Ultrasound-mediated microbubble destruction enhances gene transfection in pancreatic cancer cells

Ultrasound-Activatable Phase-Shift Nanoparticle as a Targeting Antibacterial Agent for Efficient Eradication of Pseudomonas aeruginosa Biofilms

Biofilms are physical barriers composed of extracellular polymeric substances (EPS) that enable planktonic bacteria to resist host responses and antibacterial treatments, complicating efforts to clear bacteria such as Pseudomonas aeruginosa (P. aeruginosa) and thereby contributing to persistently chronic infections. As such, it is critical to develop a robust antimicrobial strategy capable of effectively eradicating P. aeruginosa biofilms and to further address aggressive clinical infection. In this study, ultrasound-activatable targeted nanoparticles were designed by using poly(lactic-co-glycolic acid) (PLGA) nanoparticles to encapsulate phase-transformable perfluoropentane (PFP) and the antibiotic meropenem via a double emulsion approach, followed by conjugation with anti-P. aeruginosa antibodies. In this strategy, ultrasound exposure can trigger PFP to produce microbubbles, inducing ultrasonic cavitation effects that can disrupt EPS components and allow nanoparticles to release meropenem to kill P. aeruginosa directly and accelerate the associated wound healing. These nanoparticles eradicated biofilms effectively and cleared bacteria in vitro as well as exhibited potent anti-infective activity in vivo. In summary, this study demonstrates the efficacy of a sonobactericidal strategy as a means of effectively and reliably eliminating biofilms.

Exosomes Derived From Low-Intensity Pulsed Ultrasound-Treated Dendritic Cells Suppress Tumor Necrosis Factor-Induced Endothelial Inflammation

OBJECTIVES

Endothelial cell inflammation plays an important role in atherosclerosis. Low-intensity pulsed ultrasonography (LIPUS) exerts an anti-inflammatory function on endothelial cells, whereas the underlying mechanism has not been fully elucidated.

METHODS

Bone marrow dendritic cells (BMDCs) derived from bone barrow cells were treated with LIPUS, and exosomes secreted into the supernatant were purified. The isolated exosomes were incubated with human umbilical vein endothelial cells (HUVECs) to investigate their effect on tumor necrosis factor (TNF)-α-induced endothelial inflammation. Ultrastructure was analyzed by transmission electron microscopy. Messenger RNA levels were determined by quantitative reverse transcription polymerase chain reaction, and protein levels were analyzed by western blot.

RESULTS

The isolated exosomes presented a typical exosomal size of 30 to 100 nm in diameter and expressed exosome positive markers (Alix, CD63, and TSG101) but not the exosome negative marker (Calnexin). Exosomes derived from LIPUS-treated BMDCs were rich in miR-16 and miR-21, which could be engulfed by HUVECs. Pretreatment with exosomes impeded TNFα-induced HUVEC activation and downregulated TNFα-stimulated expression of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1, thus preventing TNFα-induced activation of the nuclear factor-κB signaling pathway.

CONCLUSION

Exosomes derived from LIPUS-treated BMDC inhibit TNFα-induced endothelial inflammation by inhibiting the nuclear factor-κB signaling pathway.

Apatinib-loaded lipid nanobubbles combined with ultrasound-targeted nanobubble destruction for synergistic treatment of HepG2 cells in vitro

Purpose

Apatinib, an oral small-molecule antiangiogenetic medicine, is used to treat patients with advanced hepatocellular carcinoma. However, its systemic toxic side effects cannot be ignored. The ultrasound (US)-targeted nanobubble destruction technology can minimize systemic drug exposure and maximize therapeutic efficacy. The aim of this study was to develop novel GPC3-targeted and drug-loaded nanobubbles (NBs) and further assess the associated therapeutic effects on hepatocellular carcinoma cells in vitro.

Materials and methods

Apatinib-loaded NBs were prepared by a mechanical vibration method. GPC3, a liver tumor homing peptide, was coated onto the surface of apatinib-loaded NBs through biotin–avidin interactions to target liver cancer HepG2 cells. The effects of different treatment groups on cell proliferation, cell cycle, and apoptosis of HepG2 cells were tested.

Results

The NBs could achieve 68% of optimal drug encapsulation. In addition, ligand binding assays demonstrated that attachment of targeted NBs to human HepG2 liver cancer cells was highly efficient. Furthermore, cell proliferation assays indicated that the antiproliferative activities of GPC3-targeted and apatinib-loaded NBs in combination with US (1 MHz, 1 W/cm², 30 s) were, respectively, 44.11%±2.84%, 57.09%±6.38%, and 67.51%±2.89% after 24, 48, and 72 h of treatment. Treatment with GPC3-targeted and apatinib-loaded NBs also resulted in a higher proportion of cells in the G1 phase compared with other treatment groups such as apatinib only and nontargeted apatinib-loaded NBs when US was utilized.

Conclusion

US-targeted and drug-loaded nanobubble destruction successfully achieved selective growth inhibition and apoptosis in HepG2 cells in vitro. Therefore, GPC3-targeted and apatinib-loaded NBs can be considered a novel chemotherapeutic approach for treating liver cancer in combination with US.

Ultrasound Microbubbles Enhance the Activity of Vancomycin Against Staphylococcus epidermidis Biofilms In Vivo

OBJECTIVES

Staphylococcus epidermidis is the predominant pathogen of device-associated infections. By forming biofilms on the device surface, S epidermidis has substantial resistance to antibiotics and is difficult to eradicate. This study aimed to explore the synergistic effect of ultrasound (US)-mediated microbubbles combined with vancomycin on S epidermidis biofilms in a rabbit model.

METHODS

Two polytetrafluoroethene catheters with preformed S epidermidis biofilms were implanted subcutaneously in a rabbit, one on either side of the spine. Animals were randomized into different treatment groups, with each rabbit acting as its own control and treatment. Ultrasound was applied from 24 to 72 hours after surgery 2 times a day. The parameters were 300 kHz and 0.5 W/cm² in a 50% duty cycle, with or without microbubbles injected subcutaneously into the implantation site. After treatments, animals were euthanized, and implants were removed for a scanning electron microscopic examination and bacterial counting. The hearts, kidneys, livers, and subcutaneous tissues were sent for histopathologic examinations.

RESULTS

Ultrasound + microbubbles increased the bactericidal action of vancomycin by decreasing biofilm viability from a mean ± SD of 6.44 ± 0.03 log₁₀ colony-forming units per catheter in the control group to 3.49 ± 0.02 log₁₀ colony-forming units per catheter in US + microbubble + vancomycin group (P < .001). The antibacterial effect of US + microbubbles + vancomycin was more pronounced than that of US + vancomycin (P < .001). Under scanning electron microscopy, biofilms exposed to US + microbubbles + vancomycin showed a greater reduction in thickness and bacterial density than other treatments. Histopathologic examinations showed no abnormalities in organs and skins.

CONCLUSIONS

Ultrasound microbubbles enhanced the antibacterial effect of vancomycin against S epidermidis biofilms in vivo without exerting obvious harms to the animals.

Stimulated phase-shift acoustic nanodroplets enhance vancomycin efficacy against methicillin-resistant Staphylococcus aureus biofilms

Purpose

Bacterial biofilms on the surface of prostheses are becoming a rising concern in managing prosthetic joint infections. The inherent resistant features of biofilms render traditional antimicrobial therapy unproductive and revision surgery outcomes uncertain. This situation has prompted the exploration of novel antimicrobial strategies. The synergy of ultrasound microbubbles and vancomycin has been proposed as an efficient alternative for biofilm eradication. The purpose of this study was to evaluate the anti-biofilm effect of stimulated phase-shift acoustic nanodroplets (NDs) combined with vancomycin.

Materials and methods

We fabricated lipid phase-shift NDs with a core of liquid perfluoropentane. A new phase change mode for NDs incorporating an initial unfocused low-intensity pulsed ultrasound for 5 minutes and a subsequent incubation at 37°C into a 24-hour duration was developed. Methicillin-resistant Staphylococcus aureus (MRSA) biofilms were incubated with vancomycin and NDs under the hybrid stimulation. Biofilm morphology following treatment was determined using confocal laser scanning microscopy and scanning electron microscopy. Resazurin assay was used to quantify bactericidal efficacy against MRSA biofilm bacteria.

Results

NDs treated sequentially with ultrasound and heating at 37°C achieved gradual and substantial ND vaporization and cavitation in a successive process. NDs after stimulation were capable of generating stronger destruction on biofilm structure which was best characterized by residual circular arc margins and more dead bacteria. Furthermore, NDs combined with vancomycin contributed to significantly decreasing the metabolic activity of bacteria in MRSA biofilms (P<0.05).

Conclusion

Phase-shift acoustic NDs could exert a significant bactericidal effect against MRSA biofilms through a new stimulation mode. Acoustic NDs present advantages over microbubbles for biofilm damage. This anti-biofilm strategy could be used either alone or as an enhancer of traditional antibiotics in the control of prosthetic joint infections.

Evolution of contrast agents for ultrasound imaging and ultrasound-mediated drug delivery

Ultrasound (US) is one of the most frequently used diagnostic methods. It is a non-invasive, comparably inexpensive imaging method with a broad spectrum of applications, which can be increased even more by using bubbles as contrast agents (CAs). There are various different types of bubbles: filled with different gases, composed of soft- or hard-shell materials, and ranging in size from nano- to micrometers. These intravascular CAs enable functional analyses, e.g., to acquire organ perfusion in real-time. Molecular analyses are achieved by coupling specific ligands to the bubbles' shell, which bind to marker molecules in the area of interest. Bubbles can also be loaded with or attached to drugs, peptides or genes and can be destroyed by US pulses to locally release the entrapped agent. Recent studies show that US CAs are also valuable tools in hyperthermia-induced ablation therapy of tumors, or can increase cellular uptake of locally released drugs by enhancing membrane permeability. This review summarizes important steps in the development of US CAs and introduces the current clinical applications of contrast-enhanced US. Additionally, an overview of the recent developments in US probe design for functional and molecular diagnosis as well as for drug delivery is given.

Effect of Microbubble Mixtures on the Washing Rate of Surfactant Solutions in a Swirling Flow and an Alternating Flow

Wastewater from laundry cleaning contributes to water pollution, and the amount of detergent used needs to be reduced. In the present study, water, four types of surfactants, and their microbubble mixtures were used, and washing rates were measured in swirling flows and alternating flows. The microbubble/water mixtures (average particle diameter: 25 μm; mixed with air at 1.5 vol % in water) achieved washing rates higher than those of water alone. Furthermore, microbubbles mixed with an aqueous surfactant solution had a washing rate that depended on the ionization of the surfactant: the mixtures with microbubbles and non-ionic and anionic surfactants had a washing rate that was higher than that of aqueous non-ionic and anionic surfactant solutions without microbubbles. The surface tensions of microbubble/water mixtures and mixtures of microbubbles with non-ionic and anionic surfactants were lower than those without microbubbles. These results provide evidence of an enhanced washing effect for microbubble mixtures in laundry cleaning.

Enhancement of recombinant adeno-associated virus mediated transgene expression by targeted echo-contrast agent

Ultrasound-targeted microbubble destruction (UTMD) has been recently developed for destroying bubbles carrying drugs or genes, thereby permitting local release of these target molecules. We investigated whether SonoVue®, a new contrast agent that contains phospholipid-stabilized microbubbles filled with sulfur hexafluoride vapor, is effective at delivering a recombinant adeno-associated viral (rAAV) vector to the rat heart by UTMD. Serotype-2 (rAAV2) marked with green fluorescent protein (GFP) as a reporter gene was attached to the surface of sulfur hexafluoride-filled microbubbles. Microbubbles were infused into the tail vein of rats with or without simultaneous echocardiography. Additional controls included ultrasound microbubbles that did not contain virus, virus alone, and virus plus ultrasound. One group underwent echocardiographic destruction of microbubbles followed by rAAV2-GFP infusion. Rats were killed after 4 weeks and examined for GFP expression. Green fluorescence was detected in all groups that received the rAAV2-GFP vector, indicating expression of the rAAV2 transgene; however, GFP expression in the UTMD group was significantly higher than that in control groups. We conclude that ultrasound-mediated destruction mediated by SonoVue is a promising method for delivery of rAAV2 to the heart in vivo.

Targeted microbubbles for ultrasound mediated gene transfection and apoptosis induction in ovarian cancer cells

Ultrasound-targeted microbubble destruction (UTMD) technique can be potentially used for non-viral delivery of gene therapy. Targeting wild-type p53 (wtp53) tumor suppressor gene may provide a clinically promising treatment for patients with ovarian cancer. However, UTMD mediated gene therapy typically uses non-targeted microbubbles with suboptimal gene transfection efficiency. We synthesized a targeted microbubble agent for UTMD mediated wtp53 gene therapy in ovarian cancer cells. Lipid microbubbles were conjugated with a Luteinizing Hormone-Releasing Hormone analog (LHRHa) via an avidin-biotin linkage to target the ovarian cancer A2780/DDP cells that express LHRH receptors. The microbubbles were mixed with the pEGFP-N1-wtp53 plasmid. Upon exposure to 1 MHz pulsed ultrasound beam (0.5 W/cm(2)) for 30s, the wtp53 gene was transfected to the ovarian cancer cells. The transfection efficiency was (43.90 ± 6.19)%. The expression of wtp53 mRNA after transfection was (97.08 ± 12.18)%. The cell apoptosis rate after gene therapy was (39.67 ± 5.95)%. In comparison with the other treatment groups, ultrasound mediation of targeted microbubbles yielded higher transfection efficiency and higher cell apoptosis rate (p<0.05). Our experiment verifies the hypothesis that ultrasound mediation of targeted microbubbles will enhance the gene transfection efficiency in ovarian cancer cells.

Advances in ultrasound mediated gene therapy using microbubble contrast agents

Microbubble ultrasound contrast agents have the potential to dramatically improve gene therapy treatments by enhancing the delivery of therapeutic DNA to malignant tissue. The physical response of microbubbles in an ultrasound field can mechanically perturb blood vessel walls and cell membranes, enhancing drug permeability into malignant tissue. In this review, we discuss literature that provided evidence of specific mechanisms that enhance in vivo gene delivery utilizing microbubble contrast agents, namely their ability to 1) improving cell membrane permeability, 2) modulate vascular permeability, and 3) enhance endocytotic uptake in cells. Additionally, we review novel microbubble vectors that are being developed in order to exploit these mechanisms and deliver higher gene payloads with greater target specificity. Finally, we discuss some future considerations that should be addressed in the development of next-generation microbubbles in order to improve in vivo microbubble gene delivery. Overall, microbubbles are rapidly gaining popularity as efficient gene carriers, and combined with their functionality as imaging contrast agents, they represent powerful theranostic tools for image guided gene therapy applications.

Synergy of ultrasound microbubbles and vancomycin against Staphylococcus epidermidis biofilm

OBJECTIVES

Device-associated biofilm infections primarily caused by Staphylococcus epidermidis are difficult to treat effectively with conventional antibiotics. The aim of this study was to investigate the anti-biofilm effect of ultrasound-mediated microbubbles combined with vancomycin and to explore underlying mechanisms.

METHODS

Twenty-four hour S. epidermidis biofilms were established in OptiCell(TM) chambers to facilitate ultrasound exposure. Microbubbles were prepared and diluted to concentrations of 1% and 4% (v/v). Ultrasound was applied for 5 min at 300 kHz and 0.5 W/cm(2), with a 50% duty cycle. Vancomycin at the peak serum concentration of 32 mg/L was used on preformed biofilms for 24 h. Antibiotic susceptibility tests were conducted on biofilms to confirm the synergy between ultrasound and vancomycin. Biofilms exposed to ultrasound-mediated microbubbles combined with vancomycin were subjected to plate counting and microscopic examinations. A vancomycin penetration test was also performed.

RESULTS

Ultrasound and ultrasound-mediated microbubbles both enhanced biofilm susceptibility to vancomycin. Ultrasound-mediated microbubbles without vancomycin could exert a bactericidal effect on biofilms. A bubble dose-dependent bioeffect was also observed. In the presence of vancomycin, biofilms exposed to ultrasound-mediated microbubbles exhibited significantly more micropores and more reduction in biofilm thickness than other treatment groups (P<0.05). The transportation of vancomycin through S. epidermidis biofilms was significantly enhanced by ultrasound, and microbubbles could further increase biofilm permeability to vancomycin.

CONCLUSIONS

Ultrasound-mediated microbubbles may provide an efficient and non-invasive alternative to treat device-related biofilm infections. Future research is needed to optimize ultrasound parameters and microbubble concentrations so that this technology can be both effectively and safely applied in clinical practice.

Targeted microbubbles in the experimental and clinical setting

BACKGROUND

Microbubbles have improved ultrasonography imaging techniques over the past 2 decades. Their safety, versatility, and easiness of use have rendered them equal or even superior in some instances to other imaging modalities such as computed tomography and magnetic resonance imaging. Herein, we conducted a literature review to present their types, general behavior in tissues, and current and potential use in clinical practice.

METHODS

A literature search was conducted for all preclinical and clinical studies involving microbubbles and ultrasonography.

RESULTS

Different types of microbubbles are available. These generally improve the enhancement of tissues during ultrasonography imaging. They also can be attached to ligands for the target of several conditions such as inflammation, angiogenesis, thrombosis, apoptosis, and might have the potential of carrying toxic drugs to diseased sites, thereby limiting the systemic adverse effects.

CONCLUSIONS

The use of microbubbles is evolving rapidly and can have a significant impact on the management of various conditions. The potential for their use as targeting agents and gene and drug delivery vehicles looks promising.

Neuroepithelial transforming protein 1 short interfering RNA-mediated gene silencing with microbubble and ultrasound exposure inhibits the proliferation of hepatic carcinoma cells in vitro

OBJECTIVES

Short interfering RNA (siRNA) has been used to knock down the expression of targeted genes in a process known as RNA interference. However, the key to RNA interference is the efficient intracellular delivery of the siRNA. In this study, we sought to enhance the efficiency of transduction and find a novel therapy for hepatic carcinoma.

METHODS

Three types of neuroepithelial transforming protein 1 (NET-1) siRNAs (labeled fluorescent) were designed and transduced into HepG2 cells. Then the most effective one in silencing NET-1 was determined. The HepG2 cells were divided into 5 groups: untreated control; delivery of siRNA; delivery of siRNA using Lipofectamine 2000 (Invitrogen, Carlsbad, CA; group L); delivery of siRNA using ultrasound exposure and microbubbles (group US); and delivery of siRNA using Lipofectamine, ultrasound exposure, and microbubbles (group LUS). The efficiency of siRNA transfer was determined by detection of luciferase activity on microscopy; NET-1 expression was assayed by reverse transcription-polymerase chain reaction and western blotting; and proliferation investigations of the HepG2 cells were performed. RESULTS- The transfection efficiency of microbubbles combined with ultrasound exposure was nearly equal to Lipofectamine-mediated transfection (P = .609). More importantly, the combination of Lipofectamine, microbubbles, and ultrasound exposure effectively reduced NET-1 expression compared with the other groups (P < .01). Furthermore, the proliferation of cells in groups L, US, and LUS was visibly inhibited between 24 and 72 hours.

CONCLUSIONS

The use of a microbubble contrast agent combined with ultrasound exposure could be a potent physical method for increasing gene delivery efficiency. This technique is a promising nonviral approach that can be used in liver cancer.

Therapeutic ultrasonic microbubbles carrying paclitaxel and LyP-1 peptide: preparation, characterization and application to ultrasound-assisted chemotherapy in breast cancer cells

The aim of this work was to develop a novel targeted drug-loaded microbubble (MB) and to investigate its chemotherapy effect in vitro. Paclitaxel (PTX)-loaded lipid MBs were prepared by a mechanical vibration technique. The LyP-1, a breast tumor homing peptide, was coated onto the surface of PTX-loaded MBs through biotin-avidin linkage. The resulting targeted drug-loaded MBs were characterized and applied to ultrasound-assisted chemotherapy in breast cancer cells. Our results showed the ultrasonic MBs were able to achieve 43%-63% of drug encapsulation efficiency, depending on drug loading amount. The binding affinity assay indicated the attachment of targeted MBs to human MDA-MB-231 breast cancer cells was highly efficient and stable even with ultrasonic irradiation on. The cellular uptake efficiency of payload in targeted MBs was 3.71-, 4.95-, 7.43- and 7.66-fold higher than that of non-targeted MBs at the applied ultrasound time of 30, 60, 90 and 120 s, respectively. In addition, the cell proliferation inhibition assay showed the cell viability of targeted PTX-loaded MBs was significantly lower than that of non-targeted PTX-loaded MBs and non-targeted unloaded MBs when ultrasound was utilized. In conclusion, the study indicated the LyP-1-coated PTX-loaded MBs significantly increased the antitumor efficacy and can be used as a potential chemotherapy approach for ultrasound-assisted breast cancer treatment.

Exploiting ultrasound-mediated effects in delivering targeted, site-specific cancer therapy

Although the concept of employing ultrasound for the treatment of cancer is not a new one, virtually all existing ultrasound-based clinical cancer treatments are based on hyperthermic ablation. This review seeks to highlight the potential offered by more subtle ultrasound-triggered phenomena such as sonoporation in delivering novel targeted cancer treatment modalities.

Microbubbles coated with disaturated lipids and DSPE-PEG2000: phase behavior, collapse transitions, and permeability

Saturated diacyl (disaturated) phosphatidylcholine (PC) mixed with the lipopolymer distearoylphosphatidylethanolamine (DSPE)-polyethyleneglycol molecular weight 2000 (PEG2000) self-assemble as a monolayer at the air-water interface of air-in-water micrometer-scale bubbles (microbubbles), similar to coatings (shells) on leading medical ultrasound contrast agents (UCAs). This system is characterized here to study the impact of the DSPE-PEG2000 species and PC chain-length on the monolayer coating phase behavior, collapse, shedding, and air transport resistance and microbubble dissolution rate and surface contour. Using fluorescence microscopy of dissolving microbubbles, we found that film microstructure and collapse behavior for all chain lengths (n = 14-20) was indicative of primarily condensed phase monolayers, unlike similar coatings containing polyethyleneglycol 40 stearate (PEG40S) that are either expanded phase or coexisting expanded-condensed phase monolayers. Additionally, we observed a new surface buckling type of behavior with all chain lengths, by bright field microscopy, where the air-water interface continuously appears rough (rather than cyclically rough and smooth), with this behavior most frequently observed for n = 16. In correlating the statistical frequency of this behavior with the monolayer microstructure, we propose that it arises from a slowed nucleation rate of collapse structures at condensed-condensed phase interfaces, not present in systems containing PEG40S. By modeling the dissolution (radius vs time) data, we obtained, for each chain length, the film air transport resistance (R(shell)) that was then fit to a chain-length-dependent energy barrier model. Importantly, the pre-exponential factor was approximately 10 x higher and the microbubbles persisted approximately 4 x longer (from 15 microm at a fixed dissolved oxygen content) in comparison to previously studied films containing PEG40S. We attribute the unique stability properties of microbubble coatings containing DSPE-PEG2000 to the propensity of this molecule to form a condensed-phase monolayer, such that the monolayer coatings approach the properties of one continuous condensed domain.

Induced apoptosis with ultrasound-mediated microbubble destruction and shRNA targeting survivin in transplanted tumors

INTRODUCTION

This study was designed to evaluate the consequences of survivin down-modulation on tumor growth in a nude mice model combined with short hairpin RNA recombinant vector (shRNA) and ultrasound-mediated microbubble destruction (UMMD).

METHODS

BALB/c nude mice were inoculated subcutaneously with cervical cancer cells (HeLa) and tumors (5-10 mm) developed. A shRNA recombinant vector that targeted the survivin gene (survivin-shRNA) was constructed. The mice were divided into three groups (n=6 in each group) and injected with survivin-shRNA: plasmid group (P), plasmid+ultrasound exposure group (P+US), and plasmid+microbubble (SonoVue(R))+ultrasound group (P+UMMD). Protein expression of survivin, proliferating cell nuclear antigen (PCNA), and caspase-3 were investigated by immunohistochemistry, and proliferation index (PI) and apoptotic index (AI) were measured.

RESULTS

The protein expression of survivin and PCNA was markedly downregulated, while caspase-3 was markedly upregulated in the P+UMMD group as compared with that of the P group and P+US group. PI decreased significantly (P<0.05), whereas AI increased remarkably (P<0.01) in the P+UMMD group as compared with that of the P group and P+US group. These data indicate that the combined strategy of UMMD and survivin-shRNA effectively induces silencing of the survivin gene, resulting in inhibition of proliferation and induction of apoptosis in nude mice.

CONCLUSIONS

Survivin could be regarded as an ideal target for anticancer intervention of cervical cancer. The combination of shRNA and UMMD could enhance antitumor efficacy as a result of synergism. This may be a powerful, promising non-viral technology that could be used in tumor gene therapy.