Integrative multi-omics analysis identifies a prognostic miRNA signature and a targetable miR-21-3p/TSC2/mTOR axis in metastatic pheochromocytoma/paraganglioma
Authors: Bruna Calsina, Luis Jaime Castro-Vega, Rafael Torres-Pérez, Lucía Inglada-Pérez, Maria Currás-Freixes, Juan María Roldán-Romero, Veronika Mancikova, Rocío Letón, Laura Remacha, María Santos, Nelly Burnichon, Charlotte Lussey-Lepoutre, Elena Rapizzi, Osvaldo Graña, Cristina Álvarez-Escolá, Aguirre A de Cubas, Javier Lanillos, Alfonso Cordero-Barreal, Ángel M Martínez-Montes, Alexandre Bellucci, Laurence Amar, Fabio Luiz Fernandes-Rosa, María Calatayud, Javier Aller, Cristina Lamas, Júlia Sastre-Marcos, Letizia Canu, Esther Korpershoek, Henri J Timmers, Jacques WM Lenders, Felix Beuschlein, Martin Fassnacht-Capeller, Graeme Eisenhofer, Massimo Mannelli, Fátima Al-Shahrour, Judith Favier, Cristina Rodríguez-Antona, Alberto Cascón, Cristina Montero-Conde, Anne-Paule Gimenez-Roqueplo, Mercedes Robledo
Journal: Theranostics (2019)

Rationale: Microvascular obstruction (MVO) following percutaneous coronary intervention (PCI) is a common problem associated with adverse clinical outcomes.We are developing a novel treatment, termed sonoreperfusion (SRP), to restore microvascular patency.This entails using ultrasound-targeted microbubble cavitation (UTMC) of intravenously administered gas-filled lipid microbubbles (MBs) to dissolve obstructive microthrombi in the microvasculature.In our prior work, we used standard-sized lipid MBs.In the present study, to improve upon the efficiency and efficacy of SRP, we sought to determine the therapeutic efficacy of fibrin-targeted phase shift microbubbles (FTPSMBs) in achieving successful reperfusion of MVO.We hypothesized that owing to their much smaller size and affinity for thrombus, FTPSMBs would provide more effective dissolution of microthrombi when compared to that of the corresponding standard-sized lipid MBs.Methods: MVO in the rat hindlimb was created by direct injection of microthrombi into the left femoral artery.Definity MBs (Lantheus Medical Imaging) were infused through the jugular vein for contrast-enhanced ultrasound imaging (CEUS).A transducer was positioned vertically above the hindlimb for therapeutic US delivery during the concomitant administration of various therapeutic formulations, including (1) un-targeted MBs; (2) un-targeted phase shift microbubbles (PSMBs); (3) fibrin-targeted MB (FTMBs); and (4) fibrin-targeted PSMBs (FTPSMBs).CEUS cine loops with burst replenishment were obtained at baseline (BL), 10 min post-MVO, and after each of two successive 10-minute SRP treatment sessions (TX1, TX2) and analyzed (MATLAB).Results: In-vitro binding affinity assay showed increased fibrin binding peptide (FBP) affinity for the fibrin clots compared with the untargeted peptide (DK12).Similarly, in our in-vitro model of MVO, we observed a higher binding affinity of fluorescently labeled FTPSMBs with the porcine microthrombi compared to FTMBs, PSMBs, and MBs.Finally, in our hindlimb model, we found that UTMC with FTPSMBs yielded the greatest recovery of blood volume (dB) and flow rate (dB/sec) following MVO, compared to all other treatment groups.Conclusions: SRP with FTPSMBs achieves more rapid and complete reperfusion of MVO compared to FTMBs, PSMBs, and MBs.Studies to explore the underlying physical and molecular mechanisms are underway.