Srinivasan Visish M, Gumin Joy, Camstra Kevin M, Chen Stephen R, Johnson Jeremiah N, Shimizu Yuzaburo, Parker Kerrigan Brittany C, Shpall Elizabeth J, Lang Frederick F, Kan Peter
Departments of1Neurosurgery and.
Departments of3Neurosurgery and.
J Neurosurg. 2019 Sep 6;133(4):1182-1190. doi: 10.3171/2019.6.JNS19327. Print 2020 Oct 1.
Bone marrow-derived human mesenchymal stem cells (BM-hMSCs) have been used in clinical trials for the treatment of several neurological disorders. MSCs have been explored as a delivery modality for targeted viral therapeutic agents in the treatment of intracranial pathologies. Delta-24-RGD, a tumor-selective oncolytic adenovirus designed to target malignant glioma cells, has been shown to be effective in animal models and in a recent clinical trial. However, the most efficient strategy for delivering oncolytic therapies remains unclear. BM-hMSCs have been shown to home toward glioma xenografts after intracarotid delivery. The feasibility of selective intraarterial infusion of BM-hMSCs loaded with Delta-24-RGD (BM-hMSC-Delta-24) to deliver the virus to the tumor is being investigated. To evaluate the feasibility of endovascular intraarterial delivery, the authors tested in vitro the compatibility of BM-hMSC-Delta-24 with a variety of commercially available, clinically common microcatheters.
BM-hMSCs were cultured, transfected with Delta-24-RGD, and resuspended in 1% human serum albumin. The solution was then injected via 4 common neuroendovascular microcatheters of different inner diameters (Marathon, Echelon-14, Marksman, and SL-10). Cell count and viability after injection through the microcatheters were assessed, including tests of injection velocity and catheter configuration. Transwell assays were performed with the injected cells to test the efficacy of BM-hMSC-Delta-24 activity against U87 glioma cells. BM-hMSC-Delta-24 compatibility was also tested with common neuroendovascular medications: Omnipaque, verapamil, and heparin.
The preinfusion BM-hMSC-Delta-24 cell count was 1.2 × 105 cells/ml, with 98.7% viability. There was no significant difference in postinfusion cell count or viability for any of the catheters. Increasing the injection velocity from 1.0 ml/min to 73.2 ml/min, or modifying the catheter shape from straight to tortuous, did not significantly reduce cell count or viability. Cell count and viability remained stable for up to 5 hours when the cell solution was stored on ice. Mixing BM-hMSC-Delta-24 with clinical concentrations of Omnipaque, verapamil, and heparin prior to infusion did not alter cell count or viability. Transwell experiments demonstrated that the antiglioma activity of BM-hMSC-Delta-24 was maintained after infusion.
BM-hMSC-Delta-24 is compatible with a wide variety of microcatheters and medications commonly used in neuroendovascular therapy. Stem cell viability and viral agent activity do not appear to be affected by catheter configuration or injection velocity. Commercially available microcatheters can be used to deliver stem cell neurotherapeutics via intraarterial routes.
骨髓来源的人间充质干细胞(BM-hMSCs)已用于多种神经系统疾病的临床试验。间充质干细胞已被探索作为靶向病毒治疗剂的递送方式用于治疗颅内病变。Delta-24-RGD是一种设计用于靶向恶性胶质瘤细胞的肿瘤选择性溶瘤腺病毒,已在动物模型和最近的一项临床试验中显示出有效性。然而,递送溶瘤疗法的最有效策略仍不清楚。已显示BM-hMSCs经颈动脉递送后可归巢至胶质瘤异种移植物。正在研究选择性动脉内输注负载Delta-24-RGD的BM-hMSCs(BM-hMSC-Delta-24)以将病毒递送至肿瘤的可行性。为了评估血管内动脉递送的可行性,作者在体外测试了BM-hMSC-Delta-24与多种市售的、临床常用的微导管的兼容性。
培养BM-hMSCs,用Delta-24-RGD转染,并重悬于1%人血清白蛋白中。然后将溶液通过4种不同内径的常见神经血管微导管(Marathon、Echelon-14、Marksman和SL-10)注射。评估通过微导管注射后的细胞计数和活力,包括注射速度和导管构型测试。对注射的细胞进行Transwell试验,以测试BM-hMSC-Delta-24对U87胶质瘤细胞的活性疗效。还测试了BM-hMSC-Delta-24与常见神经血管药物(欧乃派克、维拉帕米和肝素)的兼容性。
输注前BM-hMSC-Delta-24细胞计数为1.2×105个细胞/ml,活力为98.7%。任何导管的输注后细胞计数或活力均无显著差异。将注射速度从1.0 ml/min提高到73.2 ml/min,或将导管形状从直形改为弯曲形,均未显著降低细胞计数或活力。当细胞溶液保存在冰上时,细胞计数和活力在长达5小时内保持稳定。在输注前将BM-hMSC-Delta-24与临床浓度的欧乃派克、维拉帕米和肝素混合,不会改变细胞计数或活力。Transwell实验表明,输注后BM-hMSC-Delta-24的抗胶质瘤活性得以维持。
BM-hMSC-Delta-24与神经血管内治疗中常用的多种微导管和药物兼容。干细胞活力和病毒剂活性似乎不受导管构型或注射速度的影响。市售微导管可用于通过动脉内途径递送干细胞神经治疗剂。