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<p>Mild hyperthermia (39°C-43°C) has numerous therapeutic benefits as an adjuvant therapy in the treatment of a variety of tumor types. Hyperthermia increases tumor blood flow and vascular permeability, promoting drug delivery and tumor oxygenation. Hyperthermia enhances the uptake and efficacy of numerous chemotherapeutic agents, including cisplatin, resulting in increased cytotoxicity. In addition to these biological responses, hyperthermia can be used as a drug-release trigger for temperature-sensitive nanoparticles, resulting in an improved and more targeted drug delivery system. Cisplatin was chosen because 1) it shows broad spectrum activity against a wide range of heatable cancers (i.e., those in sites such as the pancreas, colon and rectum, cervix and bladder, and 2) the same hyperthermic temperatures that enable temperature-sensitive lipsome-drug release also enhance cisplatin-induced cytotoxicity.</p><p>The role of hyperthermia in enhancing cisplatin delivery and cytotoxicity was investigated at both the cellular and tissue levels. While hyperthermia treatment is applicable to a variety of tumor types, the focus of this work was on bladder cancer. The synergistic effects of hyperthermia and cisplatin were investigated, along with the role of copper transport protein 1 (Ctr1) in this process. In addition, cisplatin was encapsulated within temperature-sensitive liposomes, which were used in combination with hyperthermia for targeted drug delivery. These studies demonstrated that the combination of cisplatin and hyperthermia improved drug delivery, and potentially anti-tumor efficacy, and that targeted delivery was enhanced through incorporation of temperature-sensitive liposomes. As many current methods for administering bladder hyperthermia have drawbacks, such as invasiveness and regional heating, the final aim of this study was to develop and test a less-invasive and more focused preclinical bladder heating device in a rat model. </p><p>Hyperthermia sensitizes cells to the cytotoxic effects of the commonly used chemotherapeutic agent cisplatin by increasing drug accumulation and subsequent platinum-DNA adduct formation. However, the molecular mechanisms underlying this enhancement remain unclear. Understanding the fundamental mechanisms involved in the synergistic interaction is necessary to increase the therapeutic benefits of this combination in the clinic. The synergism between the anti-cancer benefits of cisplatin and the drug delivery benefits of hyperthermia may offer a novel and more effective treatment for many cancer patients. We hypothesized that hyperthermia increases cisplatin accumulation and efficacy in part by modulating the function of Ctr1, a major regulator of cellular cisplatin uptake. To test this hypothesis, we examined the significance of Ctr1 during combined hyperthermia and cisplatin therapies and assessed the importance of cisplatin- and hyperthermia-induced Ctr1 multimerization in enhancing cisplatin cytotoxicity. We observed increased Ctr1 multimerization following hyperthermia treatment (41°C) in vitro, compared to normothermic controls (37°C), suggesting that this may be a mechanism for increased cisplatin uptake in heat-treated cells. The impact of increased Ctr1 multimerization was evaluated by measuring platinum accumulation in wild-type (WT) and Ctr1-/- cells. WT cells contained greater levels of platinum compared to Ctr1-/- cells. A further increase in platinum was observed following hyperthermia treatment, but only in the WT cells. Hyperthermia enhanced cisplatin-mediated cytotoxicity in WT cells with a dose-modifying factor (DMF) of 1.8 compared to 1.4 in Ctr1-/- cells. Our data suggest that heat increases Ctr1 activity by increasing multimerization, resulting in enhanced drug accumulation. Although we recognize that the effect of heat on cells is multi-factorial, our results support the hypothesis that Ctr1 is, in part, involved in the synergistic interaction observed with cisplatin and hyperthermia treatment. </p><p>In addition to assessing cisplatin delivery at the cellular level, we evaluated cisplatin delivery at the tissue level, using novel cisplatin-loaded temperature-sensitive liposomes. We hypothesized that delivering cisplatin encapsulated in liposomes under hyperthermic conditions would improve the pharmacokinetic profiles of cisplatin, increase drug delivery to the tumor, decrease normal tissue toxicity, and enhance the anti-tumor activity of cisplatin. We successfully prepared temperature-sensitive liposomes loaded with cisplatin and demonstrated that heat (42°C) sensitizes cisplatin-resistant cells to the cytotoxic effects of cisplatin in vitro. </p><p>Decreased toxicity was observed in animals treated with the cisplatin liposome (± heat) compared to the free drug treatments. A pharmacokinetic study of cisplatin-loaded temperature-sensitive liposomes and free drug was performed in tumor-bearing mice under normothermic and hyperthermic conditions. Cisplatin half-life in plasma was increased following liposome treatment compared to free cisplatin, and cisplatin delivery to the tumors was greatest in mice that received liposomal cisplatin under hyperthermia. These initial in vivo data demonstrate the potential effectiveness of this cisplatin-loaded liposome formulation in the treatment of certain types of cancer. To assess the anti-cancer efficacy of the liposome treatment, a tumor growth delay study was conducted and demonstrated equivalent efficacy for the cisplatin-loaded temperature-sensitive liposome compared to free drug. </p><p>In addition to the liposome work, we developed and evaluated a novel heating device for the bladder. Despite the evidence that hyperthermia is an effective adjuvant treatment strategy, current clinical heating devices are inadequate, warranting the development of a new and improved system. We induced hyperthermia using ferromagnetic nanoparticles and an alternating magnetic field device developed by Actium Biosystems. Initial preclinical studies in a rat model demonstrated preferential bladder heating. However, our preliminary studies show severe toxicity with the direct instillation of the nanoparticles in the bladder, and further studies are needed to potentially modify the nanoparticle coating, the catheterization procedure, as well as to develop a different animal model.</p> / Dissertation

Heat exposure causes several physiological and metabolic alterations. Although lipids are vital in sustaining energy production, heat-induced alterations in lipid metabolism have not been clearly established. CHAPTER 1 reviews the known metabolic alterations resulting from heat stress, with a specific focus on changes in whole-body lipid utilization and plasma lipids. CHAPTER 1also outlines the physiological changes caused by heat stress, and their role in reducing exercise performance. The study presented in CHAPTER 2 has shown that, compared to thermoneutral conditions, NEFA concentrations were 37% higher following passive heating and 34% higher following exercise in the heat, without significant changes in whole-body lipid utilization. In addition, the level of hyperthermia attained during passive pre-heating and exercise in the heat resulted in a 13% decrease in total external work and a significantly higher rate of perceived exertion. CHAPTER 3 summarizes the study results and presents the limitations and applications of the study.

The objectives of this thesis were to optimize the synthesis and surface coating of metallic and semiconductor nanoparticles, to understand how these materials interact with cells and physiological systems and to investigate how they can be used to deliver thermal therapy for medical applications. Reproducible high-yield synthesis of gold nanorods and surface coating with a variety of polymers and silica was optimized. Using gold nanorods as a model system, the relationship between particle surface chemistry, surface charge and cellular uptake was studied, as well as the toxicity of nanoparticles of different surface chemistry. Low toxicity in vitro was encouraging and was confirmed in vivo by intravenously injecting Sprague-Dawley rats with semiconductor quantum dots of various surface coatings. Low toxicity was found during biochemical, haematological and pathological assessment, and these results indicate that applications of nanoparticles should be further investigated. One such application is the use of near infrared absorbing gold nanorods in remotely activated hyperthermia. It was shown that gold nanorods act synergistically with the chemotherapeutic cisplatin to improve cytotoxicity, and reduce the required cytotoxic drug dose to 33% of the unheated amount. Due to the success of hyperthermia treatment in vitro, continuing and future work involves the use of gold nanorods ex vivo on excised human corneas in a novel application to weld corneal tissue for improved wound closure following cataract surgery.

Hyperthermia worsens outcome after ischemia. While it seems reasonable that hyperthermia would also worsen outcome after intracerebral hemorrhage (ICH), clinical studies attempting to find a causative relationship between hyperthermia and outcome have been inconclusive. We induced ICH with an injection of autologous whole blood (100 l) immediately followed by 3 hours of hyperthermia (HYPER; 39C) or normothermia (NORMO; 37C). Surprisingly, hyperthermia reduced edema at 72 hours, and improved outcome on day 3 post-ICH. There were no behavioural differences at later time points (day 11 and 32 post-ICH) and no difference in lesion volume (NORMO 14.0 mm3, HYPER: 14.5 mm3). Overall, this study does not support the hypothesis that mild, transient hyperthermia worsens outcome after ICH. Further research is needed to determine if more severe or prolonged hyperthermia worsens outcome, or if the cause of hyperthermia (e.g. infection) is important.

Both primary and secondary liver cancers are common and the majority of patients are not eligible for surgical resection or a liver transplant, which are considered the only hope of cure. Mortality rates are high and there is a need for alternative treatment options. New forms of local treatment work best on small tumours; large ones, however, remain difficult to treat. Hyperthermia involves heating tumours to 40??-44?? C. The aim is to heat the entire tumour without damaging the surrounding normal tissue. Treating deep seated tumours is technically challenging. Ferromagnetic embolisation hyperthermia (FEH) is a novel method of treating liver tumours. Magnetic microspheres are infused into the hepatic artery and lodge primarily in the tumour periphery. An applied alternating-current magnetic field causes the microspheres to heat. Animal experiments have shown that this is a promising technique. There is a need for modelling of FEH prior to commencement of clinical trials. Analytical and numerical models of tumour heating during FEH treatment are presented here. The models help predict the temperature distributions that are likely to arise during treatment and give insight into the factors affecting tumour and liver heating. The models incorporate temperature-dependent thermal properties and blood perfusion rates of the tissues and a heterogeneous clustering of microspheres in the tumour periphery. Simulations show that the poorly perfused tumours heat preferentially while the liver is effectively cooled by blood flow from the portal vein. A peripheral distribution of heat sources produces a more even temperature field throughout the tumour, compared to a heat source that is centred within the tumour core. Large tumours reach higher temperatures and have higher heating rates, supporting experimental findings. Using temperature-dependent, rather than constant, values for thermal conductivities and blood perfusion rates results in higher temperatures within the tumour. The uneven clustering of microspheres in the tumour periphery leads to a more heterogeneous temperature distribution in the core, but it has less of an effect on the wellperfused liver. The results show that FEH has the potential to effectively treat liver tumours and the technique merits further investigation.

Basic in vitro cell experiments were conducted on the P388 mouse leukaemia cell line to determine whether a supra-additive cell killing effect from combining hyperthermia with ionising radiation exists in the case of leukaemia. Methods were established to measure the cell kill, using a Coulter counter, from hyperthermia alone, radiation alone and several combined regimes. The cell kill from hyperthermia, in the range of 38-50 degrees for 30 minutes, 1 hour, 2 hours and 3 hours, and radiation, for 1, 3, 5, 9, 11 and 15 Gy was investigated. The approach used had various limitations, such as the underestimation of cell kill. Consistent trends, however, were found for the hyperthermia and radiation data, in accordance with the literature, which killed cells in a predictable manner. Subsequently, after other preliminary combined experiments were completed, the cell kill from both 5 and 11 Gy combined with hyperthermia at 43, 45 and 47 degrees for 2 hours were investigated. 5 Gy in combination with all levels of hyperthermia resulted in a direct additive cell killing effect. This, however, was not observed for 11 Gy in which a diminished effect was found. The overall level of cell kill from 5 Gy combined with hyperthermia was found to be equal, in the case of 43 degrees, or higher, as for 45 and 47 degrees, to that of those combined with 11 Gy. A supra-additive effect was not observed.

Thesis (M.S.)--University of Toledo, 2008. / "In partial fulfillment of the requirements for the degree of Master of Science in Biomedical Sciences." Title from title page of PDF document. Bibliography: p. 153-155.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1939. / Typescript. Includes abstract and vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 100-109).

Thesis--Lund Institute of Technology, 1994.