A Nano-Emulsion Platform Functionalized with a Fully Human scFv-Fc Antibody for Atheroma Targeting: Towards a Theranostic Approach to Atherosclerosis

Atherosclerosis is at the onset of the cardiovascular diseases that are among the leading causes of death worldwide. Currently, high-risk plaques, also called vulnerable atheromatous plaques, remain often undiagnosed until the occurrence of severe complications, such as stroke or myocardial infarction. Molecular imaging agents that target high-risk atheromatous lesions could greatly improve the diagnosis of atherosclerosis by identifying sites of high disease activity. Moreover, a “theranostic approach” that combines molecular imaging agents (for diagnosis) and therapeutic molecules would be of great value for the local management of atheromatous plaques. The aim of this study was to develop and characterize an innovative theranostic tool for atherosclerosis. We engineered oil-in-water nano-emulsions (NEs) loaded with superparamagnetic iron oxide (SPIO) nanoparticles for magnetic resonance imaging (MRI) purposes. Dynamic MRI showed that NE-SPIO nanoparticles decorated with a polyethylene glycol (PEG) layer reduced their liver uptake and extended their half-life. Next, the NE-SPIO-PEG formulation was functionalized with a fully human scFv-Fc antibody (P3) recognizing galectin 3, an atherosclerosis biomarker. The P3-functionalized formulation targeted atheromatous plaques, as demonstrated in an immunohistochemistry analyses of mouse aorta and human artery sections and in an Apoe^−/− mouse model of atherosclerosis. Moreover, the formulation was loaded with SPIO nanoparticles and/or alpha-tocopherol to be used as a theranostic tool for atherosclerosis imaging (SPIO) and for delivery of drugs that reduce oxidation (here, alpha-tocopherol) in atheromatous plaques. This study paves the way to non-invasive targeted imaging of atherosclerosis and synergistic therapeutic applications.     

Synthesis and Development of Lipoprotein-Based Nanocarriers for Light-Activated Theranostics

The design and synthesis of new light-activated contrast agents for theranostics (therapy/diagnosis) has the potential to facilitate multifunctional and improved personalized medicine. The use of light as a remote activation strategy provides spatial and temporal control of drug effect and nanotechnology can play a key role in this process. Lipoproteins (LDL and HDL), which transport water-insoluble cholesteryl esters and triacylglycerols in nature, have evolved to efficiently ferry exogenous hydrophobic compounds in vivo. They are naturally biocompatible, maneuverable due to their small size (<30 nm), and can be loaded through various methods, and are therefore ideal vehicles to load and transport hydrophobic theranostic agents. This review examines the history and ongoing research activities regarding the design and synthesis of lipoprotein-based formulations, and their applications or potential applications as light-activated theranostic agents, with a main focus on photodynamic therapy. This field, while still in its infancy, will benefit from improved design and modulation of enhanced lipoprotein-based nanocarriers, with the ultimate goal of simultaneous imaging and photoactivation of therapeutic agents in a clinical setting.     

Mechanized silica nanoparticles: a new frontier in theranostic nanomedicine

Medicine can benefit significantly from advances in nanotechnology because nanoscale assemblies promise to improve on previously established therapeutic and diagnostic regimes. Over the past decade, the use of delivery platforms has attracted attention as researchers shift their focus toward new ways to deliver therapeutic and/or diagnostic agents and away from the development of new drug candidates. Metaphorically, the use of delivery platforms in medicine can be viewed as the "bow-and-arrow" approach, where the drugs are the arrows and the delivery vehicles are the bows. Even if one possesses the best arrows that money can buy, they will not be useful if one does not have the appropriate bow to deliver the arrows to their intended location. Currently, many strategies exist for the delivery of bioactive agents within living tissue. Polymers, dendrimers, micelles, vesicles, and nanoparticles have all been investigated for their use as possible delivery vehicles. With the growth of nanomedicine, one can envisage the possibility of fabricating a theranostic vector that could release powerful therapeutics and diagnostic markers simultaneously and selectively to diseased tissue. In our design of more robust theranostic delivery systems, we have focused our attention on using mesoporous silica nanoparticles (SNPs). The payload "cargo" molecules can be stored within this robust domain, which is stable to a wide range of chemical conditions. This stability allows SNPs to be functionalized with stimulus-responsive mechanically interlocked molecules (MIMs) in the shape of bistable rotaxanes and psuedorotaxanes to yield mechanized silica nanoparticles (MSNPs). In this Account, we chronicle the evolution of various MSNPs, which came about as a result of our decade-long collaboration, and discuss advances in the synthesis of novel hybrid SNPs and the various MIMs which have been attached to their surfaces. These MIMs can be designed in such a way that they either change shape or shed off some of their parts in response to a specific stimulus, such as changes in redox potential, alterations in pH, irradiation with light, or the application of an oscillating magnetic field, allowing a theranostic payload to be released from the nanopores to a precise location at the appropiate time. We have also shown that these integrated systems can operate not only within cells, but also in live animals in response to pre-existing biological triggers. Recognizing that the theranostics of the future could offer a fresh approach to the treatment of degenerative diseases including cancer, we aim to start moving out of the chemical domain and into the biological one. Some MSNPs are already being tested in biological systems.     

Novel Heterobimetallic Radiotheranostic: Preparation,Activity, and Biodistribution

A novel Ru^II(arene) theranostic complex is presented. It is based on a 1,4,7,10‐tetraazacyclododecane‐1,4,7,10‐tetraacetic acid macrocycle bearing a triarylphosphine and can be tracked in vivo by using the γ emission of ¹⁵³Sm atoms. Notably, the heteroditopic ligand can be selectively metalated with ruthenium at the phosphorus atom despite the presence of other functionalities that are prone to metal coordination. Subsequent labeling with radionuclides such as ¹⁵³Sm can then be performed easily. The resulting heterobimetallic complex exhibits favorable solubility and stability properties in biologically relevant media. It also shows in vitro cytotoxicity in line with that expected for this type of metallodrug, and is nontoxic to the organism as a whole. As a proof of concept, initial studies in healthy mice were performed to obtain information about the uptake, biodistribution, and excretion of the radiolabeled complex.     

Theranostic nanoparticles engineered for clinic and pharmaceutics

Nanomedicine is the manipulation of human biological systems at the molecular level using nanoscale or nanostructured materials. Because nanoscale materials interact effectively with biological systems, the use of nanodiagnostics and nanotherapeutics may overcome many intractable health challenges. A variety of nanoparticles have been designed with modifiable functional surfaces and bioactive cores. The engineering of nanoparticles can result in several advantageous therapeutic and diagnostic properties including enhanced permeation and retention in the circulatory system, specific delivery of drugs to target sites, highly-efficient gene transfection, and enhanced medical imaging. These nanoscale materials offer the opportunity to detect chronic diseases early and to monitor the therapeutic effects of nanoformulated drugs used in the clinic. Many of these novel nanoparticles contain both drug(s) and imaging agent(s) within an individual nanoparticle for simultaneous disease diagnosis and therapy. Further integration of therapeutic compounds with diagnostic agents into theranostic nanoparticles would be highly beneficial. However, the unique physiochemical properties that make nanomaterials attractive for therapy and diagnosis may be also associated with potential health hazards. Our research has demonstrated that the biological response to nanomaterials is related to many factors including exposure levels, systemic accumulation and excretion profiles, tissue and organ distribution, and the age of the test subject. Therefore, when engineering new nanomaterials for clinical use, researchers need to consider these factors to minimize toxicity of nanoparticles in these applications. We have fabricated and evaluated nanomaterials such as cationic amphiphilic polymers and metallofullerenes that demonstrate both high efficiency and low toxicity in gene therapy and/or chemotherapy. In this Account, we describe the development of theranostic nanomaterials with low toxicity and illustrate their potential use as novel nanomedicines in translational research.     

Prognostic and Theranostic Applications of Positron Emission Tomography for a Personalized Approach to Metastatic Castration-Resistant Prostate Cancer

Metastatic castration-resistant prostate cancer (mCRPC) represents a condition of progressive disease in spite of androgen deprivation therapy (ADT), with a broad spectrum of manifestations ranging from no symptoms to severe debilitation due to bone or visceral metastatization. The management of mCRPC has been profoundly modified by introducing novel therapeutic tools such as antiandrogen drugs (i.e., abiraterone acetate and enzalutamide), immunotherapy through sipuleucel-T, and targeted alpha therapy (TAT). This variety of approaches calls for unmet need of biomarkers suitable for patients’ pre-treatment selection and prognostic stratification. In this scenario, imaging with positron emission computed tomography (PET/CT) presents great and still unexplored potential to detect specific molecular and metabolic signatures, some of whom, such as the prostate specific membrane antigen (PSMA), can also be exploited as therapeutic targets, thus combining diagnosis and therapy in the so-called “theranostic” approach. In this review, we performed a web-based and desktop literature research to investigate the prognostic and theranostic potential of several PET imaging probes, such as ¹⁸F-FDG, ¹⁸F-choline and ⁶⁸Ga-PSMA-11, also covering the emerging tracers still in a pre-clinical phase (e.g., PARP-inhibitors’ analogs and the radioligands binding to gastrin releasing peptide receptors/GRPR), highlighting their potential for defining personalized care pathways in mCRPC.     

Metal-Based Catalytic Drug Development for Next-Generation Cancer Therapy

Considering the high increase in mortality caused by cancer in recent years, cancer drugs with novel mechanisms of anticancer action are urgently needed to overcome the drawbacks of platinum-based chemotherapeutics. Recently, in the area of metal-based cancer drug development research, the concept of catalytic cancer drugs has been introduced with organometallic Ru^II, Os^II, Rh^III and Ir^III complexes. These complexes are reported as catalysts for many important biological transformations in cancer cells such as nicotinamide adenine dinucleotide (NAD(P)H) oxidation to NAD⁺, reduction of NAD⁺ to NADH, and reduction of pyruvate to lactate. These unnatural intracellular transformations with catalytic and nontoxic doses of metal complexes are known to severely perturb several important biochemical pathways and could be the antecedent of next-generation catalytic cancer drug development. In this concept, we delineate the prospects of such recently reported organometallic Ru^II, Os^II, Rh^III and Ir^III complexes as future catalytic cancer drugs. This new approach has the potential to deliver new cancer drug candidates.     

Theranostic nanomedicine

Nanomedicine formulations aim to improve the biodistribution and the target site accumulation of systemically administered (chemo)therapeutic agents. Many different types of nanomedicines have been evaluated over the years, including for instance liposomes, polymers, micelles and antibodies, and a significant amount of evidence has been obtained showing that these submicrometer-sized carrier materials are able to improve the balance between the efficacy and the toxicity of therapeutic interventions. Besides for therapeutic purposes, nanomedicine formulations have in recent years also been increasingly employed for imaging applications. Moreover, paralleled by advances in chemistry, biology, pharmacy, nanotechnology, medicine and imaging, several different systems have been developed in the last decade in which disease diagnosis and therapy are combined. These so-called (nano) theranostics contain both a drug and an imaging agent within a single formulation, and they can be used for various different purposes. In this Account, we summarize several exemplary efforts in this regard, and we show that theranostic nanomedicines are highly suitable systems for monitoring drug delivery, drug release and drug efficacy. The (pre)clinically most relevant applications of theranostic nanomedicines relate to their use for validating and optimizing the properties of drug delivery systems, and to their ability to be used for pre-screening patients and enabling personalized medicine. Regarding the former, the combination of diagnostic and therapeutic agents within a single formulation provides real-time feedback on the pharmacokinetics, the target site localization and the (off-target) healthy organ accumulation of nanomedicines. Various examples of this will be highlighted in this Account, illustrating that by non-invasively visualizing how well carrier materials are able to deliver pharmacologically active agents to the pathological site, and how well they are able to prevent them from accumulating in potentially endangered healthy tissues, important information can be obtained for optimizing the basic properties of drug delivery systems, as well as for improving the balance between the efficacy and the toxicity of targeted therapeutic interventions. Regarding personalized medicine, it can be reasoned that only in patients which show high levels of target site accumulation, and which respond well to the first couple of treatment cycles, targeted therapy should be continued, and that in those in which this is not the case, other therapeutic options should be considered. Based on these insights, we expect that ever more efforts will be invested in developing theranostic nanomedicines, and that these systems and strategies will contribute substantially to realizing the potential of personalized medicine.     

Curcumin and Its Derivatives as Theranostic Agents in Alzheimer’s Disease: The Implication of Nanotechnology

Curcumin is a polyphenolic natural compound with diverse and attractive biological properties, which may prevent or ameliorate pathological processes underlying age-related cognitive decline, Alzheimer’s disease (AD), dementia, or mode disorders. AD is a chronic neurodegenerative disorder that is known as one of the rapidly growing diseases, especially in the elderly population. Moreover, being the eminent cause of dementia, posing problems for families, societies as well a severe burden on the economy. There are no effective drugs to cure AD. Although curcumin and its derivatives have shown properties that can be considered useful in inhibiting the hallmarks of AD, however, they have low bioavailability. Furthermore, to combat diagnostic and therapeutic limitations, various nanoformulations have also been recognized as theranostic agents that can also enhance the pharmacokinetic properties of curcumin and other bioactive compounds. Nanocarriers have shown beneficial properties to deliver curcumin and other nutritional compounds against the blood-brain barrier to efficiently distribute them in the brain. This review spotlights the role and effectiveness of curcumin and its derivatives in AD. Besides, the gut metabolism of curcumin and the effects of nanoparticles and their possible activity as diagnostic and therapeutic agents in AD also discussed.     

Analysis of Metal Effects on C-Peptide Structure and Internalization

The connecting peptide (C-peptide) has received increased attention for its potential therapeutic effects in ameliorating illnesses such as kidney disease and diabetes. Although the mechanism of C-peptide signaling remains elusive, evidence supports its internalization and intracellular function. Emerging research is uncovering the diverse biological roles metals play in controlling and affecting the function of bioactive peptides. The work presented herein investigates interactions between C-peptide and first-row d-block transition metals, as well as their effects on C-peptide internalization into cells. Through spectroscopic techniques, it is demonstrated that Cr^III, Cu^II, and Zn^II bind to C-peptide with differing stoichiometries and biologically relevant affinities. In addition, metal binding elicits both subtle changes in secondary structure and inhibits adoption of an α-helical character in environments where the dielectric constants are reduced. This study shows how metal ions can modulate peptide hormone activity through subtle structural changes to disrupt cellular uptake.     

Novel Zinc(II) Complexes [Zn(atc-Et)2] and [Zn(atc-Ph)2]: In Vitro and in Vivo Antiproliferative Studies

Cisplatin and its derivatives are the main metallodrugs used in cancer therapy. However, low selectivity, toxicity and drug resistance are associated with their use. The zinc(II) (Zn^II) thiosemicarbazone complexes [Zn(atc-Et)₂] (1) and [Zn(atc-Ph)₂] (2) (atc-R: monovalent anion of 2-acetylpyridine N4-R-thiosemicarbazone) were synthesized and fully characterized in the solid state and in solution via elemental analysis, Fourier transform infrared (FTIR), ultraviolet-visible (UV-Vis) and proton nuclear magnetic resonance (¹H NMR) spectroscopy, conductometry and single-crystal X-ray diffraction. The cytotoxicity of these complexes was evaluated in the HepG2, HeLa, MDA-MB-231, K-562, DU 145 and MRC-5 cancer cell lines. The strongest antiproliferative results were observed in MDA-MB-231 and HepG2 cells, in which these complexes displayed significant selective toxicity (3.1 and 3.6, respectively) compared with their effects on normal MRC-5 cells. In vivo studies were performed using an alternative model (Artemia salina L.) to assure the safety of these complexes, and the results were confirmed using a conventional model (BALB/c mice). Finally, tests of oral bioavailability showed maximum plasma concentrations of 3029.50 µg/L and 1191.95 µg/L for complexes 1 and 2, respectively. According to all obtained results, both compounds could be considered as prospective antiproliferative agents that warrant further research.     

Quantum-chemical calculations of the effect of cycloaliphatic groups in α-diimine and bis(imino)pyridine ethylene polymerization precatalysts on their stabilities with respect to deactivation reactions

For the first time, it is attempted to interpret an experimentally found enhancing effect of cycloaliphatic substituents in aromatic rings of Ni^II- and Pd^II-α-diimine and Fe^II-bis(imino)pyridine ethylene polymerization precatalysts on their catalytic activities at elevated temperatures (60-80 °C), using quantum chemical density functional theory calculations of relative stabilities of the complexes with respect to different deactivation processes, including thermal decomposition and one-electron reduction. It was shown that the effect correlates with the calculated higher thermal stabilities of cycloalkyl-substituted Fe^II-, Ni^II- and Pd^II-complexes as compared to the corresponding alkyl-substituted ones. Ni^II- and Pd^II-α-diimine complexes with cycloalkyl substituents are shown to be more stable than their alkyl-substituted analogues with respect to both thermal decomposition and one-electron reduction. The averaged difference of the thermal decomposition energies between the complexes with cycloaliphatic substituents on one side and aliphatic ones on the other side is ∼2.3 kcal/mol, corresponding to ∼30 times lower equilibrium constant of the thermal decomposition reaction for the cycloalkyl-containing complexes. For the Fe^II- and Pd^II-complexes, the thermal stability correlates with the calculated overlap population of the metal-nitrogen bonds. It was shown that the structure of o-substituents (cycloalkyls vs. alkyls) in the phenyl rings of the ligands does not affect the reaction energies for the transformation reactions of the precatalysts into their corresponding active catalytic cationic forms.     

Hexaphyrin as a Potential Theranostic Dye for Photothermal Therapy and 19F Magnetic Resonance Imaging

Two features of meso‐Aryl‐substituted expanded porphyrins suggest suitability as theranostic agents. They have excellent absorption in near infrared (NIR) region, and they offer the possibility of introduction of multiple fluorine atoms at structurally equivalent positions. Here, hexaphyrin (hexa) was synthesized from 2,6‐bis(trifluoromethyl)‐4‐formyl benzoate and pyrrole and evaluated as a novel expanded porphyrin with the above features. Under NIR illumination hexa showed intense photothermal and weak photodynamic effects, which were most likely due to its low excited states, close to singlet oxygen. The sustained photothermal effect caused ablation of cancer cells more effectively than the photodynamic effect of indocyanine green (a clinical dye). In addition, hexa showed potential for use in the visualization of tumors by ¹⁹F magnetic resonance imaging (MRI), because of the multiple fluorine atoms. Our results strongly support the utility of expanded porphyrins as theranostic agents in both photothermal therapy and ¹⁹F MRI.     

Binding and Release of FeIII Complexes from Glucan Particles for the Delivery of T1 MRI Contrast Agents

Yeast-derived β-glucan particles (GPs) are a class of microcarriers under development for the delivery of drugs and imaging agents to immune-system cells for theranostic approaches. However, the encapsulation of hydrophilic imaging agents in the porous GPs is challenging. Here, we show that the unique coordination chemistry of Fe^III-based macrocyclic T₁ MRI contrast agents permits facile encapsulation in GPs. Remarkably, GPs labeled with the simple Fe^III complexes are stable under physiologically relevant conditions, despite the absence of amphiphilic groups. In contrast to the free Fe^III coordination complex, the labeled Fe^III-GPs have lowered T₁ relaxivity and act as a silenced form of the contrast agent. Addition of a fluorescent tag to the Fe^III complex produces a bimodal agent to further enable tracking of the nanoparticles and to monitor release. Treatment of the iron-labeled GPs with a maltol chelator or with mildly acidic conditions releases the intact iron complex and restores enhanced T₁ relaxation of the water protons.     

Preparation of Tetradentate Copper Chelators as Potential Anti‐Alzheimer Agents

The uncontrolled redox activity of metal ions, especially copper, in the brains of patients with Alzheimer's disease (AD) should be considered the origin of intense oxidative damage to neurons in the AD brain. To obtain low‐molecular‐weight copper chelators that act as tetradentate ligands, we designed new compounds based on an 8‐aminoquinoline motif with a lateral chain attached at the 2‐position of the aromatic ring. Some of these new ligands, termed TDMQ for TetraDentate MonoQuinolines, are specific for copper chelation. Full characterization of these ligands is reported, as well as their affinities for Cu^II, and their capacities to inhibit oxidative stress induced by copper–amyloids activated by a reductant. Such metal ligands can be considered as potential anti‐AD agents, as they should be able to regulate the homeostasis of copper in brain tissue.     

Thermal, Spectroscopic, Cyclic Voltammetric, and Biological Activity Studies of Cobalt(II), Nickel(II), and Copper(II) Complexes of Dicarboxylic Amino Acids and 8-Hydroxyquinoline

Mixed ligand complexes of Co^II, Ni^II and Cu^II with dicarboxylic amino acids (aspartic, glutamic or H₂ADA) as primary ligands and 8-hydroxyquinoline as a secondary ligand were prepared and characterized by elemental analysis, conductivity measurements, thermal analysis, cyclic voltammetry, and electronic and infrared (IR) spectroscopy. Cyclic voltammetry reveals a reversibility of the Cu^II/Cu^I couple, while the reactions of the Co^II and Ni^II complexes are irreversible. All complexes have a metal-to-ligand ratios of 1:1:1 and octahedral structures are suggested to be attained by interactions among both of the amino acids and 8-hydroxyquinoline anions with the metal ions. The reaction orders and activation energies have been computed by means of the Coats–Redfern and Horowitz–Metzger equations. The biological activity of selected complexes as anti-fungal agents has been tested.     

Transmittance Measurements in Non-alternating Magnetic Field as Reliable Method for Determining of Heating Properties of Phosphate and Phosphonate Coated Fe3O4 Magnetic Nanoparticles

Different phosphates and phosphonates have shown excellent coating ability toward magnetic nanoparticles, improving their stability and biocompatibility which enables their biomedical application. The magnetic hyperthermia efficiency of phosphates (IDP and IHP) and phosphonates (MDP and HEDP) coated Fe₃O₄ magnetic nanoparticles (MNPs) were evaluated in an alternating magnetic field. For a deeper understanding of hyperthermia, the behavior of investigated MNPs in the non-alternating magnetic field was monitored by measuring the transparency of the sample. To investigate their theranostic potential coated Fe₃O₄-MNPs were radiolabeled with radionuclide ¹⁷⁷Lu. Phosphate coated MNPs were radiolabeled in high radiolabeling yield (>?99%) while phosphonate coated MNPs reached maximum radiolabeling yield of 78%. Regardless lower radiolabeling yield both radiolabeled phosphonate MNPs may be further purified reaching radiochemical purity of more than 95%. In vitro stabile radiolabeled nanoparticles in saline and HSA were obtained. The high heating ability of phosphates and phosphonates coated MNPs as sine qua non for efficient in vivo hyperthermia treatment and satisfactory radiolabeling yield justifies their further research in order to develop new theranostic agents.

     

Prostate-Specific Membrane Antigen (PSMA) Theranostics for Treatment of Oligometastatic Prostate Cancer

Theranostics, a combination of therapy and diagnostics, is a field of personalized medicine involving the use of the same or similar radiopharmaceutical agents for the diagnosis and treatment of patients. Prostate-specific membrane antigen (PSMA) is a promising theranostic target for the treatment of prostate cancers. Diagnostic PSMA radiopharmaceuticals are currently used for staging and diagnosis of prostate cancers, and imaging can predict response to therapeutic PSMA radiopharmaceuticals. While mainly used in the setting of metastatic, castrate-resistant disease, clinical trials are investigating the use of PSMA-based therapy at earlier stages, including in hormone-sensitive or hormone-naïve prostate cancers, and in oligometastatic prostate cancers. This review explores the use of PSMA as a theranostic target and investigates the potential use of PSMA in earlier stage disease, including hormone-sensitive metastatic prostate cancer, and oligometastatic prostate cancer.     

Cannabinoids in Medicine: Cancer,Immunity, and Microbial Diseases

Recently, there has been a growing interest in the medical applications of Cannabis plants. They owe their unique properties to a group of secondary metabolites known as phytocannabinoids, which are specific for this genus. Phytocannabinoids, and cannabinoids generally, can interact with cannabinoid receptors being part of the endocannabinoid system present in animals. Over the years a growing body of scientific evidence has been gathered, suggesting that these compounds have therapeutic potential. In this article, we review the classification of cannabinoids, the molecular mechanisms of their interaction with animal cells as well as their potential application in the treatment of human diseases. Specifically, we focus on the research concerning the anticancer potential of cannabinoids in preclinical studies, their possible use in cancer treatment and palliative medicine, as well as their influence on the immune system. We also discuss their potential as therapeutic agents in infectious, autoimmune, and gastrointestinal inflammatory diseases. We postulate that the currently ongoing and future clinical trials should be accompanied by research focused on the cellular and molecular response to cannabinoids and Cannabis extracts, which will ultimately allow us to fully understand the mechanism, potency, and safety profile of cannabinoids as single agents and as complementary drugs.