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Almarghalani DA, Boddu SHS, Ali M, Kondaka A, Ta D, Shah RA, Shah ZA. Small interfering RNAs based therapies for intracerebral hemorrhage: challenges and progress in drug delivery systems. Neural Regen Res 2022; 17:1717-1725. [PMID: 35017419 PMCID: PMC8820693 DOI: 10.4103/1673-5374.332129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Intracerebral hemorrhage (ICH) is a subtype of stroke associated with higher rates of mortality. Currently, no effective drug treatment is available for ICH. The molecular pathways following ICH are complicated and diverse. Nucleic acid therapeutics such as gene knockdown by small interfering RNAs (siRNAs) have been developed in recent years to modulate ICH’s destructive pathways and mitigate its outcomes. However, siRNAs delivery to the central nervous system is challenging and faces many roadblocks. Existing barriers to systemic delivery of siRNA limit the use of naked siRNA; therefore, siRNA-vectors developed to protect and deliver these therapies into the specific-target areas of the brain, or cell types seem quite promising. Efficient delivery of siRNA via nanoparticles emerged as a viable and effective alternative therapeutic tool for central nervous system-related diseases. This review discusses the obstacles to siRNA delivery, including the advantages and disadvantages of viral and nonviral vectors. Additionally, we provide a comprehensive overview of recent progress in nanotherapeutics areas, primarily focusing on the delivery system of siRNA for ICH treatment.
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Affiliation(s)
- Daniyah A Almarghalani
- Department of Pharmacology and Experimental Therapeutics; Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Mohammad Ali
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Akhila Kondaka
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Devin Ta
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Rayyan A Shah
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Zahoor A Shah
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
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2
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Stine CA, Munson JM. Convection-Enhanced Delivery: Connection to and Impact of Interstitial Fluid Flow. Front Oncol 2019; 9:966. [PMID: 31632905 PMCID: PMC6783516 DOI: 10.3389/fonc.2019.00966] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023] Open
Abstract
Convection-enhanced delivery (CED) is a method used to increase transport of therapeutics in and around brain tumors. CED works through locally applying a pressure differential to drive fluid flow throughout the tumor, such that convective forces dominate over diffusive transport. This allows therapies to bypass the blood brain barrier that would otherwise be too large or solely rely on passive diffusion. However, this also drives fluid flow out through the tumor bulk into surrounding brain parenchyma, which results in increased interstitial fluid (IF) flow, or fluid flow within extracellular spaces in the tissue. IF flow has been associated with altered transport of molecules, extracellular matrix rearrangement, and triggering of cellular motility through a number of mechanisms. Thus, the results of a simple method to increase drug delivery may have unintended consequences on tissue morphology. Clinically, prediction of dispersal of agents via CED is important to catheter design, placement, and implementation to optimize contact of tumor cells with therapeutic agent. Prediction software can aid in this problem, yet we wonder if there is a better way to predict therapeutic distribution based simply on IF flow pathways as determined from pre-intervention imaging. Overall, CED based therapy has seen limited success and we posit that integration and appreciation of altered IF flow may enhance outcomes. Thus, in this manuscript we both review the current state of the art in CED and IF flow mechanistic understanding and relate these two elements to each other in a clinical context.
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Affiliation(s)
| | - Jennifer M. Munson
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
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3
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Lynes J, Sanchez V, Dominah G, Nwankwo A, Nduom E. Current Options and Future Directions in Immune Therapy for Glioblastoma. Front Oncol 2018; 8:578. [PMID: 30568917 PMCID: PMC6290347 DOI: 10.3389/fonc.2018.00578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022] Open
Abstract
Glioblastoma is in need of innovative treatment approaches. Immune therapy for cancer refers to the use of the body's immune system to target malignant cells in the body. Such immune therapeutics have recently been very successful in treating a diverse group of cancerous lesions. As a result, many new immune therapies have gained Food and Drug Administration approval for the treatment of cancer, and there has been an explosion in the study of immune therapeutics for cancer treatment over the past few years. However, the immune suppression of glioblastoma and the unique immune microenvironment of the brain make immune therapeutics more challenging to apply to the brain than to other systemic cancers. Here, we discuss the existing barriers to successful immune therapy for glioblastoma and the ongoing development of immune therapeutics. We will discuss the discovery and classification of immune suppressive factors in the glioblastoma microenvironment; the development of vaccine-based therapies; the use of convection-enhanced delivery to introduce tumoricidal viruses into the tumor microenvironment, leading to secondary immune responses; the emerging use of adoptive cell therapy in the treatment of glioblastoma; and future frontiers, such as the use of cerebral microdialysis for immune monitoring and the use of sequencing to develop patient-specific therapeutics. Armed with a better understanding of the challenges inherent in immune therapy for glioblastoma, we may soon see more successes in immune-based clinical trials for this deadly disease.
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Affiliation(s)
- John Lynes
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States.,MedStar Georgetown University Hospital, Washington, DC, United States
| | - Victoria Sanchez
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Gifty Dominah
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Anthony Nwankwo
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Edjah Nduom
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
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4
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Matsuzaki F, Shitamukai A. Cell Division Modes and Cleavage Planes of Neural Progenitors during Mammalian Cortical Development. Cold Spring Harb Perspect Biol 2015; 7:a015719. [PMID: 26330517 DOI: 10.1101/cshperspect.a015719] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
During mammalian brain development, neural progenitor cells undergo symmetric proliferative divisions followed by asymmetric neurogenic divisions. The division mode of these self-renewing progenitors, together with the cell fate of their progeny, plays critical roles in determining the number of neurons and, ultimately, the size of the adult brain. In the past decade, remarkable progress has been made toward identifying various types of neuronal progenitors. Recent technological advances in live imaging and genetic manipulation have enabled us to link dynamic cell biological events to the molecular mechanisms that control the asymmetric divisions of self-renewing progenitors and have provided a fresh perspective on the modes of division of these progenitors. In addition, comparison of progenitor repertoires between species has provided insight into the expansion and the development of the complexity of the brain during mammalian evolution.
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Affiliation(s)
- Fumio Matsuzaki
- Laboratory for Cell Asymmetry, RIKEN Center for Developmental Biology, Chuo-ku, Kobe 650-0047, Japan
| | - Atsunori Shitamukai
- Laboratory for Cell Asymmetry, RIKEN Center for Developmental Biology, Chuo-ku, Kobe 650-0047, Japan
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Tanguy Y, Biferi MG, Besse A, Astord S, Cohen-Tannoudji M, Marais T, Barkats M. Systemic AAVrh10 provides higher transgene expression than AAV9 in the brain and the spinal cord of neonatal mice. Front Mol Neurosci 2015; 8:36. [PMID: 26283910 PMCID: PMC4516891 DOI: 10.3389/fnmol.2015.00036] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/06/2015] [Indexed: 12/14/2022] Open
Abstract
Systemic delivery of self-complementary (sc) adeno-associated-virus vector of serotype 9 (AAV9) was recently shown to provide robust and widespread gene transfer to the central nervous system (CNS), opening new avenues for practical, and non-invasive gene therapy of neurological diseases. More recently, AAV of serotype rh10 (AAVrh10) was also found highly efficient to mediate CNS transduction after intravenous administration in mice. However, only a few studies compared AAV9 and AAVrh10 efficiencies, particularly in the spinal cord. In this study, we compared the transduction capabilities of AAV9 and AAVrh10 in the brain, the spinal cord, and the peripheral nervous system (PNS) after intravenous delivery in neonatal mice. As reported in previous studies, AAVrh10 achieved either similar or higher transduction than AAV9 in all the examined brain regions. The superiority of AAVrh10 over AAV9 appeared statistically significant only in the medulla and the cerebellum, but a clear trend was also observed in other structures like the hippocampus or the cortex. In contrast to previous studies, we found that AAVrh10 was more efficient than AAV9 for transduction of the dorsal spinal cord and the lower motor neurons (MNs). However, differences between the two serotypes appeared mainly significant at low dose, and surprisingly, increasing the dose did not improve AAVrh10 distribution in the spinal cord, in contrary to AAV9. Similar dose-related differences between transduction efficiency of the two serotypes were also observed in the sciatic nerve. These findings suggest differences in the transduction mechanisms of these two serotypes, which both hold great promise for gene therapy of neurological diseases.
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Affiliation(s)
- Yannick Tanguy
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Maria G Biferi
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Aurore Besse
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Stephanie Astord
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Mathilde Cohen-Tannoudji
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Thibaut Marais
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
| | - Martine Barkats
- Center of Research on Myology, FRE 3617 Centre National de la Recherche Scientifique, UMRS 974 INSERM, French Institute of Myology, Pierre and Marie Curie University Paris, France
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Tagalakis AD, Castellaro S, Zhou H, Bienemann A, Munye MM, McCarthy D, White EA, Hart SL. A method for concentrating lipid peptide DNA and siRNA nanocomplexes that retains their structure and transfection efficiency. Int J Nanomedicine 2015; 10:2673-83. [PMID: 25878500 PMCID: PMC4388080 DOI: 10.2147/ijn.s78935] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Nonviral gene and small interfering RNA (siRNA) delivery formulations are extensively used for biological and therapeutic research in cell culture experiments, but less so in in vivo and clinical research. Difficulties with formulating the nanoparticles for uniformity and stability at concentrations required for in vivo and clinical use are limiting their progression in these areas. Here, we report a simple but effective method of formulating monodisperse nanocomplexes from a ternary formulation of lipids, targeting peptides, and nucleic acids at a low starting concentration of 0.2 mg/mL of DNA, and we then increase their concentration up to 4.5 mg/mL by reverse dialysis against a concentrated polymer solution at room temperature. The nanocomplexes did not aggregate and they had maintained their biophysical properties, but, importantly, they also mediated DNA transfection and siRNA silencing in cultured cells. Moreover, concentrated anionic nanocomplexes administered by convection-enhanced delivery in the striatum showed efficient silencing of the β-secretase gene BACE1. This method of preparing nanocomplexes could probably be used to concentrate other nonviral formulations and may enable more widespread use of nanoparticles in vivo.
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Affiliation(s)
- Aristides D Tagalakis
- Experimental and Personalised Medicine Section, University College London (UCL) Institute of Child Health, London, UK
| | - Sara Castellaro
- Experimental and Personalised Medicine Section, University College London (UCL) Institute of Child Health, London, UK ; Department of Pharmacy, University of Genova, Genova, Italy
| | - Haiyan Zhou
- Experimental and Personalised Medicine Section, University College London (UCL) Institute of Child Health, London, UK
| | - Alison Bienemann
- Functional Neurosurgery Research Group, School of Clinical Sciences, AMBI Labs, University of Bristol, Southmead Hospital, Bristol, UK
| | - Mustafa M Munye
- Experimental and Personalised Medicine Section, University College London (UCL) Institute of Child Health, London, UK
| | | | - Edward A White
- Functional Neurosurgery Research Group, School of Clinical Sciences, AMBI Labs, University of Bristol, Southmead Hospital, Bristol, UK
| | - Stephen L Hart
- Experimental and Personalised Medicine Section, University College London (UCL) Institute of Child Health, London, UK
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7
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Kanai R, Rabkin SD. Combinatorial strategies for oncolytic herpes simplex virus therapy of brain tumors. CNS Oncol 2015; 2:129-42. [PMID: 23687568 DOI: 10.2217/cns.12.42] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Oncolytic viruses, such as the oncolytic herpes simplex virus (oHSV), are an exciting new therapeutic strategy for cancer as they are replication competent in tumor cells but not normal cells. In order to engender herpes simplex virus with oncolytic activity and make it safe for clinical application, mutations are engineered into the virus. Glioblastoma multiforme (GBM) is the most common and deadly primary brain tumor in adults. Despite many advances in therapy, overall survival has not been substantially improved over the last several decades. A number of different oHSVs have been tested as monotherapy in early-phase clinical trials for GBM and have demonstrated safety and anecdotal evidence of efficacy. However, strategies to improve efficacy are likely to be necessary to successfully treat GBM. Cancer treatment usually involves multimodal approaches, so the standard of care for GBM includes surgery, radiotherapy and chemotherapy. In preclinical GBM models, combinations of oHSV with other types of therapy have exhibited markedly improved activity over individual treatments alone. In this review, we will discuss the various combination strategies that have been employed with oHSV, including chemotherapy, small-molecule inhibitors, antiangiogenic agents, radiotherapy and expression of therapeutic transgenes. Effective combinations, especially synergistic ones, are clinically important not just for improved efficacy but also to permit lower and less-toxic doses and potentially overcome resistance.
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van Tellingen O, Yetkin-Arik B, de Gooijer M, Wesseling P, Wurdinger T, de Vries H. Overcoming the blood–brain tumor barrier for effective glioblastoma treatment. Drug Resist Updat 2015; 19:1-12. [DOI: 10.1016/j.drup.2015.02.002] [Citation(s) in RCA: 438] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/23/2015] [Accepted: 02/25/2015] [Indexed: 12/23/2022]
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9
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Healy AT, Vogelbaum MA. Convection-enhanced drug delivery for gliomas. Surg Neurol Int 2015; 6:S59-67. [PMID: 25722934 PMCID: PMC4338487 DOI: 10.4103/2152-7806.151337] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022] Open
Abstract
In spite of aggressive multi-modality treatments, patients diagnosed with anaplastic astrocytoma and glioblastoma continue to display poor median survival. The success of our current conventional and targeted chemotherapies are largely hindered by systemic- and neurotoxicity, as well as poor central nervous system (CNS) penetration. Interstitial drug administration via convection-enhanced delivery (CED) is an alternative that potentially overcomes systemic toxicities and CNS delivery issues by directly bypassing the blood–brain barrier (BBB). This novel approach not only allows for directed administration, but also allows for newer, tumor-selective agents, which would normally be excluded from the CNS due to molecular size alone. To date, randomized trials of CED therapy have yet to definitely show survival advantage as compared with today's standard of care, however, early studies appear to have been limited by “first generation” delivery techniques. Taking into consideration lessons learned from early trials along with decades of research, newer CED technologies and therapeutic agents are emerging, which are reviewed herein.
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Affiliation(s)
- Andrew T Healy
- Neurosurgical Resident, Department of Neurological Surgery, Director, Center for Translational Therapeutics, Associate Director, Brain Tumor and Neuro-Oncology Center, ND40, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Michael A Vogelbaum
- Department of Neurological Surgery, Director, Center for Translational Therapeutics, Associate Director, Brain Tumor and Neuro-Oncology Center, ND40, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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10
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Kenny GD, Bienemann AS, Tagalakis AD, Pugh JA, Welser K, Campbell F, Tabor AB, Hailes HC, Gill SS, Lythgoe MF, McLeod CW, White EA, Hart SL. Multifunctional receptor-targeted nanocomplexes for the delivery of therapeutic nucleic acids to the brain. Biomaterials 2013; 34:9190-200. [PMID: 23948162 DOI: 10.1016/j.biomaterials.2013.07.081] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/23/2013] [Indexed: 01/05/2023]
Abstract
Convection enhanced delivery (CED) is a method of direct injection to the brain that can achieve widespread dispersal of therapeutics, including gene therapies, from a single dose. Non-viral, nanocomplexes are of interest as vectors for gene therapy in the brain, but it is essential that administration should achieve maximal dispersal to minimise the number of injections required. We hypothesised that anionic nanocomplexes administered by CED should disperse more widely in rat brains than cationics of similar size, which bind electrostatically to cell-surface anionic moieties such as proteoglycans, limiting their spread. Anionic, receptor-targeted nanocomplexes (RTN) containing a neurotensin-targeting peptide were prepared with plasmid DNA and compared with cationic RTNs for dispersal and transfection efficiency. Both RTNs were labelled with gadolinium for localisation in the brain by MRI and in brain sections by LA-ICP-MS, as well as with rhodamine fluorophore for detection by fluorescence microscopy. MRI distribution studies confirmed that the anionic RTNs dispersed more widely than cationic RTNs, particularly in the corpus callosum. Gene expression levels from anionic formulations were similar to those of cationic RTNs. Thus, anionic RTN formulations can achieve both widespread dispersal and effective gene expression in brains after administration of a single dose by CED.
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Affiliation(s)
- Gavin D Kenny
- Molecular Immunology Unit, UCL Institute of Child Health, London WC1N 1EH, UK; Centre for Advanced Biomedical Imaging, Department of Medicine and Institute of Child Health, University College London, London WC1E 6DD, UK
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11
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Olbricht W, Sistla M, Ghandi G, Lewis G, Sarvazyan A. Time-reversal acoustics and ultrasound-assisted convection-enhanced drug delivery to the brain. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 134:1569-1575. [PMID: 23927197 PMCID: PMC3745507 DOI: 10.1121/1.4812879] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 02/26/2013] [Accepted: 03/04/2013] [Indexed: 06/02/2023]
Abstract
Time-reversal acoustics is an effective way of focusing ultrasound deep inside heterogeneous media such as biological tissues. Convection-enhanced delivery is a method of delivering drugs into the brain by infusing them directly into the brain interstitium. These two technologies are combined in a focusing system that uses a "smart needle" to simultaneously infuse fluid into the brain and provide the necessary feedback for focusing ultrasound using time-reversal acoustics. The effects of time-reversal acoustics-focused ultrasound on the spatial distribution of infused low- and high-molecular weight tracer molecules are examined in live, anesthetized rats. Results show that exposing the rat brain to focused ultrasound significantly increases the penetration of infused compounds into the brain. The addition of stabilized microbubbles enhances the effect of ultrasound exposure.
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Affiliation(s)
- William Olbricht
- School of Chemical and Biomolecular Engineering and Department of Biomedical Engineering, Olin Hall, Cornell University, Ithaca, New York 14853, USA.
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12
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Tobias A, Ahmed A, Moon KS, Lesniak MS. The art of gene therapy for glioma: a review of the challenging road to the bedside. J Neurol Neurosurg Psychiatry 2013; 84:213-22. [PMID: 22993449 PMCID: PMC3543505 DOI: 10.1136/jnnp-2012-302946] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Glioblastoma multiforme (GBM) is a highly invasive brain tumour that is unvaryingly fatal in humans despite even aggressive therapeutic approaches such as surgical resection followed by chemotherapy and radiotherapy. Unconventional treatment options such as gene therapy provide an intriguing option for curbing glioma related deaths. To date, gene therapy has yielded encouraging results in preclinical animal models as well as promising safety profiles in phase I clinical trials, but has failed to demonstrate significant therapeutic efficacy in phase III clinical trials. The most widely studied antiglioma gene therapy strategies are suicide gene therapy, genetic immunotherapy and oncolytic virotherapy, and we have attributed the challenging transition of these modalities into the clinic to four major roadblocks: (1) anatomical features of the central nervous system, (2) the host immune system, (3) heterogeneity and invasiveness of GBM and (4) limitations in current GBM animal models. In this review, we discuss possible ways to jump these hurdles and develop new gene therapies that may be used alone or in synergy with other modalities to provide a powerful treatment option for patients with GBM.
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Affiliation(s)
- Alex Tobias
- Brain Tumour Center, The University of Chicago, 5841 South Maryland Ave, MC 3026, Chicago, IL 60637, USA
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Writer MJ, Kyrtatos PG, Bienemann AS, Pugh JA, Lowe AS, Villegas-Llerena C, Kenny GD, White EA, Gill SS, McLeod CW, Lythgoe MF, Hart SL. Lipid peptide nanocomplexes for gene delivery and magnetic resonance imaging in the brain. J Control Release 2012; 162:340-8. [PMID: 22800579 PMCID: PMC3657147 DOI: 10.1016/j.jconrel.2012.07.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 06/29/2012] [Accepted: 07/03/2012] [Indexed: 11/16/2022]
Abstract
Gadolinium-labelled nanocomplexes offer prospects for the development of real-time, non-invasive imaging strategies to visualise the location of gene delivery by MRI. In this study, targeted nanoparticle formulations were prepared comprising a cationic liposome (L) containing a Gd-chelated lipid at 10, 15 and 20% by weight of total lipid, a receptor-targeted, DNA-binding peptide (P) and plasmid DNA (D), which electrostatically self-assembled into LPD nanocomplexes. The LPD formulation containing the liposome with 15% Gd-chelated lipid displayed optimal peptide-targeted, transfection efficiency. MRI conspicuity peaked at 4h after incubation of the nanocomplexes with cells, suggesting enhancement by cellular uptake and trafficking. This was supported by time course confocal microscopy analysis of transfections with fluorescently-labelled LPD nanocomplexes. Gd-LPD nanocomplexes delivered to rat brains by convection-enhanced delivery were visible by MRI at 6 h, 24 h and 48 h after administration. Histological brain sections analysed by laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) confirmed that the MRI signal was associated with the distribution of Gd(3+) moieties and differentiated MRI signals due to haemorrhage. The transfected brain cells near the injection site appeared to be mostly microglial. This study shows the potential of Gd-LPD nanocomplexes for simultaneous delivery of contrast agents and genes for real-time monitoring of gene therapy in the brain.
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Affiliation(s)
- Michele J. Writer
- Molecular Immunology Unit, UCL Institute of Child Health, London WC1N 1EH, UK
| | - Panagiotis G. Kyrtatos
- Centre for Advanced Biomedical Imaging, Department of Medicine and UCL Institute of Child Health, University College London, London WC1E 6DD, UK
| | - Alison S. Bienemann
- The Functional Neurosurgery Research Group, Bristol University, Institute of Clinical Neurosciences, Southmead Hospital, Bristol BS16 1LE, UK
| | - John A. Pugh
- Centre For Analytical Sciences, University of Sheffield, Sheffield S10 2TN, UK
| | - Andrew S. Lowe
- Centre for Advanced Biomedical Imaging, Department of Medicine and UCL Institute of Child Health, University College London, London WC1E 6DD, UK
| | | | - Gavin D. Kenny
- Molecular Immunology Unit, UCL Institute of Child Health, London WC1N 1EH, UK
| | - Edward A. White
- The Functional Neurosurgery Research Group, Bristol University, Institute of Clinical Neurosciences, Southmead Hospital, Bristol BS16 1LE, UK
| | - Steven S. Gill
- The Functional Neurosurgery Research Group, Bristol University, Institute of Clinical Neurosciences, Southmead Hospital, Bristol BS16 1LE, UK
| | - Cameron W. McLeod
- Centre For Analytical Sciences, University of Sheffield, Sheffield S10 2TN, UK
| | - Mark F. Lythgoe
- Centre for Advanced Biomedical Imaging, Department of Medicine and UCL Institute of Child Health, University College London, London WC1E 6DD, UK
| | - Stephen L. Hart
- Molecular Immunology Unit, UCL Institute of Child Health, London WC1N 1EH, UK
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White E, Bienemann A, Pugh J, Castrique E, Wyatt M, Taylor H, Cox A, McLeod C, Gill S. An evaluation of the safety and feasibility of convection-enhanced delivery of carboplatin into the white matter as a potential treatment for high-grade glioma. J Neurooncol 2012; 108:77-88. [PMID: 22476649 DOI: 10.1007/s11060-012-0833-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 02/15/2012] [Indexed: 11/26/2022]
Abstract
Glioblastoma multiforme (GBM) is the most common and most aggressive form of intrinsic brain tumour. Despite standard treatment involving surgical resection, chemotherapy and radiotherapy this disease remains incurable with the majority of tumours recurring adjacent to the resection cavity. Consequently there is a clear need to improve local tumour control. Convection-enhanced delivery (CED) is a practical technique for administering chemotherapeutics directly into peritumoural brain. In this study, we have tested the hypothesis that carboplatin would be an appropriate chemotherapeutic agent to administer by CED into peritumoural brain to treat GBM. Within this study we have evaluated the relationships between carboplatin concentration, duration of exposure and tumour cell kill in vitro using GBM cell lines and the relationship between carboplatin concentration and clinical and histological evidence of toxicity in vivo. In addition, we have used laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) to evaluate the distribution properties of carboplatin following CED into rat brain and to determine the rate at which carboplatin is cleared from the brain. Finally, we have compared the distribution properties of carboplatin and the MRI contrast agent gadolinium-DTPA in pig brain. The results of these experiments confirm that carboplatin can be widely distributed by CED and that it remains in the brain for at least 24 h after infusion completion. Furthermore, carboplatin provokes a significant GBM cell kill at concentrations that are not toxic to normal brain. Finally, we provide evidence that gadolinium-DTPA coinfusion is a viable technique for visualising carboplatin distribution using T1-weighted MR imaging.
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Affiliation(s)
- Edward White
- Functional Neurosurgery Group, Department of Neurosurgery, Frenchay Hospital, Bristol, BS16 1LE, UK
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15
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A phase I trial of carboplatin administered by convection-enhanced delivery to patients with recurrent/progressive glioblastoma multiforme. Contemp Clin Trials 2011; 33:320-31. [PMID: 22101221 DOI: 10.1016/j.cct.2011.10.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 10/21/2011] [Accepted: 10/25/2011] [Indexed: 11/20/2022]
Abstract
Glioblastoma multiforme (GBM) is the commonest primary malignant brain tumour in adults. Standard treatment comprises surgery, radiotherapy and chemotherapy; however this condition remains incurable as these tumours are highly invasive and involve critical areas of the brain making it impossible to remove them surgically or cure them with radiotherapy. In the majority of cases the tumour recurs within 2 to 3 cm of the original site of tumour resection. Furthermore, the blood-brain barrier profoundly limits the access of many systemically administered chemotherapeutics to the tumour. Convection-enhanced delivery (CED) is a promising technique of direct intracranial drug delivery involving the implantation of microcatheters into the brain. Carboplatin represents an ideal chemotherapy to administer using this technique as glioblastoma cells are highly sensitive to carboplatin in vitro at concentrations that are not toxic to normal brain in vivo. This protocol describes a single-centre phase I dose-escalation study of carboplatin administered by CED to patients with recurrent or progressive GBM despite full standard treatment. This trial will incorporate 6 cohorts of 3 patients each. Cohorts will be treated in a sequential manner with increasing doses of carboplatin, subject to dose-limiting toxicity not being observed. This protocol should facilitate the identification of the maximum-tolerated infused concentration of carboplatin by CED into the supratentorial brain. This should facilitate the safe application of this technique in a phase II trial, treating patients with GBM, as well as for the treatment of other forms of malignant brain tumours, including metastases.
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17
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Muik A, von Laer D. Oncolytic virotherapy of glioma: what does it need to make it work? Future Virol 2011. [DOI: 10.2217/fvl.11.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Oncolytic virotherapy is a highly promising approach, with diverse viruses currently under development as therapeutic agents to treat malignant glioma. Although the first clinical trials did not show toxicity or serious adverse events related to intracerebral administration, overall the antitumor efficacy has fallen short of expectations. This article discusses multiple options on how to improve and maximize the effectiveness of oncolytic virus therapy in brain cancer, including strategies to enhance safety by attenuating neurovirulence via cancer-specific cell-targeting, increasing antitumor potency by transgene-arming and integrating the ability to trigger an effective antitumoral immune response, as well as developing optimized delivery routes in order to boost intratumoral viral distribution. Eventually, it will highlight the use of multipronged approaches, combining multiple modes of action of different agents.
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Affiliation(s)
| | - Dorothee von Laer
- Division of Virology, Innsbruck Medical University, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
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White E, Bienemann A, Taylor H, Castrique E, Bunnun C, Wyatt M, Gill S. An evaluation of site-specific immune responses directed against first-generation adenoviral vectors administered by convection-enhanced delivery. J Gene Med 2011; 13:269-82. [PMID: 21544905 DOI: 10.1002/jgm.1567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Direct adenoviral vector injections into the brain have been used in clinical trials to treat patients with high-grade gliomas. However, a recent phase 3 trial using first-generation vectors failed to demonstrate significant survival benefits. Malignant gliomas infiltrate extensively through the white matter, making them difficult to treat, and chemotherapy is at best partially effective. Convection enhanced delivery (CED) represents a rationale approach for achieving widespread targeting of infiltrating tumour cells. Previous studies have demonstrated that infusions of particle numbers above a threshold level [10(8) plaque-forming units (pfu)] are associated with a pronounced inflammatory response in rat grey matter, although no such comparisons have been made with CED infusions into the white matter. METHODS In the present study, we investigated the distribution and immune response after the administration of 10(7) and 10(9) pfu of a first-generation adenoviral vector (Ad.CMV.EGFP) by CED in both small and large animal models. RESULTS We show that Ad.CMV.EGFP can be efficiently distributed by CED over large volumes of brain. A threshold vector dose of between 10(7) and 10(9) pfu was seen in both rat striatum and white matter, above which transgene expression was lost at 30 days. Furthermore, all adenoviral infusions were associated with evidence of significant tissue damage, as demonstrated by loss of neurones and astrocytes or the presence of extensive astrocytosis. CONCLUSIONS These results indicate that CED is capable of mediating widespread adenoviral vector distribution, although these vectors are associated with significant tissue toxicity that may render their safe application in clinical trials unfeasible.
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Affiliation(s)
- Edward White
- Department of Neurosurgery, Frenchay Hospital, Bristol, UK
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Smith E, Breznik J, Lichty BD. Strategies to enhance viral penetration of solid tumors. Hum Gene Ther 2011; 22:1053-60. [PMID: 21443415 DOI: 10.1089/hum.2010.227] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The efficient delivery of viral vectors to tumors is an active area of investigation. A number of barriers exist that must be overcome to achieve good penetration of vectors into tumors and distribution of their effects throughout the tumor mass. Replicating oncolytic viruses have the advantage of being able to amplify the initial dose, but progeny virus are prevented from spreading because of a dense mass of tightly packed cells with a dense extracellular matrix, admixed normal stromal cells, and high interstitial pressure. Although intratumoral injection may ensure initial delivery the distribution achieved by intravenous administration may be superior and come with beneficial bystander damage to the tumor vasculature. Strategies to enhance intravenous delivery and subsequent spread of these vectors within tumors are being developed by a number of groups. Achieving the goal of efficient penetration and spread of viruses within solid tumors is a necessary prerequisite to significant improvements in virus-vectored therapy of solid tumors.
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Affiliation(s)
- Elspeth Smith
- Centre for Gene Therapeutics, McMaster University, Hamilton, ON, Canada L8N 3Z5
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