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Zhu X, Guo J, He C, Geng H, Yu G, Li J, Zheng H, Ji X, Yan F. Ultrasound triggered image-guided drug delivery to inhibit vascular reconstruction via paclitaxel-loaded microbubbles. Sci Rep 2016; 6:21683. [PMID: 26899550 PMCID: PMC4761943 DOI: 10.1038/srep21683] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/27/2016] [Indexed: 11/13/2022] Open
Abstract
Paclitaxel (PTX) has been recognized as a promising drug for intervention of vascular reconstructions. However, it is still difficult to achieve local drug delivery in a spatio-temporally controllable manner under real-time image guidance. Here, we introduce an ultrasound (US) triggered image-guided drug delivery approach to inhibit vascular reconstruction via paclitaxel (PTX)-loaded microbubbles (PLM) in a rabbit iliac balloon injury model. PLM was prepared through encapsulating PTX in the shell of lipid microbubbles via film hydration and mechanical vibration technique. Our results showed PLM could effectively deliver PTX when exposed to US irradiation and result in significantly lower viability of vascular smooth muscle cells. Ultrasonographic examinations revealed the US signals from PLM in the iliac artery were greatly increased after intravenous administration of PLM, making it possible to identify the restenosis regions of iliac artery. The in vivo anti-restenosis experiments with PLM and US greatly inhibited neointimal hyperplasia at the injured site, showing an increased lumen area and reduced the ratio of intima area and the media area (I/M ratio). No obvious functional damages to liver and kidney were observed for those animals. Our study provided a promising approach to realize US triggered image-guided PTX delivery for therapeutic applications against iliac restenosis.
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Affiliation(s)
- Xu Zhu
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jun Guo
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Pediatrics, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Cancan He
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Huaxiao Geng
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Gengsheng Yu
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jinqing Li
- Department of Radiology, 324 Hospital of the PLA, Chongqing, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory of Nanobiomechanics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiaojuan Ji
- Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Fei Yan
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Herdeg C, Göhring-Frischholz K, Haase KK, Geisler T, Zürn C, Hartmann U, Wöhrle J, Nusser T, Dippon J, May AE, Gawaz M. Catheter-Based Delivery of Fluid Paclitaxel for Prevention of Restenosis in Native Coronary Artery Lesions After Stent Implantation. Circ Cardiovasc Interv 2009; 2:294-301. [DOI: 10.1161/circinterventions.108.827865.108.827865] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Stents eluting antiproliferative drugs reduce the incidence of restenosis but delay healing of the vascular wall. We assessed the safety and efficacy of catheter-based local delivery of fluid paclitaxel in patients with coronary de novo stenoses after implantation of a bare metal stent.
Methods and Results—
We conducted a prospective, randomized trial comparing the local delivery of fluid paclitaxel after bare metal stent implantation (group I) with the implantation of a bare metal stent (group II) and the implantation of a paclitaxel-eluting stent (group III) in 204 patients. The primary end point was in-stent late lumen loss. Secondary end points included binary restenosis rate >50%, minimal lumen diameter, diameter stenosis, and a composite clinical end point (major adverse cardiac events and revascularization of the target lesion) 6 months after intervention. At 6 months, angiography showed an in-stent late lumen loss of 0.61�0.44 mm in group I versus 0.99�0.72 mm in group II (I versus II,
P
=0.0006) and 0.44�0.48 mm in group III (noninferiority of I versus III,
P
=0.023). The 1-sided 95% CI for the true difference of the means of in-stent late lumen loss in groups I and III was −∞ to 0.3174188. The cumulative overall rate of major cardiac events was 13.4% in group I, 26.8% in group II, and 14.9% in group III. Target lesion revascularization rate was 13.4% (group I), 22.1% (group II), and 13.4% (group III).
Conclusions—
Additional antiproliferative treatment of de novo lesions in native coronary arteries with catheter-based delivery of fluid paclitaxel after bare metal stenting was safe and significantly reduced neointimal proliferation, restenosis, and clinical events compared with bare metal stent implantation alone.
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Affiliation(s)
- Christian Herdeg
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Katrin Göhring-Frischholz
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Karl K. Haase
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Tobias Geisler
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Christine Zürn
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Ulrike Hartmann
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Jochen Wöhrle
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Thorsten Nusser
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Jürgen Dippon
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Andreas E. May
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
| | - Meinrad Gawaz
- From the Medizinische Klinik III (C.H., K.G.F., T.G., C.Z., A.M., M.G.), Eberhard Karls Universität Tübingen, Germany; Medizinische Klinik II (K.K.H.), Klinikum am Steinenberg, Reutlingen, Germany; Universitätsapotheke (U.H.), Eberhard Karls Universität Tübingen, Germany; Abteilung Innere Medizin II (J.W., T.N.), Universitätsklinikum Ulm, Germany; and Fachbereich Mathematik (J.D.), Universität Stuttgart, Germany
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