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      Multifunctional nanoparticle PEG-Ce6-Gd for MRI-guided photodynamic therapy

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          Abstract

          Gliomas are one of the most common types of primary brain tumors. Despite recent advances in the combination of surgery, radiotherapy, systemic therapy (chemotherapy, targeted therapy) and supportive therapy in the multimodal treatment of gliomas, the overall prognosis remains poor and the long-term survival rate is low. Thus, it is crucial to develop a novel glioma management method. Due to its relatively non-invasive, selective and repeatable characteristics, photodynamic therapy (PDT) has been investigated for glioma therapy in the past decade, exhibiting higher selectivity and lower side effects compared with those of conventional therapy. However, most of the photosensitizers (PSs) are highly hydrophobic, leading to poor water solubility, rapid degradation with clearance in blood circulation and ultimately, low bioavailability. In the present study, hydrophilic polyethylene glycol (PEG)-chlorin e6 (Ce6) chelated gadolinium ion (Gd 3+) nanoparticles (PEG-Ce6-Gd NPs) were synthesized via a chelation and self-assembly process. Initially, the cell cytotoxicity of PEG-Ce6-Gd NPs was evaluated with or without laser irradiation. The in vitro study demonstrated the lack of toxicity of PEG-Ce6-Gd NPs to tumor cells in the absence of laser irradiation. However, its toxicity was enhanced under laser irradiation. Moreover, the size and weight of brain tumors were significantly decreased in mice with glioma xenografts, which was further confirmed via histological analysis. Subsequently, the results indicated that the PEG-Ce6-Gd NPs had a favorable T 1-weighted contrast performance (0.43 mg ml −1 s −1) and were observed to have significant contrast enhancement at the tumor site from 0.25 to 1 h post-injection in vivo. The favorable MRI, as well as the synergetic photodynamic antitumor effect and antineoplastic ability of PEG-Ce6-Gd NPs was identified. It was suggested that PEG-Ce6-Gd NPs had great potential in the diagnosis and PDT treatment of gliomas, and possibly other cancer types, with prospects of clinical application in the near future.

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          Most cited references38

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          The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary.

          The 2016 World Health Organization Classification of Tumors of the Central Nervous System is both a conceptual and practical advance over its 2007 predecessor. For the first time, the WHO classification of CNS tumors uses molecular parameters in addition to histology to define many tumor entities, thus formulating a concept for how CNS tumor diagnoses should be structured in the molecular era. As such, the 2016 CNS WHO presents major restructuring of the diffuse gliomas, medulloblastomas and other embryonal tumors, and incorporates new entities that are defined by both histology and molecular features, including glioblastoma, IDH-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, WNT-activated and medulloblastoma, SHH-activated; and embryonal tumour with multilayered rosettes, C19MC-altered. The 2016 edition has added newly recognized neoplasms, and has deleted some entities, variants and patterns that no longer have diagnostic and/or biological relevance. Other notable changes include the addition of brain invasion as a criterion for atypical meningioma and the introduction of a soft tissue-type grading system for the now combined entity of solitary fibrous tumor / hemangiopericytoma-a departure from the manner by which other CNS tumors are graded. Overall, it is hoped that the 2016 CNS WHO will facilitate clinical, experimental and epidemiological studies that will lead to improvements in the lives of patients with brain tumors.
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            Photodynamic therapy for cancer.

            The therapeutic properties of light have been known for thousands of years, but it was only in the last century that photodynamic therapy (PDT) was developed. At present, PDT is being tested in the clinic for use in oncology--to treat cancers of the head and neck, brain, lung, pancreas, intraperitoneal cavity, breast, prostate and skin. How does PDT work, and how can it be used to treat cancer and other diseases?
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              Management of glioblastoma: State of the art and future directions

              Glioblastoma is the most common malignant primary brain tumor. Overall, the prognosis for patients with this disease is poor, with a median survival of <2 years. There is a slight predominance in males, and incidence increases with age. The standard approach to therapy in the newly diagnosed setting includes surgery followed by concurrent radiotherapy with temozolomide and further adjuvant temozolomide. Tumor-treating fields, delivering low-intensity alternating electric fields, can also be given concurrently with adjuvant temozolomide. At recurrence, there is no standard of care; however, surgery, radiotherapy, and systemic therapy with chemotherapy or bevacizumab are all potential options, depending on the patient's circumstances. Supportive and palliative care remain important considerations throughout the disease course in the multimodality approach to management. The recently revised classification of glioblastoma based on molecular profiling, notably isocitrate dehydrogenase (IDH) mutation status, is a result of enhanced understanding of the underlying pathogenesis of disease. There is a clear need for better therapeutic options, and there have been substantial efforts exploring immunotherapy and precision oncology approaches. In contrast to other solid tumors, however, biological factors, such as the blood-brain barrier and the unique tumor and immune microenvironment, represent significant challenges in the development of novel therapies. Innovative clinical trial designs with biomarker-enrichment strategies are needed to ultimately improve the outcome of patients with glioblastoma.
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                Author and article information

                Journal
                Oncol Rep
                Oncol Rep
                Oncology Reports
                D.A. Spandidos
                1021-335X
                1791-2431
                February 2021
                27 November 2020
                27 November 2020
                : 45
                : 2
                : 547-556
                Affiliations
                [1 ]Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei 430071, P.R. China
                [2 ]Department of Chemistry, Key Laboratory of Biomedical Polymers of Ministry of Education, Wuhan University, Wuhan, Hubei 430072, P.R. China
                Author notes
                Correspondence to: Dr Bo Wu or Dr Hai-Bo Xu, Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, P.R. China, E-mail: wubo5317@ 123456whu.edu.cn , E-mail: xuhaibo1120@ 123456hotmail.com
                [*]

                Contributed equally

                Article
                or-45-02-0547
                10.3892/or.2020.7871
                7757081
                33416172
                fdb12152-bc13-4d14-ae3b-a98e6afe1d5c
                Copyright: © Xu et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 16 June 2020
                : 12 November 2020
                Categories
                Articles

                theranostics,magnetic resonance imaging,photodynamic therapy,photosensitizer,chlorin e6,gadolinium,glioma

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