Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Physical and interdisciplinary approaches of the extracellular vesicle field : new tools and techniques toward clinical translation in regenerative medicine and drug delivery

Les vésicules extracellulaires sont des nano-vésicules (100nm) comprenant les exosomes, microvesicules et corps apoptotiques, sécrétées par toutes les cellules de l’organisme. Elles ont des rôles physiologiques et physiopathologiques dans l’hémostase, l’inflammation, la transmission d’information et de molécules biologiques, les métastases, ou la régénération tissulaire. Par exemple, des vésicules issues de cellules souches mésenchymateuses ont le même effet que leur cellule mère dans la régénération du myocarde infarci, mais ont beaucoup d’avantages par rapport à ces dernières : possibilité de les conserver au congélateur, peu immunogènes, ne provoquant pas d’embolies, pas de risque de différentiation anarchique, etc. Toutefois, l’utilisation en clinique de ces vésicules reste difficile pour des raisons pratiques : très faible production par les cellules, difficulté à les caractériser, méthodes de chargement avec des agents thérapeutique peu reproductible, méthodes d’imagerie ou de d’ingénierie peu efficientes, etc. Nous avons développé des méthodes pour répondre à ces défis, croisant la biologie, la pharmacie et la physique, et avons pu découvrir que certaines de ces techniques pouvaient être utilisées dans d’autres domaines et pour d’autres indications. En pratique, pour répondre au problème de la caractérisation des vésicules, nous avons proposé une nouvelle méthode d’imagerie utilisant le microscope électronique en cellule liquide « in situ » pour observer des vésicules dans leur milieu liquide en temps réel, et peut être utilisé pour observer d’autres matériaux et phénomènes comme les liposomes ou des processus biologiques. Nous avons proposé une nouvelle méthode de chargement des vésicules avec des molécules thérapeutiques en les fusionnant avec des liposomes, permettant la délivrance d’agents de chimiothérapie plus efficacement que des liposomes. La méthode de production des vésicules à grand rendement a nécessité 3 d’itérations successives, toutes basées sur le même concept de vésiculation induite par une contrainte mécanique, et a abouti à une méthode efficace, scalable, et conformes aux standards de production pharmaceutique. La protéomique de ces vésicules montre des expressions de protéines plus proche d’un sous type de vésicule issues de la membrane plasmique appelées microvésicules. Les vésicules issues de cette méthode ont été testées in vitro avec succès, induisent un phénotype régénératif dans des modèles cicatrisation de fistule cutanéo-digestives et des modèles murins d’insuffisance cardiaque chronique. D’autres études sur les vésicules produites par cette méthode sont en cours sur la régénération osseuse, articulaire et cérébrale, ou la délivrance de médicaments et sur l’inhibition du phénomène métastatique en cancérologie. Nous commençons aujourd’hui à défricher le transfert de ces vésicules en clinique par le biais de productions en conditions pharmaceutiques dites et de la mise en place d’une start-up.Extracellular Vesicles, encompassing exosomes, microvesicles, apoptotic bodies are nanosized vesicles secreted by most cells of the organism, that demonstrated physiologic and physio-pathologic roles in various processes like hemostasis, metastasis, information transfer through biological macromolecules or more recently in inflammation resolution in regenerative medicine. Therapeutic use of these EVs, in particular as drug delivery systems or as a regeneration triggering agent is of a major interest, for example the use Mesenchymal Stem Cells derived EVs after myocardial infarction or stroke. EV recapitulate their parental cell effect and benefit from unique opportunities like off the shelf availability, low immunogenicity and no anarchic differentiation or pulmonary embolism. However, major obstacles are still to be faced in the field, like the EV drug loading, engineering, targeting, characterization, delivery method and GMP high yield production toward clinical translation. We developed new methods to respond to these needs at the crossroad of biology, physics, pharmacy and medicine, and discovered meanwhile that some of these techniques can be used in other fields and indications. As an example, a new liquid cell transmission electron microscopy labeling method was used to investigate live in situ at the nanoscale level EVs behavior, and can be used for other “soft” materials like liposomes or biology processes. The PEG induced liposome/EV fusion method was designed to produce biological/synthetic hybrids with engineered membrane properties and drug loading. A first response to the production problem was made designing a microfluidic chip allowing shear stress application to trigger EV production. The concept of shear stress triggered EV release was also used in the design of 2nd generation system for high yield, scalable and compliant with Good Manufacturing Practice, EV production method that uses a controlled shear stress to induce EV secretion. These EVs were tested in regenerative medicine models of fistula healing and chronic heart insufficiency confirming the interest of a new local delivery method using thermosensitive gels and their potency compared to parental cells. Our team is now exploring the scale-up, immunogenicity, and stability of these EVs and benchmarking their cost/efficiency in various models to pave the way toward the democratization of EV-based regenerative medicine through a company/platform creation

Methodological guide for assessing the carbon footprint of external beam radiotherapy: A single-center study with quantified mitigation strategies

Background and purposes: Data on the carbon footprint of external beam radiotherapy (EBRT) are scarce. Reliable and exhaustive data, including a detailed carbon inventory, are needed to determine effective mitigation strategies. Materials and methods: This study proposes a methodology for calculating the carbon footprint of EBRT and applies it to a single center. Mitigation strategies are derived from the carbon inventory, and their potential reductions are quantified whenever possible. Results: The average emission per treatment and fraction delivered was 489 kg CO₂eq and 27 kg CO₂eq, respectively. Patient transportation (43 %) and the construction and maintenance of linear accelerators (LINACs) and scanners (17 %) represented the most significant components. Electricity, the only energy source used, accounted for only 2 % of emissions.Derived mitigation strategies include a data deletion policy (reducing emissions in 30 years by 12.5 %), geographical appropriateness (−12.2 %), transportation mode appropriateness (−9.3 %), hypofractionation (−5.9 %), decrease in manufacturers’ carbon footprint (−5.2 %), and an increase in machine durability (−3.5 %). Conclusion: Our findings indicate that a significant reduction in the carbon footprint of a radiotherapy unit can be achieved without compromising the quality of care.This study provides a methodology and a starting point for comparison and proposes and quantifies mitigation strategies, paving the way for others to follow

Autophagy as a therapeutic target in pancreatic cancer

International audiencePancreatic ductal adenocarcinoma (PDAC) is characterised by early metastasis and resistance to anti-cancer therapy, leading to an overall poor prognosis. Despite continued research efforts, no targeted therapy has yet shown meaningful efficacy in PDAC; mutations in the oncogene KRAS and the tumour suppressor TP53, which are the most common genomic alterations in PDAC, have so far shown poor clinical actionability. Autophagy, a conserved process allowing cells to recycle altered or unused organelles and cellular components, has been shown to be upregulated in PDAC and is implicated in resistance to both cytotoxic chemotherapy and targeted therapy. Autophagy is thus regarded as a potential therapeutic target in PDAC and other cancers. Although the molecular mechanisms of autophagy activation in PDAC are only beginning to emerge, several groups have reported interesting results when combining inhibitors of the extracellular-signal-regulated kinase/mitogen-activated protein kinase pathway and inhibitors of autophagy in models of PDAC and other KRAS-driven cancers. In this article, we review the existing preclinical data regarding the role of autophagy in PDAC, as well as results of relevant clinical trials with agents that modulate autophagy in this cancer

Liposomal formulation increases local antiseptic delivery in calcium hydroxide-based root canal sealer and improves antibacterial properties against E. faecalis in an in vitro model

Aim: To evaluate the drug release capacity and the antibacterial properties of incorporating chlorhexidine digluconate (CHX) liposomal formulation in a calcium hydroxide-based root canal sealer. Methods: The sealers tested were SEALAPEX and APEXIT, containing 1 % of the different liposomal formulations. The drug release capacity was assessed by Rhodamine B detection and CHX detection by spectrophotometer, and the antibacterial properties by agar diffusion test (ADT), direct contact test (DCT), and modified direct contact test (MDCT). Results: The best release profile was found for the SEALAPEX with the liposomal formulation using the 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE)/L-α-phosphatidylcholine hydrogenated (HSPC). This liposomal formulation containing 4 % CHX improved the antibacterial properties of SEALAPEX compared to non-encapsulated CHX and control. Conclusion: The liposomal formulation increased the release of CHX, improving the antibacterial effect of the SEALAPEX, representing a promising strategy for local anti-biofilm therapy in the endodontic field

Autophagy as a therapeutic target in pancreatic cancer

AbstractPancreatic ductal adenocarcinoma (PDAC) is characterised by early metastasis and resistance to anti-cancer therapy, leading to an overall poor prognosis. Despite continued research efforts, no targeted therapy has yet shown meaningful efficacy in PDAC; mutations in the oncogene KRAS and the tumour suppressor TP53, which are the most common genomic alterations in PDAC, have so far shown poor clinical actionability. Autophagy, a conserved process allowing cells to recycle altered or unused organelles and cellular components, has been shown to be upregulated in PDAC and is implicated in resistance to both cytotoxic chemotherapy and targeted therapy. Autophagy is thus regarded as a potential therapeutic target in PDAC and other cancers. Although the molecular mechanisms of autophagy activation in PDAC are only beginning to emerge, several groups have reported interesting results when combining inhibitors of the extracellular-signal-regulated kinase/mitogen-activated protein kinase pathway and inhibitors of autophagy in models of PDAC and other KRAS-driven cancers. In this article, we review the existing preclinical data regarding the role of autophagy in PDAC, as well as results of relevant clinical trials with agents that modulate autophagy in this cancer.</jats:p

Potential of on‐chip analysis and engineering techniques for extracellular vesicle bioproduction for therapeutics

International audienceThe clinical interest around extracellular vesicles (EVs) started during the year 2000s, now leading to new clinical diagnostic and therapeutic strategies. Due to their outstanding properties as biogenic drug delivery systems and as alternatives to cell therapy, the need to produce EVs with sufficiently high yield and quality for clinical use expedited the development of analytical techniques and dedicated bioproduction methods. Though preclinical studies revealed the potential of EVs to become next generation subcellular therapies that could lead to major breakthroughs in current therapeutics possibilities, they remain complex objects on both a physicochemical and biological level. Here, we review the capacity of microfluidic technologies to match EV-based therapeutics need for clinical translation via standardized and intensified bioproduction methods. Indeed, some of the current routine tools used in bioproduction are already achieved on chips such as micromixers or particle sorting and analysis using field flow fraction or nanoparticle tracking analyzer. Also, microfluidics communities have developed a wide set of new techniques to isolate and quantify EVs, but the few that are adopted in a bioproduction workflow are well-established since the 1990s. We first review the different EV generation and loading methods embedded on chip. We focus on EVs preparation methods, from purification to in-line separative techniques. We finally describe the on-chip analytical tools to analyze physicochemistry and phenotypes of EVs

Vers une oncologie plus « verte » à l’heure du réchauffement climatique ?

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Les doubles cursus médecine-sciences en France

Les doubles cursus médecine-sciences (DC/MS) permettent l’acquisition d’une formation à la recherche et d’un doctorat de sciences au cours des études médicales. En France, avant les années 2000, la formation à la recherche était réalisée durant, voire après, le troisième cycle des études médicales (internat). Des DC/MS intégrés, dits « précoces », ont été développés depuis 2003 à l’initiative du cursus national de l’École de l’Inserm Liliane Bettencourt, suivie par la création de DC/MS par diverses universités. Quel que soit le mode de réalisation du double cursus, les étudiants engagés dans ces voies d’excellence se heurtent à des difficultés qui résultent essentiellement du manque d’articulation entre les formations médicale et scientifique. Les objectifs de ce texte sont de présenter les filières DC/MS de France, de recenser les principales difficultés rencontrées par les étudiants, ainsi que de formaliser un ensemble de propositions d’aménagements pour faciliter et consolider la formation des médecins/chercheurs