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Drakopoulou E, Anagnou NP, Pappa KI. Gene Therapy for Malignant and Benign Gynaecological Disorders: A Systematic Review of an Emerging Success Story. Cancers (Basel) 2022; 14:cancers14133238. [PMID: 35805007 PMCID: PMC9265289 DOI: 10.3390/cancers14133238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary This review discusses all the major advances in gene therapy of gynaecological disorders, highlighting the novel and potentially therapeutic perspectives associated with such an approach. It specifically focuses on the gene therapy strategies against major gynaecological malignant disorders, such as ovarian, cervical, and endometrial cancer, as well as benign disorders, such as uterine leiomyomas, endometriosis, placental, and embryo implantation disorders. The above therapeutic strategies, which employ both viral and non-viral systems for mutation compensation, suicide gene therapy, oncolytic virotherapy, antiangiogenesis and immunopotentiation approaches, have yielded promising results over the last decade, setting the grounds for successful clinical trials. Abstract Despite the major advances in screening and therapeutic approaches, gynaecological malignancies still present as a leading cause of death among women of reproductive age. Cervical cancer, although largely preventable through vaccination and regular screening, remains the fourth most common and most lethal cancer type in women, while the available treatment schemes still pose a fertility threat. Ovarian cancer is associated with high morbidity rates, primarily due to lack of symptoms and high relapse rates following treatment, whereas endometrial cancer, although usually curable by surgery, it still represents a therapeutic problem. On the other hand, benign abnormalities, such as fibroids, endometriosis, placental, and embryo implantation disorders, although not life-threatening, significantly affect women’s life and fertility and have high socio-economic impacts. In the last decade, targeted gene therapy approaches toward both malignant and benign gynaecological abnormalities have led to promising results, setting the ground for successful clinical trials. The above therapeutic strategies employ both viral and non-viral systems for mutation compensation, suicide gene therapy, oncolytic virotherapy, antiangiogenesis and immunopotentiation. This review discusses all the major advances in gene therapy of gynaecological disorders and highlights the novel and potentially therapeutic perspectives associated with such an approach.
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Affiliation(s)
- Ekati Drakopoulou
- Laboratory of Cell and Gene Therapy, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece; (E.D.); (K.I.P.)
| | - Nicholas P. Anagnou
- Laboratory of Cell and Gene Therapy, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece; (E.D.); (K.I.P.)
- Correspondence:
| | - Kalliopi I. Pappa
- Laboratory of Cell and Gene Therapy, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece; (E.D.); (K.I.P.)
- First Department of Obstetrics and Gynecology, University of Athens School of Medicine, 11528 Athens, Greece
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Wang L, Lu H, Gao Q, Yuan C, Ding F, Li J, Zhang D, Ou X. A multifunctional theranostic contrast agent for ultrasound/near infrared fluorescence imaging-based tumor diagnosis and ultrasound-triggered combined photothermal and gene therapy. Acta Biomater 2019; 99:373-386. [PMID: 31525534 DOI: 10.1016/j.actbio.2019.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 08/23/2019] [Accepted: 09/11/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Encapsulated microbubbles (MBs) have been reported as new theranostic carriers for simultaneous imaging and ultrasound (US)-triggered therapy. Here, we designed a dual-modality US/NIRF contrast agent and extended its applications from image contrast enhancement to combined diagnosis and therapy with US-directed and site-specific targeting. METHODS Gold nanorods (AuNRs) resonant at 880 nm together with the NIR797 dye were first encapsulated in lipid-shelled MBs to construct fluorescent gold microbubbles (NIR797/AuMBs) via thin film hydration and mechanical shaking in the presence of sulfur hexafluoride (SF6) gas. Then, polyethylenimine (PEI)-DNA complexes were electrostatically conjugated onto the surface of the NIR797/AuMBs, forming theranostic encapsulated MBs (PEI-DNA/NIR797/AuMBs). The potential of the PEI-DNA/NIR797/AuMBs for use as a dual-modality contrast enhancement agent was evaluated in vitro and in vivo. The antitumor effect of US/NIR laser irradiation mediating double-fusion suicide gene and photothermal therapy was also investigated using Bel-7402 cells and xenografts. RESULTS The developed theranostic AuMB complexes could not only provide excellent US and NIRF imaging to detect tumors but also serve as an efficient US-triggered carrier for gene delivery and photothermal ablation of tumors in xenografted nude mice. And US + laser exposure group showed a much higher rate of cell inhibition, apoptosis and necrosis as well as a higher Bel-7402 xenograft inhibition rate than the single gene therapy or single exposure (US or laser) group. CONCLUSIONS PEI-DNA/NIR797/AuMBs would be of great value for providing more comprehensive diagnostic information and to guide more accurate and effective synergistic cancer therapy. STATEMENT OF SIGNIFICANCE This is an original paper focusing on developing a dual-modality US/NIRF contrast agent and extended its applications from image contrast enhancement to combined diagnosis and therapy with US-directed and site-specific targeting. The developed theranostic AuMB complexes could not only provide excellent US and NIRF imaging to detect tumors but also serve as an efficient US-triggered carrier for gene delivery and photothermal ablation of tumors in xenografted nude mice. PEI-DNA/NIR797/AuMBs would be of great value for providing more comprehensive diagnostic information and to guide more accurate and effective synergistic cancer therapy.
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A Combination of UTMD-Mediated HIF-1 α shRNA Transfection and TAE in the Treatment of Hepatic Cancer. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1937460. [PMID: 30911540 PMCID: PMC6399560 DOI: 10.1155/2019/1937460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 11/08/2018] [Accepted: 12/31/2018] [Indexed: 01/08/2023]
Abstract
To explore the antitumor effect of hypoxia-inducible factor-1α short hairpin RNA (HIF-1α shRNA) delivered by ultrasound targeted microbubble destruction (UTMD) and transcatheter arterial embolization (TAE) on rats with hepatic cancer. After the models of transplantation hepatoma were established, Wistar rats were randomly divided into 4 groups: Control group, UTMD group, TAE group, and UTMD+TAE group. Contrast-enhanced ultrasound (CEUS) was used to monitor tumor size on day 14 after four different treatments. Western blotting and immunohistochemistry were applied to measure the protein level of HIF-1α and VEGF in the hepatic cancer tissue. In comparison with UTMD+TAE group (21.25±10.68 days), the mean survival time was noticeably shorter in the Control group and TAE group (13.02±4.30 days and 15.03±7.32 days) (p<0.05, respectively). There was no statistical difference between UTMD+TAE group and UTMD group of the mean survival time (p>0.05). In addition, our results proved that the tumor sizes in UTMD+TAE group were obviously smaller than those in other groups (p<0.05, respectively). By CEUS, we clearly found that the tumor size was the smallest on day 14 in the UTMD+TAE group. The western blotting and immunohistochemistry results proved that the protein levels of HIF-1α and VEGF in UTMD+TAE group were obviously lower than those in TAE group and Control group on days 7 and 14 (p<0.05, respectively). However, there was no statistical difference between UTMD+TAE group and UTMD group (p>0.05). In this study we tried to explore the antitumor effect through a combination of UTMD-mediated HIF-1α shRNA transfection and TAE on rats with hepatic cancer. Our results showed that UTMD-mediated HIF-1α shRNA transfection and TAE can obviously silence HIF-1α and VEGF expression, thereby successfully inhibiting the growth of the tumor.
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Áyen Á, Jiménez Martínez Y, Marchal JA, Boulaiz H. Recent Progress in Gene Therapy for Ovarian Cancer. Int J Mol Sci 2018; 19:ijms19071930. [PMID: 29966369 PMCID: PMC6073662 DOI: 10.3390/ijms19071930] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/06/2023] Open
Abstract
Ovarian cancer is the most lethal gynecological malignancy in developed countries. This is due to the lack of specific symptoms that hinder early diagnosis and to the high relapse rate after treatment with radical surgery and chemotherapy. Hence, novel therapeutic modalities to improve clinical outcomes in ovarian malignancy are needed. Progress in gene therapy has allowed the development of several strategies against ovarian cancer. Most are focused on the design of improved vectors to enhance gene delivery on the one hand, and, on the other hand, on the development of new therapeutic tools based on the restoration or destruction of a deregulated gene, the use of suicide genes, genetic immunopotentiation, the inhibition of tumour angiogenesis, the alteration of pharmacological resistance, and oncolytic virotherapy. In the present manuscript, we review the recent advances made in gene therapy for ovarian cancer, highlighting the latest clinical trials experience, the current challenges and future perspectives.
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Affiliation(s)
- Ángela Áyen
- Department of Human Anatomy and Embryology, University of Granada, 18016 Granada, Spain.
| | - Yaiza Jiménez Martínez
- Biopathology and Medicine Regenerative Institute (IBIMER), University of Granada, 18016 Granada, Spain.
- Biosanitary Institute of Granada (ibs.GRANADA), SAS-Universidad de Granada, 18016 Granada, Spain.
| | - Juan A Marchal
- Department of Human Anatomy and Embryology, University of Granada, 18016 Granada, Spain.
- Biopathology and Medicine Regenerative Institute (IBIMER), University of Granada, 18016 Granada, Spain.
- Biosanitary Institute of Granada (ibs.GRANADA), SAS-Universidad de Granada, 18016 Granada, Spain.
- Excellence Research Unit "Modeling Nature" (MNat), University of Granada, 18016 Granada, Spain.
| | - Houria Boulaiz
- Department of Human Anatomy and Embryology, University of Granada, 18016 Granada, Spain.
- Biopathology and Medicine Regenerative Institute (IBIMER), University of Granada, 18016 Granada, Spain.
- Biosanitary Institute of Granada (ibs.GRANADA), SAS-Universidad de Granada, 18016 Granada, Spain.
- Excellence Research Unit "Modeling Nature" (MNat), University of Granada, 18016 Granada, Spain.
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Lamsam L, Johnson E, Connolly ID, Wintermark M, Hayden Gephart M. A review of potential applications of MR-guided focused ultrasound for targeting brain tumor therapy. Neurosurg Focus 2018; 44:E10. [DOI: 10.3171/2017.11.focus17620] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Magnetic resonance–guided focused ultrasound (MRgFUS) has been used extensively to ablate brain tissue in movement disorders, such as essential tremor. At a lower energy, MRgFUS can disrupt the blood-brain barrier (BBB) to allow passage of drugs. This focal disruption of the BBB can target systemic medications to specific portions of the brain, such as for brain tumors. Current methods to bypass the BBB are invasive, as the BBB is relatively impermeable to systemically delivered antineoplastic agents. Multiple healthy and brain tumor animal models have suggested that MRgFUS disrupts the BBB and focally increases the concentration of systemically delivered antitumor chemotherapy, immunotherapy, and gene therapy. In animal tumor models, combining MRgFUS with systemic drug delivery increases median survival times and delays tumor progression. Liposomes, modified microbubbles, and magnetic nanoparticles, combined with MRgFUS, more effectively deliver chemotherapy to brain tumors. MRgFUS has great potential to enhance brain tumor drug delivery, while limiting treatment toxicity to the healthy brain.
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Affiliation(s)
| | | | | | - Max Wintermark
- 2Radiology, Stanford University Medical Center, Stanford, California
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Chang EL, Ting CY, Hsu PH, Lin YC, Liao EC, Huang CY, Chang YC, Chan HL, Chiang CS, Liu HL, Wei KC, Fan CH, Yeh CK. Angiogenesis-targeting microbubbles combined with ultrasound-mediated gene therapy in brain tumors. J Control Release 2017; 255:164-175. [DOI: 10.1016/j.jconrel.2017.04.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 02/05/2017] [Accepted: 04/09/2017] [Indexed: 01/21/2023]
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Zhang B, Hou YR, Chen T, Hu B. Microscopic study of ultrasound-mediated microbubble destruction effects on vascular smooth muscle cells. ASIAN PAC J TROP MED 2015; 8:325-9. [PMID: 25975507 DOI: 10.1016/s1995-7645(14)60339-4] [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: 10/23/2022] Open
Abstract
OBJECTIVE To observe vascular smooth muscle cell morphological changes induced by ultrasound combined with microbubbles by Atomic Force Acoustic Microscopy (AFAM). METHODS A7r5 rat aortic smooth muscle cells were divided into groups: control group (without ultrasonic irradiation, no micro bubbles) and US+MB group (45 kHz, 0.4 W/cm(2) ultrasound irradiate for 20 seconds with a SonoVue™ concentration of [(56-140)×10(5)/mL]. Cell micro-morphological changes (such as topographic and acoustic prognosis) were detected, before and after ultrasound destruction by AFAM. RESULTS In cell morphology, smooth muscle cells were spread o and connected to each another by fibers. At the center of the cell, the nuclear area had a rough surface and was significantly elevated from its surroundings. The cytoskeletal structure of the reticular nucleus and cytoplasm in the morphology of A7r5 cells (20 μ m × 20 μ m) were clear before microbubble intervention. After acoustic exciting, the cell structure details of the acoustic image were improved with better resolution, showing the elasticity of different tissues. In the acoustic image, the nucleus was harder, more flexible and uneven compared with the cytoplasm. Many strong various-sized echo particles were stuck on the rough nuclear membrane's substrate surface. The nuclear membrane did not have a continuous smooth surface; there were many obstructions (pores). After ultrasound-intervention was combined with microbubbles, the dark areas of the A7r5 cell images was increased in various sizes and degrees. The dark areas showed the depth or low altitudes of the lower regions, suggesting regional depressions. However, the location and scope of the acoustic image dark areas were not similar to those found in the topographic images. Therefore, it was likely that the dark areas, both from the topographic and acoustic images, were sound-holes. In addition, some cell nuclei become round in different degrees after irradiation. CONCLUSIONS Atomic force microscopy and acoustic excitation method can noninvasively and completely display a cell's structure, connections and elastic properties at a nano scale in just several minutes. The dark areas, both from the topographic and acoustic images, may be sound-holes; therefore, it would be helpful if these sound-holes were found. These findings provide a relationship between cell apoptosis after ultrasound and microbubble ultrasound irradiation, and the sound-hole effect.
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Affiliation(s)
- Bo Zhang
- Department of Ultrasound Medicine, East Hospital, School of Medicine, Tongji University, Shanghai 200120, China.
| | - Yi-Rong Hou
- Department of Ultrasound Medicine, East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Tian Chen
- Department of Ultrasound Medicine, East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Bing Hu
- Department of Ultrasound, 6th People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
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Use of ultrasound-targeted microbubble destruction to transfect IGF-1 cDNA to enhance the regeneration of rat wounded Achilles tendon in vivo. Gene Ther 2015; 22:610-8. [PMID: 25840275 DOI: 10.1038/gt.2015.32] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/06/2015] [Accepted: 03/25/2015] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to determine whether using ultrasound-targeted microbubble destruction (UTMD) to transfect rat wounded Achilles tendon with insulin-like growth factor-1 (IGF-1) cDNA would enhance tissue regeneration. Forty rats with injured Achilles tendons were transfected with IGF-1 cDNA and divided into: (1) control group, (2) plasmid-only group, (3) plasmid+ultrasound group and (4) plasmid+microbubbles+ultrasound group. The IGF-1 cDNA expression of the Achilles tendons was evaluated by histological adhesion finding, quantitative real-time reverse transcription PCR examination and biomechanical test. The adhesion scores in group 4 were lowest at weeks 2 and 8 (P<0.05). The IGF-1 expression in the Achilles tendons was highest in group 4 at weeks 2 and 8 (P<0.05). Compared with those of other three groups, the granulation tissues and inflammatory-cell infiltration were lighter in group 4 at week 2, and the scars on the tendons in group 4 were less evident at week 8. The messenger RNA (mRNA) of IGF-1 of group 4 was upregulated at weeks 2 and 8 (P<0.01). Groups 4 and 3 showed a greater maximum load, stiffness and ultimate stress (P<0.05). Maximum load, stiffness and ultimate stress of healing Achilles tendons in group 4 were highest at weeks 2 and 8 (P<0.05).
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