Background
Intratumorally injected immune-modulating therapies have advanced to clinical trials over the last few years. Despite some reports on efficacy of different approaches, there remains a need for improved delivery strategies and non-invasive monitoring of anti-tumor effects.
Methods
This work reports a microneedle (MN) platform capable of simultaneous delivery of immune activators and collection of sample fluids to monitor therapeutic responses. While either approach has shown promise, the combination of the two into one theranostic platform has been previously untested. MNs were synthesized out of hyaluronic acid (HA) and loaded with a model immunomodulatory drug, CpG nanoparticles (TLR9 agonist), for cancer therapy. The therapeutic response was monitored by temporal analysis of entrapped immune cells in the MNs following their retrieval and digestion.
Results
Transdermal delivery of CpG-NPs induced anti-tumor immune responses in multiple syngeneic mouse cancer models. CpG-loaded MN stimulated innate immune cells and reduced tumor growth. Intravital microscopy showed spatiotemporal co-localization and sustained deposition of CpG-NPs delivered with MN in tumors. Analysis of sampled cells within the MNs revealed similar immune signature to that seen in the bulk tumor homogenate. In addition, immune surveillance using MNs showed an increase in the infiltrates of effector T cells after treatment.
Conclusions
We validated the theranostic potential of our hydrogel-based MNs in dually supporting transdermal drug delivery and temporal monitoring of tumor immune composition in a minimally invasive manner. This platform has the potential to deliver a range of combination therapies while detecting biomarkers.
Background:
Nutrition guidelines to reduce cardiovascular disease risk are well-established, and yet few patients regularly eat a healthy diet. Cardiac rehabilitation (CR) is a prime opportunity to provide education and improve nutrition. However, the most effective strategies in nutrition education are not yet established, and outcome data for various nutrition strategies is limited.
Aim:
This study aimed to evaluate self-reported nutrition metrics for individuals in CR who completed a dietician consultation compared to the usual nutrition class.
Methods:
Beginning in 2021, CR patients were offered the choice of a 1:1 dietician consultation (“consultation”) or the usual group nutrition class. This study included patients who completed intake and discharge surveys evaluating self-reported healthy food consumption [Rate Your Plate (RYP), 27-81)], confidence in preparing heart healthy meals (0-10), and percentage of heart healthy meals (0-100%). Data were evaluated based on nutrition education strategy and stratified by median baseline score.
Results:
Of the 166 participants with complete data through August 2, 2022, 87 received a consultation (mean age 65years, 63 males); and 79 chose usual care (mean 63years, 64 males).Final RYP, confidence, and percent healthy meals scores improved in both groups compared to baseline. In general, patients with a lower baseline score had a larger improvement in all nutrition metics regardless of nutrition education group (Table). The average change in RYP score was higher in the consultation arm (+11.7% (59.4 from 53.1); 95% CI [8.3%, 15.1%]), versus usual care (+4.4%, (57.3 from 54.9); 95% CI [2.2%, 6.6%]) . There was no significant difference in change in the other scores between the consultation and usual care group.
Conclusion:
Individual dietician consultation may be beneficial in providing education and improving nutrition habits for CR patients, especially for those with a low baseline level of knowledge of heart healthy nutrition.
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