Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesia and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China.
CAS Key Laboratory of Soft Matter Chemistry, Department of Polymer Science and Engineering, School of Chemistry and Materials Science, University of Science and Technology of China, Hefei, 230032, China.
Theranostics. 2023 Apr 9;13(7):2226-2240. doi: 10.7150/thno.81325. eCollection 2023.
Tumor ablation can cause severe pain to patients, but there is no satisfactory means of analgesia available. In addition, recurrence of residual tumors due to incomplete ablation threatens patient safety. Photothermal therapy (PTT), a promising approach for tumor ablation, also faces the aforementioned problems. Therefore, developing novel photothermal agents that can efficiently relieve PTT-associated pain and potentiate the PTT efficacy are urgently needed. The Pluronic F127 hydrogel doped with indocyanine green (ICG) was served as photothermal agent for PTT. Mouse model that inoculation of tumor near the sciatic nerve was constructed to assess the PTT-evoked pain. Subcutaneous and sciatic nerve vicinal tumor-bearing mice were used to test the efficacy of PTT. PTT-evoked pain depends on an increase in tumor temperature and is accompanied by the activation of TRPV1. A simple introduction of local anesthetic (LA) ropivacaine into ICG-loaded hydrogels relieves PTT-induced pain and exerts long-lasting analgesia compared with opioid analgesia. More interestingly, ropivacaine upregulates major histocompatibility complex class I (MHC-I) in tumor cells by impairing autophagy. Therefore, a hydrogel co-doped with ropivacaine, TLR7 agonist imiquimod and ICG was rationally designed. In the hydrogel system, imiquimod primes tumor-specific CD8 T cells through promoting DCs maturation, and ropivacaine facilitates tumor cells recognition by primed CD8 T cells through upregulating MHC-I. Consequently, the hydrogel maximumly increases CD8 T cells infiltration into tumor and potentiates PTT efficacy. This study for the first time provides an LA-dopped photothermal agents for painless PTT and innovatively proposes that a LA can be used as an immunomodulator to potentiate the PTT efficacy.
肿瘤消融会给患者带来严重的疼痛,但目前尚无令人满意的镇痛方法。此外,由于消融不完全导致残留肿瘤复发,这也会威胁到患者的安全。光热疗法(PTT)是一种很有前途的肿瘤消融方法,但也面临着上述问题。因此,迫切需要开发新型的光热剂,以有效缓解 PTT 相关疼痛并增强 PTT 疗效。 吲哚菁绿(ICG)掺杂的 Pluronic F127 水凝胶被用作 PTT 的光热剂。构建了肿瘤接种于坐骨神经附近的小鼠模型,以评估 PTT 引起的疼痛。使用皮下和坐骨神经附近肿瘤荷瘤小鼠来测试 PTT 的疗效。 PTT 引起的疼痛取决于肿瘤温度的升高,并伴有 TRPV1 的激活。将局部麻醉剂(LA)罗哌卡因简单地引入到 ICG 负载的水凝胶中,与阿片类镇痛药相比,可缓解 PTT 引起的疼痛并发挥持久的镇痛作用。更有趣的是,罗哌卡因通过损害自噬作用上调肿瘤细胞中的主要组织相容性复合体 I 类(MHC-I)。因此,合理设计了一种同时掺杂罗哌卡因、TLR7 激动剂咪喹莫特和 ICG 的水凝胶。在水凝胶系统中,咪喹莫特通过促进 DC 成熟来激活肿瘤特异性 CD8 T 细胞,而罗哌卡因通过上调 MHC-I 来促进被激活的 CD8 T 细胞对肿瘤细胞的识别。因此,水凝胶最大程度地增加了 CD8 T 细胞浸润到肿瘤中,并增强了 PTT 的疗效。 这项研究首次为无痛 PTT 提供了一种 LA 掺杂的光热剂,并创新性地提出 LA 可用作免疫调节剂来增强 PTT 疗效。