Nat BME: Methotrexate cell-derived microbubbles can relieve bile duct obstruction in patients with hepatic and extracellular bile duct cancer

Bile duct cancer is a type of epithelial malignant tumor, 5-year survival rate is particularly low, more than 90% of CAs from the hepatic bile duct, easy to form malignant bile duct obstructionAfter the surgical excision of the hepatic CCA (ECCA), the recurrence rate is still very high, and the current standard chemotherapy or radiation therapy does not improve the survival rateit is important to explore treatment strategies in response to these difficulties in ECCA treatmentIn recent years, we have found that tumor cell-derived particles (Tmp) can be an effective carrier of chemotherapy drugs, and at the same time play the role ofimmunoasoryregulation, is a valuable anti-tumor treatmentIn response to exogenous or endogenous stimuli, cells may rearrange the cellular skeleton, resulting in an imbalance of mechanical forces on the local membrane, and then the cytoplasm contents in the cell membrane are encased to form large vesicles, which are then released into extracellular gapsThis particular subcellular vesicle, which is 0.1-1 m in size, is called a particlethe main purpose of this study is to evaluate the efficacy of MTX-TMP treatment obstruction ECCAThe efficacy was evaluated by improving bile duct obstruction and improving the color of the patient's stoolSecondary objectives include security assessmentsBecause this was a signal generation study for patients with advanced ECCA, a before and after study was conducted on the same patientThe patient was treated with PTBD drainage of 5 to 10d and then treated with 20 ml MTX-TMPS with 6 x 10the first treatment with transdermal hepatobiliary drainage (PTBD), in which MTX load TMPS (MTX-TMPS) is 20 ml, with 6 x 10The MPS and 120?g MTX are injected into the bile duct cavity above the tumor tissue and 2 h is closed to make MTX-TMPS workThen open the tube and collect the bile duct drainageThis course of treatment is held once a day for a total of 7 daysAfter treatment, most patients (about 70%) had transient fever (1-4 hours without other uncomfortable symptoms, such as abdominal pain, nausea, vomiting or back pain), and MTX-TMP treatment had no effect on the patient's vital signs or liver functionThe color of stool was used as the initial evaluation index of treatment effectWe found that after treatment, the pale, sticky color of the faeces turned yellowDepending on the change in the color of the stool, bile duct imaging showed that 5 of the 20 patients had been relieved of obstruction, in addition, after treatment, obstruction mitigation lasted a long timeAfter treatment with MTX-TMP, the time of treatment of bile duct obstruction was up to 5 monthsThese results show that MTX-TMPS is an effective method for treating ECCA bile duct obstructionconclusion: MTX-TMPS has the ability to directly destroy tumor cells and effectively absorb a large number of neutrophils into the bile duct cavity above the obstructive CCA, thus triggering the anti-tumor activity of neutrophils, thus improving the treatment resultsGao, Y., Zhang, H., Zhou, Net al.
Methotrexate-loaded-the-cell-derived microvesicles can'r thorabiliyn yn patients withang extraic cholangiocarcinomaNat Biomed Eng(2020)Medsci Original Source: Medsioriginal