Department of Bioengineering, University of California, Los Angeles, California 90095, United States.
California NanoSystems Institute, University of California, Los Angeles, California 90095, United States.
Acc Chem Res. 2020 Nov 17;53(11):2521-2533. doi: 10.1021/acs.accounts.0c00339. Epub 2020 Oct 19.
Immune checkpoint blockade (ICB) therapy elicits antitumor response by inhibiting immune suppressor components, including programmed cell death protein 1 and its ligand (PD-1/PD-L1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). Despite improved therapeutic efficacy, the clinical response rate is still unsatisfactory as revealed by the fact that only a minority of patients experience durable benefits. Additionally, "off-target" effects after systemic administration remain challenging for ICB treatment. To this end, the local and targeted delivery of ICB agents instead could be a potential solution to maximize the therapeutic outcomes while minimizing the side effects.In this Account, our recent studies directed at the development of different strategies for the local and targeted delivery of ICB agents are discussed. For example, transdermal microneedle patches loaded with anti-programmed death-1 antibody (aPD1) and anti-CTLA4 were developed to facilitate sustained release of ICB agents at the diseased sites. Triggered release could also be achieved by various stimuli within the tumor microenvironment, including low pH and abnormally expressed enzymes. Recently, the combination of an anti-programmed death-ligand 1 antibody (aPD-L1) loaded hollow-structured microneedle patch with cold atmospheric plasma (CAP) therapy was also reported. Microneedles provided microchannels to facilitate the transdermal transport of CAP and further induce immunogenic tumor cell death, which could be synergized by the local release of aPD-L1. In addition, formed injectable or sprayable hydrogels were tailored to deliver immunomodulatory antibodies to the surgical bed to inhibit tumor recurrence after primary tumor resection. In paralell, inspired by the unique targeting ability of platelets toward the inflammatory sites, we engineered natural platelets decorated with aPD-L1 for targeted delivery after tumor resection to inhibit tumor recurrence. We further constructed a cell-cell combination delivery platform based on conjugates of platelets and hematopoietic stem cells (HSCs) for leukemia treatment. With the homing ability of HSCs to the bone marrow, the HSC-platelet-aPD1 assembly could effectively deliver aPD1 in an acute myeloid leukemia mouse model. Besides living cells, we also leveraged HEK293T-derived vesicles with PD1 receptors on their surfaces to disrupt the PD-1/PD-L1 immune inhibitory pathway. Moreover, the inner space of the vesicles allowed the packaging of an indoleamine 2,3-dioxygenase inhibitor, further reinforcing the therapeutic efficacy. A similar approach has also been demonstrated by genetically engineering platelets overexpressing PD1 receptor for postsurgical treatment. We hope the local and targeted ICB agent delivery methods introduced in this collection would further inspire the development of advanced drug delivery strategies to improve the efficiency of cancer treatment while alleviating side effects.
免疫检查点阻断 (ICB) 疗法通过抑制免疫抑制成分,包括程序性细胞死亡蛋白 1 及其配体 (PD-1/PD-L1) 和细胞毒性 T 淋巴细胞相关抗原 4 (CTLA-4),来引发抗肿瘤反应。尽管治疗效果有所提高,但临床反应率仍然不尽如人意,因为只有少数患者能获得持久的受益。此外,ICB 治疗后的“脱靶”效应仍然是一个挑战。为此,局部和靶向递送 ICB 药物可能是最大限度提高治疗效果同时最小化副作用的潜在解决方案。在本专题中,我们讨论了为局部和靶向递送 ICB 药物而开发的不同策略。例如,开发了负载抗程序性死亡-1 抗体 (aPD1) 和抗 CTLA4 的透皮微针贴片,以促进 ICB 药物在病变部位的持续释放。还可以通过肿瘤微环境中的各种刺激因素(包括低 pH 值和异常表达的酶)来实现触发式释放。最近,还报道了负载抗程序性死亡配体 1 抗体 (aPD-L1) 的中空结构微针贴片与冷等离子体 (CAP) 治疗的结合。微针提供微通道以促进 CAP 的透皮输送,并进一步诱导免疫原性肿瘤细胞死亡,这可以通过局部释放 aPD-L1 来协同增强。此外,定制了可注射或可喷涂的水凝胶,以将免疫调节抗体递送至手术床,以抑制原发性肿瘤切除后的肿瘤复发。同时,受血小板对炎症部位的独特靶向能力的启发,我们设计了用 aPD-L1 修饰的天然血小板,用于肿瘤切除后的靶向递送,以抑制肿瘤复发。我们还构建了基于血小板和造血干细胞 (HSC) 缀合物的细胞-细胞联合递药平台,用于白血病治疗。利用 HSCs 向骨髓归巢的能力,HSC-血小板-aPD1 组装可以在急性髓性白血病小鼠模型中有效地递送 aPD1。除了活细胞,我们还利用表面具有 PD1 受体的 HEK293T 衍生囊泡来破坏 PD-1/PD-L1 免疫抑制途径。此外,囊泡的内部空间允许包装色氨酸 2,3-双加氧酶抑制剂,进一步增强治疗效果。类似的方法也通过过表达 PD1 受体的基因工程血小板在手术后进行治疗得到了证明。我们希望本专题中介绍的局部和靶向 ICB 药物递送方法能够进一步激发先进药物递送策略的发展,以提高癌症治疗的效率,同时减轻副作用。
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