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      Bleomycin-Loaded pH-Sensitive Polymer–Lipid-Incorporated Liposomes for Cancer Chemotherapy

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          Abstract

          Cancer chemotherapeutic systems with high antitumor effects and less adverse effects are eagerly desired. Here, a pH-sensitive delivery system for bleomycin (BLM) was developed using egg yolk phosphatidylcholine liposomes modified with poly(ethylene glycol)-lipid (PEG-PE) for long circulation in the bloodstream and 2-carboxycyclohexane-1-carboxylated polyglycidol-having distearoyl phosphatidylethanolamine (CHexPG-PE) for pH sensitization. The PEG-PE/CHexPG-PE-introduced liposomes showed content release responding to pH decrease and were taken up by tumor cells at a rate 2.5 times higher than that of liposomes without CHexPG-PE. BLM-loaded PEG-PE/CHexPG-PE-introduced liposomes exhibited comparable cytotoxicity with that of the free drug. Intravenous administration of these liposomes suppressed tumor growth more effectively in tumor-bearing mice than did the free drug and liposomes without CHexPG-PE. However, at a high dosage of BLM, these liposomes showed severe toxicity to the spleen, liver, and lungs, indicating the trapping of liposomes by mononuclear phagocyte systems, probably because of recognition of the carboxylates on the liposomes. An increase in PEG molecular weight on the liposome surface significantly decreased toxicity to the liver and spleen, although toxicity to the lungs remained. Further improvements such as the optimization of PEG density and lipid composition and the introduction of targeting ligands to the liposomes are required to increase therapeutic effects and to reduce adverse effects.

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          Stealth liposomes: review of the basic science, rationale, and clinical applications, existing and potential

          Among several promising new drug-delivery systems, liposomes represent an advanced technology to deliver active molecules to the site of action, and at present several formulations are in clinical use. Research on liposome technology has progressed from conventional vesicles (“first-generation liposomes”) to “second-generation liposomes”, in which long-circulating liposomes are obtained by modulating the lipid composition, size, and charge of the vesicle. Liposomes with modified surfaces have also been developed using several molecules, such as glycolipids or sialic acid. A significant step in the development of long-circulating liposomes came with inclusion of the synthetic polymer poly-(ethylene glycol) (PEG) in liposome composition. The presence of PEG on the surface of the liposomal carrier has been shown to extend blood-circulation time while reducing mononuclear phagocyte system uptake (stealth liposomes). This technology has resulted in a large number of liposome formulations encapsulating active molecules, with high target efficiency and activity. Further, by synthetic modification of the terminal PEG molecule, stealth liposomes can be actively targeted with monoclonal antibodies or ligands. This review focuses on stealth technology and summarizes pre-clinical and clinical data relating to the principal liposome formulations; it also discusses emerging trends of this promising technology.
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            pH-sensitive vesicles, polymeric micelles, and nanospheres prepared with polycarboxylates.

            Titratable polyanions, and more particularly polymers bearing carboxylate groups, have been used in recent years to produce a variety of pH-sensitive colloids. These polymers undergo a coil-to-globule conformational change upon a variation in pH of the surrounding environment. This conformational change can be exploited to trigger the release of a drug from a drug delivery system in a pH-dependent fashion. This review describes the current status of pH-sensitive vesicles, polymeric micelles, and nanospheres prepared with polycarboxylates and their performance as nano-scale drug delivery systems, with emphasis on our recent contribution to this field. Copyright © 2011 Elsevier B.V. All rights reserved.
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              Meta-analysis of clinical and preclinical studies comparing the anticancer efficacy of liposomal versus conventional non-liposomal doxorubicin.

              While liposome-mediated delivery of cytotoxic chemotherapy has been shown to significantly enhance drug tolerability in patients as compared to the conventional formulation, the fundamental question remains whether they also improve anticancer efficacy. Thus, we performed a systematic literature search for randomized clinical trials directly comparing efficacy of liposomal cytotoxic chemotherapy versus their equivalent conventional formulation. The search yielded 14 clinical trials (8 anthracycline, 4 cisplatin, 1 paclitaxel, 1 irinotecan) that meet inclusion criteria, with a total of 2589 patients. We found that efficacy in patients was not different between liposomal and conventional chemotherapy as assessed by objective response (odds ratio 1.03; 95% confidence interval [CI] 0.82-1.30), overall survival (hazard ratio [HR] 1.05; 95% CI 0.95-1.17), and progression free survival rates (HR 1.01; 95% CI, 0.92-1.11). Subgroup analyses of only the anthracycline trials also did not show any efficacy advantage for the liposomal formulation. Since pegylated liposomal doxorubicin (PLD) was the most prevalent formulation in these clinical trials, we also performed a meta-analysis of 11 preclinical studies comparing efficacy of PLD and conventional doxorubicin in tumor-bearing mice. In contrast with clinical results, animal studies showed significantly increased survival in mice treated with PLD compared to conventional doxorubicin (HR 0.39; 95% CI 0.27-0.56). We discuss the possible reasons why the pharmacological advantages of carrier-mediated chemotherapy did not translate into enhanced clinical efficacy including the role of the enhanced permeability and retention (EPR) effect and the tumor microenvironment, the optimal dosing regimen for carrier-mediated agents, and the lack of standardization in the conduct and reporting of preclinical studies evaluating anticancer efficacy of these agents. Our study shows that the full clinical potential of carrier-mediated drugs remains to be realized and highlights some of the critical knowledge gaps that must be addressed in order to move the field forward.
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                Author and article information

                Journal
                Polymers (Basel)
                Polymers (Basel)
                polymers
                Polymers
                MDPI
                2073-4360
                15 January 2018
                January 2018
                : 10
                : 1
                : 74
                Affiliations
                [1 ]Department of Applied Chemistry, Graduate School of Engineering, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan; ma105114@ 123456edu.osakafu-u.ac.jp (S.P.); harada@ 123456chem.osakafu-u.ac.jp (A.H.)
                [2 ]Joint Department of Veterinary Clinical Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori 680-8553, Japan; misatosu202@ 123456gmail.com (M.O.); yamashita@ 123456muses.tottori-u.ac.jp (M.Y.); kazu-azuma@ 123456muses.tottori-u.ac.jp (K.A.); tsuka@ 123456muses.tottori-u.ac.jp (T.T.); taromobile@ 123456me.com (N.I.); imagawat@ 123456muses.tottori-u.ac.jp (T.I.); yokamoto@ 123456muses.tottori-u.ac.jp (Y.O.)
                Author notes
                [* ]Correspondence: yuba@ 123456chem.osakafu-u.ac.jp (E.Y.); tosaki@ 123456muses.tottori-u.ac.jp (T.O.); Tel.: +81-72-254-9913 (E.Y.); +81-857-31-5434 (T.O.); Fax: +81-72-254-9330 (E.Y.); +81-857-31-5434 (T.O.)
                Author information
                https://orcid.org/0000-0003-4984-2113
                Article
                polymers-10-00074
                10.3390/polym10010074
                6415073
                30966109
                f1a8ba9b-3598-4ef9-98d1-2a789535c96c
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 December 2017
                : 13 January 2018
                Categories
                Article

                bleomycin,cancer,ph-sensitive liposome,polyglycidol,polymer–lipid,poly(ethylene glycol)

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