Departamento de Ginecologia e Obstetricia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR.
Hospital Israelita Albert Einstein, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2019;74:e989. doi: 10.6061/clinics/2019/e989. Epub 2019 Jul 10.
Rapidly dividing cells in multiple types of cancer and inflammatory diseases undergo high low density lipoprotein (LDL) uptake for membrane synthesis, and coupling an LDL-like nanoemulsion, containing lipid nanoparticles (LDE) to a chemotherapeutic agent efficiently targets these cells without significant systemic effects. This was a prospective exploratory study that evaluated the uptake of a radioactively labeled LDE emulsion by receptors of endometriotic foci and the capacity of the LDE for cellular internalization.
The lipid profile of each patient was determined before surgery, and labeled LDE were injected into fourteen patients with intestinal or nonintestinal endometriosis. The radioactivity of each tissue sample (intestinal endometriosis, nonintestinal endometriosis, healthy peritoneum, or topical endometrium) was measured.
The group with intestinal endometriosis presented higher levels of plasma LDL but lower LDE uptake by foci than the nonintestinal group, suggesting less cell division and more fibrosis. The uptake of LDE was highest in the topical endometrium, followed by the healthy peritoneum, and lowest in the endometriotic lesion. Since the endometriotic foci showed significant LDE uptake, there was likely increased consumption of LDL by these cells, similar to cells in cancers and inflammatory diseases. Plasma cholesterol levels had no influence on LDE uptake, which showed that the direct delivery of the nanoemulsion to target tissues was independent of serum lipoproteins. There were no significant differences in the parameters (p>0.01) because of the small sample size, but the findings were similar to those of previous studies.
Nanotechnology is a promising therapeutic option for surgery and hormonal blockage for deep endometriosis, with a lower complication rate and no systemic side effects.
多种癌症和炎症疾病中的快速分裂细胞通过高浓度的低密度脂蛋白（LDL）摄取来合成细胞膜，而将含有脂质纳米颗粒（LDE）的 LDL 样纳米乳液与化疗药物偶联，可有效靶向这些细胞，而不会产生明显的全身作用。这是一项前瞻性探索性研究，评估了放射性标记的 LDE 乳液通过子宫内膜异位灶的受体摄取的情况，以及 LDE 进入细胞内的能力。
在手术前确定每位患者的血脂情况，并向 14 名患有肠内或非肠内子宫内膜异位症的患者注射标记的 LDE。测量每个组织样本（肠内子宫内膜异位症、非肠内子宫内膜异位症、健康腹膜或表面子宫内膜）的放射性。
肠内子宫内膜异位症组的血浆 LDL 水平较高，但病灶摄取的 LDE 水平较低，这表明细胞分裂较少，纤维化较多。LDE 的摄取在表面子宫内膜中最高，其次是健康腹膜，在子宫内膜异位症病变中最低。由于子宫内膜异位灶显示出明显的 LDE 摄取，这些细胞可能消耗了更多的 LDL，类似于癌症和炎症疾病中的细胞。血浆胆固醇水平对 LDE 的摄取没有影响，这表明纳米乳液直接递送至靶组织与血清脂蛋白无关。由于样本量小，参数之间没有显著差异（p>0.01），但结果与以前的研究相似。
纳米技术是治疗深部子宫内膜异位症的手术和激素阻断的一种有前途的治疗选择，具有较低的并发症率和无全身副作用。
