Cited by 42Nanoparticle-Based Drug DeliveryAdvanced Drug Delivery SystemsProteoglycans and glycosaminoglycans research

The DOI matches its Crossref record; 139 of the 140 references it cites were found in a registry or an index; 5 of the 50 sources its claims cite were checked for support.

Hyaluronic a cid–doxorubicin nanoparticles for targeted treatment of colorectal cancer

Open access

Abstract

Colorectal cancer, common in both men and women, occurs when tumors form in the linings of the colon. Common treatments of colorectal cancer include surgery, chemotherapy, and radiation therapy; however, many colorectal cancer treatments often damage healthy tissues and cells, inducing severe side effects. Conventional chemotherapeutic agents such as doxorubicin (Dox) can be potentially used for the treatment of colorectal cancer; however, they suffer from limited targeting and lack of selectivity. Here, we report that doxorubicin complexed to hyaluronic acid (HA) (HA‐Dox) exhibits an unusual behavior of high accumulation in the intestines for at least 24 hr when injected intravenously. Intravenous administrations of HA‐Dox effectively preserved the mucosal epithelial intestinal integrity in a chemical induced colon cancer model in mice. Moreover, treatment with HA‐Dox decreased the expression of intestinal apoptotic and inflammatory markers. The results suggest that HA‐Dox could effectively inhibit the development of colorectal cancer in a safe manner, which potentially be used a promising therapeutic option.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

HA–doxorubicin (HA-Dox) nanocomplexes injected intravenously accumulate in the intestine and persist there for at least 24 hr, unlike free doxorubicin. In an AOM/DSS mouse colon cancer model, HA-Dox preserved intestinal architecture and reduced proliferation, inflammation, and apoptosis markers compared with saline.

Key findings

  • HA-Dox showed high intestinal accumulation: ~45% injected dose (ID) at 0.5 hr and remained ~45% ID at 24 hr, versus free Dox at ~30% ID and ~15% ID, respectively; intestine:blood ratio was nearly threefold higher for HA-Dox.
  • HA-Dox had longer blood circulation than free Dox: 40% ID vs 20% ID at 0.08 hr, and 3% ID vs 2% ID at 24 hr.
  • In vitro, HA-Dox released 20.6 ± 0.8 wt% Dox over 120 hr; particles had a ~50 nm core, 175 nm hydrodynamic size, and zeta potential −4.8 ± 1.06 mV.
  • In AOM/DSS mice, HA-Dox-treated intestines had villi and colon lengths comparable to healthy mice, with lower Ki67 and COX-2 expression than saline or free Dox; iNOS and Bax-2 showed no significant differences across groups, though Bax-2 was elevated in HA-Dox duodenum.

Methods

  • HA-Dox was synthesized by conjugating Dox to 50 kDa hyaluronic acid via nucleophilic acyl substitution, purified by size-exclusion chromatography/dialysis, and characterized by TEM, DLS, NanoSight, and fluorescence.
  • Healthy female Balb/c mice received IV free Dox or HA-Dox for pharmacokinetics and biodistribution; RBC binding, agglutination, and phosphatidylserine exposure were assessed by flow cytometry and imaging.
  • Colorectal cancer was induced in female Balb/c mice with AOM (20 mg/kg) followed by 2.0% DSS in drinking water; mice received IV saline, 105 μg Dox, or 105 μg HA-Dox three times, then intestines were analyzed by H&E and immunohistochemistry for Ki67, COX-2, iNOS, caspase-3, and Bax.

Limitations

  • The paper states the intestinal targeting mechanism is unclear, notes difficulty distinguishing normal epithelial turnover from cancer-related apoptosis, and calls for future detailed toxicity studies including cardiac toxicity and anti-inflammatory mechanisms.
  • Evident from the text: biodistribution and pharmacokinetic studies used small groups (n = 3), efficacy groups were n = 4 healthy and n = 6–7 treated, only female Balb/c mice were used, and efficacy was assessed by early histologic/proliferation/inflammation markers rather than tumor incidence or survival.

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Integrity signals

Registry

Crossref · 10.1002/btm2.10166

Cites

139 of 139 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

FIGURE 1 Characterization of HA‐Dox: (a) representative transmission electron microscopy images and (b) size distribution of HA‐Dox in PBS determined by NanoSight. Thick white line represents scale bar of 1 μm (a, left panel), 200 nm (a, middle panel), and 50 nm (a, right panel)
FIGURE 1 Characterization of HA‐Dox: (a) representative transmission electron microscopy images and (b) size distribution of HA‐Dox in PBS determined by NanoSight. Thick white line represents scale bar of 1 μm (a, left panel), 200 nm (a, middle panel), and 50 nm (a, right panel)CC BY · PubMed Central
FIGURE 2 Hydrolysis of HA‐Dox: in vitro release of Dox from HA‐Dox in PBS at 37°C determined as wt% of initial amount of Dox conjugated to HA. Each value represents the mean ± SD (n = 3)
FIGURE 2 Hydrolysis of HA‐Dox: in vitro release of Dox from HA‐Dox in PBS at 37°C determined as wt% of initial amount of Dox conjugated to HA. Each value represents the mean ± SD (n = 3)CC BY · PubMed Central
FIGURE 3 Pharmacokinetics of HA‐Dox: Pharmacokinetics both free Dox and HA‐Dox represented as %ID in blood at 0.08 hr, 0.5 hr, 6 hr, and 24 hr. Each data point represent means ± SEM (n = 3).* p < .05; non paired two‐tailed t‐test
FIGURE 3 Pharmacokinetics of HA‐Dox: Pharmacokinetics both free Dox and HA‐Dox represented as %ID in blood at 0.08 hr, 0.5 hr, 6 hr, and 24 hr. Each data point represent means ± SEM (n = 3).* p < .05; non paired two‐tailed t‐testCC BY · PubMed Central
FIGURE 4 Binding and Biocompatibility of HA‐Dox on RBC: (a) representative confocal image, scale bar = 5 μm, and (b) flow cytometry histogram displaying percentage of RBC with HA‐Dox bound to their surface in the presence of 55% serum. (c) Representative plot displaying percentages of phosphatidylserine exposing RBC of HA‐Dox attached onto RBC. Polystyrene beads were used as a positive control. Values are means (n ≥ 10) ± SEM, Inset Representative agglutination image, visualized using a U‐shaped bottom plate. (1) Naïve RBC; (2) RBC:HA‐Dox; (3) RBC:Polystyrene beads
FIGURE 4 Binding and Biocompatibility of HA‐Dox on RBC: (a) representative confocal image, scale bar = 5 μm, and (b) flow cytometry histogram displaying percentage of RBC with HA‐Dox bound to their surface in the presence of 55% serum. (c) Representative plot displaying percentages of phosphatidylserine exposing RBC of HA‐Dox attached onto RBC. Polystyrene beads were used as a positive control. Values are means (n ≥ 10) ± SEM, Inset Representative agglutination image, visualized using a U‐shaped bottom plate. (1) Naïve RBC; (2) RBC:HA‐Dox; (3) RBC:Polystyrene beadsCC BY · PubMed Central
FIGURE 5 Biodistribution of HA‐Dox: Biodistribution of Dox and HA‐Dox. Bar graph represents percentages of injected dose (%ID) for free Dox and HA‐Dox following IV injection in mice at (a) 0.5 hr and (b) 24 hr. Each data point represent means ± SEM (n = 3).*, p < .05; non paired, two‐tailed t‐test
FIGURE 5 Biodistribution of HA‐Dox: Biodistribution of Dox and HA‐Dox. Bar graph represents percentages of injected dose (%ID) for free Dox and HA‐Dox following IV injection in mice at (a) 0.5 hr and (b) 24 hr. Each data point represent means ± SEM (n = 3).*, p < .05; non paired, two‐tailed t‐testCC BY · PubMed Central
FIGURE 6 Accumulation of HA‐Dox in Intestines: Kinetics of HA‐Dox represented as percentages of injected dose (% ID) for free Dox and HA‐Dox following I.V. injection in mice at (a) 0.083 hr (b) 0.5 hr (c) 6 hr and (d) 24 hr in different part of murine intestines. The amount of HA‐Dox at 24 hr Each data point represent means ± SEM (n = 3). * p < .05; non paired, two‐tailed t‐test
FIGURE 6 Accumulation of HA‐Dox in Intestines: Kinetics of HA‐Dox represented as percentages of injected dose (% ID) for free Dox and HA‐Dox following I.V. injection in mice at (a) 0.083 hr (b) 0.5 hr (c) 6 hr and (d) 24 hr in different part of murine intestines. The amount of HA‐Dox at 24 hr Each data point represent means ± SEM (n = 3). * p < .05; non paired, two‐tailed t‐testCC BY · PubMed Central
FIGURE 7 Preventive effect of HA‐Dox on inflammation‐linked carcinogenesis in AOM/DSS mouse models: (a) representative intestines and (b) stomachs are shown. Healthy mice were not injected with AOM and received distilled water only. Healthy; n = 4 mice; saline, Dox, and HA‐Dox, n = 6–7 mice; Error bars, SEM. ###, p < .001 versus healthy; ***p < .001 versus saline. Each data point represent means ± SEM (n = 3).*, p < .05; non paired, two‐tailed t‐test
FIGURE 7 Preventive effect of HA‐Dox on inflammation‐linked carcinogenesis in AOM/DSS mouse models: (a) representative intestines and (b) stomachs are shown. Healthy mice were not injected with AOM and received distilled water only. Healthy; n = 4 mice; saline, Dox, and HA‐Dox, n = 6–7 mice; Error bars, SEM. ###, p < .001 versus healthy; ***p < .001 versus saline. Each data point represent means ± SEM (n = 3).*, p < .05; non paired, two‐tailed t‐testCC BY · PubMed Central
FIGURE 8 Histological analysis of murine intestinal tissues induced with chemical induced colon cancer: Histology of intestinal tissues (a) duodenum, (b) jejunum; (c) ileum, and (d) colon treated with azoxymethane and dextran sulfate treated with saline, Free Dox, and HA‐Dox, determined by H and E staining; Representative images were taken at ×100 (top) and ×400 (bottom)
FIGURE 8 Histological analysis of murine intestinal tissues induced with chemical induced colon cancer: Histology of intestinal tissues (a) duodenum, (b) jejunum; (c) ileum, and (d) colon treated with azoxymethane and dextran sulfate treated with saline, Free Dox, and HA‐Dox, determined by H and E staining; Representative images were taken at ×100 (top) and ×400 (bottom)CC BY · PubMed Central
FIGURE 9 Cell proliferation analysis of murine intestinal tissues induced with chemical induced colon cancer: Immunohistochemistry of intestinal tissues treated with azoxymethane and dextran sulfate treated with saline, Free Dox, and HA‐Dox, determined by Ki67. Representative images were taken at ×400. Red scale bar: 50 um
FIGURE 9 Cell proliferation analysis of murine intestinal tissues induced with chemical induced colon cancer: Immunohistochemistry of intestinal tissues treated with azoxymethane and dextran sulfate treated with saline, Free Dox, and HA‐Dox, determined by Ki67. Representative images were taken at ×400. Red scale bar: 50 umCC BY · PubMed Central

Verification

Claims the paper makes

72 Own result · 25 Own interpretation · 17 Not checked yet · 14 No basis given · 7 Sources not found · 1 Supported so far · 1 Partly supported · 1 Not supported · 1 Own method · accuracy not yet measured

Verify all 28 references — free account

Show all 83 claims

  • It may state two separate claims as one. 32
  • Probably not a substantial claim. 27
56 of 56
  • The paper relies on this without support.

    There have been no reports of free Dox injected intravenously treating colorectal cancers.

    “To our knowledge, there have been no reports of free Dox, injected intravenously, treating colorectal cancers.”
  • The paper relies on this without support.

    Hyaluronic acid by itself has a blood half-life of 3–5 min in the blood.

    “Hyaluronic acid by itself has a blood half‐life of 3–5 min in the blood.”
  • The paper relies on this without support.

    There have been no reports of free Dox or any Dox complexes accumulating in the intestines via intravenous injection.

    “To our knowledge, there have been no reports of free Dox or any Dox complexes accumulating in the intestines via intravenous injection.”
  • The paper relies on this without support.

    There are no reports of the use of doxorubicin to intestinal and colon cancers.

    “However, there are no reports of the use of doxorubicin to intestinal and colon cancers.”
  • The paper relies on this without support.

    Doxorubicin undergoes acid hydrolysis in the stomach and any remaining doxorubicin reaching the intestine is discharged by P-glycoprotein, found in the epithelial cells lining the small intestine and colon.

    “Doxorubicin undergoes acid hydrolysis in the stomach and any remaining doxorubicin reaching the intestine is discharged by P‐glycoprotein, found in the epithelial cells lining the small intestine and colon.”
  • The paper relies on this without support.

    The AOM/DSS mouse model is predictive of human IBD-associated colorectal cancer for evaluating HA-Dox efficacy.

    “In conclusion, our study revealed that HA‐Dox may be an effective therapeutic agent to prevent or reduce the risk of colorectal cancer development, particularly for people who already suffer from IBD.”
  • The paper relies on this without support.

    Lowering inflammation levels in the intestine stops the further development of colorectal cancer.

    “Our findings suggest HA‐Dox lowers inflammation levels in all parts of the intestine, stopping the further development of CRC.”
  • The paper relies on this without support.

    The accumulation and therapeutic effects of HA-Dox in intestinal tissues are enhanced by increased blood flow and vascular permeability in inflammatory bowel disease.

    “The accumulation and therapeutic effects of HA‐Dox in the intestinal tissues are probably enhanced by both an increase in blood flow and in vascular permeability; both being well documented in inflammatory bowel disease (IBD).”
  • The paper relies on this without support.

    Doxorubicin slows or stops cancer growth by blocking topoisomerase 2.

    “Dox slows or stops the growth of cancer by blocking topoisomerase 2.”
9 of 9

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Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

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Metadata

Authors
Pan, D. C., Krishnan, V., Salinas, A. K., Kim, J., Sun, T., Ravid, S., Peng, K., Wu, D., Nurunnabi, M., Nelson, J. A., Niziolek, Z., Guo, J., & Mitragotri, S.
Affiliations
Harvard University (US)
Corresponding author
Mitragotri, Samir
Venue
Bioengineering & Translational Medicine
Publisher
Wiley
Published
2020-05-28
Volume
6
Issue
1
Pages
e10166-e10166
ISSN
2380-6761 (ISSN-L)
OpenAlex
W3024165904
Cited by
42
References
140
Citations by year
2026: 10 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 1 · 2020: 1
FWCI
0.97
Type
journal article
Language
en
Open access
Locations
  • Bioengineering & Translational Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • scholarworks - UTEP (The University of Texas at El Paso) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Harvard School of Engineering and Applied Sciences
  • The National Cancer Institute (#2CA174650)
  • Harvard University
Topics
  • Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Proteoglycans and glycosaminoglycans research
Keywords
hyaluronic acid, doxorubicin, nanoparticles, targeted drug delivery, colorectal cancer, intravenous injection, intestinal mucosal integrity, apoptosis, inflammation, chemotherapy side effects

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