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Fang S, Wu S, Chen P. Targeting Caveolin-1 for enhanced rotator cuff repair: findings from single-cell RNA sequencing. Cell Death Discov 2025; 11:88. [PMID: 40044676 PMCID: PMC11882801 DOI: 10.1038/s41420-025-02359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 02/05/2025] [Accepted: 02/13/2025] [Indexed: 03/09/2025] Open
Abstract
Rotator cuff injury (RCI), a prevalent cause of shoulder pain and disability, often leads to significant functional impairments due to adipocyte infiltration into the damaged tissue. Caveolin-1 (Cav-1), a critical membrane protein, plays a significant role in adipocyte differentiation and lipid metabolism. This study utilized single-cell RNA sequencing (scRNA-seq) to investigate the heterogeneity of cell subpopulations in RCI tissues and assess the regulatory effects of Cav-1. The findings revealed that Cav-1 expression negatively correlates with adipogenic activity, and its modulation through exercise or targeted therapies can significantly reduce adipocyte infiltration and enhance tissue repair. Further, Cav-1 knockout and overexpression models demonstrated the protein's impact on key genes involved in adipocyte differentiation and lipid metabolism, such as Scd1, fatty acid synthase (FASN), and peroxisome proliferator-activated receptor gamma (Pparg). Animal studies corroborated these results, showing that exercise intervention increased Cav-1 expression, decreased adipocyte infiltration, and promoted structural repair. These insights suggest that targeting Cav-1 could offer a novel therapeutic strategy for improving RCI outcomes.
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Affiliation(s)
- Shanhong Fang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, PR China
- Fujian Orthopaedics Research Institute, Fuzhou, PR China
- Fujian Orthopedic Bone and Joint Disease and Sports Rehabilitation Clinical Medical Research Center, Fuzhou, PR China
| | - Songye Wu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, PR China
- Fujian Orthopaedics Research Institute, Fuzhou, PR China
- Fujian Orthopedic Bone and Joint Disease and Sports Rehabilitation Clinical Medical Research Center, Fuzhou, PR China
| | - Peng Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China.
- Department of Sports Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, PR China.
- Fujian Orthopaedics Research Institute, Fuzhou, PR China.
- Fujian Orthopedic Bone and Joint Disease and Sports Rehabilitation Clinical Medical Research Center, Fuzhou, PR China.
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Ke G, Zhang M, Hu P, Zhang J, Naeem A, Wang L, Xu H, Liu Y, Cao M, Zheng Q. Exploratory Study on Nanoparticle Co-Delivery of Temozolomide and Ligustilide for Enhanced Brain Tumor Therapy. Pharmaceutics 2025; 17:191. [PMID: 40006558 PMCID: PMC11858958 DOI: 10.3390/pharmaceutics17020191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 01/12/2025] [Accepted: 01/16/2025] [Indexed: 02/27/2025] Open
Abstract
Background: Temozolomide (TMZ) is the first-line therapy for glioblastoma (GBM), but its clinical efficacy is limited by its short half-life, poor brain targeting, adverse side effects, and the development of drug resistance. Ligustilide (LIG) has been shown to enhance blood-brain barrier permeability and reduce P-glycoprotein activity, thereby potentiating the synergistic effect of TMZ against GBM. Methods: The dual-drug-loaded nanoparticles encapsulating both TMZ and LIG (TMZ/LIG-NPs) were prepared using Poly (d,l-lactic-co-glycolide)-monomethoxy poly (ethylene glycol) (PLGA-mPEG). The physicochemical properties of the NPs, including particle size and zeta potential, were characterized. Cellular uptake of NPs was evaluated using flow cytometry and fluorescence staining. The pharmacokinetic profile and cytotoxicity of TMZ/LIG-NPs were compared to those of free TMZ and a mixture of TMZ and LIG in rat and glioma cells, respectively. Results: The mean particle size of TMZ/LIG-NPs was 117.6 ± 0.7 nm, with a zeta potential of -26.5 ± 0.4 mV. Cellular uptake of NPs was significantly higher than that of free drug in U251 cells. Encapsulation of TMZ in NPs significantly increased its half-life by 1.62-fold compared to free TMZ and significantly improved its pharmacokinetic profile. Moreover, the storage stability of the TMZ/LIG-NPs solution was extended to one month. The toxicity of TMZ/LIG-NPs to glioma cells C6 and U251 was markedly enhanced compared to the mixture of TMZ and LIG. Conclusions: The development of TMZ/LIG-NPs using PLGA-mPEG effectively enhanced the stability and efficacy of both TMZ and LIG. This dual drug-loaded nanoparticle system represents a promising strategy for glioblastoma therapy.
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Affiliation(s)
- Gang Ke
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
- Luzhou People’s Hospital, Luzhou 646000, China
| | - Mingxia Zhang
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Pengyi Hu
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Jing Zhang
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Abid Naeem
- School of Life Science, Advanced Research Institute of Multidisciplinary Science, School of Medical Technology, Key Laboratory of Molecular Medicine and Biotherapy, Key Laboratory of Medical Molecule Science and Pharmaceutics Engineering, Beijing Institute of Technology, Beijing 100081, China;
| | - Lianfang Wang
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Huixin Xu
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Yu Liu
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Ming Cao
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
| | - Qin Zheng
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China; (G.K.); (M.Z.); (P.H.); (J.Z.); (L.W.); (H.X.); (Y.L.); (M.C.)
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Scherer B, Bogun L, Koch A, Jäger P, Maus U, Schmitt L, Krings KS, Wesselborg S, Haas R, Schroeder T, Geyh S. Antineoplastic therapy affects the in vitro phenotype and functionality of healthy human bone marrow-derived mesenchymal stromal cells. Arch Toxicol 2025; 99:393-406. [PMID: 39531065 PMCID: PMC11742341 DOI: 10.1007/s00204-024-03898-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 10/17/2024] [Indexed: 11/16/2024]
Abstract
While antineoplastic therapies aim to specifically target cancer cells, they may also exert adverse effects on healthy tissues, like healthy hematopoietic stem and progenitor cells (HSPC), leading to hematotoxicity as a common side effect. Mesenchymal stromal cells (MSC) are a major component of the bone marrow (BM) microenvironment, regulating normal hematopoiesis, while their susceptibility to anticancer therapies and contribution to therapy-related hematotoxicity remains largely unexplored. To address this, we investigated the effects of etoposide, temozolomide, 5-azacitidine, and venetoclax on healthy BM-derived MSC functionality. Doses below therapeutic effects of etoposide (0.1-0.25 µM) inhibited cellular growth and induced cellular senescence in healthy MSC, accompanied by an increased mRNA expression of CDKN1A, decreased trilineage differentiation capacity, and insufficient hematopoietic support. Pharmacological doses of 5-azacitidine (2.5 µM) shifted MSC differentiation capacity by inhibiting osteogenic capacity but enhancing the chondrogenic lineage, as demonstrated by histochemical staining and on mRNA level. At the highest clinically relevant dose, neither venetoclax (40 nM) nor temozolomide (100 µM) exerted any effects on MSC but clearly inhibited cellular growth of cancer cell lines and primary healthy HSPC, pointing to damage to hematopoietic cells as a major driver of hematotoxicity of these two compounds. Our findings show that besides HSPC, also MSC are sensitive to certain antineoplastic agents, resulting in molecular and functional alterations that may contribute to therapy-related myelosuppression. Understanding these interactions could be helpful for the development of strategies to preserve BM MSC functionality during different kinds of anticancer therapies.
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Affiliation(s)
- Bo Scherer
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Lucienne Bogun
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Annemarie Koch
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Paul Jäger
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Uwe Maus
- Department of Orthopedic Surgery and Traumatology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Moorenstraße 5, 40225, Duesseldorf, Germany
| | - Laura Schmitt
- Institute for Molecular Medicine 1, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Universitätsstraße 1, 40225, Duesseldorf, Germany
| | - Karina S Krings
- Institute for Molecular Medicine 1, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Universitätsstraße 1, 40225, Duesseldorf, Germany
| | - Sebastian Wesselborg
- Institute for Molecular Medicine 1, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Universitätsstraße 1, 40225, Duesseldorf, Germany
| | - Rainer Haas
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Thomas Schroeder
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
| | - Stefanie Geyh
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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Zhang L, Wang G, Li Z, Yang J, Li H, Wang W, Li Z, Li H. Molecular pharmacology and therapeutic advances of monoterpene perillyl alcohol. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155826. [PMID: 38897045 DOI: 10.1016/j.phymed.2024.155826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/20/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Perillyl alcohol (POH) is a aroma monoterpene commonly obtained from various plants' essential oil. Recently, increasing researches have demonstrated that POH may be useful, not only as flavor compound, but also as bioactive molecule because of a variety of biological activities. PURPOSE The aim of this review is to summarize the production, pharmacological activities and molecular mechanism, active derivatives, toxicity and parmacokinetics, and industrial application of POH. METHODS A systematic search of published articles up to January 2024 in Web of Science, China Knowledge Network, and PubMed databases is conducted using the following keywords: POH, POH derivatives, biological or pharmacological, production or synthesis, pharmacokinetics, toxicity and application. RESULTS Biotechnological production is considered to be a potential alternative approach to generate POH. POH provides diverse pharmacological benefits, including anticancer, antimicrobial, insecticidal, antioxidant, anti-inflammatory, hypotensive, vasorelaxant, antinociceptive, antiasthmatic, hepatoprotective effects, etc. The underlying mechanisms of action include modulation of NF-κB, JNK/c-Jun, Notch, Akt/mTOR, PI3K/Akt/eNOS, STAT3, Nrf2 and ERS response pathways, mitigation of mitochondrial dysfunction and membrane integrity damage, and inhibition of ROS accumulation, pro-inflammatory cytokines release and NLRP3 activation. What's more, the proteins or genes influenced by POH against diseases refer to Bax, Bcl-2, cyclin D1, CDK, p21, p53, HIF-1α, AP-1, caspase-3, M6P/IGF2R, PARP, VEGF, etc. Some clinical studies report that intranasal delivery of POH is a safe and effective treatment for cancer, but further clinical investigations are needed to confirm other health benefits of POH in human healthy. Depending on these health-promoting properties together with desirable flavor and safety, POH can be employed as dietary supplement, preservative and flavor additive in food and cosmetic fields, as building block in synthesis fields, as anticancer drug in medicinal fields, and as pesticides and herbicides in agricultural fields. CONCLUSION This review systematically summarizes the recent advances in POH and highlights its therapeutic effects and potential mechanisms as well as the clinical settings, which is helpful to develop POH into functional food and new candidate drug for prevention and management of diseases. Future studies are needed to conduct more biological activity studies of POH and its derivatives, and check their clinical efficacy and potential side effects.
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Affiliation(s)
- Lulu Zhang
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China.
| | - Guoguo Wang
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China
| | - Zehao Li
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China
| | - Jinchu Yang
- Technology Center, China Tobacco Henan Industrial Co., Ltd., Zhengzhou, Henan 450000, PR China.
| | - Haoliang Li
- Technology Center, China Tobacco Henan Industrial Co., Ltd., Zhengzhou, Henan 450000, PR China
| | - Wanying Wang
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China
| | - Zhijian Li
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China
| | - Hua Li
- College of Food Science and Technology, Henan University of Technology, Zhengzhou, Henan 450001, PR China; Henan Province Wheat-flour Staple Food Engineering Technology Research Centre, Zhengzhou, Henan 450001, PR China.
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Hartman-Houstman H, Swenson S, Minea RO, Sinha UK, Chiang MF, Chen TC, Schönthal AH. Activation of Epstein-Barr Virus' Lytic Cycle in Nasopharyngeal Carcinoma Cells by NEO212, a Conjugate of Perillyl Alcohol and Temozolomide. Cancers (Basel) 2024; 16:936. [PMID: 38473298 DOI: 10.3390/cancers16050936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/27/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
The Epstein-Barr virus (EBV) is accepted as a primary risk factor for certain nasopharyngeal carcinoma (NPC) subtypes, where the virus persists in a latent stage which is thought to contribute to tumorigenesis. Current treatments are sub-optimal, and recurrence occurs in many cases. An alternative therapeutic concept is aimed at triggering the lytic cycle of EBV selectively in tumor cells as a means to add clinical benefit. While compounds able to stimulate the lytic cascade have been identified, their clinical application so far has been limited. We are developing a novel anticancer molecule, NEO212, that was generated by covalent conjugation of the alkylating agent temozolomide (TMZ) to the naturally occurring monoterpene perillyl alcohol (POH). In the current study, we investigated its potential to trigger the lytic cycle of EBV in NPC cells in vitro and in vivo. We used the established C666.1 cell line and primary patient cells derived from the brain metastasis of a patient with NPC, both of which harbored latent EBV. Upon treatment with NEO212, there was an increase in EBV proteins Zta and Ea-D, key markers of the lytic cycle, along with increased levels of CCAAT/enhancer-binding protein homologous protein (CHOP), a marker of endoplasmic reticulum (ER) stress, followed by the activation of caspases. These effects could also be confirmed in tumor tissue from mice implanted with C666.1 cells. Towards a mechanistic understanding of these events, we used siRNA-mediated knockdown of CHOP and inclusion of anti-oxidant compounds. Both approaches blocked lytic cycle induction by NEO212. Therefore, we established a sequence of events, where NEO212 caused reactive oxygen species (ROS) production, which triggered ER stress and elevated the levels of CHOP, which was required to stimulate the lytic cascade of EBV. Inclusion of the antiviral agent ganciclovir synergistically enhanced the cytotoxic impact of NEO212, pointing to a potential combination treatment for EBV-positive cancers which should be explored further. Overall, our study establishes NEO212 as a novel agent able to stimulate EBV's lytic cycle in NPC tumors, with implications for other virus-associated cancers.
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Affiliation(s)
- Hannah Hartman-Houstman
- Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USA
| | - Steve Swenson
- Department of Neurosurgery, Keck School of Medicine, USC, Los Angeles, CA 90089, USA
| | - Radu O Minea
- Department of Neurosurgery, Keck School of Medicine, USC, Los Angeles, CA 90089, USA
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
| | - Uttam K Sinha
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
- Department of Otolaryngology, Keck School of Medicine, USC, Los Angeles, CA 90089, USA
| | - Ming-Fu Chiang
- Department of Neurosurgery, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
| | - Thomas C Chen
- Department of Neurosurgery, Keck School of Medicine, USC, Los Angeles, CA 90089, USA
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
- NeOnc Technologies, Inc., Los Angeles, CA 90069, USA
| | - Axel H Schönthal
- Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USA
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Minea RO, Thein TZ, Yang Z, Campan M, Ward PM, Schönthal AH, Chen TC. NEO212, temozolomide conjugated to NEO100, exerts superior therapeutic activity over temozolomide in preclinical chemoradiation models of glioblastoma. Neurooncol Adv 2024; 6:vdae095. [PMID: 39022643 PMCID: PMC11252566 DOI: 10.1093/noajnl/vdae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background The chemotherapeutic standard of care for patients with glioblastoma (GB) is radiation therapy (RT) combined with temozolomide (TMZ). However, during the twenty years since its introduction, this so-called Stupp protocol has revealed major drawbacks, because nearly half of all GBs harbor intrinsic treatment resistance mechanisms. Prime among these are the increased expression of the DNA repair protein O6-guanine-DNA methyltransferase (MGMT) and cellular deficiency in DNA mismatch repair (MMR). Patients with such tumors receive very little, if any, benefit from TMZ. We are developing a novel molecule, NEO212 (TMZ conjugated to NEO100), that harbors the potential to overcome these limitations. Methods We used mouse models that were orthotopically implanted with GB cell lines or primary, radioresistant human GB stem cells, representing different treatment resistance mechanisms. Animals received NEO212 (or TMZ for comparison) without or with RT. Overall survival was recorded, and histology studies quantified DNA damage, apoptosis, microvessel density, and impact on bone marrow. Results In all tumor models, replacing TMZ with NEO212 in a schedule designed to mimic the Stupp protocol achieved a strikingly superior extension of survival, especially in TMZ-resistant and RT-resistant models. While NEO212 displayed pronounced radiation-sensitizing, DNA-damaging, pro-apoptotic, and anti-angiogenic effects in tumor tissue, it did not cause bone marrow toxicity. Conclusions NEO212 is a candidate drug to potentially replace TMZ within the standard Stupp protocol. It has the potential to become the first chemotherapeutic agent to significantly extend overall survival in TMZ-resistant patients when combined with radiation.
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Affiliation(s)
- Radu O Minea
- Department of Neurological Surgery, Keck School of Medicine (KSOM), University of Southern California (USC), Los Angeles, California, USA
- Norris Comprehensive Cancer Center, KSOM, USC, Los Angeles, California, USA
| | - Thu Zan Thein
- Department of Neurological Surgery, Keck School of Medicine (KSOM), University of Southern California (USC), Los Angeles, California, USA
| | - Zhuoyue Yang
- Department of Molecular Microbiology and Immunology, KSOM, USC, Los Angeles, California, USA
| | - Mihaela Campan
- USC Clinical Laboratories, KSOM, USC, Los Angeles, California, USA
| | - Pamela M Ward
- Department of Pathology, KSOM, USC, Los Angeles, California, USA
| | - Axel H Schönthal
- Department of Molecular Microbiology and Immunology, KSOM, USC, Los Angeles, California, USA
| | - Thomas C Chen
- NeOnc Technologies, Inc., Los Angeles, California, USA
- Department of Neurological Surgery, Keck School of Medicine (KSOM), University of Southern California (USC), Los Angeles, California, USA
- Department of Pathology, KSOM, USC, Los Angeles, California, USA
- Norris Comprehensive Cancer Center, KSOM, USC, Los Angeles, California, USA
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Ahmed IA, Senan EM, Shatnawi HSA, Alkhraisha ZM, Al-Azzam MMA. Hybrid Techniques for the Diagnosis of Acute Lymphoblastic Leukemia Based on Fusion of CNN Features. Diagnostics (Basel) 2023; 13:diagnostics13061026. [PMID: 36980334 PMCID: PMC10047564 DOI: 10.3390/diagnostics13061026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
Acute lymphoblastic leukemia (ALL) is one of the deadliest forms of leukemia due to the bone marrow producing many white blood cells (WBC). ALL is one of the most common types of cancer in children and adults. Doctors determine the treatment of leukemia according to its stages and its spread in the body. Doctors rely on analyzing blood samples under a microscope. Pathologists face challenges, such as the similarity between infected and normal WBC in the early stages. Manual diagnosis is prone to errors, differences of opinion, and the lack of experienced pathologists compared to the number of patients. Thus, computer-assisted systems play an essential role in assisting pathologists in the early detection of ALL. In this study, systems with high efficiency and high accuracy were developed to analyze the images of C-NMC 2019 and ALL-IDB2 datasets. In all proposed systems, blood micrographs were improved and then fed to the active contour method to extract WBC-only regions for further analysis by three CNN models (DenseNet121, ResNet50, and MobileNet). The first strategy for analyzing ALL images of the two datasets is the hybrid technique of CNN-RF and CNN-XGBoost. DenseNet121, ResNet50, and MobileNet models extract deep feature maps. CNN models produce high features with redundant and non-significant features. So, CNN deep feature maps were fed to the Principal Component Analysis (PCA) method to select highly representative features and sent to RF and XGBoost classifiers for classification due to the high similarity between infected and normal WBC in early stages. Thus, the strategy for analyzing ALL images using serially fused features of CNN models. The deep feature maps of DenseNet121-ResNet50, ResNet50-MobileNet, DenseNet121-MobileNet, and DenseNet121-ResNet50-MobileNet were merged and then classified by RF classifiers and XGBoost. The RF classifier with fused features for DenseNet121-ResNet50-MobileNet reached an AUC of 99.1%, accuracy of 98.8%, sensitivity of 98.45%, precision of 98.7%, and specificity of 98.85% for the C-NMC 2019 dataset. With the ALL-IDB2 dataset, hybrid systems achieved 100% results for AUC, accuracy, sensitivity, precision, and specificity.
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Affiliation(s)
| | - Ebrahim Mohammed Senan
- Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, Alrazi University, Sana'a, Yemen
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