Modulation of cancer-associated fibroblasts by nanodelivery system to enhance efficacy of tumor therapy.

Cancer-associated fibroblasts (CAFs) are the most common cells in the tumor stroma and are essential for tumor development and metastasis. While decreasing the release and infiltration of nanomedicine through nonspecific internalization, CAFs specifically increase solid tumor pressure and interstitial fluid pressure by secreting tumor growth- and migration-promoting cytokines, which increases vascular and organ pressure caused by solid tumor pressure. Nanoparticles have good permeability and can penetrate tumor tissue to reach the lesion area, inhibiting tumor growth. Thus, CAFs are used as modifiable targets. Here, the authors review the biological functions, origins and biomarkers of CAFs and summarize strategies for modulating CAFs in nanodelivery systems. This study provides a prospective guide to modulating CAFs to enhance oncology treatment.

Cancer-associated fibroblasts (CAFs) participate in the growth and metastasis of cancer and also suppress the penetration of antitumor drugs into the deep tumor tissue. Therefore, many researchers have sought to improve the therapeutic efficacy of nanomedicine through the regulation of CAFs. Some nanoparticles that can precisely target CAFs can slow their growth while also assisting the immune system in fighting cancer cells and releasing pressure within the tumor. These nanoparticles may pass through tumors and inhibit the growth of cancer cells. Therefore, the modulation of CAFs with nanomedicines to enhance tumor therapy is essential.

Versatile Polymer-Initiating Biomineralization for Tumor Blockade Therapy.

Tumor blockade therapy is a promising penetration-independent antitumor modality, which effectively inhibits the exchange of nutrients, oxygen, and information between the tumor and surrounding microenvironments. However, the current blockade therapy strategies have limited antitumor efficacy due to defects of inadequate tumor obstruction, possible side effects, and short duration. For these reasons, a facilely synthesized versatile polymer 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-poly(ethylene glycol)-alendronate (DSPE-PEG-ALN, DPA) is developed to initiate the formation of biomineral shell around osteosarcoma as a potent physical barrier. The DSPE moiety shares a similar chemical structure with the cytomembrane, allowing the membrane insertion of DPA. The bisphosphonic acid groups in ALN attract ions to realize biomineralization around cells. After injection in the invasive osteosarcoma tissue, DPA inserts into the cytomembrane, induces continuous mineral deposition, and ultimately builds a physical barrier around the tumor. Meanwhile, ALN in DPA alleviates bone destruction by suppressing the activity of osteoclasts. Through hindering the exchange of necessary substances, the biomineralization coating inhibits the growth of primary osteosarcoma and pulmonary metastasis simultaneously. Therefore, the multifunctional polymer-initiating blockade therapy provides a promising modality for tumor inhibition in clinics with high efficacy and negligible side effects.

Role of nanoparticle-mediated immunogenic cell death in cancer immunotherapy.

Cancer immunotherapy, which suppresses cancer progression by activating the anti-cancer immunity of patients, shows utility in treating multiple types of cancers. Immunogenic cell death (ICD) induced by most clinical treatment modalities plays a critical role in promoting cancer immunotherapy by releasing tumor-associated antigens and neoantigens and exposing "danger signals" to stimulate immune cells. This comment article presents the different roles of nanoparticles in various treatment modalities of cancers, including chemotherapy, radiotherapy, photodynamic and photothermal therapies, and therapy with radiated tumor cell-released nanoparticles, which often activate anti-cancer immunological effects by inducing ICD of cancer cells, and highlights the challenges and opportunities of ICD-related cancer immunotherapy in the clinic.

Poly(l-glutamic acid)-cisplatin nanoformulations with detachable PEGylation for prolonged circulation half-life and enhanced cell internalization.

PEGylation has been widely applied to prolong the circulation times of nanomedicines via the steric shielding effect, which consequently improves the intratumoral accumulation. However, cell uptake of PEGylated nanoformulations is always blocked by the steric repulsion of PEG, which limits their therapeutic effect. To this end, we designed and prepared two kinds of poly(l-glutamic acid)-cisplatin (PLG-CDDP) nanoformulations with detachable PEG, which is responsive to specific tumor tissue microenvironments for prolonged circulation time and enhanced cell internalization. The extracellular pH (pHe)-responsive cleavage 2-propionic-3-methylmaleic anhydride (CDM)-derived amide bond and matrix metalloproteinases-2/9 (MMP-2/9)-sensitive degradable peptide PLGLAG were utilized to link PLG and PEG, yielding pHe-responsive PEG-pH e-PLG and MMP-sensitive PEG-MMP-PLG. The corresponding smart nanoformulations PEG-pH e-PLG-Pt and PEG-MMP-PLG-Pt were then prepared by the complexation of polypeptides and cisplatin (CDDP). The circulation half-lives of PEG-pH e-PLG-Pt and PEG-MMP-PLG-Pt were about 4.6 and 4.2 times higher than that of the control PLG-Pt, respectively. Upon reaching tumor tissue, PEG on the surface of nanomedicines was detached as triggered by pHe or MMP, which increased intratumoral CDDP retention, enhanced cell uptake, and improved antitumor efficacy toward a fatal high-grade serous ovarian cancer (HGSOC) mouse model, indicating the promising prospects for clinical application of detachable PEGylated nanoformulations.

Polypeptide nanoformulation-induced immunogenic cell death and remission of immunosuppression for enhanced chemoimmunotherapy.

Many conventional chemotherapeutics play an immune-modulating effect by inducing immunogenic cell death (ICD) in tumor cells. However, they hardly arouse strong antitumor immune response because the immunosuppressive lymphocytes are present in the tumor microenvironment. These immunosuppressive lymphocytes include regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). We used a low dose of doxorubicin (DOX) to induce ICD in combination with immune regulator 1-methyl-DL-tryptophan (1MT) to suppress indoleamine 2,3-dioxygenase and overcome Treg- and MDSC-associated immune suppression. By co-encapsulation of DOX and 1MT into a reduction-responsive polypeptide nanogel, the drugs were simultaneously released in the tumor cells and synergistically performed antitumor efficacy. After treatment, recruitment of Tregs and MDSCs was inhibited, and the frequency of tumor-infiltrating CD8+ T cells was remarkably enhanced. These results demonstrated that the chemoimmunotherapy strategy effectively suppressed tumor growth without causing evident adverse effects, indicating its great potential in clinical cancer therapy.

Biointerface engineering nanoplatforms for cancer-targeted drug delivery.

Over the past decade, nanoparticle-based therapeutic modalities have become promising strategies in cancer therapy. Selective delivery of anticancer drugs to the lesion sites is critical for elimination of the tumor and an improved prognosis. Innovative design and advanced biointerface engineering have promoted the development of various nanocarriers for optimized drug delivery. Keeping in mind the biological framework of the tumor microenvironment, biomembrane-camouflaged nanoplatforms have been a research focus, reflecting their superiority in cancer targeting. In this review, we summarize the development of various biomimetic cell membrane-camouflaged nanoplatforms for cancer-targeted drug delivery, which are classified according to the membranes from different cells. The challenges and opportunities of the advanced biointerface engineering drug delivery nanosystems in cancer therapy are discussed.

The effect of acupuncture on tumor growth and gut microbiota in mice inoculated with osteosarcoma cells.

BACKGROUND: Cancer is a complex systemic disease. As a key component of traditional Chinese medicine, acupuncture is a clinically proven medical treatment for many diseases, and it also has preventative effects as it balances the body, allowing it to self-regulate. For cancer patients, acupuncture is widely used as complementary therapy to boost the immune system and reduce the side effects of radiotherapy and chemotherapy. However, few studies have determined how acupuncture against cancer, especially in regulating the intestinal flora of the tumor-burdened mice. METHODS: We treated osteosarcoma tumor-burdened mice by using needling on different acupoints and acupoints combination, thereafter determined the effects of acupuncture on tumor growth by using imaging technology in vitro. In addition, intestinal bacteria were analyzed for further understanding the holistic and systemic treatment effects of acupuncture in osteosarcoma tumor-burdened mice. RESULTS: Acupuncture treatment can delay tumor growth and changes of intestinal bacteria in osteosarcoma tumor-burdened mice. In detail, the loss of body weight and the development of tumor volume of mice have been postposed by needling specific acupoints. In addition, acupuncture treatment has delayed the changes of the relative abundance of Bacteroidetes, Firmicutes and Candidatus Saccharibacteria at the phylum level. Moreover, the relative abundance of many bacteria (e.g., Catabacter, Acetatifactor and Aestuariispira) has been regulated by using acupuncture treatment, and the trend of structural changes of these bacteria at the genus level has also been postposed compared to that of the tumor-burdened mice model group. CONCLUSION: Our results suggest that acupuncture may provide a systemic treatment for cancer. Our findings encourage new and extensive research into the effects of acupuncture on changes of the intestinal microbiome associated with the development of cancer.

Polymer-Mediated Penetration-Independent Cancer Therapy.

The development of polymer-based drug delivery systems provides efficient modalities for cancer therapy. Most of the polymer pharmaceuticals target cancer cells directly, but the insufficient penetration always results in unsatisfactory anticancer efficacy. To break the above bottleneck, strategies of penetration-independent cancer therapy have been developed as advanced treatments for various cancers in the past decade. In this Perspective, we discussed the pros and cons of polymer-mediated biological and physical penetration-independent approaches for cancer therapy and highlighted their further prospects from bench to bedsides.

Immunomodulatory Nanosystems.

Immunotherapy has emerged as an effective strategy for the prevention and treatment of a variety of diseases, including cancer, infectious diseases, inflammatory diseases, and autoimmune diseases. Immunomodulatory nanosystems can readily improve the therapeutic effects and simultaneously overcome many obstacles facing the treatment method, such as inadequate immune stimulation, off-target side effects, and bioactivity loss of immune agents during circulation. In recent years, researchers have continuously developed nanomaterials with new structures, properties, and functions. This Review provides the most recent advances of nanotechnology for immunostimulation and immunosuppression. In cancer immunotherapy, nanosystems play an essential role in immune cell activation and tumor microenvironment modulation, as well as combination with other antitumor approaches. In infectious diseases, many encouraging outcomes from using nanomaterial vaccines against viral and bacterial infections have been reported. In addition, nanoparticles also potentiate the effects of immunosuppressive immune cells for the treatment of inflammatory and autoimmune diseases. Finally, the challenges and prospects of applying nanotechnology to modulate immunotherapy are discussed.

Special Issue: "Smart and Functional Polymers".

Polymerization provides an efficient strategy for synthesizing macromolecules with versatile functionality [...].

PEGylated Polyurea Bearing Hindered Urea Bond for Drug Delivery.

In recent years, polyureas with dynamic hindered urea bonds (HUBs), a class of promising biomedical polymers, have attracted wide attention as a result of their controlled hydrolytic properties. The effect of the chemical structures on the properties of polyureas and their assemblies has rarely been reported. In this study, four kinds of polyureas with different chemical groups have been synthesized, and the polyureas from cyclohexyl diisocyanate and tert-butyl diamine showed the fastest hydrolytic rate. The amphiphilic polyurea composed of hydrophobic cyclohexyl-tert-butyl polyurea and hydrophilic poly(ethylene glycol) (PEG) was synthesized for the controlled delivery of the antitumor drug paclitaxel (PTX). The PTX-loaded PEGylated polyurea micelle more effectively entered into the murine breast cancer 4T1 cells and inhibited the corresponding tumor growth in vitro and in vivo. Therefore, the PEGylated polyurea with adjustable degradation might be a promising polymer matrix for drug delivery.

Electrospun polymer micro/nanofibers as pharmaceutical repositories for healthcare.

Electrospun polymer micro/nanofibers have been widely explored as platforms for controlled delivery of therapeutic agents. Electrospun fibers are featured by large surface area, high porosity, and tunable morphology, which can be manipulated to fabricate micro/nanofibers with appropriate physicochemical properties, degradation kinetics, and drug release profiles. Many therapeutic agents can be separately or simultaneously loaded by electrospun fibers in the application of cancer therapy, adhesion prevention, wound repair, and regeneration of bone and nerve. In this review, we mainly introduce the basic principles of electrospinning, and the mechanisms and applications of electrospun micro/nanofibers for delivery of small molecule drugs, proteins, and nucleic acids in the healthcare field.

Evaluation of Polymer Nanoformulations in Hepatoma Therapy by Established Rodent Models.

Hepatoma is one of the most severe malignancies usually with poor prognosis, and many patients are insensitive to the existing therapeutic agents, including the drugs for chemotherapy and molecular targeted therapy. Currently, researchers are committed to developing the advanced formulations with controlled drug delivery to improve the efficacy of hepatoma therapy. Numerous inoculated, induced, and genetically engineered hepatoma rodent models are now available for formulation screening. However, animal models of hepatoma cannot accurately represent human hepatoma in terms of histological characteristics, metastatic pathways, and post-treatment responses. Therefore, advanced animal hepatoma models with comparable pathogenesis and pathological features are in urgent need in the further studies. Moreover, the development of nanomedicines has renewed hope for chemotherapy and molecular targeted therapy of advanced hepatoma. As one kind of advanced formulations, the polymer-based nanoformulated drugs have many advantages over the traditional ones, such as improved tumor selectivity and treatment efficacy, and reduced systemic side effects. In this article, the construction of rodent hepatoma model and much information about the current development of polymer nanomedicines were reviewed in order to provide a basis for the development of advanced formulations with clinical therapeutic potential for hepatoma.

Effect of Hydrophobic Polypeptide Length on Performances of Thermo-Sensitive Hydrogels.

Thermosensitive gels are commonly used as drug carriers in medical fields, mainly due to their convenient processing and easy functionalization. However, their overall performance has been severely affected by their unsatisfying biocompatibility and biodegradability. To this end, we synthesized poly(l-alanine) (PLAla)-based thermosensitive hydrogels with different degrees of polymerization by ring-opening polymerization. The obtained mPEG45−PLAla copolymers showed distinct transition temperatures and degradation abilities. It was found that slight changes in the length of hydrophobic side groups had a decisive effect on the gelation behavior of the polypeptide hydrogel. Longer hydrophobic ends led to a lower gelation temperature of gel at the same concentration, which implied better gelation capability. The hydrogels showed rapid gelling, enhanced biocompatibility, and better degradability. Therefore, this thermosensitive hydrogel is a promising material for biomedical application.

One-Step Synthesis of Targeted Acid-Labile Polysaccharide Prodrug for Efficiently Intracellular Drug Delivery.

The therapeutic potential of the active targeting and acid-sensitive polysaccharide prodrug was investigated. The active targeting of polysaccharide prodrug was based on the specific interaction between cyclo(Arg-Gly-Asp-d-Phe-Lys) peptide (c(RGDfK)) and its receptor αvß3 integrin overexpressed on the membrane of tumor cells. The cRGD-modified doxorubicin-conjugated hydroxyethyl starch (HES=DOX/cRGD) was synthesized via a one-step Schiff base reaction between oxidized HES, and DOX and c(RGDfK) that achieved an acid-accelerated drug release profile. The targeted polysaccharide prodrug self-assembled into micelle in aqueous environment with a moderate hydrodynamic diameter of 77.1 nm. All data in vitro indicated enhanced cell uptake and elevated cytotoxicity of HES=DOX/cRGD toward human malignant melanoma A375 cells compared with HES=DOX and DOX. Moreover, the smart prodrug also exhibited upregulated accumulation in the tumor, improved antitumor efficacy, and reduced systemic cytotoxicity in vivo. The cRGD-decorated acid-sensitive polysaccharide prodrug was advantageous in both antitumor efficacy and systemic security, showing great prospect in clinical application.

Reduction-Responsive Polypeptide Nanogel for Intracellular Drug Delivery in Relieving Collagen-Induced Arthritis.

Rheumatoid arthritis (RA) induces the destruction of cartilage and bone. Methotrexate (MTX) functions as an effective first-line drug to relieve RA in the clinic. However, patients treated with MTX often suffer from severe side effects mainly due to its off-target effects. Therefore, selective delivery of MTX to the affected joints may achieve upregulated efficacy and safety. The affected joints of RA feature hypoxic microenvironment and increased level of glutathione (GSH), resulting from synovial proliferation, lymphocyte infiltration, and neovascularization. In this study, a disulfide-cross-linked nanogel (NG) of methoxy poly(ethylene glycol)-poly(L-phenylalanine-co-L-cystine) (mPEG-P(LP-co-LC)) was synthesized as an intracellular delivery system of MTX. The loading nanogel NG/MTX exhibited apparent reduction-responsiveness and GSH-triggered release behavior of MTX. It also showed efficient internalization and high cytotoxicity toward activated macrophages. Moreover, NG/MTX possessed selective biodistribution in the inflammatory joints of collagen-induced arthritis mouse model. The clinical and histological scores of the mice after NG/MTX treatment were lower than those of the other groups, and the progress of collagen-induced arthritis was overall relieved. To conclude, the controlled delivery of MTX by smart polymer nanoparticles to the RA-affected joints may be a promising approach in the clinical therapy of RA.

α-Cyclodextrin concentration-controlled thermo-sensitive supramolecular hydrogels.

Supramolecular hydrogels (SHGs) built from inclusion complex of macrocyclic compound α-cyclodextrin (α-CD) and poly(ethylene glycol) (PEG) have attracted much interest due to their excellent biocompatibility and great potential for biomedical applications. In this work, the hydrogen bond of nucleic acid was introduced into the above-mentioned SHG by syntheses of nucleobase guanine/cytosine (G/C)-terminated PEG (G-PEG-G/C-PEG-C). The base-pairing interaction between G and C as an additional network junction effectively enhanced storage moduli (G's) of the hydrogels. Moreover, the prepared hydrogels exhibited excellent cytocompatibility and property for controlled drug release, outlining the potential of thermo-sensitive construct for biomedical applications, such as local chemotherapy of cancers.

Polymer materials for prevention of postoperative adhesion.

Postoperative adhesion (POA) is a common complication that often occurs after a variety of surgeries, such as plastic surgery, repair operations of abdominal, pelvic, and tendon, and so forth. Moreover, POA leads to chronic abdominal pain, secondary infertility in women, intestinal obstruction, and other severe complications, which significantly reduce the life quality of patients. In order to prevent the formation of POA, a number of strategies have been developed, among which an emerging method is physical barriers consisting of polymer materials. This review highlights the most commonly used natural and synthetic polymer materials in anti-adhesion physical barriers. The specific features of polymer materials are analyzed and compared, and the possible prospect is also predicted. STATEMENT OF SIGNIFICANCE: Postoperative adhesion (POA) is a serious complication accompanied with various surgeries. Polymer material-based physical barriers have attracted a large amount of attention in POA prevention. The polymer barriers can effectively avoid the formation of fibrous tissues among normal organs by reducing the interconnection of injured tissues. In this review, specific features of the natural and synthetic polymer materials for application in POA prevention were presented, and the possible prospects were predicted. All in all, our work can provide inspiration for researchers to choose proper polymer materials for preclinical and even clinical anti-adhesion studies.

Schiff base bond-linked polysaccharide-doxorubicin conjugate for upregulated cancer therapy.

The pH-responsive polymer prodrugs were designed to maintain sufficient stability in the bloodstream and promptly release the active drugs when entering the acidic microenvironments, such as tumor tissue and cells. This kind of polymer-drug conjugates has become increasingly intriguing given the specific advantages over traditional drug delivery system. In our work, dextran (Dex) was oxidized into aldehyde-functionalized Dex-CHO before conjugating with doxorubicin (DOX) via efficient Schiff base reaction. The amphiphilic product Dex-DOX aggregated into uniform spherical nanoparticle in aqueous condition. The imine bond in Dex-DOX stayed tough in neutral solution yet quickly fractured when pH was lowered, in which way DOX was locally released and functioned in tumor cells. Our findings proved that the newly-constructed Dex-DOX could obviously promote the pH-dependent drug release, highlight the cell uptake efficiency, and strengthen the antitumor ability toward mouse B16F10 melanoma. In addition, it also largely averted the adverse effects to vital organs, which guaranteed higher level of security. Therefore, Dex-DOX held great potential of becoming a qualified chemotherapeutic drug delivery system.

Scavenger Receptor-Mediated Targeted Treatment of Collagen-Induced Arthritis by Dextran Sulfate-Methotrexate Prodrug.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder implicated in multiple joint affection and even disability. The activated macrophages perform a predominant role in onset and persistence of RA. Scavenger receptor (SR), one of several receptors overexpressed on the activated macrophages, is a specific biomarker for targeted therapy of numerous chronic inflammation diseases like RA. In this work, dextran sulfate-graft-methotrexate conjugate (DS-g-MTX) is synthesized and characterized, which exhibits excellent targetability to SR on the activated RAW 264.7 cells. Additionally, the enhanced accumulation and potent inflammatory inhibition are observed in the affected joint after intravenous injection of DS-g-MTX, compared to the treatment with dextran-graft-methotrexate (Dex-g-MTX), as is confirmed by the detection of histopathology and pro-inflammatory cytokines. Our work highlights DS-g-MTX as a potential therapeutic option for RA aiming the SR-expressed activated macrophages.