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      Optimized Anti–Prostate‐Specific Membrane Antigen Single‐Chain Variable Fragment–Loaded Nanobubbles as a Novel Targeted Ultrasound Contrast Agent for the Diagnosis of Prostate Cancer

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          Abstract

          Objectives

          To prepare optimized prostate‐specific membrane antigen (PSMA) single‐chain variable fragment (scFv)–loaded nanobubbles (NBs) as a novel targeted ultrasound (US) contrast agent for diagnosis and treatment of prostate cancer (PCa).

          Methods

          Prostate‐specific membrane antigen scFv‐loaded NBs were prepared by membrane hydration and biotin‐streptavidin conjugation. Flow cytometry was used to observe the binding rate of the targeted NBs to PSMA‐expressing cells. Contrast‐enhanced US was used to monitor targeted and nontargeted NBs administered to nude mice with 22RV1, LNCaP, and PC‐3 xenograft tumors. The specific binding ability of the targeted NBs was further examined by fluorescence imaging of tumor cryosections.

          Results

          Uniformly sized targeted NBs were successfully prepared (mean ± SD, 485.3 ± 28.4 nm). The NBs showed good stability and bound specifically to LNCaP and 22RV1 cells with high PSMA expression in vitro but did not bind to PC‐3 cells without PSMA expression. The targeted NBs presented good US enhancement, and the results of the in vivo xenograft tumor nude mouse model showed that the peak contrast intensity in LNCaP and 22RV1 cells was significantly higher for the targeted NBs than the nontargeted NBs ( P < .05), whereas there was no significant difference in PC‐3 cells. Immunofluorescence results obtained from tumor sections confirmed that the targeted NBs were capable of targeting PSMA‐expressing tumor cells.

          Conclusions

          These novel PSMA scFv‐loaded NBs have proven to be an excellent US contrast agent for imaging PSMA‐expressing PCa and have the potential to not only enable efficient and safe molecular imaging but also to serve as a delivery system for targeted PCa therapies.

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          Most cited references31

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          The Diagnosis and Treatment of Prostate Cancer: A Review.

          Prostate cancer is the most common cancer diagnosis made in men with more than 160 000 new cases each year in the United States. Although it often has an indolent course, prostate cancer remains the third-leading cause of cancer death in men.
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            Polymeric drugs for efficient tumor-targeted drug delivery based on EPR-effect.

            For over half a century extensive research has been undertaken for the control of cancer. However, success has been limited to certain malignancies, and surgical intervention is potentially curative for early stage patients. For the majority of patients with advanced stage of cancer, the treatment is limited to chemotherapy or radiation. Chemotherapy in particular has limitations due to the lack of selectivity with severe toxicity. Under these circumstances tumor-targeted delivery of anticancer drugs is perhaps one of the most important steps for cancer chemotherapy. We reported such a drug for the first time, styrene-maleic acid copolymer-conjugated neocarzinostatin (SMANCS) in 1979, and it eventually led to formulate the concept of the enhanced permeability and retention (EPR) effect of solid tumors in 1986. Monoclonal antibody conjugates are another direction, of which interest is increasing recently though with limited success. The EPR-effect appears as a universal phenomenon in solid tumors which warrants the development of other polymeric drugs or nanomedicine. EPR-effect is applicable for any biocompatible macromolecular compounds above 40 kDa, even larger than 800 kDa, or of the size of bacteria; thus complexed molecules like micelles and liposomes containing anticancer drugs are hallmark examples. The drug concentration in tumor compared to that of the blood (T/B ratio) can be usually as high as 10-30 times. In case of SMANCS/Lipiodol given via tumor feeding artery, the T/B ratio can be as high as 2000, a real pin-point targeting. EPR-effect is not just passive targeting for momentary tumor delivery, but it means prolonged drug retention for more than several weeks or longer. This review describes the pathophysiological mechanisms of the EPR-effect, architectural difference of tumor blood vessel, various factors involved and artificial augmentation of EPR-effect with respect to tumor-selective delivery, and then advantages and problems of macromolecular drugs.
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              Regulation of transport pathways in tumor vessels: role of tumor type and microenvironment.

              Novel anti-neoplastic agents such as gene targeting vectors and encapsulated carriers are quite large (approximately 100-300 nm in diameter). An understanding of the functional size and physiological regulation of transvascular pathways is necessary to optimize delivery of these agents. Here we analyze the functional limits of transvascular transport and its modulation by the microenvironment. One human and five murine tumors including mammary and colorectal carcinomas, hepatoma, glioma, and sarcoma were implanted in the dorsal skin-fold chamber or cranial window, and the pore cutoff size, a functional measure of transvascular gap size, was determined. The microenvironment was modulated: (i) spatially, by growing tumors in subcutaneous or cranial locations and (ii) temporally, by inducing vascular regression in hormone-dependent tumors. Tumors grown subcutaneously exhibited a characteristic pore cutoff size ranging from 200 nm to 1.2 microm. This pore cutoff size was reduced in tumors grown in the cranium or in regressing tumors after hormone withdrawal. Vessels induced in basic fibroblast growth factor-containing gels had a pore cutoff size of 200 nm. Albumin permeability was independent of pore cutoff size. These results have three major implications for the delivery of therapeutic agents: (i) delivery may be less efficient in cranial tumors than in subcutaneous tumors, (ii) delivery may be reduced during tumor regression induced by hormonal ablation, and (iii) permeability to a molecule is independent of pore cutoff size as long as the diameter of the molecule is much less than the pore diameter.
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                Author and article information

                Contributors
                chenjian@sjtu.edu.cn
                shenhaibo@xinhuamed.com.cn
                Journal
                J Ultrasound Med
                J Ultrasound Med
                10.1002/(ISSN)1550-9613
                JUM
                Journal of Ultrasound in Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                0278-4297
                1550-9613
                08 November 2019
                April 2020
                : 39
                : 4 ( doiID: 10.1002/jum.v39.4 )
                : 761-773
                Affiliations
                [ 1 ] Department of Urology, Xinhua Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China
                [ 2 ] Zhejiang California International NanoSystems Institute Zhejiang University Hangzhou China
                [ 3 ] School of Pharmacy Shanghai Jiao Tong University Shanghai China
                Author notes
                [*] [* ] Address correspondence to Haibo Shen, MD, Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 200092 Shanghai, China. E‐mail: shenhaibo@ 123456xinhuamed.com.cn

                Jian Chen, PhD, School of Pharmacy, Shanghai Jiao Tong University, 800 Dongchuan Road, 200240 Shanghai, China. E‐mail: chenjian@ 123456sjtu.edu.cn

                Author information
                https://orcid.org/0000-0002-1183-6570
                Article
                JUM15155
                10.1002/jum.15155
                7155035
                31702068
                837b39af-153e-4770-9665-9f5168f06cd9
                © 2019 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals, Inc. on behalf of the American Institute of Ultrasound in Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2019
                : 12 July 2019
                : 22 September 2019
                Page count
                Figures: 6, Tables: 0, Pages: 13, Words: 6502
                Funding
                Funded by: National Natural Science Foundation of China , open-funder-registry 10.13039/501100001809;
                Award ID: 81690262
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                April 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.0 mode:remove_FC converted:14.04.2020

                molecular imaging,nanobubbles,prostate cancer,prostate‐specific membrane antigen,ultrasound contrast agents

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