Reduction-sensitive poly(ethylene glycol)-polypeptide conjugate micelles for highly efficient intracellular delivery and enhanced antitumor efficacy of hydroxycamptothecin.

The non-specific biodistribution of traditional chemotherapeutic drugs against tumors is the key factor that causes systemic toxicity and hinders their clinical application. In this study, a reduction-sensitive polymer conjugate micelle was manufactured to achieve tumor-specific targeting, reduce toxic side-effects and improve anti-tumor activity of a natural anti-cancer drug, hydroxycamptothecin (HCPT). Therefore, HCPT was conjugated with methoxy-poly(ethylene glycol)-poly(ß-benzyl-L-aspartate) (mPEG-PBLA) by a disulfide bond or succinate bond for the first time to obtain the mPEG-PBLA-SS-HCPT (PPSH) and mPEG-PBLA-CC-HCPT (PPCH) that would form micelles after high-speed agitation and dialysis. The PPSH micelles showed an average particle size of 126.3 nm, a low polydispersity index of 0.209, and a negative surface charge of -21.1 mV zeta potential. Transmission electron microscopy showed the PPSH micelles to have spherical morphology. PPSH had a low critical micelle concentration of 1.29 µg ml-1 with high dilution stability, storage stability and reproducibility. Moreover, the particle size of the PPSH micelles had no significant change after incubation with rat plasma for 72 h, probably resulting in high long circulation in the blood. The PPSH micelles showed significant reduction sensitivity to glutathione. Their sizes increased by 403.2 nm after 24 h post-incubation, and 87.6% drug release was achieved 48 h post-incubation with 40 mM glutathione solutions. The PPSH micelles showed stronger inhibition of HepG2 cells in vitro and growth of H-22 tumor in vivo than the PPCH and HCPT solutions after intravenous injection. The accumulation of PPSH micelles in the tumor tissue contributed to the high anti-tumor effect with little side-effect on the normal tissues. The reduction-sensitive PPSH micelles were a promising carrier of HCPT and other poorly soluble anti-cancer drugs.

Neonatal hand, foot, and mouth disease due to coxsackievirus A6 in Shanghai.

BACKGROUND: Evidence of hand, foot, and mouth disease (HFMD) in neonates is limited. The aim of this study was to evaluate the clinical symptoms, pathogens, possible transmission routes, and prognosis of neonatal HFMD in Shanghai. METHODS: This was a case-control study based on the HFMD registry surveillance system. All neonates and infected family members were enrolled between 2016 and 2017 in Shanghai. Neonates with HFMD were followed for at least half a year. Detailed questionnaires, medical history, and physical examination were recorded. Routine blood examination, liver and renal function, immunophenotypes of peripheral blood lymphocytes (CD3, CD4, and CD8 T-cells; NK cells), immunoglobulin (Ig) M, IgG, and IgA, and cytokine interleukin (IL-1ß, IL-2R, IL-6, IL-8, IL-10, and TNF-α) levels were measured. All rectal swab specimens were collected and genotyped for enterovirus, and phylogenetic analysis based on the VP1 sequences of coxsackievirus A6 (CV-A6) was performed to investigate molecular and evolutionary characteristics. T-test or nonparametric test was used to evaluate the differences. Logistic analysis was applied to calculate the risk of clinical manifestations in the group of HFMD neonates and their paired siblings. RESULTS: There were 16 neonates among the 12,608 diagnosed patients with HFMD, accounting for 0.13%. All neonatal infections were transmitted by other members of the family, mainly the elder siblings, and were caused by CV-A6. CV-A6 was the emerging and predominant causative agent of HFMD in Shanghai. None of the neonates with HFMD experienced fever, onychomadesis, or severe complications. However, two elder sibling patients showed lethargy, and one developed hypoperfusion. In the elder siblings with HFMD, the proportion of white blood cells was generally higher than in neonates with HFMD. The immunologic function of the neonates with HFMD was basically normal. The levels of inflammatory markers were higher in both neonates and elder siblings with HFMD compared to age-matched controls. The clinical symptoms receded about 1 week after onset. None of the neonates had sequelae. CONCLUSIONS: In our study, CV-A6 infection in neonates was benign, but had the character of family clustering. Due to the two-child policy in China, elder siblings may be the main route of HFMD transmission.

[Protective role of calcium alginate hydrogel beads in cells during calcium phosphate cement setting reaction and its influencing factors].

OBJECTIVE: To evaluate the protection of calcium alginate hydrogel beads for mouse preosteoblastic cell line (MC3T3-E1) during the setting reaction of calcium phosphate cement (CPC) pastes and to analyze related influencing factors. METHODS: The MC3T3-E1 cells encapsulated in alginate hydrogel beads were cultured in vitro with ß-tricalcium phosphate/calcium phosphate cement (ß-TCP/CPC) pastes and discs until 2 d. The cell viability and number of live/dead cells were tested using the CCK-8, Calcein-AM and PI, respectively. The effects of CPC paste and CPC disc, different treatment and time to renewal medium on cell viability were compared. RESULTS: There were no significant differences in optical density and number of live cells between ß-TCP/CPC pastes and discs (1 d: P=0.827; 2 d: P=0.965). There were different influences on cell viability between different treatment and time to renewal medium. CONCLUSION: The results indicated that the calcium alginate hydrogel beads had a good protection to MC3T3-E1 cells during the setting reaction of CPC pastes. CPC paste might affect the cell proliferation even when solidification. After setting reaction, it may be favorable for cell viability to renew the medium every 6 h in 1 d.

[Cytological study on osteoblasts and in-situ setting calcium phosphate cements].

OBJECTIVE: To evaluate biocompatibility of three kinds of self-developed injectable calcium phosphate cements (CPCs): chitosan microspheres/CPC, ß-tricalcium phosphate (ß-TCP)/CPC, and K(+)/CPC and the viability of the osteogenic cells cultured with CPC pastes and discs for 10 days. METHODS: The rabbit marrow stromal cells (rMSCs), isolated from rabbit bone marrow with density gradient centrifugation and flow cytometer, were cultured, expended and induced into osteoblasts. Alizarin red staining was used to determine the function of ossification. Then, rMSCs were incubated randomly on both the pastes and solidified discs of the 3 kinds of CPCs. The cells cultured on a 24-well plate were as blank control. Each group had 4 samples. The proliferation and differentiation of each group were observed using acid phosphatase assay (APA) and by testing the activity of alkaline phosphatase (ALP) at day 1, 4, 7, and 10. After stained by acridine orange(AO), the cells were observed, counted and analyzed with an epifluorescence microscopy. The morphology of the cells on CPCs was observed with scanning electron microscope(SEM).The data was subjected to two-way ANOVA followed by LSD test to compare between groups. RESULTS: The process of solidification of the three kinds of CPC pastes has the toxic effect on cells, which is irreversible. The proliferation( the average absortion of pastes are 0.049,0.050,0.049; the discs are 0.898,0.867,0.909;P<0.001), function(the average ALP activity of pastes after ten days are 0.775,0.782,0.798 U/g protein; the discs are 49.288,49.631, 49.744 U/g protein;P<0.001) and number of cells(the average number of cells of pastes after ten days are 3.7,3.7,3.7; the discs are 91.1,89.7,93.7;P<0.001) directly exposed to CPC paste significantly decreased compared with those contacting with the discs. By contrast, cells on the three kinds of discs showed better viability, proliferation, and ossification and cell numbers increased obviously with culture days. CONCLUSION: The process of solidification of the three kinds of CPC pastes has toxic effect on cells. Further study needs to explore a method to protect osteoblasts when seeded into the CPC paste.

A polymeric micelle with an endosomal pH-sensitivity for intracellular delivery and enhanced antitumor efficacy of hydroxycamptothecin.

Amphiphilic poly(ethylene glycol)-imino-poly(benzyl-l-aspartate) (PIPA) and poly(ethylene glycol)-poly(benzyl-l-aspartate) (PPA) block copolymers were synthesized as pH-responsive and pH-nonresponsive copolymers, respectively. Polymer micelles were fabricated by the film dispersion method, and hydroxycamptothecin (HCPT) was physically encapsulated into the micelles. The average diameter of the HCPT-loaded PIPA micelles (PIPAH micelles) was approximately 230 nm, which was slightly smaller than that of the HCPT-loaded PPA micelles (PPAH micelles, approximately 260 nm). The drug-loading content and encapsulation efficiency of the PIPAH micelles (3.33% and 68.89%, respectively) were slightly higher than those of the PPAH micelles (2.90% and 59.68%, respectively). The PIPAH micelles exhibited better colloid stability, storage stability, and plasma stability than the PPAH micelles. Drug release from the PIPAH micelles with imino groups was pH dependent, and more than 75% or 65% of the loaded HCPT was released within 24 h in weakly acidic media (pH 5.0 or 6.0, respectively). An in vitro cell assay demonstrated that the pH-sensitive micelles exhibited potent suppression of cancer cell proliferation and little cytotoxicity on normal cells. Additionally, these micelles could be efficiently internalized by the tumor cells through macropinocytosis- and caveolin-mediated endocytotic pathways. HCPT-loaded micelles had longer circulation time than the HCPT solution in a pharmacokinetic study. In vivo antitumor experiments indicate that the PIPAH micelles had better antitumor efficacy than the pH-insensitive PPAH micelles and the HCPT solution. Therefore, the pH-responsive PIPAH micelles have great potential for high-efficiency delivery of HCPT. STATEMENT OF SIGNIFICANCE: In this study, a new type of pH-responsive amphiphilic copolymer, poly(ethylene glycol)-imino-poly(benzyl-l-aspartate) (PIPA) block copolymer, was synthesized. This copolymer had then self-assembled to form nanomicelles for tumor intracellular delivery of hydroxycamptothecin (HCPT) for the first time. In in vitro test, the PIPAH micelles exhibited adequate stability and pH-dependent drug release. To one's excitement, the PIPAH micelles exhibited better antitumor efficacy and biosafety than the pH-insensitive micelles (PPAH) and the HCPT solution in in vitro and in vivo antitumor experiments. Therefore, the pH-responsive micelles in this study have significant potential to be used for high-performance delivery of HCPT and potentially for the targeted delivery of other cancer therapeutic agents. The polymer designed in this study can be used as a carrier of poorly soluble drugs or other active ingredients.

Delivering MC3T3-E1 cells into injectable calcium phosphate cement through alginate-chitosan microcapsules for bone tissue engineering.

OBJECTIVE: To deliver cells deep into injectable calcium phosphate cement (CPC) through alginate-chitosan (AC) microcapsules and investigate the biological behavior of the cells released from microcapsules into the CPC. METHODS: Mouse osteoblastic MC3T3-E1 cells were embedded in alginate and AC microcapsules using an electrostatic droplet generator. The two types of cell-encapsulating microcapsules were then mixed with a CPC paste. MC3T3-E1 cell viability was investigated using a Wst-8 kit, and osteogenic differentiation was demonstrated by an alkaline phosphatase (ALP) activity assay. Cell attachment in CPC was observed by an environment scanning electron microscopy. RESULTS: Both alginate and AC microcapsules were able to release the encapsulated MC3T3-E1 cells when mixed with CPC paste. The released cells attached to the setting CPC scaffolds, survived, differentiated, and formed mineralized nodules. Cells grew in the pores concomitantly created by the AC microcapsules in situ within the CPC. At Day 21, cellular ALP activity in the AC group was approximately four times that at Day 7 and exceeded that of the alginate microcapsule group (P<0.05). Pores formed by the AC microcapsules had a diameter of several hundred microns and were spherical compared with those formed by alginate microcapsules. CONCLUSIONS: AC microcapsule is a promising carrier to release seeding cells deep into an injectable CPC scaffold for bone engineering.