Reichel Derek, Tripathi Manisha, Butte Pramod, Saouaf Rola, Perez J Manuel
Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Current Address: Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, 79430.
Nanotheranostics. 2019 May 4;3(2):196-211. doi: 10.7150/ntno.34921. eCollection 2019.
A successful cancer surgery requires the complete removal of cancerous tissue, while also sparing as much healthy, non-cancerous tissue as possible. To achieve this, an accurate identification of tumor boundaries during surgery is critical, but intra-operative tumor visualization remains challenging. Fluorescence imaging is a promising method to improve tumor detection and delineate tumor boundaries during surgery, but the lack of stable, long-circulating, clinically-translatable fluorescent probes that can identify tumors with high signal-to-noise ratios and low background fluorescence signals have prevented its widespread application. We screened the optical properties of several fluorescent dyes before and after nanoprobe encapsulation, and then identified nanoprobes with quenched fluorescence that were re-activated upon dye release. The physical and biological properties of these nanoprobes leading to fluorescence activation were investigated . Further, the cancer imaging properties of both free dyes and nanoprobe-encapsulated dyes were compared . A novel fluorescent nanoprobe was prepared by combining two FDA-approved agents commonly used in the clinic: Feraheme (FH) and indocyanine green (ICG). The resulting FH-entrapped ICG nanoprobe [FH(ICG)] displayed quenched fluorescence compared to other nanoprobes, and this quenched fluorescence was re-activated in acidic tumor microenvironment conditions (pH 6.8) and upon uptake into cancer cells. Finally, studies in a prostate cancer mouse model demonstrated that FH(ICG) treatments enhance long-term fluorescence signals in tumors compared to ICG treatments, allowing for fluorescence-guided tumor identification using clinically relevant fluorescence cameras. FH(ICG) nanoprobes were identified as fluorescent nanoprobes with beneficial fluorescence activation properties compared to other FH-entrapped dyes. The activatable nature of this nanoprobe allows for a low background fluorescence signal and high signal-to-noise ratio within a long-circulating nanoagent, which allows for long-term fluorescence signals from tumors that enabled their fluorescence-guided detection. This activatable nanoprobe offers tremendous potential as a clinically translatable image-guided cancer therapy modality that can be prepared in a clinical setting.
成功的癌症手术需要完全切除癌组织,同时尽可能保留更多健康的非癌组织。要做到这一点,手术过程中准确识别肿瘤边界至关重要,但术中肿瘤可视化仍然具有挑战性。荧光成像有望在手术过程中改善肿瘤检测并勾勒肿瘤边界,但缺乏能够以高信噪比和低背景荧光信号识别肿瘤的稳定、长效循环且可临床转化的荧光探针,这阻碍了其广泛应用。我们筛选了几种荧光染料在纳米探针封装前后的光学特性,然后鉴定出荧光被淬灭且在染料释放时重新激活的纳米探针。研究了这些导致荧光激活的纳米探针的物理和生物学特性。此外,还比较了游离染料和纳米探针封装染料的癌症成像特性。通过结合两种临床常用的美国食品药品监督管理局(FDA)批准的药物:铁麦芽糖(FH)和吲哚菁绿(ICG),制备了一种新型荧光纳米探针。与其他纳米探针相比,所得的包载FH的ICG纳米探针[FH(ICG)]显示出淬灭的荧光,并且这种淬灭的荧光在酸性肿瘤微环境条件(pH 6.8)下以及被癌细胞摄取后会重新激活。最后,在前列腺癌小鼠模型中的研究表明,与ICG治疗相比,FH(ICG)治疗可增强肿瘤中的长期荧光信号,从而能够使用临床相关的荧光相机进行荧光引导的肿瘤识别。与其他包载FH的染料相比,FH(ICG)纳米探针被鉴定为具有有益荧光激活特性的荧光纳米探针。这种纳米探针的可激活特性使得在长效循环的纳米制剂中具有低背景荧光信号和高信噪比,从而能够实现来自肿瘤的长期荧光信号,使其能够进行荧光引导检测。这种可激活纳米探针作为一种可在临床环境中制备的可临床转化的图像引导癌症治疗方式具有巨大潜力。