Department of Biology, Cornell University, Ithaca, New York, USA.
Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, New York, New York, USA.
World Neurosurg. 2023 Oct;178:60-68. doi: 10.1016/j.wneu.2023.07.030. Epub 2023 Jul 15.
Sonodynamic therapy (SDT) has emerged as an encouraging noninvasive technique that uses ultrasound to activate targeted agents to induce antitumor effects for the treatment of glioma. With extensive variation in the types of sonosensitizers, protocols for sonication, and model systems, a comprehensive overview of existing preclinical data on the efficacy of SDT in glioma treatment is warranted. Here, we conduct a systematic review of preclinical and early clinical literature on implementing SDT to treat in vitro and in vivo models of glioma. Our findings suggest that coupling sonosensitizers such as 5-aminolevulinic acid, hematoporphyrin monomethyl ether, and sinoporphyrin sodium with focused ultrasound induces robust cytotoxic activity in tumor cells (in vitro and in vivo). These effects are likely mediated by the oxidative stress induced by reactive oxygen species production, apoptotic signaling cascades, and intracellular calcium overload. Future research is needed to better understand the biochemical and mechanistic properties of SDT, and ongoing trials may help elucidate the clinical feasibility of glioma treatment with optimized sonically activated treatments.
声动力学疗法 (SDT) 已成为一种有前途的非侵入性技术,它利用超声波激活靶向试剂,以诱导抗肿瘤效应,用于治疗脑胶质瘤。由于声敏剂的种类、超声处理方案和模型系统存在广泛差异,因此有必要对 SDT 在脑胶质瘤治疗中的现有临床前数据进行全面综述。在这里,我们对 SDT 治疗脑胶质瘤的体外和体内模型的临床前和早期临床文献进行了系统回顾。我们的研究结果表明,将 5-氨基酮戊酸、血卟啉单甲醚和血卟啉钠等声敏剂与聚焦超声结合使用,可以在肿瘤细胞中诱导强烈的细胞毒性活性(体外和体内)。这些作用可能是通过活性氧产生引起的氧化应激、凋亡信号级联和细胞内钙超载介导的。需要进一步的研究来更好地了解 SDT 的生化和机制特性,正在进行的试验可能有助于阐明优化的声激活治疗治疗脑胶质瘤的临床可行性。