Department of Microbiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan.
Mol Cancer Ther. 2018 Dec;17(12):2643-2653. doi: 10.1158/1535-7163.MCT-18-0696. Epub 2018 Sep 19.
Enhanced permeability and retention (EPR) effect-based nanomedicine is a promising strategy for successful anticancer therapy. The EPR effect is based on tumor blood flow. Because advanced large tumors, as frequently seen in clinical settings, are heterogeneous, with regions of defective vasculature and blood flow, achieving the desired tumor drug delivery is difficult. Here, we utilized the EPR effect to increase drug delivery. To augment the EPR effect for improved therapeutic effects of nanomedicine, we exploited vascular mediators-the nitric oxide (NO) generators nitroglycerin (NG), hydroxyurea, and l-arginine. These compounds generate NO in tumors with relatively high selectivity. Using different nanosized drugs in our protocol significantly increased (1.5-2 times) delivery of nanomedicines to different solid tumor models, along with markedly improving (2-3-fold) the antitumor effects of these drugs. Also, in 7,12-dimethylbenz[]anthracene-induced advanced end-stage breast cancer, often seen in clinical settings, 2 mg/kg polymer-conjugated pirarubicin (P-THP) with NG (0.2 mg/mouse) showed better effects than did 5 mg/kg P-THP, and 5 mg/kg P-THP used with NG resulted in cures or stable tumors (no tumor growth) for up to 120 days. Moreover, in a murine autochthonous azoxymethane/dextran sulfate sodium-induced colon cancer model, NO donors markedly improved the therapeutic effects of P-THP even after just one injection, results that were comparable with those achieved with three weekly P-THP treatments. These findings strongly suggest the potential usefulness of NO donors as EPR effect enhancers to improve the therapeutic efficacy of nanomedicines.
基于增强型通透性和保留(EPR)效应的纳米医学是一种有前途的抗癌治疗策略。EPR 效应基于肿瘤血流。由于在临床环境中经常见到的晚期大肿瘤是异质的,具有血管和血流缺陷的区域,因此难以实现理想的肿瘤药物输送。在这里,我们利用 EPR 效应来增加药物输送。为了增强 EPR 效应,以提高纳米医学的治疗效果,我们利用了血管介质-硝酸甘油(NG)、羟基脲和 l-精氨酸等一氧化氮(NO)生成剂。这些化合物在肿瘤中具有相对较高的选择性产生 NO。在我们的方案中使用不同的纳米药物显著增加(1.5-2 倍)了不同实体瘤模型中纳米药物的输送,并显著提高(2-3 倍)了这些药物的抗肿瘤效果。此外,在临床环境中经常见到的 7,12-二甲基苯并[a]蒽诱导的晚期终末期乳腺癌中,与 5mg/kg 的 P-THP 联合 NG(0.2mg/只小鼠)相比,2mg/kg 的聚合物偶联吡柔比星(P-THP)与 NG 联合使用显示出更好的效果,并且 5mg/kg 的 P-THP 与 NG 联合使用导致治愈或稳定肿瘤(无肿瘤生长)长达 120 天。此外,在鼠自发的氧化偶氮甲烷/葡聚糖硫酸钠诱导的结肠癌模型中,NO 供体显著提高了 P-THP 的治疗效果,即使只注射一次,其效果也可与每周三次 P-THP 治疗相当。这些发现强烈表明,NO 供体作为 EPR 效应增强剂具有提高纳米药物治疗效果的潜力。
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