Reirradiation vs. Systemic Therapy vs. Combination Therapy for Recurrent High-Grade Glioma: A Meta-Analysis of Survival and Toxicity

PURPOSE/OBJECTIVE(S)

To compare the effects of reirradiation, systemic therapy and combination therapy (reirradiation + systemic therapy) on overall survival (OS), progression-free survival (PFS) and adverse effects (AEs) in patients with recurrent high-grade glioma (rHGG).

MATERIALS/METHODS

A search was performed on PubMed, Scopus, Embase and CENTRAL on 18 March 2022, and repeated on 1 November 2022. Studies comparing OS, PFS and AEs in patients with rHGG, and encompassing the following four groups were included; reirradiation vs systemic therapy, combination therapy vs systemic therapy, combination therapy vs reirradiation, and reirradiation + bevacizumab-based systemic therapy vs reirradiation +/- non-bevacizumab-based systemic therapy. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized control trials (RCTs) and the ROBINS-I tool for non-randomized studies. The logHR and SE (logHR) for OS and PFS, and logRR and SE (logRR) for AEs were extracted or estimated if not reported. Meta-analyses were performed for each comparator group using a random effects model. Subgroup analysis was performed on only RCTs if ≥ 2 studies were available.

RESULTS

Thirty-three studies comprising of 2201 participants were included. In the reirradiation vs systemic therapy group, there was no difference in PFS (2 studies, 185 participants; HR 0.87 (95% CI 0.61-1.22)) and OS (3 studies, 237 participants; HR 0.94 (95% CI 0.67-1.31)). In the combination therapy vs systemic therapy group, combination therapy improved PFS (6 studies, 605 participants; HR = 0.70 (95% CI 0.59-0.82)) and OS (6 studies, 537 participants; HR 0.73 (95% CI 0.56-0.96)), and there was no difference in grade 3+ AEs (4 studies, 398 participants; RR 1.03 (95% CI 0.57-1.86)). Subgroup analysis of only RCTs (2 studies, 205 participants) similarly showed no difference in grade 3+ AEs (RR 1.13 (95% CI 0.71-1.82)), though no significant improvements in PFS (HR 0.51 (95% CI 0.22-1.19)) or OS (HR 0.90 (95% CI 0.65-1.26)) were demonstrated. In the combination therapy vs reirradiation group, combination therapy improved PFS (5 studies, 259 participants; HR 0.50 (95% CI 0.37-0.69)) and OS (13 studies, 713 participants; HR 0.59 (95% CI 0.47-0.74)). In the reirradiation + bevacizumab-based systemic therapy vs reirradiation +/- non-bevacizumab-based systemic therapy group, combining reirradiation with bevacizumab improved PFS (2 studies, 104 participants; HR 0.46 (95% CI 0.27-0.77)) and OS (5 studies, 256 participants; HR 0.42 (95% CI 0.24-0.72)), and reduced radionecrosis (RN) (5 studies, 353 participants; RR 0.17 (95% CI 0.06-0.48)).

CONCLUSION

Combination therapy may improve OS and PFS with acceptable toxicity in select patients with rHGG. Further RCTs comparing systemic therapy to combination therapy, particularly with bevacizumab-based systemic therapy, are needed. The limitations of previous RCTs must be addressed; namely inadequate accrual of appropriate patients, and exclusion of FLAIR abnormalities from target delineation.

Portable Microwave-Acoustic Coaxial Thermoacoustic Probe With Miniaturized Vivaldi Antennas for Breast Tumor Screening

Microwave-induced thermoacoustic (TA) imaging (MTAI), which exploits dielectric contrasts to provide images with high contrast and spatial resolution, holds the potential to serve as an additional means of clinical diagnosis and treatment. However, conventional MTAI usually uses large and heavy metal antennas to radiate pulsed microwaves, making it challenging to image different target areas flexibly. In this work, we presented the design and evaluation of a portable microwave-acoustic coaxial TA probe (51 mm × 63 mm × 138 mm) that can flexibly image the region of interest. The TA probe contains two miniaturized symmetrically distributed Vivaldi antennas (7.5 g) and a 128-element linear ultrasonic transducer. By adjusting the geometry of the antennas and the ultrasonic transducer, the TA probe's acoustic field and microwave field can be designed to be coaxial, which helps achieve homogeneous microwave illumination and high-sensitivity ultrasonic detection. The practical feasibility of the proposed probe was tested on an in vitro ewe breast and a healthy volunteer. The results demonstrate that the MTAI system with the proposed TA probe can visualize the anatomical structure of the breast tumor in ewe breast and a healthy volunteer breast with resolutions in hundreds of microns (transverse: 910 μm, axial: 780 μm) and an excellent signal-to-noise ratio can be obtained in deep adipose tissue (10 dB in 6 cm fat). The miniaturized portable TA probe takes a solid step forward in translating MTAI technology to clinical breast tumor diagnosis.

Controlling dielectric loss of biodegradable black phosphorus nanosheets by iron-ion-modification for imaging-guided microwave thermoacoustic therapy

Microwave-induced thermoacoustic (TA) technology transforms microwave into acoustic waves useable for imaging or therapy, based on the power density of the pulsed microwaves. Exploiting nanoparticles with high biocompatibility, safe metabolism, and high microwave-acoustic conversion is the key to the clinical translational application of TA therapy. In this paper, we proposed a biodegradable and high microwave absorption nanoparticle for TA therapy. The proposed nanoparticle uses iron ions to regulate the atomic defects of biodegradable black phosphorus (BP) nanosheets to augment the dielectric loss. The iron ions adsorb with the lone pair electrons indicated of BP through the conjugated π bond to increase the permanent electric dipoles. With pulsed microwave irradiation, a large number of electric dipoles are repeatedly polarized, causing instantaneous temperature rise and then generating significant TA shockwave via TA cavitation effect. TA shockwave can disrupt cell membranes in situ to trigger programmed apoptosis and produce precise anti-tumor effects. Additionally, the nanoparticle-mediated TA process generates images that deliver valuable data, such as the size, shape, and location of the tumor for treatment planning and monitoring. This hypothesis has been tested in vitro and in vivo with animal models of glioblastoma tumors. The experimental results demonstrate the high theragnostic efficiency for tumor inhibition and TA imaging, exhibiting low systemic cytotoxicity and good biocompatibility after systemic administration. The established BP-based nanoparticle with both safe metabolism and high microwave-acoustic conversion is a promising candidate for precision theranostics without obvious side effects.

Switching the NIR upconversion of nanoparticles for the orthogonal activation of photoacoustic imaging and phototherapy

Phototheranostics based on upconversion nanoparticles (UCNPs) offer the integration of imaging diagnostics and phototherapeutics. However, the programmable control of the photoactivation of imaging and therapy with minimum side effects is challenging due to the lack of ideal switchable UCNPs agents. Here we demonstrate a facile strategy to switch the near infrared emission at 800 nm from rationally designed UCNPs by modulating the irradiation laser into pulse output. We further synthesize a theranostic nanoagent by combining with a photosensitizer and a photoabsorbing agent assembled on the UCNPs. The orthogonal activation of in vivo photoacoustic imaging and photodynamic therapy can be achieved by altering the excitation modes from pulse to continuous-wave output upon a single 980 nm laser. No obvious harmful effects during photoexcitation was identified, suggesting their use for long-term imaging-guidance and phototherapy. This work provides an approach to the orthogonal activation of imaging diagnostics and photodynamic therapeutics.

Manganous-manganic oxide nanoparticle as an activatable microwave-induced thermoacoustic probe for deep-located tumor specific imaging in vivo

Deep-located tumor specific imaging has broad clinical applications in improving the accuracy of tumor diagnosis. Microwave-induced thermoacoustic imaging (MTAI), combining the high-contrast of microwave imaging with the high-resolution of ultrasound imaging, is a potential candidate for noninvasive tumor detection. Herein, a deep-located tumor specific MTAI method by tumor microenvironment (TME) activated nanoprobe is reported. In principle, manganous-manganic oxide-based nanoprobe can be triggered by TME with overexpressed glutathione and weak acidity, causing to release manganese ions and increase conductivity. With pulsed microwaves, manganese ions move repeatedly in gigahertz alternating electric field, resulting in a transient heating and thermoelastic expansion through the Joule effect, which yields a strong thermoacoustic (TA) wave in tumor site. In vitro and in vivo experiments demonstrate that manganous-manganic oxide-based nanoprobe could high-selectively amplify the TA signal in deep-located tumor. Our proposed tumor-specific MTAI method based on TME activation provides a potential approach for deep-located tumor detection.

Pulsed Microwave-Induced Thermoacoustic Shockwave for Precise Glioblastoma Therapy with the Skin and Skull Intact

Glioblastoma has a dismal prognosis and is a critical and urgent health issue that requires aggressive research and determined clinical efforts. Due to its diffuse and infiltrative growth in the brain parenchyma, complete neurosurgical resection is rarely possible. Here, pulsed microwave-induced thermoacoustic (MTA) therapy is proposed as a potential alternative modality to precisely and effectively eradicate in vivo orthotopic glioblastoma. A nanoparticle composed of polar amino acids and adenosine-based agonists is constructed with high microwave absorbance and selective penetration of the blood-brain barrier (BBB) at the tumor site. This nanoparticle can activate the adenosine receptor on the BBB to allow self-passage and tumor accumulation. The nanoparticle converts absorbed microwaves into ultrasonic shockwaves via the thermoacoustic cavitation effect. The ultrasonic shockwave can mechanically destroy tumor cells within a short range with minimal damage to adjacent normal brain tissue due to the rapid decay of the ultrasonic shockwave intensity. The deep tissue penetration characteristics of the microwave and the rapid decay of the ultrasonic shockwave make MTA therapy a promising glioblastoma cure including intact skin and skull.

[Development of a Ranking Tool for Scientificity, Transparency and Applicability of Clinical Practice Guidelines]

Objective: To address the limitations of existing methods and tools for evaluating clinical practice guidelines, we aimed to develop a comprehensive instrument focusing on the three main dimensions of guideline development: scientificity, transparency, applicability. We will use it to rank the guidelines according to the scores. We abbreviated it as STAR, and its reliability, validity and usability were also tested. Methods: A multidisciplinary expert working group was set up, including methodologists, statisticians, journal editors, medical professionals, and others. Scoping review, Delphi methods and hierarchical analysis were used to determine the final checklist of STAR. Results: The new instrument contained 11 domains and 39 items. Intrinsic reliability of each domain was indicated by Cronbach's α coefficient, with a average value of 0.646. The Cohen's kappa coefficients for methodological evaluators and clinical evaluators were 0.783 and 0.618. The overall content validity index was 0.905. The R2 for the criterion validity analysis was 0.76. The average score for usability of the items was 4.6, and the mean time spent to evaluate each guideline was 20 minutes. Conclusion: The instrument has good reliability, validity and evaluating efficiency, and can be used for evaluating and ranking guidelines more comprehensively.

A Handheld Microwave Thermoacoustic Imaging System With an Impedance Matching Microwave-Sono Probe for Breast Tumor Screening

Microwave-induced thermoacoustic imaging (MTAI) is a promising alternative for breast tumor detection due to its deep imaging depth, high resolution, and minimal biological hazards. However, due to the bulky size and complicated system configuration of conventional benchtop MTAI, it is limited to imaging various anatomical sites and its application in different clinical scenarios. In this study, a handheld MTAI system equipped with a compact impedance matching microwave-sono and an ergonomically designed probe was presented and evaluated. The probe integrates a flexible coaxial cable for microwave delivery, a miniaturized microwave antenna, a linear transducer array, and wedge-shaped polystyrene blocks for efficient acoustic coupling, achieving microwave illumination and ultrasonic detection coaxially, and enabling high signal-to-noise ratio (SNR). Phantom experiments demonstrated that the maximum imaging depth is 5 cm (SNR = 8 dB), and the lateral and axial resolutions are 1.5 mm and 0.9 mm, respectively. Finally, three healthy female volunteers of different ages were subjected to breast thermoacoustic tomography and ultrasound imaging. The results showed that the h-MTAI data are correlated with the data of ultrasound imaging, indicating the safety and effectiveness of the system. Thus, the proposed h-MTAI system might contribute to breast tumor screening.

[Correlation analysis between children and adolescents watching food TV advertising and fast food consumption]

Based on the open data of China Health and Nutrition Survey (CHNS), 249 children, adolescents and 249 heads of families who completed two rounds of surveys in 2011 and 2015 were selected in this study. According to the fast food consumption of children and adolescents, they were divided into fast food consumption group and non-fast food consumption group. Logistic regression model was used to analyze the relationship between children and adolescents watching Food TV advertising and fast food consumption. After adjusting relevant factors, the results showed that children and adolescents requiring their parents to buy food in TV advertisements (OR=3.122, P=0.001), parents buying food for their children in TV advertisements (OR=4.717, P=0.036), children and adolescents buying food in TV advertisements themselves (OR=3.728, P=0.041), children and adolescents' preference for food in TV advertisements (OR=2.946, P=0.044) and the frequency of children and adolescents reported by their parents asking their parents to buy food in TV advertisements (OR=3.113, P=0.002) were associated with children and adolescents' fast food consumption.

Gamma frequency light flicker regulates amyloid precursor protein trafficking for reducing β-amyloid load in Alzheimer's disease model

Inducing gamma oscillations with non‐invasive light flicker has been reported to impact Alzheimer's disease‐related pathology. However, it is unclear which signaling pathways are involved in reducing amyloid load. Here, we found that gamma frequency light flicker increased anchoring of amyloid precursor protein (APP) to the plasma membrane for non‐amyloidogenic processing, and then physically interacted with KCC2, a neuron‐specific K⁺‐Cl⁻ cotransporter, suggesting that it is essential to maintain surface GABA_A receptor α1 levels and reduce β‐amyloid (Aβ) production. Stimulation with such light flicker limited KCC2 internalization and subsequent degradation via both tyrosine phosphorylation and ubiquitination, leading to an increase in surface‐KCC2 levels. Specifically, PKC‐dependent phosphorylation of APP on a serine residue was induced by gamma frequency light flicker, which was responsible for maintaining plasma membrane levels of full‐length APP, leading to its reduced trafficking to endosomes and inhibiting the β‐secretase cleavage pathway. The activated PKC from the gamma frequency light flicker subsequently phosphorylated serine of KCC2 and stabilized it onto the cell surface, which contributed to the upregulation of surface GABA_A receptor α1 levels. Together, these data indicate that enhancement of APP trafficking to the plasma membrane via light flicker plays a critical modulatory role in reduction of Aβ load in Alzheimer's disease.

Human-Body-Temperature Triggerable Phase Transition of W-VO2@PEG Nanoprobes with Strong and Switchable NIR-II Absorption for Deep and Contrast-Enhanced Photoacoustic Imaging

The immense potential of temperature-responsive nanomaterials for use as contrast agents has propelled much recent research and development in the field of photoacoustic (PA) imaging, while the exorbitant transition temperature exceeding the human-tolerable range and the low reversibility of the reported temperature-sensitive nanosystems are still two severe issues that hinder effective imaging and long-term monitoring in practical applications. Herein, we propose a high-performing thermoresponsive polyethylene glycol-coated tungsten-doped vanadium dioxide (W-VO₂@PEG) nanoprobe (NP) with strong and switchable optical absorption in the near-infrared-II (NIR-II) biowindow (1000-1700 nm) near human-body temperature, to achieve deep and contrast-enhanced PA imaging. Our study shows that the PA signal amplitude of W-VO₂@PEG NPs at 1064 nm increases up to 260% when the temperature increases from 35 °C to 45 °C, with a signal fluctuation of less than 10% after 10 temperature cycles, therefore enabling great potential of "off-to-on" dynamic contrast-enhanced imaging capability in deep-seated tissues. Experiments on tissue-mimicking phantoms and in vitro chicken breast showed that, by levering the prepared W-VO₂@PEG NPs and dynamically modulating the temperature field with an external NIR optical stimulus, contrast-enhanced PA images of the target can be obtained with an imaging depth up to 1.5 cm. Furthermore, in vivo potential of the prepared thermoresponsive NPs for the detection and identification of deep-seated tumors by directly comparing to conventional "always on" NPs has been demonstrated. Our work will offer feasible guidance for the development of smart temperature-activatable PA NPs with improved imaging depth and imaging contrast.

Photoactivation of mitochondrial reactive oxygen species-mediated Src and protein kinase C pathway enhances MHC class II-restricted T cell immunity to tumours

High fluence low-level laser (HF-LLL), a mitochondria-targeted tumour phototherapy, results in oxidative damage and apoptosis of tumour cells, as well as damage to normal tissue. To circumvent this, the therapeutic effect of low fluence LLL (LFL), a non-invasive and drug-free therapeutic strategy, was identified for tumours and the underlying molecular mechanisms were investigated. We observed that LFL enhanced antigen-specific immune response of macrophages and dendritic cells by upregulating MHC class II, which was induced by mitochondrial reactive oxygen species (ROS)-activated signalling, suppressing tumour growth in both CD11c-DTR and C57BL/6 mice. Mechanistically, LFL upregulated MHC class II in an MHC class II transactivator (CIITA)-dependent manner. LFL-activated protein kinase C (PKC) promoted the nuclear translocation of CIITA, as inhibition of PKC attenuated the DNA-binding efficiency of CIITA to MHC class II promoter. CIITA mRNA and protein expression also improved after LFL treatment, characterised by direct binding of Src and STAT1, and subsequent activation of STAT1. Notably, scavenging of ROS downregulated LFL-induced Src and PKC activation and antagonised the effects of LFL treatment. Thus, LFL treatment altered the adaptive immune response via the mitochondrial ROS-activated signalling pathway to control the progress of neoplastic disease.

Quantitative and anatomical imaging of dermal angiopathy by noninvasive photoacoustic microscopic biopsy

The ability to noninvasively acquire the fine structure of deep tissues is highly valuable but remains a challenge. Here, a photoacoustic microscopic biopsy (PAMB) combined switchable spatial-scale optical excitation with single-element depth-resolved acoustic detection mode was developed, which effectively coordinated the spatial resolution and the penetration depth for visualizations of skin delamination and chromophore structures up to reticular dermis depth, with the lateral resolution from 1.5 to 104 μm and the axial resolution from 34 to 57 μm. The PAMB obtained anatomical imaging of the pigment distribution within the epidermis and the vascular patterns of the deep dermal tissue, enabling quantification of morphological abnormalities of angiopathy without the need for exogenous contrast agents. The features of healthy skin and scar skin, and the abnormal alteration of dermal vasculature in port wine stains (PWS) skin were first precisely displayed by PAMB-shown multi-layered imaging. Moreover, the quantitative vascular parameters evaluation of PWS were carried out by the detailed clinical PAMB data on 174 patients, which reveals distinct differences among different skin types. PAMB captured the PWS changes in capillary-loop depth, diameter, and vascular volume, making it possible to perform an objective clinical evaluation on the severity of PWS. All the results demonstrated the PAMB can provide vascular biopsy and new indexes deep into the dermal skin noninvasively, which should be meaningful to timely evaluate the pathological types and treatment response of skin diseases. This opens up a new perspective for label-free and non-invasive biopsies of dermal angiopathy.

All-optical noncontact phase-domain photoacoustic elastography

Mechanical properties such as elasticity are important indicators of tissue functions that can be used for clinical diagnosis and disease monitoring. However, most current elastography techniques are limited in their ability to distinguish localized microstructural mechanical variations due to employing elastic wave velocity measurement. In addition, their contact-based measurement manner is not favored and may even be prohibited in many applications. In this Letter, we propose all-optical noncontact phase-domain photoacoustic elastography (NPD-PAE), leveraging the temporal response characteristics of laser-induced thermoelastic displacement using optical interferometric detection to calculate the elastic modulus. The all-optical pump-probe method allows the capture of the initial displacement profiles generated at the origin, thus enabling the extraction of in situ elasticity. The feasibility of the method was verified using a tissue-mimicking phantom. The capability to map the mechanical contrast was demonstrated on an ex vivo biological tissue. NPD-PAE opens a new avenue for development of a noncontact elastography technique, holding great potential in the biomedical field and materials science.

Single 808 nm near-infrared-triggered multifunctional upconverting phototheranostic nanocomposite for imaging-guided high-efficiency treatment of tumors

Multifunctional phototheranostic nanocomposites are promising for early diagnosis and precision therapy of cancer. Aim to enhance their accuracy and efficiency, in this study, we develop a single-laser excited activatable phototheranostic nanocomposite (UCNPs-D-MQ): 808 nm-excited upconverting nanoparticles (UCNPs) as the matrix programmed assembly with amphipathic compound DSPE-PEG-COOH, a near-infrared absorbing polymer DPP and the pro-photosensitizer MBQB. Upon endocytosed by cancer cells and excited by the 808 nm laser, UCNPs-D-MQ could produce high-yield reactive oxygen species (ROS) as the results of singlet oxygen generation from transferring to methylene blue, GSH depletion and ROS generation from photoactivation. It was proven both in vitro and in vivo that the nanocomposites exhibits remarkable therapeutic efficacy as well as minimal photodamage to normal cells. These results reveal UCNPs-D-MQ as a robust theranostic agent for tumor phototherapy.

Ultrahigh Sensitive and Tumor-Specific Photoacoustography in NIR-II Region: Optical Writing and Redox-Responsive Graphic Fixing by AgBr@PLGA Nanocrystals

The highly up-regulated glutathione (GSH) concentration in the tumor microenvironment is generally identified to be an effective endogenous characteristic of cancerous tissues. Herein, an ultrahigh-sensitive and tumor-specific photoacoustography technique in the near-infrared (NIR-II) region based on optical writing and redox-responsive chromogenic graphic fixing is developed by introducing a self-synthesized photosensitive silver bromide modified with poly lactic-co-glycolic acid (AgBr@PLGA) nanocrystals. After they are optically triggered by external light, the NIR-transparent AgBr@PLGA nanocrystals can be reduced by the tumor-abundant GSH into strongly absorbing silver nanoparticles, significantly boosting the "turn-on" photoacoustic (PA) signal in the NIR-II region; therefore, the tumor area can be graphically fixed and developed in the photoacoustography. Experiments on both in vitro phantoms and in vivo mouse models demonstrate that the tumor area is specifically identified by the photoacoustography with the background signals effectively suppressed by dynamically modulating the exposure time. The tumor-specific photoacoustography technique prefigures great potential for high-precision cancer diagnosis and treatment monitoring.

Ultrashort-Pulse-Microwave Excited Whole-Breast Thermoacoustic Imaging with Uniform Field of Large Size Aperture Antenna for Tumor Screening

Microwave-induced thermoacoustic imaging (MTAI) has been widely used in biomedical science, and has the potential as an auxiliary measure for clinical diagnosis and treatment. Recently, there are increasing interests in using ultrashort microwave-pumped thermoacoustic imaging techniques to obtain high-efficiency, high-resolution images. However, the traditional imaging system can only provide uniform radiation in a relatively small area, which limits their large field of view in clinical applications (such as whole-breast imaging, brain imaging). To address this problem, we propose an ultrashort pulse microwave thermoacoustic imaging device with a large size aperture antenna. The system can provide a microwave radiation area of 40 cm 27 cm and a uniform imaging view of 14 cm 14 cm. With 7 cm imaging depth and a 290 m resolution. The practical feasibility of the system for breast tumor screening is tested in phantoms with different shapes and in an ex vivo human breast tumor which is embedded in the excised breast of an ewe (5 cm 5 cm). The tumor can be identified with a contrast of about 1:2. The results demonstrate that the dedicated MTAI system with the uniform large field of view, high imaging resolution, and large imaging depth have the potential for clinical routine breast screening.

Photobiomodulation therapy for thrombocytopenia by upregulating thrombopoietin expression via the ROS-dependent Src/ERK/STAT3 signaling pathway

BACKGROUND

Chemotherapy-induced thrombocytopenia (CIT) can increase the risk of bleeding, which may delay or prevent the administration of anticancer treatment schedules. Photobiomodulation therapy (PBMT), a non-invasive physical treatment, has been proposed to improve thrombocytopenia; however, its underlying regulatory mechanism is not fully understood.

OBJECTIVE

To further investigate the mechanism of thrombopoietin (TPO) in megakaryocytopoiesis and thrombopoiesis.

METHODS

Multiple approaches such as western blotting, cell transfection, flow cytometry, and animal studies were utilized to explore the effect and mechanism of PBMT on thrombopoiesis.

RESULTS

PBMT prevented a severe drop in platelet count by increasing platelet production, and then ameliorated CIT. Mechanistically, PBMT significantly upregulated hepatic TPO expression in a thrombocytopenic mouse model, which promoted megakaryocytopoiesis and thrombopoiesis. The levels of TPO mRNA and protein increased by PBMT via the Src/ERK/STAT3 signaling pathway in hepatic cells. Furthermore, the generation of the reactive oxygen species was responsible for PBMT-induced activation of Src and its downstream target effects.

CONCLUSIONS

Our research suggests that PBMT is a promising therapeutic strategy for the treatment of CIT.

Optical coherence hyperspectral microscopy with a single supercontinuum light source

In the paper, we have developed an optical coherence hyperspectral microscopy with a single supercontinuum light source. The microscopy consists of optical coherence tomography (OCT) and hyperspectral imaging (HSI), which can visualize the structural and functional characteristics of biological tissues. The 500 to 700 nm band is selected for HSI and OCT imaging, where HSI enables imaging of oxygen saturation and hemoglobin (Hb) content, while OCT acquires structural characteristics to assess the morphology of biological tissues. The system performance of the optical coherence hyperspectral microscopy is verified by normal mice ears, and the practical applications of the microscopy is further performed in 4T1 and inflammation Balb/c mice ears in vivo. The experimental results demonstrate that the microscopy has potential to provide complementary information for clinical applications.

Versatile gadolinium(III)-phthalocyaninate photoagent for MR/PA imaging-guided parallel photocavitation and photodynamic oxidation at single-laser irradiation

Current light-mediated photodynamic therapy (PDT) is far underutilized in clinical cancer treatment due to its low pharmacological effect. We herein proposed a new gadolinium(III)-phthalocyanine (GdPc)-enabled phototherapeutics, photoacoustic/dynamic therapy (PADT), towards in vivo solid tumors via parallel-produced photocavitation and photodynamic oxidation with excitation by a single pulsed laser. We demonstrated that pulsed irradiation of GdPc could simultaneously produce an intense acoustic effect and a high-level ¹O₂ quantum yield to afford mitochondrial damage and initiate programmed cell death. Under the guidance of magnetic resonance/photoacoustic dual-modal imaging, the mechanical oxygen-independent destruction of acoustic cavitation and the chemical damage of ¹O₂ were validated to afford combinatorial inhibition of tumors under either normal or hypoxic conditions after the agent delivered into the cancer cells by a pH-sensitive nanomicelle. The single-laser initiated PADT using GdPc as a versatile photoagent maximizes the use of light energy to minimize the dose requirement of oxygen and agent towards high therapeutic efficacy, surpassing dramatically over conventional PDT.

Photoactivation of TGFβ/SMAD signaling pathway ameliorates adult hippocampal neurogenesis in Alzheimer's disease model

Background

Adult hippocampal neurogenesis (AHN) is restricted under the pathological conditions of neurodegenerative diseases, especially in Alzheimer’s disease (AD). The drop of AHN reduces neural circuit plasticity, resulting in the decrease of the generation of newborn neurons in dentate gyrus (DG), which makes it difficult to recover from learning/memory dysfunction in AD, therefore, it is imperative to find a therapeutic strategy to promote neurogenesis and clarify its underlying mechanism involved.

Methods

Amyloid precursor protein/presenilin 1 (APP/PS1) mice were treated with photobiomodulation therapy (PBMT) for 0.1 mW/mm² per day in the dark for 1 month (10 min for each day). The neural stem cells (NSCs) were isolated from hippocampus of APP/PS1 transgenic mice at E14, and the cells were treated with PBMT for 0.667 mW/mm² in the dark (5 min for each time).

Results

In this study, photobiomodulation therapy (PBMT) is found to promote AHN in APP/PS1 mice. The latent transforming growth factor-β1 (LTGFβ1) was activated in vitro and in vivo during PBMT-induced AHN, which promoted the differentiation of hippocampal APP/PS1 NSCs into newborn neurons. In particular, behavioral experiments showed that PBMT enhanced the spatial learning/memory ability of APP/PS1 mice. Mechanistically, PBMT-stimulated reactive oxygen species (ROS) activates TGFβ/Smad signaling pathway to increase the interaction of the transcription factors Smad2/3 with Smad4 and competitively reduce the association of Smad1/5/9 with Smad4, thereby significantly upregulating the expression of doublecortin (Dcx)/neuronal class-III β-tubulin (Tuj1) and downregulating the expression of glial fibrillary acidic protein (GFAP). These in vitro effects were abrogated when eliminating ROS. Furthermore, specific inhibition of TGFβ receptor I (TGFβR I) attenuates the DNA-binding efficiency of Smad2/3 to the Dcx promotor triggered by PBMT.

Conclusion

Our study demonstrates that PBMT, as a viable therapeutic strategy, directs the adult hippocampal APP/PS1 NSCs differentiate towards neurons, which has great potential value for ameliorating the drop of AHN in Alzheimer’s disease mice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13287-021-02399-2.

Photobiomodulation therapy for hair regeneration: A synergetic activation of β-CATENIN in hair follicle stem cells by ROS and paracrine WNTs

Photobiomodulation therapy (PBMT) has shown encouraging results in the treatment of hair loss. However, the mechanism by which PBMT controls cell behavior to coordinate hair cycle is unclear. Here, PBMT is found to drive quiescent hair follicle stem cell (HFSC) activation and alleviate hair follicle atrophy. Mechanistically, PBMT triggers a new hair cycle by upregulating β-CATENIN expression in HFSCs. Loss of β-Catenin (Ctnnb1) in HFSCs blocked PBMT-induced hair regeneration. Additionally, we show PBMT-induced reactive oxygen species (ROS) activate the PI3K/AKT/GSK-3β signaling pathway to inhibit proteasome degradation of β-CATENIN in HFSCs. Furthermore, PBMT promotes the expression and secretion of WNTs in skin-derived precursors (SKPs) to further activate the β-CATENIN signal in HFSCs. By contrast, eliminating ROS or inhibiting WNT secretion attenuates the activation of HFSCs triggered by PBMT. Collectively, our work suggests that PBMT promotes hair regeneration through synergetic activation of β-CATENIN in HFSCs by ROS and paracrine WNTs by SKPs.

Photobiomodulation therapy promotes the ATP-binding cassette transporter A1-dependent cholesterol efflux in macrophage to ameliorate atherosclerosis

Atherosclerosis is a chronic inflammatory disease related to a massive accumulation of cholesterol in the artery wall. Photobiomodulation therapy (PBMT) has been reported to possess cardioprotective effects but has no consensus on the underlying mechanisms. Here, we aimed to investigate whether PBMT could ameliorate atherosclerosis and explore the potential molecular mechanisms. The Apolipoprotein E (ApoE)^−/− mice were fed with western diet (WD) for 18 weeks and treated with PBMT once a day in the last 10 weeks. Quantification based on Oil red O‐stained aortas showed that the average plaque area decreased 8.306 ± 2.012% after PBMT (P < .05). Meanwhile, we observed that high‐density lipoprotein cholesterol level in WD + PBMT mice increased from 0.309 ± 0.037 to 0.472 ± 0.038 nmol/L (P < .05) compared with WD mice. The further results suggested that PBMT could promote cholesterol efflux from lipid‐loaded primary peritoneal macrophages and inhibit foam cells formation via up‐regulating the ATP‐binding cassette transporters A1 expression. A contributing mechanism involved in activating the phosphatidylinositol 3‐kinases/protein kinase C zeta/specificity protein 1 signalling cascade. Our study outlines that PBMT has a protective role on atherosclerosis by promoting macrophages cholesterol efflux and provides a new strategy for treating atherosclerosis.

Spectral interferometric depth-resolved photoacoustic viscoelasticity imaging

Viscoelasticity is closely related to the physiological characteristics of biological tissues. In this Letter, we propose a novel spectral interferometric depth-resolved photoacoustic viscoelasticity imaging (SID-PAVEI) method, to the best of our knowledge for the first time, which breaks the plight of surface viscoelasticity imaging and achieves an internal visible microscale SID-PAVEI in a noncontact fashion. In this work, we employ a high-sensitive and depth-resolved spectral domain low coherence interferometry (SDLCI) to remotely track photoacoustic-induced strain response of absorbers in situ. By decoupling the phase and amplitude of the photoacoustic-encoded spectral interference signal, the SID-PAVEI and scattering structure imaging (SSI) can be obtained simultaneously. Depth-resolved performance of the SID-PAVEI and the SSI in one scan were demonstrated by imaging biological tissues. The method opens new perspectives for three-dimensional microscale viscoelasticity imaging and provides a great potential in multi-parametric characterizing pathological information.

Photobiomodulation therapy ameliorates hyperglycemia and insulin resistance by activating cytochrome c oxidase-mediated protein kinase B in muscle

Ameliorating hyperglycemia and insulin resistance are major therapeutic strategies for type 2 diabetes. Previous studies have indicated that photobiomodulation therapy (PBMT) attenuates metabolic abnormalities in insulin-resistant adipose cells and tissues. However, it remains unclear whether PBMT ameliorates glucose metabolism in skeletal muscle in type 2 diabetes models. Here we showed that PBMT reduced blood glucose and insulin resistance, and reversed metabolic abnormalities in skeletal muscle in two diabetic mouse models. PBMT accelerated adenosine triphosphate (ATP) and reactive oxygen species (ROS) generation by elevating cytochrome c oxidase (CcO) activity. ROS-induced activation of phosphatase and tensin homolog (PTEN)/ protein kinase B (AKT) signaling after PBMT promoted glucose transporter GLUT4 translocation and glycogen synthase (GS) activation, accelerating glucose uptake and glycogen synthesis in skeletal muscle. CcO subunit III deficiency, ROS elimination, and AKT inhibition suppressed the PBMT effects of glucose metabolism in skeletal muscle. This study indicated amelioration of glucose metabolism after PBMT in diabetic mouse models and revealed the metabolic regulatory effects and mechanisms of PBMT on skeletal muscle.

Aptamer-Functionalized Upconverting Nanoformulations for Light-Switching Cancer-Specific Recognition and In Situ Photodynamic-Chemo Sequential Theranostics

Biomarker-activatable theranostic formulations offer the potential for removing specific tumors with a high diagnostic accuracy and a significant pharmacological effect. Herein, we developed a novel activatable theranostic nanoformulation UAS-PD [upconversion nanophosphor (UCNP)-aptamer/ssDNA-pyropheophorbide-a (PPA)-doxyrubicin (DOX)], which can recognize specific cancer cells with sensitivity and trigger the localized photodynamic destruction and enhanced chemotherapy. UAS-PD was constructed by the conjugation of UCNPs and aptamer probes containing the photosensitizer PPA and the chemotherapeutic drug DOX. When cancer cells are present, the UAS-PD specifically binds to PTK7, an overexpressed protein present on the surface of cancer cells, through conformational recombination of the aptamer structure and switches its upconversion luminescence from 655 to 540 nm. This long-lived ratiometric optical signal provides an ultrasensitive detection limit as low as 3.9 nM for PTK7. Changes in the conformation of UAS-PD can also induce PPA to approach UCNPs, which can produce cytotoxic singlet oxygens under near-infrared excitation to destroy the cell membrane and enhance its permeability for the simultaneously released DOX that targets cellular DNA degradation, which results in a highly effective tumor-killing effect by synergistic extra-intracellular sequential damage.

Precise Tumor Photothermal Therapy Guided and Monitored by Magnetic Resonance/Photoacoustic Imaging using A Safe and pH-Responsive Fe(III) Complex

Photothermal agents with strong near infrared (NIR) optical absorbance and excellent biocompatibility and traceability are highly desired for precise photothermal therapy. This study reports the development of a dual-functional Fe³⁺ complex (Fe-ZDS) for imaging-guided, precise photothermal therapy of tumors. The complex has stable structure and obvious zwitterionic features, resulting in excellent biocompatibility and efficient renal clearance. The iron-dopa core structure renders the complex capable of generating magnetic resonance imaging (MRI) contrast, while synergistically exhibiting optical absorption in the red and NIR regions. Interestingly, the optical absorption of the complex is pH-sensitive, with significantly higher absorption intensity in a weakly acidic environment than in a neutral environment. Thus the complex can respond to acidic tumor stimuli and confine the energy of the laser to the tumor tissue. The MRI contrast and photoacoustic signal of the complex is taken advantage of to monitor the probe injection process and optimize the injection position and dosage for maximally covering the tumor tissue and assessing the activation of the complex in tumor tissues. The evolution of temperature inside the tissue during the laser irradiation is also monitored. Using Fe-ZDS as the theranostic probe, satisfactory treatment outcomes are achieved for photothermal therapy of tumors.

Mitochondria-Specific Agents for Photodynamic Cancer Therapy: A Key Determinant to Boost the Efficacy

Mitochondria-targeted photodynamic therapy (Mt-PDT), which enables the photogenerated cytotoxic oxygen species with fatal oxidative damage to block mitochondrial functions, has been considered as a promising method to enhance the anticancer effectiveness. Aiming at the challenges of PDT, in the past few decades, numerous mitochondria-targeting molecular agents have been developed to boost the PDT efficacy via directly destroying the mitochondria or activating mitochondria-mediated cell death pathways. Herein, a review for recent advances of Mt-PDT is highlighted including: mitochondrial targeting design principles and strategies, therapeutic performance of mitochondria-targeted agents-mediated PDT as well as the agent-free Mt-PDT. In addition, it puts together the achievements of the combinatory mitochondria-anchoring PDT and other anticancer strategies, demonstrating the advantages provided by Mt-PDT. The existing challenges are discussed and future settlements for the development of mitochondria-specific agents are also forecasted.

Photoacoustic Cavitation-Ignited Reactive Oxygen Species to Amplify Peroxynitrite Burst by Photosensitization-Free Polymeric Nanocapsules

Photoacoustic (PA) technology can transform light energy into acoustic wave, which can be used for either imaging or therapy that depends on the power density of pulsed laser. Here, we report photosensitizer-free polymeric nanocapsules loaded with nitric oxide (NO) donors, namely NO-NCPs, formulated from NIR light-absorbable amphiphilic polymers and a NO-releasing donor, DETA NONOate. Controlled NO release and nanocapsule dissociation are achieved in acidic lysosomes of cancer cells. More importantly, upon pulsed laser irradiation, the PA cavitation can excite water to generate significant reactive oxygen species (ROS) such as superoxide radical (O₂ ^.- ), which further spontaneously reacts with the in situ released NO to burst highly cytotoxic peroxynitrite (ONOO^- ) in cancer cells. The resultant ONOO^- generation greatly promotes mitochondrial damage and DNA fragmentation to initiate programmed cancer cell death. Apart from PA imaging, PA cavitation can intrinsically amplify reactive species via photosensitization-free materials for promising disease theranostics.

Photobiomodulation suppresses JNK3 by activation of ERK/MKP7 to attenuate AMPA receptor endocytosis in Alzheimer's disease

Alzheimer's disease (AD), a severe age‐related neurodegenerative disorder, lacks effective therapeutic methods at present. Physical approaches such as gamma frequency light flicker that can effectively reduce amyloid load have been reported recently. Our previous research showed that a physical method named photobiomodulation (PBM) therapy rescues Aβ‐induced dendritic atrophy in vitro. However, it remains to be further investigated the mechanism by which PBM affects AD‐related multiple pathological features to improve learning and memory deficits. Here, we found that PBM attenuated Aβ‐induced synaptic dysfunction and neuronal death through MKP7‐dependent suppression of JNK3, a brain‐specific JNK isoform related to neurodegeneration. The results showed PBM‐attenuated amyloid load, AMPA receptor endocytosis, dendrite injury, and inflammatory responses, thereby rescuing memory deficits in APP/PS1 mice. We noted JNK3 phosphorylation was dramatically decreased after PBM treatment in vivo and in vitro. Mechanistically, PBM activated ERK, which subsequently phosphorylated and stabilized MKP7, resulting in JNK3 inactivation. Furthermore, activation of ERK/MKP7 signaling by PBM increased the level of AMPA receptor subunit GluR 1 phosphorylation and attenuated AMPA receptor endocytosis in an AD pathological model. Collectively, these data demonstrated that PBM has potential therapeutic value in reducing multiple pathological features associated with AD, which is achieved by regulating JNK3, thus providing a noninvasive, and drug‐free therapeutic strategy to impede AD progression.

Eradication of solid tumors by chemodynamic theranostics with H2O2-catalyzed hydroxyl radical burst

Activatable theranostics, integrating high diagnostic accuracy and significant therapeutic effect, holds great potential for personalized cancer treatments; however, their chemodynamic modality is rarely exploited. Herein, we report a new in situ activatable chemodynamic theranostics PAsc/Fe@Cy7QB to specifically recognize and eradicate cancer cells with H₂O₂-catalyzed hydroxyl radical (•OH) burst cascade.

Methods: The nanomicelles PAsc/Fe@Cy7QB were constructed by self-assembly of acid-responsive copolymers incorporating ascorbates and acid-sensitive Schiff base-Fe²⁺ complexes as well as H₂O₂-responsive adjuvant Cy7QB.

Results: Upon systematic delivery of PAsc/Fe@Cy7QB into cancer cells, the acidic microenvironment triggered disassembly of the nanomicelles. The released Fe²⁺ catalyzed the oxidation of ascorbate monoanion (AscH^-) to efficiently produce H₂O₂. The released H₂O₂, together with the endogenous H₂O₂, could be converted into highly active •OH via the Fenton reaction, resulting in enhanced Fe-mediated T₁ magnetic resonance imaging (MRI). The synchronously released Cy7QB was activated by H₂O₂ to produce a glutathione (GSH)-scavenger quinone methide to boost the •OH yield and recover the Cy7 dye for fluorescence and photoacoustic imaging.

Conclusion: The biodegradable PAsc/Fe@Cy7QB designed for tumor-selective multimodal imaging and high therapeutic effect provides an exemplary paradigm for precise chemodynamic theranostic.

Cascade CRISPR/cas enables amplification-free microRNA sensing with fM-sensitivity and single-base-specificity

A cascade CRISPR/cas nucleic acid diagnostic system, which can achieve high-sensitive and single-base specificity without target amplification, was developed for miRNA detection.

Ultrasonic evaluation of systemic and renal perfusion in sepsis patients before and after fluid resuscitation

OBJECTIVE

This study aimed to explore the significance of renal Doppler ultrasound in evaluating systemic and renal perfusion in sepsis patients before and after fluid resuscitation.

PATIENTS AND METHODS

Forty sepsis patients admitted to the Department of Intensive Medicine and intensive care unit (ICU) of the Fourth Hospital of Hebei Medical University from June 2014 to December 2014 were enrolled in this study, and 35 patients were included in the final analysis. These patients were divided into positive and negative fluid responsiveness groups. They were also divided into an acute kidney injury (AKI) group and a non-AKI group according to changes in creatinine and urine volume. The correlations of the changes in hemodynamics before and after fluid resuscitation in each group with the changes in renal resistance index (RRI) and renal blood flow (RBF) grades were evaluated.

RESULTS

Before and after fluid resuscitation, the heart rate (HR), blood creatinine (Cre), and lactate (Lac) levels of all patients, including the patients in the positive fluid responsiveness group decreased, and the stroke volume (SV) and central venous pressure (CVP) increased. Only HR decreased in the negative fluid responsiveness group. In the AKI group, HR, Cre, and Lac decreased, while in the non-AKI group, HR decreased, but CVP and SV increased. There were differences between HR, Lac, and change rate of Lac (Lac%) after fluid resuscitation for the positive and negative fluid responsiveness groups. There was no statistical difference between the RRI values of each group before and after fluid resuscitation. The RRI values of the AKI group were higher than those of the non-AKI group, while the AKI group's RBF grades were lower than those of the non-AKI group. The change rate of RRI (RRI%) was higher in the AKI group than in the non-AKI group. Except for the negative fluid responsiveness group, the RBF grade of each group increased.

CONCLUSIONS

The approach of RBF classification based on Doppler ultrasound can be used to evaluate the systemic and renal perfusion of patients with severe sepsis before and after fluid resuscitation, while the RRI value cannot be used for evaluation. However, the RRI value can be used as a dynamic index for the evaluation of renal perfusion in patients with AKI.

Photobiomodulation reduces hepatic lipogenesis and enhances insulin sensitivity through activation of CaMKKβ/AMPK signaling pathway

Photobiomodulation (PBM) could improve systemic blood glucose and insulin resistance in diet-induced diabetic mice. A few possible molecular mechanisms for the beneficial effects of PBM on diabetes have been proposed, but there is still an urgent need to explore the underlying mechanisms that support the application of PBM in the treatment of diabetes. Our study aimed to evaluate the effects of PBM on lipid metabolism in the liver of high-fat diet (HFD)-induced mice and explore the potential mechanisms of PBM on obesity and type 2 diabetes. Here, we administered PBM therapy (wavelength: 635 nm, energy density: 8 J/cm²) daily for eight weeks to HFD-induced mice. We detected that eight-week daily administration of PBM ameliorated HFD-induced gain weight, hyperlipidemia, and hyperglycemia, but also protected against diet-induced hepatic steatosis and insulin resistance. Furthermore, PBM increased AMP-activated protein kinase (AMPK) activation, lowered nuclear translocation of sterol regulatory element binding protein 1 (SREBP1), decreased aberrant lipogenesis, and enhanced insulin sensitive in HFD-induced mice livers. We also observed that Ca²⁺/calmodulin-dependent protein kinase kinase β (CaMKKβ) activation was responsible for AMPK activation in insulin-resistant HepG2 cells exposed to PBM. In summary, PBM at 635 nm and 8 J/cm² improved hepatic lipid metabolism and inhibited the development of HFD-induced obesity and type 2 diabetes. Moreover, increased intracellular Ca²⁺ content and CaMKKβ-dependent AMPK activation were possible molecular mechanisms underlying the PBM-induced improvement on obesity and type 2 diabetes.

Dual-Responsive Polyprodrug Nanoparticles with Cascade-Enhanced Magnetic Resonance Signals for Deep-Penetration Drug Release in Tumor Therapy

Smart transformable nanocarriers are promising to treat deep-seated diseases but require adaptable diagnostic/imaging potency to reflect the morphology change and therapeutic feedback, yet their design and synthesis remains challenging. Herein, stimuli-responsive polyprodrug nanoparticles (SPNs) are formulated from the co-assembly of negatively charged corona and positively charged polyprodrug cores, exhibiting high loading content of camptothecin (CPT, ∼28.6 wt %) tethered via disulfide linkages in the core. SPNs are sequentially sensitive to tumor acidic condition and elevated reductive milieu in the cytosol for deep-penetration drug delivery. Upon accumulation at acidic tumor sites, SPNs dissociate to release smaller positively charged polyprodrug nanoparticles, which efficiently enter deep-seated tumor cells to trigger high-dosage parent CPT release in the reductive cytosolic milieu. Meanwhile, the polyprodrug cores of SPNs labeled with DTPA(Gd), a magnetic resonance imaging contrast agent, can trace the cascade degradation and biodistribution of SPNs as well as the resulting intracellular CPT release. The longitudinal relaxivity of SPNs increases stepwise in the above two processes. The size-switchable polyprodrug nanoparticles exhibit remarkable tumor penetration and noteworthy tumor inhibition in vitro and in vivo, which are promising for endogenously activated precision diagnostics and therapy.

Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography

Accurate and timely assessment of the severity of burn is essential for the treatment of burns. Currently, although most first-degree and third-degree burns are easily diagnosed through visual inspection or auxiliary diagnostic methods, the second-degree burn is still difficult to distinguish due to the ambiguity boundaries of second-degree with first-degree and third-degree burns. In this study, we proposed a non-invasive technique by combing photoacoustic imaging (PAI) and optical coherence tomography (OCT) to multi-parameter quantitatively assess the burns. The feasibility and capacity of the dual-mode PAT/OCT for assessing the burns was first testified by tissue-mimicking phantom and burn wounds in mouse pinna in vivo. The further experiments conducted on the back of rats showed that the changes in skin scattering structure, vascular morphology and blood flow provided by the dual-mode PAI/OCT system can determine distinct boundaries and depth of the burns. The experimental results prove that combined PAI/OCT as a novel method can be used to assess the severity of burn, which has the potential to diagnose the burns in clinic.

Photoacoustic-immune therapy with a multi-purpose black phosphorus-based nanoparticle

Effective therapeutic strategies to precisely eradicate primary tumors with minimal side effects on normal tissue, inhibit metastases, and prevent tumor relapses, are the ultimate goals in the battle against cancer. We report a novel therapeutic strategy that combines adjuvant black phosphorus nanoparticle-based photoacoustic (PA) therapy with checkpoint-blockade immunotherapy. With the mitochondria targeting nanoparticle, PA therapy can achieve localized mechanical damage of mitochondria via PA cavitation and thus achieve precise eradication of the primary tumor. More importantly, PA therapy can generate tumor-associated antigens via the presence of the R848-containing nanoparticles as an adjuvant to promote strong antitumor immune responses. When combined with the checkpoint-blockade using anti-cytotoxic T-lymphocyte antigen-4, the generated immunological responses will further promote the infiltrating CD8 and CD4 T-cells to increase the CD8/Foxp3 T-cell ratio to inhibit the growth of distant tumors beyond the direct impact range of the PA therapy. Furthermore, the number of memory T cells detected in the spleen is increased, and these cells inhibit tumor recurrence. This proposed strategy offers precise eradication of the primary tumor and can induce long-term tumor-specific immunity.

ELECTRONIC SUPPLEMENTARY MATERIAL

Supplementary material is available for this article at 10.1007/s12274-020-3028-x and is accessible for authorized users.

A stimulated liquid-gas phase transition nanoprobe dedicated to enhance the microwave thermoacoustic imaging contrast of breast tumors

Microwave-induced thermoacoustic imaging (MTAI), combining the advantages of the high contrast of microwave imaging and the high resolution of ultrasonic imaging, is a potential candidate for breast tumor detection. MTAI probes have been used to extend thermoacoustic imaging to molecular imaging. However, due to the high content of water molecules in tissues, the thermoelastic expansion-based probes used in conventional MTAI are not capable of adequate enhancement. Herein, an MTAI nanoprobe for amplification of thermoacoustic (TA) signals by the stimulated liquid-gas phase transition mechanism has been developed, providing significantly higher signal amplitude than that from the conventional mechanism of thermoelastic expansion. The nanoprobe consists of liquid perfluorohexane (PFH) and tungsten disulfide (WS2) nanoparticles rich in defect electric dipoles. When irradiated with pulsed microwaves, the defect electric dipoles in WS2 were repeatedly polarized by gigahertz. This results in localized transient heating and an acoustic shockwave, which destroys the van der Waals forces between PFH molecules. Ultimately, liquid PFH droplets undergo a liquid-gas phase transition, generating dramatically enhanced TA signals. The practical feasibility was tested in vitro and in a breast tumor animal model. The results show that the proposed nanoprobe can greatly improve the contrast of tumor imaging. It will be a new generation probe for MTAI.

Integrated photoacoustic and hyperspectral dual-modality microscopy for co-imaging of melanoma and cutaneous squamous cell carcinoma in vivo

Skin carcinoma such as melanoma (MM) and cutaneous squamous cell carcinoma (cSCC) are considered as the highest mortality and the most aggressive skin cancers in dermatology. In view that early diagnosis and treatment can greatly improve the survival rate and life quality of the patients, developing noninvasive and effective evaluation methods is of great significance for the detection and identification of early stage cutaneous cancers. In this article, we propose a hybrid photoacoustic and hyperspectral dual-modality microscopy to evaluate and differentiate skin carcinoma by structural and multiphysiological parameters. The proposed system's imaging abilities are verified by mimic phantoms and normal mice experiments. Furthermore, in vivo characterization and evaluation results of MM and cSCC mice are obtained successfully, which prove this novel method could be used as a reliable and useful method for skin cancer detection in early stages.

Pancreatic Cancer detection via Galectin-1-targeted Thermoacoustic Imaging: validation in an in vivo heterozygosity model

Purpose: To investigate the feasibility of microwave-induced thermoacoustic imaging (MTAI) in detecting small pancreatic tumors (< 10 mm in diameter) and to complement the limitation of current clinical imaging methods.

Methods: A home-made MTAI system composed of a portable antenna and pulsed microwave generator was developed. The thermoacoustic nanoparticles were composed of the galectin-1 antibody for targeting pancreatic tumors and Fe₃O₄ nanoparticles as microwave absorbers (anti-Gal1-Fe₃O₄ nanoparticles). The microwave absorption properties of the nanoparticles were measured with a vector network analyzer and the resolving power of MTAI was investigated by imaging excised pancreatic tumors of different sizes (diameters of 1.0 mm, 3.1 mm, 5.0 mm, 7.2 mm). To simulate actual imaging scenarios, an in vivo heterozygosity model was constructed by covering the pancreatic tumors (~ 3 mm in diameter) in BALB/c nude mice with biologic tissue (~ 5 cm in depth). MTAI images of the heterozygosity model were acquired with/without the injection of the anti-Gal1-Fe₃O₄ nanoparticles and the thermoacoustic contrast from pancreatic tumors was evaluated with Student's paired t test. The data were analyzed with analysis of variance and nonparametric statistics.

Results: Following intravenous infusion, anti-Gal1-Fe₃O₄ nanoparticles efficiently accumulated in the tumor. The MTAI contrast enhancement in pancreatic tumors with anti-Gal1-Fe₃O₄ nanoparticles was verified in vitro and in vivo. The pancreatic tumors were visible in nude mice examined with MTAI with a mean contrast enhancement ratio of 2.3 ± 0.15 (standard error of the mean) (P =. 001) at 6 h post-injection of the nanoparticles. MTAI identified tiny pancreatic tumors in deep tissues with high fidelity.

Conclusion: MTAI offers deep imaging depth and high contrast when used with anti-Gal1-Fe₃O₄ nanoparticles. It can identify pancreatic tumors smaller than 5 mm, which is beyond the identification limit size (~10 mm) of other nondestructive clinical imaging methods. Thus, MTAI has great potential as an alternative imaging modality for early pancreatic cancer detection.

CRISPR/Cas13a Powered Portable Electrochemiluminescence Chip for Ultrasensitive and Specific MiRNA Detection

MicroRNAs (miRNAs) have been widely investigated as potential biomarkers for early clinical diagnosis of cancer. Developing an miRNA detection platform with high specificity, sensitivity, and exploitability is always necessary. Electrochemiluminescence (ECL) is an electrogenerated chemiluminescence technology that greatly decreases background noise and improves detection sensitivity. The development of a paper-based ECL biosensor further makes ECL suitable for point-of-care detection. Recently, clustered regularly interspaced short palindromic repeats (CRISPR)/Cas13a as high-fidelity, efficient, and programmable CRISPR RNA (crRNA) guided RNase has brought a next-generation biosensing technology. However, existing CRISPR/Cas13a based detection often faces a trade-off between sensitivity and specificity. In this research, a CRISPR/Cas13a powered portable ECL chip (PECL-CRISPR) is constructed. Wherein target miRNA activates Cas13a to cleave a well-designed preprimer, and triggers the subsequent exponential amplification and ECL detection. Under optimized conditions, a limit-of-detection of 1 × 10-15 m for miR-17 is achieved. Through rationally designing the crRNA, the platform can provide single nucleotide resolution to dramatically distinguish miRNA target from its highly homologous family members. Moreover, the introduction of "light-switch" molecule [Ru(phen)2dppz]2+ allows the platform to avoid tedious electrode modification and washing processes, thereby simplifying the experimental procedure and lower testing cost. Analysis results of miRNA from tumor cells also demonstrate the PECL-CRISPR platform holds a promising potential for molecular diagnosis.

Single-Cell Photoacoustic Microrheology

Rheological properties, such as elasticity and viscosity, are fundamental biomechanical parameters that are related to the function and pathological status of cells and tissues. In this paper, an innovative photoacoustic microrheology (PAMR), which utilized the time and phase characteristics of photoacoustic (PA) response, was proposed to extract elastic modulus and viscosity. The feasibility and accuracy of the method were validated by tissue-mimicking agar-gelatin phantoms with various viscoelasticity values. PAMR realized single cell elasticity and viscosity mappings on the adipocyte and myocyte with micrometer scale. In clinical samples, normal blood cells and iron deficiency anemia cells were successfully distinguished due to their various rheological properties. This method expands the scope of conventional PA imaging and opens new possibilities for developing microrheological technology, prefiguring great clinical potential for interrogating mechanocellular properties.

Optical Biopsy of Melanoma and Basal Cell Carcinoma Progression by Noncontact Photoacoustic and Optical Coherence Tomography: In Vivo Multi-Parametric Characterizing Tumor Microenvironment

Measuring the structural and functional status of tumor microenvironment for malignant melanoma (MM) and basal cell carcinoma (BCC) is of profound significance in understanding dermatological condition for biopsy. However, conventional optical imaging techniques are limited to visualize superficial skin features and parameter information is deficient to depict pathophysiology correlations of skin diseases. Here, we demonstrate a preclinical device, all-optically integrated photoacoustic and optical coherence tomography (AOPA/OCT), that, for the first time, can simultaneously provide label-free biomarkers of vascular patterns, temporal and spatial heterogeneity of blood flow, and tissue micro-structure changes during tumor growth with pathophysiological correlations in mice models. We found that tumor microenvironment of MM and BCC led to the alternation in spatial-temporal heterogeneity that affected morphological and functional parameters, performing the AOPA/OCT quantitative metrics. A robust correlation between imaging biomarkers derived from this in vivo technique and histopathology validation ex vivo in distinguishing benign from malignant is also presented. In receiver operating characteristics (ROC) analysis, multi-parametric AOPA/OCT yields improved diagnostic accuracy of 98.4% and 95.8% for MM and BCC respectively, which indicate that AOPA/OCT represents a high-performance and clinically translatable technique for accurate diagnosis and therapy monitoring in dermatology.