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      Clinical validation of a nanodiamond-embedded thermoplastic biomaterial

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          Significance

          There is a continued need to advance novel nanomedicine platforms into the clinic to address treatment challenges in oncology, infection, and regenerative medicine, among other areas. As such, this work demonstrates the in-human validation of nanodiamonds through their incorporation into gutta percha [nanodiamond-embedded gutta percha (NDGP)], a polymer that repairs root canal treatment sites following tissue disinfection. A randomized, dual-arm clinical trial was implemented, and study endpoints included confirmation of lesion healing, postoperative pain reduction, and the absence of reinfection. To date, the NDGP-treated patients successfully met the study endpoints. Therefore, these findings support the potential expansion of nanodiamonds, and the broader nanomedicine field, into other disease indications.

          Abstract

          Detonation nanodiamonds (NDs) are promising drug delivery and imaging agents due to their uniquely faceted surfaces with diverse chemical groups, electrostatic properties, and biocompatibility. Based on the potential to harness ND properties to clinically address a broad range of disease indications, this work reports the in-human administration of NDs through the development of ND-embedded gutta percha (NDGP), a thermoplastic biomaterial that addresses reinfection and bone loss following root canal therapy (RCT). RCT served as the first clinical indication for NDs since the procedure sites involved nearby circulation, localized administration, and image-guided treatment progress monitoring, which are analogous to many clinical indications. This randomized, single-blind interventional treatment study evaluated NDGP equivalence with unmodified GP. This progress report assessed one control-arm and three treatment-arm patients. At 3-mo and 6-mo follow-up appointments, no adverse events were observed, and lesion healing was confirmed in the NDGP-treated patients. Therefore, this study is a foundation for the continued clinical translation of NDs and other nanomaterials for a broad spectrum of applications.

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          Most cited references49

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          Hydrogels in Biology and Medicine: From Molecular Principles to Bionanotechnology

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            The properties and applications of nanodiamonds.

            Nanodiamonds have excellent mechanical and optical properties, high surface areas and tunable surface structures. They are also non-toxic, which makes them well suited to biomedical applications. Here we review the synthesis, structure, properties, surface chemistry and phase transformations of individual nanodiamonds and clusters of nanodiamonds. In particular we discuss the rational control of the mechanical, chemical, electronic and optical properties of nanodiamonds through surface doping, interior doping and the introduction of functional groups. These little gems have a wide range of potential applications in tribology, drug delivery, bioimaging and tissue engineering, and also as protein mimics and a filler material for nanocomposites.
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              Preclinical development and clinical translation of a PSMA-targeted docetaxel nanoparticle with a differentiated pharmacological profile.

              We describe the development and clinical translation of a targeted polymeric nanoparticle (TNP) containing the chemotherapeutic docetaxel (DTXL) for the treatment of patients with solid tumors. DTXL-TNP is targeted to prostate-specific membrane antigen, a clinically validated tumor antigen expressed on prostate cancer cells and on the neovasculature of most nonprostate solid tumors. DTXL-TNP was developed from a combinatorial library of more than 100 TNP formulations varying with respect to particle size, targeting ligand density, surface hydrophilicity, drug loading, and drug release properties. Pharmacokinetic and tissue distribution studies in rats showed that the NPs had a blood circulation half-life of about 20 hours and minimal liver accumulation. In tumor-bearing mice, DTXL-TNP exhibited markedly enhanced tumor accumulation at 12 hours and prolonged tumor growth suppression compared to a solvent-based DTXL formulation (sb-DTXL). In tumor-bearing mice, rats, and nonhuman primates, DTXL-TNP displayed pharmacokinetic characteristics consistent with prolonged circulation of NPs in the vascular compartment and controlled release of DTXL, with total DTXL plasma concentrations remaining at least 100-fold higher than sb-DTXL for more than 24 hours. Finally, initial clinical data in patients with advanced solid tumors indicated that DTXL-TNP displays a pharmacological profile differentiated from sb-DTXL, including pharmacokinetics characteristics consistent with preclinical data and cases of tumor shrinkage at doses below the sb-DTXL dose typically used in the clinic.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                7 November 2017
                23 October 2017
                : 114
                : 45
                : E9445-E9454
                Affiliations
                [1] aDivision of Oral Biology and Medicine, School of Dentistry, University of California , Los Angeles, CA 90095;
                [2] bThe Jane and Jerry Weintraub Center for Reconstructive Biotechnology, School of Dentistry, University of California , Los Angeles, CA 90095;
                [3] cDepartment of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California , Los Angeles, CA 90095;
                [4] dSection of Endodontics, Division of Constitutive & Regenerative Sciences, School of Dentistry, University of California , Los Angeles, CA 90095;
                [5] eNanoCarbon Research Institute, Shinshu University , Ueda, Nagano 386-8567, Japan;
                [6] fCancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore , Singapore 117599, Singapore;
                [7] gDepartment of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore 177599, Singapore;
                [8] h National University Cancer Institute , Singapore 119082, Singapore;
                [9] iDivision of Advanced Prosthodontics, School of Dentistry, University of California , Los Angeles, CA 90095;
                [10] jCalifornia NanoSystems Institute, University of California , Los Angeles, CA 90095;
                [11] kJonsson Comprehensive Cancer Center, University of California , Los Angeles, CA 90095
                Author notes
                2To whom correspondence may be addressed. Email: esung@ 123456dentistry.ucla.edu , mkang@ 123456dentistry.ucla.edu , or dean.ho@ 123456ucla.edu .

                Edited by Eun Ji Chung, University of Southern California Biomedical Engineering Department, Los Angeles, CA, and accepted by Editorial Board Member Mark E. Davis September 21, 2017 (received for review July 4, 2017)

                Author contributions: D.-K.L., T.K., E.C.S., M.K.K., and D. Ho designed research; D.-K.L., Z.L., E.K.-H.C., E.C.S., M.K.K., and D. Ho performed research; D.-K.L. and E.O. contributed new reagents/analytic tools; D.-K.L., T.K., Z.L., D. Hsiou, D.M., B.W., E.C.S., M.K.K., and D. Ho analyzed data; and D.-K.L., T.K., Z.L., D. Hsiou, D.M., B.W., E.O., E.K.-H.C., E.C.S., M.K.K., and D. Ho wrote the paper.

                1D.-K.L., T.K., and Z.L. contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-0725-1801
                Article
                PMC5692571 PMC5692571 5692571 201711924
                10.1073/pnas.1711924114
                5692571
                29078364
                264cc3e9-c38d-4c72-960b-ec8cfb0796c4
                Published under the PNAS license.
                History
                Page count
                Pages: 10
                Funding
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: CMMI-1350197
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: DMI-0327077
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: CMMI-0856492
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: DMR-1343991
                Funded by: National Science Foundation (NSF) 100000001
                Award ID: OISE-1444100
                Funded by: V Foundation for Cancer Research (V Foundation) 100001368
                Award ID: Scholar Award
                Funded by: Wallace H. Coulter Foundation (WHCF) 100001062
                Award ID: Translational Research Award
                Funded by: HHS | NIH | National Cancer Institute (NCI) 100000054
                Award ID: U54CA151880
                Funded by: Ministry of Education - Singapore (MOE) 501100001459
                Award ID: MOE2015-T2-2-126
                Categories
                PNAS Plus
                Physical Sciences
                Engineering
                Biological Sciences
                Medical Sciences
                PNAS Plus

                nanodiamonds,nanomedicine,clinical trial,biomaterial,infection

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