Showing papers by "Gert Storm published in 2015"

Noninvasive Imaging of Nanomedicines and Nanotheranostics : Principles, Progress, and Prospects

Abstract: Noninvasive imaging is used for many different (pre)clinical purposes, ranging from disease diagnosis, disease staging, and treatment monitoring to the visualization and quantification of nanomedicine-mediated drug targeting and (triggered) drug release. Noninvasive imaging can be employed to visualize and quantify how efficient passive or active drug targeting is in individual patients and, on this basis, to preselect patients likely to respond to nanomedicine-based chemotherapeutic interventions. In addition, it can be used to visualize the off-target localization of nanomedicines, e.g., in potentially endangered healthy tissues, which under certain circumstances might lead to exclusion from targeted treatment. Moreover, by systematically integrating imaging also during follow-up and by closely monitoring therapeutic responses upon nanomedicine treatment, clinical decision making can be facilitated and improved, as decisions on whether or not to (dis)continue treatment and on whether or not to adjust drug doses can be made relatively early on. Noninvasive imaging may be particularly useful in the case of metastatic disease. By subsequently performing PET or SPECT scans with radionuclide-labeled nanomedicines, information can be obtained on the accumulation of these formulations in both primary tumors and metastases, and treatment protocols can be adapted accordingly.

Complete Regression of Xenograft Tumors upon Targeted Delivery of Paclitaxel via Π–Π Stacking Stabilized Polymeric Micelles

Abstract: Treatment of cancer patients with taxane-based chemotherapeutics, such as paclitaxel (PTX), is complicated by their narrow therapeutic index. Polymeric micelles are attractive nanocarriers for tumor-targeted delivery of PTX, as they can be tailored to encapsulate large amounts of hydrophobic drugs and achiv prolonged circulation kinetics. As a result, PTX deposition in tumors is increased, while drug exposure to healthy tissues is reduced. However, many PTX-loaded micelle formulations suffer from low stability and fast drug release in the circulation, limiting their suitability for systemic drug targeting. To overcome these limitations, we have developed PTX-loaded micelles which are stable without chemical cross-linking and covalent drug attachment. These micelles are characterized by excellent loading capacity and strong drug retention, attributed to π–π stacking interaction between PTX and the aromatic groups of the polymer chains in the micellar core. The micelles are based on methoxy poly(ethylene gl...

Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation

Abstract: Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E–deficient mice (Apoe−/−) with advanced atherosclerotic plaques. This resulted in the rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an 8-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis.

Enhancing photodynamic therapy of refractory solid cancers : Combining second-generation photosensitizers with multi-targeted liposomal delivery

Abstract: Contemporary photodynamic therapy (PDT) for the last-line treatment of refractory cancers such as nasopharyngeal carcinomas, superficial recurrent urothelial carcinomas, and non-resectable extrahepatic cholangiocarcinomas yields poor clinical outcomes and may be associated with adverse events. This is mainly attributable to three factors: (1) the currently employed photosensitizers exhibit suboptimal spectral properties, (2) the route of administration is associated with unfavorable photosensitizer pharmacokinetics, and (3) the upregulation of survival pathways in tumor cells may impede cell death after PDT. Consequently, there is a strong medical need to improve PDT of these recalcitrant cancers. An increase in PDT efficacy and reduction in clinical side-effects may be achieved by encapsulating second-generation photosensitizers into liposomes that selectively target to pharmacologically important tumor locations, namely tumor cells, tumor endothelium, and tumor interstitial spaces. In addition to addressing the drawbacks of clinically approved photosensitizers, this review addresses the most relevant pharmacological aspects that dictate clinical outcome, including photosensitizer biodistribution and intracellular localization in relation to PDT efficacy, the mechanisms of PDT-induced cell death, and PDT-induced antitumor immune responses. Also, a rationale is provided for the use of second-generation photosensitizers such as diamagnetic phthalocyanines (e.g., zinc or aluminum phthalocyanine), which exhibit superior photophysical and photochemical properties, in combination with a multi-targeted liposomal photosensitizer delivery system. The rationale for this PDT platform is corroborated by preliminary experimental data and proof-of-concept studies. Finally, a summary of the different nanoparticulate photosensitizer delivery systems is provided followed by a section on phototriggered release mechanisms in the context of liposomal photosensitizer delivery systems.

Atherosclerotic plaque targeting mechanism of long-circulating nanoparticles established by multimodal imaging

Abstract: Atherosclerosis is a major cause of global morbidity and mortality that could benefit from novel targeted therapeutics. Recent studies have shown efficient and local drug delivery with nanoparticles, although the nanoparticle targeting mechanism for atherosclerosis has not yet been fully elucidated. Here we used in vivo and ex vivo multimodal imaging to examine permeability of the vessel wall and atherosclerotic plaque accumulation of fluorescently labeled liposomal nanoparticles in a rabbit model. We found a strong correlation between permeability as established by in vivo dynamic contrast enhanced magnetic resonance imaging and nanoparticle plaque accumulation with subsequent nanoparticle distribution throughout the vessel wall. These key observations will enable the development of nanotherapeutic strategies for atherosclerosis.

Sonochemotherapy: from bench to bedside

Abstract: The combination of microbubbles and ultrasound has emerged as a promising method for local drug delivery Microbubbles can be locally activated by a targeted ultrasound beam, which can result in several bio-effects For drug delivery, microbubble-assisted ultrasound is used to increase vascular- and plasma membrane permeability for facilitating drug extravasation and the cellular uptake of drugs in the treated region, respectively In the case of drug-loaded microbubbles, these two mechanisms can be combined with local release of the drug following destruction of the microbubble The use of microbubble-assisted ultrasound to deliver chemotherapeutic agents is also referred to as sonochemotherapy In this review, the basic principles of sonochemotherapy are discussed, including aspects such as the type of (drug-loaded) microbubbles used, the routes of administration used in vivo, ultrasound devices and parameters, treatment schedules and safety issues Finally, the clinical translation of sonochemotherapy is discussed, including the first clinical study using sonochemotherapy

Superoxide dismutase enzymosomes: carrier capacity optimization, in vivo behaviour and therapeutic activity.

Abstract: Purpose A strategy not usually used to improve carrier-mediated delivery of therapeutic enzymes is the attachment of the enzymes to the outer surface of liposomes. The aim of our work was to design a new type of enzymosomes with a sufficient surface-exposed enzyme load while preserving the structural integrity of the liposomal particles and activity of the enzyme.

Alginate Microspheres Containing Temperature Sensitive Liposomes (TSL) for MR-Guided Embolization and Triggered Release of Doxorubicin

Abstract: Objective The objective of this study was to develop and characterize alginate microspheres suitable for embolization with on-demand triggered doxorubicin (DOX) release and whereby the microspheres as well as the drug releasing process can be visualized in vivo using MRI. Methods and Findings For this purpose, barium crosslinked alginate microspheres were loaded with temperature sensitive liposomes (TSL/TSL-Ba-ms), which release their payload upon mild hyperthermia. These TSL contained DOX and [Gd(HPDO3A)(H2O)], a T1 MRI contrast agent, for real time visualization of the release. Empty alginate microspheres crosslinked with holmium ions (T2* MRI contrast agent, Ho-ms) were mixed with TSL-Ba-ms to allow microsphere visualization. TSL-Ba-ms and Ho-ms were prepared with a homemade spray device and sized by sieving. Encapsulation of TSL in barium crosslinked microspheres changed the triggered release properties only slightly: 95% of the loaded DOX was released from free TSL vs. 86% release for TSL-Ba-ms within 30 seconds in 50% FBS at 42°C. TSL-Ba-ms (76 ± 41 μm) and Ho-ms (64 ± 29 μm) had a comparable size, which most likely will result in a similar in vivo tissue distribution after an i.v. co-injection and therefore Ho-ms can be used as tracer for the TSL-Ba-ms. MR imaging of a TSL-Ba-ms and Ho-ms mixture (ratio 95:5) before and after hyperthermia allowed in vitro and in vivo visualization of microsphere deposition (T2*-weighted images) as well as temperature-triggered release (T1-weighted images). The [Gd(HPDO3A)(H2O)] release and clusters of microspheres containing holmium ions were visualized in a VX2 tumor model in a rabbit using MRI. Conclusions In conclusion, these TSL-Ba-ms and Ho-ms are promising systems for real-time, MR-guided embolization and triggered release of drugs in vivo.

Liposomes: The Science and the Regulatory Landscape

Abstract: Liposomes are vesicular (phospho)lipid-based drug carrier systems in the nanometer/micrometer range The therapeutic performance of these ‘composite’ drug products heavily depends on their supramolecular structure They are heterodisperse, difficult to fully characterize by physicochemical means and produced via complex manufacturing processes This renders them part of the NBCD group

The possible role of factor H in complement activation-related pseudoallergy (CARPA) : A failed attempt to correlate blood levels of FH with liposome-induced hypersensitivity reactions in patients with autoimmune disease

Abstract: Factor H (FH) is a natural inhibitor of the alternative pathway (AP) of complement (C) activation, an abundant protein in blood whose reduced level has been associated with proneness for increased C activation. There are also 5 FH-related proteins (FHR), which have different impacts on C function. After brief outlines of the C system and its activation via the AP, this review focuses on FH and FHR, collecting data from the literature that suggest that reduced levels or function of FH is associated with C activation-related hypersensitivity reactions (HSRs), called C activation related pseudoallergy (CARPA). Based on such observations we initiated the measurement of FH in the blood of patients with inflammatory bowel disease (IBD) and rheumatoid arthritis (RA), and examined the correlation between FH levels and HSRs following i.v. administration of PEGylated liposomal prednisolone phosphate (PLPP). ELISA assay of FH was conducted on plasma samples before treatment, immediately after treatment and at follow-up visits up to 7 weeks, and an attempt was made to correlate the FH levels obtained with the presence or absence of HSR that occurred in five of twenty patients. However, the initial data presented here on three reactive and three non-reactive patients showed FH levels >600 μg/mL, while the normal range of FH is 2-300 μg/mL. This unexpected outcome of the test led us to realize that the ELISA we used was based on antibodies raised against the short consensus repeats (SCR) in FH, which are also present in FHR. Thus the kit cannot distinguish these proteins and we most likely measured the combined levels of FH and FHR. These initial data highlighted an unforeseen technical problem in assessing FH function when using a FH ELISA that cross reacts with FHR, information that helps in further studies exploring the role of FH in CARPA.