Nanomedicine: Nanotechnology, Biology and Medicine
Volume 8, Issue 2 , Pages 176-184 , February 2012

Liposome-induced complement activation and related cardiopulmonary distress in pigs: factors promoting reactogenicity of Doxil and AmBisome

  • János Szebeni, MD, PhD, DSc

      Affiliations

    • Nanomedicine Research and Education Center, Bay Zoltan Foundation for Applied Research, Semmelweis University, and Department of Pathophysiology, Miskolc University, Faculty of Health, and Seroscience Ltd., Budapest, Hungary
    • Corresponding Author InformationCorresponding author: Nanomedicine Research and Education Center, Semmelweis University, Budapest, 1089 Nagyvárad tér 4, Hungary.
    • Equal contributors.
  • ,
  • Péter Bedőcs, MD

      Affiliations

    • Semmelweis University, Budapest, Hungary, and Department of Anatomy, Physiology and Cell Biology, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
    • Equal contributors.
  • ,
  • Zoltán Rozsnyay, MSc, PhD

      Affiliations

    • Seroscience Ltd., Budapest, Hungary
  • ,
  • Zsóka Weiszhár, MSc

      Affiliations

    • Seroscience Ltd., Budapest, Hungary
  • ,
  • Rudolf Urbanics, MD, PhD

      Affiliations

    • Seroscience Ltd., Budapest, Hungary
  • ,
  • László Rosivall, MD, PhD, DSc

      Affiliations

    • Department of Pathophysiology, Faculty of Medicine, Semmelweis University, Hungarian Academy of Sciences-Semmelweis University, Nephrology Research Group, Budapest, Hungary
  • ,
  • Rivka Cohen, PhD

      Affiliations

    • Laboratory of Membrane and Liposome Research, Hebrew University-Hadassah Medical School, Jerusalem, Israel
  • ,
  • Olga Garbuzenko, PhD

      Affiliations

    • Laboratory of Membrane and Liposome Research, Hebrew University-Hadassah Medical School, Jerusalem, Israel
  • ,
  • György Báthori, MD, PhD

      Affiliations

    • Nanomedicine Research and Education Center, Bay Zoltan Foundation for Applied Research, and Semmelweis University, Budapest, Hungary
  • ,
  • Miklós Tóth, MD, PhD, DSc

      Affiliations

    • Department of Health Science and Sport Medicine, Faculty of Physical Education and Sport Science, Semmelweis Medical University, Budapest, Hungary
  • ,
  • Rolf Bünger, MD, PhD

      Affiliations

    • Department of Anatomy, Physiology and Cell Biology, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
  • ,
  • Yechezkel Barenholz, PhD

      Affiliations

    • Laboratory of Membrane and Liposome Research, Hebrew University-Hadassah Medical School, Jerusalem, Israel

Received 22 September 2010 ,Accepted 4 June 2011.

References 

  1. Goyal P, Goyal K, Gurusamy S, Kumar V, Singh A, Katare Opnath Mishra DN. Liposomal drug delivery systems–clinical applications. Acta Pharm. 2005;55:1–25
  2. Immordino ML, Dosio F, Cattel L. Stealth liposomes: review of the basic science, rationale, and clinical applications, existing and potential. Int J Nanomedicine. 2006;1:297–315
  3. De Jong WH, Borm PJ. Drug delivery and nanoparticles: applications and hazards. Int J Nanomedicine. 2008;3:133–149
  4. Torchilin V. Antibody-modified liposomes for cancer chemotherapy. Expert Opin Drug Deliv. 2008;5:1003–1025
  5. Marcato PD, Durán N. New aspects of nanopharmaceutical delivery systems. J Nanosci Nanotechnol. 2008;8:2216–2229
  6. Gabizon A, Goren D, Cohen R, Barenholz Y. Development of liposomal anthracyclines: from basics to clinical applications. J Control Release. 1998;53:275–279
  7. Amselem S, Gabizon A, Barenholz Y. Optimization and upscaling of doxorubicin-containing liposomes for clinical use. J Pharm Sci. 2006;79:1045–1052
  8. Walsh TJ, Finberg RW, Arndt C, Hiemenz J, Schwartz C, Bodensteiner D, et al. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. N Engl J Med. 1999;340:764–771
  9. Wingard JR, White MH, Anaissie E, Raffalli J, Goodman J, Arietta A, et al. A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia. Clin Infect Dis. 2000;31:1155–1163
  10. Doxil. Package label. Available from: http://www.Doxil.com.
  11. Ambisome. Package label. Available from: http://www.ambisome.com.
  12. Szebeni J. The interaction of liposomes with the complement system. Crit Rev Ther Drug Carrier Syst. 1998;15:57–88
  13. Szebeni J, Baranyi B, Savay S, Bodo M, Morse DS, Basta M, et al. Liposome-induced pulmonary hypertension: properties and mechanism of a complement-mediated pseudoallergic reaction. Am J Physiol. 2000;279:H1319–H1328
  14. Szebeni J, Baranyi B, Savay S, Lutz LU, Jelezarova E, Bunger R. The role of complement activation in hypersensitivity to pegylated liposomal doxorubicin (Doxil). J Liposome Res. 2000;10:347–361
  15. Szebeni J, Fontana JL, Wassef NM, Mongan PD, Morse DS, Dobbins DE, et al. Hemodynamic changes induced by liposomes and liposome-encapsulated hemoglobin in pigs: a model for pseudo-allergic cardiopulmonary reactions to liposomes. Role of complement and inhibition by soluble CR1 and anti-C5a antibody. Circulation. 1999;99:2302–2309
  16. Szebeni J. Complement activation-related pseudoallergy: a new class of drug-induced immune toxicity. Toxicology. 2005;216:106–121
  17. Moghimi SM, Hamad I, Andresen TL, Jörgensen K, Szebeni J. Methylation of the phosphate oxygen moiety of phospholipid-methoxy(polyethylene glycol) conjugate prevents PEGylated liposome-mediated complement activation and anaphylatoxin production. FASEB J. 2006;20:2591–2593
  18. Priev A, Zalipsky S, Cohen R, Barenholz Y. Determination of critical micelle concentration of lipopolymers and other amphiphiles: comparison of sound velocity and fluorescent measurements. Langmuir. 2002;18:612–617
  19. Shmeeda H, Even Chen S, Honen R, Cohen R, Weintraub C, Barenholz Y. Enzymatic assays for quality control and pharmacokinetics of liposome formulations: comparison with nonenzymatic conventional methodologies. Methods Enzymol. 2003;367:272–292
  20. Zuidam NJ, Barenholz Y. Electrostatic parameters of cationic liposomes commonly used for gene delivery as determined by 7-heptadecyl-4-hydroxycoumarin. Biochim Biophys Acta. 1997;1329:211–222
  21. Schmidtgen M, Brandl M. Detection of lipopolysaccharides in phospholipids and liposomes using the limulus test. J Liposome Res. 1995;5:109–116
  22. Szebeni J, Muggia FM, Alving CR. Complement activation by Cremophor EL as a possible contributor to hypersensitivity to paclitaxel: an in vitro study. J Natl Cancer Inst. 1998;90:300–306
  23. Szebeni J, Baranyi L, Savay S, Milosevits J, Bodo M, Bunger R, et al. The interaction of liposomes with the complement system: in vitro and in vivo assays. Methods Enzymol. 2003;373:136–154
  24. Bellare JR, Davis HT, Scriven LE, Talmon Y. Controlled environment vitrification system: an improved sample preparation technique. J Electron Microsc Tech. 1988;10:87–111
  25. Talmon Y. Cryogenic temperature transmission electron microscopy in the study of surfactant systems. In:  Binks BP editors. Modern characterization methods of surfactant systems. New York: Marcel Dekker; 1999;p. 147–178
  26. Szebeni J, Baranyi L, Sávay S, Bodó M, Milosevits J, Alving CR, et al. Complement activation-related cardiac anaphylaxis in pigs: role of C5a anaphylatoxin and adenosine in liposome-induced abnormalities in ECG and heart function. Am J Physiol. 2006;290:H1050–H1058
  27. Peleg-Shulman T, Gibson D, Cohen R, Abra R, Barenholz Y. Characterization of sterically stabilized cisplatin liposomes by nuclear magnetic resonance. Biochim Biophys Acta. 2001;1510:278–291
  28. Dezube BJ. Safety assessment: DoxilR (doxorubicin HCl liposome injection) in refractory AIDS-related Kaposi's sarcoma. In:  Alberts DS,  Garcia DJ editor. Doxil clinical series. Vol. 1:Califon, New Jersey: Gardiner-Caldwell SynerMed; 1996;p. 1–8
  29. Gabizon A, Isacson R, Libson E, Kaufman B, Uziely B, Catane R, et al. Clinical studies of liposome-encapsulated doxorubicin. Acta Oncol. 1994;33:779–786
  30. Hubert A, Lyass O, Pode D, Gabizon A. Doxil (Caelyx): an exploratory study with pharmacokinetics in patients with hormone-refractory prostate cancer. Anticancer Drugs. 2000;11:123–127
  31. Skubitz KM, Skubitz AP. Mechanism of transient dyspnea induced by pegylated-liposomal doxorubicin (Doxil). Anticancer Drugs. 1998;9:45–50
  32. Gabizon A, Catane R, Uziely B, Kaufman B, Safra T, Cohen R, et al. Prolonged circulation time and enhanced accumulation in malignant exudates of doxorubicin encapsulated in polyethylene-glycol coated liposomes. Cancer Res. 1994;54:987–992
  33. Alberts DS, Garcia DJ. Safety aspects of pegylated liposomal doxorubicin in patients with cancer. Drugs. 1997;54(Suppl. 4):30–45
  34. Lyass O, Hubert A, Gabizon AA, Phase I. study of Doxil-cisplatin combination chemotherapy in patients with advanced malignancies. Clin Cancer Res. 2001;7:3040–3046
  35. Lenz HJ. Management and preparedness for infusion and hypersensitivity reactions. Oncologist. 2007;12:601–609
  36. Gabizon AA. Pegylated liposomal doxorubicin: metamorphosis of an old drug into a new form of chemotherapy. Cancer Invest. 2001;19:424–436
  37. Chanan-Khan A, Szebeni J, Savay S, Liebes L, Rafique NM, Alving CR, et al. Complement activation following first exposure to pegylated liposomal doxorubicin (Doxil): possible role in hypersensitivity reactions. Ann Oncol. 2003;14:1430–1437
  38. Szebeni J, Baranyi L, Savay S, Milosevits J, Bunger R, Laverman P, et al. Role of complement activation in hypersensitivity reactions to Doxil and HYNIC-PEG liposomes: experimental and clinical studies. J Liposome Res. 2002;12:165–172
  39. Utkhede DR, Tilcock CP. Studies upon the toxicity of polyethylene glycol coated lipid vesicles: acute hemodynamic effects, pyrogenicity and complement activation. J Liposome Res. 1998;8:537–550
  40. Garbuzenko O, Barenholz Y, Priev A. Effect of grafted PEG on liposome size and on compressibility and packing of lipid bilayer. Chem Phys Lipids. 2005;135:117–129
  41. Roeise O, Garred P, Mollnes TE, Aasen AO. Studies on the dose dependence of endotoxin-induced in vitro activation of the complement system. Eur Surg Res. 1989;21:34–42
  42. Szebeni J, Wassef N, Spielberg H, Rudolph AS, Alving CR. Complement activation by liposome-encapsulated hemoglobin in vitro. The role of endotoxin contamination. Artif Cells Blood Substit Immobil Biotechnol. 1995;23:355–363
  43. Inoue K, Takano H. Aggravating impact of nanoparticles on immune-mediated pulmonary inflammation. Sci World J. 2011;11:382–390
  44. Shin JA, Lee EJ, Seo SM, Kim HS, Kang JL, Park EM. Nanosized titanium dioxide enhanced inflammatory responses in the septic brain of mouse. Neuroscience. 2010;165:445–454
  45. Pedersen MB, Zhou X, Larsen EK, Sørensen US, Kjems J, Nygaard JV, et al. Curvature of synthetic and natural surfaces is an important target feature in classical pathway complement activation. J Immunol. 2010;184:1931–1945
  46. Szebeni J, Alving CR, Savay S, Barenholz Y, Priev A, Danino D, et al. Formation of complement-activating particles in aqueous solutions of Taxol: possible role in hypersensitivity reactions. Int Immunopharmacol. 2001;1:721–735

 Financial support from the following organizations is gratefully acknowledged: The Barenholz Fund; Nanomedi and Carpa777 grants from the National Office of Research and Technology of Hungary; FP7 grant “Anticarb", USUHS RO70LO; TÁMOP-4.2.1/B-09/1/KMR for Semmelweis University and TAMOP-4.2.1.B-10/2/KONV-2010-0001 for Miskolc University, with support by the European Union, co-financed by the European Social Fund.

PII: S1549-9634(11)00256-5

doi: 10.1016/j.nano.2011.06.003

Nanomedicine: Nanotechnology, Biology and Medicine
Volume 8, Issue 2 , Pages 176-184 , February 2012