Nano‐Theranostic Modality for Visualization of the Placenta and Photo‐Hyperthermia for Potential Management of Ectopic Pregnancy

Abstract

Ectopic pregnancy (EP) is the leading cause of maternity‐related death in the first trimester of pregnancy. Approximately 98% of ectopic implantations occur in the fallopian tube, and expedient management is crucial for preventing hemorrhage and maternal death in the event of tubal rupture. Current ultrasound strategies misdiagnose EP in up to 40% of cases, and the failure rate of methotrexate treatment for confirmed EP exceeds 10%. Here the first theranostic strategy for potential management of EP is reported using a near‐infrared naphthalocyanine dye encapsulated within polymeric nanoparticles. These nanoparticles preferentially accumulate in the developing murine placenta within 24 h following systemic administration, and enable visualization of implantation sites at various gestational stages via fluorescence and photoacoustic imaging. These nanoparticles do not traverse the placental barrier to the fetus or impact fetal development. However, excitation of nanoparticles localized in specific placentas with focused NIR light generates heat (>43 °C) sufficient for disruption of placental function, resulting in the demise of targeted fetuses with no effect on adjacent fetuses. This novel approach would enable diagnostic confirmation of EP when current imaging strategies are unsuccessful, and elimination of EP could subsequently be achieved using the same nano‐agent to generate localized hyperthermia resulting in targeted placental impairment.

Abordagens Diagnósticas E Terapêuticas Na Gravidez Ectópica: Revisão Integrativa Da Literatura

“…Além dos aspectos clínicos, é essencial abordar as considerações éticas e humanísticas relacionadas ao diagnóstico e tratamento da gravidez ectópica (Mori et al, 2022). A abordagem centrada na paciente, respeitando seus valores e proporcionando um ambiente de apoio emocional, é crucial para o cuidado integral (Moses et al, 2022). A promoção da educação e conscientização sobre essa condição entre profissionais de saúde e a comunidade em geral também desempenha um papel vital na prevenção e no manejo adequado (Thomas et al, 2020).…”

Recent Advances in Nanotechnology-Based Drug Delivery Systems for the Diagnosis and Treatment of Reproductive Disorders

“…Ectopic pregnancy stands as the primary cause of death in women during the first trimester of their pregnancy. The conceptus, upon fertilization, is unable to sustain viability outside the confines of the uterine environment throughout gestation . Surgical procedures that prioritize fertility preservation pose a significant difficulty when dealing with early stage ectopic pregnancies, particularly in cases when women have anomalous placements of pregnancy outside the uterus.…”

“…The conceptus, upon fertilization, is unable to sustain viability outside the confines of the uterine environment throughout gestation. 156 Surgical procedures that prioritize fertility preservation pose a significant difficulty when dealing with early stage ectopic pregnancies, particularly in cases when women have anomalous placements of pregnancy outside the uterus. A case has been seen in which EnGeneIC delivery vehicles were used to administer doxorubicin.…”

Targeted Nanocarriers for Systemic Delivery of IRAK4 Inhibitors to Inflamed Tissues

“…[14][15][16][17] PEG-PCL nanoparticles exhibit prolonged systemic circulation and effectively deliver therapeutic and imaging agents to diseased tissues with leaky vasculature through passive targeting. [15,[17][18][19] According to previous research, angiogenesis also contributes to the development of inflammatory disorders (e.g., inflammatory bowel disease) and growth factors such as vascular endothelial growth factor cause blood vessel leakiness in inflamed tissues. [20,21] To increase the specificity and internalization efficiency of our developed nanocarriers into inflamed cells, their surface was functionalized with a peptide (VHPKQHRGGSKGC) exhibiting high binding affinity to a vascular cell adhesion molecule 1 (VCAM1).…”