Selma
Leulmi Pichot
*a,
Sabrina
Bentouati
a,
Saif S.
Ahmad
b,
Marios
Sotiropoulos
c,
Raj
Jena
b and
Russell
Cowburn
a
aDepartment of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK. E-mail: sl766@cam.ac.uk
bDepartment of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge Biomedical Campus, Cambridge CB2 0XZ, UK
cDivision of Molecular and Clinical Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
First published on 25th February 2020
This study describes the use of highly versatile, lithographically defined magnetic microdiscs. Gold covered magnetic microdiscs are used in both radiosensitizing cancer cells, acting as intracellular emitters of secondary electrons during radiotherapy, and as well as inducing mechanical damage by exerting a mechanical torque when exposed to a rotating magnetic field. This study reveals that lithographically defined microdiscs with a uniform size of 2 microns in diameter highly increase the DNA damage and reduce the glioblastoma colony formation potential compared to conventional radiation therapy. Furthermore, the addition of mechanical disruption mediated by the magnetic component of the discs increased the efficiency of brain cancer cell killing.
Equally actively studied, mechanobiology is a vibrant and rapidly-progressing field, with a growing contribution of nanotechnology to the understanding and treatment of diseases. The recent development of advanced magnetic micro and nanostructures with complex magnetic responses provide powerful tools to explore new approaches in this emerging field.
In the present study, we report the potential use of gold covered magnetic microdiscs that serve both as efficient radiosensitizers for enhanced radiotherapy, and intracellular mechanical actuators for mechanically induced cell damage in glioblastoma. The radioenhancement during radiotherapy is coupled with the intracellular mechanical disruption with rotating magnetic microdiscs when exposed to an external magnetic field. The goal is to maximize the therapeutic effect of versatile magnetic microdiscs in vitro, before moving onto animal models of disease. The delivery of the technology described in this paper to the clinical phase will rely on the latest development in cancer treatment such as the local delivery via microdialysis catheters coupled with kilovoltage range Intra Operative Radiation Therapy (IORT) techniques.
Advances in physical sciences and nanotechnology provide new tools to explore the radioenhancement with metal-based nanomaterials. Studies on nanomaterials that enhance the therapeutic efficiency of radiotherapy have reported the use of a wide range of materials such as bismuth,2,3 gold,4,5 platinum,6 tantalum7 and silver.8 Among these studies, gold stands as the ideal choice because of the high-mass energy absorption coefficients, biocompatibility, and easy surface modification. To date, investigations have described the use of simple constructs of gold particles with different shapes9 (nanoparticles, nanorods or nanospikes), and with various coating strategies to improve the cellular uptake4,10. However, no studies have used multi-layered magnetic structures combining gold and other materials to evaluate their potential in cancer radiotherapy.
A new class of magnetic nanomaterials, in which manufacturing techniques usually used in microchip fabrication, have recently been investigated.11,12 This new material class exhibits a high level of functionality without the need for complex external equipment. For example, the magnetic nanostructures can be manipulated, guided, concentrated, rotated, vibrated, assembled or disassembled with low magnetic fields.
The magnetic microdiscs used for this study consist of a synthetic antiferromagnetic stack of thin films of tantalum, platinum, cobalt iron boron alloy and ruthenium. The thickness of each thin film and their order are carefully tuned in order to provide specific magnetic properties, such as avoiding the agglomeration of microdiscs in solution and delivering high forces to biological species once actuated with magnetic fields. These advanced magnetic particles deliver tunable forces, ranging from pN (pico newtons) to a few nN (nano newtons). Previous studies investigated ways to synthesize particles with artificially embedded properties and controllable magnetic behaviors11,12. When interfaced with cancer cells, the magnetic particles are actuated with external magnetic fields inducing mechanical stress within cells, leading ultimately to the death of the glioma cells.13
Besides their intrinsic magnetic properties, the multi-layered magnetic discs have great potential for radioenhancement. The use of such magnetic microdiscs during radiotherapy maximizes the radiation doses delivered to cancer cells at a very short range, by locally enhancing free radical production. Indeed, the microdiscs are made from high atomic number materials such as gold (Z = 79), platinum (Z = 78) and tantalum (Z = 73). These high Z layers absorb X-rays energy and emit scattered X-rays/photons, photoelectrons, Auger electrons and Compton electrons (where the predominant effect depends on the energy of the X-ray beam). The secondary electron emission generates reactive oxygen radicals through the ionization of intracellular water molecules and other elements14 These free radicals diffuse via chain reactions inside the cells and induce irreversible damage to double stranded DNA15 and other organelles.16 In this sense, the particles act as radiation enhancing sources within tumors. When combined with the cellular weakening from the mechanical stress caused by the particles, this phenomenon leads to efficient damage, localized to a spatially restricted region, sparing neighboring tissue.
The motivation of such a study is to provide microdiscs which would be inserted into the tumour cavity at the time of surgery, as this avoids the need to design blood brain barrier penetrant constructs for systemic (blood based) delivery. Our proposal is that microdiscs are deposited peri-operatively via delivery devices that were already developed for the local application of tumoricidal agents such as convection-enhanced delivery catheters17
Rather than using high energy X-rays, we investigated the effect of low energy X rays (195 kV) for the radioenhancement in cells loaded with magnetic microdiscs. With the prospect of using low energy X-ray sources that can be placed into the tumour cavity at the time of surgery. Such intracavitary therapies are already used in the treatment of tumors and are called intra operative radiation therapy. This approach involves the insertion of an X-ray tube at the target site and utilizes low-energy X-ray beams to irradiate locally the cancer cells. This study emphasize the use of microdiscs for intracellular radiation amplification through their intrinsic composition, with an additional leverage of mechanical weakening brought by the magnetic properties. A schematic of the clinical procedure is shown in Fig. 1. The results reported in this paper pave the way to investigate advanced preclinical and clinical studies, conducted both on animal models and on patient derived brain tumor cells. Such studies investigate, along with other parameters, the internalization timescales of the microdiscs in a realistic in vivo scenario, allowing the clinician teams to determine the timescales related to the final surgical procedure (intra-operative or post-operative radiotherapy exposure).
Fig. 1 Schematic of the clinical procedure involving the use of magnetic microdiscs for the radioenhancement and mechanical killing of glioblastoma cancer cells. |
In the following sections, we evaluate the cytotoxicity of these microdiscs, as well as their radioenhancement potential on T98G glioblastoma cells. We also report the cellular impact of rotating such magnetic microdiscs located at the intracellular level. We also demonstrate the reduced proliferative activity of the glioblastoma cells using enhanced radiotherapy (RT) using intracellular magnetic microdiscs, and the combination of microdisc-enhanced RT with the mechanical damage using an activating rotating magnetic field.
The building block structure consists of Ta/Pt/CoFeB/Pt/Ru/PT/CoFeB, which is repeated ten times in order to increase the total magnetic moment, giving a total magnetic thickness of 18 nm. This magnetic multilayer stack is grown onto lithographically patterned pillars of MA-N 1410 photoresist. The photoresist pillars are then dissolved in acetone, releasing the 2 micron wide, 132 nm thick discs into solution (Fig. 2). Further details can be found in the Method section.
Fig. 2 Magnetic microdisc properties. (a) Schematic of the magnetic microdisc composition. (b) VSM hysteresis loop of the multilayer stack. (c) Scanning electron microscopy of released microdiscs. |
A dose enhancement is observed predominantly around the bases of the disc, rather than the sides. The dose distribution observed is mainly a factor of two components. Firstly, it is a result of the directionality of the electrons produced by the photon–microdisc interactions. Very few of the electrons generated will be scattered perpendicular to the beam direction; most of them will be generated towards the beam's direction. Secondly, the shape of the microdisc allows more electrons to escape towards the bases. This is a similar situation with the properties of some nanoparticles (NPs). Normally small NPs will allow more secondary electrons to escape.22 On the other hand, when the NPs aggregate, the secondary electrons from the inner NP are more likely to be reabsorbed, rendering the outermost NPs to contribute to the dose enhancement.23
In the Fig. 7, one can notice that the enhancement is localized at the very close vicinity of the discs, with a dose enhancement of approximately 5-fold observed within 0.5 μm around the microdisc, when the microdisc is perpendicular to the beam direction. This result is useful to provide explanations for our experimental results, particularly on the intracellular mechanisms involved in microdiscs-loaded T98G cells after irradiation.
Compared to cells treated with RT alone with different radiation doses ranging from 1 Gy to 8 Gy (Group A), treated cells irradiated with similar doses exhibit a large decrease in the surviving fraction when microdiscs are loaded into cells prior to the radiations (Group B). The proliferation of the cells was even lower when the radiation therapy was followed by exposure to a rotating magnetic field (Group C).
The survival rate shown in Fig. 8 exhibits a decreasing trend with increasing dose of X-rays, as expected. When T98G cells loaded with microdiscs are exposed to the same X-ray doses, the survival rates are lower than those of the control group (a) confirming the radioenhancement effect expected and corroborating the previous γH2AX staining results. As for Group (c) exposed to the rotating magnetic field, survival fractions are the lowest of all conditions, confirming that the magnetic disc-mediated radioenhancement combined with a further mechanical weakening through the disc rotation cause an effective reduction in the proliferation of cells.
As mentioned previously, rather than a blood systemic delivery, the magnetic microdiscs are directly put into the tumor cavity after the surgical resection. Different options may be used for the microdiscs delivery, we think of the microdialysis catheters as being the most suitable technique as microdialysis catheters are already used in brain tumors to deliver locally therapeutic agents. Then, the irradiation procedure will be very similar to the electron beam Inta Operative Radiation Therapy (IORT) where a low voltage energy source will be placed inside the tumor cavity to irradiate locally the tumor cavity, previously loaded with the microdiscs. A rotating magnetic field would be applied subsequently to actuate the magneto mechanical component of the discs in order to increase the cancer cells death. This technology allows to efficiently sterilize the cavity from remaining tumor cells and to bridge the therapeutic gap between surgery and radiotherapy. Some studies show evidence that radiation damage to mitochondria and to cell membrane may contribute also to the cytotoxic effect of radiation.24 Results revealed by our Monte Carlo simulations suggest that, unless the microdisc is touching the nucleus surface, direct DNA damage would not be expected. Rather, the concentrated energy deposited around the microdisc could lead to the increased production of reactive oxygen species (ROS) during RT that reaches the nucleus causing DNA structural damage.25 The ROS overproduction is also associated with the release of cytochrome C, and other apoptogenic factors.26 One can conclude that the observed radioenhancing effect may also be caused by the production of reactive oxygen species that lead to increased oxidative stress within the cell. These results are in line with other publications investigating nanostructures. For example, Laprise-Pelletier et al.27 showed that radioactive nanoparticles could lead to increased dose deposition around the NP, but the energy deposited is confined in a region close to the NP. In this case, the increased reactive oxygen species created from the dose enhancement are more likely to contribute to the radioenhancement effect observed. However, it is still commonly accepted that the most effective damage induced by radiotherapy is the induction of single and double-strand DNA breaks, with γH2AX foci being the sensors of DNA double-strand breaks. In the present study, we demonstrated that microdisc driven radioenhancement induces a high level of γH2AX foci staining when compared to RT treatment alone. In accordance with the DNA damage results, the cell survival fraction assay revealed that the proliferation rate was drastically affected by the microdisc mediated radioenhancement. The survival fraction was even more affected when the radioenhancement was combined with the exposure to the rotating magnetic field, thus combined with the internal mechanical weakening of cells.
This perspective may also be true for other complex magnetic particles that may have a possible radioenhancement effect, and which should be tested in the future, such as iron–nickel alloy vortex type particles.11 More importantly, studies on the mechanism inducing radioenhancement indicated that different shaped gold nanostructures affected the radioenhancement effect through regulating the ROS level, with the higher sensitization enhancement ratios directly linked to the amount of gold nanomaterial cellular uptake.9
We believe this study brings a new insight into the field of radioenhancement mediated by internalized metallic materials. With most of the studies to date focusing on nano-sized materials, this is the first study that reports the impact of micron-sized materials with high aspect ratio. Regarding the uptake efficiency, Champion and coworkers28 previously reported that elongated particles with higher aspect ratio are more prone to phagocytosis. In the case presented here, internalization is enhanced due to the large surface area of the magnetic discs, which increases adhesion to cells. This increase in adhesion contact area will also enhance the interaction between the flat disk-shaped particle and the membrane, facilitating full wrapping through membrane bending. The adhesive interactions between the flat discs and the membranes seem to be sufficiently strong to compensate for the energetic cost of membrane bending.29
While the ease of internalization of such particles by cancer cells is an advantage for the treatment modalities presented above, one cannot deny the possibility of side effects if such particles are internalized by healthy cells. Thus an extensive study on diffusing the microdiscs in a 3D environment and targeting a specific cell subpopulation is critical. Several targeting strategies include the covalent grafting of antibodies on the gold outer layers covering the magnetic discs. This ligand–receptor mediated targeting strategy involves the construction of self-assembled monolayers of thiols on the gold surface.13 It is well established that cancer cells overexpress particular membrane receptors. For example, vascular endothelial growth factor receptor (VEGFR), transferrin receptors, integrins, or folate receptor have been widely exploited for tumor targeting strategies. In practice, tumors exhibit particular biological and physico-chemical properties that need to be exploited to optimize the targeted biodistribution of the microdisc in vivo (e.g. local blood flow, pH condition, vasculature and extracellular matrix organization). This novel mechanism of cell kill based on direct DNA damage from intensely ionising particle, and physical disruption of tumour cells, may be attractive in being independent of any specific mutation pathways, which may help overcome treatment resistance in highly heterogenous tumours such as GBM.
It is understandable that concerns on the fate of the magnetic microdiscs after the treatment might be raised. However, median survival for the group of patients diagnosed with glioblastoma multiforme is 12–15 months even with aggressive treatment. We believe that concerns about long term toxicity due to particles accumulation in the brain need to be balanced against the poor long-term survival rates.
If the magnetic microdiscs developed in this study were to demonstrate very high levels of toxicity to normal brain parenchyma in animal models, then alternative routes exist. Clinicians have the capability to instill the magnetic microdiscs, magnetically activate them at the time of operation, and then wash out particles from the tumor cavity. Another possibility for the clearance of any remaining microdiscs which relies on magnetic attraction forces could also be explored. After the treatment, the microdiscs magnetic component will be exploited in order to attract them toward a high magnetic gradient source. Such a source might be a catheter-like device coated with a high remanence magnetic material that attracts the surrounding particles present in the sterilized cavity after the treatment.
It should be considered that there is a wealth of research on the feasibility of localized delivery of nanoparticles bound to a range of therapeutic agents in humans. Mechanisms include stereotactic injection, implantation into the surgical cavity at the time of surgery, or using convection enhanced delivery via microdialysis catheters. In each case, systemic toxicity from the payload has been demonstrated to be minimal.30
Before the FIB milling, a thin layer on platinum (1 μm) is deposited on the surface of the region of interest, to ensure a sharp edge of the sample surface. For the FIB sectioning, the sample is positioned at a 52° tilt, facing the FIB beam. To ensure that the FIB beam is at a right angle to the sample surface in order to cut a precise trench on the site of interest. As the sample is positioned at a junction between the FIB and SEM beams, SEM imaging is carried out both after and during the FIB milling. In order to increase the edge sharpness of the cells, 1 μm thin layer of platinum is deposited in situ at the surface on the regions of interest. Fig. 9 represent a schematic showing the positioning of the sample, FIB and SEM beams during FIB-SEM cross sectioning.
Fig. 9 Schematic showing the positioning of the sample, FIB and SEM beams during FIB-SEM cross sectioning. |
After 24 h incubation, MTT solution was added into each well and cells were cultured with MTT at 37 °C for 4 h. After removal of the MTT solution, 100 μL of dimethyl sulfoxide (DMSO), was used to dissolve the formed formazan crystals. The relative absorbance at 570 nm was read on the Omega microplate reader. 3 replicates were included for each condition and the experiments were repeated twice. In addition, the scattering effects due to the magnetic microdiscs were accounted for by including the microdiscs in the control group.
Treated cells were irradiated with different doses ranging from 1 Gy to 8 Gy. To facilitate the results reading, conditions were divided into three groups; Group (a) are cells treated with irradiations only. Group (b) represents cells loaded with magnetic microdiscs (30 units per cell) and treated with the same radiation doses as cells in group (a). Group (c) are cells loaded with magnetic microdiscs, treated with the same radiation doses as cells in group (a and b) and submitted to 20 min of rotating 1 T magnetic field.
After 24 hours incubation time with the microdiscs to allow their internalization, groups (a), (b) and (c) received the following radiation doses of 1, 2, 4, and 8 Gy. When all treatments were completed, the cells were trypsinized to allow their detachment from the culture dishes. The cells detachment process was carefully monitored to ensure that the entire cells population has been harvested from the well plate, for all the samples.
The collected cells were resuspended in fresh complete medium, seeded into 6 wells plates, and left in the incubator for 8 days, allowing enough time for their proliferation. For visualization convenience, photographs of wells seeded with 1000 cells each were used.
Cells were fixed with 4% paraformaldehyde solution and stained for 4 hours with 0.5% crystal violet solution.
As for counting the survival fractions, we used lower cell densities of 200 cells per well. Results shown in Fig. 5 reveal a marked decrease of irradiated microdiscs-T98G cells proliferation compared to T98G cells receiving irradiation only. Group (c) samples exposed to the rotating magnetic field, therefore receiving the mechanical disruptive treatment, exhibited an even lower proliferation rate than group (a) and (b).
The cell survival fraction of each group was calculated by the ratio of the number of colonies formed by seeded cells after various treatments normalized to the untreated cells. The results of differences in survival fractions of the three groups are shown in Fig. 5(a).
Note that for each group there were three replicates.
Footnote |
† Electronic supplementary information (ESI) available. See DOI: 10.1039/d0ra00164c |
This journal is © The Royal Society of Chemistry 2020 |