A Transistor-like pH Nanoprobe for Tumour Detection and Image-guided Surgery

Because of profound genetic and histological differences in cancerous tissue, it is challenging to detect a broad range of malignant tumours at high resolution. Here, we report the design and performance of a fluorescent nanoprobe with transistor-like responses (transition pH = 6.9) for the detection of the deregulated pH that drives many of the invasive properties of cancer. The nanoprobe amplifies fluorescence signal in the tumour over that in the surrounding normal tissues, resulting in a discretized, binary output signal with spatial resolution smaller than 1 mm. The nanoprobe allowed us to image a broad range of tumours in mouse models using a variety of clinical cameras, and to perform real-time tumour-acidosis-guided detection and surgery of occult nodules (< 1 mm3) in mice bearing head-and-neck or breast tumours, significantly lengthening mice survivability. We also show that the pH nanoprobe can be used as a reporter in a fast, quantitative assay to screen for tumour-acidosis inhibitors. The binary delineation of pH achieved by the nanoprobe promises to improve the accuracy of cancer detection, surveillance and therapy.

[1]  Sukhmahendra Singh,et al.  Mechanisms of tumor growth retardation by modulation of pH regulation in the tumor-microenvironment of a murine T cell lymphoma. , 2011, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[2]  A. Gown,et al.  HER-2/neu protein expression in breast cancer evaluated by immunohistochemistry. A study of interlaboratory agreement. , 2000, American journal of clinical pathology.

[3]  R Holland,et al.  The presence of an extensive intraductal component following a limited excision correlates with prominent residual disease in the remainder of the breast. , 1990, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  H. Maeda,et al.  Tumor vascular permeability and the EPR effect in macromolecular therapeutics: a review. , 2000, Journal of controlled release : official journal of the Controlled Release Society.

[5]  E. Jähde,et al.  pH in human tumour xenografts: effect of intravenous administration of glucose. , 1993, British Journal of Cancer.

[6]  L. Cantley,et al.  Understanding the Warburg Effect: The Metabolic Requirements of Cell Proliferation , 2009, Science.

[7]  Kevin J. Sykes,et al.  Functional swallowing outcomes following transoral robotic surgery vs primary chemoradiotherapy in patients with advanced-stage oropharynx and supraglottis cancers. , 2013, JAMA otolaryngology-- head & neck surgery.

[8]  P. Low,et al.  Intraoperative tumor-specific fluorescence imaging in ovarian cancer by folate receptor-α targeting: first in-human results , 2011, Nature Medicine.

[9]  Ruth Katz,et al.  Impact of epidermal growth factor receptor expression on survival and pattern of relapse in patients with advanced head and neck carcinoma. , 2002, Cancer research.

[10]  N. Robert,et al.  Tumor margin assessment as a guide to optimal conservation surgery and irradiation in early stage breast carcinoma. , 1989, International journal of radiation oncology, biology, physics.

[11]  Nina M. Muñoz,et al.  Tumor paint: a chlorotoxin:Cy5.5 bioconjugate for intraoperative visualization of cancer foci. , 2007, Cancer research.

[12]  C. Snyderman,et al.  Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[13]  S. Leung,et al.  Targeting tumor hypoxia: suppression of breast tumor growth and metastasis by novel carbonic anhydrase IX inhibitors. , 2011, Cancer research.

[14]  Gregory S Karczmar,et al.  MRI of the tumor microenvironment , 2002, Journal of magnetic resonance imaging : JMRI.

[15]  Jinming Gao,et al.  Multicolored pH-tunable and activatable fluorescence nanoplatform responsive to physiologic pH stimuli. , 2012, Journal of the American Chemical Society.

[16]  C. Supuran,et al.  Ureido-substituted benzenesulfonamides potently inhibit carbonic anhydrase IX and show antimetastatic activity in a model of breast cancer metastasis. , 2011, Journal of medicinal chemistry.

[17]  Hyunsuk Shim,et al.  Metabolic positron emission tomography imaging in cancer detection and therapy response. , 2011, Seminars in oncology.

[18]  Baran D. Sumer,et al.  Ultra-pH-Sensitive Nanoprobe Library with Broad pH Tunability and Fluorescence Emissions , 2014, Journal of the American Chemical Society.

[19]  Christian M. Metallo,et al.  Macropinocytosis of protein is an amino acid supply route in Ras-transformed cells , 2013, Nature.

[20]  Claudiu T. Supuran,et al.  Interfering with pH regulation in tumours as a therapeutic strategy , 2011, Nature Reviews Drug Discovery.

[21]  D. Schultz,et al.  The significance of the pathology margins of the tumor excision on the outcome of patients treated with definitive irradiation for early stage breast cancer. , 1991, International journal of radiation oncology, biology, physics.

[22]  R. Deberardinis,et al.  A nanoparticle-based strategy for the imaging of a broad range of tumours by nonlinear amplification of microenvironment signals , 2013 .

[23]  K. Kinzler,et al.  Cancer Genome Landscapes , 2013, Science.

[24]  Hisataka Kobayashi,et al.  Targeted, activatable, in vivo fluorescence imaging of prostate-specific membrane antigen (PSMA) positive tumors using the quenched humanized J591 antibody-indocyanine green (ICG) conjugate. , 2011, Bioconjugate chemistry.

[25]  S. Paik,et al.  HER2 and choice of adjuvant chemotherapy for invasive breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-15. , 2000, Journal of the National Cancer Institute.

[26]  J. Bardeen Research Leading to Point-Contact Transistor. , 1957, Science.

[27]  Julien Verrax,et al.  Targeting lactate-fueled respiration selectively kills hypoxic tumor cells in mice. , 2008, The Journal of clinical investigation.

[28]  Pernille R. Jensen,et al.  Magnetic resonance imaging of pH in vivo using hyperpolarized 13C-labelled bicarbonate , 2008, Nature.

[29]  Allan Tucker,et al.  Local Failure and Margin Status in Early‐Stage Breast Carcinoma Treated with Conservation Surgery and Radiation Therapy , 1993, Annals of surgery.

[30]  G. Cook,et al.  Pitfalls and artifacts in 18FDG PET and PET/CT oncologic imaging. , 2004, Seminars in nuclear medicine.

[31]  Robert J Gillies,et al.  pH imaging. A review of pH measurement methods and applications in cancers. , 2004, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[32]  J. Pouysségur,et al.  Disrupting proton dynamics and energy metabolism for cancer therapy , 2013, Nature Reviews Cancer.

[33]  D. Hanahan,et al.  Hallmarks of Cancer: The Next Generation , 2011, Cell.

[34]  Matthew P. Jacobson,et al.  Dysregulated pH: a perfect storm for cancer progression , 2011, Nature Reviews Cancer.

[35]  P. Choyke,et al.  Spectral Fluorescence Molecular Imaging of Lung Metastases Targeting HER2/neu , 2007, Clinical Cancer Research.

[36]  Jinming Gao,et al.  Tunable, ultrasensitive pH-responsive nanoparticles targeting specific endocytic organelles in living cells. , 2011, Angewandte Chemie.

[37]  Chun Li,et al.  Near-infrared optical imaging of epidermal growth factor receptor in breast cancer xenografts. , 2003, Cancer research.

[38]  Krzysztof Matyjaszewski,et al.  Nanostructured functional materials prepared by atom transfer radical polymerization , 2009, Nature Chemistry.

[39]  R. Cardone,et al.  The role of disturbed pH dynamics and the Na+/H+ exchanger in metastasis , 2005, Nature Reviews Cancer.

[40]  Jinming Gao,et al.  Molecular basis of cooperativity in pH-triggered supramolecular self-assembly , 2016, Nature Communications.