Department of Pharmacy, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou Red Cross Hospital, Hangzhou, 310003, Zhejiang, People's Republic of China.
Department of Pharmacy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, 310022, China.
Drug Deliv Transl Res. 2021 Jun;11(3):1186-1197. doi: 10.1007/s13346-020-00842-0.
The poor penetration of nanoparticles in solid tumors has been a critical factor limiting the clinical benefits of nanomedicine. Therefore, we depleted the dense extracellular matrix (ECM) and normalized tumor vessels to enhance drug delivery and therapeutic efficacy. We used candesartan as an angiotensin system inhibitor, which reduced ECM content and facilitated "vascular normalization" by targeting the angiotensin-signaling axis, resulting in improved anti-cancer therapeutic effects. We also combined candesartan with PEGylated liposome-encapsulated zoledronic acid (ZOL) (PEG-ZOL-LPs) to assess how this affected anti-tumor therapy. Our findings indicated that the migration of 4T1 mouse breast cancer cells was inhibited by candesartan. Moreover, the ECM depletion (including collagen I and hyaluronan) by candesartan was achieved through the downregulation of TGF-β1 in vitro, consistent with in vivo results. Furthermore, treatment groups that received candesartan also had significantly decreased tumor vessel permeability and proportions of circulating endothelial progenitor cells (CEPCs) in the serum, which resulted in normalization of tumor vasculature and improved delivery of PEG-ZOL-LPs. Finally, the positive effect candesartan in terms of tumor growth was found not to have an impact of the efficacy of the PEG-ZOL-LPs treatment. This unexpected lack of effect of candesartan on the performance of PEG-ZOL-LPs would be due to dynamics of the effect of both treatments. It might be possible that a different protocol of administration could lead to a synergistic effect. Graphical abstract The schematic illustration showed that candesartan favored depletion of tumor stroma and tumor vascular normalization to improve the anti-cancer efficacy of PEG-ZOL-LPs.
纳米颗粒在实体瘤中的渗透不良一直是限制纳米医学临床获益的关键因素。因此,我们耗尽致密的细胞外基质 (ECM) 并使肿瘤血管正常化,以增强药物输送和治疗效果。我们使用坎地沙坦作为血管紧张素系统抑制剂,通过靶向血管紧张素信号轴,减少 ECM 含量并促进“血管正常化”,从而提高抗癌治疗效果。我们还将坎地沙坦与聚乙二醇化脂质体包裹的唑来膦酸 (ZOL)(PEG-ZOL-LPs)联合使用,以评估这对肿瘤治疗的影响。我们的研究结果表明,坎地沙坦抑制了 4T1 小鼠乳腺癌细胞的迁移。此外,坎地沙坦通过下调 TGF-β1 在体外实现 ECM 耗竭(包括 I 型胶原和透明质酸),与体内结果一致。此外,接受坎地沙坦治疗的治疗组还显著降低了肿瘤血管通透性和血清中循环内皮祖细胞 (CEPC) 的比例,导致肿瘤血管正常化和 PEG-ZOL-LPs 的输送改善。最后,发现坎地沙坦在肿瘤生长方面的积极作用不会影响 PEG-ZOL-LPs 治疗的疗效。坎地沙坦对 PEG-ZOL-LPs 性能的这种出乎意料的无影响可能是由于两种治疗方法的效果动力学不同。可能不同的给药方案可能会产生协同作用。 图表抽象 示意图显示,坎地沙坦有利于耗尽肿瘤基质并使肿瘤血管正常化,从而提高 PEG-ZOL-LPs 的抗癌疗效。