Ziemys Arturas, Simic Vladimir, Milosevic Miljan, Kojic Milos, Liu Yan Ting, Yokoi Kenji
Houston Methodist Research Institute, Houston, TX 77030, USA.
Bioengineering Research and Development Center BioIRC Kragujevac, 3400 Kragujevac, Serbia.
Pharmaceutics. 2021 May 12;13(5):703. doi: 10.3390/pharmaceutics13050703.
Metastatic cancer disease is the major cause of death in cancer patients. Because those small secondary tumors are clinically hardly detectable in their early stages, little is known about drug biodistribution and permeation into those metastatic tumors potentially contributing to insufficient clinical success against metastatic disease. Our recent studies indicated that breast cancer liver metastases may have compromised perfusion of intratumoral capillaries hindering the delivery of therapeutics for yet unknown reasons. To understand the microcirculation of small liver metastases, we have utilized computational simulations to study perfusion and oxygen concentration fields in and around the metastases smaller than 700 µm in size at the locations of portal vessels, central vein, and liver lobule acinus. Despite tumor vascularization, the results show that blood flow in those tumors can be substantially reduced indicating the presence of inadequate blood pressure gradients across tumors. A low blood pressure may contribute to the collapsed intratumoral capillary lumen limiting tumor perfusion that phenomenologically corroborates with our previously published in vivo studies. Tumors that are smaller than the liver lobule size and originating at different lobule locations may possess a different microcirculation environment and tumor perfusion. The acinus and portal vessel locations in the lobule were found to be the most beneficial to tumor growth based on tumor access to blood flow and intratumoral oxygen. These findings suggest that microcirculation states of small metastatic tumors can potentially contribute to physiological barriers preventing efficient delivery of therapeutic substances into small tumors.
转移性癌症是癌症患者死亡的主要原因。由于那些小的继发性肿瘤在临床早期很难被检测到,因此对于药物在这些转移性肿瘤中的生物分布和渗透情况了解甚少,这可能导致针对转移性疾病的临床治疗效果不佳。我们最近的研究表明,乳腺癌肝转移瘤可能存在瘤内毛细血管灌注受损的情况,但其原因尚不清楚,这阻碍了治疗药物的递送。为了了解小肝转移瘤的微循环情况,我们利用计算机模拟研究了在门静脉、中央静脉和肝小叶腺泡位置处,大小小于700微米的转移瘤内部及其周围的灌注和氧浓度场。尽管肿瘤已血管化,但结果表明这些肿瘤中的血流可能会大幅减少,这表明肿瘤两端存在血压梯度不足的情况。低血压可能导致瘤内毛细血管腔塌陷,从而限制肿瘤灌注,这在现象学上与我们之前发表的体内研究结果相符。小于肝小叶大小且起源于不同小叶位置的肿瘤可能具有不同的微循环环境和肿瘤灌注情况。基于肿瘤对血流和瘤内氧气的获取情况,发现小叶中的腺泡和门静脉位置对肿瘤生长最为有利。这些发现表明,小转移性肿瘤的微循环状态可能会形成生理屏障,阻碍治疗物质有效递送至小肿瘤中。