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Obrador E, Moreno-Murciano P, Oriol-Caballo M, López-Blanch R, Pineda B, Gutiérrez-Arroyo JL, Loras A, Gonzalez-Bonet LG, Martinez-Cadenas C, Estrela JM, Marqués-Torrejón MÁ. Glioblastoma Therapy: Past, Present and Future. Int J Mol Sci 2024; 25:2529. [PMID: 38473776 DOI: 10.3390/ijms25052529] [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: 12/23/2023] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Glioblastoma (GB) stands out as the most prevalent and lethal form of brain cancer. Although great efforts have been made by clinicians and researchers, no significant improvement in survival has been achieved since the Stupp protocol became the standard of care (SOC) in 2005. Despite multimodality treatments, recurrence is almost universal with survival rates under 2 years after diagnosis. Here, we discuss the recent progress in our understanding of GB pathophysiology, in particular, the importance of glioma stem cells (GSCs), the tumor microenvironment conditions, and epigenetic mechanisms involved in GB growth, aggressiveness and recurrence. The discussion on therapeutic strategies first covers the SOC treatment and targeted therapies that have been shown to interfere with different signaling pathways (pRB/CDK4/RB1/P16ink4, TP53/MDM2/P14arf, PI3k/Akt-PTEN, RAS/RAF/MEK, PARP) involved in GB tumorigenesis, pathophysiology, and treatment resistance acquisition. Below, we analyze several immunotherapeutic approaches (i.e., checkpoint inhibitors, vaccines, CAR-modified NK or T cells, oncolytic virotherapy) that have been used in an attempt to enhance the immune response against GB, and thereby avoid recidivism or increase survival of GB patients. Finally, we present treatment attempts made using nanotherapies (nanometric structures having active anti-GB agents such as antibodies, chemotherapeutic/anti-angiogenic drugs or sensitizers, radionuclides, and molecules that target GB cellular receptors or open the blood-brain barrier) and non-ionizing energies (laser interstitial thermal therapy, high/low intensity focused ultrasounds, photodynamic/sonodynamic therapies and electroporation). The aim of this review is to discuss the advances and limitations of the current therapies and to present novel approaches that are under development or following clinical trials.
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Affiliation(s)
- Elena Obrador
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - María Oriol-Caballo
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Rafael López-Blanch
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Begoña Pineda
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - Alba Loras
- Department of Medicine, Jaume I University of Castellon, 12071 Castellon, Spain
| | - Luis G Gonzalez-Bonet
- Department of Neurosurgery, Castellon General University Hospital, 12004 Castellon, Spain
| | | | - José M Estrela
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Department of Physiology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
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Lou W, Xie L, Xu L, Xu M, Xu F, Zhao Q, Jiang T. Present and future of metal nanoparticles in tumor ablation therapy. NANOSCALE 2023; 15:17698-17726. [PMID: 37917010 DOI: 10.1039/d3nr04362b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Cancer is an important factor affecting the quality of human life as well as causing death. Tumor ablation therapy is a minimally invasive local treatment modality with unique advantages in treating tumors that are difficult to remove surgically. However, due to its physical and chemical characteristics and the limitation of equipment technology, ablation therapy cannot completely kill all tumor tissues and cells at one time; moreover, it inevitably damages some normal tissues in the surrounding area during the ablation process. Therefore, this technology cannot be the first-line treatment for tumors at present. Metal nanoparticles themselves have good thermal and electrical conductivity and unique optical and magnetic properties. The combination of metal nanoparticles with tumor ablation technology, on the one hand, can enhance the killing and inhibiting effect of ablation technology on tumors by expanding the ablation range; on the other hand, the ablation technology changes the physicochemical microenvironment such as temperature, electric field, optics, oxygen content and pH in tumor tissues. It helps to stimulate the degree of local drug release of nanoparticles and increase the local content of anti-tumor drugs, thus forming a synergistic therapeutic effect with tumor ablation. Recent studies have found that some specific ablation methods will stimulate the body's immune response while physically killing tumor tissues, generating a large number of immune cells to cause secondary killing of tumor tissues and cells, and with the assistance of metal nanoparticles loaded with immune drugs, the effect of this anti-tumor immunotherapy can be further enhanced. Therefore, the combination of metal nanoparticles and ablative therapy has broad research potential. This review covers common metallic nanoparticles used for ablative therapy and discusses in detail their characteristics, mechanisms of action, potential challenges, and prospects in the field of ablation.
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Affiliation(s)
- Wenjing Lou
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
| | - Liting Xie
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
| | - Lei Xu
- Department of Ultrasound Medicine, Affiliated Jinhua Hospital Zhejiang University School of Medicine, Jinhua, Zhejiang, 321000, China
| | - Min Xu
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
| | - Fan Xu
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
| | - Qiyu Zhao
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
| | - Tianan Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 31000, P. R. China.
- Zhejiang University Cancer Center, Zhejiang, Hangzhou, China
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Liang R, Wu C, Liu S, Zhao W. Targeting interleukin-13 receptor α2 (IL-13Rα2) for glioblastoma therapy with surface functionalized nanocarriers. Drug Deliv 2022; 29:1620-1630. [PMID: 35612318 PMCID: PMC9135425 DOI: 10.1080/10717544.2022.2075986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 11/03/2022] Open
Abstract
Despite surgical and therapeutic advances, glioblastoma multiforme (GBM) is among the most fatal primary brain tumor that is aggressive in nature. Patients with GBM have a median lifespan of just 15 months when treated with the current standard of therapy, which includes surgical resection and concomitant chemo-radiotherapy. In recent years, nanotechnology has shown considerable promise in treating a variety of illnesses, and certain nanomaterials have been proven to pass the blood-brain barrier (BBB) and stay in glioblastoma tissues. Recent preclinical research suggests that the diagnosis and treatment of brain tumor is significantly explored through the intervention of nanomaterials that has showed enhanced effect. In order to elicit an antitumor response, it is necessary to retain the therapeutic candidates within glioblastoma tissues and this job is effectively carried out by nanocarrier particularly functionalized nanocarriers. In the arena of neoplastic diseases including GBM have achieved great attention in recent decades. Furthermore, interleukin-13 receptor α chain variant 2 (IL13Rα2) is a highly expressed and studied target in GBM that is lacked by the surrounding environment. The absence of IL13Rα2 in surrounding normal tissues has made it a suitable target in glioblastoma therapy. In this review article, we highlighted the role of IL13Rα2 as a potential target in GBM along with design and fabrication of efficient targeting strategies for IL13Rα2 through surface functionalized nanocarriers.
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Affiliation(s)
- Ruijia Liang
- Department of Neurosurgery, Hangzhou Medical College Affiliated Lin’an People’s Hospital, The First People’s Hospital of Hangzhou Lin’an District, Hangzhou, China
| | - Cheng Wu
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Shiming Liu
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Wenyan Zhao
- Department of General Practice Medicine, Center for General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
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Bioelectronic medicines: Therapeutic potential and advancements in next-generation cancer therapy. Biochim Biophys Acta Rev Cancer 2022; 1877:188808. [DOI: 10.1016/j.bbcan.2022.188808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/07/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2022]
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Shu T, Ding L, Fang Z, Yu S, Chen L, Moser MAJ, Zhang W, Qin Z, Zhang B. Lethal Electric Field Thresholds for Cerebral Cells With Irreversible Electroporation and H-FIRE Protocols: An In Vitro Three-Dimensional Cell Model Study. J Biomech Eng 2022; 144:1140297. [PMID: 35445240 DOI: 10.1115/1.4054381] [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: 01/24/2022] [Indexed: 11/08/2022]
Abstract
The lethal electric field (LEF) thresholds for three typical cerebral cells, including a malignant glioblastoma (GBM) cell line and two cell lines from the healthy blood-brain barrier (BBB), treated by irreversible electroporation (IRE) or high-frequency irreversible electroporation (H-FIRE) protocols were investigated in an in vitro three-dimensional (3D) cell model. A conventional IRE protocol (90 pulses, 1 Hz, and 100-μs pulse duration) and three novel H-FIRE protocols (1-3-1, 0.5-1-0.5, and 1-1-1) were used to treat the cerebral cells in both 3D single-cell and two-cell models. The electrical conductivity of the 3D cell model under different electric field strengths were characterized with the method of electrochemical impedance spectroscopy (EIS). Based on EIS, a numerical electrothermal model of electroporation was built for the determination of the LEF threshold with different protocols and temperature monitoring. Cell viability was assessed by fluorescence staining 6 h after the treatment. The results showed no thermal lethal effect on cells when these protocols were used. The LEF threshold for GBM cells was significantly lower than that of the healthy BBB cells. These results suggest the possibility of selective ablation of human cerebral GBM by IRE and H-FIRE treatments with no injury or reversible injury to healthy cells, and the potential use of IRE or H-FIRE for transient disruption of the BBB to allow chemotherapy to reach the tumor.
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Affiliation(s)
- Ting Shu
- Intelligent Energy-Based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Lujia Ding
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Zheng Fang
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Shuangquan Yu
- Department of Neurosurgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Lingchao Chen
- Department of Neurosurgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Michael A J Moser
- Department of Surgery, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
| | - Wenjun Zhang
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
| | - Zhiyong Qin
- Department of Neurosurgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Bing Zhang
- Intelligent Energy-Based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
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Marie Butty E, Forsyth B, Labato MA. Irreversible Electroporation Balloon Therapy for Palliative Treatment of Obstructive Urethral Transitional Cell Carcinoma in Dogs. J Am Anim Hosp Assoc 2022; 58:231-239. [PMID: 36049240 DOI: 10.5326/jaaha-ms-7160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 11/11/2022]
Abstract
Progression of transitional cell carcinoma (TCC) in dogs often leads to urinary obstruction. This observational pilot study aimed to evaluate the safety and efficacy of irreversible electroporation (IRE) balloon therapy for the palliative treatment of TCC with partial urethral obstruction. Three client-owned dogs diagnosed with TCC causing partial urethral obstruction were enrolled. After ultrasonographic and cystoscopic examination, IRE pulse protocols were delivered through a balloon catheter device inflated within the urethral lumen. After the procedure, the patients were kept overnight for monitoring and a recheck was planned 28 days later. No complication was observed during the procedure and postprocedural monitoring. After 28 days, one dog had a complete normalization of the urine stream, one dog had stable stranguria, and one dog was presented with a urethral obstruction secondary to progression of the TCC. On recheck ultrasound, one dog had a 38% diminution of the urethral mass diameter whereas the other two dogs had a mass stable in size. IRE balloon therapy seems to be a feasible and apparently safe minimally invasive novel therapy for the palliative treatment of TCC causing urethral obstruction. Further studies are needed to better characterize the safety, efficacy, and outcome of this therapy.
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Affiliation(s)
- Emmanuelle Marie Butty
- From the Department of Clinical Sciences, Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (E.M.B., M.A.L.)
| | - Bruce Forsyth
- Research and Development Interventional Oncology, Boston Scientific Corporation, Marlborough, Massachusetts (B.F.)
| | - Mary Anna Labato
- From the Department of Clinical Sciences, Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (E.M.B., M.A.L.)
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Poulkouras R, Dijk G, Lefevre M, Bača M, Moreau D, O'Connor RP. PEDOT:PSS coated electrodes reduce intracellular oxidation and cell damage with pulsed electric field application. Bioelectrochemistry 2022; 147:108163. [DOI: 10.1016/j.bioelechem.2022.108163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
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Murphy KR, Aycock KN, Hay AN, Rossmeisl JH, Davalos RV, Dervisis NG. High-frequency irreversible electroporation brain tumor ablation: exploring the dynamics of cell death and recovery. Bioelectrochemistry 2022; 144:108001. [PMID: 34844040 PMCID: PMC8792323 DOI: 10.1016/j.bioelechem.2021.108001] [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: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 11/02/2022]
Abstract
Improved therapeutics for malignant brain tumors are urgently needed. High-frequency irreversible electroporation (H-FIRE) is a minimally invasive, nonthermal tissue ablation technique, which utilizes high-frequency, bipolar electric pulses to precisely kill tumor cells. The mechanisms of H-FIRE-induced tumor cell death and potential for cellular recovery are incompletely characterized. We hypothesized that tumor cells treated with specific H-FIRE electric field doses can survive and retain proliferative capacity. F98 glioma and LL/2 Lewis lung carcinoma cell suspensions were treated with H-FIRE to model primary and metastatic brain cancer, respectively. Cell membrane permeability, apoptosis, metabolic viability, and proliferative capacity were temporally measured using exclusion dyes, condensed chromatin staining, WST-8 fluorescence, and clonogenic assays, respectively. Both tumor cell lines exhibited dose-dependent permeabilization, with 1,500 V/cm permitting and 3,000 V/cm inhibiting membrane recovery 24 h post-treatment. Cells treated with 1,500 V/cm demonstrated significant and progressive recovery of apoptosis and metabolic activity, in contrast to cells treated with higher H-FIRE doses. Cancer cells treated with recovery-permitting doses of H-FIRE maintained while those treated with recovery-inhibiting doses lost proliferative capacity. Taken together, our data suggest that H-FIRE induces reversible and irreversible cellular damage in a dose-dependent manner, and the presence of dose-dependent recovery mechanisms permits tumor cell proliferation.
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Affiliation(s)
- Kelsey R Murphy
- Department of Biomedical and Veterinary Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, United States.
| | - Kenneth N Aycock
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, United States.
| | - Alayna N Hay
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, United States.
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, United States.
| | - Rafael V Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, United States; ICTAS Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, United States.
| | - Nikolaos G Dervisis
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, United States; Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, United States.
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9
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Oshin EA, Guo S, Jiang C. Determining tissue conductivity in tissue ablation by nanosecond pulsed electric fields. Bioelectrochemistry 2022; 143:107949. [PMID: 34583212 PMCID: PMC8643318 DOI: 10.1016/j.bioelechem.2021.107949] [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: 10/30/2020] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
Nanosecond pulsed electric field (nsPEF) causes the permeabilization of the cell membrane and has been used to non-thermally treat cancerous tissues. As increased permeabilization in membranes were reported to be accompanied by impedance changes, the ablation effect of nsPEF on tissues can be monitored via the changes in tissue conductivity. In this study, effects of nsPEF on biological tissues were evaluated by determining the conductivities of potato and 4 T1-luc breast tumor tissues ex vivo from a murine model subjected to multiple 100-ns, 1-10 kV pulses. Using a four-needle electrode system with a calibrated electrode constant of 1.1 ± 0.1 cm, the conductivities of tissues was determined from both the network-analyzer measurement, before and after treatment, and voltage-current measurement in real-time. The conductivity of the potato tissue was measured for a frequency range of 0.1-3 MHz, and it increased with increasing pulse number and voltage amplitude. The conductivity of the tumor tissue was also observed to increase with pulse number and pulse voltage over a similar frequency range. In addition, the linear correlation between the ablation area in a treated potato tissue and the conductivity change in the tissue suggests that conductivity analysis of biological tissue under treatment could be a fast and sensitive approach to evaluate the effectiveness of a nsPEF treatment.
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Affiliation(s)
- Edwin A Oshin
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA; Department of Electrical and Computer Engineering, Old, Dominion University, Norfolk, VA, USA
| | - Siqi Guo
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA
| | - Chunqi Jiang
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, VA, USA; Department of Electrical and Computer Engineering, Old, Dominion University, Norfolk, VA, USA.
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Acerbo E, Safieddine S, Weber P, Botzanowski B, Missey F, Carrère M, Gross RE, Bartolomei F, Carron R, Jirsa V, Vanzetta I, Trébuchon A, Williamson A. Non-thermal Electroporation Ablation of Epileptogenic Zones Stops Seizures in Mice While Providing Reduced Vascular Damage and Accelerated Tissue Recovery. Front Behav Neurosci 2022; 15:774999. [PMID: 35002646 PMCID: PMC8740210 DOI: 10.3389/fnbeh.2021.774999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
In epilepsy, the most frequent surgical procedure is the resection of brain tissue in the temporal lobe, with seizure-free outcomes in approximately two-thirds of cases. However, consequences of surgery can vary strongly depending on the brain region targeted for removal, as surgical morbidity and collateral damage can lead to significant complications, particularly when bleeding and swelling are located near delicate functional cortical regions. Although focal thermal ablations are well-explored in epilepsy as a minimally invasive approach, hemorrhage and edema can be a consequence as the blood-brain barrier is still disrupted. Non-thermal irreversible electroporation (NTIRE), common in many other medical tissue ablations outside the brain, is a relatively unexplored method for the ablation of neural tissue, and has never been reported as a means for ablation of brain tissue in the context of epilepsy. Here, we present a detailed visualization of non-thermal ablation of neural tissue in mice and report that NTIRE successfully ablates epileptic foci in mice, resulting in seizure-freedom, while causing significantly less hemorrhage and edema compared to conventional thermal ablation. The NTIRE approach to ablation preserves the blood-brain barrier while pathological circuits in the same region are destroyed. Additionally, we see the reinnervation of fibers into ablated brain regions from neighboring areas as early as day 3 after ablation. Our evidence demonstrates that NTIRE could be utilized as a precise tool for the ablation of surgically challenging epileptogenic zones in patients where the risk of complications and hemorrhage is high, allowing not only reduced tissue damage but potentially accelerated recovery as vessels and extracellular matrix remain intact at the point of ablation.
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Affiliation(s)
- Emma Acerbo
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Sawssan Safieddine
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Pascal Weber
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Boris Botzanowski
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Florian Missey
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Marcel Carrère
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Robert E Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Romain Carron
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France.,Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Aix-Marseille Université, Marseille, France
| | - Viktor Jirsa
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Ivo Vanzetta
- Institut de Neurosciences de la Timone, CNRS, Aix-Marseille Université, Marseille, France
| | - Agnès Trébuchon
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France
| | - Adam Williamson
- Institut de Neurosciences des Systèmes, UMR 1106, Aix-Marseille Université, Marseille, France.,Center for Bioelectronic Medicine, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Fang Z, Chen L, Moser MAJ, Zhang W, Qin Z, Zhang B. Electroporation-Based Therapy for Brain Tumors: A Review. J Biomech Eng 2021; 143:100802. [PMID: 33991087 DOI: 10.1115/1.4051184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 12/21/2022]
Abstract
Electroporation-based therapy (EBT), as a high-voltage-pulse technology has been prevalent with favorable clinical outcomes in the treatment of various solid tumors. This review paper aims to promote the clinical translation of EBT for brain tumors. First, we briefly introduced the mechanism of pore formation in a cell membrane activated by external electric fields using a single cell model. Then, we summarized and discussed the current in vitro and in vivo preclinical studies, in terms of (1) the safety and effectiveness of EBT for brain tumors in animal models, and (2) the blood-brain barrier (BBB) disruption induced by EBT. Two therapeutic effects could be achieved in EBT for brain tumors simultaneously, i.e., the tumor ablation induced by irreversible electroporation (IRE) and transient BBB disruption induced by reversible electroporation (RE). The BBB disruption could potentially improve the uptake of antitumor drugs thereby enhancing brain tumor treatment. The challenges that hinder the application of EBT in the treatment of human brain tumors are discussed in the review paper as well.
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Affiliation(s)
- Zheng Fang
- Energy-Based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Lingchao Chen
- Department of Neurosurgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Michael A J Moser
- Department of Surgery, University of Saskatchewan, Saskatoon SK S7N 5A9, Canada
| | - Wenjun Zhang
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon SK S7N 5A9, Canada
| | - Zhiyong Qin
- Department of Neurosurgery, Huashan Hospital Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Bing Zhang
- Energy-Based Tumor Ablation Laboratory, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
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12
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Jenkins EPW, Finch A, Gerigk M, Triantis IF, Watts C, Malliaras GG. Electrotherapies for Glioblastoma. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2100978. [PMID: 34292672 PMCID: PMC8456216 DOI: 10.1002/advs.202100978] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Indexed: 05/08/2023]
Abstract
Non-thermal, intermediate frequency (100-500 kHz) electrotherapies present a unique therapeutic strategy to treat malignant neoplasms. Here, pulsed electric fields (PEFs) which induce reversible or irreversible electroporation (IRE) and tumour-treating fields (TTFs) are reviewed highlighting the foundations, advances, and considerations of each method when applied to glioblastoma (GBM). Several biological aspects of GBM that contribute to treatment complexity (heterogeneity, recurrence, resistance, and blood-brain barrier(BBB)) and electrophysiological traits which are suggested to promote glioma progression are described. Particularly, the biological responses at the cellular and molecular level to specific parameters of the electrical stimuli are discussed offering ways to compare these parameters despite the lack of a universally adopted physical description. Reviewing the literature, a disconnect is found between electrotherapy techniques and how they target the biological complexities of GBM that make treatment difficult in the first place. An attempt is made to bridge the interdisciplinary gap by mapping biological characteristics to different methods of electrotherapy, suggesting important future research topics and directions in both understanding and treating GBM. To the authors' knowledge, this is the first paper that attempts an in-tandem assessment of the biological effects of different aspects of intermediate frequency electrotherapy methods, thus offering possible strategies toward GBM treatment.
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Affiliation(s)
- Elise P. W. Jenkins
- Division of Electrical EngineeringDepartment of EngineeringUniversity of CambridgeCambridgeCB3 0FAUK
| | - Alina Finch
- Institute of Cancer and Genomic ScienceUniversity of BirminghamBirminghamB15 2TTUK
| | - Magda Gerigk
- Division of Electrical EngineeringDepartment of EngineeringUniversity of CambridgeCambridgeCB3 0FAUK
| | - Iasonas F. Triantis
- Department of Electrical and Electronic EngineeringCity, University of LondonLondonEC1V 0HBUK
| | - Colin Watts
- Institute of Cancer and Genomic ScienceUniversity of BirminghamBirminghamB15 2TTUK
| | - George G. Malliaras
- Division of Electrical EngineeringDepartment of EngineeringUniversity of CambridgeCambridgeCB3 0FAUK
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13
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Zhang LY, Yang X, Wang SB, Chen H, Pan HY, Hu ZM. Membrane Derived Vesicles as Biomimetic Carriers for Targeted Drug Delivery System. Curr Top Med Chem 2021; 20:2472-2492. [PMID: 32962615 DOI: 10.2174/1568026620666200922113054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/25/2020] [Accepted: 04/25/2020] [Indexed: 02/06/2023]
Abstract
Extracellular vesicles (EVs) are membrane vesicles (MVs) playing important roles in various cellular and molecular functions in cell-to-cell signaling and transmitting molecular signals to adjacent as well as distant cells. The preserved cell membrane characteristics in MVs derived from live cells, give them great potential in biological applications. EVs are nanoscale particulates secreted from living cells and play crucial roles in several important cellular functions both in physiological and pathological states. EVs are the main elements in intercellular communication in which they serve as carriers for various endogenous cargo molecules, such as RNAs, proteins, carbohydrates, and lipids. High tissue tropism capacity that can be conveniently mediated by surface molecules, such as integrins and glycans, is a unique feature of EVs that makes them interesting candidates for targeted drug delivery systems. The cell-derived giant MVs have been exploited as vehicles for delivery of various anticancer agents and imaging probes and for implementing combinational phototherapy for targeted cancer treatment. Giant MVs can efficiently encapsulate therapeutic drugs and deliver them to target cells through the membrane fusion process to synergize photodynamic/photothermal treatment under light exposure. EVs can load diagnostic or therapeutic agents using different encapsulation or conjugation methods. Moreover, to prolong the blood circulation and enhance the targeting of the loaded agents, a variety of modification strategies can be exploited. This paper reviews the EVs-based drug delivery strategies in cancer therapy. Biological, pharmacokinetics and physicochemical characteristics, isolation techniques, engineering, and drug loading strategies of EVs are discussed. The recent preclinical and clinical progresses in applications of EVs and oncolytic virus therapy based on EVs, the clinical challenges and perspectives are discussed.
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Affiliation(s)
- Le-Yi Zhang
- Department of General Surgery, Chun’an First People’s Hospital (Zhejiang Provincial People's Hospital Chun’an
Branch), Hangzhou 311700, China
| | - Xue Yang
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Shi-Bing Wang
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Hong Chen
- Department of Stomatology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou
Medical College, Hangzhou 310014, China
| | - Hong-Ying Pan
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China,Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Zhi-Ming Hu
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China,Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
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14
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Establishing an immunocompromised porcine model of human cancer for novel therapy development with pancreatic adenocarcinoma and irreversible electroporation. Sci Rep 2021; 11:7584. [PMID: 33828203 PMCID: PMC8027815 DOI: 10.1038/s41598-021-87228-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 03/25/2021] [Indexed: 02/07/2023] Open
Abstract
New therapies to treat pancreatic cancer are direly needed. However, efficacious interventions lack a strong preclinical model that can recapitulate patients’ anatomy and physiology. Likewise, the availability of human primary malignant tissue for ex vivo studies is limited. These are significant limitations in the biomedical device field. We have developed RAG2/IL2RG deficient pigs using CRISPR/Cas9 as a large animal model with the novel application of cancer xenograft studies of human pancreatic adenocarcinoma. In this proof-of-concept study, these pigs were successfully generated using on-demand genetic modifications in embryos, circumventing the need for breeding and husbandry. Human Panc01 cells injected subcutaneously into the ears of RAG2/IL2RG deficient pigs demonstrated 100% engraftment with growth rates similar to those typically observed in mouse models. Histopathology revealed no immune cell infiltration and tumor morphology was highly consistent with the mouse models. The electrical properties and response to irreversible electroporation of the tumor tissue were found to be similar to excised human pancreatic cancer tumors. The ample tumor tissue produced enabled improved accuracy and modeling of the electrical properties of tumor tissue. Together, this suggests that this model will be useful and capable of bridging the gap of translating therapies from the bench to clinical application.
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15
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Robinson AJ, Jain A, Sherman HG, Hague RJM, Rahman R, Sanjuan‐Alberte P, Rawson FJ. Toward Hijacking Bioelectricity in Cancer to Develop New Bioelectronic Medicine. ADVANCED THERAPEUTICS 2021. [DOI: 10.1002/adtp.202000248] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Andie J. Robinson
- Regenerative Medicine and Cellular Therapies, School of Pharmacy University of Nottingham Nottingham NG7 2RD UK
| | - Akhil Jain
- Regenerative Medicine and Cellular Therapies, School of Pharmacy University of Nottingham Nottingham NG7 2RD UK
| | - Harry G. Sherman
- Regenerative Medicine and Cellular Therapies, School of Pharmacy University of Nottingham Nottingham NG7 2RD UK
| | - Richard J. M. Hague
- Centre for Additive Manufacturing, Faculty of Engineering University of Nottingham Nottingham NG8 1BB UK
| | - Ruman Rahman
- Children's Brain Tumour Research Centre, Biodiscovery Institute, School of Medicine University of Nottingham Nottingham NG7 2RD UK
| | - Paola Sanjuan‐Alberte
- Regenerative Medicine and Cellular Therapies, School of Pharmacy University of Nottingham Nottingham NG7 2RD UK
- Department of Bioengineering and iBB‐Institute for Bioengineering and Biosciences, Instituto Superior Técnico Universidade de Lisboa Lisbon 1049‐001 Portugal
| | - Frankie J. Rawson
- Regenerative Medicine and Cellular Therapies, School of Pharmacy University of Nottingham Nottingham NG7 2RD UK
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16
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Sano MB, DeWitt MR. Thermochromic Tissue Phantoms for Evaluating Temperature Distribution in Simulated Clinical Applications of Pulsed Electric Field Therapies. Bioelectricity 2020; 2:362-371. [PMID: 34476365 PMCID: PMC8370349 DOI: 10.1089/bioe.2020.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Irreversible electroporation (IRE) induces cell death through nonthermal mechanisms, however, in extreme cases, the treatments can induce deleterious thermal transients. This study utilizes a thermochromic tissue phantom to enable visualization of regions exposed to temperatures above 60°C. Materials and Methods: Poly(vinyl alcohol) hydrogels supplemented with thermochromic ink were characterized and processed to match the electrical properties of liver tissue. Three thousand volt high-frequency IRE protocols were administered with delivery rates of 100 and 200 μs/s. The effect of supplemental internal applicator cooling was then characterized. Results: Baseline treatments resulted thermal areas of 0.73 cm2, which decreased to 0.05 cm2 with electrode cooling. Increased delivery rates (200 μs/s) resulted in thermal areas of 1.5 and 0.6 cm2 without and with cooling, respectively. Conclusions: Thermochromic tissue phantoms enable rapid characterization of thermal effects associated with pulsed electric field treatments. Active cooling of applicators can significantly reduce the quantity of tissue exposed to deleterious temperatures.
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Affiliation(s)
- Michael B. Sano
- UNC/NCSU Joint Department of Biomedical Engineering, Raleigh, North Carolina, USA
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17
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Fesmire CC, Petrella RA, Kaufman JD, Topasna N, Sano MB. Irreversible electroporation is a thermally mediated ablation modality for pulses on the order of one microsecond. Bioelectrochemistry 2020; 135:107544. [DOI: 10.1016/j.bioelechem.2020.107544] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022]
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18
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The effects of point-source electroporation on the blood-brain barrier and brain vasculature in rats: An MRI and histology study. Bioelectrochemistry 2020; 134:107521. [DOI: 10.1016/j.bioelechem.2020.107521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022]
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19
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Petrella RA, Fesmire CC, Kaufman JD, Topasna N, Sano MB. Algorithmically Controlled Electroporation: A Technique for Closed Loop Temperature Regulated Pulsed Electric Field Cancer Ablation. IEEE Trans Biomed Eng 2020; 67:2176-2186. [PMID: 32673194 DOI: 10.1109/tbme.2019.2956537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effect of a closed-loop temperature based feedback algorithm on ablative outcomes for pulsed electric field treatments. METHODS A 3D tumor model of glioblastoma was used to assess the impact of 2 μs duration bipolar waveforms on viability following exposure to open and closed-loop protocols. Closed-loop treatments evaluated transient temperature increases of 5, 10, 15, or 22 °C above baseline. RESULTS The temperature controlled ablation diameters were conditionally different than the open-loop treatments and closed-loop treatments generally produced smaller ablations. Closed-loop control enabled the investigation of treatments with steady state 42 °C hyperthermic conditions which were not feasible without active feedback. Baseline closed-loop treatments at 20 °C resulted in ablations measuring 9.9 ± 0.3 mm in diameter while 37 °C treatments were 20% larger (p < 0.0001) measuring 11.8 ± 0.3 mm indicating that this protocol induces a thermally mediated biological response. CONCLUSION A closed-loop control algorithm which modulated the delay between successive pulse waveforms to achieve stable target temperatures was demonstrated. Algorithmic control enabled the evaluation of specific treatment parameters at physiological temperatures not possible with open-loop systems due to excessive Joule heating. SIGNIFICANCE Irreversible electroporation is generally considered to be a non-thermal ablation modality and temperature monitoring is not part of the standard clinical practice. The results of this study indicate ablative outcomes due to exposure to pulses on the order of one microsecond may be thermally mediated and dependent on local tissue temperatures. The results of this study set the foundation for experiments in vivo utilizing temperature control algorithms.
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20
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Poompavai S, Gowri Sree V, Kaviya Priyaa A. Electrothermal Analysis of the Breast-Tumor Model During Electroporation. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020. [DOI: 10.1109/trpms.2020.2967558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Temperature Dependence of High Frequency Irreversible Electroporation Evaluated in a 3D Tumor Model. Ann Biomed Eng 2020; 48:2233-2246. [PMID: 32409902 DOI: 10.1007/s10439-019-02423-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/21/2019] [Indexed: 12/18/2022]
Abstract
Electroporation is a bioelectric phenomenon used to deliver target molecules into cells in vitro and irreversible electroporation (IRE) is an emerging cancer therapy used to treat inoperable tumors in situ. These phenomena are generally considered to be non-thermal in nature. In this study, a 3D tumor model was used to investigate the correlation between temperature and the effectiveness of standard clinical IRE and high frequency (H-FIRE) protocols. It was found for human glioblastoma cells that in the range of 2 to 37 °C the H-FIRE lethal electric field threshold value, which describes the minimum electric field to cause cell death, is highly dependent on temperature. Increasing the initial temperature from 2 to 37 °C resulted in a significant decrease in lethal electric field threshold from 1168 to 507 V/cm and a 139% increase in ablation size for H-FIRE burst treatments. Standard clinical protocol IRE treatments resulted in a decrease in lethal threshold from 485 to 453 V/cm and a 7% increase in ablation size over the same temperature range. Similar results were found for pancreatic cancer cells which indicate that tissue temperature may be a significant factor affecting H-FIRE ablation size and treatment planning in vivo while lower temperatures may be useful in maintaining cell viability for transfection applications.
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22
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Sano MB, Petrella RA, Kaufman JD, Fesmire CC, Xing L, Gerber D, Fogle CA. Electro-thermal therapy: Microsecond duration pulsed electric field tissue ablation with dynamic temperature control algorithms. Comput Biol Med 2020; 121:103807. [PMID: 32568680 DOI: 10.1016/j.compbiomed.2020.103807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/27/2020] [Accepted: 05/02/2020] [Indexed: 12/13/2022]
Abstract
Electro-thermal therapy (ETT) is a new cancer treatment modality which combines the use of high voltage pulsed electric fields, dynamic energy delivery rates, and closed loop thermal control algorithms to rapidly and reproducibly create focal ablations. This study examines the ablative potential and profile of pulsed electric field treatments delivered in conjunction with precise temperature control algorithms. An ex vivo perfused liver model was utilized to demonstrate the capability of 5000 V 2 μs duration bipolar electrical pulses and dynamic temperature control algorithms to produce ablations. Using a three applicator array, 4 cm ablation zones were created in under 27 min. In this configuration, the algorithms were able to rapidly achieve and maintain temperatures of 80 °C at the tissue-electrode interface. A simplified single applicator and grounding pad approach was used to correlate the measured ablation zones to electric field isocontours in order to determine lethal electric field thresholds of 708 V/cm and 867 V/cm for 45 °C and 60 °C treatments, respectively. These results establish ETT as a viable method for hepatic tumor treatment with ablation profiles equivalent to other energy based techniques. The single applicator and multi-applicator approaches demonstrated may enable the treatment of complex tumor geometries. The flexibility of ETT temperature control yields a malleable intervention which gives clinicians robust control over the ablation modality, treatment time, and safety profile.
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Affiliation(s)
- Michael B Sano
- UNC/ NCSU Joint Department of Biomedical Engineering, Raleigh, NC, USA.
| | - Ross A Petrella
- UNC/ NCSU Joint Department of Biomedical Engineering, Raleigh, NC, USA
| | - Jacob D Kaufman
- UNC/ NCSU Joint Department of Biomedical Engineering, Raleigh, NC, USA
| | | | - Lei Xing
- Stanford University School of Medicine, Division of Radiation Physics, Stanford, CA, USA
| | - David Gerber
- Division of Abdominal Transplantation, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Callie A Fogle
- Department of Clinical Sciences and Population Health & Pathobiology, North Carolina State University College of Veterinary Medicine, USA
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23
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Wang M, Zarafshani A, Samant P, Merrill J, Li D, Xiang L. Feasibility of Electroacoustic Tomography: A Simulation Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:889-897. [PMID: 31765310 DOI: 10.1109/tuffc.2019.2955900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The feasibility of electroacoustic tomography (EAT) was investigated for in situ monitoring the electric field distribution in soft tissue. EAT exploits the phenomenon that the amplitude of acoustic emission generated by an electric field is proportional to the electrical energy deposition in tissue. After detecting these acoustic waves with ultrasound transducers, an image of the electric field distribution can be reconstructed in real-time. In our computer simulations, the electric field distribution in soft tissue was generated by solving general partial differential equations (PDEs) using finite element analysis (FEA). The electric field distributions were converted into initial pressure distributions, and the propagation of the induced acoustic waves was simulated using K-Wave simulation. A circular array of 128 ultrasound transducers was placed around the target to detect the acoustic waves, and a time reversal reconstruction algorithm was used to reconstruct the EAT image. A different number of electrodes set at different distances with different voltage inputs on the electrodes were performed to simulate different electric field distributions during electroporation. It was found that the electrical energy deposition in reconstructed EAT imaging is decreased as the distance of the electrodes increases. We also have investigated the sensitivity of the EAT imaging with different voltage inputs. The minimal voltage we can detect with EAT is 970 V at the pulsewidth of 180 ns. The results of this study demonstrated that EAT is a feasible technique for monitoring the electric field distribution and guiding the electrotherapy in future clinical practice.
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24
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Packer RA, McGrath S. Onscreen-guided resection of extra-axial and intra-axial forebrain masses through registration of a variable-suction tissue resection device with a neuronavigation system. Vet Surg 2020; 49:676-684. [PMID: 32220078 DOI: 10.1111/vsu.13414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 01/10/2020] [Accepted: 03/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To describe a novel surgical technique in which neuronavigation is used to guide a tissue resection device during excision of forebrain masses in locations difficult to visualize optically. STUDY DESIGN Short case series. ANIMALS Six dogs and one cat with forebrain masses (five neoplastic, two nonneoplastic) undergoing excision with a novel tissue resection device and veterinary neuronavigation system. METHODS The animals and resection instrument were coregistered to the neuronavigation system. Surgery was guided by real-time onscreen visualization of the resection instrument position relative to the preoperative MR images. Surgical outcome was evaluated by calculating residual tumor volume according to postoperative MRI. RESULTS The technique was technically simple and led to the collection of diagnostic tissue samples in all cases. Postoperative MRI was available in six cases, two with gross-total resection, three with near-total resection, and one with subtotal resection. CONCLUSION Neuronavigation-guided resection of intra-axial and extra-axial brain masses with the resection device resulted in gross-total or near-total resection in five of six animals with tumors otherwise difficult to visualize. Risk of brain shift limited absolute reliance on navigation images. CLINICAL SIGNIFICANCE Real-time neuronavigation assistance is a feasible method for guidance and successful resection of brain masses that are poorly visualized because of intra-axial or deep location, tumor appearance, or hemorrhage.
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Affiliation(s)
- Rebecca A Packer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Stephanie McGrath
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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25
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Partridge BR, O'Brien TJ, Lorenzo MF, Coutermarsh-Ott SL, Barry SL, Stadler K, Muro N, Meyerhoeffer M, Allen IC, Davalos RV, Dervisis NG. High-Frequency Irreversible Electroporation for Treatment of Primary Liver Cancer: A Proof-of-Principle Study in Canine Hepatocellular Carcinoma. J Vasc Interv Radiol 2020; 31:482-491.e4. [PMID: 31956003 PMCID: PMC7418213 DOI: 10.1016/j.jvir.2019.10.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the safety and feasibility of percutaneous high-frequency irreversible electroporation (HFIRE) for primary liver cancer and evaluate the HFIRE-induced local immune response. MATERIALS AND METHODS HFIRE therapy was delivered percutaneously in 3 canine patients with resectable hepatocellular carcinoma (HCC) in the absence of intraoperative paralytic agents or cardiac synchronization. Pre- and post-HFIRE biopsy samples were processed with histopathology and immunohistochemistry for CD3, CD4, CD8, and CD79a. Blood was collected on days 0, 2, and 4 for complete blood count and chemistry. Numeric models were developed to determine the treatment-specific lethal thresholds for malignant canine liver tissue and healthy porcine liver tissue. RESULTS HFIRE resulted in predictable ablation volumes as assessed by posttreatment CT. No detectable cardiac interference and minimal muscle contraction occurred during HFIRE. No clinically significant adverse events occurred secondary to HFIRE. Microscopically, a well-defined ablation zone surrounded by a reactive zone was evident in the majority of samples. This zone was composed primarily of maturing collagen interspersed with CD3+/CD4-/CD8- lymphocytes in a proinflammatory microenvironment. The average ablation volumes for the canine HCC patients and the healthy porcine tissue were 3.89 cm3 ± 0.74 and 1.56 cm3 ± 0.16, respectively (P = .03), and the respective average lethal thresholds were 710 V/cm ± 28.2 and 957 V/cm ± 24.4 V/cm (P = .0004). CONCLUSIONS HFIRE can safely and effectively be delivered percutaneously, results in a predictable ablation volume, and is associated with lymphocytic tumor infiltration. This is the first step toward the use of HFIRE for treatment of unresectable liver tumors.
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Affiliation(s)
- Brittanie R Partridge
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Timothy J O'Brien
- Department of Biomedical Engineering and Mechanics, Virginia Tech University, Blacksburg, Virginia
| | - Melvin F Lorenzo
- Department of Biomedical Engineering and Mechanics, Virginia Tech University, Blacksburg, Virginia
| | - Sheryl L Coutermarsh-Ott
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Sabrina L Barry
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Krystina Stadler
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Noelle Muro
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Mitchell Meyerhoeffer
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Irving C Allen
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061
| | - Rafael V Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Tech University, Blacksburg, Virginia
| | - Nikolaos G Dervisis
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, DSACS, Phase II, 205 Duck Pond Drive (0442), Blacksburg, VA 24061.
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26
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Sharabi S, Guez D, Daniels D, Cooper I, Atrakchi D, Liraz-Zaltsman S, Last D, Mardor Y. The application of point source electroporation and chemotherapy for the treatment of glioma: a randomized controlled rat study. Sci Rep 2020; 10:2178. [PMID: 32034261 PMCID: PMC7005896 DOI: 10.1038/s41598-020-59152-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/23/2020] [Indexed: 11/28/2022] Open
Abstract
The prognosis of Glioblastoma Multiforme patients is poor despite aggressive therapy. Reasons include poor chemotherapy penetration across the blood-brain barrier and tumor infiltration into surrounding tissues. Here we studied the effects of combined point-source electroporation (EP) and systemic chemotherapy in glioma-bearing rats. 128 rats were studied. Treatment groups were administered systemic Cisplatin/Methotrexate before EP (either 90 or 180 pulses). Control groups were treated by EP, chemotherapy, or no treatment. Tumor volumes were determined by MRI. Tumors growth rates of the EP + Methotrexate group (1.02 ± 0.77) were significantly lower (p < 0.01) than the control (5.2 ± 1.0) 1-week post treatment. No significant difference was found compared to Methotrexate (1.7 ± 0.5). Objective response rates (ORR) were 40% and 57% for the Methotrexate and EP + Methotrexate groups respectively. Tumor growth rates and ORR of the EP + Cisplatin groups (90 pulses 0.98 ± 0.2, 57%, 180 pulses 1.2 ± 0.1, 33%) were significantly smaller than the control (6.4 ± 1.0, p < 0.01, p < 0.02, 0%) and Cisplatin (3.9 ± 1.0, p < 0.04, p < 0.05, 13%) groups. No significant differences were found between the control groups. Increased survival was found in the EP + Cisplatin group, Χ2 = 7.54, p < 0.006 (Log Rank). Point-source EP with systemic chemotherapy is a rapid, minimal-invasive treatment that was found to induce significant antineoplastic effects in a rat glioma model.
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Affiliation(s)
- Shirley Sharabi
- The Advanced Technology Center, Sheba Medical Center, Ramat-Gan, 52621, Israel.
| | - David Guez
- The Advanced Technology Center, Sheba Medical Center, Ramat-Gan, 52621, Israel
| | - Dianne Daniels
- The Advanced Technology Center, Sheba Medical Center, Ramat-Gan, 52621, Israel
| | - Itzik Cooper
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Dana Atrakchi
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Sigal Liraz-Zaltsman
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Gand Faculty of Health Profession, Ono Academic College, Kiryat Ono, Israel.,Department of Pharmacology, Institute for Drug Research, Hebrew University, Jerusalem, Israel
| | - David Last
- The Advanced Technology Center, Sheba Medical Center, Ramat-Gan, 52621, Israel
| | - Yael Mardor
- The Advanced Technology Center, Sheba Medical Center, Ramat-Gan, 52621, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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27
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Wasson EM, Alinezhadbalalami N, Brock RM, Allen IC, Verbridge SS, Davalos RV. Understanding the role of calcium-mediated cell death in high-frequency irreversible electroporation. Bioelectrochemistry 2020; 131:107369. [PMID: 31706114 PMCID: PMC10039453 DOI: 10.1016/j.bioelechem.2019.107369] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 12/13/2022]
Abstract
High-frequency irreversible electroporation (H-FIRE) is an emerging electroporation-based therapy used to ablate cancerous tissue. Treatment consists of delivering short, bipolar pulses (1-10μs) in a series of 80-100 bursts (1 burst/s, 100μs on-time). Reducing pulse duration leads to reduced treatment volumes compared to traditional IRE, therefore larger voltages must be applied to generate ablations comparable in size. We show that adjuvant calcium enhances ablation area in vitro for H-FIRE treatments of several pulse durations (1, 2, 5, 10μs). Furthermore, H-FIRE treatment using 10μs pulses delivered with 1mM CaCl2 results in cell death thresholds (771±129V/cm) comparable to IRE thresholds without calcium (698±103V/cm). Quantifying the reversible electroporation threshold revealed that CaCl2 enhances the permeabilization of cells compared to a NaCl control. Gene expression analysis determined that CaCl2 upregulates expression of eIFB5 and 60S ribosomal subunit genes while downregulating NOX1/4, leading to increased signaling in pathways that may cause necroptosis. The opposite was found for control treatment without CaCl2 suggesting cells experience an increase in pro survival signaling. Our study is the first to identify key genes and signaling pathways responsible for differences in cell response to H-FIRE treatment with and without calcium.
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Affiliation(s)
- Elisa M Wasson
- Department of Mechanical Engineering, Virginia Tech, Goodwin Hall, 635 Prices Fork Road, Blacksburg, VA 24061, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, USA.
| | - Nastaran Alinezhadbalalami
- Department of Biomedical Engineering and Mechanics, Virginia Tech- Wake Forest University, 325 Stanger Street, Blacksburg, VA 24061, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, USA.
| | - Rebecca M Brock
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States of America; Department of Biomedical Sciences and Pathobiology, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA.
| | - Irving C Allen
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States of America; Department of Biomedical Sciences and Pathobiology, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, USA.
| | - Scott S Verbridge
- Department of Biomedical Engineering and Mechanics, Virginia Tech- Wake Forest University, 325 Stanger Street, Blacksburg, VA 24061, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, USA.
| | - Rafael V Davalos
- Department of Mechanical Engineering, Virginia Tech, Goodwin Hall, 635 Prices Fork Road, Blacksburg, VA 24061, USA; Department of Biomedical Engineering and Mechanics, Virginia Tech- Wake Forest University, 325 Stanger Street, Blacksburg, VA 24061, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, VA 24061, USA.
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Lorenzo MF, Thomas SC, Kani Y, Hinckley J, Lee M, Adler J, Verbridge SS, Hsu FC, Robertson JL, Davalos RV, Rossmeisl JH. Temporal Characterization of Blood-Brain Barrier Disruption with High-Frequency Electroporation. Cancers (Basel) 2019; 11:cancers11121850. [PMID: 31771214 PMCID: PMC6966593 DOI: 10.3390/cancers11121850] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022] Open
Abstract
Treatment of intracranial disorders suffers from the inability to accumulate therapeutic drug concentrations due to protection from the blood–brain barrier (BBB). Electroporation-based therapies have demonstrated the capability of permeating the BBB, but knowledge of the longevity of BBB disruption (BBBD) is limited. In this study, we quantify the temporal, high-frequency electroporation (HFE)-mediated BBBD in an in vivo healthy rat brain model. 40 male Fisher rats underwent HFE treatment; two blunt tipped monopolar electrodes were advanced into the brain and 200 bursts of HFE were delivered at a voltage-to-distance ratio of 600 V/cm. BBBD was verified with contrast enhanced T1W MRI (gadopentetate dimeglumine) and pathologically (Evans blue dye) at time points of 1, 24, 48, 72, and 96 h after HFE. Contrast enhanced T1W scans demonstrated BBBD for 1 to 72 h after HFE but intact BBB at 96 h. Histologically, tissue damage was restricted to electrode insertion tracks. BBBD was induced with minimal muscle contractions and minimal cell death attributed to HFE. Numerical modeling indicated that brief BBBD was induced with low magnitude electric fields, and BBBD duration increased with field strength. These data suggest the spatiotemporal characteristics of HFE-mediated BBBD may be modulated with the locally applied electric field.
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Affiliation(s)
- Melvin F. Lorenzo
- Bioelectromechanical Systems Laboratory, School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA; (M.F.L.); (M.L.); (R.V.D.)
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (S.C.T.); (S.S.V.); (J.L.R.)
| | - Sean C. Thomas
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (S.C.T.); (S.S.V.); (J.L.R.)
| | - Yukitaka Kani
- Department of Small Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA; (Y.K.); (J.H.); (J.A.)
| | - Jonathan Hinckley
- Department of Small Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA; (Y.K.); (J.H.); (J.A.)
| | - Matthew Lee
- Bioelectromechanical Systems Laboratory, School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA; (M.F.L.); (M.L.); (R.V.D.)
| | - Joy Adler
- Department of Small Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA; (Y.K.); (J.H.); (J.A.)
| | - Scott S. Verbridge
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (S.C.T.); (S.S.V.); (J.L.R.)
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - John L. Robertson
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (S.C.T.); (S.S.V.); (J.L.R.)
- Department of Small Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA; (Y.K.); (J.H.); (J.A.)
| | - Rafael V. Davalos
- Bioelectromechanical Systems Laboratory, School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA; (M.F.L.); (M.L.); (R.V.D.)
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (S.C.T.); (S.S.V.); (J.L.R.)
| | - John H. Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia Tech, Blacksburg, VA 24061, USA; (Y.K.); (J.H.); (J.A.)
- Correspondence: ; Tel.: +1-540-231-7288
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Abstract
Over the past decade, interventional oncology techniques have become integrated into the treatment plans of companion animals with cancer on a regular basis. Although procedures such as stenting are performed commonly, other less frequently utilized techniques for locoregional therapy, such as embolization and ablation, are emerging and demonstrating promise. Tumor ablation techniques are categorized into two subgroups: chemical ablation and energy-based ablation. Increased utilization of ablation will allow for the determination of specific indications and evaluation of outcomes for these techniques.
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Ringel-Scaia VM, Beitel-White N, Lorenzo MF, Brock RM, Huie KE, Coutermarsh-Ott S, Eden K, McDaniel DK, Verbridge SS, Rossmeisl JH, Oestreich KJ, Davalos RV, Allen IC. High-frequency irreversible electroporation is an effective tumor ablation strategy that induces immunologic cell death and promotes systemic anti-tumor immunity. EBioMedicine 2019; 44:112-125. [PMID: 31130474 PMCID: PMC6606957 DOI: 10.1016/j.ebiom.2019.05.036] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 12/18/2022] Open
Abstract
Background Despite promising treatments for breast cancer, mortality rates remain high and treatments for metastatic disease are limited. High-frequency irreversible electroporation (H-FIRE) is a novel tumor ablation technique that utilizes high-frequency bipolar electric pulses to destabilize cancer cell membranes and induce cell death. However, there is currently a paucity of data pertaining to immune system activation following H-FIRE and other electroporation based tumor ablation techniques. Methods Here, we utilized the mouse 4T1 mammary tumor model to evaluate H-FIRE treatment parameters on cancer progression and immune system activation in vitro and in vivo. Findings H-FIRE effectively ablates the primary tumor and induces a pro-inflammatory shift in the tumor microenvironment. We further show that local treatment with H-FIRE significantly reduces 4T1 metastases. H-FIRE kills 4T1 cells through non-thermal mechanisms associated with necrosis and pyroptosis resulting in damage associated molecular pattern signaling in vitro and in vivo. Our data indicate that the level of tumor ablation correlates with increased activation of cellular immunity. Likewise, we show that the decrease in metastatic lesions is dependent on the intact immune system and H-FIRE generates 4T1 neoantigens that engage the adaptive immune system to significantly attenuate tumor progression. Interpretation Cell death and tumor ablation following H-FIRE treatment activates the local innate immune system, which shifts the tumor microenvironment from an anti-inflammatory state to a pro-inflammatory state. The non-thermal damage to the cancer cells and increased innate immune system stimulation improves antigen presentation, resulting in the engagement of the adaptive immune system and improved systemic anti-tumor immunity.
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Affiliation(s)
- Veronica M Ringel-Scaia
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Natalie Beitel-White
- Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA; Department of Electrical and Computer Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Melvin F Lorenzo
- Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA; Virginia Tech - Wake Forest University, Virginia Tech, School of Biomedical Engineering & Sciences, Blacksburg, VA, USA
| | - Rebecca M Brock
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Kathleen E Huie
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Sheryl Coutermarsh-Ott
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Kristin Eden
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Dylan K McDaniel
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Scott S Verbridge
- Virginia Tech - Wake Forest University, Virginia Tech, School of Biomedical Engineering & Sciences, Blacksburg, VA, USA; Center for Engineered Health, Virginia Tech, Institute for Critical Technology and Applied Science, Blacksburg, VA, USA
| | - John H Rossmeisl
- Center for Engineered Health, Virginia Tech, Institute for Critical Technology and Applied Science, Blacksburg, VA, USA; Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - Kenneth J Oestreich
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA; Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Center for Engineered Health, Virginia Tech, Institute for Critical Technology and Applied Science, Blacksburg, VA, USA; Virginia Tech, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Rafael V Davalos
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA; Virginia Tech - Wake Forest University, Virginia Tech, School of Biomedical Engineering & Sciences, Blacksburg, VA, USA; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Center for Engineered Health, Virginia Tech, Institute for Critical Technology and Applied Science, Blacksburg, VA, USA
| | - Irving C Allen
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Biomedical Sciences and Pathobiology, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Center for Engineered Health, Virginia Tech, Institute for Critical Technology and Applied Science, Blacksburg, VA, USA.
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31
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Latouche EL, Arena CB, Ivey JW, Garcia PA, Pancotto TE, Pavlisko N, Verbridge SS, Davalos RV, Rossmeisl JH. High-Frequency Irreversible Electroporation for Intracranial Meningioma: A Feasibility Study in a Spontaneous Canine Tumor Model. Technol Cancer Res Treat 2018; 17:1533033818785285. [PMID: 30071778 PMCID: PMC6077896 DOI: 10.1177/1533033818785285] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
High-frequency irreversible electroporation is a nonthermal method of tissue ablation
that uses bursts of 0.5- to 2.0-microsecond bipolar electric pulses to permeabilize cell
membranes and induce cell death. High-frequency irreversible electroporation has potential
advantages for use in neurosurgery, including the ability to deliver pulses without
inducing muscle contraction, inherent selectivity against malignant cells, and the
capability of simultaneously opening the blood–brain barrier surrounding regions of
ablation. Our objective was to determine whether high-frequency irreversible
electroporation pulses capable of tumor ablation could be delivered to dogs with
intracranial meningiomas. Three dogs with intracranial meningiomas were treated.
Patient-specific treatment plans were generated using magnetic resonance imaging-based
tissue segmentation, volumetric meshing, and finite element modeling. Following tumor
biopsy, high-frequency irreversible electroporation pulses were stereotactically delivered
in situ followed by tumor resection and morphologic and volumetric
assessments of ablations. Clinical evaluations of treatment included pre- and
posttreatment clinical, laboratory, and magnetic resonance imaging examinations and
adverse event monitoring for 2 weeks posttreatment. High-frequency irreversible
electroporation pulses were administered successfully in all patients. No adverse events
directly attributable to high-frequency irreversible electroporation were observed.
Individual ablations resulted in volumes of tumor necrosis ranging from 0.25 to 1.29
cm3. In one dog, nonuniform ablations were observed, with viable tumor cells
remaining around foci of intratumoral mineralization. In conclusion, high-frequency
irreversible electroporation pulses can be delivered to brain tumors, including areas
adjacent to critical vasculature, and are capable of producing clinically relevant volumes
of tumor ablation. Mineralization may complicate achievement of complete tumor
ablation.
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Affiliation(s)
| | | | - Jill W Ivey
- 2 Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University School of Biomedical Engineering, Blacksburg, VA, USA
| | | | - Theresa E Pancotto
- 3 Veterinary and Comparative Neuro-oncology Laboratory, Virginia Tech, Blacksburg, VA, USA.,4 Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Noah Pavlisko
- 3 Veterinary and Comparative Neuro-oncology Laboratory, Virginia Tech, Blacksburg, VA, USA.,4 Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Scott S Verbridge
- 2 Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University School of Biomedical Engineering, Blacksburg, VA, USA
| | - Rafael V Davalos
- 2 Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University School of Biomedical Engineering, Blacksburg, VA, USA
| | - John H Rossmeisl
- 2 Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University School of Biomedical Engineering, Blacksburg, VA, USA.,3 Veterinary and Comparative Neuro-oncology Laboratory, Virginia Tech, Blacksburg, VA, USA.,4 Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
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32
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Poompavai S, Gowri Sree V. Dielectric Property Measurement of Breast—Tumor Phantom Model Under Pulsed Electric Field Treatment. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2018. [DOI: 10.1109/trpms.2018.2868818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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33
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Brighi C, Puttick S, Rose S, Whittaker AK. The potential for remodelling the tumour vasculature in glioblastoma. Adv Drug Deliv Rev 2018; 136-137:49-61. [PMID: 30308226 DOI: 10.1016/j.addr.2018.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 12/19/2022]
Abstract
Despite significant improvements in the clinical management of glioblastoma, poor delivery of systemic therapies to the entire population of tumour cells remains one of the biggest challenges in the achievement of more effective treatments. On the one hand, the abnormal and dysfunctional tumour vascular network largely limits blood perfusion, resulting in an inhomogeneous delivery of drugs to the tumour. On the other hand, the presence of an intact blood-brain barrier (BBB) in certain regions of the tumour prevents chemotherapeutic drugs from permeating through the tumour vessels and reaching the diseased cells. In this review we analyse in detail the implications of the presence of a dysfunctional vascular network and the impenetrable BBB on drug transport. We discuss advantages and limitations of the currently available strategies for remodelling the tumour vasculature aiming to ameliorate the above mentioned limitations. Finally we review research methods for visualising vascular dysfunction and highlight the power of DCE- and DSC-MRI imaging to assess changes in blood perfusion and BBB permeability.
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34
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Rezaee Z, Yadollahpour A, Bayati V. Single Intense Microsecond Electric Pulse Induces Radiosensitization to Ionizing Radiation: Effects of Time Intervals Between Electric Pulse and Ionizing Irradiation. Front Oncol 2018; 8:418. [PMID: 30319980 PMCID: PMC6171481 DOI: 10.3389/fonc.2018.00418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/10/2018] [Indexed: 12/16/2022] Open
Abstract
Background and Objective: Recent studies have shown the potential of electroporation (EP) as a physical radiosensitizer for ionizing radiation (IR). The amount of sensitizing effect depends on some factors the most important of them is the time interval between the EP and IR. This experimental in vitro study aims to investigate the radiosensitizing effect of EP exposure prior to IR and also evaluate the effects of EP-IR time intervals on the amount of radiosensitizing effects. Methods: Chinese hamster ovary (CHO) cell lines were cultured in vitro. The cells were divided into 10 groups including one untreated or control group, IR, and EP treatment alone groups, and seven combined EP-IR groups with 10, 20, 30, 40, 50, 60, and 70 min intervals. The dose enhancement factors (DEFs) for 6 MV X-rays IR were comparatively investigated between the groups using MTT assay. Results: The EP significantly induced radiosensitizing effect and its amount depends on the time intervals. The viability rate of the cells in the combined EP-IR treatment groups for intervals of 10, 20, 30, 40, and 50 min was significantly lower than the IR alone group. The highest DEF (1.18) was observed 10 min time interval between EP and IR. Conclusion: The radiosensitizing effects of EP persist long enough, 10–50 min, which allows safe application of EP as a radiosensitizer before IR in clinical setting.
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Affiliation(s)
- Zohre Rezaee
- Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Yadollahpour
- Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Vahid Bayati
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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35
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Dermol-Černe J, Miklavčič D, Reberšek M, Mekuč P, Bardet SM, Burke R, Arnaud-Cormos D, Leveque P, O'Connor R. Plasma membrane depolarization and permeabilization due to electric pulses in cell lines of different excitability. Bioelectrochemistry 2018; 122:103-114. [PMID: 29621662 DOI: 10.1016/j.bioelechem.2018.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 12/18/2022]
Abstract
In electroporation-based medical treatments, excitable tissues are treated, either intentionally (irreversible electroporation of brain cancer, gene electrotransfer or ablation of the heart muscle, gene electrotransfer of skeletal muscles), or unintentionally (excitable tissues near the target area). We investigated how excitable and non-excitable cells respond to electric pulses, and if electroporation could be an effective treatment of the tumours of the central nervous system. For three non-excitable and one excitable cell line, we determined a strength-duration curve for a single pulse of 10ns-10ms. The threshold for depolarization decreased with longer pulses and was higher for excitable cells. We modelled the response with the Lapicque curve and the Hodgkin-Huxley model. At 1μs a plateau of excitability was reached which could explain why high-frequency irreversible electroporation (H-FIRE) electroporates but does not excite cells. We exposed cells to standard electrochemotherapy parameters (8×100μs pulses, 1Hz, different voltages). Cells behaved similarly which indicates that electroporation most probably occurs at the level of lipid bilayer, independently of the voltage-gated channels. These results could be used for optimization of electric pulses to achieve maximal permeabilization and minimal excitation/pain sensation. In the future, it should be established whether the in vitro depolarization correlates to nerve/muscle stimulation and pain sensation in vivo.
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Affiliation(s)
- Janja Dermol-Černe
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Matej Reberšek
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Primož Mekuč
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia
| | - Sylvia M Bardet
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.
| | - Ryan Burke
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France
| | | | - Philippe Leveque
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.
| | - Rodney O'Connor
- École des Mines de Saint-Étienne, Department of Bioelectronics, Georges Charpak Campus, Centre Microélectronique de Provence, 880 Route de Mimet, 13120 Gardanne, France.
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36
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Bonakdar M, Graybill PM, Davalos RV. A microfluidic model of the blood-brain barrier to study permeabilization by pulsed electric fields. RSC Adv 2017; 7:42811-42818. [PMID: 29308191 PMCID: PMC5753766 DOI: 10.1039/c7ra07603g] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Pulsed electric fields interact with the blood-brain barrier (BBB) and have been shown to increase the BBB permeability under some pulsing regimes. Pulsed electric fields may enhance drug delivery to the brain by disrupting the integrity of the BBB and allowing otherwise impermeable drugs to reach target areas. Microfluidic, in vitro models offer an alternative platform for exploring the impact of pulsed electric fields on the BBB because they create physiologically relevant microenvironments and eliminate the confounding variables of animal studies. We developed a microfluidic platform for real-time measurement of BBB permeability pre- and post-treatment with pulsed electric fields. Permeability is measured optically by the diffusion of fluorescent tracers across a monolayer of human cerebral microcapillary endothelial cells (hCMECs) cultured on a permeable membrane. We found that this device is able to capture real-time permeability of hCMEC monolayers for both reversible and irreversible electroporation pulsing regimes. Furthermore, preliminary testing of deep brain stimulation pulsing regimes reveals possible impacts on BBB integrity. This device will enable future studies of pulsed electric field regimes for improved understanding of BBB permeabilization.
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Affiliation(s)
- M. Bonakdar
- Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - P. M. Graybill
- Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - R. V. Davalos
- Bioelectromechanical Systems Laboratory, Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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37
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Sano MB, Volotskova O, Xing L. Treatment of Cancer In Vitro Using Radiation and High-Frequency Bursts of Submicrosecond Electrical Pulses. IEEE Trans Biomed Eng 2017; 65:928-935. [PMID: 28783621 DOI: 10.1109/tbme.2017.2734887] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
High-frequency irreversible electroporation (H-FIRE) is an emerging cancer therapy, which uses bursts of short duration, alternating polarity, high-voltage electrical pulses to focally ablate tumors. Here, we present a preliminary investigation of the combinatorial effects of H-FIRE and ionizing radiation. In vitro cell cultures were exposed to bursts of 500 ns pulses and single radiation doses of 2 or 20 Gy then analyzed for 14 days. H-FIRE and radiation therapy (RT) appear to induce different delayed cell death mechanisms and in all treatment groups combinatorial therapy resulted in lower overall viabilities. These results indicate that in vivo investigation of the antitumor efficacy of combined H-FIRE and RT is warranted.
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38
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Garcia PA, Kos B, Rossmeisl JH, Pavliha D, Miklavčič D, Davalos RV. Predictive therapeutic planning for irreversible electroporation treatment of spontaneous malignant glioma. Med Phys 2017; 44:4968-4980. [DOI: 10.1002/mp.12401] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 04/14/2017] [Accepted: 05/07/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Paulo A. Garcia
- School of Biomedical Engineering and Sciences Virginia Tech – Wake Forest University Blacksburg VA 24061 USA
- Laboratory for Energy and Microsystems Innovation Department of Mechanical Engineering Massachusetts Institute of Technology Cambridge MA 02142 USA
| | - Bor Kos
- Faculty of Electrical Engineering University of Ljubljana Trzaska 25 1000 Ljubljana Slovenia
| | - John H. Rossmeisl
- School of Biomedical Engineering and Sciences Virginia Tech – Wake Forest University Blacksburg VA 24061 USA
- Department of Small Animal Clinical Sciences Virginia‐Maryland Regional College of Veterinary Medicine Blacksburg VA 24060 USA
- Veterinary and Comparative Neuro‐oncology LaboratoryVirginia‐Maryland Regional College of Veterinary Medicine Blacksburg VA 24060 USA
| | - Denis Pavliha
- Faculty of Electrical Engineering University of Ljubljana Trzaska 25 1000 Ljubljana Slovenia
| | - Damijan Miklavčič
- Faculty of Electrical Engineering University of Ljubljana Trzaska 25 1000 Ljubljana Slovenia
| | - Rafael V. Davalos
- School of Biomedical Engineering and Sciences Virginia Tech – Wake Forest University Blacksburg VA 24061 USA
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39
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A Comprehensive Characterization of Parameters Affecting High-Frequency Irreversible Electroporation Lesions. Ann Biomed Eng 2017; 45:2524-2534. [DOI: 10.1007/s10439-017-1889-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022]
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40
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Dolera M, Malfassi L, Bianchi C, Carrara N, Finesso S, Marcarini S, Mazza G, Pavesi S, Sala M, Urso G. Frameless stereotactic radiotherapy alone and combined with temozolomide for presumed canine gliomas. Vet Comp Oncol 2017. [DOI: 10.1111/vco.12316] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M. Dolera
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - L. Malfassi
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - C. Bianchi
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - N. Carrara
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - S. Finesso
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - S. Marcarini
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - G. Mazza
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - S. Pavesi
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - M. Sala
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
| | - G. Urso
- La Cittadina Fondazione Studi e Ricerche Veterinarie; Romanengo Italy
- Azienda Socio Sanitaria Territoriale di Lodi; Lodi Italy
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41
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Yao C, Dong S, Zhao Y, Lv Y, Liu H, Gong L, Ma J, Wang H, Sun Y. Bipolar Microsecond Pulses and Insulated Needle Electrodes for Reducing Muscle Contractions During Irreversible Electroporation. IEEE Trans Biomed Eng 2017; 64:2924-2937. [PMID: 28391185 DOI: 10.1109/tbme.2017.2690624] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To minimize the effect of muscle contractions during irreversible electroporation (IRE), this paper attempts to research the ablation effect and muscle contractions by applying high-frequency IRE (H-FIRE) ablation to liver tissue in vivo. METHODS An insulated needle electrode was produced by painting an insulating coating on the outer surface of the needle electrode tip. A series of experiments were conducted using insulated needle electrodes and traditional needle electrodes to apply H-FIRE pulses and traditional monopolar IRE pulses to rabbit liver tissues. The finite element model of the rabbit liver tissue was established to determine the lethal thresholds of H-FIRE in liver tissues. Muscle contractions were measured by an accelerometer. RESULTS With increased constitutive pulse width and pulse voltage, the ablation area and muscle contraction strength are also increased, which can be used to optimize the ablation parameters of H-FIRE. Under the same pulse parameters, the ablation areas are similar for the two types of electrodes, and the ablation region has a clear boundary. H-FIRE and insulated needle electrodes can mitigate the extent of muscle contractions. The lethal thresholds of H-FIRE in rabbit liver tissues were determined. CONCLUSION This paper describes the relationships between the ablation area, muscle contractions, and pulse parameters; the designed insulated needle electrodes can be used in IRE for reducing muscle contraction. SIGNIFICANCE The study provides guidance for treatment planning and reducing muscle contractions in the clinical application of H-FIRE.
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Bonakdar M, Wasson EM, Lee YW, Davalos RV. Electroporation of Brain Endothelial Cells on Chip toward Permeabilizing the Blood-Brain Barrier. Biophys J 2016; 110:503-513. [PMID: 26789772 DOI: 10.1016/j.bpj.2015.11.3517] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/06/2015] [Accepted: 11/17/2015] [Indexed: 12/24/2022] Open
Abstract
The blood-brain barrier, mainly composed of brain microvascular endothelial cells, poses an obstacle to drug delivery to the brain. Controlled permeabilization of the constituent brain endothelial cells can result in overcoming this barrier and increasing transcellular transport across it. Electroporation is a biophysical phenomenon that has shown potential in permeabilizing and overcoming this barrier. In this study we developed a microengineered in vitro model to characterize the permeabilization of adhered brain endothelial cells to large molecules in response to applied pulsed electric fields. We found the distribution of affected cells by reversible and irreversible electroporation, and quantified the uptaken amount of naturally impermeable molecules into the cells as a result of applied pulse magnitude and number of pulses. We achieved 81 ± 1.7% (N = 6) electroporated cells with 17 ± 8% (N = 5) cell death using an electric-field magnitude of ∼580 V/cm and 10 pulses. Our results provide the proper range for applied electric-field intensity and number of pulses for safe permeabilization without significantly compromising cell viability. Our results demonstrate that it is possible to permeabilize the endothelial cells of the BBB in a controlled manner, therefore lending to the feasibility of using pulsed electric fields to increase drug transport across the BBB through the transcellular pathway.
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Affiliation(s)
- Mohammad Bonakdar
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, Virginia.
| | - Elisa M Wasson
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, Virginia
| | - Yong W Lee
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Virginia Tech, Blacksburg, Virginia
| | - Rafael V Davalos
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, Virginia; Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Virginia Tech, Blacksburg, Virginia
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Multiphoton imaging reveals that nanosecond pulsed electric fields collapse tumor and normal vascular perfusion in human glioblastoma xenografts. Sci Rep 2016; 6:34443. [PMID: 27698479 PMCID: PMC5048165 DOI: 10.1038/srep34443] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/13/2016] [Indexed: 12/18/2022] Open
Abstract
Despite the biomedical advances of the last century, many cancers including glioblastoma are still resistant to existing therapies leaving patients with poor prognoses. Nanosecond pulsed electric fields (nsPEF) are a promising technology for the treatment of cancer that have thus far been evaluated in vitro and in superficial malignancies. In this paper, we develop a tumor organoid model of glioblastoma and apply intravital multiphoton microscopy to assess their response to nsPEFs. We demonstrate for the first time that a single 10 ns, high voltage electric pulse (35–45 kV/cm), collapses the perfusion of neovasculature, and also alters the diameter of capillaries and larger vessels in normal tissue. These results contribute to the fundamental understanding of nsPEF effects in complex tissue environments, and confirm the potential of nsPEFs to disrupt the microenvironment of solid tumors such as glioblastoma.
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Langus J, Kranjc M, Kos B, Šuštar T, Miklavčič D. Dynamic finite-element model for efficient modelling of electric currents in electroporated tissue. Sci Rep 2016; 6:26409. [PMID: 27211822 PMCID: PMC4876422 DOI: 10.1038/srep26409] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/03/2016] [Indexed: 12/18/2022] Open
Abstract
In silico experiments (numerical simulations) are a valuable tool for non-invasive research of the influences of tissue properties, electrode placement and electric pulse delivery scenarios in the process of electroporation. The work described in this article was aimed at introducing time dependent effects into a finite element model developed specifically for electroporation. Reference measurements were made ex vivo on beef liver samples and experimental data were used both as an initial condition for simulation (applied pulse voltage) and as a reference value for numerical model calibration (measured pulse current). The developed numerical model is able to predict the time evolution of an electric pulse current within a 5% error over a broad range of applied pulse voltages, pulse durations and pulse repetition frequencies. Given the good agreement of the current flowing between the electrodes, we are confident that the results of our numerical model can be used both for detailed in silico research of electroporation mechanisms (giving researchers insight into time domain effects) and better treatment planning algorithms, which predict the outcome of treatment based on both spatial and temporal distributions of applied electric pulses.
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Affiliation(s)
- J Langus
- C3M d.o.o., Technology park 21, SI-1000 Ljubljana, Slovenia
| | - M Kranjc
- University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Biocybernetics, Tržaška 25, 1000 Ljubljana, Slovenia
| | - B Kos
- University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Biocybernetics, Tržaška 25, 1000 Ljubljana, Slovenia
| | - T Šuštar
- C3M d.o.o., Technology park 21, SI-1000 Ljubljana, Slovenia
| | - D Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Laboratory of Biocybernetics, Tržaška 25, 1000 Ljubljana, Slovenia
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45
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Targeted cellular ablation based on the morphology of malignant cells. Sci Rep 2015; 5:17157. [PMID: 26596248 PMCID: PMC4657158 DOI: 10.1038/srep17157] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/26/2015] [Indexed: 11/25/2022] Open
Abstract
Treatment of glioblastoma multiforme (GBM) is especially challenging due to a shortage of methods to preferentially target diffuse infiltrative cells, and therapy-resistant glioma stem cell populations. Here we report a physical treatment method based on electrical disruption of cells, whose action depends strongly on cellular morphology. Interestingly, numerical modeling suggests that while outer lipid bilayer disruption induced by long pulses (~100 μs) is enhanced for larger cells, short pulses (~1 μs) preferentially result in high fields within the cell interior, which scale in magnitude with nucleus size. Because enlarged nuclei represent a reliable indicator of malignancy, this suggested a means of preferentially targeting malignant cells. While we demonstrate killing of both normal and malignant cells using pulsed electric fields (PEFs) to treat spontaneous canine GBM, we proposed that properly tuned PEFs might provide targeted ablation based on nuclear size. Using 3D hydrogel models of normal and malignant brain tissues, which permit high-resolution interrogation during treatment testing, we confirmed that PEFs could be tuned to preferentially kill cancerous cells. Finally, we estimated the nuclear envelope electric potential disruption needed for cell death from PEFs. Our results may be useful in safely targeting the therapy-resistant cell niches that cause recurrence of GBM tumors.
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46
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Bonakdar M, Latouche EL, Mahajan RL, Davalos RV. The Feasibility of a Smart Surgical Probe for Verification of IRE Treatments Using Electrical Impedance Spectroscopy. IEEE Trans Biomed Eng 2015; 62:2674-84. [PMID: 26057529 DOI: 10.1109/tbme.2015.2441636] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
SIGNIFICANCE Irreversible electroporation (IRE) is gaining popularity as a focal ablation modality for the treatment of unresectable tumors. One clinical limitation of IRE is the absence of methods for real-time treatment evaluation, namely actively monitoring the dimensions of the induced lesion. This information is critical to ensure a complete treatment and minimize collateral damage to the surrounding healthy tissue. GOAL In this study, we are taking advantage of the biophysical properties of living tissues to address this critical demand. METHODS Using advanced microfabrication techniques, we have developed an electrical impedance microsensor to collect impedance data along the length of a bipolar IRE probe for treatment verification. For probe characterization and interpretation of the readings, we used potato tuber, which is a suitable platform for IRE experiments without having the complexities of in vivo or ex vivo models. We used the impedance spectra, along with an electrical model of the tissue, to obtain critical parameters such as the conductivity of the tissue before, during, and after completion of treatment. To validate our results, we used a finite element model to simulate the electric field distribution during treatments in each potato. RESULTS It is shown that electrical impedance spectroscopy could be used as a technique for treatment verification, and when combined with appropriate FEM modeling can determine the lesion dimensions. CONCLUSIONS This technique has the potential to be readily translated for use with other ablation modalities already being used in clinical settings for the treatment of malignancies.
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Sano MB, Arena CB, Bittleman KR, DeWitt MR, Cho HJ, Szot CS, Saur D, Cissell JM, Robertson J, Lee YW, Davalos RV. Bursts of Bipolar Microsecond Pulses Inhibit Tumor Growth. Sci Rep 2015; 5:14999. [PMID: 26459930 PMCID: PMC4602310 DOI: 10.1038/srep14999] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 09/02/2015] [Indexed: 02/06/2023] Open
Abstract
Irreversible electroporation (IRE) is an emerging focal therapy which is demonstrating utility in the treatment of unresectable tumors where thermal ablation techniques are contraindicated. IRE uses ultra-short duration, high-intensity monopolar pulsed electric fields to permanently disrupt cell membranes within a well-defined volume. Though preliminary clinical results for IRE are promising, implementing IRE can be challenging due to the heterogeneous nature of tumor tissue and the unintended induction of muscle contractions. High-frequency IRE (H-FIRE), a new treatment modality which replaces the monopolar IRE pulses with a burst of bipolar pulses, has the potential to resolve these clinical challenges. We explored the pulse-duration space between 250 ns and 100 μs and determined the lethal electric field intensity for specific H-FIRE protocols using a 3D tumor mimic. Murine tumors were exposed to 120 bursts, each energized for 100 μs, containing individual pulses 1, 2, or 5 μs in duration. Tumor growth was significantly inhibited and all protocols were able to achieve complete regressions. The H-FIRE protocol substantially reduces muscle contractions and the therapy can be delivered without the need for a neuromuscular blockade. This work shows the potential for H-FIRE to be used as a focal therapy and merits its investigation in larger pre-clinical models.
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Affiliation(s)
- Michael B. Sano
- School of Biomedical Engineering and Sciences, Virginia Tech, USA
- Department of Radiation Oncology, Division of Radiation Physics, Stanford University, USA
| | | | | | | | - Hyung J. Cho
- School of Biomedical Engineering and Sciences, Virginia Tech, USA
| | | | | | | | - John Robertson
- School of Biomedical Engineering and Sciences, Virginia Tech, USA
| | - Yong W. Lee
- School of Biomedical Engineering and Sciences, Virginia Tech, USA
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Rossmeisl JH, Garcia PA, Pancotto TE, Robertson JL, Henao-Guerrero N, Neal RE, Ellis TL, Davalos RV. Safety and feasibility of the NanoKnife system for irreversible electroporation ablative treatment of canine spontaneous intracranial gliomas. J Neurosurg 2015; 123:1008-25. [DOI: 10.3171/2014.12.jns141768] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECT
Irreversible electroporation (IRE) is a novel nonthermal ablation technique that has been used for the treatment of solid cancers. However, it has not been evaluated for use in brain tumors. Here, the authors report on the safety and feasibility of using the NanoKnife IRE system for the treatment of spontaneous intracranial gliomas in dogs.
METHODS
Client-owned dogs with a telencephalic glioma shown on MRI were eligible. Dog-specific treatment plans were generated by using MRI-based tissue segmentation, volumetric meshing, and finite element modeling. After biopsy confirmation of glioma, IRE treatment was delivered stereotactically with the NanoKnife system using pulse parameters and electrode configurations derived from therapeutic plans. The primary end point was an evaluation of safety over the 14 days immediately after treatment. Follow-up was continued for 12 months or until death with serial physical, neurological, laboratory, and MRI examinations.
RESULTS
Seven dogs with glioma were treated. The mean age of the dogs was 9.3 ± 1.6 years, and the mean pretreatment tumor volume was 1.9 ± 1.4 cm3. The median preoperative Karnofsky Performance Scale score was 70 (range 30–75). Severe posttreatment toxicity was observed in 2 of the 7 dogs; one developed fatal (Grade 5) aspiration pneumonia, and the other developed treatment-associated cerebral edema, which resulted in transient neurological deterioration. Results of posttreatment diagnostic imaging, tumor biopsies, and neurological examinations indicated that tumor ablation was achieved without significant direct neurotoxicity in 6 of the 7 dogs. The median 14-day post-IRE Karnofsky Performance Scale score of the 6 dogs that survived to discharge was 80 (range 60–90), and this score was improved over the pretreatment value in every case. Objective tumor responses were seen in 4 (80%) of 5 dogs with quantifiable target lesions. The median survival was 119 days (range 1 to > 940 days).
CONCLUSION
With the incorporation of additional therapeutic planning procedures, the NanoKnife system is a novel technology capable of controlled IRE ablation of telencephalic gliomas.
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Affiliation(s)
- John H. Rossmeisl
- 1Department of Small Animal Clinical Sciences and
- 2Veterinary and Comparative Neurooncology Laboratory, Virginia-Maryland Regional College of Veterinary Medicine, and
- 3Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia; and
| | - Paulo A. Garcia
- 2Veterinary and Comparative Neurooncology Laboratory, Virginia-Maryland Regional College of Veterinary Medicine, and
- 3Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia; and
| | | | - John L. Robertson
- 1Department of Small Animal Clinical Sciences and
- 2Veterinary and Comparative Neurooncology Laboratory, Virginia-Maryland Regional College of Veterinary Medicine, and
- 3Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia; and
| | | | - Robert E. Neal
- 3Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia; and
| | - Thomas L. Ellis
- 4Department of Neurosurgery and Deep Brain Stimulation Program, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Rafael V. Davalos
- 3Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia; and
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Jiang C, Davalos RV, Bischof JC. A review of basic to clinical studies of irreversible electroporation therapy. IEEE Trans Biomed Eng 2015; 62:4-20. [PMID: 25389236 DOI: 10.1109/tbme.2014.2367543] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The use of irreversible electroporation (IRE) for cancer treatment has increased sharply over the past decade. As a nonthermal therapy, IRE offers several potential benefits over other focal therapies, which include 1) short treatment delivery time, 2) reduced collateral thermal injury, and 3) the ability to treat tumors adjacent to major blood vessels. These advantages have stimulated widespread interest in basic through clinical studies of IRE. For instance, many in vitro and in vivo studies now identify treatment planning protocols (IRE threshold, pulse parameters, etc.), electrode delivery (electrode design, placement, intraoperative imaging methods, etc.), injury evaluation (methods and timing), and treatment efficacy in different cancer models. Therefore, this study reviews the in vitro, translational, and clinical studies of IRE cancer therapy based on major experimental studies particularly within the past decade. Further, this study provides organized data and facts to assist further research, optimization, and clinical applications of IRE.
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50
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Groselj A, Kos B, Cemazar M, Urbancic J, Kragelj G, Bosnjak M, Veberic B, Strojan P, Miklavcic D, Sersa G. Coupling treatment planning with navigation system: a new technological approach in treatment of head and neck tumors by electrochemotherapy. Biomed Eng Online 2015; 14 Suppl 3:S2. [PMID: 26355773 PMCID: PMC4565575 DOI: 10.1186/1475-925x-14-s3-s2] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Electrochemotherapy provides highly effective local treatment for a variety of tumors. In deep-seated tumors of the head and neck, due to complex anatomy of the region or inability to cover the whole tumor with standard electrodes, the use of long single needle electrodes is mandatory. In such cases, a treatment plan provides the information on the optimal configuration of the electrodes to adequately cover the tumor with electric field, while the accurate placement of the electrodes in the surgical room in patients can remain a problem. Therefore, during electrochemotherapy of two head and neck lymph-node metastases of squamous cell carcinoma origin, a navigation system for placement of electrodes was used. PATIENT AND METHODS Electrochemotherapy of two lymph-node metastases of cutaneous squamous cell carcinoma, one in the left parotid gland and the other in the neck just behind the left mandibular angle, was performed using intravenous administration of bleomycin and long single needle electrodes. The tumors were treated according to the prepared treatment plan, and executed with the use of navigation system. RESULTS Coupling of treatment plan with the navigation system aided to an accurate placement of the electrodes. The navigation system helped the surgeon to identify the exact location of the tumors, and helped with the positioning of the long needle electrodes during their insertion, according to treatment plan. Five electrodes were inserted for each metastasis, one centrally in the tumor and four in the periphery of the tumor. Five weeks after electrochemotherapy, computed tomography images demonstrated partial response of the first metastasis and complete response of the second one. Six weeks after electrochemotherapy, fine-needle aspiration biopsy specimen obtained from the treated lesions revealed necrosis and inflammatory cells, without any viable tumor cells. CONCLUSION We describe a new technological approach for electrochemotherapy of deep-seated head and neck tumors, coupling of the treatment planning with navigation system for accurate placement of the single long needle electrodes into and around the tumors, according to the treatment plan. Evidence of its effectiveness on two lymph-node metastases of cutaneous squamous cell carcinoma origin in neck lymph is provided.
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