Sonodynamic Therapy Using Dacarbazine-Loaded AuSiO2 Nanoparticles for Melanoma Treatment: An In-Vitro Study on the B16F10 Murine Melanoma Cell Line

The use of nanoparticles as a sonosensitizer in cancer sonodynamic therapy has been gaining attention because of their great advantages in drug delivery applications. By conjugating chemotherapy agents with nanoparticles, we can develop a drug delivery platform, control drug release and improve the outcome of treatments. The in-vitro study described here evaluates the combination of AuSiO₂ nanoparticles and dacarbazine (DTIC@AuSiO₂) as a sonosensitizer for sonodynamic therapy of melanoma. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry assays revealed that the viability of B16F10 melanoma cells was significantly inhibited by the increase in apoptosis induction in treatment with DTIC@AuSiO₂ nanoparticles under ultrasound exposure compared with treatment with the free DTIC or AuSiO₂ nanoparticles. The sonosensitization activity of AuSiO₂ nanoparticles and greater uptake of DTIC by tumor cells after loading in DTIC@AuSiO₂ nanoparticles inhibited the proliferation of melanoma tumor cells effectively. In conclusion, the DTIC@AuSiO₂ nanoparticles established in this study could represent a good drug delivery and sonosensitizer platform for use in melanoma sonodynamic therapy.     

Characterization of Definity™ ultrasound contrast agent at frequency range of 5-15 MHz

The status of vasa vasorum, which can be imaged using ultrasound contrast agents, is an indication for the progression of atherosclerosis. The preferred ultrasound frequency for this purpose is between 5 and 15 MHz. Therefore, it is essential to have knowledge about the acoustic properties of microbubbles such as elasticity and viscosity to be able to implement the current models for lipid encapsulated microbubbles developed for frequencies used in precordial imaging. In this study, the shell parameters, stiffness S_p and friction S_f, of Definity™ microbubbles have been calculated at frequency range of 5-15 MHz by comparing the theoretical modeling of acoustic bubble response and experimental measurements. Derived parameters are in good agreement with previous estimations on SonoVue™ and Sonazoid™ contrast agent. However, the value of S_f is higher than previously estimated for Definity™ between 12-28 MHz. (E-mail: t.faez@erasmusmc.nl)     

Sonodynamically Induced Apoptosis by Protoporphyrin IX on Hepatoma-22 cells In Vitro

The synergistic effect of ultrasound and certain chemicals on cells is known as sonodynamic therapy (SDT). It has been reported that the direct sonochemical and subsequent redox reactions induced by SDT treatment can lead to apoptotic cell death. However, the detailed biologic mechanism about it is not well understood until now. In this study the effect of low-intensity ultrasound on Hepatoma-22 cells (H22) in the presence of the sonosensitizing drug protoporphyrin IX (PpIX) was evaluated at different incubation times after sonication. Trypan blue exclusion was used to detect cell viability. The presence of apoptotic cells was identified by 4'-6-diamidino-2-phenylindole (DAPI) nuclear staining and transmission electric microscope (TEM) observation. An inverted confocal laser scanning microscope was used to detect the release of mitochondrial protein cytochrome c (Cyt c) and the redistribution of Bcl-2 family proteins Bid and Bax. Additionally, the generation of intracellular reactive oxygen species (ROS) and the loss of mitochondria membrane potential (MMP) were quantificationally measured by a fluorescence microplate reader. The results indicated that the synergistic cytotoxicity of PpIX and ultrasound increased in a time-dependent manner and the mitochondria damage may be the main factor for sonodynamically induced apoptosis by PpIX in H22 cells. (E-mail: lshaof@snnu.edu.cn)     

Sonodynamic Effect of an Anti-Inflammatory Agent - Emodin on Macrophages

Emodin has been used as an anti-inflammatory agent and inflammation is a crucial feature of atherosclerosis. Here, we investigated the sonodynamic effect of emodin on macrophages, the pivotal inflammatory cells in atherosclerotic plaque. THP-1 derived macrophages were cultured with emodin and exposed to ultrasound. Six hours later, unlike the cells treated for 5 and 10 min, the viability of cells treated for 15 min decreased significantly and the cells showed typical apoptotic chromatin fragmentation. The percentage of apoptotic and necrotic cells in the sonodynamic therapy (SDT) group was higher than that in the ultrasound group. Two hours after treatment for 15 min, the cytoskeleton lost its original features as the filaments dispersed and the cytoskeletal proteins aggregated. The percentage of cells with disturbed cytoskeletal filaments in the SDT group was higher than that in the ultrasound group. These results suggest emodin has a sonodynamic effect on macrophages and might be used as a novel sonosensitizer for SDT for atherosclerosis.     

Ultrasound Enhances the Efficacy of Chlorin e6-Mediated Photodynamic Therapy in MDA-MB-231 Cells

Sono-photodynamic therapy (SPDT) is a new modality for cancer treatment. Some studies have reported enhanced tumor cytotoxicity when sonodynamic therapy (SDT) is combined with photodynamic therapy (PDT). In this study, we investigated the cytotoxic effect of SPDT-activated chlorin e6 (Ce6) on MDA-MB-231 cells. Ce6 was found to localize mainly in mitochondria, with maximal uptake within 4 h. Cell survival was estimated by MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltertrazolium bromide tetrazolium) assay 24 h after irradiation; the combined therapy enhanced cytotoxicity to a greater extent. Apoptosis was analyzed using annexin V-PE/7-ADD (7-aminoactinomycin D) staining as well as DAPI (4', 6-diamidino-2-phenylindole) staining, and the results indicated that the cells with apoptotic characteristics were significantly increased in groups given combined therapy. Rhodamine-123 staining and cytochrome c release revealed more serious damage of mitochondria after combined treatment. The generation of reactive oxygen species detected by flow cytometry was greatly increased in cells treated with the combination therapy, and the loss in cell viability could be effectively rescued with the reactive oxygen species inhibitor N-acetylcysteine. Moreover, enhancement of cell membrane permeability after ultrasound treatment was evaluated using FD-500, and it was found that the much higher uptake of Ce6 might be involved in PDT therapy with pre-treatment ultrasound. These results suggest that ultrasound enhances the cytotoxicity of Ce6-mediated PDT, possibly because of the increased intracellular Ce6 level and ROS formation by ultrasound pre-treatment.     

线粒体凋亡通路在声动力学疗法诱导肿瘤细胞凋亡中的作用

目的研究超声激活血卟啉诱导S180肿瘤细胞凋亡的作用机制,并探讨声动力学处理对线粒体凋亡相关蛋白表达变化的影响。方法采用频率为1.75 MHz,声强2W/cm~2的高频聚焦超声结合血卟啉处理S180腹水型肿瘤细胞,流式细胞仪检测细胞凋亡率;激光共聚焦扫描显微镜观察线粒体内膜通透性的变化和细胞色素C的释放;Western blotting检测线粒体凋亡相关蛋白Bcl-2、Bax和Caspase-3的表达变化。结果超声结合血卟啉联合作用后,S180肿瘤细胞凋亡率显著提高,线粒体内膜通透性增强,细胞色素C释放,Bax、Caspase-3蛋白的表达明显升高,而Bcl-2表达降低。结论线粒体凋亡通路在超声激活血卟啉诱导S180肿瘤细胞凋亡中可能起重要作用。     

抗VEGF抗体联合重组人可溶性TRAIL诱导白血病细胞K562凋亡的研究

本研究探讨肿瘤坏死因子相关凋亡诱导配体(TRAIL)和抗血管内皮生长因子(VEGF)抗体对人慢性髓系白血病细胞K562的生长抑制和诱导凋亡的协同作用。将TRAIL和抗VEGF抗体单独及联合作用于K562细胞,应用CCK-8法检测各组的细胞抑制率和用流式细胞仪检测各组的细胞凋亡率。结果表明:以TRAIL 75、100和150ng/ml的浓度作用于K562细胞48小时的凋亡率分别为(4.26±0.67)%、(8.91±0.55)%、(11.71±0.78)%;抗VEGF抗体2.5、5和7.5μg/ml的浓度作用于K562细胞48小时的凋亡率分别为(3.95±0.69)%、(7.98±0.74)%和(10.26±0.83)%。以抗VEGF抗体2.5μg/ml+TRAIL 75 ng/ml或抗VEGF抗体5μg/ml+TRAIL100 ng/ml或抗VEGF抗体7.5μg/ml+TRAIL150 ng/ml作用于K562细胞48小时的细胞凋亡率分别为(22.16±0.93)%、(36.32±1.31)%和(49.19±0.71)%。抗VEGF抗体与TRAIL联合作用于K562细胞后,细胞抑制率及凋亡率显著高于单独应用TRAIL组或抗VEGF抗体组(p0.05)。结论:TRAIL和抗VEGF抗体对K562细胞在诱导凋亡过程中具有协同作用。     

TRAIL receptor-mediated JNK activation and Bim phosphorylation critically regulate Fas-mediated liver damage and lethality

TNF-related apoptosis-inducing ligand (TRAIL) is a member of the TNF family with potent apoptosis-inducing properties in tumor cells. In particular, TRAIL strongly synergizes with conventional chemotherapeutic drugs to induce tumor cell death. Thus, TRAIL has been proposed as a promising future cancer therapy. Little, however, is known regarding what the role of TRAIL is in normal untransformed cells and whether therapeutic administration of TRAIL, alone or in combination with other apoptotic triggers, may cause tissue damage. In this study, we investigated the role of TRAIL in Fas-induced (CD95/Apo-1-induced) hepatocyte apoptosis and liver damage. While TRAIL alone failed to induce apoptosis in isolated murine hepatocytes, it strongly amplified Fas-induced cell death. Importantly, endogenous TRAIL was found to critically regulate anti-Fas antibody-induced hepatocyte apoptosis, liver damage, and associated lethality in vivo. TRAIL enhanced anti-Fas-induced hepatocyte apoptosis through the activation of JNK and its downstream substrate, the proapoptotic Bcl-2 homolog Bim. Consistently, TRAIL- and Bim-deficient mice and wild-type mice treated with a JNK inhibitor were protected against anti-Fas-induced liver damage. We conclude that TRAIL and Bim are important response modifiers of hepatocyte apoptosis and identify liver damage and lethality as a possible risk of TRAIL-based tumor therapy.     

载声敏剂的高分子超声造影剂体内抑瘤效应及其副反应考察

目的通过对比观察载声敏剂血卟啉(HP)的高分子聚合材料聚乳酸羟基乙酸共聚物(PL-GA)超声微泡造影剂(HP-PLGA)的光敏副反应,并观察超声联合该载药微泡对小鼠H22肝癌皮下移植瘤的声动力治疗效果。方法将35只Balb/c小鼠分为5组,分别将不同浓度的HP-PLGA与单纯HP溶液经尾静脉注入各组小鼠体内,阳光辐照后比较观察不同组小鼠眼睛、背部皮肤、尾巴及肝脏产生的副反应。另建立小鼠H22肝癌皮下移植瘤模型,将荷瘤鼠随机分为A、B两大组进行处理,每组30只。A、B组又分为空白对照(C)组、单纯超声辐照(US)组、超声加空白微泡(US+MB)组、超声加单纯HP(US+HP)组和超声加载HPPLGA微泡(US+HP-PLGA)组,隔天处理一次,连续处理3次。A组荷瘤小鼠治疗后15d,比较各组荷瘤小鼠的质量抑瘤率;B组荷瘤小鼠治疗处理后继续喂养,观察各处理组小鼠的生存期。结果注射40mg/ml与20mg/ml单纯HP组小鼠背部皮肤出现明显的红斑焦痂,眼睛红肿,尾巴肿胀,肝脏出现损伤性病理改变,而其他各组无明显反应。与其他各处理组相比较,超声联合载声敏剂PLGA微泡组质量抑瘤率最大,平均生存天数最长,差异具有统计学意义(P<0.05)。结论将声敏剂包裹进高分子造影剂内可以大大降低声敏剂的光敏毒性副反应,且该载声敏剂的高分子造影剂具有明显的体内抑瘤作用,为寻求一种安全、有效、靶向性高、毒副作用小的声动力抗肿瘤方法提供了新的思路和依据。     

TRAIL and doxorubicin combination enhances anti-glioblastoma effect based on passive tumor targeting of liposomes

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a novel anticancer agent for glioblastoma multiforme (GBM). Some GBM cell lines, however, are relatively resistant to TRAIL. Doxorubicin (DOX) can sensitize GBM cells to TRAIL-induced apoptosis, indicating that the combination of DOX and TRAIL may be an effective strategy to kill TRAIL-resistant GBM cells. However, the therapeutic effect is limited by the short serum half-life of TRAIL, chronic cardiac toxicity of DOX, multidrug resistance (MDR) property of GBM cells and poor drug delivery across the blood-brain barrier (BBB). To solve such problems, combination treatment of TRAIL liposomes (TRAIL-LP) and DOX liposomes (DOX-LP) were developed for the first time. The in vitro cytotoxicity study indicated that DOX-LP sensitized GBM cell line U87MG but not normal bovine caruncular epithelial cells (BCECs) to TRAIL-LP-induced apoptosis, demonstrating the safety of the combination treatment. This sensitization was accompanied by up-regulation of death receptor 5 (DR5) expression and caspase activation. Furthermore, the combination therapy of TRAIL-LP and DOX-LP displayed stronger anti-GBM effect than free drugs or liposomal drugs alone in vivo. In summary, the combination treatment reported here showed improved therapeutic effect on GBM. Therefore, it has good potential to become a new therapeutic approach for patients with GBM.     

Efficient melanoma cell killing and reduced melanoma growth in mice by a selective replicating adenovirus armed with tumor necrosis factor-related apoptosis-inducing ligand

High mortality and therapy resistance of melanoma demand the development of new strategies, and overcoming apoptosis deficiency appears as particularly promising. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has shown high potential for apoptosis induction in melanoma cells and may be applicable for gene therapy because of its selective impact on tumor cells. We have constructed a conditional replication-competent adenoviral vector with TRAIL controlled by a tetracycline-inducible promoter (AdV-TRAIL). A variant E1A protein and the lack of E1B aimed at the restriction of viral replication to tumor cells. In particular, the replication gene E1A is controlled by a tyrosinase promoter with high selectivity for melanoma cells. AdV-TRAIL mediated strong expression of E1A and doxycycline-dependent induction of TRAIL selectively in melanoma cells, which resulted in tumor cell lysis and induction of apoptosis. In contrast, non-melanoma cells and normal human melanocytes appeared to be protected. Comparison of the AdV-TRAIL approach with a comparable CD95L vector revealed similar efficacy in vitro. In mouse xenotransplantation models, AdV-TRAIL demonstrated its activity by significant melanoma growth reduction. Melanoma cell killing by AdV-TRAIL was further improved in vitro by combinations with chemotherapeutics. We demonstrate that melanoma cells may be efficiently targeted by TRAIL-based gene therapy, and resistance may be overcome by combined chemotherapy.     

5-Aminoimidazole-4-carboxamide riboside sensitizes TRAIL- and TNF{alpha}-induced cytotoxicity in colon cancer cells through AMP-activated protein kinase signaling

Death receptor-mediated tumor cell death, either alone or in combination with other anticancer drugs, is considered as a new strategy for anticancer therapy. In this study, we have investigated the effects and molecular mechanisms of 5-aminoimidazole-4-carboxamide riboside [AICAR; a pharmacologic activator of AMP-activated protein kinase (AMPK)] in sensitizing tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)- and TNFalpha-induced apoptosis of human colon cancer HCT116 cells. The cytotoxic action of AICAR requires AMPK activation and may occur at various stages of apoptotic pathways. AICAR cotreatment with either TRAIL or TNFalpha enhances activities of caspase-8, caspase-9, and caspase-3; down-regulates the antiapoptotic protein Bcl-2; increases the cleavage of Bid and results in the decrease of mitochondrial membrane potential; potentiates activation of p38 and c-Jun NH(2)-terminal kinase; and inhibits nuclear factor-kappaB activity. In addition, this sensitized cell apoptosis was neither observed in p53-null HCT116 cells nor affected by the cotreatment with mevalonate. In summary, we have developed a novel strategy of combining AICAR with TRAIL for the treatment of colon cancer cells. The sensitization effect of AICAR in cell apoptosis was mediated through AMPK pathway, requires p53 activity, and involves mitochondria-dependent apoptotic cascades, p38 and c-Jun NH(2)-terminal kinase.     

Photodynamic and Sonodynamic Therapy with Protoporphyrin IX: In Vitro and In Vivo Studies

Sono-photodynamic therapy is a promising anticancer technique based on the combination of sonodynamic and photodynamic therapy to improve the cancer treatment effectiveness. This study was aimed at analyzing the effects of the sono-photodynamic (SPD) activity on protoporphyrin IX (PpIX) solution and PpIX-loaded rat liver. In vitro, PpIX 5 μM solutions were irradiated with light (635 nm, 30–50 mW/cm²), ultrasound (1 MHz, 1–2 W/cm²) and both. The PpIX absorption spectra recorded over exposure time revealed that the PpIX decay rate induced by SPD activity (combined irradiation) was approximately the sum of those induced by photodynamic and sonodynamic activity. In vivo, rats were intraperitoneally injected with 5-aminolevulinic acid at the dose of 500 mg/kg weight. After 3 h of injection, the PpIX-loaded livers were irradiated with light (635 nm, 180 ± 9 J/cm²), ultrasound (1.0 MHz, 770 ± 40 J/cm²) and both using a single probe capable of illuminating and sonicating the liver simultaneously. After 30 h, the liver damage induced by each protocol was analyzed histologically. It was found that a greater necrosis depth was induced by the SPD activity. These results suggest that the SPD activity could improve the PpIX decay rate and have greater scope than photodynamic or sonodynamic activity. Further studies should be performed to gain a better understanding of this protocol.     

TRAIL联合药物诱导肿瘤细胞凋亡协同机制的研究

肿瘤坏死因子相关的凋亡诱导配体（tumor necrosis factor-related apoptosis inducingligand,TRAIL）能选择性诱导肿瘤细胞和恶性转化细胞凋亡,对大多数正常细胞却无杀伤作用,被认为是一种非常具有发展潜力的抗肿瘤因子,近年已成为国内外研究的热点。许多学者发现在TRAIL联合各种药物作用于肿瘤细胞的过程中二者有协同效应,但不同药物与TRAIL协同诱导肿瘤细胞凋亡的机制各不相同。     

In Vivo Molecular Imaging Using Low-Boiling-Point Phase-Change Contrast Agents: A Proof of Concept Study

Sub-micron phase-change contrast agents (PCCAs) have been proposed as a tool for ultrasound molecular imaging based on their potential to extravasate and target extravascular markers and also because of the potential to image these contrast agents with a high contrast-to-tissue ratio. We compare in vivo ultrasound molecular imaging with targeted low-boiling-point PCCAs and targeted microbubble contrast agents. Both agents were targeted to the intravascular (endothelial) integrin α_vß₃via a cyclic RGD peptide (cyclo-Arg–Gly–Asp–D-Tyr–Cys) mechanism and imaged in vivo in a rodent fibrosarcoma model, which exhibits angiogenic microvasculature. Signal intensity was measured using two different techniques, conventional contrast-specific imaging (amplitude/phase modulation) and a droplet vaporization imaging sequence, which detects the unique signature of vaporizing PCCAs. Data indicate that PCCA-specific imaging is more sensitive to small numbers of bound agents than conventional contrast imaging. However, data also revealed that contrast from targeted microbubbles was greater than that provided by PCCAs. Both control and targeted PCCAs were observed to be retained in tissue post-vaporization, which was expected for targeted agents but not expected for control agents. The exact mechanism underlying this observation remains unknown.     

载血卟啉的乳酸/羟基乙酸共聚物超声微泡造影剂制备及工艺优化

目的 探讨载声敏剂血卟啉(hematoporphyrin,HP)的高分子材料乳酸/羟基乙酸共聚物[Poly(lactic-co-glycolic acid),PLGA]超声微泡造影剂的优化制备工艺.方法 采用双乳化法制备包裹HP的PLGA超声微泡造影剂,通过正交设计筛选出比较理想的制备工艺,并对所制备的造影剂进行药物体外释放评估及体外超声造影观察.结果 载HP的PLGA造影剂(HP-PLGA)平均粒径602.3 nm,平均包封率63.5%,平均载药量2.15%,电位-(17.1±1.6)mV,体外14 d缓释约86.5%,体外超声显影良好.结论 通过采用双乳化法制备的HP-PLGA造影剂,具备缓释长效的特性,体外显像效果好,符合理想药物载体的基本特性,为实时监控下体内声动力治疗肿瘤提供了一种新型的药物剂型.     

Study of THP-1 Macrophage Viability after Sonodynamic Therapy Using Methyl Ester of 5-Aminolevulinic Acid Gold Nanoparticles

Sonodynamic therapy (SDT) is emerging as new atherosclerosis treatment. The use of gold nanoparticles (AuNPs) as the vehicle for a sensitizer delivery improves reactive oxygen species formation. In this study, methyl ester of aminolevulinic acid (MALA) gold nanoparticles (MALA:AuNPs) functionalized with polyethylene glycol (PEG) were synthesized by photoreduction and characterized by ultraviolet/visible optical absorption, zeta potential and electron microscopy. The reactive oxygen species generation induced by ultrasound irradiation of MALA:AuNPs solutions was studied by observing the decrease in the 1,3-diphenylisobenzofuran emission band. The potential use of MALA:AuNPs as sensitizer for sonodynamic therapy was investigated on THP-1 macrophages. The cytotoxicity test was also described. The findings suggested that ultrasound combined with MALA:AuNPs provides impressive results in in vitro studies. Sonodynamic therapy with MALA:AuNPs through 2 minutes of ultrasound exposure (1 MHz and 1 W/cm²) culminated with total macrophage reduction. Thus, sonodynamic therapy combined with MALA:AuNPs has potential as a treatment for atherosclerosis.     

Gene therapy with TRAIL against renal cell carcinoma

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in cancer cells. However, TRAIL is not toxic against most normal cells. We have accordingly examined by in vivo electroporation whether TRAIL induces apoptosis in renal cell carcinoma. In addition, combination treatment with TRAIL and 5-fluorouracil (5-FU) against renal cell carcinoma was also investigated. The NC65 renal cell carcinoma line was used as a target. pCAGGS TRAIL was injected into the NC65 tumors in the right flanks of severe combined immunodeficient mice. Tumors were pulsed with the CUY21 electroporator. Electroporation was done once on day 0 or thrice on days 0, 2, and 4. Apoptosis was determined by terminal deoxyribonucleotide transferase-mediated nick-end labeling assay. When TRAIL gene therapy using in vivo i.t. electroporation was done once only, the growth of NC65 tumors was not inhibited. However, when TRAIL gene therapy was done thrice, growth suppression of the NC65 tumors was observed. Transfection of the TRAIL gene by in vivo electroporation induced apoptosis in NC65 tumors. When NC65 cells were treated with TRAIL gene therapy in combination with 5-FU, stronger growth suppression was obtained. TRAIL gene therapy did not induce liver dysfunction in severe combined immunodeficient mice. This study shows that TRAIL gene therapy induced growth suppression and apoptosis in NC65 tumors without severe side effects, and that combination treatment of NC65 cells with TRAIL gene therapy and 5-FU resulted in higher antitumor activity. These findings suggest that TRAIL gene therapy and/or 5-FU may be effective against renal cell carcinoma without harmful toxic effects.     

Hypocrellin B Enhances Ultrasound-Induced Cell Death of Nasopharyngeal Carcinoma Cells

Hypocrellin B, a natural pigment from a traditional Chinese herb, has been attracting extensive attention. The present study aims to investigate whether hypocrellin B can enhance cell death induced by ultrasound sonification on nasopharyngeal carcinoma cells in vitro. The sonodynamic action of hypocrellin B was investigated on nasopharyngeal carcinoma cell line CNE2 cells as tumor model cells. In the experiments, the hypocrellin B concentration was kept constant at 2.5 μM and the cells were subject to ultrasound exposure for 15 s at an intensity of 0.65 W/cm². Cytotoxicity was investigated 24 h after ultrasound sonification. Apoptosis was evaluated using flow cytometry with annexin V-FITC and propidium iodine staining and nuclear staining with Hoechst 33258. Cell ultrastructure morphology was observed using transmission electron microscopy (TEM). No significant dark cytotoxicity of hypocrellin B in the CNE2 cells was observed at the concentration of 2.5 μM. The cell death rate induced by ultrasound sonification was significantly higher in the presence of hypocrellin B than in the absence of hypocrellin B. Flow cytometry showed that ultrasound exposure in the presence of hypocrellin B significantly increased the early and late apoptotic rate, 18.64% and 22.57%, respectively, compared with the controls. Nuclear condensation was observed in the nuclear staining and swollen mitochondria and more vacuolar and broken cell membrane were found in TEM after the treatment of hypocrellin B and ultrasound. Our findings demonstrated that the presence of hypocrellin B significantly enhanced the cytotoxicity of ultrasound radiation in CNE2 cells, suggesting that hypocrellin B is a novel sonosensitizer and hypocrellin B-mediated sonodynamic therapy is a potential therapeutic modality in the management of malignant tumors. (E-mail: xcshan@163.com or awnleung@cuhk.edu.hk)     

Ultrasound Dose Fractionation in Sonodynamic Therapy

Sonodynamic therapy (SDT) is a new modality in cancer therapy and it is based on preferential uptake and/or retention of a sonosensitizing drug in tumor tissues and subsequent activation of the drug by ultrasound. The dose fractionation effect in radiation therapy has been known for more than a century, but it is not reported in SDT so far. In this study, the in vivo antitumor effect of the simultaneous dual-frequency ultrasound (1 MHz and 150 kHz) at low-level intensity (cumulative I_SATA = 2.2W/cm²; total energy density 3960J/cm²; for 30 min sonication) in combination with the sonosensitizer of photofrin (PF) (sodium porfimer) was investigated in dose fractionation regime in a spontaneous murine model of breast adenocarcinoma in Balb/c mice. The tumor-bearing mice were divided into six groups (n = 8 to 10): Untreated groups included control and sham; experimental groups were treated with 5 mg/kg intravenous injection of PF alone, with combined PF and ultrasound for 30-min sonication in one fraction at 24 h after PF administration; with combined PF and ultrasound for 30 min sonicatin in three fraction at 18, 24 and 30 h after PF administration; and finally with combined PF and ultrasound for 30 min sonication in five fraction at 12, 18, 24, 30 and 36 h after PF administration. The tumor growth delay (TGD) parameters and the percent of apoptotic index AI (%) were measured in treated and untreated groups. The results show that the TGD parameters in treatment groups with combined drug and ultrasound fractionation mode were significantly different compared with other groups (p < 0.05). Also the sonodynamic ultrasound dose fractionation in five fractions is more effective than of the three-fraction regime. The AI of the tumor tissues treated by ultrasound dose fractionation was also significantly higher in the other groups (p < 0.05), in which the AI (%) in the group treated with five fractions was higher with respect to group treated with 3 fractions (11.56 ± 1.2; 8.7 ± 0.87), respectively. In conclusion, the ultrasound dose fractionation can be useful in therapeutic effect in SDT and may have future clinical applications. (E-mail: ah_barati@yahoo.com)