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Villata S, Canta M, Baruffaldi D, Pavan A, Chiappone A, Pirri CF, Frascella F, Roppolo I. 3D printable acrylate polydimethylsiloxane resins for cell culture and drug testing. Biomater Sci 2023; 11:2950-2959. [PMID: 36912680 DOI: 10.1039/d3bm00152k] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Nowadays, most of the microfluidic devices for biological applications are fabricated with only few well-established materials. Among these, polydimethylsiloxane (PDMS) is the most used and known. However, it has many limitations, like the operator dependent and time-consuming manufacturing technique and the high molecule retention. TEGORad or Acrylate PDMS is an acrylate polydimethylsiloxane copolymer that can be 3D printed through Digital Light Processing (DLP), a technology that can boast reduction of waste products and the possibility of low cost and rapid manufacturing of complex components. Here, we developed 3D printed Acrylate PDMS-based devices for cell culture and drug testing. Our in vitro study shows that Acrylate PDMS can sustain cell growth of lung and skin epithelium, both of great interest for in vitro drug testing, without causing any genotoxic effect. Moreover, flow experiments with a drug-like solution (Rhodamine 6G) show that Acrylate PDMS drug retention is negligible unlike the high signal shown by PDMS. In conclusion, the study demonstrates that this acrylate resin can be an excellent alternative to PDMS to design stretchable platforms for cell culture and drug testing.
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Affiliation(s)
- Simona Villata
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Marta Canta
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Désirée Baruffaldi
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Alice Pavan
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Annalisa Chiappone
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Candido Fabrizio Pirri
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy. .,Center for Sustainable Futures @PolitoIstituto Italiano di Tecnologia, Via Livorno 60, Turin 10144, Italy
| | - Francesca Frascella
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
| | - Ignazio Roppolo
- Dipartimento di Scienza Applicata e Tecnologia, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca degli Abruzzi 24, Turin 10129, Italy.
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Dumontel B, Susa F, Limongi T, Vighetto V, Debellis D, Canta M, Cauda V. Nanotechnological engineering of extracellular vesicles for the development of actively targeted hybrid nanodevices. Cell Biosci 2022; 12:61. [PMID: 35568919 PMCID: PMC9107671 DOI: 10.1186/s13578-022-00784-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/06/2022] [Indexed: 12/18/2022] Open
Abstract
Background We propose an efficient method to modify B-cell derived EVs by loading them with a nanotherapeutic stimuli-responsive cargo and equipping them with antibodies for efficient targeting of lymphoma cells. Results The post-isolation engineering of the EVs is accomplished by a freeze–thaw method to load therapeutically-active zinc oxide nanocrystals (ZnO NCs), obtaining the so-called TrojanNanoHorse (TNH) to recall the biomimetism and cytotoxic potential of this novel nanoconstruct. TNHs are further modified at their surface with anti-CD20 monoclonal antibodies (TNHCD20) achieving specific targeting against lymphoid cancer cell line. The in vitro characterization is carried out on CD20+ lymphoid Daudi cell line, CD20-negative cancerous myeloid cells (HL60) and the healthy counterpart (B lymphocytes). The TNH shows nanosized structure, high colloidal stability, even over time, and good hemocompatibility. The in vitro characterization shows the high biocompatibility, targeting specificity and cytotoxic capability. Importantly, the selectivity of TNHCD20 demonstrates significantly higher interaction towards the target lymphoid Daudi cell line compared to the CD20-negative cancerous myeloid cells (HL60) and the healthy counterpart (lymphocytes). An enhanced cytotoxicity directed against Daudi cancer cells is demonstrated after the TNHCD20 activation with high-energy ultrasound shock-waves (SW). Conclusion This work demonstrates the efficient re-engineering of EVs, derived from healthy cells, with inorganic nanoparticles and monoclonal antibodies. The obtained hybrid nanoconstructs can be on-demand activated by an external stimulation, here acoustic pressure waves, to exploit a cytotoxic effect conveyed by the ZnO NCs cargo against selected cancer cells. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13578-022-00784-9.
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Giacobino C, Canta M, Fornaguera C, Borrós S, Cauda V. Extracellular Vesicles and Their Current Role in Cancer Immunotherapy. Cancers (Basel) 2021; 13:cancers13092280. [PMID: 34068657 PMCID: PMC8126043 DOI: 10.3390/cancers13092280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary In recent years, immunotherapy has shown great advancement, becoming a powerful tool to combat cancer. In this context, the use of biologically derived vesicles has also acquired importance for cancer immunotherapy. Extracellular vesicles are thus proposed to transport molecules able to trigger an immune response and thus fight cancer cells. As a particular immunotherapeutic approach, a new technique also consists in the exploitation of extracellular vesicles as new cancer vaccines. The present review provides basic notions on cancer immunotherapy and describes several clinical trials in which therapeutic anticancer vaccines are tested. In particular, the potential of extracellular vesicles-based therapeutic vaccines in the treatment of cancer patients is highlighted, even with advanced stage-cancer. A focus on the clinical studies, already completed or still in progress, is offered and a systematic collection and reorganization of the present literature on this topic is proposed to the reader. Abstract Extracellular vesicles (EVs) are natural particles formed by the lipid bilayer and released from almost all cell types to the extracellular environment both under physiological conditions and in presence of a disease. EVs are involved in many biological processes including intercellular communication, acting as natural carriers in the transfer of various biomolecules such as DNA, various RNA types, proteins and different phospholipids. Thanks to their transfer and targeting abilities, they can be employed in drug and gene delivery and have been proposed for the treatment of different diseases, including cancer. Recently, the use of EVs as biological carriers has also been extended to cancer immunotherapy. This new technique of cancer treatment involves the use of EVs to transport molecules capable of triggering an immune response to damage cancer cells. Several studies have analyzed the possibility of using EVs in new cancer vaccines, which represent a particular form of immunotherapy. In the literature there are only few publications that systematically group and collectively discuss these studies. Therefore, the purpose of this review is to illustrate and give a partial reorganization to what has been produced in the literature so far. We provide basic notions on cancer immunotherapy and describe some clinical trials in which therapeutic cancer vaccines are tested. We thus focus attention on the potential of EV-based therapeutic vaccines in the treatment of cancer patients, overviewing the clinically relevant trials, completed or still in progress, which open up new perspectives in the fight against cancer.
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Affiliation(s)
- Carla Giacobino
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy; (C.G.); (M.C.)
| | - Marta Canta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy; (C.G.); (M.C.)
| | - Cristina Fornaguera
- Grup d’Enginyeria de Materials (Gemat), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), Via Augusta 390, 08017 Barcelona, Spain; (C.F.); (S.B.)
| | - Salvador Borrós
- Grup d’Enginyeria de Materials (Gemat), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), Via Augusta 390, 08017 Barcelona, Spain; (C.F.); (S.B.)
| | - Valentina Cauda
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy; (C.G.); (M.C.)
- Correspondence:
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Abstract
In the last 30 years the research about zinc oxide nanoparticles (ZnO NPs) and their related toxicity has shown a boom. ZnO NPs show cytotoxicity for both prokaryotic and eukaryotic cells and many studies demonstrated their selective toxicity towards cancer cells. However, with the increasing number of publications, it is observed an increase in the discrepancies obtained between the various results. Soon the scientific community understood that the ZnO NC toxicity behaviour is affected by many factors, related not only to the ZnO NPs themselves, but also to the experimental conditions used. Many recent reviews discussed these parameters by reporting experimental evidence and tried to assess the general statements about the ZnO NP cytotoxicity. This information is extremely useful for the evaluation of which type of ZnO NPs is more or less suitable for a specific study or application. However, despite that, a deep comprehension of the ZnO NP behaviour in relation to the different experimental conditions is still lacking. Actually, a full understanding of the reasons behind the NP behaviour is essential to better assess their biological activity and in particular their therapeutic application, avoiding undesired effects both in the experimental and clinical contexts. This tutorial review aims to be an experimental and practical guide for scientists that faced with the use of ZnO NPs for biomedical applications and, in particular, for their therapeutic purposes. The driving idea is to not simply summarize the results reported in the literature, but to provide instruments for a deep comprehension of the mechanisms affecting the ZnO NP cytotoxicity and behavior. This review also aims to point out the critical experimental parameters to be considered when working with these NPs, as well as the main related risks and limitations that scientists have to face.
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Affiliation(s)
- Marta Canta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
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Villata S, Canta M, Cauda V. EVs and Bioengineering: From Cellular Products to Engineered Nanomachines. Int J Mol Sci 2020; 21:ijms21176048. [PMID: 32842627 PMCID: PMC7504061 DOI: 10.3390/ijms21176048] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/15/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022] Open
Abstract
Extracellular vesicles (EVs) are natural carriers produced by many different cell types that have a plethora of functions and roles that are still under discovery. This review aims to be a compendium on the current advancement in terms of EV modifications and re-engineering, as well as their potential use in nanomedicine. In particular, the latest advancements on artificial EVs are discussed, with these being the frontier of nanomedicine-based therapeutics. The first part of this review gives an overview of the EVs naturally produced by cells and their extraction methods, focusing on the possibility to use them to carry desired cargo. The main issues for the production of the EV-based carriers are addressed, and several examples of the techniques used to upload the cargo are provided. The second part focuses on the engineered EVs, obtained through surface modification, both using direct and indirect methods, i.e., engineering of the parental cells. Several examples of the current literature are proposed to show the broad variety of engineered EVs produced thus far. In particular, we also report the possibility to engineer the parental cells to produce cargo-loaded EVs or EVs displaying specific surface markers. The third and last part focuses on the most recent advancements based on synthetic and chimeric EVs and the methods for their production. Both top-down or bottom-up techniques are analyzed, with many examples of applications.
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Racca L, Limongi T, Vighetto V, Dumontel B, Ancona A, Canta M, Canavese G, Garino N, Cauda V. Zinc Oxide Nanocrystals and High-Energy Shock Waves: A New Synergy for the Treatment of Cancer Cells. Front Bioeng Biotechnol 2020; 8:577. [PMID: 32582682 PMCID: PMC7289924 DOI: 10.3389/fbioe.2020.00577] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/12/2020] [Indexed: 01/10/2023] Open
Abstract
In the last years, different nanotools have been developed to fight cancer cells. They could be administered alone, exploiting their intrinsic toxicity, or remotely activated to achieve cell death. In the latter case, ultrasound (US) has been recently proposed to stimulate some nanomaterials because of the US outstanding property of deep tissue penetration and the possibility of focusing. In this study, for the first time, we report on the highly efficient killing capability of amino-propyl functionalized ZnO nanocrystals (ZnO NCs) in synergy with high-energy ultrasound shock waves (SW) for the treatment of cancer cells. The cytotoxicity and internalization of ZnO NCs were evaluated in cervical adenocarcinoma KB cells, as well as the safety of the SW treatment alone. Then, the remarkably high cytotoxic combination of ZnO NCs and SW was demonstrated, comparing the effect of multiple (3 times/day) SW treatments toward a single one, highlighting that multiple treatments are necessary to achieve efficient cell death. At last, preliminary tests to understand the mechanism of the observed synergistic effect were carried out, correlating the nanomaterial surface chemistry to the specific type of stimulus used. The obtained results can thus pave the way for a novel nanomedicine treatment, based on the synergistic effect of nanocrystals combined with highly intense mechanical pressure waves, offering high efficiency, deep and focused tissue penetration, and a reduction of side effects on healthy cells.
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Affiliation(s)
- Luisa Racca
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Tania Limongi
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Veronica Vighetto
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Bianca Dumontel
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Andrea Ancona
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Marta Canta
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Giancarlo Canavese
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Nadia Garino
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
| | - Valentina Cauda
- Department of Applied Science and Technology, Politecnico di Torino, Turin, Italy
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7
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Dumontel B, Susa F, Limongi T, Canta M, Racca L, Chiodoni A, Garino N, Chiabotto G, Centomo ML, Pignochino Y, Cauda V. ZnO nanocrystals shuttled by extracellular vesicles as effective Trojan nano-horses against cancer cells. Nanomedicine (Lond) 2019; 14:2815-2833. [PMID: 31747855 PMCID: PMC7610546 DOI: 10.2217/nnm-2019-0231] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The effective application of nanoparticles in cancer theranostics is jeopardized by their aggregation in biological media, rapid degradation and clearance. The design of biomimetic nanoconstructs with enhanced colloidal stability and non-immunogenicity is therefore essential. We propose naturally stable cell-derived extracellular vesicles to encapsulate zinc oxide (ZnO) nanocrystals as efficacious nanodrugs, to obtain highly biomimetic and stable Trojan nano-horses (TNHs). Materials & methods Coupling efficiency, biostability, cellular cytotoxicity and internalization were tested. Results In vitro studies showed a high internalization of TNHs into cancer cells and efficient cytotoxic activity thanks to ZnO intracellular release. Conclusion TNHs represent an efficient biomimetic platform for future nanotheranostic applications, with biomimetic extracellular vesicle-lipid envelope, facilitated ZnO cellular uptake and potential therapeutic implications.
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Affiliation(s)
- Bianca Dumontel
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Francesca Susa
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Tania Limongi
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Marta Canta
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Luisa Racca
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Angelica Chiodoni
- Center for Sustainable Future Technologies - CSFT@POLITO, Istituto Italiano di Tecnologia, Via Livorno, 60, 10144 Turin, Italy
| | - Nadia Garino
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.,Center for Sustainable Future Technologies - CSFT@POLITO, Istituto Italiano di Tecnologia, Via Livorno, 60, 10144 Turin, Italy
| | - Giulia Chiabotto
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Str. Prov.le 142, km. 3.95, Candiolo (TO) 10060, Italy.,Department of Medical Sciences,University of Torino, Torino 10126, Italy
| | - Maria L Centomo
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Str. Prov.le 142, km. 3.95, Candiolo (TO) 10060, Italy.,Department of Oncology, University of Torino, Str. Prov.le 142,km. 3.95, Candiolo (TO) 10060, Italy
| | - Ymera Pignochino
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Str. Prov.le 142, km. 3.95, Candiolo (TO) 10060, Italy.,Department of Oncology, University of Torino, Str. Prov.le 142,km. 3.95, Candiolo (TO) 10060, Italy
| | - Valentina Cauda
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
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Limongi T, Canta M, Racca L, Ancona A, Tritta S, Vighetto V, Cauda V. Improving dispersal of therapeutic nanoparticles in the human body. Nanomedicine (Lond) 2019; 14:797-801. [PMID: 30895871 DOI: 10.2217/nnm-2019-0070] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Tania Limongi
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Marta Canta
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Luisa Racca
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Andrea Ancona
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Stefania Tritta
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Via Nizza 52, Torino 10126, Italy
| | - Veronica Vighetto
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Valentina Cauda
- Department of Applied Science & Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
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Garino N, Limongi T, Dumontel B, Canta M, Racca L, Laurenti M, Castellino M, Casu A, Falqui A, Cauda V. A Microwave-Assisted Synthesis of Zinc Oxide Nanocrystals Finely Tuned for Biological Applications. Nanomaterials (Basel) 2019; 9:nano9020212. [PMID: 30736299 PMCID: PMC6410313 DOI: 10.3390/nano9020212] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 01/25/2023]
Abstract
Herein we report a novel, easy, fast and reliable microwave-assisted synthesis procedure for the preparation of colloidal zinc oxide nanocrystals (ZnO NCs) optimized for biological applications. ZnO NCs are also prepared by a conventional solvo-thermal approach and the properties of the two families of NCs are compared and discussed. All of the NCs are fully characterized in terms of morphological analysis, crystalline structure, chemical composition and optical properties, both as pristine nanomaterials or after amino-propyl group functionalization. Compared to the conventional approach, the novel microwave-derived ZnO NCs demonstrate outstanding colloidal stability in ethanol and water with long shelf-life. Furthermore, together with their more uniform size, shape and chemical surface properties, this long-term colloidal stability also contributes to the highly reproducible data in terms of biocompatibility. Actually, a significantly different biological behavior of the microwave-synthesized ZnO NCs is reported with respect to NCs prepared by the conventional synthesis procedure. In particular, consistent cytotoxicity and highly reproducible cell uptake toward KB cancer cells are measured with the use of microwave-synthesized ZnO NCs, in contrast to the non-reproducible and scattered data obtained with the conventionally-synthesized ones. Thus, we demonstrate how the synthetic route and, as a consequence, the control over all the nanomaterial properties are prominent points to be considered when dealing with the biological world for the achievement of reproducible and reliable results, and how the use of commercially-available and under-characterized nanomaterials should be discouraged in this view.
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Affiliation(s)
- Nadia Garino
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
- Istituto Italiano di Tecnologia, Center for Sustainable Future Technologies, Via Livorno 60, 10144 Torino, Italy.
| | - Tania Limongi
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Bianca Dumontel
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Marta Canta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Luisa Racca
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Marco Laurenti
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Micaela Castellino
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
| | - Alberto Casu
- King Abdullah University of Science and Technology (KAUST), Biological and Engineering (BESE) Division, NABLA Lab, Thuwal 23955, Saudi Arabia.
| | - Andrea Falqui
- King Abdullah University of Science and Technology (KAUST), Biological and Engineering (BESE) Division, NABLA Lab, Thuwal 23955, Saudi Arabia.
| | - Valentina Cauda
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
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Canavese G, Ancona A, Racca L, Canta M, Dumontel B, Barbaresco F, Limongi T, Cauda V. Nanoparticle-assisted ultrasound: A special focus on sonodynamic therapy against cancer. Chem Eng J 2018; 340:155-172. [PMID: 30881202 PMCID: PMC6420022 DOI: 10.1016/j.cej.2018.01.060] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
At present, ultrasound radiation is broadly employed in medicine for both diagnostic and therapeutic purposes at various frequencies and intensities. In this review article, we focus on therapeutically-active nanoparticles (NPs) when stimulated by ultrasound. We first introduce the different ultrasound-based therapies with special attention to the techniques involved in the oncological field, then we summarize the different NPs used, ranging from soft materials, like liposomes or micro/nano-bubbles, to metal and metal oxide NPs. We therefore focus on the sonodynamic therapy and on the possible working mechanisms under debate of NPs-assisted sonodynamic treatments. We support the idea that various, complex and synergistics physical-chemical processes take place during acoustic cavitation and NP activation. Different mechanisms are therefore responsible for the final cancer cell death and strongly depends not only on the type and structure of NPs or nanocarriers, but also on the way they interact with the ultrasonic pressure waves. We conclude with a brief overview of the clinical applications of the various ultrasound therapies and the related use of NPs-assisted ultrasound in clinics, showing that this very innovative and promising approach is however still at its infancy in the clinical cancer treatment.
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Affiliation(s)
- Giancarlo Canavese
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
- Center for Sustainable Future Technologies CSFT@Polito, Istituto Italiano di Tecnologia, Corso Trento 21, 10129, Turin, Italy
| | - Andrea Ancona
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Luisa Racca
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Marta Canta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Bianca Dumontel
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Federica Barbaresco
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Tania Limongi
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Valentina Cauda
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
- Center for Sustainable Future Technologies CSFT@Polito, Istituto Italiano di Tecnologia, Corso Trento 21, 10129, Turin, Italy
- Corresponding author at: Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy. (V. Cauda)
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Dumontel B, Canta M, Engelke H, Chiodoni A, Racca L, Ancona A, Limongi T, Canavese G, Cauda V. Enhanced biostability and cellular uptake of zinc oxide nanocrystals shielded with a phospholipid bilayer. J Mater Chem B 2017; 5:8799-8813. [PMID: 29456858 PMCID: PMC5779080 DOI: 10.1039/c7tb02229h] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/03/2017] [Indexed: 12/20/2022]
Abstract
The surface chemistry and charge of zinc oxide nanocrystals influence their behaviour in biological fluids. A novel lipid bilayer assembly is developed to shield ZnO nanocrystals improving their stability and cell internalization.
The widespread use of ZnO nanomaterials for biomedical applications, including therapeutic drug delivery or stimuli-responsive activation, as well as imaging, imposes a careful control over the colloidal stability and long-term behaviour of ZnO in biological media. Moreover, the effect of ZnO nanostructures on living cells, in particular cancer cells, is still under debate. This paper discusses the role of surface chemistry and charge of zinc oxide nanocrystals, of around 15 nm in size, which influence their behaviour in biological fluids and effect on cancer cells. In particular, we address this problem by modifying the surface of pristine ZnO nanocrystals (NCs), rich of hydroxyl groups, with positively charged amino-propyl chains or, more innovatively, by self-assembling a double-lipidic membrane, shielding the ZnO NCs. Our findings show that the prolonged immersion in simulated human plasma and in the cell culture medium leads to highly colloidally dispersed ZnO NCs only when coated by the lipidic bilayer. In contrast, the pristine and amine-functionalized NCs form huge aggregates after already one hour of immersion. Partial dissolution of these two samples into potentially cytotoxic Zn2+ cations takes place, together with the precipitation of phosphate and carbonate salts on the NCs’ surface. When exposed to living HeLa cancer cells, higher amounts of lipid-shielded ZnO NCs are internalized with respect to the other samples, thus showing a reduced cytotoxicity, based on the same amount of internalized NCs. These results pave the way for the development of novel theranostic platforms based on ZnO NCs. The new formulation of ZnO shielded with a lipid-bilayer will prevent strong aggregation and premature degradation into toxic by-products, and promote a highly efficient cell uptake for further therapeutic or diagnostic functions.
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Affiliation(s)
- B Dumontel
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy .
| | - M Canta
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy .
| | - H Engelke
- Department of Chemistry , Ludwig-Maximilians-University of Munich , Butenandtstrasse 11E , 81377 Munich , Germany
| | - A Chiodoni
- Center for Sustainable Future Technologies - CSFT@POLITO , Istituto Italiano di Tecnologia , Corso Trento 21 , 10129 Turin , Italy
| | - L Racca
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy .
| | - A Ancona
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy .
| | - T Limongi
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy .
| | - G Canavese
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy . .,Center for Sustainable Future Technologies - CSFT@POLITO , Istituto Italiano di Tecnologia , Corso Trento 21 , 10129 Turin , Italy
| | - V Cauda
- Department of Applied Science and Technology , Politecnico di Torino , Corso Duca degli Abruzzi 24 , 10129 Turin , Italy . .,Center for Sustainable Future Technologies - CSFT@POLITO , Istituto Italiano di Tecnologia , Corso Trento 21 , 10129 Turin , Italy
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12
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Pignochino Y, Capozzi F, D'Ambrosio L, Dell'Aglio C, Basiricò M, Canta M, Lorenzato A, Vignolo Lutati F, Aliberti S, Palesandro E, Boccone P, Galizia D, Miano S, Chiabotto G, Napione L, Gammaitoni L, Sangiolo D, Benassi MS, Pasini B, Chiorino G, Aglietta M, Grignani G. PARP1 expression drives the synergistic antitumor activity of trabectedin and PARP1 inhibitors in sarcoma preclinical models. Mol Cancer 2017; 16:86. [PMID: 28454547 PMCID: PMC5410089 DOI: 10.1186/s12943-017-0652-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 04/17/2017] [Indexed: 01/05/2023] Open
Abstract
Background Enhancing the antitumor activity of the DNA-damaging drugs is an attractive strategy to improve current treatment options. Trabectedin is an isoquinoline alkylating agent with a peculiar mechanism of action. It binds to minor groove of DNA inducing single- and double-strand-breaks. These kinds of damage lead to the activation of PARP1, a first-line enzyme in DNA-damage response pathways. We hypothesized that PARP1 targeting could perpetuate trabectedin-induced DNA damage in tumor cells leading finally to cell death. Methods We investigated trabectedin and PARP1 inhibitor synergism in several tumor histotypes both in vitro and in vivo (subcutaneous and orthotopic tumor xenografts in mice). We searched for key determinants of drug synergism by comparative genomic hybridization (aCGH) and gene expression profiling (GEP) and validated their functional role. Results Trabectedin activated PARP1 enzyme and the combination with PARP1 inhibitors potentiated DNA damage, cell cycle arrest at G2/M checkpoint and apoptosis, if compared to single agents. Olaparib was the most active PARP1 inhibitor to combine with trabectedin and we confirmed the antitumor and antimetastatic activity of trabectedin/olaparib combination in mice models. However, we observed different degree of trabectedin/olaparib synergism among different cell lines. Namely, in DMR leiomyosarcoma models the combination was significantly more active than single agents, while in SJSA-1 osteosarcoma models no further advantage was obtained if compared to trabectedin alone. aCGH and GEP revealed that key components of DNA-repair pathways were involved in trabectedin/olaparib synergism. In particular, PARP1 expression dictated the degree of the synergism. Indeed, trabectedin/olaparib synergism was increased after PARP1 overexpression and reduced after PARP1 silencing. Conclusions PARP1 inhibition potentiated trabectedin activity in a PARP1-dependent manner and PARP1 expression in tumor cells might be a useful predictive biomarker that deserves clinical evaluation. Electronic supplementary material The online version of this article (doi:10.1186/s12943-017-0652-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ymera Pignochino
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy. .,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.
| | - Federica Capozzi
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Lorenzo D'Ambrosio
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Carmine Dell'Aglio
- Pathology Unit, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Marco Basiricò
- Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Marta Canta
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Annalisa Lorenzato
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | | | - Sandra Aliberti
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Erica Palesandro
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Paola Boccone
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Danilo Galizia
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Sara Miano
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Giulia Chiabotto
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Lucia Napione
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Current address: Department of Applied Science and Technology, Politecnico di Torino, Torino, Italy
| | - Loretta Gammaitoni
- Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Dario Sangiolo
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Maria Serena Benassi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Barbara Pasini
- Department of Genetics, Biology and Biochemistry, University of Torino, Torino, Italy
| | | | - Massimo Aglietta
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Giovanni Grignani
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.
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13
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Pignochino Y, Dell'Aglio C, Inghilleri S, Zorzetto M, Basiricò M, Capozzi F, Canta M, Piloni D, Cemmi F, Sangiolo D, Gammaitoni L, Soster M, Marchiò S, Pozzi E, Morbini P, Luisetti M, Aglietta M, Grignani G, Stella GM. The combination of sorafenib and everolimus shows antitumor activity in preclinical models of malignant pleural mesothelioma. BMC Cancer 2015; 15:374. [PMID: 25952930 PMCID: PMC4429519 DOI: 10.1186/s12885-015-1363-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 04/24/2015] [Indexed: 12/21/2022] Open
Abstract
Background Malignant Pleural Mesothelioma (MPM) is an aggressive tumor arising from mesothelial cells lining the pleural cavities characterized by resistance to standard therapies. Most of the molecular steps responsible for pleural transformation remain unclear; however, several growth factor signaling cascades are known to be altered during MPM onset and progression. Transducers of these pathways, such as PIK3CA-mTOR-AKT, MAPK, and ezrin/radixin/moesin (ERM) could therefore be exploited as possible targets for pharmacological intervention. This study aimed to identify ‘druggable’ pathways in MPM and to formulate a targeted approach based on the use of commercially available molecules, such as the multikinase inhibitor sorafenib and the mTOR inhibitor everolimus. Methods We planned a triple approach based on: i) analysis of immunophenotypes and mutational profiles in a cohort of thoracoscopic MPM samples, ii) in vitro pharmacological assays, ii) in vivo therapeutic approaches on MPM xenografts. No mutations were found in ‘hot spot’ regions of the mTOR upstream genes (e.g. EGFR, KRAS and PIK3CA). Results Phosphorylated mTOR and ERM were specifically overexpressed in the analyzed MPM samples. Sorafenib and everolimus combination was effective in mTOR and ERM blockade; exerted synergistic effects on the inhibition of MPM cell proliferation; triggered ROS production and consequent AMPK-p38 mediated-apoptosis. The antitumor activity was displayed when orally administered to MPM-bearing NOD/SCID mice. Conclusions ERM and mTOR pathways are activated in MPM and ‘druggable’ by a combination of sorafenib and everolimus. Combination therapy is a promising therapeutic strategy against MPM. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1363-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ymera Pignochino
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Carmine Dell'Aglio
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Simona Inghilleri
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Michele Zorzetto
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Marco Basiricò
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Federica Capozzi
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Marta Canta
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Davide Piloni
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Francesca Cemmi
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Dario Sangiolo
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Loretta Gammaitoni
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Marco Soster
- Laboratory of Tumor Microenvironment, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Serena Marchiò
- Laboratory of Tumor Microenvironment, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Ernesto Pozzi
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Patrizia Morbini
- Department of Molecular Medicine- Section of Pathology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Maurizio Luisetti
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
| | - Massimo Aglietta
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Giovanni Grignani
- Division of Medical Oncology, IRCCS-Institute for Cancer Research and Treatment, Candiolo, (TO), 10060, Italy.
| | - Giulia M Stella
- Department of Molecular Medicine, - Section of Pneumology, Laboratory of Biochemistry & Genetics, University and Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy.
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Gerasimou A, Oliaro E, Quaglia C, Canta M, Calachanis M, Morello M, Mangiardi L. When should asymptomatic patients with combined severe aortic stenosis and aortic insufficiency undergo valve replacement? A clinical case. Minerva Cardioangiol 2004; 52:339-44. [PMID: 15284683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Indications to prosthetic aortic valve implantation in patients with aortic stenosis or aortic regurgitation or both stenotic or regurgitant aortic valve, who present without symptoms, are controversial. We present the case of an asymptomatic patient with combined severe aortic stenosis and an equally important insufficiency, undergoing surgery for valve substitution with a bileaflet prosthesis. After surgery he was treated with warfarin according to the doses recommended and underwent follow-up with clinical and echocardiographic exams. Eight months after intervention the patient had an embolic stroke with aphasia and right hemiplegia, despite the therapeutic level of INR. At present, even though he has partly recovered motor function, he reports a noteworthy decline in life quality, because of the persistent speech difficulties. We use this case as the starting point for a discussion of the chance of referring patients affected by aortic valvulopathy to valve substitution, in the absence of symptoms.
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Affiliation(s)
- A Gerasimou
- Department of Cardiology, University of Turin, Turin, Italy
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15
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Levis A, Vitolo U, Ciocca Vasino MA, Cametti G, Urgesi A, Bertini M, Canta M, Monetti U, Bosio C, Jayme A. Predictive value of the early response to chemotherapy in high-risk stages II and III Hodgkin's disease. Cancer 1987; 60:1713-9. [PMID: 3651998 DOI: 10.1002/1097-0142(19871015)60:8<1713::aid-cncr2820600804>3.0.co;2-c] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A series of 60 patients with "high risk" Stage II and III Hodgkin's disease (B symptoms, or large mediastinal mass, or E lung disease) were staged without laparotomy and treated with combined modality treatment: mechlorethamine, vincristine, procarbazine, and prednisone (6 MOPP) plus radiotherapy. Patients were restaged after the first three courses of MOPP and the status of response to therapy at that time was called early response to chemotherapy (ERC). The rate of nitrogen mustard and procarbazine delivery (MRD) during the first three cycles of chemotherapy also was assessed. At the completion of the therapy patients were restaged and the final response was assessed. Fifty-two (86.7%) patients entered complete remission (CR). Forty-eight percent of the complete responders achieved CR in the first three courses of MOPP. Eight-year survival and disease-free survival (DFS) rates of the patients achieving CR were 71% and 73%, respectively. Survival and DFS were significantly better for the patients who achieved CR in the first three cycles of chemotherapy than for patients who entered CR at a later stage of therapy: 8-year survival 90% versus 55% (P = 0.00); 8-year DFS 87% versus 59% (P = 0.01). The attainment of a complete ERC was adversely affected by lymphocyte depletion (LD) histologic type (P = 0.01) and MRD less than 65% (P = 0.04). However, when a multivariate regression analysis was used, ERC was the only significant prognostic variable for survival and DFS and its predictive value was confirmed even after correction by MRD. These data suggest that the rapidity of response to chemotherapy could be an important prognostic factor in high-risk Stage II and III Hodgkin's disease.
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Affiliation(s)
- A Levis
- Divisione di Medicina E-Servizio di Ematologia, Ospedale Maggiore di San Giovanni Battista e della Cittá di Torino, Italy
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Abstract
Seventy-four consecutive patients with nonblastic chronic granulocytic leukemia (CGL) were observed from diagnosis and retrospectively studied. The patients were segregated into three risk groups according to the staging system proposed by Sokal et al. A significant difference in survival was observed only between Stage I and III (P = 0.01). The prognostic role of other variables, different from those considered in the Sokal et al. equation, was then investigated. Multiple regression analysis of data was made, by forcing into the Cox's regression model the Sokal et al. equation, while allowing the remaining variables to move in and out of the model. Only the presence of peripheral nucleated erythrocytes improved the significance (chi-square improvement = 4.565; P value improvement = 0.033). The evaluation of peripheral erythroid precursors is proposed for further implementation of the staging systems in CGL.
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