Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Department of Biomedical Engineering, School of Engineering and Applied Science, Yale University, New Haven, CT, USA.
J Pediatr Surg. 2022 Mar;57(3):544-550. doi: 10.1016/j.jpedsurg.2021.03.060. Epub 2021 Apr 15.
Intraamniotic microparticle injection is a novel technique for the treatment of myelomeningocele (MMC) in which microparticles are delivered in-utero in a minimally invasive fashion to bind to and protect the exposed spinal cord. This technique could offer earlier intervention and greater access to prenatal treatment of MMC. Here we demonstrate progress on the engineering of the microparticles to promote binding to the MMC defect. We hypothesized that when the particle's surface charge was decreased and delivery concentration increased, particles would bind to the MMC defect more frequently and more specifically.
Alginate microparticles underwent surface modification to alter the particle charge. Dye-loaded alginate, alginate- dextran sulfate, and alginate- chitosan were injected on e17 into the amnion of a rat model of MMC and the incidence of successful binding and specificity of particle binding to the MMC defect were calculated. Specificity of binding was described using a defect-to-skin brightness ratio based on specimen imaging. Comparisons were made with chi-square, p< 0.05 marked significance.
There was no difference in the incidence of successful binding at e17 with 0.6 mg/fetal kg between the three tested alginate particles. However, alginate- dextran sulfate bound most specifically to the defect (p< 0.05). Alginate-dextran sulfate also demonstrated more frequent binding at higher doses than lower doses (79% at 1.2 mg/kg vs 38% at 0.6 mg/kg and 24% at 0.8 mg/kg, p< 0.01 for both). Specificity was not sacrificed at higher dose injections: defect-to-skin brightness ratio of 5.4 at 1.2 mg/kg vs 1.8 at 0.6 mg/kg (p< 0.05) CONCLUSION: We demonstrate that the intraamniotic injection of alginate-dextran sulfate microparticles at high concentration bind more frequently and more specifically to MMC defects than the previously tested unmodified alginate microparticles.
羊膜内微粒子注射是一种治疗脊髓脊膜膨出(MMC)的新技术,它通过微创的方式将微粒子递送到子宫内,以结合和保护暴露的脊髓。这种技术可以提供更早的干预,并为产前治疗 MMC 提供更多的途径。在这里,我们展示了在工程微粒子以促进与 MMC 缺陷结合方面的进展。我们假设当粒子的表面电荷减少并且递增加大时,粒子将更频繁和更具体地结合到 MMC 缺陷。
海藻酸盐微粒子经历了表面修饰以改变粒子的电荷。负载有染料的海藻酸盐、海藻酸盐-硫酸葡聚糖和海藻酸盐-壳聚糖在 e17 时被注射到 MMC 大鼠模型的羊膜中,并计算成功结合的发生率和粒子结合到 MMC 缺陷的特异性。结合的特异性是基于标本成像的缺陷到皮肤的亮度比来描述的。采用卡方检验进行比较,p<0.05 标记为显著性差异。
在 e17 时,三种测试的海藻酸盐粒子之间,在 0.6mg/胎儿 kg 时,成功结合的发生率没有差异。然而,海藻酸盐-硫酸葡聚糖与缺陷结合最具体(p<0.05)。海藻酸盐-硫酸葡聚糖在较高剂量下比在较低剂量下更频繁地结合(1.2mg/kg 时为 79%,0.6mg/kg 时为 38%,0.8mg/kg 时为 24%,两者均 p<0.01)。在较高剂量注射时,特异性没有丧失:1.2mg/kg 时的缺陷到皮肤的亮度比为 5.4,0.6mg/kg 时为 1.8(p<0.05)。
我们证明了高浓度的海藻酸盐-硫酸葡聚糖微粒子在羊膜内注射比以前测试的未修饰的海藻酸盐微粒子更频繁和更具体地结合到 MMC 缺陷。