载有艾司氯胺酮和 DDP 的免疫增强型可注射水凝胶促进无痛免疫化疗抑制乳腺癌生长。

An Immune-Enhancing Injectable Hydrogel Loaded with Esketamine and DDP Promotes Painless Immunochemotherapy to Inhibit Breast Cancer Growth.

机构信息

Department of Anesthesiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical School, Nanjing, 210008, China.

The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China.

出版信息

Adv Healthc Mater. 2024 Nov;13(29):e2401373. doi: 10.1002/adhm.202401373. Epub 2024 Aug 9.

Abstract

Chemotherapy is the cornerstone of triple-negative breast cancer. The poor effectiveness and severe neuropathic pain caused by it have a significant impact on the immune system. Studies confirmed that immune cells in the tumor microenvironment (TME), have critical roles in tumor immune regulation and prognosis. In this study, it is revealed that the painless administration of Esketamine, combined with Cisplatin (DDP), can exert an anti-tumor effect, which is further boosted by the hydrogel delivery system. It is also discovered that Esketamine combined with DDP co-loaded in Poloxamer Hydrogel (PDEH) induces local immunity by increasing mature Dendritic Cells (mDCs) and activated T cells in PDEH group while the regulatory T cells (Tregs) known as CD4CD25FoxP3decreased significantly. Finally, , CD8 and CD4 T cells in the spleen exhibited a significant increase, suggesting a lasting immune impact of PDEH. This study proposes that Esketamine can serve as a painless immune modulator, enhancing an anti-tumor effect while co-loaded in poloxamer hydrogel with DDP. Along with improving immune cells in the microenvironment, it can potentially alleviate anxiety and depression. With its outstanding bio-safety profile, it offers promising new possibilities for painless clinical therapy.

摘要

化疗是三阴性乳腺癌的基石。其疗效差和引起的严重神经病理性疼痛对免疫系统有显著影响。研究证实,肿瘤微环境(TME)中的免疫细胞在肿瘤免疫调节和预后中具有关键作用。本研究揭示,无痛给予氯胺酮(Esketamine)联合顺铂(DDP)可以发挥抗肿瘤作用,水凝胶递送系统进一步增强了这种作用。还发现氯胺酮联合 DDP 共同负载于泊洛沙姆水凝胶(PDEH)中通过增加 PDEH 组中成熟树突状细胞(mDCs)和活化 T 细胞,诱导局部免疫,而众所周知的调节性 T 细胞(Tregs)CD4CD25FoxP3 则显著减少。最后,脾脏中的 CD8 和 CD4 T 细胞显著增加,表明 PDEH 具有持久的免疫影响。本研究提出氯胺酮可以作为一种无痛免疫调节剂,与 DDP 共同负载于泊洛沙姆水凝胶中增强抗肿瘤作用。同时改善微环境中的免疫细胞,可能缓解焦虑和抑郁。由于其出色的生物安全性,为无痛临床治疗提供了有前途的新可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ad6/11582503/24cae9632819/ADHM-13-0-g006.jpg

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