Enhancing Curcumin's therapeutic potential in cancer treatment through ultrasound mediated liposomal delivery

Improving the efficacy of chemotherapy remains a key challenge in cancer treatment, considering the low bioavailability, high cytotoxicity, and undesirable side effects of some clinical drugs. Targeted delivery and sustained release of therapeutic drugs to cancer cells can reduce the whole-body cytotoxicity of the agent and deliver a safe localized treatment to the patient. There is growing interest in herbal drugs, such as curcumin, which is highly noted as a promising anti-tumor drug, considering its wide range of bioactivities and therapeutic properties against various tumors. Conversely, the clinical efficacy of curcumin is limited because of poor oral bioavailability, low water solubility, instability in gastrointestinal fluids, and unsuitable pH stability. Drug-delivery colloid vehicles like liposomes and nanoparticles combined with microbubbles and ultrasound-mediated sustained release are currently being explored as effective delivery modes in such cases. This study aimed to synthesize and study the properties of curcumin liposomes (CLs) and optimize the high-frequency ultrasound release and uptake by a human breast cancer cell line (HCC 1954) through in vitro studies of culture viability and cytotoxicity. CLs were effectively prepared with particles sized at 81 ± 2 nm, demonstrating stability and controlled release of curcumin under ultrasound exposure. In vitro studies using HCC1954 cells, the combination of CLs, ultrasound, and Definity microbubbles significantly improved curcumin's anti-tumor effects, particularly under specific conditions: 15 s of continuous ultrasound at 0.12 W/cm2 power density with 0.6 × 107 microbubbles/mL. Furthermore, the study delved into curcumin liposomes' cytotoxic effects using an Annexin V/PI-based apoptosis assay. The treatment with CLs, particularly in conjunction with ultrasound and microbubbles, amplified cell apoptosis, mainly in the late apoptosis stage, which was attributed to heightened cellular uptake within cancer cells.

Encapsulation and release of calcein from herceptin-conjugated eLiposomes

Achieving an optimal therapeutic level is crucial in effectively eradicating cancer cells during treatment. However, conventional chemotherapy-associated systemic administration of anticancer agents leads to many side effects. To achieve the desired control over the target site, active targeting of HER2-positive breast cancer cells can be achieved by conjugating liposomal vesicles with Human Epidermal growth factor Receptor 2 (HER2) and inducing release of the encapsulated drug using ultrasound. To further enhance the delivery efficiency, nanoemulsion droplets exhibiting responsiveness to low-frequency ultrasound are encapsulated within these lipid vesicles. In this study, we prepared four different liposomal formulations, namely pegylated liposomes, emulsion liposomes (eLiposomes), HER-conjugated liposomes, and HER-conjugated eLiposomes, each loaded with calcein and subjected to a thorough characterization process. Their sizes, phospholipid concentration, and amount of antibody conjugation were compared and analyzed. Cryogenic transmission electron microscopy was used to confirm the encapsulation of nanoemulsion droplets within the liposomes. The drug-releasing performance of Herceptin-conjugated eLiposomes was found to surpass that of other liposomal formulations with a notably higher calcein release and established it as a highly effective nanocarrier. The study showcases the efficacy of calcein-loaded and Herceptin-conjugated eLiposomes, which demonstrate rapid and efficient drug release among other liposomal formulations when subjected to ultrasound. This discovery paves the way for a more targeted, efficient, and humane approach to cancer therapy.

Scaffold-based 3D cell culture models in cancer research

Three-dimensional (3D) cell cultures have emerged as valuable tools in cancer research, offering significant advantages over traditional two-dimensional (2D) cell culture systems. In 3D cell cultures, cancer cells are grown in an environment that more closely mimics the 3D architecture and complexity of in vivo tumors. This approach has revolutionized cancer research by providing a more accurate representation of the tumor microenvironment (TME) and enabling the study of tumor behavior and response to therapies in a more physiologically relevant context. One of the key benefits of 3D cell culture in cancer research is the ability to recapitulate the complex interactions between cancer cells and their surrounding stroma. Tumors consist not only of cancer cells but also various other cell types, including stromal cells, immune cells, and blood vessels. These models bridge traditional 2D cell cultures and animal models, offering a cost-effective, scalable, and ethical alternative for preclinical research. As the field advances, 3D cell cultures are poised to play a pivotal role in understanding cancer biology and accelerating the development of effective anticancer therapies. This review article highlights the key advantages of 3D cell cultures, progress in the most common scaffold-based culturing techniques, pertinent literature on their applications in cancer research, and the ongoing challenges.

Nanoparticle-based materials in anticancer drug delivery: Current and future prospects

The past decade has witnessed a breakthrough in novel strategies to treat cancer. One of the most common cancer treatment modalities is chemotherapy which involves administering anti-cancer drugs to the body. However, these drugs can lead to undesirable side effects on healthy cells. To overcome this challenge and improve cancer cell targeting, many novel nanocarriers have been developed to deliver drugs directly to the cancerous cells and minimize effects on the healthy tissues. The majority of the research studies conclude that using drugs encapsulated in nanocarriers is a much safer and more effective alternative than delivering the drug alone in its free form. This review provides a summary of the types of nanocarriers mainly studied for cancer drug delivery, namely: liposomes, polymeric micelles, dendrimers, magnetic nanoparticles, mesoporous nanoparticles, gold nanoparticles, carbon nanotubes and quantum dots. In this review, the synthesis, applications, advantages, disadvantages, and previous studies of these nanomaterials are discussed in detail. Furthermore, the future opportunities and possible challenges of translating these materials into clinical applications are also reported.

Effect of phospholipid head group on ultrasound-triggered drug release and cellular uptake of immunoliposomes

Liposomes are the most successful nanoparticles used to date to load and deliver chemotherapeutic agents to cancer cells. They are nano-sized vesicles made up of phospholipids, and targeting moieties can be added to their surfaces for the active targeting of specific tumors. Furthermore, Ultrasound can be used to trigger the release of the loaded drugs by disturbing their phospholipid bilayer structure. In this study, we have prepared pegylated liposomes using four types of phospholipids with similar saturated hydrocarbon tails including a phospholipid with no head group attached to the phosphate head (DPPA) and three other phospholipids with different head groups attached to their phosphate heads (DPPC, DPPE and DPPG). The prepared liposomes were conjugated to the monoclonal antibody trastuzumab (TRA) to target the human epidermal growth factor receptor 2 (HER2) overexpressed on HER2-positive cancer cells (HER2+). We have compared the response of the different formulations of liposomes when triggered with low-frequency ultrasound (LFUS) and their cellular uptake by the cancer cells. The results showed that the different formulations had similar size, polydispersity, and stability. TRA-conjugated DPPC liposomes showed the highest sensitivity to LFUS. On the other hand, incubating the cancer cells with TRA-conjugated DPPA liposomes triggered with LFUS showed the highest uptake of the loaded calcein by the HER2+ cells.

Recent Breakthroughs in Using Quantum Dots for Cancer Imaging and Drug Delivery Purposes

Cancer is one of the leading causes of death worldwide. Because each person's cancer may be unique, diagnosing and treating cancer is challenging. Advances in nanomedicine have made it possible to detect tumors and quickly investigate tumor cells at a cellular level in contrast to prior diagnostic techniques. Quantum dots (QDs) are functional nanoparticles reported to be useful for diagnosis. QDs are semiconducting tiny nanocrystals, 2-10 nm in diameter, with exceptional and useful optoelectronic properties that can be tailored to sensitively report on their environment. This review highlights these exceptional semiconducting QDs and their properties and synthesis methods when used in cancer diagnostics. The conjugation of reporting or binding molecules to the QD surface is discussed. This review summarizes the most recent advances in using QDs for in vitro imaging, in vivo imaging, and targeted drug delivery platforms in cancer applications.

Transferrin-Targeted Liposomes in Glioblastoma Therapy: A Review

Glioblastoma (GBM) is a highly aggressive brain tumor, and its treatment is further complicated by the high selectivity of the blood-brain barrier (BBB). The scientific community is urgently seeking innovative and effective therapeutic solutions. Liposomes are a promising new tool that has shown potential in addressing the limitations of chemotherapy, such as poor bioavailability and toxicity to healthy cells. However, passive targeting strategies based solely on the physicochemical properties of liposomes have proven ineffective due to a lack of tissue specificity. Accordingly, the upregulation of transferrin receptors (TfRs) in brain tissue has led to the development of TfR-targeted anticancer therapeutics. Currently, one of the most widely adopted methods for improving drug delivery in the treatment of GBM and other neurological disorders is the utilization of active targeting strategies that specifically target this receptor. In this review, we discuss the role of Tf-conjugated liposomes in GBM therapy and present some recent studies investigating the drug delivery efficiency of Tf-liposomes; in addition, we address some challenges currently facing this approach to treatment and present some potential improvement possibilities.

Liposomes for the Treatment of Brain Cancer-A Review

Due to their biocompatibility, non-toxicity, and surface-conjugation capabilities, liposomes are effective nanocarriers that can encapsulate chemotherapeutic drugs and facilitate targeted delivery across the blood-brain barrier (BBB). Additionally, strategies have been explored to synthesize liposomes that respond to internal and/or external stimuli to release their payload controllably. Although research into liposomes for brain cancer treatment is still in its infancy, these systems have great potential to fundamentally change the drug delivery landscape. This review paper attempts to consolidate relevant literature regarding the delivery to the brain using nanocarriers, particularly liposomes. The paper first briefly explains conventional treatment modalities for cancer, followed by describing the blood-brain barrier and ways, challenges, and techniques involved in transporting drugs across the BBB. Various nanocarrier systems are introduced, with attention to liposomes, due to their ability to circumvent the challenges imposed by the BBB. Relevant studies involving liposomal systems researched to treat brain tumors are reviewed in vitro, in vivo, and clinical studies. Finally, the challenges associated with the use of liposomes to treat brain tumors and how they can be addressed are presented.

A Review on Membrane Fouling Prediction Using Artificial Neural Networks (ANNs)

Membrane fouling is a major hurdle to effective pressure-driven membrane processes, such as microfiltration (MF), ultrafiltration (UF), nanofiltration (NF), and reverse osmosis (RO). Fouling refers to the accumulation of particles, organic and inorganic matter, and microbial cells on the membrane's external and internal surface, which reduces the permeate flux and increases the needed transmembrane pressure. Various factors affect membrane fouling, including feed water quality, membrane characteristics, operating conditions, and cleaning protocols. Several models have been developed to predict membrane fouling in pressure-driven processes. These models can be divided into traditional empirical, mechanistic, and artificial intelligence (AI)-based models. Artificial neural networks (ANNs) are powerful tools for nonlinear mapping and prediction, and they can capture complex relationships between input and output variables. In membrane fouling prediction, ANNs can be trained using historical data to predict the fouling rate or other fouling-related parameters based on the process parameters. This review addresses the pertinent literature about using ANNs for membrane fouling prediction. Specifically, complementing other existing reviews that focus on mathematical models or broad AI-based simulations, the present review focuses on the use of AI-based fouling prediction models, namely, artificial neural networks (ANNs) and their derivatives, to provide deeper insights into the strengths, weaknesses, potential, and areas of improvement associated with such models for membrane fouling prediction.

Acoustically-Activated Liposomal Nanocarriers to Mitigate the Side Effects of Conventional Chemotherapy with a Focus on Emulsion-Liposomes

To improve currently available cancer treatments, nanomaterials are employed as smart drug delivery vehicles that can be engineered to locally target cancer cells and respond to stimuli. Nanocarriers can entrap chemotherapeutic drugs and deliver them to the diseased site, reducing the side effects associated with the systemic administration of conventional anticancer drugs. Upon accumulation in the tumor cells, the nanocarriers need to be potentiated to release their therapeutic cargo. Stimulation can be through endogenous or exogenous modalities, such as temperature, electromagnetic irradiation, ultrasound (US), pH, or enzymes. This review discusses the acoustic stimulation of different sonosensitive liposomal formulations. Emulsion liposomes, or eLiposomes, are liposomes encapsulating phase-changing nanoemulsion droplets, which promote acoustic droplet vaporization (ADV) upon sonication. This gives eLiposomes the advantage of delivering the encapsulated drug at low intensities and short exposure times relative to liposomes. Other formulations integrating microbubbles and nanobubbles are also discussed.

Comprehensive Study of a Diabetes Mellitus Mathematical Model Using Numerical Methods with Stability and Parametric Analysis

Diabetes is sweeping the world as a silent epidemic, posing a growing threat to public health. Modeling diabetes is an effective method to monitor the increasing prevalence of diabetes and develop cost-effective strategies that control the incidence of diabetes and its complications. This paper focuses on a mathematical model known as the diabetes complication (DC) model. The DC model is analyzed using different numerical methods to monitor the diabetic population over time. This is by analyzing the model using five different numerical methods. Furthermore, the effect of the time step size and the various parameters affecting the diabetic situation is examined. The DC model is dependent on some parameters whose values play a vital role in the convergence of the model. Thus, parametric analysis was implemented and later discussed in this paper. Essentially, the Runge-Kutta (RK) method provides the highest accuracy. Moreover, Adam-Moulton's method also provides good results. Ultimately, a comprehensive understanding of the development of diabetes complications after diagnosis is provided in this paper. The results can be used to understand how to improve the overall public health of a country, as governments ought to develop effective strategic initiatives for the screening and treatment of diabetes.

A Review on Membrane Biofouling: Prediction, Characterization, and Mitigation

Water scarcity is an increasing problem on every continent, which instigated the search for novel ways to provide clean water suitable for human use; one such way is desalination. Desalination refers to the process of purifying salts and contaminants to produce water suitable for domestic and industrial applications. Due to the high costs and energy consumption associated with some desalination techniques, membrane-based technologies have emerged as a promising alternative water treatment, due to their high energy efficiency, operational simplicity, and lower cost. However, membrane fouling is a major challenge to membrane-based separation as it has detrimental effects on the membrane's performance and integrity. Based on the type of accumulated foulants, fouling can be classified into particulate, organic, inorganic, and biofouling. Biofouling is considered the most problematic among the four fouling categories. Therefore, proper characterization and prediction of biofouling are essential for creating efficient control and mitigation strategies to minimize the damage associated with biofouling. Moreover, the use of artificial intelligence (AI) in predicting membrane fouling has garnered a great deal of attention due to its adaptive capability and prediction accuracy. This paper presents an overview of the membrane biofouling mechanisms, characterization techniques, and predictive methods with a focus on AI-based techniques, and mitigation strategies.

Ultrasound-sensitive cRGD-modified liposomes as a novel drug delivery system

Targeted liposomes enable the delivery of encapsulated chemotherapeutics to tumours by targeting specific receptors overexpressed on the surfaces of cancer cells; this helps in reducing the systemic side effects associated with the cytotoxic agents. Upon reaching the targeted site, these liposomes can be triggered to release their payloads using internal or external triggers. In this study, we investigate the use of low-frequency ultrasound as an external modality to trigger the release of a model drug (calcein) from non-targeted and targeted pegylated liposomes modified with cyclic arginine-glycine-aspartate (cRGD). Liposomes were exposed to sonication at 20-kHz using three different power densities (6.2, 9, and 10 mW/cm²). Our results showed that increasing the power density increased calcein release from the sonicated liposomes. Moreover, cRGD conjugation to the surface of the liposomes rendered cRGD-liposomes more susceptible to ultrasound compared to the non-targeted liposomes. cRGD conjugation was also found to increase cellular uptake of calcein by human colorectal carcinoma (HCT116) cells which were further enhanced following sonicating the cells with low-frequency ultrasound (LFUS).

Gold-Nanoparticle Hybrid Nanostructures for Multimodal Cancer Therapy

With the urgent need for bio-nanomaterials to improve the currently available cancer treatments, gold nanoparticle (GNP) hybrid nanostructures are rapidly rising as promising multimodal candidates for cancer therapy. Gold nanoparticles (GNPs) have been hybridized with several nanocarriers, including liposomes and polymers, to achieve chemotherapy, photothermal therapy, radiotherapy, and imaging using a single composite. The GNP nanohybrids used for targeted chemotherapy can be designed to respond to external stimuli such as heat or internal stimuli such as intratumoral pH. Despite their promise for multimodal cancer therapy, there are currently no reviews summarizing the current status of GNP nanohybrid use for cancer theragnostics. Therefore, this review fulfills this gap in the literature by providing a critical analysis of the data available on the use of GNP nanohybrids for cancer treatment with a specific focus on synergistic approaches (i.e., triggered drug release, photothermal therapy, and radiotherapy). It also highlights some of the challenges that hinder the clinical translation of GNP hybrid nanostructures from bench to bedside. Future studies that could expedite the clinical progress of GNPs, as well as the future possibility of improving GNP nanohybrids for cancer theragnostics, are also summarized.

Redox-Responsive Drug Delivery Systems: A Chemical Perspective

With the widespread global impact of cancer on humans and the extensive side effects associated with current cancer treatments, a novel, effective, and safe treatment is needed. Redox-responsive drug delivery systems (DDSs) have emerged as a potential cancer treatment with minimal side effects and enhanced site-specific targeted delivery. This paper explores the physiological and biochemical nature of tumors that allow for redox-responsive drug delivery systems and reviews recent advances in the chemical composition and design of such systems. The five main redox-responsive chemical entities that are the focus of this paper are disulfide bonds, diselenide bonds, succinimide-thioether linkages, tetrasulfide bonds, and platin conjugates. Moreover, as disulfide bonds are the most commonly used entities, the review explored disulfide-containing liposomes, polymeric micelles, and nanogels. While various systems have been devised, further research is needed to advance redox-responsive drug delivery systems for cancer treatment clinical applications.

Ultrasound Triggering of Liposomal Nanodrugs for Cancer Therapy: A Review

Efficient conventional chemotherapy is limited by its nonspecific nature, which causes severe systemic toxicity that can lead to patient discomfort and low therapeutic efficacy. The emergence of smart drug delivery systems (SDDSs) utilizing nanoparticles as drug nanocarriers has shown great potential in enhancing the targetability of anticancer agents and limiting their side effects. Liposomes are among the most investigated nanoplatforms due to their promising capabilities of encapsulating hydrophilic, lipophilic, and amphiphilic drugs, biocompatibility, physicochemical and biophysical properties. Liposomal nanodrug systems have demonstrated the ability to alter drugs' biodistribution by sufficiently delivering the entrapped chemotherapeutics at the targeted diseased sites, sparing normal cells from undesired cytotoxic effects. Combining liposomal treatments with ultrasound, as an external drug release triggering modality, has been proven effective in spatially and temporally controlling and stimulating drug release. Therefore, this paper reviews recent literature pertaining to the therapeutic synergy of triggering nanodrugs from liposomes using ultrasound. It also highlights the effects of multiple physical and chemical factors on liposomes' sonosensetivity, several ultrasound-induced drug release mechanisms, and the efficacy of ultrasound-responsive liposomal systems in cancer therapy. Overall, liposomal nanodrug systems triggered by ultrasound are promising cancer therapy platforms that can potentially alleviate the detriments of conventional cancer treatments.

The Kinetics of Calcein Release from Mixed Targeted Liposomes Using Ultrasound

Site-specific delivery of chemotherapeutics using actively targeted-stimuli-responsive liposomes is a promising approach to enhance the therapeutic efficiency of anti-cancer drugs while reducing the associated undesirable side effects. Recently, the co-functionalization of liposomes has shown interesting results in enhancing cellular uptake; however, such systems suffer from stability issues. This study proposes mixing calcein-loaded liposomes decorated with different ligands, namely estrone and Herceptin, to treat breast cancer. We investigated the low-frequency ultrasound-mediated release of calcein from the synthesized liposomes (control, estrone-modified, Herceptin-modified, and mixed estrone and Herceptin liposomes at different volume fractions). The results showed that the release increased as the power density increased and that estrone-conjugated liposomes achieved the highest release under all test conditions.

In Vitro Evaluation of Ultrasound Effectiveness in Controlling Doxorubicin Release from Albumin-Conjugated Liposomes

Functionalized liposomes are among the most promising antineoplastic agents delivery vehicles. Contemporaneous to their accretion at the tumor site, they need to be potentiated to release their cargo using a suitable triggering modality. In this work, targeted Doxorubicin (DOX)-loaded stealth liposomes were synthesized and functionalized with Human Serum Albumin (HSA) to target the overexpressed HSA receptors (HSA-Rs). The effects of low-frequency ultrasound (LFUS) in inducing DOX release from the synthesized liposomes were investigated In Vitro. DOX release increased with the increasing power density of ultrasound. HSA conjugation to the liposomes increased their sensitivity to LFUS. Furthermore, HSA conjugation also enhanced the liposome’s cytotoxic activity and uptake by the cancer cells overexpressing HSA-Rs. This cytotoxic activity and cellular uptake were further enhanced by triggering drug release from those targeted liposomes using LFUS. Combining HSA-targeted liposomes with LFUS is a promising approach in drug delivery.

Effect of High-Frequency Ultrasound on Targeted Liposomes

Delivering highly toxic drugs inside a safe carrier to tumors while achieving controlled and effective drug release at the targeted sites represents an attractive approach to enhance drug efficiency while reducing its undesirable side effects. Functionalization of highly biocompatible nanocarriers such as liposomes conjugated with targeting moieties enhances their ability to target specific cancer cells overexpressing the targeted receptors. Furthermore, upon their accumulation at the target site, high-frequency ultrasound (HFUS) can be used to stimulate the controlled release of the loaded drugs. Here, the US-mediated drug release from calcein-loaded non-pegylated, pegylated as well as targeted-pegylated liposomes modified with human serum albumin (HSA) and transferrin (Tf) was investigated. HFUS at two different frequencies (1 MHz and 3 MHz) was found to trigger calcein release, with higher release rates recorded at the lower frequency (i.e., 1 MHz) compared to the higher frequency (i.e., 3 MHz) despite a higher power density. Pegylation was found to enhance liposomal sensitivity to HFUS. In addition, targeted pegylated liposomes were more susceptible to HFUS than non-targeted pegylated (control) liposomes. These findings show that pegylation and targeting moieties directly influence liposomal sensitivity to HFUS. Therefore, combining targeted-pegylated liposomes with HFUS represents a promising controlled and effective drug delivery system.

Combined and Single Doxorubicin/Naproxen Drug Loading and Dual-Responsive pH/Ultrasound Release from Flexible Metal-Organic Framework Nanocarriers

In this study, the flexible aluminum-based MIL-53(Al) metal-organic framework was loaded with doxorubicin (DOX) and naproxen (NAP) and was examined as a promising pH/ultrasound dual-responsive drug delivery system. The two drugs were encapsulated in MIL-53(Al) individually to produce the DOX@MIL-53(Al) and NAP@MIL-53(Al) nanocarriers. They were also encapsulated as a dual-drug formulation to produce the DOX* + NAP*@MIL-53(Al) nanocarrier. The MOF nanoparticles were characterized using the Scanning Electron Microscopy (SEM), X-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), and Dynamic Light Scattering (DLS) techniques. In the case of the DOX@MIL, the nanocarriers’ drug Encapsulation Efficiency (EE) and Encapsulation Capacity (EC) were 92% and 16 wt.%, respectively, whereas, in the case of NAP@MIL-53(Al), the average NAP EE and EC were around 97.7% and 8.5 wt.%, respectively. On the other hand, in the DOX* + NAP*@MIL-53(Al) nanoparticles, the average DOX* EE and EC were 38.9% and 6.22 wt.%, respectively, while for NAP*, the average EE and EC were 70.2% and 4.49 wt.%, respectively. In vitro release experiments demonstrated the good pH and Ultrasound (US) dual-responsiveness of these nanocarriers, with a maximum US-triggered DOX and NAP release, at a pH level of 7.4, of approximately 53% and 95%, respectively. In comparison, the measured release was around 90% and 36% at pH 5.3 for DOX and NAP, respectively. In the case of the dualdrug formulation, the nanocarrier displayed similar pH/US dual-responsive behavior. Finally, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) results confirmed the biocompatibility and low cytotoxicity of MIL-53(Al) at concentrations up to 1000 μg/ml.

pH-Responsive Nanocarriers in Cancer Therapy

A number of promising nano-sized particles (nanoparticles) have been developed to conquer the limitations of conventional chemotherapy. One of the most promising methods is stimuli-responsive nanoparticles because they enable the safe delivery of the drugs while controlling their release at the tumor sites. Different intrinsic and extrinsic stimuli can be used to trigger drug release such as temperature, redox, ultrasound, magnetic field, and pH. The intracellular pH of solid tumors is maintained below the extracellular pH. Thus, pH-sensitive nanoparticles are highly efficient in delivering drugs to tumors compared to conventional nanoparticles. This review provides a survey of the different strategies used to develop pH-sensitive nanoparticles used in cancer therapy.

Thermosensitive Polymers and Thermo-Responsive Liposomal Drug Delivery Systems

Temperature excursions within a biological milieu can be effectively used to induce drug release from thermosensitive drug-encapsulating nanoparticles. Oncological hyperthermia is of particular interest, as it is proven to synergistically act to arrest tumor growth when combined with optimally-designed smart drug delivery systems (DDSs). Thermoresponsive DDSs aid in making the drugs more bioavailable, enhance the therapeutic index and pharmacokinetic trends, and provide the spatial placement and temporal delivery of the drug into localized anatomical sites. This paper reviews the fundamentals of thermosensitive polymers, with a particular focus on thermoresponsive liposomal-based drug delivery systems.

Encapsulation, Release, and Cytotoxicity of Doxorubicin Loaded in Liposomes, Micelles, and Metal-Organic Frameworks: A Review

Doxorubicin (DOX) is one of the most widely used anthracycline anticancer drugs due to its high efficacy and evident antitumoral activity on several cancer types. However, its effective utilization is hindered by the adverse side effects associated with its administration, the detriment to the patients’ quality of life, and general toxicity to healthy fast-dividing cells. Thus, delivering DOX to the tumor site encapsulated inside nanocarrier-based systems is an area of research that has garnered colossal interest in targeted medicine. Nanoparticles can be used as vehicles for the localized delivery and release of DOX, decreasing the effects on neighboring healthy cells and providing more control over the drug’s release and distribution. This review presents an overview of DOX-based nanocarrier delivery systems, covering loading methods, release rate, and the cytotoxicity of liposomal, micellar, and metal organic frameworks (MOFs) platforms.

Biomedical Applications of Metal-Organic Frameworks for Disease Diagnosis and Drug Delivery: A Review

Metal-organic frameworks (MOFs) are a novel class of porous hybrid organic-inorganic materials that have attracted increasing attention over the past decade. MOFs can be used in chemical engineering, materials science, and chemistry applications. Recently, these structures have been thoroughly studied as promising platforms for biomedical applications. Due to their unique physical and chemical properties, they are regarded as promising candidates for disease diagnosis and drug delivery. Their well-defined structure, high porosity, tunable frameworks, wide range of pore shapes, ultrahigh surface area, relatively low toxicity, and easy chemical functionalization have made them the focus of extensive research. This review highlights the up-to-date progress of MOFs as potential platforms for disease diagnosis and drug delivery for a wide range of diseases such as cancer, diabetes, neurological disorders, and ocular diseases. A brief description of the synthesis methods of MOFs is first presented. Various examples of MOF-based sensors and DDSs are introduced for the different diseases. Finally, the challenges and perspectives are discussed to provide context for the future development of MOFs as efficient platforms for disease diagnosis and drug delivery systems.

Ultrasound-Mediated Cancer Therapeutics Delivery using Micelles and Liposomes: A Review

BACKGROUND

Existing cancer treatment methods have many undesirable side effects that greatly reduce the quality of life of cancer patients.

OBJECTIVE

This review will focus on the use of ultrasound-responsive liposomes and polymeric micelles in cancer therapy.

METHODS

This review presents a survey of the literature regarding ultrasound-triggered micelles and liposomes using articles recently published in various journals, as well as some new patents in this field.

RESULTS

Nanoparticles have proven promising as cancer theranostic tools. Nanoparticles are selective in nature, have reduced toxicity, and controllable drug release patterns making them ideal carriers for anticancer drugs. Numerous nanocarriers have been designed to combat malignancies, including liposomes, micelles, dendrimers, solid nanoparticles, quantum dots, gold nanoparticles, and, more recently, metal-organic frameworks. The temporal and spatial release of therapeutic agents from these nanostructures can be controlled using internal and external triggers, including pH, enzymes, redox, temperature, magnetic and electromagnetic waves, and ultrasound. Ultrasound is an attractive modality because it is non-invasive, can be focused on the diseased site, and has a synergistic effect with anticancer drugs.

CONCLUSION

The functionalization of micellar and liposomal surfaces with targeting moieties and the use of ultrasound as a triggering mechanism can help improve the selectivity and enable the spatiotemporal control of drug release from nanocarriers.

Modeling the Effects of Chemotherapy and Immunotherapy on Tumor Growth

Mathematical modeling has been used to simulate the interaction of chemotherapy and immunotherapy drugs intervention with the dynamics of tumor cells growth. This work studies the interaction of cells in the immune system, such as the natural killer, dendritic, and cytotoxic CD8+ T cells, with chemotherapy. Four different cases were considered in the simulation: no drug intervention, independent interventions (either chemotherapy or immunotherapy), and combined interventions of chemotherapy and immunotherapy. The system of ordinary differential equations was initially solved using the Runge-Kutta method and compared with two additional methods: the Explicit Euler and Heun's methods. Results showed that the combined intervention is more effective compared to the other cases. In addition, when compared with Runge-Kutta, the Heun's method presented a better accuracy than the Explicit Euler technique. The proposed mathematical model can be used as a tool to improve cancer treatments and targeted therapy.

Modeling of Anti-cancer Drug Release Kinetics from Liposomes and Micelles: A review

Nanocarriers, such as liposomes and micelles, were developed to enhance the delivery of therapeutic drugs to malignant tissues. Internal or external stimuli can be applied to achieve spatiotemporal controlled release from these carriers. This will result in enhancing their therapeutic efficacy while reducing toxicity. Mathematical modeling is used to simulate drug release from nanocarriers; this will facilitate and optimize the development and design of desirable nanocarriers in a systematic manner, rather than a trial-and-error approach. This review summarizes nine mathematical models often used to simulate drug release from nanocarriers and reviews studies which employed these models to simulate drug release from conventional as well as temperature-, pH-, and ultrasound-triggered micelles and liposomes.

Dual-Targeting and Stimuli-Triggered Liposomal Drug Delivery in Cancer Treatment

The delivery of chemotherapeutics to solid tumors using smart drug delivery systems (SDDSs) takes advantage of the unique physiology of tumors (i.e., disordered structure, leaky vasculature, abnormal extracellular matrix (ECM), and limited lymphatic drainage) to deliver anticancer drugs with reduced systemic side effects. Liposomes are the most promising of such SDDSs and have been well investigated for cancer therapy. To improve the specificity, bioavailability, and anticancer efficacy of liposomes at the diseased sites, other strategies such as targeting ligands and stimulus-sensitive liposomes have been developed. This review highlights relevant surface functionalization techniques and stimuli-mediated drug release for enhanced delivery of anticancer agents at tumor sites, with a special focus on dual functionalization and design of multistimuli responsive liposomes.

Identification of Novel MicroRNAs Targeting SARS-CoV-2 through the Regulation of TMPRSS2/PI3K/AKT/PTEN Alignment in Lung Cancer: An in Silico Analysis

In this study, we investigated the interactions between SARS-CoV-2 and miRNAs associated with lung cancer using bioinformatic approaches. A special focus was placed on TMPRSS2 and lung cancer progression pathways involving AKT/PI3K/PTEN genes.

Transferrin-modified liposomes triggered with ultrasound to treat HeLa cells

Targeted liposomes are designed to target specific receptors overexpressed on the surfaces of cancer cells. This technique ensures site-specific drug delivery to reduce undesirable side effects while enhancing the efficiency of the encapsulated therapeutics. Upon reaching the tumor site, these liposomes can be triggered to release their content in a controlled manner using ultrasound (US). In this study, drug release from pegylated calcein-loaded liposomes modified with transferrin (Tf) and triggered with US was evaluated. Low-frequency ultrasound at 20-kHz using three different power densities (6.2 mW/cm2, 9 mW/cm2 and 10 mW/cm2) was found to increase calcein release. In addition, transferrin-conjugated pegylated liposomes (Tf-PEG liposomes) were found to be more sonosensitive compared to the non-targeted (control) liposomes. Calcein uptake by HeLa cells was found to be significantly higher with the Tf-PEG liposomes compared to the non-targeted control liposomes. This uptake was further enhanced following the exposure to low-frequency ultrasound (at 35 kHz). These findings show that targeted liposomes triggered with US have promising potential as a safe and effective drug delivery platform.

Ultrasound-Responsive Nanocarriers in Cancer Treatment: A Review

The safe and effective delivery of anticancer agents to diseased tissues is one of the significant challenges in cancer therapy. Conventional anticancer agents are generally cytotoxins with poor pharmacokinetics and bioavailability. Nanocarriers are nanosized particles designed for the selectivity of anticancer drugs and gene transport to tumors. They are small enough to extravasate into solid tumors, where they slowly release their therapeutic load by passive leakage or biodegradation. Using smart nanocarriers, the rate of release of the entrapped therapeutic(s) can be increased, and greater exposure of the tumor cells to the therapeutics can be achieved when the nanocarriers are exposed to certain internally (enzymes, pH, and temperature) or externally (light, magnetic field, and ultrasound) applied stimuli that trigger the release of their load in a safe and controlled manner, spatially and temporally. This review gives a comprehensive overview of recent research findings on the different types of stimuli-responsive nanocarriers and their application in cancer treatment with a particular focus on ultrasound.

Ultrasound-triggered herceptin liposomes for breast cancer therapy

The functionalization of liposomes with monoclonal antibodies is a potential strategy to increase the specificity of liposomes and reduce the side-effects associated with chemotherapeutic agents. The active targeting of the Human Epidermal growth factor Receptor 2 (HER2), which is overexpressed in HER2 positive breast cancer cells, can be achieved by coating liposomes with an anti-HER2 monoclonal antibody. In this study, we synthesized calcein and Doxorubicin-loaded immunoliposomes functionalized with the monoclonal antibody Trastuzumab (TRA). Both liposomes were characterized for their size, phospholipid content and antibody conjugation. Exposing the liposomes to low-frequency ultrasound (LFUS) triggered drug release which increased with the increase in power density. Trastuzumab conjugation resulted in enhancing the sensitivity of the liposomes to LFUS. Compared to the control liposomes, TRA-liposomes showed higher cellular toxicity and higher drug uptake by the HER2 + cell line (SKBR3) which was further improved following sonication with LFUS. Combining immunoliposomes with LFUS is a promising technique in the field of targeted drug delivery that can enhance efficiency and reduce the cytotoxicity of antineoplastic drugs.

Targeting Breast Cancer Using Hyaluronic Acid-Conjugated Liposomes Triggered with Ultrasound

The successful targeting of tumors can be achieved by conjugating targeting moieties to nanoparticles. These modifications allow nannocarriers to achieve greater targeting specificity through binding to specific receptors overexpressed on the surface of the tumor cells. In this study, pegylated liposomes encapsulating the model drug/dye calcein and conjugated to hyaluronic acid (HA) molecules were successfully synthesized, and their ability to target HA receptors overexpressed on a breast cancer cell line was investigated in vitro. Low-frequency ultrasound (LFUS), applied at three different power densities (6.2, 9, and 10 mW/cm²) were used to trigger the release of the entrapped calcein. Both the control and HAconjugated liposomes showed similar release profiles. HA conjugation to the liposomes resulted in a significant increase in calcein uptake by the breast cancer cell line MDA-MB-231 known for its CD44 (HA receptor) overexpression, while such an effect was not recorded with NIH-3T3, an embryonic mouse fibroblast, with low levels of CD44 expression. The application of low LFUS showed a significant enhancement of calcein uptake by MDA-MB-231 cells from our liposome compared to calcein uptake without cell exposure to ultrasound. These findings suggest that combining HA-conjugated liposomes with ultrasound is a promising drug delivery platform in breast cancer treatment.

Ultrasound-triggered immunotherapy for cancer treatment: An update

Over the past few decades, immunotherapy has emerged as a promising therapeutic approach to treat some types of cancer. Moreover, antibody-based cancer therapies can trigger apoptosis and cell growth inhibition to induce immune cell destruction of target cells through antibody-dependent cellular cytotoxicity (ADCC). Nevertheless, immunotherapeutic efficiency is often restricted to either deficient delivery or low accumulation of therapeutic molecules at the tumor site. Therefore, exposing immunoliposomes to ultrasound can effectively improve drug accessibility by enhancing cell membrane permeability and drug release. This review summarizes existing traditional cancer treatments and their limitations, emphasizing the recent advancements in ultrasound-triggered immunotherapy.

Identification of Novel MicroRNAs as Promising Therapeutics for SARS-CoV-2 by Regulating the EGFR-ADAM17 Axis: An In Silico Analysis

Cancer patients contracting SARS-CoV-2 encounter additional challenges due to inflammatory bursts and lymphopenia, which may aggravate breast cancer prognosis. In this in silico analysis, we identified the potential of miRNAs as new therapeutic targets to treat breast cancer patients infected with COVID-19 via the regulation of ADAM17 and EGFR expression microRNAs.

Recent Advances in Metal-Organic Frameworks as Anticancer Drug Delivery Systems: A Review

BACKGROUND

Metal-organic frameworks (MOFs), as attractive hybrid crystalline porous materials, are increasingly being investigated in biomedical applications owing to their exceptional properties, including high porosity, ultrahigh surface areas, tailorable composition and structure, and tunability and surface functionality. Of interest in this review is the design and development of MOFbased drug delivery systems (DDSs) that have excellent biocompatibility, good stability under physiological conditions, high drug loading capacity, and controlled/targeted drug release.

OBJECTIVE

This review highlights the latest advances in MOFs as anticancer drug delivery systems (DDSs) along with insights on their design, fabrication, and performance under different stimuli that are either internal or external. The synthesis methods of MOFs, along with their advantages and disadvantages, are briefly discussed. The emergence of multifunctional MOF-based theranostic platforms is also discussed. Finally, the future challenges facing the developments of MOFs in the field of drug delivery are discussed.

METHODS

The review was prepared by carrying out a comprehensive literature survey using relevant work published in various scientific databases.

RESULTS

Novel MOFs in biomedical applications, especially in drug delivery, have shown great potentials. MOF-based DDSs can be classified into normal (non-controllable) DDSs, stimuli-responsive DDSs, and theranostic platforms. The normal DDSs are pristine MOFs loaded with MOFs and offer little to no control over the drug delivery. Stimuli-responsive DDSs offer better spatiotemporal control over the drug release by responding to either endogenous (pH, redox, ions, ATP) or exogenous stimuli (light, magnetism, US, pressure, temperature). The theranostic platforms combine stimuli-responsive drug delivery with diagnostic imaging functionality, paving the road for imaging-guided drug delivery.

CONCLUSION

This review presented a summary of the various methods utilized in MOF synthesis along with the advantages and disadvantages of each method. Furthermore, the review highlighted and discussed the latest developments in the field of MOF-based DDSs and theranostic platforms. The review is focused on the characteristics of MOF-based DDSs, the encapsulation of different anticancer drugs as well as their stimuli-responsive release.

Ultrasound-Mediated Drug Delivery in Cancer Therapy: A Review

The use of ultrasound as a medical diagnostic tool began in the 1940s. Ever since, the medical applications of ultrasound have included imaging, tumor ablation, and lithotripsy; however, an ever-increasing body of literature demonstrates that ultrasound has potential in other medical applications, including targeted drug delivery. Site-specific drug delivery involves delivering drugs to diseased areas with a high degree of precision, which is particularly advantageous in cancer treatment as it would minimize the adverse side effects experienced by patients. This review addresses the ability of ultrasound to induce localized and controlled drug release from nanocarriers, namely micelles and liposomes, utilizing thermal and/or mechanical effects. The interactions of ultrasound with micelles and liposomes, the effects of the lipid composition, and ultrasound parameters on the release of encapsulated drugs are discussed. In addition, a survey of the literature detailing some in vitro and in vivo ultrasound triggered drug delivery systems is presented.

Facile Ultrasound-Triggered Release of Calcein and Doxorubicin from Iron-Based Metal-Organic Frameworks

Metal-organic frameworks (MOFs) are promising new nanocarriers with potential use in anticancer drug delivery. However, there is a scarcity of studies on the uptake and release of guest molecules associated with MOF nanovehicles, and their mechanism is poorly understood. In this work, newly developed iron-based MOFs, namely Fe-NDC nanorods, were investigated as potential nanocarriers for calcein (as a model drug/dye) and Doxorubicin (a chemotherapeutic drug (DOX)). Calcein was successfully loaded by equilibrating its solution with the MOFs nanoparticles under constant stirring. The calcein average encapsulation efficiency achieved was 43.13%, with a corresponding capacity of 17.74 wt.%. In-vitro calcein release was then carried out at 37°C in phosphate buffer saline (PBS) using ultrasound (US) as an external trigger. MOFs released an average of 17.8% (without US), whereas they released up to 95.2% of their contents when 40-kHz US at ~1 W/cm² was applied for 10 min. The Cytotoxic drug DOX was also encapsulated in Fe-NDC, and its In-vitro release profile was determined under the same conditions. DOX encapsulation efficiency and capacity were found to be 16.10% and 13.37 wt.%, respectively. In-vitro release experiments demonstrated significant release, reaching 80% in 245 minutes, under acoustic irradiation, compared to around 6% in the absence of US. Additionally, experimental results showed that Fe-NDC nanoparticles are biocompatible even at relatively high concentrations, with an MCF-7 IC₅₀ of 1022 g/ml. Our work provides a promising platform for anticancer drug delivery by utilizing biocompatible Fe-NDC nanoparticles and US as an external trigger mechanism.

Multi-Model Investigation and Adaptive Estimation of the Acoustic Release of a Model Drug From Liposomes

This paper researches a suitable mathematical model that can reliably predict the release of a model drug (namely calcein) from biologically targeted liposomal nanocarriers triggered by ultrasound. Using mathematical models, curve fitting is performed on a set of five experimental acoustic drug release runs from Albumin-, Estrone-, and RGD-based Drug Delivery Systems (DDS). The three moieties were chosen to target specific cancers using receptor-mediated endocytosis. The best-fitting mathematical model is then enhanced using a Kalman filtering (KF) algorithm to account for the statistics of the dynamic and measurements noise sequences in predicted drug release. Unbiased drug-release estimates are realized by implementing an online noise identification algorithm. The algorithm is first deployed in a simulated environment in which it was rigorously tested and compared with the correct solution. Then, the algorithm was used to process the five experimental datasets. The results suggest that the Adaptive Kalman Filter (AKF) is exceptionally good at handling drug release estimation problems with a priori unknown or with changing noise covariances. In comparison with the KF, the AKF approach exhibited as low as a 69% reduction in the level of error in estimating the drug release state. Finally, the proposed algorithm is not computationally demanding and is capable of online estimation tasks.

Factors Affecting the Acoustic In Vitro Release of Calcein from PEGylated Liposomes

Typical methods used in cancer treatment, including chemotherapy, are debilitating because of the various adverse side effects experienced by cancer patients. The free drug injected into the patient at given doses affects both healthy and cancerous cells. Therefore, novel methods are being researched to ensure the selectivity of the treatment. The purpose of this study is to test the release of a model fluorescent drug, calcein, from echogenic stealth liposomes, triggered by lowfrequency pulsed ultrasound. Several experimental parameters related to the ultrasound (US) and the investigated liposomes were varied in order to examine their effect on the acoustic release. Upon analysis of experimental results, the study concluded that release can be maximized by optimizing the sonication frequency, power density, and US pulse duration. When a non-isothermal chamber is used to conduct the experiments, it is important to have longer 'Off' than 'On' US periods in order to avoid overheating the liposomes. Applying such pulsation pattern can also be utilized to achieve slower release rates, which safely meet the desired drug levels at the end of the session. Our study also concluded that optimizing the liposome concentration is vital to delivering desired drug doses. Additionally, the type of lipids used in the synthesis should be carefully selected to produce stable yet acoustically sensitive liposomes capable of releasing at desired rates.

Factors affecting sedimentational separation of bacteria from blood

Rapid diagnosis of blood infections requires fast and efficient separation of bacteria from blood. We have developed spinning hollow disks that separate bacteria from blood cells via the differences in sedimentation velocities of these particles. Factors affecting separation included the spinning speed and duration, and disk size. These factors were varied in dozens of experiments for which the volume of separated plasma, and the concentration of bacteria and red blood cells (RBCs) in separated plasma were measured. Data were correlated by a parameter of characteristic sedimentation length, which is the distance that an idealized RBC would travel during the entire spin. Results show that characteristic sedimentation length of 20 to 25 mm produces an optimal separation and collection of bacteria in plasma. This corresponds to spinning a 12-cm-diameter disk at 3,000 rpm for 13 s. Following the spin, a careful deceleration preserves the separation of cells from plasma and provides a bacterial recovery of about 61 ± 5%.

Effect of Pegylation and Targeting Moieties on the Ultrasound-Mediated Drug Release from Liposomes

The use of targeted liposomes encapsulating chemotherapy drugs enhances the specific targeting of cancer cells, thus reducing the side effects of these drugs and providing patient-friendly chemotherapy treatment. Targeted pegylated (stealth) liposomes have the ability to safely deliver their loaded drugs to the cancer cells by targeting specific receptors overly expressed on the surface of these cells. Applying ultrasound as an external stimulus will safely trigger drug release from these liposomes in a controlled manner. In this study, we investigated the release kinetics of the model drug "calcein" from targeted liposomes sonicated with low-frequency ultrasound (20 kHz). Our results showed that pegylated liposomes were more sonosensitive compared to nonpegylated liposomes. A comparison of the effect of three targeting moieties conjugated to the surface of pegylated liposomes, namely human serum albumin (HSA), transferrin (Tf) and arginylglycylaspartic acid (RGD), on calcein release kinetics was conducted. The fluorescent results showed that HSA-PEG and Tf-PEG liposomes were more sonosensitive (showing higher calcein release following the exposure to pulsed LFUS) compared to the control pegylated liposomes, thus adding more acoustic benefits to their targeting efficacy.

Improving the Efficacy of Anticancer Drugs via Encapsulation and Acoustic Release

Conventional chemotherapeutics lack the specificity and controllability, thus may poison healthy cells while attempting to kill cancerous ones. Newly developed nano-drug delivery systems have shown promise in delivering anti-tumor agents with enhanced stability, durability and overall performance; especially when used along with targeting and triggering techniques. This work traces back the history of chemotherapy, addressing the main challenges that have encouraged the medical researchers to seek a sanctuary in nanotechnological-based drug delivery systems that are grafted with appropriate targeting techniques and drug release mechanisms. A special focus will be directed to acoustically triggered liposomes encapsulating doxorubicin.

Synthesis of Metal-Organic Framework from Iron Nitrate and 2,6-Naphthalenedicarboxylic Acid and Its Application as Drug Carrier

Metal-organic frameworks (MOFs) are highly crystalline porous organic-inorganic materials that are comprised of metal salts and organic linkers. The common synthetic methodologies of MOFs include: solvothermal, microwave-assisted, electrochemical, mechanochemical, and sonochemical routes. The synthesized MOF particles can be characterized using several characterization techniques including: X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and other analytical techniques. Recently, MOFs have garnered increasing attention due to their potential applications in numerous areas including: catalysis, gas storage and separation, drug delivery, and others. In this research paper, a new metal-organic framework was synthesized successfully from iron nitrate and 2,6-naphthalenedicarboxylic acid (1) by means of microwave irradiation (Fe-NDC-M) and (2) solvothermally using a conventional electric oven (Fe-NDC-O). They were characterized using XRD, SEM, FTIR, energy-dispersive X-ray (EDS), thermogravimetric analysis (TGA), and N2 sorption experiments. The characterization results showed that the synthesized samples were crystals with a rod-like shape. The particle diameters ranged between 50-80 nm with a length of 300-450 nm. The BJH adsorption averagepore diameters were found to be 148.551 Å and 139.265 Å for Fe-NDC-M and Fe-NDC-O, respectively. As a result, the new Fe-NDC-MOF particles can be used as nanocarriers for anticancer drug delivery applications utilizing the enhanced permeability and retention effect.

Drug Delivery Systems Based on Polymeric Micelles and Ultrasound: A Review

BACKGROUND

Anti-neoplastic drugs used for cancer treatment often produce damage to healthy cells, leading to severe side effects in patients undergoing chemotherapy. The encapsulation of these agents in nanoparticles reduces the adverse side effects of conventional chemotherapy on healthy tissues. Such nanoparticles, considered as drug delivery vehicles, are diverse and include micelles, liposomes, dendrimers, nanocapsules, nanospheres and others. Polymeric micelles have been widely researched as nanocarriers for hydrophobic drugs. They can be designed to have increased stability and blood circulation time, as well as binding specificity to certain receptors overexpressed on the surface of cancer cells. Once these drug-encapsulating nanoparticles reach the tumor site, an external stimulus, such as ultrasound, can be used to spatially and temporally trigger drug release.

METHODS

This review paper focuses on the recent advances of cancer drug delivery systems employing polymeric micelles and ultrasound. An extensive literature review was performed mainly using PubMed. The introduction explains how nanocarriers are related to chemotherapy and the several modalities of use for this application. Afterwards, the review focuses on polymeric micelles used for drug delivery, their advantages and disadvantages. Subsequently, the physics of ultrasound is briefly reviewed, as well as the way it interacts with polymeric micelles to trigger the delivery of the drug transported by these nanocarriers. The following section focuses on targeting, discussing the several ways by which the nanoparticles can be directed to the target cells, and there deliver their cargo. Finally, a selection of relevant in vitro and in vivo studies, as well as clinical trials, is presented and discussed.

CONCLUSION

Although there are still several research studies to be performed before the combination of micelles and ultrasound can enter clinical trials, the future of controlled delivery using this drug delivery system is promising as a way to reduce the mortality and morbidity of cancer and the noxious side effects of conventional chemotherapy.