1
|
Jaffal K, Chevillard L, Mégarbane B. Lipid Emulsion to Treat Acute Poisonings: Mechanisms of Action, Indications, and Controversies. Pharmaceutics 2023; 15:pharmaceutics15051396. [PMID: 37242638 DOI: 10.3390/pharmaceutics15051396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Biodetoxification using intravenous lipid emulsion (ILE) in acute poisoning is of growing interest. As well as for local anesthetics, ILE is currently used to reverse toxicity caused by a broad-spectrum of lipophilic drugs. Both pharmacokinetic and pharmacodynamic mechanisms have been postulated to explain its possible benefits, mainly combining a scavenging effect called "lipid sink" and cardiotonic activity. Additional mechanisms based on ILE-attributed vasoactive and cytoprotective properties are still under investigation. Here, we present a narrative review on lipid resuscitation, focusing on the recent literature with advances in understanding ILE-attributed mechanisms of action and evaluating the evidence supporting ILE administration that enabled the international recommendations. Many practical aspects are still controversial, including the optimal dose, the optimal administration timing, and the optimal duration of infusion for clinical efficacy, as well as the threshold dose for adverse effects. Present evidence supports the use of ILE as first-line therapy to reverse local anesthetic-related systemic toxicity and as adjunct therapy in lipophilic non-local anesthetic drug overdoses refractory to well-established antidotes and supportive care. However, the level of evidence is low to very low, as for most other commonly used antidotes. Our review presents the internationally accepted recommendations according to the clinical poisoning scenario and provides the precautions of use to optimize the expected efficacy of ILE and limit the inconveniences of its futile administration. Based on their absorptive properties, the next generation of scavenging agents is additionally presented. Although emerging research shows great potential, several challenges need to be overcome before parenteral detoxifying agents could be considered as an established treatment for severe poisonings.
Collapse
Affiliation(s)
- Karim Jaffal
- Department of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, 75010 Paris, France
- INSERM UMRS-1144, Paris-Cité University, 75006 Paris, France
| | - Lucie Chevillard
- Department of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, 75010 Paris, France
- INSERM UMRS-1144, Paris-Cité University, 75006 Paris, France
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, 75010 Paris, France
- INSERM UMRS-1144, Paris-Cité University, 75006 Paris, France
| |
Collapse
|
2
|
Banerjee S, Zargari M, Medzikovic L, Russino H, Mikhael M, Koons N, Grogan T, Rahman S, Eghbali M, Umar S. Intralipid® improves left ventricular function in rats with lipopolysaccharide-induced endotoxaemia by a Src-STAT3-mediated mechanism. Br J Anaesth 2023; 130:e183-e187. [PMID: 36462942 PMCID: PMC10170391 DOI: 10.1016/j.bja.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Somanshu Banerjee
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Michael Zargari
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Lejla Medzikovic
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Hanzi Russino
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Matthew Mikhael
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Natalie Koons
- University of New England School of Osteopathic Medicine, Biddeford, ME, USA
| | - Tristan Grogan
- Department of Medicine Statistics Core, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Siamak Rahman
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Mansoureh Eghbali
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Soban Umar
- Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
| |
Collapse
|
3
|
Monge C, Stoppa I, Ferraris C, Bozza A, Battaglia L, Cangemi L, Miglio G, Pizzimenti S, Clemente N, Gigliotti CL, Boggio E, Dianzani U, Dianzani C. Parenteral Nanoemulsions Loaded with Combined Immuno- and Chemo-Therapy for Melanoma Treatment. Nanomaterials (Basel) 2022; 12:nano12234233. [PMID: 36500861 PMCID: PMC9740980 DOI: 10.3390/nano12234233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 06/01/2023]
Abstract
High-grade melanoma remains a major life-threatening illness despite the improvement in therapeutic control that has been achieved by means of targeted therapies and immunotherapies in recent years. This work presents a preclinical-level test of a multi-pronged approach that includes the loading of immunotherapeutic (ICOS-Fc), targeted (sorafenib), and chemotherapeutic (temozolomide) agents within Intralipid®, which is a biocompatible nanoemulsion with a long history of safe clinical use for total parenteral nutrition. This drug combination has been shown to inhibit tumor growth and angiogenesis with the involvement of the immune system, and a key role is played by ICOS-Fc. The inhibition of tumor growth in subcutaneous melanoma mouse models has been achieved using sub-therapeutic drug doses, which is most likely the result of the nanoemulsion's targeting properties. If translated to the human setting, this approach should therefore allow therapeutic efficacy to be achieved without increasing the risk of toxic effects.
Collapse
Affiliation(s)
- Chiara Monge
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
| | - Ian Stoppa
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, via Solaroli 17, 28100 Novara, Italy
| | - Chiara Ferraris
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
- Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Regione Gonzole 10, 10043 Orbassano, Italy
| | - Annalisa Bozza
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
| | - Luigi Battaglia
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
- Nanostructured Interfaces and Surfaces (NIS) Interdepartmental Centre, Università degli Studi di Torino, 10124 Torino, Italy
| | - Luigi Cangemi
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
| | - Gianluca Miglio
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
| | - Stefania Pizzimenti
- Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Corso Raffaello 30, 10124 Torino, Italy
| | - Nausicaa Clemente
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, via Solaroli 17, 28100 Novara, Italy
| | - Casimiro Luca Gigliotti
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, via Solaroli 17, 28100 Novara, Italy
| | - Elena Boggio
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, via Solaroli 17, 28100 Novara, Italy
| | - Umberto Dianzani
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, via Solaroli 17, 28100 Novara, Italy
- Azienda Ospedaliero-Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
| | - Chiara Dianzani
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, via Pietro Giuria 9, 10125 Torino, Italy
| |
Collapse
|
4
|
Dianzani C, Monge C, Miglio G, Serpe L, Martina K, Cangemi L, Ferraris C, Mioletti S, Osella S, Gigliotti CL, Boggio E, Clemente N, Dianzani U, Battaglia L. Nanoemulsions as Delivery Systems for Poly-Chemotherapy Aiming at Melanoma Treatment. Cancers (Basel) 2020; 12:cancers12051198. [PMID: 32397484 PMCID: PMC7281359 DOI: 10.3390/cancers12051198] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 11/17/2022] Open
Abstract
Aims: Advanced melanoma is characterized by poor outcome. Despite the number of treatments having been increased over the last decade, current pharmacological strategies are only partially effective. Therefore, the improvement of the current systemic therapy is worthy of investigation. Methods: a nanotechnology-based poly-chemotherapy was tested at preclinical level. Temozolomide, rapamycin, and bevacizumab were co-loaded as injectable nanoemulsions for total parenteral nutrition (Intralipid®), due to suitable devices, and preliminarily tested in vitro on human and mouse cell models and in vivo on the B16-F10 melanoma mouse model. Results: Drug combination was efficiently loaded in the liquid lipid matrix of Intralipid®, including bevacizumab monoclonal antibody, leading to a fast internalization in tumour cells. An increased cytotoxicity towards melanoma cells, as well as an improved inhibition of tumour relapse, migration, and angiogenesis were demonstrated in cell models for the Intralipid®-loaded drug combinations. In preliminary in vivo studies, the proposed approach was able to reduce tumour growth significantly, compared to controls. A relevant efficacy towards tumour angiogenesis and mitotic index was determined and immune response was involved. Conclusions: In these preliminary studies, Intralipid® proved to be a safe and versatile poly-chemotherapy delivery system for advanced melanoma treatment, by acting on multiple mechanisms.
Collapse
Affiliation(s)
- Chiara Dianzani
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Chiara Monge
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Gianluca Miglio
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Loredana Serpe
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Katia Martina
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Luigi Cangemi
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Chiara Ferraris
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
| | - Silvia Mioletti
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, Italy;
| | - Sara Osella
- San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154 Turin, Italy;
| | - Casimiro Luca Gigliotti
- Department of Health Sciences and Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Eastern Piedmont (UPO), via Solaroli 17, 28100 Novara, Italy; (C.L.G.); (E.B.); (N.C.); (U.D.)
| | - Elena Boggio
- Department of Health Sciences and Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Eastern Piedmont (UPO), via Solaroli 17, 28100 Novara, Italy; (C.L.G.); (E.B.); (N.C.); (U.D.)
| | - Nausicaa Clemente
- Department of Health Sciences and Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Eastern Piedmont (UPO), via Solaroli 17, 28100 Novara, Italy; (C.L.G.); (E.B.); (N.C.); (U.D.)
| | - Umberto Dianzani
- Department of Health Sciences and Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Eastern Piedmont (UPO), via Solaroli 17, 28100 Novara, Italy; (C.L.G.); (E.B.); (N.C.); (U.D.)
| | - Luigi Battaglia
- Department of Drug Science and Technology, University of Turin, via Pietro Giuria 9, 10125 Turin, Italy; (C.D.); (C.M.); (G.M.); (L.S.); (K.M.); (L.C.); (C.F.)
- Correspondence:
| |
Collapse
|
5
|
Lédée N, Vasseur C, Petitbarat M, Chevrier L, Vezmar K, Dray G, Chenière S, Lobersztajn A, Vitoux D, Cassuto GN, Chaouat G. Intralipid® may represent a new hope for patients with reproductive failures and simultaneously an over-immune endometrial activation. J Reprod Immunol 2018; 130:18-22. [PMID: 30286362 DOI: 10.1016/j.jri.2018.09.050] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/03/2018] [Accepted: 09/19/2018] [Indexed: 01/01/2023]
Abstract
PROBLEM Continuous failures to achieve a pregnancy despite effective embryo transfers is extremely distressing for couples. In consequence, many adjuvant therapies to IVF have been proposed to achieve an "ideal" immune environment. We here focus on Intralipid® therapy (IL) reported to have immunosuppressive properties on NK cells. METHOD OF STUDY 94 patients exhibited an immune profile of endometrial over-immune activation and an history of repeated implantation failures despite multiple embryos transfers (RIF). They received a slow perfusion of Intralipid®. We here report the live birth rate following the procedure at the next embryo transfer. To get new insight on its mechanism of action, a second immune profiling had been performed under Intralipid® before the embryo transfer. RESULTS The live birth rate of the RIF cohort treated with Intralipid® reached 54% (51/94) at the next embryo transfer. In patients successfully pregnant under Intralipid® who benefitted of a test of sensibility before the embryo transfer, we observed a significant decrease of the three biomarkers used to diagnose the over-immune endometrial activation (CD56 cells; IL-18/TWEAK, IL-14/FN-14). CONCLUSIONS Double blind placebo versus Intralipid® studies should be conducted. Intralipid® may be an option to explore in RIF patients who exhibit an over-immune activation of uNK cells.
Collapse
Affiliation(s)
- Nathalie Lédée
- MatriceLAB Innove, Pépinière Paris Santé Cochin, 29 rue du Faubourg Saint Jacques, 75014 Paris, France; Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France.
| | - Claudine Vasseur
- Pole Sante Vinci 1 Avenue Du Pr Alexandre Minkowski, 37170 Chambray Les Tours, France
| | - Marie Petitbarat
- MatriceLAB Innove, Pépinière Paris Santé Cochin, 29 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Lucie Chevrier
- MatriceLAB Innove, Pépinière Paris Santé Cochin, 29 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Katia Vezmar
- MatriceLAB Innove, Pépinière Paris Santé Cochin, 29 rue du Faubourg Saint Jacques, 75014 Paris, France; Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France; Pole Sante Vinci 1 Avenue Du Pr Alexandre Minkowski, 37170 Chambray Les Tours, France; Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Geraldine Dray
- Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France
| | - Sandra Chenière
- Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France
| | - Annina Lobersztajn
- Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France
| | - Dominique Vitoux
- MatriceLAB Innove, Pépinière Paris Santé Cochin, 29 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Guy Nino Cassuto
- Centre d'assistance médical à la procréation Bluets-Drouot, Hospital Les Bluets, 4 rue Lasson 75012 Paris, France
| | - Gérard Chaouat
- Institut National de Santé et de Recherche Médicale, INSERM UMR-976, Saint-Louis Hospital, Research Center, 1 Avenue Claude Vellefaux, 75010, Paris, France
| |
Collapse
|