vivo physiological properties or in vitro devices to bypass or cross the BBB are discussed. This review further focuses on the application of nano-TCMs in the treatment of various CNS diseases. Finally, this article anticipates a design strategy for nano-TCMs with higher delivery efficiency and probes their application potential in treating a wider range of CNS diseases.
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Affiliation(s)
- Jing Li
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio‐Cerebral Diseases, School of Integrated Chinese and Western MedicineHunan University of Chinese MedicineChangshaHunan410208China
- Beijing Institute of Nanoenergy and NanosystemsChinese Academy of SciencesBeijing101400China
| | - Qingyin Long
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio‐Cerebral Diseases, School of Integrated Chinese and Western MedicineHunan University of Chinese MedicineChangshaHunan410208China
| | - Huang Ding
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio‐Cerebral Diseases, School of Integrated Chinese and Western MedicineHunan University of Chinese MedicineChangshaHunan410208China
| | - Yang Wang
- Institute of Integrative MedicineDepartment of Integrated Traditional Chinese and Western MedicineXiangya HospitalCentral South University ChangshaChangsha410008China
| | - Dan Luo
- Beijing Institute of Nanoenergy and NanosystemsChinese Academy of SciencesBeijing101400China
| | - Zhou Li
- Beijing Institute of Nanoenergy and NanosystemsChinese Academy of SciencesBeijing101400China
| | - Wei Zhang
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio‐Cerebral Diseases, School of Integrated Chinese and Western MedicineHunan University of Chinese MedicineChangshaHunan410208China
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Vagaggini C, Petroni D, D'Agostino I, Poggialini F, Cavallini C, Cianciusi A, Salis A, D'Antona L, Francesconi V, Manetti F, Damonte G, Musumeci F, Menichetti L, Dreassi E, Carbone A, Schenone S. Early investigation of a novel SI306 theranostic prodrug for glioblastoma treatment. Drug Dev Res 2024; 85:e22158. [PMID: 38349262 DOI: 10.1002/ddr.22158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/14/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024]
Abstract
Glioblastoma multiforme (GBM) is one of the most aggressive malignancies with a high recurrence rate and poor prognosis. Theranostic, combining therapeutic and diagnostic approaches, arises as a successful strategy to improve patient outcomes through personalized medicine. Src is a non-receptor tyrosine kinase (nRTK) whose involvement in GBM has been extensively demonstrated. Our previous research highlighted the effectiveness of the pyrazolo[3,4-d]pyrimidine SI306 and its more soluble prodrug CMP1 as Src inhibitors both in in vitro and in vivo GBM models. In this scenario, we decided to develop a theranostic prodrug of SI306, ProSI-DOTA(68 Ga) 1, which was designed to target GBM cells after hydrolysis and follow-up on the disease's progression and improve the therapy's outcome. First, the corresponding nonradioactive prodrug 2 was tested to evaluate its ADME profile and biological activity. It showed good metabolic stability, no inhibition of CYP3A4, suboptimal aqueous solubility, and slight gastrointestinal and blood-brain barrier passive permeability. Compound 2 exhibited a drastic reduction of cell vitality after 72 h on two different GBM cell lines (GL261 and U87MG). Then, 2 was subjected to complexation with the radionuclide Gallium-68 to give ProSI-DOTA(68 Ga) 1. The cellular uptake of 1 was evaluated on GBM cells, highlighting a slight but significant time-dependent uptake. The data obtained from our preliminary studies reflect the physiochemical properties of 1. The use of an alternative route of administration, such as the intranasal route, could overcome the physiochemical limitations and enhance the pharmacokinetic properties of 1, paving the way for its future development.
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Affiliation(s)
- Chiara Vagaggini
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Debora Petroni
- Institute of Clinical Physiology, Italian National Research Council (CNR), Pisa, Italy
| | - Ilaria D'Agostino
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Federica Poggialini
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Chiara Cavallini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Pisa, Italy
| | | | - Annalisa Salis
- DIMES, Section of Biochemistry, University of Genova, Genova, Italy
| | - Lucia D'Antona
- Medical Genetics Unit, Mater Domini University Hospital, Catanzaro, Italy
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Fabrizio Manetti
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Gianluca Damonte
- DIMES, Section of Biochemistry, University of Genova, Genova, Italy
| | | | - Luca Menichetti
- Institute of Clinical Physiology, Italian National Research Council (CNR), Pisa, Italy
| | - Elena Dreassi
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, Siena, Italy
| | - Anna Carbone
- Department of Pharmacy, University of Genoa, Genoa, Italy
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